Getting rapid diagnostic test data into the appropriate hands by leveraging pharmacy staff and a clinical surveillance platform: a case study from a US community hospital.

Objectives: To outline the procedural implementation and optimization of rapid diagnostic test (RDT) results for bloodstream infections (BSIs) and to evaluate the combination of RDTs with real-time antimicrobial stewardship team (AST) support plus clinical surveillance platform (CSP) software on time to appropriate therapy in BSIs at a single health system.

Methods: Blood culture reporting and communication were reported for four time periods: (i) a pre-BCID [BioFire® FilmArray® Blood Culture Identification (BCID) Panel] implementation period that consisted of literature review and blood culture notification procedure revision; (ii) a BCID implementation period that consisted of BCID implementation, real-time results notification via CSP, and creation of a treatment algorithm; (iii) a post-BCID implementation period; and (iv) a BCID2 implementation period. Time to appropriate therapy metrics was reported for the BCID2 time period.

Integrated epigenomic exposure signature discovery.

The epigenome influences gene regulation and phenotypes in response to exposures. Epigenome assessment can determine exposure history aiding in diagnosis. Here we developed and implemented a machine learning algorithm, the exposure signature discovery algorithm (ESDA), to identify the most important features present in multiple epigenomic and transcriptomic datasets to produce an integrated exposure signature (ES).

An Algorithmic Approach to Understanding Osteoarthritic Knee Pain.

Background: Osteoarthritic knee pain is a complex phenomenon, and multiple factors, both within the knee and external to it, can contribute to how the patient perceives pain. We sought to determine how well a deep neural network could predict osteoarthritic knee pain and other symptoms solely from a single radiograph view.

Methods: We used data from the Osteoarthritis Initiative, a 10-year observational study of patients with knee osteoarthritis.

Functional analysis of Rickettsia monacensis strain humboldt folA dihydrofolate reductase gene via complementation assay.

Nutritive symbiosis between bacteria and ticks is observed across a range of ecological contexts; however, little characterization on the molecular components responsible for this symbiosis has been done. Previous studies in our lab demonstrated that Rickettsia monacensis str. Humboldt (strain Humboldt) can synthesize folate de novo via the folate biosynthesis pathway involving folA, folC, folE, folKP, and ptpS genes.

Do Patient-Reported Outcomes Reflect Objective Measures of Function? Implications for Total Knee Arthroplasty.

Background: Patient-reported outcomes (PROs) are used in research, clinical practice, and by federal reimbursement models to assess outcomes for patients who have knee osteoarthritis (OA) and total knee arthroplasty (TKA). We examined a large cohort of patients to determine if commonly used PROs reflect observed evaluation as measured by standardized functional tests (SFTs).

Methods: We used data from the Osteoarthritis Initiative, a 10-year observational study of knee osteoarthritis patients.

Transgender gender-affirming surgery consultation among patients seeking care in the Midwestern United States.

Gender-affirming surgery (GAS) is among the most rapidly growing and expanding subfields in plastic surgery due to increased awareness, decreased stigma, rising demand, and improved access for transgender and gender non-conforming individuals (TGNC). In order to address potential barriers and facilitators in GAS education and training, there is a need to explore the experiences of TGNC individuals. The purpose of this study was to qualitatively explore the factors that influence TGNC patient experiences in surgical consultation for GAS.

An mHealth Intervention to Improve Pre-Exposure Prophylaxis Knowledge Among Young Black Women in Family Planning Clinics: Development and Usability Study.

Background: Young Black women between the ages of 18 and 24 years are disproportionately impacted by HIV, yet they have a low self-perception of HIV risk and limited exposure to prevention strategies. Pre-exposure prophylaxis (PrEP) is a safe and effective biomedical HIV prevention strategy for those at risk for HIV infection, but uptake has been slow among cisgender women. Family planning clinics are a primary source of health care access for young women, providing an ideal opportunity to integrate PrEP information and care into existing clinic practices.

Deep Learning and Imaging for the Orthopaedic Surgeon: How Machines "Read" Radiographs.

➤: In the not-so-distant future, orthopaedic surgeons will be exposed to machines that begin to automatically "read" medical imaging studies using a technology called deep learning.

➤: Deep learning has demonstrated remarkable progress in the analysis of medical imaging across a range of modalities that are commonly used in orthopaedics, including radiographs, computed tomographic scans, and magnetic resonance imaging scans.

➤: There is a growing body of evidence showing clinical utility for deep learning in musculoskeletal radiography, as evidenced by studies that use deep learning to achieve an expert or near-expert level of performance for the identification and localization of fractures on radiographs.

Transgender Care and the COVID-19 Pandemic: Exploring the Initiation and Continuation of Transgender Care In-Person and Through Telehealth.

Gender-affirming care is essential to the health and wellbeing of transgender and nonbinary people. The COVID-19 pandemic has the potential to disrupt transgender care. This study explores transgender care before and during the onset of the pandemic using patient data from 10 family planning clinics in Arkansas, Kansas, Missouri, and Oklahoma.

Employment as HIV Prevention: An Employment Support Intervention for Adolescent Men Who Have Sex With Men and Adolescent Transgender Women of Color.

Background: The purpose of this study was to adapt and pilot-test an employment support, primary HIV intervention tailored to the needs of adolescent men who have sex with men and adolescent transgender women of color.

Setting: The intervention was implemented in 2 settings: controlled environment (Phase 1) and real-world community-based (Phase 2) setting in Chicago, IL.

Methods: Eighty-seven adolescent men who have sex with men and adolescent transgender women of color ages 16-24 participated in Work2Prevent , a 4-session employment and HIV prevention intervention, designed to increase job-readiness and reduce HIV risk.

Evaluation of Treatment Practices for Urinalyses and Urine Cultures at an Outpatient Multiple Sclerosis Clinic.

Background: Patients with multiple sclerosis (MS) experience disease flares that can be precipitated by the presence of infection. Discerning asymptomatic bacteriuria from urinary tract infection (UTI) in patients with MS is complicated by lower urinary tract dysfunction, leading to potentially inappropriate antimicrobial use. In this study the antimicrobial treatment practices for positive urine cultures in patients with MS were evaluated.

Chlamydial Infection Among Adolescents and Young Adults Receiving Sexual and Reproductive Health Care During the COVID-19 Pandemic.

The impact of the COVID-19 pandemic on adolescent and young adult chlamydial infection is unknown. Patient testing data were extracted from the electronic health records of 10 family planning clinics. Prepandemic and pandemic comparisons revealed an increase in observed chlamydial infection, with greater positivity among Black/African American female adolescent patients.

Coronavirus Disease 2019 (COVID-19) and Access to Abortion: Assessing Patient Sociodemographic and Travel Characteristics.

Sociodemographics and travel among patients receiving abortion care differed during the pandemic, suggesting coronavirus disease 2019 (COVID-19)–related restrictions may have negatively affected abortion access, particularly for patients of color.

Racial and ethnic differences in family planning telehealth use during the onset of the COVID-19 response in Arkansas, Kansas, Missouri, and Oklahoma.

Objectives: To explore racial/ethnic disparities in family planning telehealth use.

Study Design: We analyzed telehealth and in-clinic visits (n = 3142) from ten family planning clinics (April 1-July 31, 2020) by race/ethnicity and month.

Results: Telehealth comprised 1257/3142 (40.

Police Enforcement of Sex Work Criminalization Laws in an "End Demand" City: The Persistence of Quality-of-Life Policing and Seller Arrests.

The purported goals of commercial sex work criminalization policies in the United States have shifted over the past two decades as local jurisdictions have adopted End Demand reforms. These reforms aim to refocus arrest from individuals who sell sexual services to buyers and facilitators, representing a departure from the quality-of-life, nuisance-focused approach of the late twentieth century. This article presents a case study examining enforcement of commercial sex laws in Chicago, a city that has been heralded as a leader in End Demand reforms.

COVID-19 Pandemic, Pre-exposure Prophylaxis (PrEP) Care, and HIV/STI Testing Among Patients Receiving Care in Three HIV Epidemic Priority States.

The COVID-19 pandemic has the potential to disrupt HIV prevention services. We conducted an electronic health record analysis of PrEP, HIV, and STI visits at eight sexual health clinics in Arkansas, Missouri, and Oklahoma during the onset of the pandemic (March 1, 2020 to June 30, 2020) and compared the data with pre-pandemic (March 1, 2019 to June 30, 2019) volumes. Our data revealed a significant increase in the proportion of male PrEP visits during the pandemic compared to the pre-pandemic period, with the majority provided via telehealth/telePrEP.

Implementation of a Rapid Phenotypic Susceptibility Platform for Gram-Negative Bloodstream Infections With Paired Antimicrobial Stewardship Intervention: Is the Juice Worth the Squeeze?

Background: Implementation of the Accelerate PhenoTM Gram-negative platform (RDT) paired with antimicrobial stewardship program (ASP) intervention projects to improve time to institutional-preferred antimicrobial therapy (IPT) for Gram-negative bacilli (GNB) bloodstream infections (BSIs). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing.

Methods: A single-center, pre-/post-intervention study of consecutive, nonduplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention was performed.

A Pragmatic Randomized Controlled Trial to Increase PrEP Uptake for HIV Prevention: 55-Week Results From PrEPChicago.

Objectives: We tested preliminary efficacy of a peer change agent type I network intervention to increase pre-exposure prophylaxis (PrEP) linkage to care among network members connected to young Black men who have sex with men.

Design: Parent study is a pragmatic randomized controlled trial with 110 weeks of total follow-up. Interim midpoint analyses are performed here using participant data before crossover assignment at 55 weeks.

Psychosocial Support, Sexual Health, and HIV Risk among Older Men Who Have Sex with Younger Men.

This study examines the extent to which older males are willing to offer psychosocial and sexual health promoting support to their younger male partners, as well as the individual and relationship-level factors associated with this willingness to provide support. In total, 324 men over the age of 45, who currently or previously had younger male sexual partners, completed an anonymous online survey. Results show that participants were most willing to provide emotional support to their younger male partners, followed by health-related encouragement, HIV/STI testing support, and financial support.

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 1): Protocol for Determining Essential Intervention Components Using Qualitative Interviews and Focus Groups.

Background: HIV continues to have a disparate impact on young cisgender men who have sex with men (YMSM), young trans women (YTW), and gender-nonconforming (GNC) youth who are assigned male at birth. Outcomes are generally worse among youth of color. Experiences of discrimination and marginalization often limit educational attainment and may even more directly limit access to gainful employment.

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 2): Protocol for a Single-Arm Mixed Methods Pilot Test to Assess Feasibility and Acceptability.

Background: Young cisgender men who have sex with men (YMSM), young transgender women (YTW), and gender nonconforming (GNC) youth of color face substantial economic and health disparities. In particular, HIV risk and infection among these groups remains a significant public health issue. In 2017, 17% of all new HIV diagnoses were attributed to male-to-male sexual contact among adolescents and young adults aged 13 to 24 years.

Parenting and child-caretaking among black men who have sex with men and associated sexual and reproductive health factors: A brief report.

The purpose of this exploratory study was to examine the prevalence of parenting and child-caretaking among a sample of black men who have sex with men (MSM), as well as associations between parenting roles and sexual and reproductive health (SRH) factors. Parenting and SRH data were derived from a survey of 199 black MSM. Nearly half of the sample reported being a father or father-figure (44.

A Baker's Dozen of Top Antimicrobial Stewardship Intervention Publications in 2018.

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2018. The top 13 publications were selected using a modified Delphi technique.