bluuebunny/crossref_metadata_2025 huggingface dataset:
Does work commitment and job satisfaction matter to junior high school teachers in the Philippines?
Authors: Caleja Heidi Belle Francisco , Averion Rebecca Fullero
Published: November 2020

This study finds out the relationship between work performance and job satisfaction among teachers of junior high schools in Philippines. They were well aware of the facts of their job satisfaction, e.g., school policies, supervision methods, pay and other benefits, relationships between faculty and students, further growth and promotions, workplace conditions, achievement and recognition, and responsibility and accountability. It was concluded that teachers’ job satisfaction could produce an effectiveness and sustainability in educational institutions. Using a descriptive method, a non-probability convenience sampling was employed for 70 public school teachers. Two existing validated questionnaires were used: the Three-Component Model Employee Commitment Survey, to surface the level of work commitment of teachers in an organisation; and Job Satisfaction Survey, to evaluate the teachers’ overall job satisfaction. Findings show a significant relationship between work commitment and job satisfaction, specifically in terms of position and educational level. In addition, teachers are satisfied with the people within the organisation; however, it also shows that teachers are not satisfied with too much paper work. It is recommended that teachers should consider the teaching job as a profession and as a vocation.

 

Keywords: High schools in Philippines, job satisfaction, descriptive method, work commitment.
Folds trending at various angles to the transport direction in the Marcq area, Brabant Massif, Belgium
Authors: DEBACKER Timothy
Published: November 2020

Generally folds in fold belts are expected to trend approximately parallel to the main axis of the fold belt. Indeed, most of the fold hinge lines along the southern rim of the poorly exposed Lower Palaeozoic Brabant Massif reflect the general trend of the massif (transverse folds). However, in some places, folds exist oriented at high angles to the general trend of the massif (longitudinal folds).
New field work in the Marcq area, situated in the southwestern part of the Brabant Massif, reveals the presence of transverse, longitudinal and oblique asymmetric folds. Direct field observations, combined with borehole and geophysical data, indicate the presence of a low-angle high-strain zone, interpreted as a reverse shear zone. The various fold orientations are explained by means of differential movement within this shear zone. All the structural features are considered to be the result of one single progressive deformation.
Although this shear zone is probably of minor regional significance, the kinematic inferences made in the Marcq area may have important implications for the outline of the overall tectonic image of the southwestern part of the Brabant Massif.
Infrared emission spectroscopy study of the dehydroxylation of 10 Å halloysite from a Neogene cryptokarst of South Belgium
Authors: KLOPROGGE J. Theo , FROST Ray L.
Published: November 2020

The dehydroxylation of 10 Å halloysite from the Wellin (Weillen) cryptokarst (southern Belgium) was studied in situ by applying infrared emission spectroscopy. Dehydroxylation is evidenced by the loss of the OH-stretching modes between 3600 and 3700 cm-1. A slow decrease of all intensities up to ± 500 °C is observed followed between 500° and 550 °C by a rapid decrease to almost zero. The IES bands at 920 and 938 cm-1, attributed to the accompanying inner and outer or inner sheet Al-OH libration modes, are removed on heating at the same rate and disappears at the same temperature as the OH-stretching bands. The low frequency bands that disappear upon heating are associated with OH-libration (920 and 938 cm-1) or OH-translation modes (798, 754 and 693 cm-1). At high temperatures only very broad bands around 800 cm-1, a weak shoulder around 900 cm-1 and two broad bands around 1000 and 1175 cm-1 are observed. The first two are associated with newly formed Al-O bonds whereas the other two are associated with Si-O bonds in the dehydroxylated halloysite, an X-ray amorphous mullite-like phase.
K-MEANS CLUSTER ANALYSIS OF SUB-DISTRICTS IN SIDOARJO BASED ON LONG-TERM CONTRACEPTIVE METHOD
Authors: Siwi Cempaka Puspita , Nurfirdaus Yasmine
Published: November 2020

The success of the Family Planning program can be measured from the ratio of the use of the Long-Term Contraceptive Method by the couples of childbearing age in each region. The approach used in the Family Planning program is a regional approach, so this study aimed to group sub-districts based on the proportion users of the Long-Term Contraceptive Method by couples of childbearing age in Sidoarjo in 2018. This study was non-reactive study, which is a type of research using secondary data. The data source came from the Report of the Office of Women's Empowerment and Child Protection, Family Planning Sidoarjo in 2018. This study used cross-sectional design with the K-Means Clustering model data analysis. The results of this study produced three regional clusters: Cluster 1 with a low success rate sub-districts category with 8 sub-districts; Cluster 2 with a medium success rate category that has 6 subdistrict members; and Cluster 3 with a high success rate category consisting of 4 sub-districts in Sidoarjo. Based on the study results, broad accessibility was needed to obtain information so that the level of the Long-Term Contraceptive Method users in Sidoarjo increases.
Machine Learning Approaches for Accurate Prediction of Relative Humidity based on Temperature and Wet-Bulb Depression
Authors: Ghadiri Mahdi , Marjani Azam , Mohammadinia Samira , Shokri Manouchehr
Published: November 2020

The main parameters for calculation of relative humidity are the wet-bulb depression and dry bulb temperature. In this work, easy-to-used predictive tools based on statistical learning concepts, i.e., the Adaptive Network-Based Fuzzy Inference System (ANFIS) and Least Square Support Vector Machine (LSSVM) are developed for calculating relative humidity in terms of wet bulb depression and dry bulb temperature. To evaluate the aforementioned models, some statistical analyses have been done between the actual and estimated data points. Results obtained from the present models showed their capabilities to calculate relative humidity for divers values of dry bulb temperatures and also wet-bulb depression. The obtained values of MSE and MRE were 0.132 and 0.931, 0.193 and 1.291 for the LSSVM and ANFIS approaches respectively. These developed tools are user-friend and can be of massive value for scientists especially, those dealing with air conditioning and wet cooling towers systems to have a noble check of the relative humidity in terms of wet bulb depression and dry bulb temperatures.
Face Masks Against COVID-19: An Evidence Review
Authors: Howard Jeremy , Huang Austin , Li Zhiyuan , Tufekci Zeynep , Zdimal Vladimir , van der Westhuizen Helene-Mari , von Delft Arne , Price Amy , Fridman Lex , Tang Lei-Han , Tang Viola , Watson Gregory L. , Bax Christina E. , Shaikh Reshama , Questier Frederik , Hernandez Danny , Chu Larry F. , Ramirez Christina M. , Rimoin Anne W.
Published: November 2020

The science around the use of masks by the general public to impede COVID-19 transmission is advancing rapidly. Policymakers need guidance on how masks should be used by the general population to combat the COVID-19 pandemic. In this narrative review, we develop an analytical framework to examine mask usage, considering and synthesizing the relevant literature to inform multiple areas: population impact; transmission characteristics; source control; PPE; sociological considerations; and implementation considerations. A primary route of transmission of COVID-19 is via respiratory droplets, and is known to be transmissible from presymptomatic and asymptomatic individuals. Reducing disease spread requires two things: first, limit contacts of infected individuals via physical distancing and other measures, and second, reduce the transmission probability per contact. The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both laboratory and clinical contexts. Public mask wearing is most effective at reducing spread of the virus when compliance is high. The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low. Given the current shortages of medical masks we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. Because many respiratory droplets become smaller due to evaporation, we recommend increasing focus on a previously overlooked aspect of mask usage: mask-wearing by infectious people ("source control") with benefits at the population-level, rather than mask-wearing by susceptible people, such as health-care workers, with focus on individual outcomes. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.
Modern Clinical Text Mining: A Guide and Review
Authors: Percha Bethany
Published: November 2020

Electronic health records (EHRs) are becoming a vital source of data for healthcare quality improvement, research, and operations. However, much of the most valuable information contained in EHRs remains buried in unstructured text. The field of clinical text mining has advanced rapidly in recent years, transitioning from rule-based approaches to machine learning and, more recently, deep learning. With new methods come new challenges, however, especially for those new to the field. This review provides an overview of clinical text mining for those who are encountering it for the first time (e.g. physician researchers, operational analytics teams, machine learning scientists from other domains). While not a comprehensive survey, it describes the state of the art, with a particular focus on new tasks and methods developed over the past few years. It also identifies key barriers between these remarkable technical advances and the practical realities of implementation at health systems and in industry.
Changing Role of Users - Innovating Responsibly in Digital Health
Authors: Iakovleva Tatiana , Oftedal Elin , Bessant John
Published: November 2020

Despite the recognition of the importance of stakeholder inclusion into decisions about new solutions offered to society, responsible innovation (RI) has stalled at the point of articulating a process of governance with a strongly normative loading, without clear practical guidelines toward implementation practices. The principles of RI direct us to involve the user early in the innovation process. However, it lacks direction of how to involve users and stakeholders into this process. In this article, we try to understand how to empower users to become a part of innovation process though empirical cases. Based on 11 cases of firms innovating in digital health and welfare services, we look on firm practices for user integration into their innovation process, as well as how user’s behavior is changing due to new trends such as availability of information and digitalization of services. We try to explore this question through lenses of responsible innovation in the emerging field of digital healthcare.
Lights and Shadows on Hepatic Encephalopathy Diagnosis
Authors: Amodio Piero , Montagnese Sara
Published: November 2020

Hepatic encephalopathy (HE) is a form of brain dysfunction that is specifically caused by liver insufficiency and/or portal-systemic shunt. The exact nature of HE is debated, so that conflicting uses of the term HE may cause inconsistencies in its detection and, in turn, issues with its management. This review highlights the meaning of the term HE on the basis of both its historical origins and current consensus. It also provides criteria for the diagnosis of the condition, on the basis of its phenotypes and the risk factors for its occurrence. The procedure for differential diagnosis from other conditions which result in similar phenotypes is considered, together with precipitants and confounders. Finally, the current multidimensional approach for the correct clinical recording of HE episodes is discussed.
Incorporating Sea Surface Temperature into Bioeconomic Fishery Models: An Examination of Western and Central Pacific Tuna Fisheries
Authors: Porreca Zachary
Published: November 2020

Ocean temperatures are increasing. Little work has been done to examine the effects that these changes will have on fishery production. The study at hand seeks to incorporate the influence of climate change into established bioeconomic fishery models. Stock biomass is approximated to be a function of sea surface temperature. Following a feasible generalized least squares regression using data from the Western and Central Pacific, the interaction between fishery effort and temperature is found to be statistically significant. From this model, various functional forms relating effort, catch, and temperature are specified. In particular, a function that returns an effort requirement given a target catch level and temperature forecast is generated.The importance of these tools for fishery management is explored through application to Western and Central Pacific tuna fisheries. Recommendations for extensions into future research are made and the foundation for a model of efficient effort allocation across time and the entirety of a management area, given changing temperatures, is specified.
The Missing Tailed Phages: Prediction of Small Capsid Candidates
Authors: Luque Antoni , Benler Sean , Lee Diana , Brown Colin , White Simon
Published: November 2020

Tailed phages are the most abundant and diverse group of viruses on the planet. Yet, the smallest tailed phages display relatively complex capsids and large genomes compared to other viruses. The lack of tailed phages forming the common icosahedral capsid architectures T = 1 and T = 3 is puzzling. Here, we extracted geometrical features from high-resolution tailed phage capsid reconstructions and built a statistical model based on physical principles to predict the capsid diameter and genome length of the missing small tailed phage capsids. We applied the model to 3,348 isolated tailed phage genomes and 1,496 gut metagenome-assembled tailed phage genomes. Four isolated tailed phages were predicted to form T = 3 icosahedral capsids, and twenty-one metagenome-assembled tailed phages were predicted to form T < 3 capsids. The smallest capsid predicted was a T = 4/3 ≈ 1.33 architecture. No tailed phages were predicted to form the smallest icosahedral architecture, T = 1. We discuss the feasibility of the missing T = 1 tailed phage capsids and the implications of isolating and characterizing small tailed phages for viral evolution and phage therapy.
PNA-based Graphene Oxide/porous Silicon Hybrid Biosensor: Towards a Label-free Optical Assay for Brugada Syndrome
Authors: Moretta Rosalba , Terracciano Monica , Borbone Nicola , Oliviero Giorgia , Schiattarella Chiara , Piccialli Gennaro , Falanga Andrea Patrizia , Marzano Maria , Dardano Principia , De Stefano Luca , Rea Ilaria
Published: November 2020

Peptide nucleic acid (PNA) is a synthetic DNA mimic that outperforms the properties of traditional oligonucleotides (ONs). On account of its outstanding features, such as remarkable binding affinity towards complementary DNA or RNA as well as high thermal and chemical stability, PNA has been proposed as a valuable alternative to the ON probe in gene-sensor design. In this study, a hybrid transducer made-up of graphene oxide (GO) nano-sheets covalently grafted onto a porous silicon (PSi) matrix has been investigated for the early detection of a genetic cardiac disorder, the Brugada syndrome (BS). A functionalization strategy towards the realization of a potential PNA-based device is described. A peptide nucleic acid (PNA), able to detect the SCN5A associated with the BS has been properly synthesized and used as a bioprobe for the realization of a proof-of-concept label-free optical PNA-biosensor. PSi reflectance and GO photoluminescence (PL) signals were simultaneously exploited for the monitoring of the device functionalization and response.
Optimising Embodied Energy and Thermal Performance of Thermal Insulation in Building Envelopes Via an Automated Building Information Modelling (BIM) Tool
Authors: Chen Zixuan , Hammad Ahmed W A , Kamardeen Imriyas , Akbarnezhad Ali
Published: November 2020

Insulation systems for the floor, roof and external walls play a prominent role in providing a thermal barrier for the building envelope. Design decisions made for the insulation material type and thickness can alleviate potential impacts on the embodied energy and improve the building thermal performance. This design problem is often addressed using a BIM-integrated optimisation approach. However, one major weakness lies in the current studies is that BIM is merely used as the source for design parameters input. This study proposes a BIM-based envelope insulation optimisation design framework using a common software Revit to find the trade-off between the total embodied energy of the insulation system and the thermal performance of the envelope by considering the material type and thickness. In addition, the framework also permits data visualisation in a BIM environment, and subsequent material library mapping together with instantiating the optimal insulation designs. The framework is tested on a case study based in Sydney, Australia. By analysing sample designs from the Pareto front, it is found that slight improvement in the thermal performance (1.3399 to 1.2112 GJ/m2) would cause the embodied energy to increase by more than 50 times.
A Roadmap to Immunotherapy: Lesson from the Hallmarks and Signaling Pathways of Cancer
Authors: Derakhshani Afshin , Rostami Zeinab , Safarpour Hossein , Taefehshokr Sina , Tabrizi Neda Jalili , Abdoli Shadbad Mahdi , Kooshkaki Omid , Astamal Reza Vaezi , Argentiero Antonella , Singh Pankaj K. , Taefehshokr Nima , Alizadeh Nazila , Silvestris Nicola , Baradaran Behzad
Published: November 2020

Cancer is the second leading cause of death worldwide. It is theorized that underlying genetic and epigenetic changes enable cells to proliferate out of control by escaping regulatory mechanisms. Although traditional molecular profiling techniques, i.e., bulk sequencing, can identify common mutations and gene expression patterns in cancer cells, they cannot detect tumour heterogeneity. However, single-cell technology has provided an ample opportunity to overcome this difficulty. Since this technology allows us to detect the heterogeneous properties of all cancer cells, this can further our knowledge of the signaling pathways in cancer cells. Indeed, single-cell transcriptomics technology has paved the road for identifying novel biomarkers and signaling pathways, which can serve as targets. This study aims to review the current knowledge about pathways involved in developing cancer cells and shed light on single-cell studies as promising therapeutic approaches.
A Creative Living Lab for the Adaptive Re-use of the Morticelli Church: the SSMOLL project
Authors: Cerreta Maria , Rocca Ludovica La , Elefante Alessia
Published: November 2020

The international debate on the adaptive re-use of cultural heritage sites following the Sustainable Development Goals becomes more central than ever in the implementation of circular economy models for urban policies. The new values that characterise the cultural assets, considered as the result of a collaborative process, can enhance both the manufactured capital and the human capital, and to carry out the system of relationships that bind them. At the same time, the values of historical-artistic assets and produced by community-based regeneration processes are particularly relevant when they characterise abandoned commons and cult buildings, to which communities attribute an identity and symbolic value. Starting from the definition of the concept of Complex Social Value, we propose a methodological process that combines approaches and techniques typical of deliberative evaluations and collaborative decision-making processes. The aim is to identify the complex value chains generated by adaptive re-use, in which intrinsic values can play a driving role in the regeneration strategies of discarded cultural heritage. The experimentation, tested with the project “San Sebastiano del Monte dei Morti Living Lab” (SSMOLL), activates a creative and cultural Living Lab in the former church of “Morticelli”, in the historic centre of Salerno, in southern Italy. The re-use project is part of a more comprehensive process of social innovation and culture-led urban regeneration triggered in Salerno starting from SSMOLL.
Synchronous online discussion: teaching English in higher education amidst the covid-19 pandemic
Authors: Rinekso Aji Budi , Muslim Ahmad Bukhori
Published: November 2020

During the outbreak of Covid-19 pandemic, many educational institutions have adapted various online teaching modes. However, studies exploring the employment of synchronous online discussion for teaching English in higher education context were still limited. This study aimed at investigating EFL university students’ perceptions and challenges on the use of synchronous online discussions. Employing virtual observations and semi-structured interviews, five Master students of English education study program of a public university in Bandung participated in this study. Data were based on three domains of communication types for e-learning; content-related, planning of tasks and social supports. The findings showed that the students had positive response to the employment of synchronous online discussion. They believed that synchronous online discussion was a good online teaching mode where task negotiation, task planning, opinions, questions and answers can be done easily. In addition, they could improve critical thinking and writing skills as well as get social supports. Meanwhile, poor internet connection and misunderstanding of tasks became the challenge. HIGHLIGHTS Covid-19 pandemic demands the employment of online learning mode. Synchronous online discussion offers distinctive features for accommodating higher education learning, specifically in the teaching of English. Data analysis based on three domains namely content-related, planning of tasks and social supports would be administered.
Automatic speech recognition in computer-assisted language learning for individual learning in speaking
Authors: Junining Esti , Alif Sony , Setiarini Nuria
Published: November 2020

This study is intended to help English as a Foreign Language (EFL) learners in Indonesia to reduce their anxiety level while speaking in front of other people. This study helps to develop an atmosphere that encourages students to practice speaking independently. The interesting atmosphere can be obtained by using Automatic Speech Recognition (ASR) where every student can practice speaking individually without feeling anxious or pressurized, because he/she can practice independently in front of a computer or a gadget. This study used research and development design as it tried to develop a product which can create an atmosphere that encourages students to practice their speaking. The instrument used is a questionnaire which is used to analyze the students’ need of learning English. This study developed a product which utilized ASR technology using C# programming language. This study revealed that the product developed using ASR can make students practice speaking individually without feeling anxious and pressurized.
A Measurement System for the Study of Nonlinear Propagation Through Arrays of Scatterers
Authors: Hart Carl R. , Lyons Gregory W.
Published: November 2020

Various experimental challenges exist in measuring the spatial and temporal field of a nonlinear acoustic pulse propagating through an array of scatterers. Probe interference and undesirable high-frequency response plague typical approaches with acoustic microphones, which are also limited to resolving the pressure field at a single position. Measurements made with optical methods do not have such drawbacks, and schlieren measurements are particularly well suited to measuring both the spatial and temporal evolution of nonlinear pulse propagation in an array of scatterers. Herein, a measurement system is described based on a z-type schlieren setup, which is suitable for measuring axisymmetric phenomena and visualizing weak shock propagation. In order to reduce directivity and initiate nearly spherically-symmetric propagation, laser induced breakdown serves as the source for the nonlinear pulse. A key component of the schlieren system is a standard schliere, which allows quantitative schlieren measurements to be performed. Sizing of the standard schliere is aided by generating estimates of the expected light refraction from the nonlinear pulse, by way of the forward Abel transform. Finally, considerations for experimental sequencing, image capture, and a reconfigurable rod array designed to minimize spurious wave interactions are specified. 15.
Sine qua non larva, turmoil and disdain: Responsiveness to ‘Covid-19 face-mask’ at Ogunpa, Ibadan, Nigeria
Authors: Akande Abiodun , Adenle John
Published: November 2020

This research is a criticism addressing the formal and ergonomic analysis of Covid-19 face-masks at Giwa Adini, Ogunpa market, Ibadan, Nigeria. However, the research doubles as an ‘interrogative’ tool to elicit narratives on the responsiveness of illiterate and semi-literate traders at Giwa Adini on the advent of the coronavirus. Employing the survey technique, 100 randomly selected respondents were interviewed. The result obtained identifies five fabric mask types in the study area, the cup-shaped fabric mask being the most popular because of its adaptability to extant aso ebi culture. Other extemporized masks, reminiscent of traditional egungun masks, were also observed. With regards to the response to Covid-19, 21 respondents consider the coronavirus as falsehood, 23 claim it is God’s affliction, 43 agree to its reality, but query its low epidemiology and only 13 appear informed. The research showcases a variety of perceptions of Nigerians towards Covid-19,confirming the gross ignorance about the disease and their nonchalant attitude towards it.
Young ones having younger ones: Adolescent mothers’ repeated pregnancy experiences in the Philippines
Authors: Monterona Adreal Denver
Published: November 2020

Many adolescents in the Philippines are not only getting pregnant under theage of 20 but are also having repeated pregnancies. Several local studies havedetermined the prevalence and the correlates of repeated pregnancies amongFilipino adolescents, but the qualitative contexts in which these pregnanciesare occurring are unclear yet are important for program development. This paper discusses some qualitative data drawn from experiences of youth who have had repeated pregnancies as a result of a qualitative study that employed the phenomenological and the narrative methodological approach. The study made use of data collected through individual in-depthinterviews with adolescents from the province of Pampanga, Philippines who have experienced more than one pregnancy from ages 15 to 19. Overall themes on the experiences of young mothers include positivity amid within the negativity and old connections, new unions. Found to be both a biological and social phenomenon, repeated adolescent pregnancy heightens both personal and social experiences of the young mother while it involves gender, forming and rebuilding of families as well as local context, and as such validates the need for further research.
Evolution of pathogen response genes associated with increased disease susceptibility during adaptation to an extreme drought in a Brassica rapa plant population
Authors: O'Hara Niamh Breda , Franks Steven J , Kane Nolan C , Tittes Silas , Rest Joshua S
Published: November 2020

BACKGROUND: Pathogens are key components in natural and agricultural plant systems. There is evidence of evolutionary changes in disease susceptibility as a consequence of climate change, but we know little about the underlying genetic basis of this evolution. To address this, we took advantage of a historical seed collection of a Brassica rapa population, which we previously demonstrated evolved an increase in disease susceptibility to a necrotrophic fungal pathogen following a drought.RESULTS: Previously, we combined a resurrection experiment with genome-wide sequencing of 124 pooled ancestral and descendant plants. Here, using these previously generated sequence data (Franks et al, 2016), we show that well-characterized necrotrophic fungal pathogen response (NFPR) genes have evolved, as indicated by changes in allele frequency, between ancestors and descendants, with several of them identified as extreme FST outliers. The jasmonic acid (JA) signaling pathway in particular seems to underlie the evolution of disease susceptibility, in addition to its well characterized role in plastic disease response. We identify a list of 260 genes that are both NFPR genes and are differentially expressed in response to drought, based on publicly available data. We present evidence that five of these genes evolved between ancestors and descendants, suggesting that the drought acted as the evolutionary driver, and that the accompanying increase in disease susceptibility may have been a consequence of genetic pleiotropy.CONCLUSIONS: Our study provides evidence that for this population, standing variation in NFPR genes is affected by natural selection related to climate change. Our results reveal potentially important candidates that may underlie trait evolution in both crops and natural systems. Additionally, this trade-off between adaptation to biotic and abiotic stresses is an example of how climate change can have diverse and unexpected consequences.
Developing whole-school mental health and wellbeing intervention through pragmatic formative process evaluation: A case-study of innovative local practice within the School Health Research Network
Authors: Gobat Nina H , Littlecott Hannah , Williams Andy , McEwan Kirsten , Stanton Helen , Robling Michael , Rollnick Stephen , Murphy Simon , Evans Rhiannon
Published: November 2020

Background: The evidence-base for whole school approaches aimed at improving student mental health and wellbeing remains limited. This may be due to a focus on developing and evaluating de-novo, research-led interventions, while neglecting the potential of local, contextually-relevant innovation that has demonstrated acceptability and feasibility. This study reports a novel approach to modelling and refining the programme theory of a whole-school restorative approach, alongside plans to scale up through a national educational infrastructure in order to support robust scientific evaluation.Methods: A pragmatic formative process evaluation was conducted of a routinized whole-school restorative approach aimed at improving student mental health and wellbeing in Wales.Results: The study reports the six phases of the pragmatic formative process evaluation. These are: 1) identification of innovative local practice; 2) scoping review of evidence-base to identify potential programme theory; outcomes; and contextual characteristics that influence implementation; 3) establishment of a Transdisciplinary Action Research (TDAR) group; 4) co-production and confirmation of an initial programme theory with stakeholders; 5) planning to optimise intervention delivery in local contexts; and 6) planning for feasibility and outcome evaluation. The phases of this model may be iterative and not necessarily sequential.Conclusions: Formative, pragmatic process evaluations can support researchers, policy-makers and practitioners in developing robust scientific evidence-bases for acceptable and feasible local innovations that do not already have a clear evidence base. The case of a whole-school restorative approach provides a case example of how such an evaluation may be undertaken.
Mix Of Destinations And Sedentary Behavior Among Brazilian Adults: A Cross Sectional Study 
Authors: Florindo Alex Antonio , Turrel Gavin , Garcia Leandro Martin Totaro , Barbosa Joao Paulo dos Anjos Souza , Cruz Michele Santos , Failla Marcelo Antunes , Aguiar Breno Souza , Barrozo Ligia Vizeu , Goldbaum Moises
Published: November 2020

Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey. Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and mix of destinations score in 500m buffers was the exposure variable. Associations between mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results: After adjustment for covariates, mix of destinations was inversely associated with minutes of sitting time on a weekday (β=-8.8, p=0.001) and weekend day (β=-6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion: Greater mix of destinations within 500m of peoples’ residences were inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.
Cost-effectiveness Analysis of Text Messaging to Support Health Advice for Smoking Cessation
Authors: Cobos-Campos Raquel , Mar Javier , Apiñaniz Antxon , de Lafuente Arantza Sáez , Parraza Naiara , Aizpuru Felipe , Orive Gorka
Published: November 2020

Background: Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide. Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed.Methods: We performed a Markov model-based cost-effectiveness analysis comparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to smokers’ mobile phones. A Markov model was used in which smokers transitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costs for lost productivity, respectively. Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option.Results: Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained (ICER) for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant.Conclusions: Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.
Recommendations for Delivering Oral Health Advice: a Qualitative Supplementary Analysis of Dental Teams, Parents’ and Children’s Experiences 
Authors: Bhatti Amrit , Vinall-Collier Karen A , Duara Raginie , Owen Jenny C , Gray-Burrows Kara , Day Peter F
Published: November 2020

Background: Tooth decay has a significant impact on children, their families and wider society. The dental consultation provides an opportunity to prevent tooth decay by engaging in an effective oral health conversation with parents and children. However, there is limited literature which explores how these oral health conversations are delivered, received, and understood. Aim: To explore the common facilitators of delivering oral health advice from dental teams, parents' and children's experiences, to identify and inform practical recommendations for clinical practice. Method: The current paper used a qualitative supplementary analysis to reanalyse data of existing published studies by applying a different research question. Qualitative focus groups were undertaken following a semi-structured interview guide with 27 dental team members (dentists, dental nurses, practice managers and receptionists), 37 parents and 120 children (aged 7-10 years old) in the northern region of England. Thematic analysis informed the identification of themes and aggregation of findings. Results:Three overarching themes were developed: (1) An engaging and personalised dental visit for parents and children; (2) Dental teams, parents and children working collaboratively to improve oral health habits; and (3) Recommending appropriate oral health products. Many parents and children had little recollection of any preventive oral health conversations when visiting the dentist. Practical solutions were identified by different stakeholders to facilitate three-way, personalised, non-judgemental and supportive oral health conversations. Adopting these innovative approaches will help to enable parents and their children to adopt and maintain appropriate oral health behaviours. Conclusion: Understanding the context and triangulating the experiences of different stakeholders involved in preventive oral health conversations for young children is an essential step in co-designing a complex oral health intervention following Medical Research Council (MRC, UK) guidance. The current study has provided recommendations not only for dental practices, but insights for wider paediatric health care services. Findings from this study have informed the design of a complex oral health intervention called "Strong Teeth", which aims to support dental teams to have effective behaviour change conversations with parents of young children.
Elevated Blood Urea Nitrogen is associated with Recurrence of post-operative Chronic Subdural Hematoma
Authors: Wang Ning , Hu Jiangnan , Oppong-Gyebi Anthony , Zhu Xuanhao , Li Yihao , Yang Jianjing , Ruan Linhui , Zhuge Qichuan , Ye Sheng
Published: November 2020

Background: Chronic subdural hematoma (CSDH) is fundamentally treatable with about a 2-31% recurrence rate. Recently, there has been renewed interest in the association between Blood Urea Nitrogen (BUN) and intracranial lesion. Therefore, this paper attempts to show the relationship between BUN and CSDH recurrence.Methods: A total of 653 CSDH cases with Burr-hole Irrigation (BHI) were enrolled from December 2014 to April 2019. The analyzed parameters included age, gender, comorbidities, laboratory investigations, medication use and hematoma location. The cases were divided into recurrence and non-recurrence groups while postoperative BUN concentration was further separated into quartiles (Q1 ≤ 4.0 mmol/L, 4.0 < Q2 ≤ 4.9 mmol/L, 4.9 < Q3 ≤ 6.4 mmol/L, Q4 > 6.4 mmol/L). Restricted cubic spline regressions and logistic regression models were performed to estimate the effect of BUN on CSDH recurrence.Results: CSDH recurrence was observed in 96 (14.7%) cases. Significant distinctions were found between recurrence and non-recurrence groups in postoperative BUN quartiles of cases (P=0.003). After adjusting for the potential confounders, the odds ratio of recurrence was 3.069 (95%CI =1.488–6.330, p = 0.002) for the highest quartile of BUN compared with the lowest quartile. In multiple-adjusted spline regression, a high BUN level visually showed a significantly high OR value of recurrence risk.Conclusions: Elevated BUN at post-operation is significantly associated with the recurrence of CSDH, and it is indicated that high levels of serum BUN after evacuation may serve as a risk factor for CSDH recurrence.
Comparative gene expression profiling of mouse ovaries upon stimulation with natural equine chorionic gonadotropin (N-eCG) and tethered recombinant-eCG (R-eCG)
Authors: Min Kwan-Sik , Park Jong-Ju , Lee So-Yun , Byambaragchaa Munkhzaya , Kang Myung-Hwa
Published: November 2020

Background: Equine chorionic gonadotropin (eCG) induces super-ovulation in laboratory animals. Notwithstanding its extensive usage, limited information is available regarding the differences between the in vivo effects of natural eCG (N-eCG) and recombinant eCG (R-eCG). This study aimed to investigate the gene expression profiles of mouse ovaries upon stimulation with N-eCG and R-eCG produced from CHO-suspension (CHO-S) cells. R-eCG gene was constructed and transfected into CHO-S cells and quantified. Subsequently, we determined the metabolic clearance rate (MCR) of N-eCG and R-eCG up to 24 h after intravenous administration through the mice tail vein and identified differentially expressed genes in both ovarian tissues, via quantitative real-time PCR (qRT-PCR) and immunohistochemistry (IHC).Results: R-eCG was markedly expressed initially after transfection and maintained until recovery on day 9. Glycan chains were substantially modified in R-eCG protein produced from CHO-S cells and eliminated through PNGase F treatment. The MCR was higher for R-eCG than for N-eCG, and no significant difference was observed after 60 min. Notwithstanding their low concentrations, R-eCG and N-eCG were detected in the blood at 24h post-injection. Microarray analysis of ovarian tissue revealed that 20 of 12,816 genes assessed therein were significantly up-regulated and 43 genes were down-regulated by >2-fold in the group that received R-eCG (63 [0.49%] differentially regulated genes in total). The microarray results were concurrent with and hence validated by those of RT-PCR, qRT-PCR, and IHC analyses.Conclusions: The present results indicate that R-eCG can be adequately produced through a cell-based expression system through post-translational modification of eCG and can induce ovulation in vivo. These results provide novel insights into the molecular mechanisms underlying the up- or down-regulation of specific ovarian genes and the production of R-eCG with enhanced biological activity in vivo.
Evidence of integrated primary-secondary health care in low-and middle-income countries: protocol for a scoping review
Authors: Hasan Md Zabir , Singh Shalini , Arora Dinesh , Jain Nishant , Gupta Shivam
Published: November 2020

Background: Integrated care is a people-centered health delivery approach that ensures the comprehensiveness, quality, and continuity of service across the settings and levels of health systems. The World Health Organization (WHO) recommends integration across levels and building-blocks of health systems as a prerequisite of Universal Health Coverage (UHC). While health systems of low and middle-income countries (LMICs) are often fragmented and led by siloed service delivery structure, several LMICs – including India – have attempted health system integration. Several systematic reviews of evidence on healthcare integration from developed countries exist, but no synthesis from LMICs was reported to date. This review will overview the existing evidence of Primary-Secondary care Integration (PSI) in the context of LMICs, aiming to support policy decisions for the effective integration of health delivery systems in India. Methods: The review will be conducted following the six steps recommend by Arksey and O'Malley. Scientific and grey literature will be systematically selected from PubMed, Embase, Scopus, Web of Science, Global Index Medicus, and electronic repositories (such as WHO, World Bank, Health Policy Plus, and OpenGrey). Using a comprehensive search strategy, literature written in English and published between 2000-2020 will be selected, and two independent authors will screen their titles and abstracts. The result will be charted using a data extraction form and reported using tables, figures, and narrative forms. Discussion: No ethical approval is necessary for the review. The final report will be developed with the consultation of other stakeholders and disseminated through workshops, conference papers, and peer review articles. The review will serve as a guiding tool to approach, implement, and test the PSI models in India and other LMICs.Scoping review registration: https://osf.io/kjhzt
Inequality in health service utilization among migrant and local children: a cross-sectional survey of children aged 0–14 years in Shenzhen, China
Authors: Ke Xiatong , Zhang Liang , Li Zhong , Tang Wenxi
Published: November 2020

Background: Shenzhen is characterized with the largest scale of migrant children among all the cities in China. Unequal access to health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in using community-based healthcare between local and migrant children and to identify the influencing factors in Futian District of Shenzhen.Methods: Households in 12 communities in Futian District of Shenzhen were randomly sampled. Children aged 0-14 years were investigated using self-administered questionnaire - the 2018 Survey of Health Service Needs of Chinese Residents. Differences in healthcare including physical examination, feeding guidance, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance, and mental health guidance, were tested between local and migrant children. Binary logistic regressions were used in identifying potential influencing factors which affected the use in the above healthcare items.Results: A total of 936 participants from1512 families were sampled and 508 of them were included. Compared with local children, migrant children had less use of development guidance (OR=0.417, 95% CI: 0.279-0.624) and oral health care guidance (OR=0.557, 95% CI: 0.381-0.813). Children whose father received higher education level enjoyed a better use of disease prevention guidance as compared to whose father stopped at junior high school education or below (senior high vs junior high and below, OR=1.286, 95% CI: 0.791-2.090; bachelor and above vs junior high and below, OR=2.257, 95% CI: 1.417-3.595). Children whose fathers were blue-collar workers had less use of injury prevention guidance (OR=0.750, 95% CI: 0.334-1.684) and mental health guidance (OR=0.784, 95% CI: 0.295-2.080) as compared to whose father were white collar workers. Conclusions: Except feeding guidance, healthcare utilization were lower among migrant children than among local children. Generally, fathers have a stronger influence on children’s use of community-based healthcare than mothers do. The potential influence of fathers in promoting children’s healthcare use behaviors should be carefully considered, and fathers’ attention to children’s health should be increased.