bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for readmission for phototherapy due to jaundice in healthy newborns: a retrospective, observational study
Authors: Blumovich Amit , Mangel Laurence , Yochpaz Sivan , Mandel Dror , Marom Ronella 
Published: May 2020

Abstract
Background
The guidelines of the American Academy of Pediatrics (AAP) for monitoring neonatal jaundice recommend universal postnatal screening for hyperbilirubinemia within 48 h from discharge. We observed that neonate with low-risk jaundice were more likely to be readmitted to hospital for phototherapy compared to neonate with high-risk jaundice. The aim of this study was to identify additional factors that increase the risk for jaundice-related readmission.

Methods
This observational case-control study was performed on 100 consecutive neonates with jaundice who were readmitted to hospital for phototherapy treatment and were compared to 100 neonates with jaundice during hospitalization who were not readmitted after discharge. The data retrieved from the medical records of all participants included maternal characteristics, delivery type and noteworthy events, gestational age at delivery, birth weight and weight loss, neonate physical findings, Apgar scores, laboratory findings, length of hospital stay, and administration of phototherapy during hospitalization. The length of time since discharge and readmission for jaundice was also recorded.

Results
The risk of readmission decreased by 48% [odds ratio (OR) =0.52; 95% confidence interval (CI) 0.341–0.801] with every day added to the original hospitalization stay, and by 71% (OR = 0.29; 95% CI 0.091–0.891) if phototherapy had been administered during postnatal hospitalization. In contrast, the risk increased by 28% (OR = 1.28; 95% CI 1.164–1.398) with every elevation by 1% in hematocrit, and by 2.78 time (95% CI 1.213–6.345; p = 0.0156) when the delta in infant weight was > 5% (the difference between birth weight and weight at discharge during the postnatal hospitalization).

Conclusions
The risk factors for readmission, such as substantial weight loss (> 5% difference between birth and discharge) and elevated hematocrit should be taken into account in the decision to discharge neonate with low-risk jaundice. The AAP guidelines for decreasing readmission rates of neonatal jaundice by postnatal screening for hyperbilirubinemia alone may be more appropriate for neonate with high-risk jaundice.
Problematic internet use in children and adolescents: associations with psychiatric disorders and impairment
Authors: Restrepo Anita , Scheininger Tohar , Clucas Jon , Alexander Lindsay , Salum Giovanni A. , Georgiades Kathy , Paksarian Diana , Merikangas Kathleen R. , Milham Michael P. 
Published: May 2020

Abstract
Background
Problematic internet use (PIU) is an increasingly worrisome issue, as youth population studies are establishing links with internalizing and externalizing problems. There is a need for a better understanding of psychiatric diagnostic profiles associated with this issue, as well as its unique contributions to impairment. Here, we leveraged the ongoing, large-scale Child Mind Institute Healthy Brain Network, a transdiagnostic self-referred, community sample of children and adolescents (ages 5–21), to examine the associations between PIU and psychopathology, general impairment, physical health and sleep disturbances.

Methods
A total sample of 564 (190 female) participants between the ages of 7–15 (mean = 10.80, SD = 2.16), along with their parents/guardians, completed diagnostic interviews with clinicians, answered a wide range of self-report (SR) and parent-report (PR) questionnaires, including the Internet Addiction Test (IAT) and underwent physical testing as part of the Healthy Brain Network protocol.

Results
PIU was positively associated with depressive disorders (SR: aOR = 2.43, CI: 1.22–4.74, p = .01; PR: aOR = 2.56, CI: 1.31–5.05, p = .01), the combined presentation of ADHD (SR: aOR = 1.91, CI: 1.14–3.22, p = .01; PR: n.s.), Autism Spectrum Disorder (SR: n.s.; PR: aOR = 2.24, CI: 1.34–3.73, p < .001), greater levels of impairment (SR: Standardized Beta = 4.63, CI: 3.06–6.20, p < .001; PR: Standardized Beta = 5.05, CI: 3.67–6.42, p < .001) and increased sleep disturbances (SR: Standardized Beta = 3.15, CI: 0.71–5.59, p = .01; PR: Standardized Beta = 3.55, CI: 1.34–5.75, p < .001), even when accounting for demographic covariates and psychiatric comorbidity.

Conclusions
The association between PIU and psychopathology, as well as its impact on impairment and sleep disturbances, highlight the urgent need to gain an understanding of mechanisms in order to inform public health recommendations on internet use in U.S. youth.
Lonely places or lonely people? Investigating the relationship between loneliness and place of residence
Authors: Victor Christina R. , Pikhartova Jitka 
Published: May 2020

Abstract
Background
Loneliness in later life is largely presented as a problem of the individual focusing upon antecedents such as demographic or health factors. Research examining the role of the broader living environments is much rarer. We examined the relationship between loneliness and three dimensions of the lived environment: geographical region, deprivation, and area classification (urban or rural).

Methods
Our sample consisted of 4663 core members (44% males) aged 50+ (wave 7 mean age 72.8, S.D. = 7.1) present both in waves 3 (2006) and 7 (2014) of the English Longitudinal Study of Ageing (ELSA). Loneliness was measured using two approaches, individual and area-based, and both waves included these questions. Individual-based (self-reported) loneliness was assessed using the three item University of California Los Angeles (UCLA) scale (ranging from 3 = not lonely to 9 = lonely) with a score of 6+ defining loneliness. We also used a novel question which asked participants to evaluate how often they felt lonely in their area of residence (area-based; ranging from 1 = often to 7 = never, using cut off 4+ to define loneliness). The lived environment was classified in three different ways: the Index of Multiple Deprivation (IMD), Government Office Regions (GOR), and area classification (urban or rural). Covariates with established relationship with loneliness including demographic factors, social engagement and health, were included in the analyses.

Results
In wave 7, the prevalence of individual-based loneliness was 18% and area-based was 25%. There was limited congruence between measures: 68% participants reported no individual- or area-based loneliness and 9% reported loneliness for both measures. After adjusting for individual co-variates only one significant relationship was observed between loneliness and area -based characteristics. A significant association was observed between area-based loneliness and deprivation score, with higher levels of loneliness in more deprived areas (OR = 1.4 for highest quintile of deprivation).

Conclusions
Our results indicate that loneliness in older adults is higher in the most deprived areas independent of individual-level factors. In order to develop appropriate interventions further research is required to investigate how area-level factors combine with individual-level loneliness vulnerability measures to generate increased levels of loneliness in deprived areas.
Combined effects of gender affirmation and economic hardship on vulnerability to HIV: a qualitative analysis among U.S. adult transgender women
Authors: Jennings Mayo-Wilson Larissa , Benotsch Eric G. , Grigsby Sheila R. , Wagner Sarah , Timbo Fatmata , Poteat Tonia , Cathers Lauretta , Sawyer Ashlee N. , Smout Shelby A. , Zimmerman Rick S. 
Published: May 2020

Abstract
Background
Transgender women (“trans women”), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hardship and sexual risk. This study qualitatively examined how gender-affirming behaviors enhance or diminish vulnerability to HIV in light of structural and economic barriers to gender transition.

Methods
We conducted individual interviews with 19 adult trans women in two U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors and recent economic hardship related to employment/income, housing, or food security. Interviews were recorded, transcribed, and analyzed using thematic content analysis.

Results
The majority (74%) of trans women were racial/ethnic minorities with mean age of 26.3 years. Gender-affirming behaviors varied with 58% of trans women having legally changed their name and gender marker; 79% having initiated hormone therapy; and 11% having not initiated any medical or legal changes. None had undertaken surgical changes. Findings suggested that the process of gender transitioning resulted in both increasing and decreasing HIV risk. The high need for gender affirmation by male sex partners contributed to trans women’s exposure to sexual objectification, sexual risk behaviors, and conflicting interests in HIV prevention messaging. Loss of housing and employment due to transition along with the high costs of transition products and medical visits increased reliance on sex work and created new obstacles in accessing HIV services. Trans women experienced lower HIV risk as they acquired legal and medical transition services, reshaped interactions with sex partners, and received gender-affirming support by others, including health providers, employers, peers, and housing professionals. Sexual abstinence was viewed as a negative consequence of incomplete transition, although characterized as a period of low HIV risk.

Conclusions
Structural and policy initiatives that promote safe gender transition and economic stability in trans women may play a critical role in reducing HIV in this population. Addressing the harmful pressures for U.S. trans women to conform to perceived feminine stereotypes may also serve an important role.
Effectiveness of mobile SMS based counselling intervention in improving the knowledge, attitude, and practices of HIV/AIDS patients enrolled in hospitals/NGOs in Terengganu, Malaysia: a mixed mode study protocol
Authors: Hossain Md Mosharaf , Min Ruhani Binti Mat , Muhammad Zikri , Mani Kulanthayan K. C. 
Published: May 2020

Abstract
Background
HIV/AIDS is one of the most serious problems in many parts of the world, and is a high priority for health managers and decision-makers. The aim of the qualitative part of this study will be to develop a mobile SMS (short messaging services) counselling intervention to prevent HIV/AIDS, while the quantitative part will be to test the effectiveness of a mobile SMS counselling intervention to improve the knowledge, attitude, and practices of patients concerning the prevention of HIV/AIDS.

Method
A mixed methods approach will be used. Qualitative part: Design: focus group discussions (FGDs) will be conducted. Setting: Hospital/NGOs in Terengganu, Malaysia. Participants: Three FGDs will be conducted with male and female HIV/AIDS patients, and one group of local community leaders. One FGD will be conducted for each group. Three in-depth interviews (IDIs) will be conducted with patients who had HIV/AIDS, of which one will be female. Quantitative part: Design: a cluster randomized clinical trial with 384 HIV/AIDS patients in Terengganu, Malaysia. Intervention: Mobile SMS counselling intervention for patients concerning the prevention of HIV/AIDS.

Results
The main outcomes of this study will be the differences in knowledge, attitude, and practices of patients concerning the prevention of HIV/AIDS between the baseline and immediate follow-up after the intervention, and after 3 months.

Conclusions
The mobile based SMS counselling intervention developed will be effective in improving the knowledge, attitude, and practices of patients concerning HIV/AIDS prevention in Terengganu, Malaysia.

Trial registration
Thai Clinical Trials Registry, TCTR20200212001; 7/02/2020.
Attitude, practice and its associated factors towards Diabetes complications among type 2 diabetic patients at Addis Zemen District hospital, Northwest Ethiopia
Authors: Belsti Yitayeh , Akalu Yonas , Animut Yaregal 
Published: May 2020

AbstractBackgroundThis study aimed to assess the level of attitude, practices, and its associated factors towards complications of diabetes mellitus among type 2 diabetes patients.MethodsAn institution-based cross-sectional study was done on type 2 diabetes patients coming to the diabetes outpatient department at Addis Zemen District Hospital in Northwest Ethiopia. Interviewer-administered structured questionnaires were used to collect data from 402 patients. Multivariable logistic regression was employed to decide on factors related to practices and attitudes towards diabetes complications. AOR with 95% CI andp-value under 0.05 was considered to select significantly associated variables.ResultsTwo-thirds of the study participants (65.2% (95% CI: 60.2, 69.4)) had a good attitude level while less than half of study participants (48.8% (95% CI: 44.0, 53.5)) had a good practice on diabetes complications. Educational status of read and write (AOR = 2.32, 95% CI(1.26, 4.27)), primary school (AOR = 4.31, 95% CI(2.06, 9.02)), high school and above (AOR = 2.79, 95% CI (1.41, 5.50)), and urban residence (AOR = 1.80, 95% CI (1.12 2.91)) were significant factors for good attitude while educational status of read and write (AOR = 1.96, 95% CI (1.06, 3.61)), and high school and above (AOR = 2.57, 95% CI (1.32, 5.02)) were associated with diabetes complication practices.ConclusionsA greater proportion of diabetes patients had a relatively good attitude but poor practice towards diabetes complication preventions. Residence was a contributing variable for a good attitude while the level of education was significantly associated with both practice and attitude. The current study suggests the need for structured educational programs about diabetes complications regularly to improve patient’s attitudes and practice.
The impact of the nurses’, doctors’ and clinical officer strikes on mortality in four health facilities in Kenya
Authors: Kaguthi Grace Kiringa , Nduba Videlis , Adam Mary Beth 
Published: May 2020

AbstractBackgroundHealth worker strikes are a significant threat to universal access to care globally and especially in sub Saharan Africa. Kenya’s health sector has seen an increase in such industrial action. Globally there is limited data that has examined mortality related to such strikes in countries where emergency services were preserved. We sought to assess the mortality impact of an 100 day physician strike which was followed by 151 day nurses’ strike and 20 day clinical officer strike in Kenya.MethodsMonthly mortality data was abstracted from four public hospitals, Kenyatta National Referral Hospital, AIC Kijabe Hospital, Mbagathi Hospital and Siaya Hospital between December 2016 and March 2018. Differences in mortality were assessed using t-tests and multiple linear regression adjusting for facility, numbers of patients utilizing the hospital and department.ResultsThere was a significant decline in the numbers of patients seen, comparing the non-strike and strike periods; beta (ß) coefficient − 649 (95% CI -950, − 347)p < 0.0001. The physicians’ strike saw a significant decline in mortality (ß) coefficient − 19.0 (95%CI -29.2, − 8.87)p < 0.0001. Nurses and Clinical Officer strikes’ did not significantly impact mortality. There was no mortality increase in the post-strike period beta (ß) coefficient 7.42 (95%CI -16.7, 1.85)p = 0.12.ConclusionDeclines in facility-based mortality during strike months was noted when compared to a non-striking facility, where mortality increased. The decline is possibly associated with the reduced patient volumes, and a possible change in quality of care. Public health facilities are congested and over-utilized by the local population majority of whom cannot afford even low cost private care. Health worker strikes in Kenya where the public health system is the only financially accessible option for 80% of the population pose a significant threat to universal access to care. Judicious investment in the health infrastructure and staffing may decrease congestion and improve quality of care with attendant mortality decline.
Effect of kidney transplantation on right ventricular function, assessment by 2- dimensional speckle tracking echocardiography
Authors: Khani Mohammad , Tara Ahmad , Shekarkhar Shadi , Esfahani Morteza Abdar , Bayat Fariba 
Published: May 2020

Abstract
Background
Advanced chronic kidney disease often results in adverse cardiovascular outcomes and is the leading cause of mortality in patients with end stage renal diseases (ESRD). There is much information about the effect of chronic kidney diseases (CKD) on the left ventricle (LV) chamber, but the right ventricle (RV) as a neglected chamber had not been evaluated precisely, in spite of its importance.

Objectives
The aim of this study was to evaluate the impact of successful kidney transplants on the RV systolic and diastolic function using the advanced method of 2D speckle tracking echocardiography and comparison with the conventional methods.

Method
The study included 48 patients with CKD who were eligible for kidney transplantation and underwent successful kidney transplantations. Right ventricular indices were evaluated, while RV function was focused by conventional methods and 2D speckle tracking echocardiography before the successful kidney transplant and 1 week, 1 month, and 3 months after the successful kidney transplant.

Results
The results of the study showed that RV global longitudinal strain and RV free wall longitudinal strain improved over the time (P = 0.024, P < 0.001 respectively). It also represented that kidney transplantation did not have significant effect on the RV mid cavity diameter, tissue velocity, Myocardial performance index, RV longitudinal diameter, and Tricuspid annular plane systolic excursion indices, but for other indices this effect was significant. On the differences between the mean slope of regression line of the GLS variable in hypertensive subjects (1.0 ± 0.2) and non-hypertensive subjects (0.36 ± 0.32), an independent t-test showed that between the two groups in terms of the improvement of RVGLS, there was a significant statistical difference (P = 0.0067).

Conclusion
Most of the ESRD patients had subtle RV dysfunction which could be better detected by recent echocardiography methods than conventional methods. Moreover, kidney transplantation led to considerable improvements in RV function in this population.
Effectiveness and safety of follitropin alfa (Ovaleap®) for ovarian stimulation using a GnRH antagonist protocol in real-world clinical practice: a multicenter, prospective, open, non-interventional assisted reproductive technology study
Authors: Sydow Peter , Gmeinwieser Norbert , Pribbernow Katrin , Keck Christoph , Wiegratz Inka 
Published: May 2020

Abstract
Background
The use of recombinant human follicle-stimulating hormone (r-hFSH) in ovarian stimulation protocols for infertility treatment in assisted reproductive technology (ART) clinical practice is well established. More recent advancements include the availability of biosimilar r-hFSH products, which expand the choices available to healthcare practitioners and patients. Better understanding of how such a product contributes to routine clinical practice is valuable to help prescribers make informed treatment choices. The objective of this study was to examine the effectiveness and safety of ovarian stimulation (OS) with follitropin alfa (Ovaleap®) for routine IVF or intracytoplasmic sperm injection treatment in gonadotropin-releasing hormone (GnRH) antagonist cycles in real-world ART clinical practice.

Methods
This non-interventional, multicenter, prospective study was initiated in 34 specialized reproductive medicine centers in Germany. Eligible women were 18–40 years old with a body mass index < 30 kg/m2, menstrual cycle 24–35 days and anti-Müllerian hormone ≥1 ng/mL, who were undergoing a first OS cycle exclusively with Ovaleap® during routine ART using a GnRH antagonist protocol. Primary effectiveness outcomes were number of retrieved oocytes after OS and clinical pregnancy rate (CPR). Secondary outcomes included fertilization rate, number of transferred embryos, live birth delivery rate, safety, and user satisfaction with the Ovaleap® pen.

Result(s)
Of 507 women screened, 463 received at least 1 dose of Ovaleap® and 439 had Visit 2 data (per protocol population; PPP). The mean(±SD) number of retrieved oocytes was 11.8 ± 7.2 (PPP). The CPR among women with documented embryo transfer was 41.3% (158/383), resulting in a live birth delivery rate of 31.6% (138/437) among PPP patients with available follow-up information. Overall, 8.6% (40/463) of women reported ≥1 adverse drug reaction. Ovarian hyperstimulation syndrome occurred in 23 (5.0%) patients, rated mild in 14 (3.0%), moderate in 8 (1.7%), and severe in 1 (0.2%). Patients reported high user satisfaction and high convenience with use of the Ovaleap® pen.

Conclusion
The effectiveness and safety of OS with Ovaleap® in a GnRH antagonist protocol were extended to real-world ART clinical practice for the first time.

Trial registration
Registered on 22 June 2016 (retrospectively registered) at ClinicalTrials.gov (NCT02809989).
Trends and determinants of adolescent childbirth in Uganda- analysis of rural and urban women using six demographic and health surveys, 1988–2016
Authors: Amongin Dinah , Benova Lenka , Nakimuli Annettee , Nakafeero Mary , Kaharuza Frank , Atuyambe Lynn , Hanson Claudia 
Published: May 2020

Abstract
Introduction
Uganda has high adolescent pregnancy. The details of adolescent childbirth and urban/rural patterns are scarce. We investigated the levels, time trends and determinants of adolescent childbirth in Uganda separately for urban and rural women.

Methods
We estimated the percentage of women 20–24 years at each of the six Uganda Demographic and Health Surveys (1988/89, 1995, 2000/01, 2006, 2011 and 2016) who reported a live childbirth before age 20 years (“adolescent childbirth”), and examined change over time using t-test. A modified multivariable Poisson regression was used to examine determinants of having adolescent childbirth on the 2016 survey.

Results
Among these women, 67.5, 66.4, 70.1, 62.3, 57.3 and 54.1% reported an adolescent childbirth in 1988/89, 1995, 2000/01, 2006, 2011 and 2016 surveys, respectively. Between 1988/89 to 2000/01, there was no evidence of change (+ 2.6% point (pp), p = 0.170), unlike between the 2000/01 and 2016 surveys when a significant decline occurred (− 16.0 pp., p < 0.001). First childbirth < 18 years of age declined by − 13.5 pp. (p < 0.001) between 2000/01 and 2016. There was no change over time in the percentage of adolescents 18–19.9 years of age having first childbirth. Among rural residents, childbirth < 18 years declined from 43.8% in 1988/89 to 32.7% in 2016 (− 11.1 pp., p < 0.001), in urban it declined from 28.3 to 18.2% (− 10.1 pp., p = 0.006). There was an increase over time in the percentage of women, both rural and urban, who wanted to delay their first pregnancy. Independent determinants of reporting an adolescent childbirth in both urban and rural residents were: no education/incomplete primary and younger age at first sex. Additional determinants for rural women were residence in Eastern region, Muslim religion, and poor household wealth index.

Conclusion
In the 30-year period examined, adolescent childbirth in Uganda declined from highs of 7 in 10 to approximately 5 in 10 women, with more wanting to delay the pregnancy. The decline started after the 2000/01 survey and affected predominantly younger adolescent childbirth < 18 years among both rural and urban residence women. Efforts need to be intensified to sustain the decline in adolescent pregnancies. Targeted and specific strategies for urban and rural areas might be required.