bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community-Engaged Curriculum Development in Sexual and Reproductive Health Equity
Authors: Julian Zoë , Mengesha Biftu , McLemore Monica R. , Steinauer Jody 
Published: March 2021

BACKGROUND:
Inequitable outcomes in sexual and reproductive health disproportionately burden communities minoritized by systems of oppression. Although there is evidence linking structural determinants to these inequities, clinical learners have limited exposure to these topics in their training. We developed a curriculum aimed to teach clinical learners the structural determinants of sexual and reproductive health.

METHOD:
We implemented Kern’s six-step method for curriculum development. Through literature review, we identified structural competency as the foundational framework and explored community priorities for clinical training. We assessed learner needs regarding structural equity training, articulated goals and objectives, and chose video modules as the primary educational strategy. We collaboratively developed content with community scholars and reproductive justice advocates. For phase 1 of our curriculum, we created pillar videos with reflection questions, resources, and a visual glossary of key terms. All materials are available through an online educational platform offering open-access, evidence-based curricula.

EXPERIENCE:
We launched our curriculum with a social media campaign and presented our videos at several national convenings. We implemented videos with clinical learners with positive preliminary evaluation results.

CONCLUSION:
With rigorous development rooted in community engagement, our curriculum contributes to the tools promoting structural equity training in obstetrics and gynecology.
Racial–Ethnic Comparison of Guideline-Adherent Gynecologic Cancer Care in an Equal-Access System
Authors: Eaglehouse Yvonne L. , Darcy Kathleen M. , Tian Chunqiao , Casablanca Yovanni , Shriver Craig D. , Zhu Kangmin 
Published: March 2021

OBJECTIVE:
To compare receipt of National Comprehensive Cancer Network Guideline–adherent treatment for gynecologic cancers, inclusive of uterine, cervical, and ovarian cancer, between non-Hispanic White women and racial–ethnic minority women in the equal-access Military Health System.

METHODS:
We accessed MilCanEpi, which links data from the Department of Defense Central Cancer Registry and Military Health System Data Repository administrative claims data, to identify a cohort of women aged 18–79 years who were diagnosed with uterine, cervical, or ovarian cancer between January 1, 1998, and December 31, 2014. Information on tumor stage, grade, and histology was used to determine which treatment(s) (surgery, chemotherapy, radiotherapy) was indicated for each patient according to the National Comprehensive Cancer Network Guidelines during the period of the data (1998–2014). We compared non-Hispanic Black, Asian, and Hispanic women with non-Hispanic White women in their likelihood to receive guideline-adherent treatment using multivariable logistic regression models given as adjusted odds ratios (aORs) and 95% CIs.

RESULTS:
The study included 3,354 women diagnosed with a gynecologic cancer of whom 68.7% were non-Hispanic White, 15.6% Asian, 9.0% non-Hispanic Black, and 6.7% Hispanic. Overall, 77.8% of patients received guideline-adherent treatment (79.1% non-Hispanic White, 75.9% Asian, 69.3% non-Hispanic Black, and 80.5% Hispanic). Guideline-adherent treatment was similar in Asian compared with non-Hispanic White patients (aOR 1.18, 95% CI 0.84–1.48) or Hispanic compared with non-Hispanic White women (aOR 1.30, 95% CI 0.86–1.96). Non-Hispanic Black patients were marginally less likely to receive guideline-adherent treatment compared with non-Hispanic White women (aOR 0.73, 95% CI 0.53−1.00, P=.011) and significantly less likely to receive guideline-adherent treatment than either Asian (aOR 0.65, 95% CI 0.44–0.97) or Hispanic patients (aOR 0.56, 95% CI 0.34–0.92).

CONCLUSION:
Racial–ethnic differences in guideline-adherent care among patients in the equal-access Military Health System suggest factors other than access to care contributed to the observed disparities.
Superior Hypogastric Plexus Block to Reduce Pain After Laparoscopic Hysterectomy
Authors: Clark Nisse V. , Moore Kristin , Maghsoudlou Parmida , North Alexandra , Ajao Mobolaji O. , Einarsson Jon I. , Louie Michelle , Schiff Lauren , Moawad Gaby , Cohen Sarah L. , Carey Erin T. 
Published: March 2021

OBJECTIVE:
To assess whether a superior hypogastric plexus block performed during laparoscopic hysterectomy reduces postoperative pain.

METHODS:
We conducted a multicenter, randomized, single-blind, controlled trial of superior hypogastric plexus block at the start of laparoscopic hysterectomy. Women undergoing a laparoscopic hysterectomy for any indication and with any other concomitant laparoscopic procedure were eligible. Standardized preoperative medications and incisional analgesia were provided to all patients. Our primary outcome was the proportion of patients with a mean visual analog scale (VAS) pain score lower than 4 within 2 hours postoperatively. Patients but not surgeons were blinded to the treatment group. Twenty-nine patients per group was estimated to be sufficient to detect a 38% absolute difference in the proportion of patients with a VAS score lower than 4 at 2 hours postoperatively, with 80% power and an α of 0.05. To account for loss to follow-up and potential imbalances in patient characteristics, we planned to enroll 50 patients per group. All analyses were intention to treat.

RESULTS:
Between January 2018 and February 2019, 186 patients were eligible; 100 were randomized and analyzed. Demographic and clinical characteristics were similar between the two groups. There was no significant difference in the proportion of patients with a mean VAS score lower than 4 within 2 hours postoperatively between patients who received a superior hypogastric plexus block (57%) and patients who did not (43%) (odds ratio 1.63, 95% CI 0.74–3.59; adjusted odds ratio 1.84, 95% CI 0.75–4.51).

CONCLUSION:
Among patients undergoing laparoscopic hysterectomy with standardized enhanced perioperative recovery pathways, superior hypogastric plexus block did not significantly reduce postoperative pain.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT03283436.
Ethical and human subject burdens of trials conducted to evaluate biosimilars
Authors: Ohn Jennifer A. , Atteberry Preston J. , Trusheim Mark R. , Bach Peter B. 
Published: March 2021

ABSTRACTBackground/AimsWith a policy goal of introducing price competition into the market for biologic drugs after their period of market monopoly is over (called ‘loss of exclusivity’), policymakers created a pathway for companies to make copies of those treatments and termed them ‘biosimilars’. But unlike generic drugs, biosimilar drug copies must be studied in human trials to assure they have the same clinical effect as the original biologic products. The burden that this places on human subject participants, and the opportunity cost on the clinical trial system generally, have not been considered in detail.MethodsFor all biosimilar drugs in development, approved, or that failed to obtain approval in the US, we abstracted from clinicaltrials.gov registry the number of subjects enrolled at each phase of development.ResultsWe identified 105 clinical trials for approved or withdrawn biosimilars and another 20 studies that are either planned, ongoing or completed for biosimilars in development. These studies collectively enrolled (or plan to enroll) 38,169 human subjects. Most (28,130) are enrolled in phase 3 studies. The mean number of human subject participants per approval is 1,045, about 25% of the number required for a new drug approval on average.ConclusionsA consequential number of human subjects are required for the testing of biosimilar drugs prior to approval. The explicit and sole purpose of biosimilars is to induce competition in order to lower prices of biologic drugs after loss of exclusivity. The burden the biosimilar approval trials place on human subjects with no direct clinical benefits but definite risks, and the possibility that they rob subjects from trials that are of more scientific importance, are ones policymakers might consider. Price regulation of biologic drugs after loss of exclusivity could achieve lower prices as well, without the burdens of the current approach.Funding SourceArnold Ventures (Grant to support Drug Pricing Lab at Memorial Sloan Kettering Cancer Center)
Genome-wide annotation of gene regulatory elements linked to cell fitness
Authors: Klann Tyler S. , Barrera Alejandro , Ettyreddy Adarsh R. , Rickels Ryan A. , Bryois Julien , Jiang Simon , Adkar Shaunak S. , Iglesias Nahid , Sullivan Patrick F. , Reddy Timothy E. , Crawford Gregory E. , Gersbach Charles A. 
Published: March 2021

AbstractNoncoding regulatory elements control gene expression and govern all biological processes. Epigenomic profiling assays have identified millions of putative regulatory elements, but systematically determining the function of each of those regulatory elements remains a substantial challenge. Here we adapt CRISPR-dCas9-based epigenomic regulatory element screening (CERES) technology to screen all >100,000 putative non-coding regulatory elements defined by open chromatin sites in human K562 leukemia cells for their role in regulating essential cellular processes. In an initial screen containing more than 1 million gRNAs, we discovered approximately 12,000 regulatory elements with evidence of impact on cell fitness. We validated many of the screen hits in K562 cells, evaluated cell-type specificity in a second cancer cell line, and identified target genes of regulatory elements using CERES perturbations combined with single cell RNA-seq. This comprehensive and quantitative genome-wide map of essential regulatory elements represents a framework for extensive characterization of noncoding regulatory elements that drive complex cell phenotypes and for prioritizing non-coding genetic variants that likely contribute to common traits and disease risk.
Transposon-induced inversions activate gene expression in Maize pericarp
Authors: Sharma Sharu Paul , Zuo Tao , Peterson Thomas 
Published: March 2021

AbstractChromosomal inversions can have considerable biological and agronomic impacts including disrupted gene function, change in gene expression and inhibited recombination. Here we describe the molecular structure and functional impact of six inversions caused by Alternative Transpositions betweenp1andp2genes responsible for floral pigmentation in maize. In maize linep1-wwB54, thep2gene is expressed in anther and silk but not in pericarp, making the kernels white. We identified inversions in this region caused by transposition ofAcandfractured Ac(fAc) transposable elements. These inversions change the position of ap1enhancer and activate the expression ofp2in the kernel pericarp, resulting in red kernel color. We hypothesize that these inversions place thep2gene promoter near ap1gene enhancer, thereby activatingp2expression in kernel pericarp.
A tandem-repeat dimeric RBD protein-based COVID-19 vaccine ZF2001 protects mice and nonhuman primates
Authors: An Yaling , Li Shihua , Jin Xiyue , Han Jian-bao , Xu Kun , Xu Senyu , Han Yuxuan , Liu Chuanyu , Zheng Tianyi , Liu Mei , Yang Mi , Song Tian-zhang , Huang Baoying , Zhao Li , Wang Wen , Ruhan A , Cheng Yingjie , Wu Changwei , Huang Enqi , Yang Shilong , Wong Gary , Bi Yuhai , Ke Changwen , Tan Wenjie , Yan Jinghua , Zheng Yong-tang , Dai Lianpan , Gao George F. 
Published: March 2021

AbstractA safe, efficacious and deployable vaccine is urgently needed to control COVID-19 pandemic. We report here the preclinical development of a COVID-19 vaccine candidate, ZF2001, which contains tandem-repeat dimeric receptor-binding domain (RBD) protein with alum-based adjuvant. We assessed vaccine immunogenicity and efficacy in both mice and non-human primates (NHPs). ZF2001 induced high levels of RBD-binding and SARS-CoV-2 neutralizing antibody in both mice and NHPs, and also elicited balanced TH1/TH2 cellular responses in NHPs. Two doses of ZF2001 protected Ad-hACE2-transduced mice against SARS-CoV-2 infection, as detected by reduced viral RNA and relieved lung injuries. In NHPs, vaccination of either 25 μg or 50 μg ZF2001 prevented infection with SARS-CoV-2 in lung, trachea and bronchi, with milder lung lesions. No evidence of disease enhancement is observed in both models. ZF2001 is being evaluated in the ongoing international multi-center Phase 3 trials (NCT04646590) and has been approved for emergency use in Uzbekistan.
Freedom and flexibility: the work–family balance of single female entrepreneurs in Nigeria
Authors: Adisa Toyin Ajibade , Mordi Chima , Akanji Babatunde 
Published: March 2021

PurposeWork–family research has mainly focused on nuclear families, neglecting other types of families, such as single self-employed parents. To what extent does the freedom and flexibility attached to being single and self-employed hinder or enhance single parents' work–family balance? Using role theory as a theoretical lens, this study examines single-self-employed parents' work–family balance.Design/methodology/approachDrawing on the accounts of 25 single self-employed parents in Nigeria, the article uses semi-structured interviews to examine how this group achieves work–family balance.FindingsWe found that the freedom and flexibility associated with being single and self-employed form a double-edged sword that increases the spate of singlehood and intensifies commitments to work, altogether preventing the participants in the study from achieving work–family balance. The findings also indicate that singlehood and a lack of spousal support cause and exacerbate work–family imbalance for this group. The findings further indicate that the reconstruction of functions, and the recreation of the traditional masculine gender role overwhelm single self-employed women in their entrepreneurial activities, thereby causing a lack of time and the energy required to function well in a family role, thus creating imbalance between the different spheres of life.Research limitations/implicationsThe extent to which the findings of this research can be generalised is constrained by the limited sample and scope of the research.Practical implicationsWhile literature espouses freedom and flexibility as important ingredients needed to achieve work–family balance, this study shows that they enhance inter-role role conflict. The study suggests creation of private or family time, devoid of work or entrepreneurial engagements, for single female entrepreneurs. This will ensure quality time and energy for the family and for fresh relationship – all of which will impact business positively.Originality/valueRather than enhancing work–family balance, the freedom and flexibility attached to being single and self-employed remain the main source of work–family imbalance for Nigerian single self-employed parents.
Incorporating the risk of knowledge loss in supply chain risk management
Authors: Daghfous Abdelkader , Qazi Abroon , Khan M. Sajid 
Published: March 2021

PurposeThe literature on supply chain risk management (SCRM) has investigated a multitude of supply chain risks. This paper aims to make a case for the importance of managing the risk of knowledge loss in the supply chain management (SCM) function and incorporating knowledge loss as a critical risk within the SCRM process.Design/methodology/approachThis paper adopts a knowledge-based view of the SCRM process and attempts to bring to light insights based on a synthesis of the relevant literature. The authors conducted a systematic literature review of peer-reviewed articles published between 1998 and 2019. Further, a case study was conducted to illustrate the significance of the risk of knowledge loss in the SCM function in terms of how it operates and why it has such a significant impact on performance.FindingsKnowledge loss is a relatively neglected type of supply chain risk that can be added to the existing typologies. This paper argues that knowledge loss in the SCM function has the propensity to significantly impact the performance of the focal firm, exacerbate other types of supply chain risk and impede risk mitigation efforts. We put forth several strategies that supply chain managers can adopt to mitigate the risk of knowledge loss in their function.Research limitations/implicationsThis paper generates an exploratory opening that could pave the way for a systematic theory of knowledge loss as a supply chain risk and future empirical research. The study culminates in a number of important insights and initiatives for supply chain managers to recognize and manage the risk of knowledge loss.Originality/valueThis paper argues for the importance of incorporating the risk of knowledge loss in SCRM research and practice. It also provides an examination of some promising angles for future research in SCRM from a knowledge-based perspective.
Technical efficiency, intellectual capital efficiency and bank performance in emerging markets: the case of India
Authors: Maji Santi Gopal , Hussain Farah 
Published: March 2021

PurposeThis paper examines the impacts of technical efficiency and intellectual capital efficiency (ICE) on bank performance in India after controlling other bank-, industry-specific and macroeconomic variables.Design/methodology/approachThe authors use secondary data on listed Indian commercial banks for the period 2005–2018. The authors use data envelopment analysis (DEA) technique-based Malmquist index (MI) to obtain technical efficiency and value-added intellectual coefficient (VAIC) model for computing ICE. System generalized method of moments (GMM) (SGMM) model in a dynamic framework is used to estimate the parameters, which takes into consideration issues of endogeneity, heterogeneity and persistence of bank performance. Further, the authors use quantile regression model to examine whether the impacts of covariates are homogeneous at different locations of the conditional distribution of bank performance.FindingsThe authors find positive impact of technical efficiency and negative influence of market concentration on bank performance. The results of the study support the efficient structure (ES) hypothesis (ESH). The authors observe positive influence of intellectual capital (IC) on bank performance, which indicates the relevance of intellectual resources in enhancing banks' value. Further, the results of quantile regression indicate that the impacts of technical efficiency and ICE are more pronounced at higher quantiles of the conditional distribution of bank performance.Originality/valueThis paper in the Indian context examines the influences of technical efficiency and ICE after controlling bank-, industry-specific and macroeconomic factors.
A coordination mechanism through cost sharing of corporate social responsibility and government subsidy in a two-echelon supply chain
Authors: Liu Yong , Ren Wenwen , Xu Qian , Liu Zhiyang 
Published: March 2021

Purpose
This paper aims to deal with the coordination problem of the supply chain through cost sharing of corporate social responsibility (CSR) and government subsidy.

Design/methodology/approach
With respect to the coordination problem of the supply chain with CSR, this paper constructs a three-stage game model consisting of a dominant retailer, n suppliers and government. From the perspective of cost sharing and government subsidies, this paper discussed the decentralized and centralized decision-making, respectively. On this basis, this paper designed a coordination mechanism considering both cost sharing and government subsidies and explore the impact of cost sharing rate and government subsidy rate on CSR efforts, members’ profits and social welfare.

Findings
CSR can improve the profits of supply chain members and the overall performance of the supply chain. Then the profits of supply chain nodal enterprises will be affected by the fulfillment level of CSR of their partners. Furthermore, excessive CSR will erode the supply chain profits and cause resource waste. High CSR costs often make retailers low CSR effort level, while a high CSR cost sharing rate can reduce the profits of suppliers and the supply chain. In addition, excessive government subsidies will lead to the decline of social welfare. Excessive government subsidies will cause the dependence of enterprises and affect their operating efficiency.

Practical implications
The proposed coordination mechanism can effectively do with the coordination problem of the supply chain.

Originality/value
The proposed coordination mechanism considering cost sharing and government subsidies simultaneously can effectively deal with conflict problems and guarantee the supply chain members and the supply chain to maximize their profits and social welfare.
Collections, local interactions, conservation and tourism aspects of monastic heritage sites in the Lake Tana region of Ethiopia: the case of Mandeba Medahinealem Monastery
Authors: Genet Abraham , Kebede Marshet 
Published: March 2021

PurposeAlong with the varied values of heritages which are rationale for their safeguarding, sustainable conservation and tourism development have become central agendas in the field of heritage management in contemporary world. This study attempts to elaborate such interconnected issues at Mandeba Monastery, emphasizing not only cultural heritages but also mutually reflecting on natural features which are integral part of the monastery.Design/methodology/approachInterviewing and systematic observation alongside secondary sources were used to generate data which were analyzed thematically.FindingsBeing a site for incredible collections, Mandeba maintained a tradition of not only heritage conservation and benevolent communal interaction but also of ecological sustainability. The rich collections together with its spectacular location on the shore of Lake Tana enable Mandeba to have highly noticeable tourism potentials. However, Mandeba encounters such challenges as inadequate museum, safety and security problems, lack of sufficient budget, professional, parasitic animal damages, weak promotion and lack of tourist facilities which hamper both conservation and tourism development on the site, which need to be tackled for the overall improvement of the monastery.Originality/valueThis research is original, presenting the ground knowledge and practice regarding the relationship between heritage conservation on the one hand, and local livelihood, environmental management and tourism sustainability on the other hand, with regard to the immovable cultural/religious heritage site of Mandeba Medahinealem Monastery.