bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organisational best practices for advancing women in leadership: protocol for a systematic literature review
Authors: Mousa Mariam , Mullins Alexandra K , Skouteris Helen , Boyle Jacqueline , Teede Helena J 
Published: April 2021

IntroductionEvidence-based approaches for achieving gender equity for women in leadership are lacking. Current efforts are of limited effectiveness, especially in healthcare. This work occurs in the context of an Australian National Health and Medical Research Council funded partnership to advance women in healthcare leadership. Partners include government, professional colleges and healthcare organisations with national reach and international links. Here we present a protocol for a systematic review, aiming to capture evidence on effective organisational strategies across multiple sectors with comparable challenges in advancing women in leadership. The aim of the review is to learn from other sectors and analyse the evidence to inform implementation in the health sector.Methods and analysisA systematic search will be performed on Ovid MEDLINE, PsycINFO and SCOPUS databases to identify studies since 2000, reflecting a major shift in the global gender equality agenda with the development of the 2000 Millennium Development Goals. Titles and abstracts will be screened to assess eligibility; data extraction, quality assessment (using the Critical Appraisal Skill Programme checklist) and synthesis of outcomes will be performed. Outcomes will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation framework. Studies in English using quantitative or qualitative design, which investigate organisational practices in any sector, for advancing women in leadership, and report on one or more measurable outcomes (eg, capacity-building, incidence of promotion) will be included. Findings will be analysed, themes will be extracted and results will be described.Ethics and disseminationEthics approval is not required. To our knowledge, this review will be the first to provide a comprehensive synthesis of available evidence on organisational practices for advancing women in leadership from the last two decades. Findings will be published in peer-reviewed journals and disseminated at conferences and meetings. Through a large-scale funded partnership, this work will inform practice, linking to international initiatives.PROSPERO registration numberCRD42020162115; International Prospective Register of Systematic Reviews.
Contact-free and fast detection of energetic materials in containments
Authors: Wild Dominik , Theiß Cathrin , Holl Gerhard 
Published: April 2021

AbstractThe identification of energetic materials in containments is an important challenge for analytical methods in the field of safety and security. Opening a package without knowledge of its contents and the resulting hazards is highly involved with risks and should be avoided whenever possible. Therefore, preferable methods work non-destructive with minimal interaction and are capable of identifying target substances in a containment quickly and reliably. Most spectroscopic methods find their limits, if the target substance is shielded by a covering material. To solve this problem, a combined laser drilling method with subsequent identification of the target substance by means of Raman spectroscopic measurements through microscopic bore holes of the covering material is presented. A pulsed laser beam is used for both the drilling process and as an excitation source for Raman measurements in the same optical setup. Results show the ability of this new method to gain high-quality spectra even when performed through microscopic small bore channels. With the laser parameters chosen right, the method can even be performed on highly sensitive explosives like triacetone triperoxide (TATP). Another advantageous effect arises in an observed reduction in unwanted fluorescence signal in the spectral data, resulting from the confocal-like measurement setup with the bore hole acting as aperture.
DETERMINATION OF THE STRESS OF ANTERIOR CRUCIATE LIGAMENT IN VARIOUS DEGREES OF KNEE FLEXION, COMPARISON OF NORMAL AND RECONSTRUCTED LIGAMENT
Authors: KARIMI MOHAMMAD TAGHI , HOSSEINI SAYED IMAN , LARI YOUSEF BAZARGAN 
Published: April 2021

Background: Knee joint stability is enhanced by ligamentus structures such as anterior cruciate (ACL), posterior cruciate (PCL), medial collateral (MCL) and lateral collateral ligaments (LCL). Rupture of ACL is the most common knee injuries, especially in sport related activities. The aim of this study is to evaluate the stress developed in knee joint structures in various degrees of knee flexion in ACL ruptured compared to normal condition. Method: CT scan images of knee joint were used to create 3d model of knee joint by use of Mimics software. Abaqus software was used to evaluate the stress developed in knee joint in normal and in ACL reconstructed conditions in various degrees of knee flexion. Results: The stress developed in ACL and other knee joint structures increased significantly by increase in knee joint flexion. The stress of knee joint structures (especially in ACL) in ACL reconstructed condition was more than that of normal condition. Conclusion: It is recommended to immobilize the knee joint in extension up to [Formula: see text] of knee flexion in those with ACL injuries. The stress of ACL increased due to an increase in tibia translation associated with knee flexion.
The Mexican Front-of-Pack Labeling Reform: Is It Compatible with International Trade Law?
Authors: Bahri Amrita , Charvel Ana Sofia 
Published: April 2021

Abstract
Mexico has by far the world’s highest death rate linked to obesity and other chronic diseases. As a response to the growing pandemic of obesity, Mexico has adopted a new compulsory front-of-pack labeling regulation for pre-packaged foods and non-alcoholic beverages. This article provides an assessment of the regulation’s consistency with international trade law and the arguments that might be invoked by either side in a hypothetical trade dispute on this matter.
Sexuality education for primary school students with disability in Fiji
Authors: Botfield Jessica R , Ratu Sera , Turagabeci Esiteri , Chivers Jane , McDonald Loren , Wilson Eleanor G , Cheng Yan 
Published: April 2021

Background: People with disability have the same sexual and reproductive health needs and rights as people without disability, yet experience considerable barriers in accessing information and services. The Reproductive and Family Health Association of Fiji, Family Planning Australia, and disability stakeholders implemented a comprehensive sexuality education (CSE) disability inclusion project to increase access for students with disability to age-appropriate sexuality education. Method: A train the trainer model was utilised, whereby staff and disability stakeholders undertook competency-based training on delivering sexuality education to teachers and people with disability, then trained and supported teachers working in special disability schools to provide sexuality education to students. An evaluation explored the acceptability and effectiveness of the project, utilising baseline and endline surveys and interviews. Findings: From 2016 to 2018, the CSE disability project reached teachers and students in nine special disability schools in Fiji. At project completion, teachers reported increased confidence overall in teaching about sexuality and relationships, and students demonstrated increased knowledge regarding puberty and body changes. Interview findings suggested the project contributed to overcoming silence and stigma for people with disability and promoting safety for young people. Conclusion: Age- and developmentally appropriate sexuality education for people with disability is essential for equipping them with necessary knowledge and skills. The CSE disability project utilised a collaborative, capacity building approach to co-design and implement sexuality education in special disability schools in Fiji. With commitment from stakeholders, this could be sustained and expanded to support students with disability in achieving optimal sexual and reproductive health.
What Makes Adolescents Free Time Use Differently?
Authors: Lee Yong-Kwan 
Published: April 2021

This study examined allocation of adolescents’ free time differs depending on financial and spatial availability by exploiting the exogenous change on the school day. Using Korea Time Use Survey data, I found that adolescents allocate free time created by Saturday without school to mainly leisure activities. I also found that adolescents’ private education and social activity time are not affected by parents’ income, but adolescents living in big (small-medium) cities spend more time on private education, social and cultural activities (screen-based activities). These results suggest that the determinants of adolescents’ free time allocation differ from those of their time use patterns, and reducing the education environment heterogeneity by region is important in bridging adolescents’ inequality of educational opportunity. Subject classification codes: I24, I28, J13, J22
FACT effectiveness in primary care; a single visit RCT for depressive symptoms
Authors: Arroll B , Frischtak H , Roskvist R , Mount V , Sundram F , Fletcher S , Kingsford DW , Buttrick L , Bricker J , van der Werf B 
Published: April 2021

Background Patients with depressive symptoms are common in primary care. Brief, simple therapies are needed. Aim Is a focussed acceptance and commitment therapy (FACT) intervention more effective than the control group for patients with depressive symptoms in primary care at one week follow up? Design and setting: A randomised, blinded controlled trial at a single primary care clinic in Auckland, New Zealand. Methods Patients presenting to their primary care practice for any reason were recruited from the clinic waiting room. Eligible patients who scored ≥2 on the PHQ-2 indicating potential depressive symptoms were randomised using a remote computer to intervention or control groups. Both groups received a psychosocial assessment using the “work-love-play” questionnaire. The intervention group received additional FACT-based behavioural activation activities. The primary outcome was the mean PHQ-8 score at one week. Results 57 participants entered the trial and 52 had complete outcome data after one week. Baseline PHQ-8 scores were similar for intervention (11.0) and control (11.7). After one week, the mean PHQ-8 score was significantly lower in the intervention group (7.4 vs 10.1 for control; p<0.039 one sided and 0.078 two sided). The number needed to treat to achieve a PHQ-8 score ≤6 was 4.0 on intention to treat analysis (p = 0.043 two sided). There were no significant differences observed on the secondary outcomes. Conclusion This is the first effectiveness study to examine FACT in any population. The results suggest that it is effective compared with control, at one week, for patients with depressive symptoms in primary care.
Body mass index increase in preschoolers with heterogeneous psychiatric diagnoses treated with risperidone
Authors: Avrahami Matan , Peskin Miriam , Moore Tyler , Drapisz Adi , Taylor Jerome , Segal-Gavish Hadar , Balan-Moshe Livia , Shachar Issac , Levy Tomer , Weizman Abraham , Barzilay Ran 
Published: April 2021

Objective: Use of risperidone in preschool-aged children is growing, with rising concerns of adverse metabolic consequences. Longitudinal data on risperidone-related weight gain in preschoolers are scarce. We aimed to evaluate changes in body mass index (BMI) that are associated with risperidone treatment in preschoolers. Method: We analyzed naturalistic, longitudinal data on 141 preschool children (112 boys, 29 girls) receiving psychiatric care. Mean patient age at baseline was 5.0 years (SD=0.8) and average follow-up period was 1.3 years (SD=0.8), with >8 mean BMI measurements per patient. We studied the effect of risperidone exposure ( n=78) on age-and-sex-standardized BMI (BMI Z-score) implementing mixed models with random subject intercepts to account for repeated measures, covarying for multiple confounders including demographics, stimulant treatment and psychiatric diagnoses. We employed similar models to study dose and duration effects. Results: Risperidone treatment was significantly associated with an increase in BMI (effect size of exposure=0.45 SD (SE=0.06), t (949)=7.7, p<0.001) covarying for stimulant exposure and other confounders, independent of treatment indication. Females exhibited stronger effects (risperidone treatment × sex interaction t=2.32, p=0.02)). Risperidone daily dose was associated with increase in BMI (for each additional 1 mg, effect size=0.28 SD (SE=0.07), t(419)=3.76, p<0.001). Conclusion: Similar to older populations, risperidone treatment in preschoolers is associated with significant weight gain, with evidence for dose effects. Findings provide critical data that can inform clinicians.
Vaccine Hesitancy and Differential Susceptibility to Media Coverage: A Critical Documentary Led to Substantial Reductions in Human Papillomavirus Vaccine Uptake in Denmark
Authors: Humlum Maria Knoth , Skipper Niels , Thingholm Peter Rønø 
Published: April 2021

Objectives To investigate whether negative media coverage of the human papillomavirus (HPV) vaccine led to a decrease in the uptake of the first dose of the HPV vaccine (HPV1) in Denmark and, importantly, whether some groups of individuals were more susceptible to negative media coverage. Methods We measured HPV vaccine uptake of 12-year-old girls born in 2001 to 2004 using Danish administrative data. A quasi-experimental design was employed to assess whether a documentary that was critical of the HPV vaccine and aired in March 2015 affected HPV uptake. Results The documentary led to a quick and substantial decrease in the monthly propensity to vaccinate, which dropped 3 percentage points—or about 50%—in response to the documentary. Responses differed substantially across subgroups, and girls from families with high socioeconomic status (SES) were more susceptible to the negative media coverage. Conclusions Susceptibility to negative media coverage varied substantially across subgroups, highlighting the need for policy makers to appropriately target and differentiate initiatives to improve vaccine compliance rates.
Predicting the Effectiveness of Endemic Infectious Disease Control Interventions: The Impact of Mass Action versus Network Model Structure
Authors: Malloy Giovanni S. P. , Goldhaber-Fiebert Jeremy D. , Enns Eva A. , Brandeau Margaret L. 
Published: April 2021

Background Analyses of the effectiveness of infectious disease control interventions often rely on dynamic transmission models to simulate intervention effects. We aim to understand how the choice of network or compartmental model can influence estimates of intervention effectiveness in the short and long term for an endemic disease with susceptible and infected states in which infection, once contracted, is lifelong. Methods We consider 4 disease models with different permutations of socially connected network versus unstructured contact (mass-action mixing) model and heterogeneous versus homogeneous disease risk. The models have susceptible and infected populations calibrated to the same long-term equilibrium disease prevalence. We consider a simple intervention with varying levels of coverage and efficacy that reduces transmission probabilities. We measure the rate of prevalence decline over the first 365 d after the intervention, long-term equilibrium prevalence, and long-term effective reproduction ratio at equilibrium. Results Prevalence declined up to 10% faster in homogeneous risk models than heterogeneous risk models. When the disease was not eradicated, the long-term equilibrium disease prevalence was higher in mass-action mixing models than in network models by 40% or more. This difference in long-term equilibrium prevalence between network versus mass-action mixing models was greater than that of heterogeneous versus homogeneous risk models (less than 30%); network models tended to have higher effective reproduction ratios than mass-action mixing models for given combinations of intervention coverage and efficacy. Conclusions For interventions with high efficacy and coverage, mass-action mixing models could provide a sufficient estimate of effectiveness, whereas for interventions with low efficacy and coverage, or interventions in which outcomes are measured over short time horizons, predictions from network and mass-action models diverge, highlighting the importance of sensitivity analyses on model structure. Highlights • We calibrate 4 models—socially connected network versus unstructured contact (mass-action mixing) model and heterogeneous versus homogeneous disease risk—to 10% preintervention disease prevalence. • We measure the short- and long-term intervention effectiveness of all models using the rate of prevalence decline, long-term equilibrium disease prevalence, and effective reproduction ratio. • Generally, in the short term, prevalence declined faster in the homogeneous risk models than in the heterogeneous risk models. • Generally, in the long term, equilibrium disease prevalence was higher in the mass-action mixing models than in the network models, and the effective reproduction ratio was higher in network models than in the mass-action mixing models.
Occurrence of spontaneous fistulas detected by contrast filling during computed tomography-guided percutaneous drainage placement of splenic and perisplenic fluid collections
Authors: Bäumler Wolf , Dollinger Marco , Rennert Janine , Beutl Michael , Stroszczynski Christian , Schicho Andreas 
Published: April 2021

Background Fistulas are serious complications of splenic and perisplenic fluid accumulations, which are often difficult to detect by routine imaging methods. Purpose To evaluate the occurrence of spontaneous fistulas detectable during computed tomography-guided percutaneous drainage placement (CTGDP) with contrast filling of splenic or perisplenic fluid collections and to assess characteristics in comparison with perihepatic or peripancreatic fluid accumulations, also being treated with CTGDP. Material and Methods In 127 CTGDP-procedures, pre-interventional CTs conducted with intravenous contrast agent were compared to post-interventional CTs including contrast filling of the drain to identify spontaneous fistulas. Patient and case characteristics were evaluated, and therapeutic consequences of fistula identification were analyzed. Results A total of 43 perisplenic, 40 peripancreatic, and 44 perihepatic drains were evaluated; 13 (30.2%) perisplenic, 7 (17.5%) peripancreatic, and 10 (22.7%) perihepatic fistulas were observed. Concerning the frequency of fistulas, no significant difference was found between the patient groups ( P = 0.39). All fistulas were solely proven in CT scans including contrast filling of the drain. Seven fistulas (23.3%) required additional interventions. Perihepatic drains were significantly more often associated with recent surgery ( P < 0.001). The mean size of peripancreatic drains was significantly greater (11.8 ± 3.9 F; P < 0.001) than in perihepatic or perisplenic fluid collections. Conclusion Spontaneous fistulas detected during CTGDP of splenic or perisplenic fluid collections are common. Post-interventional contrast filling of the drain drastically improves the detection rate of perisplenic, peripancreatic and perihepatic fistulas simultaneously initiating appropriate follow-up interventions.
Medication adherence and persistence among patients with non-small cell lung cancer receiving tyrosine kinase inhibitors and estimation of the economic burden associated with the unused medicines
Authors: Joret Romain , Matti Nazish , Beck Morgane , Michel Bruno 
Published: April 2021

Background Non–small cell lung cancer (NSCLC) is a leading cause of cancer deaths. Its treatment includes specific oral tyrosine kinases inhibitors (TKIs). Objectives To estimate adherence and persistence among patients receiving TKIs and to assess the economic burden of the unused medicines in Alsace (France). Method This retrospective study was carried out using the Insurance Healthcare database. Main outcome measures Adherence was calculated using medication possession ratio (MPR), persistence using estimated level of persistence with therapy (ELPT) and economic impact using prescription refill data. Results 242 patients were receiving TKIs. The most common TKIs prescribed were erlotinib (75.6%, n = 183) and crizotinib (12.8%, n = 31). Total of 149 patients were included in the adherence analysis. Overall MPR was 0.98. 180 patients were included in the persistence analysis. Almost half of patients had stopped treatment at 60 days and only 38.3% (n = 69) were still persistent with the therapy at 120 days. The expenses related to unused TKIs amounted to €356,392 and were related majorly to treatment discontinuation followed by overlapping refills, patient deaths and dose- or drug-switching, respectively. Conclusions Our data indicated overall adherence medicines above the acceptable limit of 0.80 but also pointed out a significant decline in persistence over time. The resulting economic losses justify the need for physicians and pharmacists to closely monitor their patients to ensure continuity of treatment. To limit the cost associated with unused medicines, interventions such as app-based monitoring, dispensing TKIs per unit over shorter periods and not only on monthly intervals could be implemented.
Immune-checkpoint inhibitor toxicity during a pandemic: Overcoming patient fears to provide care. A case report
Authors: Elder Christopher T , Davis Elizabeth C , Jaipal Stephanie , Wight Charles E 
Published: April 2021

Background Pembrolizumab is a humanized monoclonal antibody that is used to treat a variety of cancers. It exerts its mechanism of action by blocking the programmed death receptor-1 (PD-1). Toxicity concerns include immune-related toxicities, including colitis, hepatitis, pneumonitis, nephritis, endocrine toxicities and more rarely, myocarditis and other organ system toxicities. Objective To review a real-world case involving immunotherapy induced myocarditis after a patient received pembrolizumab and discuss how the current pandemic created complexity in toxicity management. Discussion An 83 year old male with metastatic lung cancer developed fatal myocarditis after receiving 2 doses of pembrolizumab. Applying the Naranjo score, the likelihood of pembrolizumab causing the myocarditis is probable, with a score of 6. Severe cardiac toxicities are rare with pembrolizumab, but can still occur. It is vital to be aware of these toxicities, and educate patients on signs and symptoms. Complicating the situation even further was the global pandemic, which created fear and hesitation in the patient and the patient’s family to seek medical treatment out of fear of exposure. This pandemic adds another layer to the complexity of care for patients with cancer and management of toxicities. Pharmacists play a significant role in ensuring the safety and efficacy of medications, especially oncology agents. Conclusion Proper education of patients regarding symptoms and when to report are paramount to assisting in early detection and intervention for immunotherapy-related adverse events. New management and treatment strategies will need to be discussed and implemented considering the changing landscape around the SARS-CoV-2 pandemic.