bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Limits of Expectations and the Minimization of Collateral Consequences: The Experience of Electronic Home Monitoring
Authors: Kirk Gabriela 
Published: April 2020

AbstractElectronic home monitoring (EHM), also known as house arrest, is often described by policy makers as a less punitive, more humane alternative to incarceration. However, studies on its use have found it is often not used as an alternative, but rather as an increase in the level of supervision for individuals in the criminal justice system. This fact calls into question whether the language of alternatives and direct comparisons to incarceration obscures our understanding of both the sanction and how individuals experience it. Although previous studies of the experience of EHM have concluded that individuals do not find the sanction overly burdensome, this article articulates the importance of considering 1) how respondents frame their experience on EHM in comparison to incarceration and 2) how they draw on expectations surrounding their legal alternatives. Using 30 interviews with individuals who have been on EHM in Chicago, Illinois, I argue that the pervasiveness of the prison distorts expectations of the legal process and causes respondents to minimize the hardships they detail. Both the existing framing of studies on EHM and the ways in which individuals experience it demonstrate the hegemony of carceral logics in an era of mass incarceration.
When Mothers Can’t “Pay the Cost to Be the Boss”: Roles and Identity within Doubled-Up Households
Authors: Harvey Hope 
Published: April 2020

AbstractAlthough the independent nuclear family remains the ideal family form in most Americans’ minds, rising housing costs have made residential independence increasingly difficult. Sharing a home provdes a common safety net for lower-income mothers, yet we know little about how mothers experience and interpret this household form. Drawing on data from in-depth interviews with 52 mothers, I find that doubling up as a guest in someone else’s home – though not hosting someone else in their home – threatens mothers’ identities as adults and good parents. Mothers describe doubling up in someone else’s home as incompatible with their ideals of adulthood and family life, which are organized around the independent nuclear family. While mothers expect to control their daily lives and childrearing, householders retain authority over the home and its inhabitants, and there is no taken-for-granted way of reconciling household members’ conflicting expectations. In response to the stress on their identities, mothers who live doubled-up in someone else’s home often seek to establish themselves as head of their nuclear family, even when they are not the household head, by engaging in identity work: defining physical space as their own, emphasizing their contributions to the household, and asserting their status as parents.
Demobilizing or Activating? The Effect of Anti-Muslim Discrimination on Muslims’ Counter-Extremism Engagement
Authors: Shanaah Sadi 
Published: April 2020

Abstract
Scholars have reported mixed findings on the effect of discrimination on political and social behavior. In some cases, experiences of discrimination reduce mainstream political and social engagement; in other cases, the opposite seems to be true. The indeterminate outcome of discrimination has important bearing on counter-extremism policies in the West. These policies aim at galvanizing Muslim communities’ engagement in countering extremism, but they do so in the context of heightened levels of anti-Muslim discrimination. This article investigates the effect of anti-Muslim discrimination on the willingness of Muslims to take action against Islamist extremism. I analyze data from unique large-N nationally representative surveys of British Muslims, using both cross-sectional and experimental designs. Neither analysis found support for the hypothesis that anti-Muslim discrimination reduces the willingness of Muslims to engage in counter-extremism. Furthermore, the investigated relationship appears to be curvilinear, where few experiences with anti-Muslim discrimination increase the likelihood of Muslims’ engagement in counter-extremism in comparison to those who did not have such experiences and those who encountered discrimination more frequently. If confirmed by further research, this finding can potentially help to reconcile the mixed results in the literature.
Anaemia among Kenyan children: a call for improved monitoring and intervention in school-aged children
Authors: Okiro Emelda A , Joseph Noel K , Gitonga Caroline W , Snow Robert W 
Published: April 2020

AbstractBackgroundAnaemia has long been recognised as a major public health problem among young children in lower- and middle-income countries and is an indicator of both poor nutrition and health status. There has been little progress towards improvement of anaemia in part due to its complex aetiology. An added impediment to the progress is that the monitoring of anaemia does not routinely target the whole population, with school-aged children (SAC) largely overlooked.MethodsWe re-examined data on the prevalence of anaemia among children aged &lt;15 y sampled from 2008–2015 in Kenya.ResultsApproximately one in four Kenyan children aged &lt;15 y were described as anaemic, including 12% with WHO-defined moderate anaemia and 1% who were severely anaemic. Average haemoglobin concentrations increased with age and the risk of having anaemia decreased with age. However, one in five SAC in Kenya were suffering from anaemia; most were either mild (11.4%) or moderately (10.9%) anaemic.ConclusionsThe monitoring of anaemia in SAC continues to be a neglected area limiting a careful articulation of the need to target interventions in this age group.
Menstrual Cup Use and Intrauterine Device Expulsion in a Copper Intrauterine Device Contraceptive Efficacy Trial [OP01-1B]
Authors: Long Jill , Schreiber Courtney , Creinin Mitchell D. , Kaneshiro Bliss , Nanda Kavita , Blithe Diana 
Published: April 2020

INTRODUCTION:
Menstrual cup use for menstrual hygiene is increasingly popular. We evaluated relationship of menstrual cup use and intrauterine device (IUD) expulsion in a prospective trial of two copper IUDs.

METHODS:
An ongoing 3-year contraceptive efficacy trial randomized women to one of two copper IUDs, with successful placement in 1,092 women. Institutional Review Board approval was obtained, and all subjects provided informed consent. Follow-up visits in the first year occurred at 6 weeks, and then 3, 6, and 12 months after insertion. At nine months after initiating enrollment, we modified the protocol to advise subjects against concurrent menstrual cup use with the IUD. We evaluated the association of menstrual cup use and expulsion risk over the first 24 months of study conduct.

RESULTS:
Overall, 266 (24.4%) women reported menstrual cup use. At 24 months after initiating enrollment, 46 (17.3%) cup users and 43 (5.2%) non-users experienced expulsion (odds ratio 3.81 [95% CI 2.45-5.92]). Fourteen (30.4%) menstrual cup users with expulsion reported the event occurred during menstrual cup removal. At Year 1 of the study, expulsion rates among menstrual cup users and non-users were 14.3% and 4.7%, respectively (P<.001). By the end of Year 2, these rates were 23.2% and 6.5% (P<.001).

CONCLUSION:
We found higher than expected IUD expulsion rates in menstrual cup users amongst participants in a prospective trial of two copper IUDs. Copper IUD users should be cautioned that concurrent menstrual cup use increases the risk of IUD expulsion and expulsion risk continues with ongoing menstrual cup use.
Use of Multi-modal Analgesia in Enhanced Recovery After Surgery (ERAS) for Cesarean Sections to Reduce the Use of Opioids [OP02-1B]
Authors: Gwacham Nnamdi I. , Goral Jan , Miller Richard , Pitera Richard , Cinicolo Luciana 
Published: April 2020

INTRODUCTION:
Enhanced recovery after surgery (ERAS) protocols are mechanisms for obtaining value-based improvements in surgery and they have become embedded within multiple surgical disciplines including colorectal, urological, gynecological, and hepatobiliary surgery. ERAS has been shown to result in both clinical and health system benefits1. The objective of this study is to evaluate the effect of such a program on opioid use in cesarean sections (CS) at a community teaching hospital.

METHODS:
The ERAS pathway was applied to all patients undergoing CS since its implementation. 98% of patients received transversus abdominis plane (TAP) blocks in the immediate postoperative period. All patients were started on scheduled multimodal analgesia with a combination of ibuprofen, acetaminophen, and dextromethorphan until discharge. Patients whose pain was not well controlled with the above regimen were given opioids for pain control. A retrospective review of patients undergoing CS after the implementation of the ERAS pathway (January 2019-current) was performed. The number of opioid units utilized, as well as mean morphine equivalents were compared to a historical patient cohort (January 2018 – June 2018).

RESULTS:
An historical cohort of patients (n = 2109) was compared to patients in the ERAS pathway (n = 1463). Patients that were admitted to the hospital > 3 days prior to cesarean section were excluded in an effort to remove antepartum cases (n = 110). Planned CS were designated as those that were scheduled prior to patient check-in to hospital. There was no difference in age, race or body mass index (BMI). There was a significant difference in average length of stay in days between the two cohorts (3.19 vs 2.63, p<0.001). There was also a significant difference in average direct cost in dollars (4290 vs 3957, p < 0.001). The number of patients requiring opioids was also significantly reduced (1766 vs 341, p<0.001). There were 8082 opioid units utilized prior to the implementation of the ERAS pathway whereas 803 opioid units have been utilized since the advent of ERAS for CS.

CONCLUSIONS:
Post-operative pain control can be achieved in a majority of patients undergoing CS without routine use of opioids in a standardized ERAS pathway.
Does Use of Testicular Sperm Improve Outcomes in Nonazoospermic Couples With Previous IVF Failure Using Ejaculated Sperm? [OP02-2B]
Authors: Eubanks Allison A. 
Published: April 2020

INTRODUCTION:
Due to controversial evidence that testicular sperm is associated with lower sperm DNA fragmentation (SDF) and improved outcomes compared to ejaculated sperm (ES), this study evaluates intracytoplasmic sperm injection (ICSI) outcomes using testicular sperm in nonazoospermic couples with prior IVF failure using ES.

METHODS:
From Jan 2015-Aug 2018, nonazoospermic couples with ≥1 prior failed ART cycles using ES underwent testicular sperm extraction (TESE) for IVF/ICSI. Outcomes using TESE sperm were compared to the mean values of couples’ prior cycles using ES. Primary outcomes: clinical pregnancy and live birth rates (CPR & LBR). Secondary outcomes: fertilization and blastocyst conversion.

RESULTS:
64 couples were evaluated with an average of 2.5 prior failed ART cycles using ES. There were 76 total transfers including fresh/frozen transfers and supernumerary embryo transfers. Compared to prior failed cycles with ES, TESE sperm resulted equivalent fertilization rates (61.4% vs. 59.0%, p=0.66), but significantly improved blastocyst conversion rates (61.9% vs. 42.9%, p<0.001) and blastocysts available for vitrification (1.6 vs. 0.6, p<0.003). CPR and LBR were improved (42.1% and 35.5%, respectively), but not statistically compared to the prior failed cycles due to regression of the mean. A comparison of TESE-ICSI cycles in couples with ≥2 prior failed ART cycles using ES did not change the findings.

CONCLUSION:
In nonazoospermic couples with failed ART using ES, ICSI using TESE sperm may improve blastocyst development, number of embryos available for vitrification, CPRs, and LBRs. Testicular sperm may bypass adverse effects of elevated SDF from ES and improve pregnancy outcomes.
Influence of Medicaid Expansion on Short Interpregnancy Interval Rates in the US [OP03-1C]
Authors: Patel Kriya , Bakk Juliana , Pensak Meredith , DeFranco Emily 
Published: April 2020

INTRODUCTION:
To assess the impact of improved access to contraception through Medicaid expansion (ME) on the rate of short interpregnancy intervals (IPIs) in the US.

METHODS:
Population-based retrospective cohort study using US live birth data of multiparous women with data on IPI in 2012 and 2016 (pre and post expansion in 2014). Rate differences of short IPI (<12 months) from 2012 to 2016 were compared between ME vs non-ME states.

RESULTS:
The rate of short IPI in the US was slightly lower in 2016 (17.3%) compared to 2012 (17.4%), p=0.0006; rate difference 0.13% (95% CI 0.05-0.20). Short IPIs occurred more frequently in non-ME states compared to ME states in both 2012 (18.08% vs 16.55%, p<.001) and 2016 (18.12% vs 16.44%, p<.001). The rate of short IPI decreased 0.11% (95% CI 0.01%-0.22%) in ME states vs increased 0.04% (95% CI 0.09-0.17) in non-ME states over the time period.

CONCLUSION:
The rate of short interpregnancy interval increased over time in non-expansion states but decreased in the states that adopted Medicaid expansion. If non-ME states had experienced the same rate of decrease in short IPI as ME states, 1122 fewer women would have experienced a short IPI in the US in 2016. Considering the known association between short IPI and adverse maternal and infant outcomes, these findings indicate Medicaid expansion could have an impact on improvement of perinatal outcomes in the US.
The Effects of Postpartum Long-Acting Reversible Contraceptive Insertion From the Medicaid Payer Perspective [OP03-2C]
Authors: Swiatlo Alison , Miele Kathryn , Morse Jessica E. , Lich Kristen , Krashin Jamie 
Published: April 2020

INTRODUCTION:
This model was created to determine the difference in short interval pregnancies, costs, and cost effectiveness with immediate versus standard placement of postpartum long-acting reversible contraception (ppLARC), which includes intrauterine devices and implants.

METHODS:
This Markov model examines a theoretical cohort of 1,000 women whose obstetrical care was paid for by North Carolina Medicaid (NC Medicaid) and who requested ppLARC prior to discharge from their delivery hospitalization from the perspective of NC Medicaid. Short interval pregnancy was defined as conception prior to 18 months from delivery. Probability inputs came from the literature and cost inputs are from NC Medicaid fee schedules. Markov cycles were weekly with an 18 month time horizon. During the time horizon postpartum, a woman could continue with her current contraceptive method, change to a different method, or become pregnant. Pregnancy is an absorbing state with five different outcomes. Probabilistic sensitivity analyses were conducted on key model parameters.

RESULTS:
Immediate ppLARC would result in 182 fewer unintended short interval pregnancies and save North Carolina $624,372 over 18 months. Immediate ppLARC was cost saving, with an incremental cost-effectiveness ratio of $3,435 saved per short interval pregnancy prevented. In sensitivity analyses, immediate ppLARC remained cost saving except when parameters were varied widely from expected values.

CONCLUSION:
Immediate post-partum insertion of long-acting reversible contraceptives was associated with cost-savings and fewer short interval pregnancies.
Assessment of Adequacy of Oxytocin Use in Pregnant Women Undergoing Induction of Labor [OP03-4C]
Authors: Eid Joe , Moutos Christopher , Jacobs Sara , Goslawski Melissa , Saade George R. , Saad Antonio 
Published: April 2020

INTRODUCTION:
Evaluation of adequacy of intrapartum management often includes quantification of oxytocin use, such as maximum rate of oxytocin used or length of time on oxytocin. Our objective was to evaluate a calculated measure that combines rate and time of oxytocin and its relationship with mode of delivery.

METHODS:
This is a secondary analysis of a randomized trial comparing speculum vs digital placement of Foley balloon for cervical ripening. Trial participants who did not receive oxytocin were excluded. Total dose of oxytocin received (OXYTOT) was calculated as the sum of the product of oxytocin rate and time on that rate for each concentration used. Area under the curve (AUC) was determined. Receiver operator characteristic (ROC) curves, and Wilcoxon rank sum test were used for analysis. OXYTOT was also categorized into deciles and its relationship to rate of cesarean section (CS) was studied.

RESULTS:
This analysis included 368 patients. Patients’ characteristics were similar in both CS and vaginal delivery (VD) groups. OXYTOT was predictive of mode of delivery (AUC of 0.62 95% CI 0.55-0.69). Women who underwent CS had a significant higher OXYTOT compared to women who had VD (9,308 vs 6,307 mIU, P<.0001). Rate of CS started significantly increasing at the 7th decile of OXYTOT (8,120 mIU).

CONCLUSION:
OXYTOT is a useful measure to assess adequacy of oxytocin use in induction of labor. CS rate remains low until high levels of this measure are reached. This measure may be a useful adjunct in assessing the quality of induction of labor and monitoring CS rates.
Labor Induction Outcomes With Outpatient Misoprostol for Cervical Ripening Among Low-Risk Patients [OP03-6C]
Authors: Schneider Allison N. , Tucker Lue-Yen , Kandahari Nazineen , Raine-Bennett Tina , Mohta Vanitha J. 
Published: April 2020

INTRODUCTION:
Labor induction is becoming increasingly common. The objective of this study is to evaluate the effect of outpatient misoprostol for cervical ripening on inpatient time-to-delivery and maternal and neonatal outcomes.

METHODS:
We conducted an IRB approved retrospective cohort study of 10,467 patients (559 outpatient, 9,908 inpatient) who received misoprostol for cervical ripening at Kaiser Permanente Northern California hospitals between 2012 and 2017. Time-to-delivery and maternal and neonatal outcomes after misoprostol administration were analyzed with standard statistical tests.

RESULTS:
Patients induced with misoprostol in the outpatient and inpatient settings were comparable in demographics and predominantly nulliparous (70.3% and 64.3%, respectively). Patients who received outpatient misoprostol were more likely to have a cervical dilation of 3cm on admission (39.5% vs 9.7%, P < .0001). The outpatient misoprostol cohort had a shorter time between admission and delivery (20.6 [interquartile range (IQR) 12.4-31.7] vs 27.5 [IQR 19.2-37.4] hours, P < .0001), with no difference in mode of delivery or neonatal outcomes. Patients who received outpatient misoprostol were more likely to have a C-section for failure to progress in labor (14.0% vs 11.2%, P=.04), however the overall C-section rate was not significantly different between groups. Patients who received outpatient misoprostol had a higher rate of chorioamnionitis and a trend towards a lower maternal blood transfusion (14.3% vs 10.6%, P=.01; 0.7% vs 1.8%, P=.06, respectively).

CONCLUSION:
Outpatient misoprostol reduced inpatient time-to-delivery by a median of 7 hours with no significant differences in maternal or neonatal outcomes. An outpatient misoprostol protocol has the potential to decrease inpatient burden on Labor and Delivery.
Bone Mineral Density Assessment With Relugolix Combination Therapy: Results From the Phase 3 LIBERTY Program [OP04-2D]
Authors: McClung Michael R. , Santora Arthur C. , Al-Hendy Ayman , McKain Laura , Pazirandeh Jessica , Wagman Rachel B. 
Published: April 2020

INTRODUCTION:
In phase 3 Institutional Review Board-approved LIBERTY 1 and 2 studies, relugolix combination therapy (Relugolix-CT [once daily relugolix 40 mg, estradiol 1.0 mg, norethindrone acetate 0.5 mg]) significantly reduced menstrual blood loss (MBL) in women with heavy menstrual bleeding associated with uterine fibroids (UF). We assessed the effects of Relugolix-CT in preventing bone loss from estrogen deprivation associated with GnRH receptor antagonist monotherapy.

METHODS:
Premenopausal women (age 18–50 years) with MBL volume ≥80 mL/cycle were randomized 1:1:1 to receive Relugolix-CT for 24 weeks, relugolix 40 mg alone for 12 weeks followed by Relugolix-CT for 12 weeks (delayed Relugolix-CT), or placebo for 24 weeks. Bone mineral density (BMD) by dual energy X-ray absorptiometry of the lumbar spine (LS) (L1–4), total hip, and femoral neck was assessed at screening and Weeks 12 and 24. Percent change from baseline between treatment groups was summarized by location using a mixed-effect model adjusted for region, visit and selected baseline characteristics.

RESULTS:
In LIBERTY 1 (N: 387), mean % changes from baseline at 24 weeks in LS BMD for Relugolix-CT and placebo were -0.36% and 0.05%, respectively and delayed Relugolix-CT was -1.82%. In LIBERTY 2 (N: 381), mean % changes from baseline in BMD at LS for Relugolix-CT and placebo were -0.13% and 0.32%, respectively, and delayed Relugolix-CT was -2.12%.

CONCLUSION:
Compared with relugolix monotherapy, relugolix-CT preserves bone mass over 24 weeks. Initiating treatment for UF with relugolix combined with E2/NETA represents a potential method for preserving BMD while providing therapeutic benefit over the long-term.
Up to 12 Months of Elagolix Sustained Menstrual Blood Loss Reduction in Women With Uterine Fibroids [OP04-5D]
Authors: Simon James A. , Bradley Linda D. , Liu Ran , Owens Charlotte , Schlaff William 
Published: April 2020

INTRODUCTION:
An investigational, IRB-approved, phase 3 extension study (Elaris UF-EXTEND) of two 6-month, phase 3 studies evaluated the efficacy and safety of an additional 6-months (up to 12-months) of elagolix (oral gonadotropin-releasing hormone antagonist) with hormonal add-back therapy in women with heavy menstrual bleeding (HMB) and uterine fibroids (UF).

METHODS:
Women who received elagolix 300 mg twice-daily with add-back (estradiol 1 mg/norethindrone acetate 0.5 mg once-daily [E2/NETA]) or elagolix alone in the preceding studies continued the same treatment for an additional 6-months in the extension study. Primary endpoint was the percentage of women with menstrual blood loss (MBL) <80 mL during final month of treatment and ≥50% MBL reduction from baseline to final month of treatment; MBL measured by alkaline hematin method. Safety assessments included bone mineral density (BMD) changes.

RESULTS:
433 women who completed the 6-month treatment period in either of the two preceding studies were enrolled in the extension study. In women who received up to 12-months of elagolix+E2/NETA, 87.9% met the primary endpoint; 74.8% had suppression of bleeding (no bleeding, spotting allowed) at final month; 72.5% with baseline hemoglobin ≤10.5g/dL had an hemoglobin increase >2 g/dL at extension month 6. Mean baseline MBL (mean±SD=224.7±147.9 mL) was reduced with elagolix+E2/NETA as early as extension month 1 (mean [95% CI]=-186.5 [-209.2, -163.9] mL) and sustained through extension month 6 (mean [95% CI]=-221.4 [-239.11, -183.68] mL). Mean BMD decreases from baseline to extension month 6 were significantly less with elagolix+E2/NETA than elagolix alone.

CONCLUSION:
Up to 12-months of elagolix+E2/NETA provided sustained MBL reduction in women with UF. Inclusion of add-back attenuated BMD decreases associated with elagolix alone.