bluuebunny/crossref_metadata_2025 huggingface dataset:
Influencers of effective behavior change communication interventions delivered by community health workers in adults: A Scoping Review Protocol
Authors: Nagi Raunaq Singh , Prasad Pankaj , Kumar Sanjeev
Published: November 2020

Introduction

Behavior Change Communication (BCC) serves as a key pathway for delivery of messages for modifying risky behaviors such as unsafe sex, tobacco use, consumption of unhealthy diet and sedentary lifestyle. Behavior Change Communication has been successfully applied in various health conditions, settings and on different participants. In Low- and Middle-Income Countries (LMICs), the delivery of BCC is achieved through Community Health Workers (CHWs) due to limited availability of medical personnel. Current evidence indicates that delivering such interventions through CHWs is a promising approach to achieve desired behavior change and has potential to be upscaled. However, unavailability of information regarding the applicability of these interventions at different community settings, health conditions, and medium for intervention delivery, has made upscale and implementation a challenge. This scoping review will summarize the scope of settings, communication channels, and characteristics of message delivery protocols of behavior change communication interventions targeted at adults delivered via CHWs.

Methods and analysis

The scoping review methodology framework outlined by Arskey and O’Malley will guide this review. We will search the following databases, MEDLINE, ERIC, JSTOR, ScienceDirect, using pre-defined search strategy. We will include studies published in English language, without any limits on the time of publication. Firstly, titles and abstracts will be screened, followed by full-length articles, for inclusion in the review. We will extract the data in a well-defined template developed for the purpose. All the reviewers will synthesize the evidence regarding and present the results using descriptive statistics and narrative.

Ethics and dissemination

This review is being conducted as a part of a doctoral thesis approved by the institutional ethics committee. The results of this scoping review will be disseminated in the form of peer-reviewed publication, and presented in conferences and will be used to design behavior change intervention to be introduced in community.

Strengths and limitations

This will be the first scoping review to scale the community settings where behavior change communication interventions have been delivered.

This review will also scale the characteristics of such interventions, viz, modality and medium of communication, and duration and periodicity of interventions.

This review will only include articles published in English language across the named freely searchable databases.

Assessment of quality of the included studies is beyond the scope of this review and hence will not be carried out.
Integrative Analysis of Phenomic, Genomic, and Transcriptomic to Identify Potential Functional Genes of Yaks in Plain and Plateau
Authors: Wang Jiabo , Guan Jiuqiang , Yixi Kangzhu , Shu Tao , Chai Zhixin , Wang Jikun , Wang Hui , Wu Zhijuan , Cai Xin , Zhong Jincheng , Luo Xiaolin
Published: November 2020

Background

The yak is an important source of livelihood for the people living in the Qinghai-Tibet Plateau. Most genetics detection studies have focused on the comparison between different tissues of different breeds, both living in the Plateau and in the plains. The genetic background and complex regulatory relationship have frequently puzzled researchers. In this study, we divided a population of 10 yaks into two subgroups, namely Plateau (living in the Plateau) and Plain (living in the plains). Phenomic, genomic, and transcriptomic analyses were used to reveal the molecular genetic type in the body weight, slaughter, and beef quality of yaks.

Results

We found a significant difference (P <0.01) between the third (60 days), fourth (90 days), fifth (120 days), and sixth (150 days) weights of Plateau and plain subpopulations. The difference in body weight was due to differences in kidney weight, meat weight, fur weight, and head weight. However, the beef quality was not significantly different. We identified 540 Differentially Expressed Genes (DEGs). Using weighted gene co-expression network analysis (WGCNA), we have constructed a co-express network, and the modules were strongly related to traits. In the genome-wide association studies (GWAS), we detected significant 156, 52, 33, 15, and 3 signals in the meat weight, head weight, fur weight, liver weight, and the last body weight traits. Based on the epigenome-wide association studies (eWAS) results, we created a link relationship between the DEGs expression level and genotype.

Conclusion

In summary, our study demonstrated the effectiveness and representative of multidimensional data from a finite number of yak populations. The study highlights the underlying way, as well as a related network, to yield new information on genome genetics and pathogen-host interactions of both the living Plateau and plain yak populations.
CoxBase: an online platform for epidemiological surveillance, visualization, analysis and typing ofCoxiella burnetiigenomic sequences
Authors: Fasemore Akinyemi. M. , Helbich Andrea , Walter Mathias. C. , Dandekar Thomas , Vergnaud Gilles , Förstner Konrad U. , Frangoulidis Dimitrios
Published: November 2020

Q (query) fever is an infectious zoonotic disease caused by the Gram-negative bacteriaCoxiella burnetii. Although the disease has been studied since decades, it still represents a threat due to sporadic outbreaks across farms in Europe. The absence of a central platform forCoxiellatyping data management in an important epidemiological gap which is relevant in the case of an outbreak. To fill this gap, we have designed and implemented an online, open-source, and, web-based platform called CoxBase (https://coxbase.q-gaps.de). This platform includes a database that holds genotyping information of more than 400Coxiellaisolates alongside metadata that annotates them. We have also implemented features forin silicogenotyping of completely or minimally assembledCoxiellasequences using five different typing methods, querying existing isolates, visualization of isolate’s geodata via aggregation on a world map and submission of new isolates. We tested ourin silicotyping method on 50Coxiellagenomes downloaded from the RefSeq database and we successfully genotyped all except for cases where the sequence quality was poor. We identified new spacer sequences using our implementation of the MSTin silicotyping method, and established adaA gene phenotypes for all 50 genomes as well as their plasmid types.
Genome Scale-Differential Flux Analysis reveals deregulation of lung cell metabolism on SARS Cov2 infection
Authors: Nanda Piyush , Ghosh Amit
Published: November 2020

The COVID-19 pandemic is posing an unprecedented threat to the whole world. In this regard, it is absolutely imperative to understand the mechanism of metabolic reprogramming of host human cells by SARS Cov2. A better understanding of the metabolic alterations would aid in design of better therapeutics to deal with COVID-19 pandemic. We developed an integrated genome-scale metabolic model of normal human bronchial epithelial cells (NHBE) infected with SARS Cov2 using gene-expression and macromolecular make-up of the virus. The reconstructed model predicts growth rates of the virus in high agreement with the experimental measured values. Furthermore, we report a method for conducting genome-scale differential flux analysis (GS-DFA) in context-specific metabolic models. We apply the method to the context-specific model and identify severely affected metabolic modules predominantly comprising of lipid metabolism. We conduct an integrated analysis of the flux-altered reactions, host-virus protein-protein interaction network and phospho-proteomics data to understand the mechanism of flux alteration in host cells. We show that several enzymes driving the altered reactions inferred by our method to be directly interacting with viral proteins and also undergoing differential phosphorylation under diseased state. In case of SARS Cov2 infection, lipid metabolism particularly fatty acid oxidation and beta-oxidation cycle along with arachidonic acid metabolism are predicted to be most affected which confirms with clinical metabolomics studies. GS-DFA can be applied to existing repertoire of high-throughput proteomic or transcriptomic data in diseased condition to understand metabolic deregulation at the level of flux.
The Company Canids Confront: Spatiotemporal Partitioning at Local Scales Facilitates Carnivore Coexistence at the Landscape Level
Authors: Devarajan Kadambari , Vanak Abi Tamim
Published: November 2020

Canids are the most widely distributed carnivores in the world. The increasing impacts of commensal carnivores such as free-ranging dogs on wildlife communities has resulted in an urgent need to understand putative interactions within carnivore guilds. It is thus imperative to understand the processes driving canid assemblages in different landscapes and at multiple spatial and temporal scales, in order to conserve and manage wildlife communities. Here, we demonstrate the complex interactions and spatiotemporal dynamics underlying the coexistence of co-occurring carnivores in a landscape modified by the invasive,Prosopis juliflora. We investigated spatial, temporal, and habitat partitioning within a guild of four co-occurring canids in the arid northwest of India. The results indicate complex associations between the study species, where co-occurrence at the local spatial scale between species corresponds with temporal partitioning. Our study offers evidence that avoidance at the local scale and coexistence at the landscape scale are maintained in co-occurring intra-guild carnivores that are of similar body size through both facultative and behavioral character displacement such as temporal partitioning. It has also resulted in essential baseline information on the occurrence and distribution patterns of multiple canids in a human-dominated and understudied landscape threatened by global change. Understanding these biotic and abiotic drivers that impact carnivore guilds is crucial for the conservation and management of communities at the landscape scale.
CSF1R-dependent macrophages control postnatal somatic growth and organ maturation
Authors: Keshvari Sahar , Caruso Melanie , Teakle Ngari , Batoon Lena , Sehgal Anuj , Patkar Omkar L. , Ferrari-Cestari Michelle , Snell Cameron E. , Chen Chen , Stevenson Alex , Davis Felicity M. , Bush Stephen J. , Pridans Clare , Summers Kim M. , Pettit Allison R. , Irvine Katharine M. , Hume David A.
Published: November 2020

Homozygous mutation of theCsf1rlocus (Csf1rko) in mice, rats and humans leads to multiple postnatal developmental abnormalities. To enable analysis of the mechanisms underlying the phenotypic impacts ofCsf1rmutation, we bred a ratCsf1rkoallele to the inbred dark agouti (DA) genetic background and to aCsf1r-mApple reporter transgene. TheCsf1rkoled to almost complete loss of embryonic macrophages and ablation of most adult tissue macrophage populations. We extended previous analysis of theCsf1rkophenotype to early postnatal development to reveal impacts on musculoskeletal development and proliferation and morphogenesis in multiple organs. Expression profiling of 3-week old wild-type (WT) andCsf1rkolivers identified 2760 differentially expressed genes associated with the loss of macrophages, severe hypoplasia, delayed hepatocyte maturation, disrupted lipid metabolism and the IGF1/IGF binding protein system. OlderCsf1rkorats developed severe hepatic steatosis. Consistent with the developmental delay in the liverCsf1rkorats had greatly-reduced circulating IGF1. Transfer of WT bone marrow (BM) cells at weaning without conditioning repopulated resident macrophages in all organs, including microglia in the brain and reversed the mutant phenotypes enabling long term survival and fertility. WT BM transfer restored osteoclasts, eliminated osteopetrosis, restored bone marrow cellularity and architecture and reversed granulocytosis and B cell deficiency.Csf1rkorats had an elevated circulating CSF1 concentration which was rapidly reduced to WT levels following BMT. However, CD43hinon-classical monocytes, absent in theCsf1rko, were not rescued and bone marrow progenitors remained unresponsive to CSF1. The results demonstrate that theCsf1rkophenotype is autonomous to BM-derived cells and indicate that BM contains a progenitor of tissue macrophages distinct from hematopoietic stem cells. The model provides a unique system in which to define the pathways of development of resident tissue macrophages and their local and systemic roles in growth and organ maturation.
Experimental evaluation of thermodynamic speed limit in living cells via information geometry
Authors: Ashida Keita , Aoki Kazuhiro , Ito Sosuke
Published: November 2020

Chemical reactions are responsible for information processing in living cells, and thermodynamic trade-off relations can explain their accuracy and speed. Its experimental test in living cells had not existed despite its importance because it is hard to justify sample size sufficiency. This paper reports the first experimental test of the thermodynamic trade-off relation, namely the thermodynamic speed limit, in living systems at the single-cell level where the sample size is relatively small. Due to the information-geometric approach, we can demonstrate the thermodynamic speed limit for the extracellular signal-regulated kinase phosphorylation using time-series fluorescence imaging data. Our approach quantifies the intrinsic speed of cell proliferation and can potentially apply other signal transduction pathways to detect their information processing speed.

One-Sentence Summary

Experimental measurement of information thermodynamic speed by fluorescence imaging in living cells
Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe
Authors: Sri-Pathmanathan Clarisse , Nhamo Definate , Mamvuto Takudzwa , Chapwanya Gwendoline , Terris-Prestholt Fern , Mahaka Imelda , Marks Michael , Tucker Joseph D.
Published: November 2020

Objectives

Self-testing for STIs such as HIV and syphilis may empower sexual minorities and expand uptake of STI testing. While much is known about HIV self-testing (HIVST), less is known about syphilis self-testing, particularly in low-income settings. The objective of this study is to determine context-specific facilitators and barriers for self-testing and to assess the usability of syphilis self-testing in Zimbabwe among men who have sex with men (MSM).

Methods

This mixed methods study was conducted in Harare as part of a larger syphilis self-testing trial. The study included in-depth interviews (phase one) followed by usability testing and a second interview (phase two). In-depth interviews were conducted with MSM and key informants prior to syphilis self-testing. The same MSM then used the syphilis self-test, quantitatively assessed its usability and participated in a second in-depth interview. Phase one data was analysed using a thematic approach, guided by an adapted Social Ecological Model conceptual framework. Phase two interviews were analysed using Rapid Assessment Procedure qualitative methodology, and usability was assessed using a pre-established index, adapted from existing HIVST evaluation scales.

Results

Twenty MSM and 10 key informants were recruited for phase one in-depth interviews and 16 of these MSM participated in phase two by completing a syphilis self-test kit. Facilitating factors for self-testing included the potential for increased privacy, convenience, autonomy and avoidance of social and healthcare provider stigma. Barriers included the fear to test and uncertainty about linkage to care and treatment. Data from the usability index suggested high usability (89.6% on a 0-100 scale) among the men who received the self-test.

Conclusions

MSM in Zimbabwe were willing to use syphilis self-test kits and many of the barriers and facilitators were similar to those observed for HIVST. Syphilis self-testing may increase syphilis test uptake among sexual minorities in Zimbabwe and other low- and middle-income countries.

Key messages

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Syphilis self-testing is an empowering, innovative tool that can be used to expand uptake of STI testing among sexual minorities in Zimbabwe.

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Facilitators and barriers for syphilis self-testing are similar to those observed for HIV self-testing in Zimbabwe and other low- and middle-income countries.

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Participants reported high self-test usability and found that self-testing provided increased privacy, convenience and autonomy in comparison to facility-based testing.
New Lisbon Airport: Politics of a Mega-Project
Authors: Huber Hans
Published: November 2020

One can trace territorial planning for a New Lisbon Airport back to the post-Salazarian 1970s. In the new millennium, the project has encountered new obstacles such as regional political movements and the post-2007 financial crisis that seriously challenged government plans. The case seeks to analyse the project in terms of space and time while comparing it with alternatives that emerged in the process of planning and politics.
Amadubi Rural Tourism Project in Jharkhand: Development of Project Risk Management (A)
Authors: Dutta Goutam , Santra Sumitro
Published: November 2020

Rural Tourism is an important feature in development of emerging states in India. This case study, an UNDP funded project with ministry of Tourism, GOI, focuses the problem faced by a NGO in developing a rural tourism in Jharkhand in India for a decade. The management issues are feasibility and financial viability, lack of project and infrastructure planning, role of government agencies. The case stresses need of project risk management in this type of private partner partnership
Ownership Retention Terms in Sale Contracts Gone Astray: PST Energy 7 Shipping v.O.W. Bunker Malta Limited
Authors: Pathak Akhileshwar
Published: November 2020

‘Title retention Clause’ was introduced in sale of goods contracts to prevent the transfer of ownership till the seller was fully paid. Exigencies of businesses have led to introduction of further clauses allowing the buyer to use or sub-sell the goods even before the transfer of ownership. The conflicting provisions, as the judgment of the United Kingdom Supreme Court in PST Energy 7 Shipping v O.W. Bunker Malta Limited brings out, changes the very character of the contract. The contract fails to be a contract of sale of goods depriving the parties of the valuable rights.
Employee Resistance to Change: Is it the Message or the Messenger?
Authors: Kulkarni Vaibhavi
Published: November 2020

The case revolves around a change initiative introduced in the Indian division of a US-based organization operating in the field of building and composite glass materials. The case has been written from the perspective of Sreenath, who has recently joined as the country head, and has identified a four-point change agenda as part of his aggressive growth strategy. These changes pertain to shift in market focus, revised annual targets, reorganization of the sales and marketing vertical and revised compensation structure with increase in variable pay. However, Sreenath's communication with his team regarding the changes indicates that he is likely to face resistance during change implementation.
Attention Passengers: Your Flight has been Delayed
Authors: Kulkarni Vaibhavi
Published: November 2020

The case explicates a situation wherein an international flight from Newark to Ahmedabad, with a stopover in Mumbai, is delayed during the final leg of its journey between Mumbai and Ahmedabad. The situation is further exacerbated by the fact that all international and domestic passengers are already on board when they face this five-hour delay. The case provides a rich context to discuss issues related to difficult communication and persuasion during crisis. The captain communicates with the passengers, through a series of announcements, with updates on the situation. He attempts to manage the escalating tension within the airplane and does succeed to a certain level. The case highlights the significance of timely and well-crafted messages during crisis situations. It also illuminates how the use of rhetorical strategies influence customer perception of credibility and at times, shift attribution of blame.
An efficient local search for large-scale set-union knapsack problem
Authors: Zhou Yupeng , Zhao Mengyu , Fan Mingjie , Wang Yiyuan , Wang Jianan
Published: November 2020

Purpose

The set-union knapsack problem is one of the most significant generalizations of the Non-deterministic Polynomial (NP)-hard 0-1 knapsack problem in combinatorial optimization, which has rich application scenarios. Although some researchers performed effective algorithms on normal-sized instances, the authors found these methods deteriorated rapidly as the scale became larger. Therefore, the authors design an efficient yet effective algorithm to solve this large-scale optimization problem, making it applicable to real-world cases under the era of big data.

Design/methodology/approach

The authors develop three targeted strategies and adjust them into the adaptive tabu search framework. Specifically, the dynamic item scoring tries to select proper items into the knapsack dynamically to enhance the intensification, while the age-guided perturbation places more emphasis on the diversification of the algorithm. The lightweight neighborhood updating simplifies the neighborhood operators to reduce the algorithm complexity distinctly as well as maintains potential solutions. The authors conduct comparative experiments against currently best solvers to show the performance of the proposed algorithm.

Findings

Statistical experiments show that the proposed algorithm can find 18 out of 24 better solutions than other algorithms. For the remaining six instances on which the competitor also achieves the same solutions, ours performs more stably due to its narrow gap between best and mean value. Besides, the convergence time is also verified efficiency against other algorithms.

Originality/value

The authors present the first implementation of heuristic algorithm for solving large-scale set-union knapsack problem and achieve the best results. Also, the authors provide the benchmarks on the website for the first time.
Enhancing student engagement through heterogeneous pedagogical approaches: action research in a university level course in Saudi Arabia
Authors: Asif Muhammad , Thomas George , Awan Muhammad Usman , Muhammad Din Asfa
Published: November 2020

Purpose

Previous studies have mainly discussed the impact of student engagement on different facets of academic performance. Research on the approaches to promote student engagement in a classroom setting (i.e., micro-level practices) is relatively sparse. This paper provides a framework for enhancing student engagement in a university undergraduate classroom setting.

Design/methodology/approach

This study builds on action research. At the core of this approach is making interventions through a set of pedagogical approaches, derived from the literature. The impact of these interventions was measured, followed by reflections on the outcomes and developing a future improvement strategy.

Findings

Student engagement can be enhanced by using heterogeneous pedagogical approaches that positively influence student performance. Further, the use of mixed pedagogical approaches helps students and teachers acquire meta-cognitive knowledge (i.e., knowledge of their learning preferences) and sets the direction for learning.

Research limitations/implications

The key contribution of this study is providing a student engagement framework applicable in a sophomore-level classroom setting. The framework discusses a set of techniques, their theoretical underpinnings, the course of their execution and the challenges faced in this process. The framework can be used to guide enhancing student engagement.

Originality/value

Contrary to the macro-level measures, research on micro-level measures for promoting student engagement approaches is scarce. This study discusses not only different strategies but also details the dynamic course of their deployment. The study, therefore, is unique in its contribution.
Country-of-origin as a dynamic concept: an analysis of Chinese consumer electronics brands in Germany
Authors: Polfuß Jonas , Sönmez Dilara
Published: November 2020

Purpose

Using consumer electronics brands as examples, this paper aims to present country-of-origin (COO) as a dynamic concept, by analyzing changes in the representation and perception of the “Made in China” label in Germany.

Design/methodology/approach

Building on previous COO research, the study formulates four research questions, which are answered with a comprehensive brand analysis using website, media, and consumer data. Information were collected from 11 Chinese brand websites, 10,681 German media articles and a sample of 490 German consumers. The authors statistically evaluated the survey data and examined the website and media data by means of a qualitative content analysis.

Findings

The results of the study show how Chinese brands currently present their COO in Germany and how the perception of “Made in China,” by German media and consumers, has changed to varying degrees. These changes pose marketing challenges for the increasingly prevalent Chinese brands in Germany, which need to be addressed by companies using strategic PR and marketing activities.

Research limitations/implications

This study suggests that COO images should be understood as a dynamic construct, and the multifaceted brand perceptions, including media reports, should be given greater consideration.

Practical implications

International marketers will find information on current country product recognition, and recommendations for the analysis and strategic communication of (Chinese) brands abroad.

Originality/value

This study contributes to COO research by examining the recent status of “Made in China” labels in Germany, focusing on China not as a manufacturing location, but as the home country for branded products. A media analysis is incorporated to add a novel dimension to the examination of brand identity-image gaps.
Embedding sustainability dimensions in university collections management: a “scientific journey” into a natural history museum
Authors: Magliacani Michela , Sorrentino Daniela
Published: November 2020

Purpose

The purpose of this research aims at extending the knowledge on whether and how universities include sustainability dimensions in managing their collections. Precisely, the study focusses on the creation of a university museum (UM), as an embryonic stage of life during which management concerns both strategic and operational issues.

Design/methodology/approach

Sustainability is envisioned as a multifaceted concept, composed of the economic, cultural, environmental and social dimensions. Resorting to an acknowledged theoretical model for sustainable development in museum management, a qualitative interpretative study is carried out, gathering data from multiple sources. The empirical setting is the University of Pavia, which has recently created a new Museum of Natural History (Kosmos).

Findings

Results highlight how sustainability dimensions intertwin in UM creation. Moreover, the economic dimension emerges as a basement for the others. Value for the community, expressed in economic terms, must be ensured in UMs creation as well as throughout its entire life, in order to support cultural, environmental and social sustainability.

Research limitations/implications

Focussing on the embryonic stage of UMs life allowed to consider how sustainability is embedded in relevant strategic and operational decisions. Nevertheless, scholars are encouraged to replicate the study in other stages of UMs' life, in a way to provide insights on its dynamics.

Practical implications

University collections managers can benefit from this research by acknowledging the role played by the economic dimension of sustainability. Notwithstanding their mission, universities should pay attention to extracting economic value from the management of their collections, as a means to ensure innovative and sustainable management on the cultural, environmental and social respects. Furthermore, this research suggests how a higher education system is able to create a new museum by relying on interdisciplinary competencies, which support sustainability since the embryonic stage.

Originality/value

This research contributes to the cultural heritage management literature by proposing an updated version of the sustainable development model for museums, which highlights the different relevance of the sustainability dimensions with particular regard to the UM creation and management.
Late Ottoman period preventive health institutions in Istanbul: an architectural approach
Authors: Gider Sümeyye , Gül Ünal Zeynep
Published: November 2020

Purpose

The preventive health institutions were founded in Istanbul as a result of the Ottoman Empire's policy to fight epidemic diseases that affected all parts of the world in the nineteenth century. The purpose of this paper is to examine the historical and current state of these heritage buildings.

Design/methodology/approach

Through the original documents, photographs and floor plans dating nineteenth and early twentieth century obtained from the Ottoman State Archives, historical development and architectural features of the buildings have been identified. And the original geographical locations of the buildings, especially the destroyed ones, are investigated by the historic maps. Plan and façade features, construction techniques are examined according to the information gained from the newspapers, journals and health annuals of the period.

Findings

This paper presents the findings of an MSc thesis conducted on the historical approach of preventive health institutions and preservation problems of the Pendik Institute of Veterinary Bacteriology. In the study, it has been examined that institutes in five different functions which were established after the foundation of the Quarantine Council in 1838 with parallel to the course of epidemics and scientific development in the West. In Istanbul, eight quarantine stations, three disinfection stations, one rabies laboratory, one vaccination institute and five bacteriology institutes have been documented. Some of these institutions fell out of use due to the loss of their original function and have been abandoned and demolished, some of them have survived with functional changes. The extant samples of these preventive health institutions are studied on the purpose of investigating their conditions of preservation.

Originality/value

Late Ottoman period preventive health institutions in Istanbul have been the subject of the researches within the field of medicine and science history to date. There is no study in Turkish and International literature discussing these institutions in terms of architecture. In the study these buildings have been thoroughly examined based on their architectural features and heritage values. The glass plate photographs of the Pendik Institute of Veterinary Bacteriology, floor plans and some photographs of the other institutions which are obtained from Ottoman State Archives and newspapers of the period have been published for the first time in this paper.
Halting and Reversing Escalation in the South China Sea: A Bargaining Framework
Authors: Vuković Siniša , Alfieri Riccardo
Published: November 2020

Escalating tensions in South China Sea have epitomized US–China relations for nearly a decade. Warning signs of a possible collision between a rising China and steadfast US, bring to light the need to think about ways that can halt and reverse the intensification of their confrontational moves. The historical trends regarding the freedom of the seas suggest that a way out of this predicament is possible through negotiations. The tenets of the freedom of the seas seem to prevail once they begin to serve the challenger’s interest. Yet, the path toward interest alignment between the challenger and the norm‐maker, in this case between China and the US, depends on their ability to avoid any miscalculation that can provoke further escalation of tensions, which in turn may lead to violent confrontation between nuclear powers. A particular historical precedent between the US and Soviet Union demonstrates that a compromised solution can be found in upholding the normative framework based on the Law of the Sea Convention (UNCLOS). Emulating this approach may help the parties to avoid an unnecessary and avoidable military gamble in South China Sea.
Links between perinatal risk factors and maternal psychological distress: A network analysis
Authors: Speyer Lydia Gabriela , Hall Hildigunnur Anna , Ushakova Anastasia , Murray Aja Louise , Luciano Michelle , Auyeung Bonnie
Published: November 2020

Introduction

This paper explores a range of perinatal risk factors that may increase maternal vulnerability to postnatal psychological distress in a sample of 17 531 women participating in the Millennium Cohort Study, a diverse British, longitudinal birth cohort study.

Material and methods

Using a graphical network modeling framework, this study models the links between postnatal psychological distress and perinatal risk factors, while controlling for sociodemographic factors and history of depression and anxiety. Postnatal psychological distress was assessed at 9 months postpartum using the Rutter Malaise Inventory.

Results

Results of the graphical network models indicate that lower levels of happiness about the pregnancy (Edge weight [w] = 0.084, 95% CI = 0.069‐0.100,b = 0.095), smoking during pregnancy (w = 0.026, 95% CI = −0.009‐0.060,b = 0.029), infection during pregnancy (w = 0.071, 95% CI = 0.024‐0.118,b = 0.090), hyperemesis gravidarum (w = 0.068, 95% CI = 0.013‐0.123,b = 0.083), baby in special care (w = 0.048, 95% CI = −0.004‐0.099,b = 0.062), not being white (w = 0.101, 95% CI = 0.062‐0.140,b = 0.118), being from a more deprived area (w = −0.028, 95% CI = −0.051 to −0.005,b = −0.039), lower income (w = −0.025, 95% CI = −0.055‐0.005,b = −0.036), and history of depression or anxiety (w = 0.574, 95% CI = 0.545‐0.603,b = 0.764) were associated with increased psychological distress.

Conclusions

Some perinatal risk factors may be directly associated with postnatal psychological distress, but many risk factors appear to be primarily associated with demographic factors. This emphasizes the importance of taking a holistic approach when evaluating an individual's risk of developing postnatal psychological distress.
Parental experiences of their infant’s hospital admission undergoing cardiac surgery: A systematic review
Authors: de Man Marjorie A.C.P. , Segers Elisabeth W. , Schappin Renske , van der Leeden Kees , Wösten‐van Asperen Roelie M. , Breur Hans , de Weerth Carolina , van den Hoogen Agnes
Published: November 2020

Aim

To explore parents’ experiences of parenting a child hospitalised with congenital heart disease (CHD) and undergoing surgery.

Methods

Five electronic databases were systematically searched for articles describing the experiences of parents with a child with a CHD. A thematic analysis approach was used to identify the most common themes.

Results

A total of 188 articles were identified. Eight studies were included in the review. Four themes emerged, including balancing the parental role, experiencing anticipatory grief, decreasing parental stress using coping strategies and professional support.

Conclusion

Having a child with CHD undergoing heart surgery is a stressful experience due to, among other things, the different situation‐related parenting role during the hospital stay and feelings of anticipatory grief. Healthcare professionals in the PICU have an essential role in supporting parents and understanding the needs that are crucial for the parents in order to provide better support and reduce stress and anxiety. More qualitative research regarding the pathway from the prenatal diagnosis through the early childhood period is warranted.
Forecasting future dental health expenditures: Development of a framework using data from 32 OECD countries
Authors: Jevdjevic Milica , Listl Stefan , Beeson Morgan , Rovers Maroeska , Matsuyama Yusuke
Published: November 2020

Objective

To (1) develop a framework for forecasting future dental expenditures, using currently available information, and (2) identify relevant research and data gaps such that dental expenditure predictions can continuously be improved in the future.

Methods

Our analyses focused on 32 OECD countries. Dependent on the number of predictors, we employed dynamic univariate and multivariate modelling approaches with various model specifications. For univariate modelling, an auto‐regressive (AR) dynamic model was employed to incorporate historical trends in dental expenditures. Multivariate modelling took account of historical trends, as well as of relationships between dental expenditures, dental morbidity, economic growth in terms of gross domestic product and demographic changes.

Results

Estimates of dental expenditures varied substantially across different model specifications. Models relying on dental morbidity as one of the predictors performed worst regardless of their specification. Using the best‐fitted model specification, that is the univariate second‐order autoregression [AR(2)], the forecasted dental expenditures across 32 OECD countries amounted to US$316bn (95% forecasted interval, FI: 258‐387) in 2020, US$434bn (95%FI: 354‐532) in 2030 and US$594bn (95%FI: 485‐728) in 2040. Per capita spending in 2040 was forecasted to be highest in Germany (US$889, 95%FI: 726‐1090) and lowest in Mexico (US$52, 95%FI: 42‐64).

Conclusions

The present study demonstrates the feasibility and challenges in predicting dental expenditures and can serve as a basis for improvement towards more sustainable and resilient health policy and resource planning. Within the limitations of available data sources, our findings suggest that dental expenditures in OECD countries could increase substantially over the next two decades and vary considerably across countries. For more accurate estimation and a better understanding of determinants of dental expenditures, more comprehensive data on dental spending and dental morbidity are urgently needed.
Provozieren konvergierende zelluläre und Signalübertragungs‐Störungen die atopische Dermatitis?
Authors: Elias Peter M. , Wakefield Joan S.
Published: November 2020

Diverse vererbte und erworbene Störungen epidermaler Strukturproteine und Enzyme beeinträchtigen Permeabilität, Barrierefunktion und antimikrobielle Abwehr bei atopischer Dermatitis (AD). Obwohl verschiedene Mutationen in Filaggrin (FLG) überwiegen, sind Veränderungen in anderen S‐100‐Vorstufen‐Proteinen des cornified envelope (Hornerin [HRNR], Filaggrin 2 [FLG2], SPRR3, Mattrin), die die Bildung der Lamellarkörperchen (lamellar bodies) regulieren, unabhängig voneinander mit dem AD‐Phänotyp assoziiert: SPINK5, das einen Serin‐Protease‐Inhibitor kodiert, LEKTI1, und ein Fettsäuretransporter, FATP4. Exogene und endogene Stressoren, wie anhaltender psychischer Stress, geringe Umgebungsfeuchtigkeit oder Kontakt zu basischen Seifen und Tensiden können die Barrierefunktion zusätzlich beeinträchtigen und die Erkrankung auslösen. Aus immunologischer Perspektive ist die Barrierestörung nur deshalb relevant, da sie Antigenen und Pathogenen Zutritt ermöglicht, während sie die Produktion von Th2‐Zytokinen stimuliert. Diese Proteine regulieren wiederum das Niveau Lipid‐synthetisierender Enzyme und antimikrobieller Peptide sowie vieler epidermaler Strukturproteine, wie Filaggrin, herunter. Jede vererbte und erworbene Störung kann unabhängig voneinander die Produktion der Sekretion der Lamellarkörperchen beeinträchtigen, was zu fehlerhafter Organisation der Lamellarmembran und der antimikrobiellen Abwehr führt. Darüber hinaus ist ein erhöhter pH‐Wert des Stratum corneum für die AD‐Pathogenese kritisch, da er die postsekretorische Lipidverarbeitung beeinträchtigt, während er gleichzeitig die Entzündung verstärkt. Es gibt zahlreiche therapeutische Optionen, die die verschiedenen Stadien dieses pathogenen Prozesses unterbrechen können.
Überdiagnose von Melanomen – Ursachen, Konsequenzen und Lösungsansätze
Authors: Kutzner Heinz , Jutzi Tanja B. , Krahl Dieter , Krieghoff‐Henning Eva I. , Heppt Markus V. , Hekler Achim , Schmitt Max , Maron Roman C. R. , Fröhling Stefan , von Kalle Christof , Brinker Titus J.
Published: November 2020

Das maligne Melanom ist diejenige Form von Hautkrebs, an der die meisten Menschen sterben. Im Frühstadium ist das Melanom gut behandelbar, eine Früherkennung ist also lebenswichtig. Kritiker bemängeln, dass seit der bundesweiten Einführung des Hautkrebs‐Screenings häufiger Melanome diagnostiziert werden, die Sterblichkeit am malignen Melanom jedoch nicht zurückgegangen ist. Sie führen dies vor allem auf Überdiagnosen zurück. Ein Grund ist die zum Teil komplexe Unterscheidung zwischen benignen und malignen Läsionen. Hinzu kommt, dass es auch Übergangsformen zwischen eindeutig gut‐ oder bösartigen Läsionen geben kann, und dass einige bösartige Läsionen so wenig aggressiv wachsen, dass sie nie lebensbedrohlich geworden wären. Bisher kann mangels entsprechender Biomarker nicht festgestellt werden, bei welchen Melanomen dies der Fall ist. Auch die Progressionswahrscheinlichkeit eines In‐situ‐Melanoms zu einem invasiven Tumor kann bisher nicht sicher beurteilt werden. Die Konsequenzen für überdiagnostizierte benigne Läsionen sind unnötige psychische und körperliche Belastungen für die Betroffenen und anfallende Therapiekosten. Umgekehrt können Unterdiagnosen zu gravierenden Einschränkungen der Prognose der Betroffenen und zur Notwendigkeit belastender(er) Therapien führen. Präzisere Diagnosemöglichkeiten könnten die Anzahl der korrekten Diagnosen erhöhen. Hier haben sich in Studien mit auf künstlicher Intelligenz basierenden Assistenzsystemen bereits erste Erfolge gezeigt, die allerdings noch in die klinische und pathologische Routine übertragen werden müssen.
Neurostimulation therapies in major depressive disorder: A decision‐analytic model
Authors: Teng Monica , Khoo Ai Leng , Zhao Ying Jiao , Abdin Edimansyah , Mok Yee Ming , Lim Boon Peng , Tor Phern Chern
Published: November 2020

Aim

Neurostimulation techniques are effective treatments for major depressive disorders (MDD). However, the optimal sequence of electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) as part of antidepressant treatment algorithm is unclear. We examined the cost‐effectiveness of ECT and TMS in MDD.

Methods

A decision‐analytic model was developed to determine total costs, quality‐adjusted life‐years (QALYs) and incremental cost‐effectiveness ratios (ICERs) for 10 strategies. Each strategy comprised four treatment lines with ECT and TMS incorporated as second, third, or fourth line. A scenario analysis that explored the cost‐effectiveness of maintenance approach by continuing ECT and TMS after acute treatment was performed.

Results

In the base case, fourth‐line TMS after three preceding trials of antidepressants was least costly at US$ 5523 yielding 1.424 QALYs. Compared with this strategy, fourth‐line ECT and third‐line TMS followed by ECT were cost‐effective with ICERs of US$ 7601 per QALY gained and US$ 11 388 per QALY gained, respectively. In the scenario analysis where continuation treatments of ECT and TMS were provided, third‐line TMS followed by ECT was cost‐effective, with an ICER of US$ 17 198 per QALY gained. Effectiveness of ECT and cost of managing severe depression were influential parameters affecting the cost‐effectiveness results.

Conclusions

In acute treatment of MDD, fourth‐line ECT was the most cost‐effective strategy. In maintenance treatment, the strategy that incorporated third‐line TMS and fourth‐line ECT was cost‐effective. The overall findings confirmed the value of neurostimulation therapies which should be offered early in the process of managing depression.
Cell type‐specific genetic reconstitution of CB1 receptor subsets to assess their role in exploratory behaviour, sociability, and memory
Authors: De Giacomo Vanessa , Ruehle Sabine , Lutz Beat , Häring Martin , Remmers Floortje
Published: November 2020

Several studies support the notion that exploratory behaviour depends on the functionality of the cannabinoid type 1 (CB1) receptor in a cell type‐specific manner. Mice lacking the CB1 receptor in forebrain GABAergic or dorsal telencephalic glutamatergic neurons have served as essential tools revealing the necessary CB1 receptor functions in these two neuronal populations. However, whether these specific CB1 receptor populations are also sufficient within the endocannabinoid system for wild‐type‐like exploratory behaviour has remained unknown. To evaluate cell‐type‐specific sufficiency of CB1 receptor signalling exclusively in dorsal telencephalic glutamatergic neurons (Glu‐CB1‐RS) or in forebrain GABAergic neurons (GABA‐CB1‐RS), we utilised a mouse model in which CB1 receptor expression can be reactivated conditionally at endogenous levels from a complete CB1‐KO background. The two types of conditional CB1‐rescue mice were compared with CB1 receptor‐deficient [no reactivation (Stop‐CB1)] and wild‐type [ubiquitous reactivation of endogenous CB1 receptor (CB1‐RS)] controls to investigate the behavioural consequences. We evaluated social and object exploratory behaviour in four different paradigms. Remarkably, the reduced exploration observed in Stop‐CB1 animals was rescued in Glu‐CB1‐RS mice and sometimes even surpassed CB1‐RS (wild‐type) exploration. In contrast, GABA‐CB1‐RS animals showed the lowest exploratory drive in all paradigms, with an even stronger phenotype than Stop‐CB1 mice. Interestingly, these effects weakened with increasing familiarity with the environment, suggesting a causal role for altered neophobia in the observed phenotypes. Taken together, using our genetic approach, we were able to substantiate the opposing role of the CB1 receptor in dorsal telencephalic glutamatergic versus forebrain GABAergic neurons regarding exploratory behaviour.