bluuebunny/crossref_metadata_2025 huggingface dataset:
Human umbilical cord-derived mesenchymal stem/stromal cells: a promising candidate for the development of advanced therapy medicinal products
Authors: Mebarki Miryam , Abadie Camille , Larghero Jérôme , Cras Audrey
Published: February 2021

Umbilical cord-derived mesenchymal stem/stromal cells (UC-MSCs) emerge as a perspective for therapeutic use in immune and inflammatory diseases. Indeed, immunomodulatory and anti-inflammatory properties, associated to fewer ethical, availability, and safety issues, position UC-MSCs as a promising active substance to develop medicinal products. Since 2007, UC-MSC-based products are classified as advanced therapy medicinal products (ATMP) according to the European Regulation 1394/2007/EC. This new regulatory status required a total adaptation of stakeholders wishing to develop UC-MSC-based ATMPs. Cell production in tissue and cell banks has been replaced by the manufacturing of a medicine, in authorized establishments, according to the good manufacturing practices (GMP) specific to ATMPs. After a brief description of UC-MSCs, we described in this review their recent use in a large panel of immune and inflammatory pathologies, including early and late phase clinical trials. Despite the use of the same product, we noticed an important heterogeneity in terms of indication, posology and study design. Then, we discussed regulatory and manufacturing challenges for stakeholders, especially in terms of process harmonization and cells characterization. Our aim was to point that despite MSCs use for several decades, the development of an UC-MSC-based ATMP remains at this day a real challenge for both academic institutions and pharmaceutical companies.
“Top-down bottom-up” estimation of per capita cost of new-born care interventions in four regions of Ghana: beyond implementation to scalability and sustainability
Authors: Alhassan Robert Kaba , Nketiah-Amponsah Edward , Twum-Danso Nana A. Y. , Bawa John , Kwarah Williams , Ucer Sebnem , Ibn Abass Abdul Fatawu
Published: February 2021

Background

Limited financial, human and material health resources coupled with increasing demand for new-born care services require efficiency in health systems to maximize the available sources for improved health outcomes. Making Every Baby Count Initiative (MEBCI) implemented by local and international partners in 2013 in Ghana aimed at attaining neonatal mortality of 21 per 1000 livebirths by 2018 in four administrative regions in Ghana. MEBCI interventions benefited 4027 health providers, out of which 3453 (86%) were clinical healthcare staff.

Objective

Determine the per capita cost of the MEBCI interventions towards enhancing new-born care best practices through capacity trainings for frontline clinical and non-clinical staff.

Methods

Parameters for determining per capita cost of the new-born care interventions were estimated using expenditure on trainings, supervisions, monitoring and evaluation, advocacy, administrative/services and medical logistics. Data collection started in October 2017 and ended in September 2018. Data sources for the per capita cost estimations were invoices, expense reports and ledger books at the national, regional and district levels of the health system.

Results

Total of 4027 healthcare providers benefited from the MEBCI training activities comprising of 3453 clinical staff and 574 non-clinical personnel. Cumulative cost of implementing the MEBCI interventions did not necessarily match the cost per capita in staff capacity building; average cost per capita for all staff (clinical and non-clinical staff) was approximately US$ 982 compared to a per capita cost of US$ 799 for training only core clinical staff. Average cost per capita for all regions was approximately US$ 965 for all staff compared to US$ 777 per capita cost for only clinical staff. Per capita cost of training was relatively lower in regions with more staff than regions with lower numbers, perhaps due to economies of scale.

Conclusion

The MEBCI intervention had a wide coverage in terms of training for frontline healthcare providers albeit the associated cost may be potentially unsustainable for Ghana’s health system. Emerging digital training platforms could be leveraged to reduce per capita cost of training. Large-scale on-site batch-training approach could also be replaced with facility-based workshops using training of trainers (TOTs) approach to promote efficiency.
Dapagliflozin attenuates hypoxia/reoxygenation-caused cardiac dysfunction and oxidative damage through modulation of AMPK
Authors: Tsai Kun-Ling , Hsieh Pei-Ling , Chou Wan-Ching , Cheng Hui-Ching , Huang Yu-Ting , Chan Shih-Hung
Published: February 2021

Background

Emerging evidence demonstrated dapagliflozin (DAPA), a sodium-glucose cotransporter 2 inhibitor, prevented various cardiovascular events. However, the detailed mechanisms underlying its cardioprotective properties remained largely unknown.

Results

In the present study, we sought to investigate the effects of DAPA on the cardiac ischemia/reperfusion (I/R) injury. Results from in vitro experiments showed that DAPA induced the phosphorylation of AMPK, resulting in the downregulation of PKC in the cardiac myoblast H9c2 cells following hypoxia/reoxygenation (H/R) condition. We demonstrated that DAPA treatment diminished the H/R-elicited oxidative stress via the AMPK/ PKC/ NADPH oxidase pathway. In addition, DAPA prevented the H/R-induced abnormality of PGC-1α expression, mitochondrial membrane potential, and mitochondrial DNA copy number through AMPK/ PKC/ NADPH oxidase signaling. Besides, DAPA reversed the H/R-induced apoptosis. Furthermore, we demonstrated that DAPA improved the I/R-induced cardiac dysfunction by echocardiography and abrogated the I/R-elicited apoptosis in the myocardium of rats. Also, the administration of DAPA mitigated the production of myocardial infarction markers.

Conclusions

In conclusion, our data suggested that DAPA treatment holds the potential to ameliorate the I/R-elicited oxidative stress and the following cardiac apoptosis via modulation of AMPK, which attenuates the cardiac dysfunction caused by I/R injury.
On the fractional p-Laplacian problems
Authors: Choi Q-Heung , Jung Tacksun
Published: February 2021

This paper deals with nonlocal fractionalp-Laplacian problems with difference. We get a theorem which shows existence of a sequence of weak solutions for a family of nonlocal fractionalp-Laplacian problems with difference. We first show that there exists a sequence of weak solutions for these problems on the finite-dimensional subspace. We next show that there exists a limit sequence of a sequence of weak solutions for finite-dimensional problems, and this limit sequence is a sequence of the solutions of our problems. We get this result by the estimate of the energy functional and the compactness property of continuous embedding inclusions between some special spaces.
Cluster randomised controlled feasibility study of HENRY: a community-based intervention aimed at reducing obesity rates in preschool children
Authors: Bryant Maria , Collinson Michelle , Burton Wendy , Stamp Elizabeth , Schofield Holly , Copsey Bethan , Hartley Suzanne , Webb Edward , Farrin Amanda J.
Published: February 2021

Background

Community-based obesity prevention interventions are often commissioned despite the limited evidence base. HENRY (Health, Exercise, Nutrition for the Really Young) is a programme delivered to parents of preschool children across the UK. Early evidence suggests that it may be effective, but a robust evaluation has not been conducted. We initiated a systematic evaluation of HENRY by studying the feasibility of conducting a multi-centre definitive trial to evaluate its effectiveness and cost-effectiveness to prevent obesity. Objectives were to assess the feasibility of recruiting local authorities, centres and parents; test processes and time required to train and certify intervention staff; explore HENRY commissioning processes; identify potential sources (and associated impact) of contamination; and consider the feasibility of trial procedures.

Methods

We conducted a multi-centre, open labelled, two group, prospective, cluster randomised, controlled, feasibility study, with embedded process evaluation and pre-defined criteria for progression to definitive trial. We sought to recruit 120 parents from 12 children’s centres, across two UK local authority (government) areas. Within each local authority, we planned to randomise three centres to HENRY and three to ‘standard care’ control. Our plan was to collect data in family homes at baseline and 12 months, including parent and child height and weight, and parent-reported questionnaires on self-efficacy, feeding, eating habits, quality of life and resource use. Contamination, implementation and study acceptability were explored using parent interviews.

Results

We recruited two local authorities and 12 children’s centres within eight months. One hundred and seventeen parents were recruited (average 3.9 parents per programme) and follow-up data were collected from 85% of participants. Process data from 20 parents and 24 members of staff indicate that both would benefit from more detail about their involvement as participants, but that methods were acceptable. Contamination was likely, though the impact of this on behaviour was unclear.

Conclusion

Our findings indicate that a cluster RCT of HENRY to assess its effect on childhood obesity prevention is feasible. This study has allowed us to design a pragmatic definitive trial with minimal bias, taking account of lessons learnt from conducting evaluation research in public health settings.

Trial registration

ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017.
British and Japanese international retirement migration and creative responses to health and care challenges: a bricolage perspective
Authors: Hall Kelly , Ono Mayumi , Kohno Ayako
Published: February 2021

Most research on international retirement migration has focused on the Western context and the motivations and lifestyle choices of migrants when they are healthy. This paper instead explores how British retirees in Spain and Japanese retirees in Malaysia respond to declining health and increasing care needs through bricolage as they begin to ‘age in place’. The paper combines qualitative interviews, focus groups and observations collected by the authors from 215 British and Japanese international retirement migrants. We focus on two key types of bricolage behaviour: ‘within-system bricolage’ undertaken by migrants to help them access and navigate existing health and care systems; and ‘added-to-system bricolage’ that is enacted to fill gaps in health and care provision. Our analysis suggests that IRMs engage in ‘transnational care bricolage’ by combining multiple economic, social and legal resources across local and transnational spaces to address their health and care needs.
Community-driven citizen science approach to explore cardiovascular disease risk perception, and develop prevention advocacy strategies in sub-Saharan Africa: a programme protocol
Authors: Okop Kufre Joseph , Murphy Kathy , Lambert Estelle Victoria , Kedir Kiya , Getachew Hailemichael , Howe Rawleigh , Niyibizi Jean Berchmans , Ntawuyirushintege Selemani , Bavuma Charlotte , Rulisa Stephen , Kasenda Stephen , Chipeta Effie , Bunn Christopher , Crampin Amelia C. , Chapotera Gertrude , King Abby C. , Banchoff Ann , Winter Sandra J. , Levitt Naomi S.
Published: February 2021

Background

In sub-Saharan Africa (SSA), which experiences a disproportionately high cardiovascular disease (CVD) burden, population-based screening and prevention measures are hampered by low levels of knowledge about CVD and associated risk factors, and inaccurate perceptions of severity of risk.

Methods

This protocol describes the planned processes for implementing community-driven participatory research, using a citizen science method to explore CVD risk perceptions and to develop community-specific advocacy and prevention strategies in the rural and urban SSA settings. Multi-disciplinary research teams in four selected African countries will engage with and train community members living in rural and urban communities as citizen scientists to facilitate conceptualization, co-designing of research, data gathering, and co-creation of knowledge that can lead to a shared agenda to support collaborative participation in community-engaged science. The emphasis is on robust community engagement, using mobile technology to support data gathering, participatory learning, and co-creation of knowledge and disease prevention advocacy.

Discussion

Contextual processes applied and lessons learned in specific settings will support redefining or disassembling boundaries in participatory science to foster effective implementation of sustainable prevention intervention programmes in Low- and Middle-income countries.
Design of PSMA ligands with modifications at the inhibitor part: an approach to reduce the salivary gland uptake of radiolabeled PSMA inhibitors?
Authors: Felber Veronika Barbara , Valentin Manuel Amando , Wester Hans-Jürgen
Published: February 2021

Aim

To investigate whether modifications of prostate-specific membrane antigen (PSMA)-targeted radiolabeled urea-based inhibitors could reduce salivary gland uptake and thus improve tumor-to-salivary gland ratios, several analogs of a high affinity PSMA ligand were synthesized and evaluated in in vitro and in vivo studies.

Methods

Binding motifs were synthesized ‘on-resin’ or, when not practicable, in solution. Peptide chain elongations were performed according to optimized standard protocols via solid-phase peptide synthesis. In vitro experiments were performed using PSMA+ LNCaP cells. In vivo studies as well as μSPECT/CT scans were conducted with male LNCaP tumor xenograft-bearing CB17-SCID mice.

Results

PSMA ligands with A) modifications within the central Zn2+-binding unit, B) proinhibitor motifs and C) substituents & bioisosteres of the P1′-γ-carboxylic acid were synthesized and evaluated. Modifications within the central Zn2+-binding unit of PSMA-10 (Glu-urea-Glu) provided three compounds. Thereof, only natLu-carbamate I (natLu-3) exhibited high affinity (IC50 = 7.1 ± 0.7 nM), but low tumor uptake (5.31 ± 0.94% ID/g, 1 h p.i. and 1.20 ± 0.55% ID/g, 24 h p.i.). All proinhibitor motif-based ligands (three in total) exhibited low binding affinities (> 1 μM), no notable internalization and very low tumor uptake (< 0.50% ID/g). In addition, four compounds with P1′-ɣ-carboxylate substituents were developed and evaluated. Thereof, only tetrazole derivative natLu-11 revealed high affinity (IC50 = 16.4 ± 3.8 nM), but also this inhibitor showed low tumor uptake (3.40 ± 0.63% ID/g, 1 h p.i. and 0.68 ± 0.16% ID/g, 24 h p.i.). Salivary gland uptake in mice remained at an equally low level for all compounds (between 0.02 ± 0.00% ID/g and 0.09 ± 0.03% ID/g), wherefore apparent tumor-to-submandibular gland and tumor-to-parotid gland ratios for the modified peptides were distinctly lower (factor 8–45) than for [177Lu]Lu-PSMA-10 at 24 h p.i.

Conclusions

The investigated compounds could not compete with the in vivo characteristics of the EuE-based PSMA inhibitor [177Lu]Lu-PSMA-10. Although two derivatives (3 and 11) were found to exhibit high affinities towards LNCaP cells, tumor uptake at 24 h p.i. was considerably low, while uptake in salivary glands remained unaffected. Optimization of the established animal model should be envisaged to enable a clear identification of PSMA-targeting radioligands with improved tumor-to-salivary gland ratios in future studies.
What are the key themes associated with the positive learning experience in MOOCs? An empirical investigation of learners’ ratings and reviews
Authors: Deng Ruiqi , Benckendorff Pierre
Published: February 2021

Past MOOC research has tended to focus on learning outcomes valued in traditional higher education settings, such as achievement and retention. This study recognises that student ratings are an important alternative outcome measure in MOOCs. This paper adopted a semiautomatic text mining approach to collect and analyse 8475 ratings and reviews submitted for 1794 MOOCs. The analysis revealed six important themes that contributed to positive ratings: ‘learning’, ‘understanding’, ‘interesting’, ‘videos’, ‘recommend’, and ‘questions’. The paper then investigated the characteristics of each identified theme based on the proximity of themes, distribution of concepts within themes, and important connections. Based on research findings, the paper presents the following propositions to assist educators and providers to enhance the learning experience in MOOCs: (1) provide realistic learning contexts and instructional conditions in MOOCs to facilitate the acquisition of knowledge that transfers more readily to real-world practices; (2) carefully design the instructional conditions so that some mental challenge and stimulation is required for learners to achieve a full understanding of the content, rather than making MOOCs too simple or effortless to complete; (3) design the course content, materials, and communications to generate interest; (4) allocate sufficient resources to create high-quality video lectures; (5) employ video lectures to elicit positive emotions from MOOC learners and simplify complex, difficult concepts; and (6) incorporate discussion boards in MOOCs and invest in human and digital resources to address learners’ queries.
Differential expression of viral pathogen-associated molecular pattern receptors mRNA in Egyptian chronic hepatitis C virus patients
Authors: Suef Reda A. , Mohamed Ezz Elden M. , Mansour Mohamed T. M. , Weigand Kilian , Farag Mohamed M. S.
Published: February 2021

Background

One possible mechanism utilized by hepatitis C virus (HCV) to escape from the host’s innate immune surveillance is modification of its pathogen-associated molecular patterns (PAMPs) by altering or hiding its RNA which interfering with toll-like receptors (TLRs) signaling and ultimately hindering the production of proinflammatory cytokines, chemokines, and interferons (IFNs). This study aimed to examine the expression levels of TLR3, TLR7, and IFN-α to investigate the correlated expression pattern among them in chronic HCV patients. Patients included in this study were categorized into two different groups, non-treated chronic HCV patients and treated chronic HCV patients, in addition to healthy volunteers as a control group. The blood samples were assessed for HCVAb, HCVRNA, HCV genotypes, and different biochemical analyses. The mRNA levels of TLR3, TLR7, and IFN-α in peripheral blood of chronic HCV patients were quantitatively measured in comparison to healthy controls.

Results

The expression levels of TLR3, TLR7, and IFN-α were significantly downregulated in non-treated chronic HCV patients compared to both treated HCV patients and control subjects. On the other hand, treated HCV patients showed non-significant downregulation of the same three sensing receptors (TLR3, TLR7, and IFN-α) compared to control group. Obviously, the expression levels of IFN-α were positively correlated with the levels of both TLR3 and TLR7.

Conclusion

The exhausted innate immunity against HCV may correlate to HCV downregulation of TLR3 and TLR7 expression on innate immune cells with a subsequent decrease in INF-α production and the possibility of targeting these receptors to enhance the immune response and clear the infection needs further studies.
Urinary epidermal growth factor as a marker for lupus nephritis: clinical, laboratory, and histopathological study
Authors: Hefny Hesham M. , Abualfadl Esam M. , Youssef Emad A. M. , Ismail Mohamed Ali , Soliman Tamer M. , Ahmed Ahmed Roshdi Hamed , Abozaid Hanan S. M.
Published: February 2021

Background

Lupus nephritis can be seen in up to 60% of all SLE patients with 10–15% of nephritis patients progressing to end-stage renal disease; late diagnosis of lupus nephritis is correlated with a higher frequency of renal insufficiency. The study aim is determination of the value of urinary human epidermal growth factor (urinary EGF) as an early biomarker of lupus nephritis in SLE patients and its relevance to disease activity and renal histopathology.

Results

The study included 58 SLE patients and 30 healthy controls; a significant difference was noticed between SLE and controls in urinary protein, creatinine, protein/creatinine ratio, and urinary EGF. The mean level of urinary EGF was less in classes IV and V renal nephritis than in classes I, II, and III.

There is a significant difference in urinary EGF (33±29, 27±16, P = 0.04) between class II and class III lupus nephritis, with no significant differences in urinary protein, creatinine, protein/creatinine ratio, and SLEDAI. On the other hand, the comparison between classes II and IV showed significant difference not only in urinary EGF (33±29, 11.7±4.9 m, P=0.003), but also in SLEDAI (37.4±8, 70.5±27, P= 0.007), and protein/creatinine ratio (0.98±0.62, 3±1.8, P=0.006).

Conclusion

This study raises the attention to test the sensitivity of urinary EGF in detecting the early and the subsequent changes in renal pathology of SLE patients as an easy, non-invasive, accurate, cheap marker that could help in following up the nephritis progression and adjusting the plan of treatment; also, it can be used to guide the time of biopsy or as an alternative in cases where renal biopsy is contraindicated.
The First Cardiac Anesthesiology Fellow, William A. Lell: A Brief History
Authors: Reves J.G.
Published: February 2021

Fifty years ago, on August 1, 1971, William A. Lell became the first cardiac anesthesia fellow at Harvard’s Massachusetts General Hospital (MGH) Department of Anesthesiology, training with the world’s first group of anesthesiologists whose clinical practice, teaching, and research efforts were exclusively devoted to cardiac anesthesia. Lell’s early interest in cardiovascular medicine and how mentors, particularly at the MGH, influenced his early career development are recounted. The challenges a young pioneer faced in establishing and maintaining an academic cardiac anesthesia program during the initial and rapid growth of an exciting new subspecialty are described. Dr Lell’s experience emphasizes the importance of seizing new opportunities and establishing meaningful working relationships with colleagues based on mutual trust as fundamental to successful career development and research in a new medical subspecialty.
Catalytic Roles and Synergetic Effects of Iron-Group Elements on Monometals and Alloys for Electrochemical Oxidation of Ammonia
Authors: Kitano Sho , Ooi Mei Lee , Yamamoto Tomokazu , Matsumura Syo , Yamauchi Miho
Published: February 2021

Electrooxidation of NH3 has gained extensive attention for energy and environmental applications such as fuel cells and water purification. Pt-based precious metal alloy catalysts have been intensively studied as anode catalysts for the NH3 electrooxidation whereas applicability of earth-abundant transition metals to catalysts has not been sufficiently examined. In this study, we synthesized carbon-supported simple metal-nanoparticle, binary- and ternary-nanoalloy (NA) catalysts composed of Fe-group elements, i.e., Fe, Co and Ni, and systematically investigated catalytic performance of these catalysts for NH3 electrooxidation in alkaline media. We found that the affinity of constituent metals to nitrogen species controls overpotential and durability for the NH3 electrooxidation on Fe-group simple monometal and NA catalysts for the first time. Furthermore, each Fe-group element shows distinctive catalytic features for the NH3 electrooxidation, i.e., Ni ensures chemical stability, Fe effectively lowers overpotential and Co increases current density. The ternary FeCoNi/C shows excellent activities due to combination of all the catalytic features and synergetic effects exerted by the alloying.
Tariff Pass-Through at the Border and at the Store: Evidence from US Trade Policy
Authors: Cavallo Alberto , Gopinath Gita , Neiman Brent , Tang Jenny
Published: February 2021

We use microdata collected at the border and the store to characterize the price impact of recent US trade policy on importers, exporters, and consumers. At the border, import tariff pass-through is much higher than exchange rate pass-through. Chinese exporters did not lower their dollar prices by much, despite the recent appreciation of the dollar. By contrast, US exporters significantly lowered prices affected by foreign retaliatory tariffs. In US stores, the price impact is more limited, suggesting that retail margins have fallen. Our results imply that, so far, the tariffs’ incidence has fallen in large part on US firms. (JEL E31, F13, F14, F31, L11)
“Soft” Affirmative Action and Minority Recruitment
Authors: Fershtman Daniel , Pavan Alessandro
Published: February 2021

We study search, evaluation, and selection of candidates of unknown quality for a position. We examine the effects of “soft” affirmative action policies increasing the relative percentage of minority candidates in the candidate pool. We show that, while meant to encourage minority hiring, such policies may backfire if the evaluation of minority candidates is noisier than that of nonminorities. This may occur even if minorities are at least as qualified and as valuable as nonminorities. The results provide a possible explanation for why certain soft affirmative action policies have proved counterproductive, even in the absence of (implicit) bias. (JEL J15, J23, J24, M51)
Roadblocks to Integration; Faculty’s perspective on transition from Traditional to Integrated Medical Curriculum
Authors: Hafeez Asma , Jamil Brekhna , Khan Aaiz Feroze
Published: February 2021

Objective: This study was conducted to explore the faculty’s opinion regarding factors impeding practical transition from traditional to integrated medical curriculum at the outset and a few years after the process.

Methods: This qualitative exploratory study was conducted from April 2018 to October 2018 at two undergraduate medical colleges; one where integrated curriculum was at the outset and the second running it successfully. A total of 12 semi-structured interviews (six from each college) were recorded and transcribed. Thematic content analysis was carried out and faculty’s perceptions about factors impeding practical transition to integrated curriculum were explored at two stages, i.e., at the outset and after its implementation.

Results: Four impediments identified at the outset were deemed genuine by faculty who had gone through the experience including, faculty’s resistance, lack of training, lack of incentives, and insufficient resources. Four more impediments were identified after the experience including lack of leadership, lack of attention to faculty’s concerns, lack of communication and difficulties in setting appropriate assessment.

Conclusions: Several factors if ignored can result in failure of integration of curriculum in undergraduate medical colleges. Relevantly appropriate policies should be outlined by the regulatory body to ensure the control on the impediments.

doi: https://doi.org/10.12669/pjms.37.3.3217

How to cite this:Hafeez A, Jamil B, Khan AF. Roadblocks to Integration; Faculty’s perspective on transition from Traditional to Integrated Medical Curriculum. Pak J Med Sci. 2021;37(3):788-793. doi: https://doi.org/10.12669/pjms.37.3.3217

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Regional disparities in postnatal care among mothers aged 15-49 years old in Indonesia
Authors: Cahyono Mochammad Nur , Efendi Ferry , Harmayetty Harmayetty , Adnani Qorinah Estiningtyas Sakilah , Hung Hsiao Ying
Published: February 2021

Background: In Indonesia, maternal mortality remains high, significantly 61.59% occur in the postnatal period. Postnatal care (PNC) provision is a critical intervention between six hours and 42 days after childbirth and is the primary strategy to reduce maternal mortality rates. However, underutilization of PNC in Indonesia still remains high, and limited studies have shown the regional disparities of PNC in Indonesia.

Methods: This study aims to explore the gaps between regions in PNC service for mothers who have had live births during the last five years in Indonesia. This study was a secondary data analysis study using the Indonesian Demographic and Health Survey (IDHS) in 2017. A total of 13,901 mothers aged 15-49 years having had live births within five years were included. Chi-squared test and binary logistic regression were performed to determine regional disparities in PNC.

Results: Results indicated that the prevalence of PNC service utilization among mothers aged 15-49 years was 70.94%. However, regional gaps in the utilization of PNC service were indicated. Mothers in the Middle of Indonesia have used PNC services 2.54 times compared to mothers in the East of Indonesia (OR = 2.54; 95% CI = 1.77-3.65, p<0.001). Apart from the region, other variables have a positive relationship with PNC service, including wealth quintile, accessibility health facilities, age of children, childbirth order, mother's education, maternal occupation, husband's age, and husband's education.

Conclusion: Structured policies are needed to reduce gaps in areas with low service utilization. Developing innovative strategies to address PNC inequality in maternal services to improve maternal health is expected.
Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology
Authors: Marques Marta M. , Carey Rachel N. , Norris Emma , Evans Fiona , Finnerty Ailbhe N. , Hastings Janna , Jenkins Ella , Johnston Marie , West Robert , Michie Susan
Published: February 2021

Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project.

Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) and publishing online.

Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational, Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it.

Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.
Pharmaceutical industry, academia and people with experience of mental illness as partners in research: a need for ethical guidance
Authors: Lignou Sapfo , Singh Ilina
Published: February 2021

Background: Several social and policy developments have led to research partnerships in mental health research, which depart from traditional research models. One form of such partnerships is among Research institutions, Industry (pharmaceutical and biotech) and People with lived experience of mental illness (RIPs) in the NIHR services. There are several benefits but also challenges in such partnerships. An ethics-based approach to anticipating and addressing such problems is lacking. Given the expansion of RIPs in treatment development for mental health illness, guidance to support ethical and effective collaborations in NIHR-funded mental health research is essential.

Methods: To develop a moral framework for evaluating the ethics of RIPs, we systematically searched PubMed for peer-reviewed literature discussing good practices in research partnerships. Searches were also conducted in websites of known organizations supporting patient engagement with industry in mental health research and in the references of short-listed articles. Following application of exclusion criteria, remaining articles were critically examined and summarised to synthesise principles for ethical RIPs and inform clear guidance and practices.

Results: Critical analysis and synthesis of the short-listed articles highlighted the need for two sets of principles to guide ethical RIPs: principles for (a) RIPs as a trustworthy enterprise and (b) fair RIPs. We discuss the application of these principles in problem-solving strategies that can support best practice in establishing fair and effective research partnerships among research institutions, industry and people with lived experience of mental illness in the NIHR services.

Conclusions: Ethical guidance is needed to prevent and address challenges in RIPs and to promote the scientific and social benefits of these new research partnership models in mental health research in the NIHR services. We show how the proposed moral framework can guide research partners in designing, sustaining and assessing ethical and effective mental health research collaborations.
Experiences of lockdown during the Covid-19 pandemic: descriptive findings from a survey of families in the Born in Bradford study
Authors: Dickerson Josie , Kelly Brian , Lockyer Bridget , Bridges Sally , Cartwright Christopher , Willan Kathryn , Shire Katy , Crossley Kirsty , Bryant Maria , Sheldon Trevor A. , Lawlor Deborah A. , Wright John , McEachan Rosemary R C , Pickett Kate E. ,   on behalf of the Bradford Institute for Health Research Covid-19 Scientific Advisory Group
Published: February 2021

Background: Lockdown measures implemented to contain the Covid-19 virus have increased health inequalities, with families from deprived and ethnically diverse backgrounds most likely to be adversely affected. This paper describes the experiences of families living in the multi-ethnic and deprived city of Bradford, England.

Methods: A wave of survey data collection using a combination of email, text and phone with postal follow-up during the first Covid-19 UK lockdown (10th April to 30thJune 2020) with parents participating in two longitudinal studies. Cross tabulations explored variation by ethnicity and financial insecurity. Text from open questions was analysed using thematic analysis.

Results: Of 7,652 families invited, 2,144 (28%) participated. The results presented are based on the 2,043 (95%) mothers’ responses: 957 (47%) of whom were of Pakistani heritage, 715 (35%) White British and 356 (18%) other ethnicity 971 (46%) lived in the most deprived decile of material deprivation in England. and 738 (37%) were financially insecure.

Many families lived in poor quality (N=574, 28%), overcrowded (N=364, 19%) housing. Food (N=396, 20%), employment (N=728, 37%) and housing (N=204, 10%) insecurities were common, particularly in those who were furloughed, self-employed not working or unemployed. Clinically important depression and anxiety were reported by 372 (19%) and 318 (16%) mothers. Ethnic minority and financially insecure families had a worse experience during the lockdown across all domains, with the exception of mental health which appeared worse in White British mothers.  Open text responses corroborated these findings and highlighted high levels of anxiety and fear about Covid-19.

Conclusions: There is a need for policy makers and commissioners to better support vulnerable families during and after the pandemic. Future work will use longitudinal data from before the pandemic, and from future surveys during the pandemic, to describe trajectories and the long-term consequences of the pandemic on vulnerable populations.
General Analysis of the Shape of Two Similar Second-Order Surfaces’ Intersection Line
Authors: Ivaschenko A. , Vavanov D.
Published: February 2021

The presented paper is devoted to classification questions of fourth-order spatial curves, obtained as a result of intersection of non-degenerate second-order surfaces (quadrics) from the point of view of the forms of the original quadrics generating this curve. At the beginning of the paper is performed a brief historical overview of appearance of well-known and widely used curves ranging from ancient times and ending with the current state in the theory of curves and surfaces. Then a general analysis of the influence of the shape parameters and the relative position of original surfaces on the shape of the resulting curve and some of its parameters (number of components, presence of singular points, curve components flatness or spatiality) is carried out. Curves obtained as a result of intersection of equitype surfaces are described in more detail. The concept of interacting surfaces is introduced, various possible cases of the forms of the quadrics generating the curve are analyzed. A classification of fourth-order curves based on the shape parameters and relative position of second-order surfaces is proposed as an option. Illustrations of the resulting curve shapes with different shape parameters and location of generating quadrics are given. All surfaces and curves are considered in real affine space, taking into account the possibility of constructing them using descriptive geometry methods. Possible further research directions related to the analysis of the curves under discussion are briefly considered. In addition, are expressed hypotheses related to these curves use in the process of studying by students of technical universities the courses in analytical geometry, descriptive geometry, differential geometry and computer graphics. The main attention is paid to forms, therefore a wide variability of the surface shape in the framework of its described equation has been shown, provided by various values of numerical parameters.
Augmenting Medical Diagnosis Decisions? An Investigation into Physicians’ Decision-Making Process with Artificial Intelligence
Authors: Jussupow Ekaterina , Spohrer Kai , Heinzl Armin , Gawlitza Joshua
Published: February 2021

Systems based on artificial intelligence (AI) increasingly support physicians in diagnostic decisions, but they are not without errors and biases. Failure to detect those may result in wrong diagnoses and medical errors. Compared with rule-based systems, however, these systems are less transparent and their errors less predictable. Thus, it is difficult, yet critical, for physicians to carefully evaluate AI advice. This study uncovers the cognitive challenges that medical decision makers face when they receive potentially incorrect advice from AI-based diagnosis systems and must decide whether to follow or reject it. In experiments with 68 novice and 12 experienced physicians, novice physicians with and without clinical experience as well as experienced radiologists made more inaccurate diagnosis decisions when provided with incorrect AI advice than without advice at all. We elicit five decision-making patterns and show that wrong diagnostic decisions often result from shortcomings in utilizing metacognitions related to decision makers’ own reasoning (self-monitoring) and metacognitions related to the AI-based system (system monitoring). As a result, physicians fall for decisions based on beliefs rather than actual data or engage in unsuitably superficial evaluation of the AI advice. Our study has implications for the training of physicians and spotlights the crucial role of human actors in compensating for AI errors.
Content-Based Model of Web Search Behavior: An Application to TV Show Search
Authors: Liu Jia , Toubia Olivier , Hill Shawndra
Published: February 2021

We develop a flexible content-based search model that links the content preferences of search engine users to query search volume and click-through rates, while allowing content preferences to vary systematically based on the context of a search. Content preferences are defined over latent topics that describe the content of search queries and search result descriptions. Compared with existing applications of topic modeling in marketing and recommendation systems, our proposed approach can simultaneously capture multiple types of information and investigate multiple aspects of behavioral dynamics in a single framework that enables interpretable results for business decision making. To facilitate efficient and scalable inference, we develop a full Bayesian variational inference algorithm. We evaluate our modeling framework using real-world search data for TV shows from the Bing search engine. We illustrate how our model can quantify the content preferences associated with each query and how these preferences vary systematically based on whether the query is observed before, during, or after a TV show is aired. We also show that our model can help the search engine improve its ranking of search results as well as address the cold-start problem for new page links.

This paper was accepted by Hamid Nazerzadeh, big data analytics.
On a Deterministic Approximation of Inventory Systems with Sequential Service-Level Constraints
Authors: Wei Lai , Jasin Stefanus , Xin Linwei
Published: February 2021

Solving Inventory Models with Service-Level Constraints by Using a Deterministic Approximation
How Do Institutional Carriers Alleviate Normative and Cognitive Barriers to Regulatory Change?
Authors: Armanios Daniel Erian , Eesley Charles E.
Published: February 2021

How do we reconcile misalignments between a system’s existing normative and cognitive elements and novel regulatory change? Prior work either largely focuses only on regulatory change or analyzes normative and cognitive barriers in parallel to rather than in interaction with regulatory change. Moreover, the institutional entrepreneurship literature that focuses on reconciling such misalignments is predominantly centered on the tactics of entrepreneurs rather than the support provided by institutional carriers. We, therefore, use the case of the Chinese Academy of Sciences (CAS) Knowledge Innovation Program (KIP) to better understand these neglected facets of institutional change. Through a mixed methods approach, we posit and find support for two key mechanisms that support regulatory change. First, institutional carriers (e.g., CAS institutes) clarify the market relevance of technical knowledge, linking cognitive support to regulatory change. Second, institutional carriers (e.g., science parks) create shared standards that could not occur otherwise, linking normative support to regulatory change. Finally, these changes to institutions seem particularly associated with more nascent clusters. Our study contributes to studies at the nexus between institutional change and entrepreneurship by highlighting the role of linking cognitive and normative support to regulatory changes aimed at increasing entrepreneurship.
Strategic management as an enabler of co-creation in public services
Authors: Ongaro Edoardo , Sancino Alessandro , Pluchinotta Irene , Williams Hannah , Kitchener Martin , Ferlie Ewan
Published: February 2021

The current transformations in society, the economy and the public sector call for the development of more unified theoretical frameworks. This article takes the literature on strategic management as a theoretical entry angle and aims to better understand how the adoption of models of strategic management can enable processes of public value co-creation. Utilising the literature centred on the notion of ‘schools of thought’ in the strategic management of public services, the article discusses how co-creation as a mode of governance in public services can contribute to innovative public service solutions and value co-creation. The Welsh Water’s ‘Water Resilient Community’ – a project characterised by long-term strategic planning as well as by local innovation – is used to illustrate the argument. Four propositions on the drivers/enablers and key managerial issues for undertaking a strategic approach to co-creation as a mode of governance are offered to enhance future practice, research and theory.
Intrusion behavior classification method applied in a perimeter security monitoring system
Authors: Mi Qiushi , Yu Houdan , Xiao Qian , Wu Hongyan
Published: February 2021

A distributed optic fiber perimeter security system is proved to be an effective strategy for the security monitoring of some vital targets, such as power plants, power substations and telecommunication base stations. However, this method can hardly distinguish different categories of the intrusion behavior and is easily mis-triggered by different kinds of environmental interference. To distinguish different intrusion patterns and different interference events effectively, a vibration pattern recognition algorithm is proposed and demonstrated based on the merged Sagnac interferometer structure. The method consists of two parts: the pre-processing algorithm and the multi-layer perceptron neural networks (MLP-NNs). The pre-processing algorithm is applied to retrieve and extract the vibration signal from the captured source signal, and the MLP-NN is used to realize pattern recognition from each type of input. Typically, a high-dimensional vector group which contains hundreds of orders of vibration signal’s power frequency is obtained to cover as many signalized features as possible. Moreover, results of the experiment deployed on a 10 kilometer long perimeter fence in the transformer substation show that the proposed classification-based model achieves 97.6% classification accuracy in the test. Through multiple comparison tests, the proposed model gives a solid performance in the subsequent integrated evaluation to classify each intrusion pattern.
Propagation and transformation of a light beam on a curved surface
Authors: Shao Ziqiu , Wang Zhaoying
Published: February 2021

Starting from the wave equation with a non-zero space curvature, a generalized coordinate-independent expression for the evolution of a light beam on a curved space is derived. By defining the propagation axes, the expression reduces to integrable Green functions without an inevitable singular point. With a Gaussian incident field, the stationary status and refocusing effect of the light field on different shapes of curved surfaces are discussed. Different from a constant diffusion behavior in a flat space, the field experiences a periodical diffraction and refocusing spontaneously with no additional optical elements. To be more specific, we noticed that the laser field on a curved surface experiences a fractional Fourier transform, with a propagation angle to be the transform order. We hope our theoretical results can provide some references for the practical application in a curved surface space.