bluuebunny/crossref_metadata_2025_split huggingface dataset:
A three-arm, multicenter, open-label randomized controlled trial of hydroxychloroquine and low-dose prednisone on recurrent spontaneous abortion with undifferentiated connective tissue diseases: Protocol for the immunosuppressant regimens for Living FEtuses (ILIFE) Trial
Authors: Yang Shaoying , Ni Ruoning , Lu Yikang , Wang Suli , Xie Feng , Zhang Chunyan , Lu Liangjing 
Published: August 2019

Abstract
Background Undifferentiated connective tissue disease (UCTD) is known to induce adverse pregnancy outcomes, and even recurrent spontaneous abortion (RSA) by placental vascular damage and inflammation activation. Anticoagulation can prevent pregnancy morbidities. However, it is unknown whether the addition of immune suppressant to anticoagulation can prevent spontaneous pregnancy loss in UCTD patients. The purpose of this study is to evaluate the efficacy of hydroxychloroquine (HCQ) and low-dose prednisone on recurrent pregnancy loss for women with UCTD. Methods The Immunosuppressant for Living Fetuses (ILIFE) Trial is a three-arm, multicenter, open-label randomized controlled trial of comparing hydroxychloroquine combined with low-dose prednisone and anticoagulation, hydroxychloroquine combined with anticoagulant, or anticoagulation alone in treating UCTD women with recurrent spontaneous abortion. Eligible patients will be randomly assigned to each of the tree arms with a 1:1:1 allocation ratio. The primary outcome is the rate of live births. Secondary outcomes include adverse pregnancy outcomes and progression of UCTD. Discussion This is the first multi-center, open-label, randomized controlled trial which evaluates the efficacy of immunosuppressant regimens on pregnancy outcomes and UCTD progression. It will provide evidence on whether the immunosuppressant ameliorates the pregnancy prognosis in UCTD patients with RSA and the progression into defined connective tissue disease.
Primary or secondary wound healing of the Pin Sites After Removal of the External Fixator: Study Protocol for a Prospective, Randomized Controlled Mono-center Trial
Authors: Roth Franz , Cagienard Flavio , Link Björn-Christian , Hodel Sandro , Lehnig Drik , Babst Reto , Beeres Frank J.P. 
Published: August 2019

Abstract
Background: Temporary fixation with an external fixator is used for numerous indications in orthopedic trauma surgery. It is unclear whether primary wound healing or the secondary open wound healing after removal of the external fixator should be advocated for the pin site. This study compares primary wound closure with secondary wound healing for the pin sites. The primary aim is to compare the infections rates of the pin site. Secondary aim is to compare time to wound healing and esthetic outcome. The hypothesis was that primary wound closure does not lead to more infections than secondary wound healing. Methods: This is a prospective, randomized, controlled and blinded monocenter study based on a non-inferiority design. To obtain an equal patient population and groups, all pin entry sites of the patients are treated alternately at the time of removal of the external fixator with primary wound closure and secondary wound healing. Patients are randomized whether the proximal pin entry site is treated with wound closure or by secondary open wound healing, from which the further sequence develops. The pre- and postoperative protocol is standardized for all pin entry sites. A photo documentation of the pin entry sites takes place 2 and 52 weeks postoperatively during the routine clinically follow-up visits. Further controls take place after 6, 12 and 26 weeks after the removal. The primary outcome was to demonstrate the non-inferiority of primary wound closure compared to secondary wound healing in terms of postoperative wound infections according to center of disease control (CDC). The secondary outcomes are time to complete wound healing (days) and esthetical outcome (Subjective preference of patients and Vancouver scar scale). Discussion: This study aims in answering how to deal with the pin site after removal of the external fixator. To date, no routine and generally accepted protocol exists for the management of pin sites after removal of the external fixator. This prospective, randomized, blinded monocenter trial will answer if primary wound closure or secondary wound healing should be advocated after removal of the external fixator.
Protocol for a Randomized Controlled Trial Examining Multi-level Prediction of Response to Behavioral Activation and Exposure-based Therapy for Generalized Anxiety Disorder
Authors: Santiago Jessica , Akeman Elisabeth , Kirlic Namik , Clausen Ashley , Cosgrove Kelly , McDermott Timothy , Mathis Bailey , Paulus Martin , Craske Michelle , Abelson James , Martell Christopher , Wolitzky-Taylor Kate , Bodurka Jerzy , Thompson Westley , Aupperle Robin 
Published: August 2019

Abstract
Background: Only 40 to 60% of patients with generalized anxiety disorder experience long-lasting improvement with gold-standard psychosocial interventions. Identifying neurobehavioral factors that predict treatment success might provide specific targets for more individualized interventions, fostering more optimal outcomes and bringing us closer to the goal of “personalized medicine.” Research suggests that reward and threat processing (approach/avoidance behavior) and cognitive control may be important for understanding anxiety and comorbid depressive disorders and have relevance to treatment outcomes. This study was designed to determine whether approach-avoidance behaviors and associated neural responses moderate treatment response to exposure-based versus behavioral activation therapy for generalized anxiety disorder. Methods: We are conducting a randomized, controlled trial involving two ten-week, group-based interventions – exposure-based therapy or behavioral activation therapy. These interventions focus on specific and unique aspects of threat and reward processing, respectively. Prior to and after treatment, participants are interviewed and undergo behavioral, biomarker and neuroimaging assessments, with a focus on approach and avoidance processing and decision-making. Primary analyses will utilize mixed models to examine whether hypothesized approach, avoidance, and conflict arbitration behaviors and associated neural responses at baseline moderate symptom change with treatment, as assessed using the GAD-7. Exploratory analyses will examine additional potential treatment moderators and utilize data reduction and machine learning methods. Discussion: This protocol provides a framework for how studies may be designed to move the field towards neuroscience-informed and personalized psychosocial treatments. Results will have implications for approach-avoidance processing in generalized anxiety disorder, relationships between levels of analysis (i.e., behavioral, neural), and predictors of behavioral therapy outcome. Trial registration: The study was retrospectively registered within 21 days of first participant enrollment in accordance with FDAAA 801 at the US National Institutes of Health (ClinicalTrials.gov) #NCT02807480 (registration date: June 21, 2016), pre-results.
Comprehensive 5-P framework for active ageing through ecological approach: an iterative systematic review
Authors: Lak Azadeh , Rashidghalam Parichehr , Myint Phyo K , Bradaran Hamid R 
Published: August 2019

Abstract
Background

"Active Ageing" is an inclusive term thus has been defined from a variety of aspects in different domains throughout the literature. The aim of this review is to identify the aspects which play significant roles in building this concept in an ecological approach.Methods

We searched seven online database s, JSTOR, Pub-Med, Web of Science, Google Scholar, ProQuest, EBSCO, and Scopus, from 2002 to 2018 (from introducing this concept by WHO) for both qualitative and quantitative articles in only English language. Two reviewers independently found the related articles using the search terms “active ageing” and “built environment” and included both “ageing” and “aging”.Results

Of 1337 records which passed the screening, 86 were eligible for the inclusion for the review purpose. A total of 15 themes were derived: Personal characteristic, Behavioral attitude, Land- use, Access, Physical form, Cityscape/City Image, Public open spaces, Housing, Social Environment, Cultural Environment, Economic Environment, Good Governance, Physical Health, Mental Health, and Social Health. Ecological themes of active ageing can be defined as the 5P model: Person, Processes, Place and Policy- Making based on the Prime aspect of health.Conclusions

This study sheds light on the aspects of "Active Ageing" through ecological model while offering the significance of the multidimensional nature of active ageing micro (person), meso-(process) and macro-system (place and policy-making) based on health (prime) environments according to the relationships between person and environment at the individual, interpersonal and environmental levels for the future research and population ageing policies.
Sickness absence and disability pension among women with breast cancer: a population-based cohort study with a predictive model
Authors: Kvillemo Pia , Chen Lingjing , Bottai Matteo , Frumento Paolo , Mittendorfer-Rutz Ellenor , Friberg Emilie , Alexanderson Kristina 
Published: August 2019

Abstract
Background: Women’s return to work after diagnosis of breast cancer (BC) are becoming more prevalent. However, register-based national investigation on sickness absence (SA) and disability pension (DP) in BC women is lacking.
Methods: The aim of the study was to explore SA and DP before and after a first BC diagnosis and the possibility to predict new cancer-related SA by using disease-related and sociodemographic factors. A longitudinal register study of the 3536 women in Sweden aged 19-64 with a first BC diagnosis in 2010 was conducted by linkage of multiple national registers. Particularly, information on SA and DP was obtained from the National Social Insurance Agency’s database. Descriptive statistics on SA and DP before and after the BC diagnosis were performed. The risk of being on sickness with a new SA spell due to BC or BC-related diagnoses was modeled using logistic regression.
Results: The proportion of women with SA increased during the year following the BC diagnosis date and declined over the next two years to proportions before diagnosis. At the time of BC diagnosis, half of the women began a new SA spell >14 days with cancer, cancer-related, or mental diagnosis. Disease-related and sociodemographic factors including occupational sector, living area, age, cancer stage, educational level, and number of previous SA days showed statistical significance (p<0.05) in predicting a new SA around BC diagnosis. By using these factors, it was possible to correctly predict 67% of the new SA spell.
Conclusion: SA among women with BC was elevated mainly in the first year after diagnosis. New SA following BC diagnosis can accurately be predicted
Correlates Of Intimate Partner Violence Among Ugandan Women Age 20-29 Years: A Cross-sectional Survey
Authors: Gubi Derrick , Nansubuga Elizabeth , Wandera Stephen Ojiambo 
Published: August 2019

Abstract
Abstract
Background: In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among women age 20-29 years are limited. The aim of this study was to determine correlates of IPV among Ugandan women age 20-29 years.
Methods: The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 2765 women who had been in a union and age 20-29 years were selected from the Domestic Violence module. Frequency distributions were used to obtain the background and other IPV related characteristics of the women while chi-square tests established the relationship between IPV and the explanatory variables. Binary logistic regressions established the factors that were associated with IPV.
Results: More than half (52%) of the women age 20-29 years experienced some form of IPV. Sexual IPV was the least prevalent (22%) and almost 4 in 10 women (36% and 38%) experienced physical and emotional IPV respectively. Factors associated with all the different forms of IPV included partner’s education, witnessing parental violence, partner’s controlling behaviors, marital duration, number of co-wives and frequency of being drunk by the partner. Age difference, age at first marriage and woman’s education were associated with emotional, physical and sexual violence respectively.
Conclusion: IPV towards Ugandan women age 20-29 years was high. This calls for its reduction through collective efforts that target men to address issues like excessive alcohol consumption, controlling behaviors and raising awareness among others. Intervention programs aimed at countering perpetration and tolerance of violence in the home setting should be promoted.
Keywords: Intimate partner violence, Alcohol, Witnessing parental violence, Controlling behaviors, Uganda
Associations between psychoactive substance use and sensation seeking behavior among drivers in Norway
Authors: Jamt Ragnhild Elén Gjulem , Gjerde Hallvard , Furuhaugen Håvard , Romeo Giovanni , Vindenes Vigdis , Ramaekers Jan G. , Bogstrand Stig Tore 
Published: August 2019

Abstract
BackgroundDrug use and risky driving is associated with sensation seeking. The aim of this study was to investigate the association between use of psychoactive substances and levels of the sensation seeking personality trait as measured with the Brief Sensation Seeking Scale 4 among drivers in Norway. MethodA cross-sectional design was applied to estimate the association between psychoactive substance use and sensation seeking behavior. Drivers in normal traffic were included in two roadside surveys: one in the north (September 2014 – October 2015) and the other in the south-east of Norway (April 2016 – April 2017). Oral fluid was analyzed for alcohol and psychoactive drugs, and data on sex, age and time of participation were recorded. Participants filled in the Brief Sensation Seeking Scale 4 questionnaire. ResultsA total of 8053 drivers were included, of which 32% were women and 62% were under 40 years. The prevalence of alcohol was 0.3%, stimulants 0.6%, tetrahydrocannabinol 1.4% and benzodiazepines and/or z-hypnotics 2.0% and polydrug use 0.6% Associations between the use of tetrahydrocannabinol or benzodiazepines and/or z-hypnotics and a low score on the “thrill and adventure seeking” domain of the Brief Sensation Seeking Scale 4 (OR = 1.723, 95% C.I. = 1.001- 2.966, p = 0.05) were found. Associations were also found between the use of stimulants and the highest scores on the “experience seeking” (OR = 2.085, 95% C.I. = 1.084-4.009, p = 0.028) and “disinhibition” (OR = 4.791, 95% C.I. =1.748-13.135, p = 0.002) domains of the Brief Sensation Seeking Scale 4. No associations were found between sensation seeking behavior and alcohol or polydrug use. ConclusionA high degree of sensation seeking was found among drivers who had used stimulants, in contrast to drives who had used tetrahydrocannabinol and benzodiazepines and/or z-hypnotics who showed a low degree of sensation seeking. The combination of sensation seeking behavior and the use of stimulants might lead to increased risky behavior and thus traffic crashes.
No association between early antiretroviral therapy during pregnancy and plasma levels of angiogenic factors: a cohort study
Authors: Djeha Ameyo , Girard Sylvie , Trottier Helen , Kakkar Fatima , Soudeyns Hugo , Boucher Marc , Lapointe Normand , Boucoiran Isabelle 
Published: August 2019

Abstract
Background: Early antiretroviral therapy (ART) during pregnancy has dramatically reduced the risk of perinatal HIV transmission. However, studies have shown an association between premature delivery and the use of ART during pregnancy (particularly protease inhibitor (PI)-based therapies), which could be explained by placental dysfunction. The objective of this study was to evaluate the association of ART (class, duration of exposure and time of initiation) with placental function by using angiogenic factors placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) as biomarkers. Methods: Clinical and biological data from 159 pregnant women living with HIV were analyzed. Levels of each biomarker were measured in the first and second trimester of pregnancy. After logarithmic transformation, we compared these using generalized estimating equations according to (a) the type of ART; (b) the duration of exposure to ART; and (c) the time of initiation of ART. Results: After adjusting for variables such as ethnicity, maternal age, gestational age, body mass index, parity, smoking status, and sex of the fetus, we found no significant association between the class of ART (PI-based or not) and serum concentrations of PlGF or sFlt-1. Furthermore, no significant association was found between biomarker levels and the duration of ART exposure or the timing of ART initiation (pre- or post-conception). Conclusions: This study suggests that first and second trimester angiogenic factor levels are not significantly associated with ART, regardless of the duration or type (with or without PI). These observations seem reassuring when considering the use of ART during early pregnancy.
“I have to provide for another life emotionally, physically and financially”: Understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal, South Africa
Authors: Govender Desiree , Naidoo Saloshni , Taylor Myra 
Published: August 2019

Abstract
Background

Adolescent pregnancy and adolescent parenting have been controversial and much disputed subjects in the field of public health. There are increasing concerns that the psychosocial challenges that adolescent mothers face may remain in the background because research in this field has mainly focused on the medical complications of early childbearing.

Aim

The aim of this qualitative study was to explore adolescent pregnancy and motherhood in order to understand this phenomenon from the perspective of adolescent mothers and to gain insight into their future aspirations.

Methods

This descriptive qualitative study utilised data that were generated from focus group discussions with adolescent mothers who utilised healthcare services at a hospital in the Ugu district in KwaZulu-Natal, South Africa. The data were analysed using thematic analysis.

Results

Adolescent mothers reported a range of positive and negative experiences. Some adolescent mothers’ partners were in denial and rejected them and the child, while others’ partners were happy and supported them during their pregnancy. Families’ reactions to the pregnancies ranged between anger and disappointment to abandonment, the “silent treatment”, and acceptance and forgiveness. The psychological issues experienced by some of the adolescent mothers included suicidal ideation, guilt, loneliness, anxiety, and stress. They also experienced financial constraints, difficulty in returning to school, and stigmatisation by society. The participants envisioned completing their education, focusing on their dream careers, and contributing positively to society.

Conclusion

Experiences of adolescent pregnancy and parenting are multifaceted and the healthcare needs of pregnant and parenting adolescents extend beyond information and knowledge. A multidisciplinary approach is required in the care of adolescent mothers. A key policy priority should encompass the collaboration of different professionals from various healthcare sectors to assist adolescent mothers in achieving better health and psychosocial and socio-economic outcomes as steps to securing a better future for themselves and their children.
The impact of obstetric interventions and complications on women’s satisfaction with childbirth - a population based cohort study including 16 000 women
Authors: Falk Maja , Nelson Marie , Blomberg Marie 
Published: August 2019

Abstract
Background: As a quality marker and a tool for benchmarking between units, a visual analogue scale (VAS) (ranging from 1 to 10) to estimate woman’s satisfaction with childbirth was introduced in 2014. This study aimed to assess how obstetric interventions and complications affected women’s satisfaction with childbirth.
Methods: A retrospective cohort study including 16,775 women with an available VAS score who gave birth between January 2016 and December 2017. VAS score, maternal and obstetric characteristics were obtained from electronic medical records and crude and adjusted odds ratios (aOR) were calculated.

Results: The total prevalence of dissatisfaction with childbirth (VAS 1-3) was 5.7%. The main risk factors for dissatisfaction with childbirth were emergency cesarean section, aOR 3.98 95% confidence interval (CI) 3.27-4.86, postpartum hemorrhage ≥2000 ml, aOR 1.85 95%CI 1.24-2.76 and Apgar score <7 at five minutes, aOR 2.95 95%CI 1.95-4.47. The amount of postpartum hemorrhage showed a dose-response relation to dissatisfaction with childbirth. Moreover, labor induction, instrumental vaginal delivery, and obstetric anal sphincter injury were significantly associated with women´s dissatisfaction with childbirth. 21% of women giving birth during the study period (4429/21,204) had missing values on VAS. A comparison of characteristics between women with and without a recorded VAS score was performed without any significant differences.
Conclusions: Obstetric interventions and complications, including emergency cesareans section and postpartum hemorrhage, were significantly related to dissatisfaction with childbirth.
Maternal characteristics and pregnancy outcomes among Chinese women with infertility undergoing assisted reproductive technology: a retrospective cohort study
Authors: wang jingxue , liu qiwei , Deng Boer , chen fang , liu xiaowei , cheng jiumei 
Published: August 2019

Abstract
Background: To examine differences in maternal characteristics and pregnancy outcomes among Chinese women with infertility due to various reasons who underwent assisted reproductive technology(ART).
Methods: This retrospective cohort study included women who used ART for various reasons. Demographics, medical history, laboratory tests, and delivery data were reviewed.
Results: The ART treatment group was divided into 5 subgroups according to reason for infertility: ovulation disorder, tubal disease, male factor, endometriosis, multiple infertility-related diagnoses. Compared with spontaneous pregnancies, significant increases in the following were observed with ART: rates of gestational diabetes mellitus(GDM), preeclampsia, preterm premature rupture of membranes, postpartum hemorrhage, and chorioamnionitis in ovulation disorder; GDM, placenta previa and postpartum hemorrhage in tubal disease; placenta previa in endometriosis and male factor; and GDM, placenta previa and chorioamnionitis in multiple infertility-related diagnoses. Preterm birth, low birthweight, and small for gestational age were increased in all ART groups. Macrosomia and neonatal intensive care unit admission were increased in maternal factors with ART.
Conclusions: During the perinatal period, women with different reasons for undergoing ART have different maternal characteristics and infant outcomes when compared with women not using ART, perinatal morbidities are higher in women undergoing ART for most reasons. The worst and best prognoses for infertility were found for that caused by ovulation disorder and male factor, respectively.