bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of effective coverage for type 2 diabetes in Mexican primary care health information systems: a retrospective registry analysis
Authors: Gallardo-Rincón Héctor , Ríos-Blancas María Jesús , Montoya Alejandra , Saucedo-Martínez Rodrigo , Morales-Juárez Linda , Mujica Ricardo , Cantoral Alejandra , Idueta Lorena Suarez , Lozano Rafael , Tapia-Conyer Roberto
Published: April 2023

Background

As the leading cause of disability and the fourth leading cause of premature death in Mexico, type 2 diabetes (T2D) represents a serious public health concern. The incidence of diabetes has increased dramatically in recent years, and data from the Mexican National Health and Nutrition Survey (ENSANUT) indicate that many people remain undiagnosed. Persistent socioeconomic health care barriers exacerbate this situation, as T2D morbidity and mortality are worsened in vulnerable populations, such as those without social security. We evaluated the performance of public primary health centers (PHCs) in T2D medical attention through the measure of effective coverage (EC, a combined measure of health care need, use, and quality) at national, state, health jurisdiction, and municipality levels.

Methods

This retrospective analysis used blinded data recorded during 2017 in the Non-communicable Diseases National Information System (SIC) and T2D prevalence reported in 2018 ENSANUT to evaluate the EC achieved. We included individuals ≥ 20 years old without social security who did not declare the use of private health care services. Each EC component (need, use, and quality) was estimated based on the Shengelia adapted framework. The Kruskal–Wallis test was applied to evaluate the associations among EC quintiles and demographics.

Results

In 2017, 26.5 million individuals, aged ≥ 20 years, without social security, and without the use of private health care services, were under the care of 12,086 PHCs. The national prevalence of T2D was 10.3%, equivalent to 2.6 million people living with T2D in need of primary health care. Large contrasts were seen among EC components between and within Mexican states. We found that only 37.1% of the above individuals received health services at PHCs and of them, 25.8% improved their metabolic condition. The national EC was 9.3%, and the range (by health jurisdiction) was 0.2%–38.6%, representing a large geographic disparity in EC. We found an evident disconnect among need, utilization, and quality rates across the country.

Conclusions

Expansion and improvement of EC are urgently needed to address the growing number of people living with T2D in Mexico, particularly in states with vulnerable populations.
Soluções para problemas públicos em juízo: Uma prática interdisciplinar entre Campo de Públicas e Direito
Authors: Silveira Raquel Maria da Costa , Leite Gisele Maria da Silva Araújo , Cavalcanti Flávio , Meira Maísa de Oliveira , Inácio Márcio Vinícius do Nascimento
Published: April 2023

O presente artigo objetiva refletir sobre a experiência do Projeto de Extensão Construindo Soluções Colaborativas para Questões Públicas Judicializadas, tomando-a como base para destacar a potencialidade do Campo de Públicas no debate sobre conflitos públicos judicializados. Para tanto, fundamentou-se em pesquisas bibliográfica e documental. Além disso, foram coletadas informações sobre a percepção dos discentes participantes por meio de entrevistas, gerando resultados relativos aos aprendizados construídos e proporcionados pela participação nessa extensão, como também por aqueles próprios do Bacharelado em Gestão de Políticas Públicas da Universidade Federal do Rio Grande do Norte e do Projeto, como atividade extensionista, na motivação para a busca de novas aprendizagens. Ao final, foram destacadas as potencialidades da iniciativa na participação de mediações para conflitos públicos judicializados e, igualmente, no fortalecimento do elo entre saberes e o ensino, a pesquisa e a extensão. Demonstrou-se que o Projeto vem gerando frutos concretos, ampliando a abertura ao diálogo entre diversas instituições.
Discussing Values in Paramedic Practice
Authors: Cook Antonia L. , Capsey Matt , Jones Chris , Davidson Tom , Eaton Georgette
Published: April 2023

A case-based discussion around values-based practice illustrates how the elements of values-based practice can be used to: navigate a challenging situation in practice; examine how it intersects with legal considerations; and offer both opportunities and challenges to clinicians.
High prevalence of olfactory impairment among leprosy patients: A cross-sectional study
Authors: Kondo Rogério Nabor , Araújo Milene Cripa Pizatto de , Ramos Paulo Muller , Miot Hélio Amante , Fornazieri Marco Aurélio
Published: April 2023

Background

The effect of leprosy on the sense of smell is not yet fully established. Studies that have relied only on patients’ perceptions may have under- or over-estimated the change in smell perception. A validated and psychophysical method is necessary to avoid these errors in assessment.

Objectives

This study aimed to validate the existence of olfactory involvement in leprosy patients.

Methods

A cross-sectional, controlled study was conducted, in which individuals with leprosy (exposed individuals) and individuals without leprosy (control patients) were recruited. For each exposed individual, we selected two control patients. A total of 108 patients (72 control patients and 36 exposed individuals) with no history of infection with the new coronavirus (COVID-19) took the University of Pennsylvania Smell Identification Test (UPSIT).

Results

Most exposed individuals had olfactory dysfunction [n = 33, 91.7% (CI 95%: 77.5%–98.3%)] when compared with the control patients [n = 28, 38.9% (CI 95%: 27.6%-51.1%)], but only two (5.6%) had olfactory complaints. The olfactory function was significantly worse among exposed individuals [UPSIT leprosy = 25.2 (CI 95%: 23.1–27.3) when compared with the UPSIT control patients = 34.1 (CI 95%: 33.0–35.3); p<0.001]. The risk of olfactory loss was higher among the exposed individuals [OR: 19.5 (CI 95%: 5.18–105.70; p < 0.001)].

Conclusions

Olfactory dysfunction was highly prevalent among exposed individuals, although they had little or no self-knowledge of the disorder. The results show that it is important to assess the sense of smell in exposed individuals.
Retroalimentación pedagógico - interactiva para desarrollar habilidades blandas en la formación del psicólogo educativo de una universidad privada de Lima
Authors:   , Rojas Torres Estephany Abigail
Published: April 2023

En el ámbito laboral y en consideración con el perfil profesional que las empresas buscan, esta tesis genera la retroalimentación pedagógica – interactiva para el desarrollo de las habilidades blandas, con el fin de proponer un modelo pedagógico para el psicólogo educativo en formación. Por ello, el estudio de tipo científico aplicada educacional recolectó información mediante la técnica de la encuesta y la entrevista, en la que se empleó como instrumento al cuestionario y la guía de entrevista semiestructurada. En los resultados se pudo evidenciar que existe ausencia de la habilidad liderazgo pedagógico transformador, así como una falta de estrategias para el desarrollo y logro de aprendizajes profesionalizadores. El diseño de un modelo basado en la retroalimentación pedagógica interactiva experiencial, promueve el aprendizaje personalizado de las funciones del psicólogo educativo y la adquisición de competencias profesionalizadores, en su rol como futuros psicólogos educativos.
3D-PDNet: Automated Product Disassembly Sequence Planning
Authors: Upadhyay Abhinav , Ladrecha Bharat , Dubey Alpana , Kuriakose Suma Mani , Goenka Piyush
Published: April 2023

Product Disassembly has become an area of active research as it sup- ports sustainable development by aiding effective end-of-life (EOL) stage strategies like reuse, re-manufacturing, recycling, etc. In this work, we propose a new approach, 3D-PDNet, that can utilize 3D data from CAD assembly models to generate a feasible disassembly sequence. Our approach uses Graph-based learning to process the graph representa- tion of CAD models. Currently, the available 3D CAD model datasets lack ground truth disassembly sequences. We propose and curate a new dataset, the 3D-PD dataset, which includes ground truth information about the disassembly sequence for 3D product models. We carry out evaluation and analysis of results to explain the efficacy of the proposed method. Our approach significantly outperforms the existing baseline. We develop an Autodesk Fusion 360 plug-in that generates disassembly sequence animation, allowing intuitive analysis of the disassembly plan.
Interaction between N6-methyladenosine and autophagy in the immune infiltration and subtype classification of thyroid eye disease
Authors: Zhao Andi , Gong Qi , Chen Xuejuan
Published: April 2023

Background:Thyroid eye disease (TED) is a chronic inflammatory autoimmune disease with a complex etiology. N6-methyladenosine (m6A) modification and autophagy were confirmed separately to be involved in the TED process. Increased evidence has shown that m6A is critical in regulating autophagy in various diseases. However, there is limited knowledge about the interactive effects of m6A modification and autophagy in TED. Our research aimed to investigate the effects of m6A modification and autophagy interactivity in TED.
Results: We first identified dysregulation of five m6A regulators and 44 ARGs in TED patients compared to healthy controls. After correlation analysis, overlapping with the validated target genes from the RM2target database, and verification in our samples, FTO and BNIP3 were considered biomarkers for TED. Subsequently, based on dysregulated m6A regulators and ARGs separately, we classified 27 TED patients into two clusters, and the immune infiltration characteristics of clusters were further evaluated. Cluster-related differentially expressed genes were identified, and the enriched biological functions and pathways were elucidated. In addition, using two machine learning algorithms, we created a prediction model for TED patients with different molecular clusters. The nomogram, calibration curve, and decision curve analysis were performed to assess the performance of the predictive model.
Conclusions: This study revealed that an interactive effect between FTO and BNIP3, suppressed FTO might downregulate the expression of BNIP3 in an m6A-dependent manner, inhibiting the autophagy and subsequently promoting the TED process. In addition, we constructed a nomogram model in predicting the TED. These results provide new insights into understanding the mechanism of TED.
OmniGlasses: An Optical Aid for Stereo Vision CNNs to Enable Omnidirectional Image Processing
Authors: Seuffert Julian Bruno , Grassi Ana Cecilia Perez , Ahmed Hamza , Seidel Roman , Hirtz Gangolf
Published: April 2023

Stereo vision is a key technology for 3D scene reconstruction from image pairs. Most approaches process perspective images from commodity cameras. These images, however, have a very limited field of view and only picture a small portion of the scene. In contrast, omnidirectional images, also known as fisheye images, exhibit a much larger field of view and allow a full 3D scene reconstruction with a small amount of cameras if placed carefully. However, omnidirectional images are strongly distorted which make the 3D reconstruction much more sophisticated. Nowadays, a lot of research is conducted on CNNs for omnidirectional stereo vision. Nevertheless, a significant gap between estimation accuracy and throughput can be observed in the literature. This work aims to bridge this gap by introducing a novel set of transformations, namely OmniGlasses. These are incorporated into the architecture of a fast network, i.e., AnyNet, originally designed for scene reconstruction on perspective images. Our network, Omni-AnyNet, produces accurate omnidirectional distance maps with a mean absolute error of around 13 cm at 36.4 fps and is therefore real-time capable.
Estudo epidemiológico das maloclusões em escolares de 6 a 8 anos na cidade de Curitiba – Paraná
Authors: Marina de Oliveira RIBAS  , Bruno ORELLANA  , Felipe FRONZA  , Gisele Ribas GASPARIM  , Guilherme Sfier de MELLO  , Maria Luiza Schimidt SIMAS NETA  , Romeu Valério KOWALSKI  , Rosemari de Castro ARAÚJO
Published: April 2023

Avaliaram-se 1.550 crianças de 6 a 8 anos na cidade de Curitiba, a fim dedeterminar a prevalência de maloclusão e a sua distribuição segundodiferentes grupos étnicos. Foi selecionada para participar do estudo,aleatoriamente, uma escola de 1.º grau da rede estadual de ensino decada uma das 9 regiões de Curitiba. Todos os grupos raciais apresentaramuma maior incidência de maloclusão de Classe I. O grupo racial feodermadenotou maior porcentagem de maloclusão de Classe III e a maloclusãode Classe II teve grande prevalência nos grupos raciais dos leucodermase melanodermas. Neste estudo foram avaliadas as condições bucais deperdas prematuras e cáries extensas e a prevalência de maloclusões emrelação ao nível socioeconômico de crianças na faixa etária de 6 a 8 anosda rede estadual de ensino de Curitiba. O método estatístico utilizado foio qui-quadrado. Os resultados encontrados demonstraram que, de um modo geral, não houve diferença estatisticamente significativaem relação às condições bucais e à prevalência de maloclusõesentre as diferentes regiões da cidade, com exceção da regiãodo bairro Cajuru, onde houve maior prevalência demaloclusões de Classe I e de Classe III do que o esperado.
Análise da eficiência do protocolo de dupla centrifugação para o preparo do plasma rico em plaquetas (PRP) – estudo experimental em coelhos
Authors: Michel Reis MESSORA  , Maria José Hitomi NAGATA  , Flávia Aparecida Chaves FURLANETO  , Tatiana Miranda DELIBERADOR  , Luiz Gustavo Nascimento de MELO  , Valdir Gouveia GARCIA  , Alvaro Francisco BOSCO
Published: April 2023

Introdução e objetivo: O objetivo deste estudo foi avaliar as concentrações de plaquetas obtidas de plasma rico em plaquetas (PRP) preparado de acordo com um protocolo de dupla centrifugação. Material e métodos: Foram utilizados 8 coelhos (White New Zealand) machos, adultos, com pesos entre 2,8 e 4 kg. Após anestesia geral, realizou-se punção cardíaca, obtendo-se 10 mL de sangue de cada animal. Cada amostra de sangue foi centrifugada de acordo com o protocolo de Sonnleitner et al. (2000). Fez-se, então, a contagem manual de plaquetas do sangue periférico (total) coletado de cada animal e das amostras de PRP. Os dados obtidos foram submetidos a análise estatística. A normalidade dos dados foi comprovada e o teste t de Student foi utilizado (p < 0,05). Resultados: As amostras de PRP apresentaram uma quantidade média de plaquetas significativamente maior que a do sangue periférico. Conclusão: Dentro dos limites deste estudo, concluiu-se que o protocolo de dupla centrifugação foi apropriado para a produção do PRP.
Infliximab: A Novel Treatment Option for Refractory Orofacial Granulomatosis
Authors: Peitsch Wiebke K. , Kemmler Nicole , Goerdt Sergij , Goebeler Matthias
Published: April 2023

This article does not have an abstract.
Coexistence of Diffuse Reactive Angioendotheliomatosis and Neutrophilic Dermatosis Heralding Primary Antiphospholipid Syndrome
Authors: Kawaoka John , McBean Jason , Li Hongmei , Mihm Martin C. , Kroumpouzos George
Published: April 2023

This article does not have an abstract.
Topical Application of Imiquimod Induces Alterations in Peripheral Blood Lymphocytes in Healthy Individuals*
Authors: Pasmatzi Efi , Chaidaroglou Antigoni , Sakkis Theophilos , Monastirli Alexandra , Georgiou Sophia , Sagriotis Alexandros , Badavanis George , Vryzaki Eleftheria , Matsouka Panagiota , Degiannis Dimitrios , Tsambaos Dionysios
Published: April 2023

The aim of this study was to determine whether imiquimod, a Toll-like receptor-7/8 agonist, in addition to its well-known topical action on the cutaneous immune response, might also induce alterations in the peripheral blood lymphocytes. A 62.5 mg quantity of imiquimod (5% cream) was applied topically under occlusion once daily every second day for 3 weeks to the skin of 10 healthy volunteers, age range 30–57 years. Ten sex- and age-matched healthy controls applied corresponding quantities of the vehicle under occlusion. Before, and one and 3 weeks after the start of treatment, peripheral blood lymphocyte subpopulations were measured by flow cytometry. Statistically significant alterations in the percentage or absolute numbers of peripheral blood lymphocyte subpopulations were found in the imiquimod-treated group compared with the control group. These alterations indicate for the first time that topical application of imiquimod induces alterations in peripheral blood lympho cyte subsets in healthy individuals, which may be of importance in the immunotherapy of neoplastic and infectious disorders and should be taken into careful consideration in patients who are treated with imiquimod.
Enfermedad de Cushing en el embarazo y uso de cabergolina
Authors: Murillo Natacha Belén , Ramacciotti Constanza Fernanda , Fux-Otta Carolina , Cecenarro Laura Anahi
Published: April 2023

Introducción: La enfermedad de Cushing (EC) es rara durante el embarazo y se asocia con complicaciones maternas y fetales significativas. El objetivo fue reportar el caso de una paciente con EC que logró embarazo y parto sin complicaciones tras el tratamiento con dosis bajas de cabergolina. Métodos: Mujer de 29 años con diagnóstico de EC (macroadenoma secretor de ACTH que produce desplazamiento del quiasma óptico, infiltra el seno cavernoso derecho y engloba la arteria carótida interna). Se somete a cirugía transesfenoidal con resección tumoral incompleta. Luego de un año de estabilidad clínica, reaparecen los síntomas por lo que se instaura tratamiento médico con cabergolina. Durante el tratamiento la paciente concibe embarazo y se suspende la medicación. Resultados: En el primer trimestre, los parámetros clínicos y bioquímicos indican EC activa, por lo que se decide reinstaurar Cabergolina a dosis bajas durante el resto de la gestación. Con el agonista dopaminérgico se alcanza normalizar parámetros clínicos y de laboratorio y la paciente dio a luz una niña sana a las 38 semanas, dentro de percentiles normales y sin complicaciones. Conclusión: El embarazo es un evento raro en pacientes con EC. Sin embargo, las consecuencias de la exposición materno-fetal al hipercortisolismo pueden ser graves. Nuestra experiencia con el uso de cabergolina a dosis bajas en una embarazada con EC, aporta datos favorables a los escasos reportes bibliográficos existentes, sumando evidencia sobre el perfil de seguridad del fármaco en esta población de pacientes.
Minat Beli Memediasi Pengaruh E-Service Quality Dan Promosi Terhadap Keputusan Pembelian Di Shopee (Studi Kasus Pada Mahasiswa Manajemen Ukrida 2017)
Authors: Tecoalu Melitina , Yonathan Kelvin , Tj Hery Winoto
Published: April 2023

Technological developments support an increase in online buying and selling activities in marketplaces that have turned conventional transactions into digital ones. The quality of services and promotions offered have also turned digital. The purpose of this study was to examine the effect of e-service quality and promotion on purchasing decisions at Shopee which are mediated by purchase intention. By using a sample of 60 students of the 2017 UKRIDA Management Departement with a purposive sampling technique. The data analysis technique used in this research is Structural Equation Modeling (SEM) using the SmartPLS version 3.0 software. The results obtained in this study indicate that there is an effect of e-service quality on purchasing decisions and purchase intentions, while promotion has no effect on purchasing decisions. Meanwhile, mediation of purchase intention strengthens the influence of e-service quality and promotion on purchasing decisions.

Keywords: e-service quality, promotion, purchasing decisions, purchase intention
Ứng dụng phương pháp học máy trong dự báo rủi ro phá sản của các doanh nghiệp Việt Nam
Authors: Trương Thị Thùy Dương , Lê Hải Trung
Published: April 2023

Dự báo rủi ro phá sản của doanh nghiệp đóng vai trò quan trọng trong việc đưa ra các cảnh báo sớm cho các doanh nghiệp. Các nghiên cứu đánh giá rủi ro phá sản sử dụng các phương pháp thống kê truyền thống và mô hình học máy. Trong nghiên cứu này sử dụng hồi quy logistic và các mô hình học máy để dự báo rủi ro phá sản của các doanh nghiệp Việt Nam. Nghiên cứu đi kiểm chứng tính hiệu quả của các mô hình học máy so với thống kê truyền thống và kiểm tra tính hiệu quả của các mô hình học máy. Kết quả cho thấy sự ưu thế của mô hình XGBoost và Random Forest so với logistic và các phương pháp khác.
C36 WA SOLVER: PENDAMPINGAN ISOMAN PEMANFAATAN WAG
Authors: Arifin Samsul
Published: April 2023

Isolasi mandiri merupakan langkah pertama yang dilakukan oleh seseorang yang terinfeksi COVID-19 baik untuk seseorang yang memiliki gejala maupun orang tanpa gejala (OTG). Tujuan dilakukannya isolasi mandiri adalah demi mencegah penularan virus terhadap orang-orang sekitar terutama keluarga terdekat. C36 WA Solver merupakan salah satu upaya yang dilakukan untuk memonitoring pasien COVID-19 yang tengah melaksanakan isolasi mandiri dengan membantu mereka melalui pengecekan kondisi berbasis aplikasi chat WhatsApp. C36 WA Solver dikelola oleh anggota kelompok 36 KKM Untirta yang bekerja sama dengan satgas yang bertugas di desa tersebut. Hasil penelitian menunjukkan bahwa C36 WA Solver cukup efektif untuk membantu memonitoring warga yang terinfeksi COVID-19 dalam melaksanakan isolasi mandiri di rumah.
Pelatihan Editing Video dan Youtube sebagai bagian dari Literasi Digital bagi Siswa SMA Mardisiswa Semarang
Authors: Astuti Yani Parti , Subhiyakto Egia Rosi , Umaroh Liya , Utomo Danang Wahyu
Published: April 2023

Pada era pandemic saat ini, hampir semua kegiatan dilakukan secara online. Dengan adanya kegiatan online, maka peranan media sosial menjadi tinggi. Begitu halnya dengan youtube. Youtube adalah medsos yang tidak asing dari pendengaran kita. Bahkan apapun yang ingin diketahui, tidak sedikit orang yang langsung mencarinya melalui youtube. Youtube sangat dikenal baik dari kalangan anak – anak sampai kakek nenek. Penggunaan youtube yang sangat luar biasa ini, menandakan bahwa perkembangan di dunia teknologi sangatlah pesat. Namun harus selalu diwaspadai bahwa perkembangan teknologi juga berpengaruh pada perkembangan psikologi anak. Dengan adanya dampak teknologi ini, maka perlu adanya literasi yang sudah sudah menjadi bagian dari kehidupan dan perkembangan manusia. Literasi yang dikaitkan dengan teknologi saat ini dikenal dengan Literasi Digital. Literasi digital dapat membuat individu bisa berpartisipasi pada era yang modern saat ini. Literasi digital juga bisa menciptakan sebuah tatanan masyarakat dengan pola pikir dan pandangan yang kritis-kreatif, sehingga mereka tidak akan mudah tertipu yang berbasis digital seperti halnya masyarakat yang telah menjadi korban informasi hoaks. Dengan melihat hal tersebut di atas, maka diperlukan suatu wawasan kepada anak – anak muda tentang pentingnya literasi digital pada era teknologi saat ini. Literasi digital perlu diberikan kepada anak – anak remaja. Dalam hal ini sasaran yang akan diambil adalah siswa SMA. Literasi digital yang diberikan berkaitan dengan youtube, karena diharapkan siswa bisa mengoptimalkan pemakaian youtube. Sehingga siswa harus didampingi dan diberi pelatihan bagaimana memfilter informasi – informasi yang didapatkan dari youtube. Untuk itu, diharapkan siswa tidak hanya sebagai pengguna pasif, tapi harus bisa menjadi pengguna aktif. Sehingga siswa diberi pelatihan tentang bagaimana membuat akun youtube, bagaimana membuat youtube dengan baik dan sesuai aturan, dan juga bagaimana mengunggah video agar menjadi lebih menarik.
Membangun Potensi Wisata dan UMKM Berkelanjutan Ranting ‘Aisyiyah Sidodadi Melalui KKN-T9 UMSIDA
Authors: Marzuki Taufik , Sari Noor Reta Dwi , Rahayu Ruci Arizanda
Published: April 2023

Kuliah Kerja Nyata Terpadu (KKN-T) Universitas Muhammadiyah Sidoarjo tahun 2022 berkerja sama dengan Ranting ‘Aisyiyah Kecamatan Candi Desa Sidodadi Dusun Jambe melakukan aktivitas yang di ikuti oleh mahasiswa dan mahasiswi dari berbagai progam studi. Program kerja disusun dengan melihat permasalahan mitra Ranting ‘Aisyiyah Sidodadi untuk memberi solusi terhadap setiap permasalahan secara tepat guna dan sesuai sasaran. Salah satunya yaitu dengan menjadikan produk olahan minuman herbal melalui riset yang selanjutnya diberlakukan pengembangan untuk menjadi Usaha Mikro Kecil dan Menengah (UMKM) dan mendorong pengetahuan tentang tanaman herbal dengan menambah edukasi wisata alam serta mendorong untuk menciptakan perekonomian mandiri di dalam organisasi Ranting ‘Aisyiyah Sidodadi.
Optimalisasi Kelembagaan POKDARWIS Gunungsari Desa Ngesrepbalong Kecamatan Limbangan Kabupaten Kendal
Authors: Budi Wahid Akhsin , Rahayuningsih Margareta , Martuti Nana Kariada Tri , Maretta Yoris Adi , Mutiatari Dhita Prasisca , Khatamy Muhammad Adam
Published: April 2023

Kegiatan pariwisata di Desa Ngesrepbalong semakin berkembang dan ditandai dengan meningkatnya jumlah kunjungan wisatawan. Namun, kegiatan pariwisata yang berlangsung saat ini masih menerapkan konsep pariwisata massal (mass tourism) yang belum memperhatikan keberlanjutan serta daya dukung ekosistem. Melalui kegiatan pengabdian masyarakat di Dusun Gunungsari, Desa Ngesrepbalong bertujuan untuk mengoptimalkan kapasitas kelembagaan Kelompok Sadar Wisata (Pokdarwis) Gunungsari dalam mengelola pariwisata berbasis potensi lokal. Upaya yang dilakukan meliputi: 1) pelatihan manajemen serta penguatan kelompok Pokdarwis; dan 2) pelatihan sapta pesona pariwisata. Hasil dari kegiatan ini adalah pemahaman terkait konsep pariwisata berkelanjutan bagi peserta, identifikasi potensi wisata lokal, penyusunan rancangan paket wisata. Kegiatan pengabdian ini meningkatkan kemampuan pelaku pariwisata dalam merumuskan potensi wisata serta pengelolaan objek pariwisata yang berkelanjutan.
Multisystem inflammatory syndrome in children during the first two years of the COVID-19 pandemic in Luxembourg
Authors: Ooms C. , Mossong J. , Vergison A. , Biver A. , Wagner K. , Niel O. , Parrish A. , Abdelrahman T. T. , de la Fuente Garcia I.
Published: April 2023

Objective

Estimate the incidence of multisystem inflammatory syndrome (MIS-C) in children (0–15 years), the role of SARS-CoV-2 variants during the first two years of COVID-19 pandemic in Luxembourg; and describe the demographic, biological and clinical characteristics of the patients.

Method

Observational retrospective cohort study. Cases between March 2020 and February 2022 were ascertained from the national registry of MIS-C cases by a retrospective review of medical records. Reported SARS-CoV-2 infections were obtained from the national COVID-19 surveillance system. We calculated monthly MIS-C incidence, the ratio between MIS-C and SARS-CoV-2 infections and associated rate ratios by the periods corresponding to the circulation of different variants.

Results

18 children were diagnosed with MIS-C among 35,200 reported infections. The incidence rate of MIS-C was 7.2 [95% confidence interval (CI) 4.5–11.4] per 1,000,000 person-months. A higher incidence of MIS-C was observed between September and December 2021, corresponding to the circulation of the Delta variant than during the first year of the pandemic (RR 3.6, 95% CI, 1.1–12.3). The lowest rate of MIS-C per infection was observed during the Omicron (RR 0.17, 95% CI, 0.03–0.82). Median age at diagnosis was 6.5 years. Previously healthy children made up 88% of MIS-C cases, none were vaccinated against SARS-CoV-2. 33% required intensive care. All patients recovered fully.

Conclusions

MIS-C incidence and MIS-C risk per infection changed significantly over time during the first two years of COVID-19 pandemic. Monitoring of MIS-C incidence in future SARS-CoV-2 waves will be essential to guide public health interventions and vaccination policies for children.
Impact of Hiring Contractual Workers on Sustainable Supply Chain in Exporting Textile of Pakistan
Authors: Faraz Muhammad , Singh Harwindar
Published: April 2023

Textile industry is one of the major sources of revenue generation for Pakistan. For the last two decade this has been the key source of the inflow of foreign exchange through export of garments and textiles goods. Many global retailers and brands like Tesco, JC Penny, Wal-Mart, and Next etc. are sourcing their goods from Pakistan. These Retailers purchase garments and textile on some specific conditions such as cheap merchandising, quality standards and social and environmental compliance. In order to comply with social standards these multinational buyers enforce their vendors to follow the land law and their own code of conduct. The severity of issues varies from violation to violation. For example, nonpayment of overtime violations is taken as serious issues. In contrast, failure to pay legal benefits to labors as EOBI, group insurance and leaves are less threatening. Hiring contractual employment especially on piece rate is one of the core factors that lead to these non-compliances (NCs). A total of 60 unpublished social compliance onsite audit reports of textile and garment factories working with foreign buyers in Pakistan were analyzed. Chai-Square test applied to test the hypothesis. The result reflects that there is an association exists between hiring contractual piece rate workers, employment old age benefit, and group insurance and leaves violation. Current study may be helpful in exploring the major factors that may lead to overtime, employment old age benefit, group insurance and leaves violation. The findings may also help NGOs, government and global buyers to develop policies that provide better control over workers’ rights in developing countries like Pakistan for sustainable business growth.
Compare the Effectiveness of Carbimazole Single Dose and Divided Dose Regimens for Euthyroid Induction in Hyperthyroid Patients
Authors: Khan Aamir , Khan Muhammad Shoaib , Iqbal Atif , Tahir Muhammad Hamza , Rizvi Mohammad Basil , Murtaza Muhammad Amir
Published: April 2023

Objective: The purpose of the current study was to examine the effectiveness of carbimazole administered as a single dose with a divided dose regimen for inducing euthyroidism in hyperthyroid patients. Study Design: Prospective/Randomized study Place and Duration: This Prospective/Randomized study was conducted at Khyber Teaching Hospital Peshawar in the duration from June, 2022 to November, 2022. Methods: There were 92 patients of hyperthyroidism were presented in this study. Age, sex, BMI, and residency details for each enrolled case were recorded after receiving informed written consent. Patients were divided into two groups equally. Carbimazole (OD-CMZ) was administered as a single dosage to 46 patients in group I, and as two separate doses to 46 patients in group II (DD-CMZ). For six months, the effectiveness of the treatment was monitored on a regular basis (every four weeks). SPSS 22.0 was used to analyze all data. Results: There were 54 (58.7%) females and 38 (41.3%) males in this study. In group I mean age was 35.13±6.60 years and in group II mean age was 40.10±8.86 years. Mean duration of disease was 3.6±10.57 months in group I and in group II mean duration was 4.3 ±8.35 months. There was no discernible difference between the two groups in terms of baseline TSH and T4 concentrations or their cumulative rates of reduction (p-value, 0.014). Frequency of euthyroidism in group I after final follow up was 46 (100%) and in group II found in 45 (97.8%) cases but difference is insignificance. Conclusion: In this study, we came to the conclusion that a single dosage regimen is a more effective way to treat hyperthyroidism since there is no discernible difference in efficacy and a greater risk of developing hypothyroidism with a split dose strategy. Keywords: Hyperthyroidism, Drug therapy, Single dose, Carbimazole, Multidose
Evaluation of Darn Repair for Recurrence Rate in the Management of Indirect Inguinal Hernia
Authors: Khan Hafiz Gul Nasib , Khan Muhammad Shoaib , Khan Atif Iqbal , Rizvi Mohammad Basil , Murtaza Muhammad Amir , . Aamir
Published: April 2023

When an organ, or even part of an organ, protrudes through the inguinal canal, it is called an inguinal hernia. Two-thirds of all herniations are of the indirect inguinal subtype; they are most common in adults between 30 and 59; and men are twice as likely to be affected as women. The standard treatment for a hernia is surgery. A decrease in collagen metabolism and fibro-connective tissue in the groin is typically the root cause of an inguinal hernia. Both of these things cause the fascia transversalis to weaken. Because of this, surgeons have come up with a number of ways to strengthen the back wall of the inguinal canal. Methodology: Approximately 220 patients with indirect inguinal hernias participated in this descriptive study. The study collected data on the demographic characteristics of the patients, the clinical characteristics of the hernias, and the outcomes of the treatment. The results showed that the majority of the patients responded well to the treatment. The study also revealed that the incidence of hernia recurrence was low. Jinnah International Hospital Abbottabad and DHQ Battagram, Department of Surgery served as the study site for these individuals. Patients were followed for six months after therapy to check for problems or recurrence; darn repair was the modality of choice. Results: Results showed that darn repair had a low recurrence rate reported in the literature, despite some patients being lost to follow-up and others perceiving early complications like wound infection, seroma, hematoma formation, scrotal swelling, or prolonged postoperative pain. Restoring damaged tissues has also been shown to be less expensive than replacing damaged tissues with mesh. Tissue repair has showed potential and costs less than mesh repair for treating inguinal hernias, thus both options should be investigated. There is also a lower chance of infection with tissue repair compared to mesh repair Keywords: hernias,indirect inguinal hernia,darn repair,recurrence.
Impact of Dialysis on Periodontal and General Oral Health of Chronic Kidney Disease Patients
Authors: Noor Hafsa , Mirza Waqas , Arshad Mariah Muhammad , Arshad Rabia , Shafqat Faiqa , Babary Darab Fatima , Butt Hira
Published: April 2023

Objective: To assess the impact of dialysis on periodontal and general oral health of chronic kidney disease patients. Methodology: A Cross sectional comparative study was conducted in the department of Nephrology and Urology, Sharif Medical and Dental College, Lahore on 32 patients with chronic kidney disease in the time duration of one year. Chronic kidney disease stage 3, 4 and 5 patients with age above 18 years, belonging to both the genders and same socioeconomic status were a part of the study. Data collection was based on the following parameters: Community Periodontal Index of Treatment Needs (CPITN). Results: There was a statistically non-significant association between stage of chronic kidney disease and periodontal health of patients undergoing dialysis (p=0.185) and general oral health (p=0.120). Practical Implication: This study will help dental practitioners understand the impact of renal dialysis on general oral and periodontal health of patients with chronic kidney disease and in turn help them provide effective health care to these patients who have specialized treatment needs. Conclusion: It was seen that stage 3 patients had the highest percentage of bleeding gums while none had periodontal pockets nor calculus deposition. Stage 4 patients had an equal percentage of calculus deposition and periodontal pocket depth of 4-5 mm. Stage 5 patients had a high percentage of Periodontal pocket depths of 4-5mm followed by calculus and then bleeding gums. A higher percentage of stage 3 and 5 patients undergoing dialysis had a high DMFT whereas the percentage of stage 4 patients with high and low DMFT scores was equal. Keywords: Dialysis, Chronic kidney disease, periodontal health, Community periodontal index for treatment needs (CPITN)
Comparison of Methods of Assessment and Results of Traditional Osce with Electronic-Osce
Authors: Ismail Mehvr , Rehman Mashala , Irshad Khadija , Malik Zarafshan
Published: April 2023

Introduction: The onset and rise of COVID-19 and its sudden progression to a worldwide pandemic lead medical and dental institutes to change their way of teaching and conducting assessments to distance learning as compared to the previously applied conventional approaches. Teaching and assessment during this era have changed vastly, earlier it was solely traditional/live Objective Structured Clinical Examination (OSCE) but due to the current circumstances electronic/online OSCE (E-OSCE) method was introduced. In Pakistan also, Pakistan Medical Council (PMC) and the College of Physicians and Surgeons of Pakistan (CPSP) conducted online exams so that the scheduled exams do not get delayed. Aim: The main objective of this paper is to measure the reliability of an E-OSCE and to compare it with the traditional OSCE. Methodology: This was a cross-sectional study which got conducted at the Rawal Institute of Health Sciences, Islamabad. Traditional OSCEs and E-OSCEs were conducted with 71 participants including final year students and house officers. Each OSCEs had 10 stations, including one interactive station in traditional OSCE. Students’ scores in both the OSCEs were collected and paired t-test was used to compare the mean scores at p<0.05. Results: Total number of house officers were 27 and final year students were 44. The scores of 71 participants were collected. The difference between mean scores of house officers’ traditional OSCE and E-OSCE was statistically significant (p=0.000). The difference between final year students traditional OSCE and E-OSCE was also statistically significant (p=0.020). Finally, the overall difference between traditional OSCE and E-OSCE was also statistically significant (p=0.000) Practical implication: The main objective of this study was to assess the reliability of an E-OSCE and to compare whether the electronic method of conducting OSCE is more reliable than the traditional method of conducting OSCE. Conclusion: Despite limitations and the biases, the results of E-OSCE proved to be better than traditional OSCE. Further research needs to be conducted on E-OSCE to control the factors causing biases and limitations. Keywords: Traditional OSCE, E-OSCE, COVID-19, methods of assessment, medical education, dental education, distance learning.
Study of Association of Dietary Factors with Severity of Acute Pancreatitis
Authors: Abidi Aliza , Bilal Hazrat , Agha Shazadi Neelum , Zahoor Danyal , Shabbir Ghulam , Baksh Imam
Published: April 2023

Objective: To determine the association of dietary factors with severity of acute pancreatitis (AP). Materials and Methods: A total of 250 patients who presented in General Surgery unit from Jan-2022 to Dec-2022 were included. Data regarding etiology of AP and demographics of patients was obtained. A special questionnaire was designed to obtain information regarding the dietary habits of patients based on different types of diet. The questionnaire included information regarding use of meat, fat in daily diet, dairy products use, and desserts use. Results: Mean age of study patients was 48.3±18.5 years. Majority were females, 135 (54%) were females and 115 (46%) were males. There was significant association of meat rich diet and fat rich diet with severity of AP, 81 (60.9%) patients of mild AP had main diet as meat, 47 (68.1%) in moderate AP group and 40 (83.3%) in severe AP group had main diet as meat (p-value 0.01). 15 (11.3%) patients in mild AP, 11 (15.9%) in moderate AP and 13 (27.1%) in severe AP group reported to have use high fat usage in daily diet (p-value 0.03). Conclusion: Meat rich and fat rich diets are independently associated with severe AP. So modification of diet in-terms of reduction in meat and fat and addition of fibrous food in daily diet can help to reduce in incidence and severity of AP in high risk patients. Keywords: Acute Pancreatitis, dietary factors, disease severity, meat, fat.
Knowledge, Attitude and Practice of Dentists Towards Resin Bonded Bridges Across Pakistan
Authors: Khan Mahvish Wahad , Saleem Tayyaba , Zaigham Abdul Mueed , Inayat Naveed , Munir Nadia , Chaudhry Sana
Published: April 2023

Objective: The object of this survey study was to assess the knowledge, attitude and practice of dentists towards resin bonded bridges across Pakistan. Methodology: A cross-sectional survey study was conducted. A self-administered questionnaire was distributed among 500 dentists across Pakistan as a google form through electronic media. The questionnaire had three sections. First two sections had details about purpose of study and demographic details respectively. In the third section knowledge, attitude and practice of the participants were assessed. Knowledge and attitude were scored. Level of knowledge and attitude towards use of RBBs was correlated with other variables. Significance of factors related to RBB success was evaluated as percentages. Results: A total of 162 males (78%) and 128 females (63.1%) had adequate knowledge. Overall, 303 (75.2%) participants were inclined to use the RBB while only 100 (24.8%) were not in the favor of using this treatment. 286 participants (71%) were confident to offer this treatment to their patients however, 85% of them actually employed RBBs for ≤ 20% of their tooth replacements. Lack of skills was considered as a major hindrance to employ RBB treatment followed by the lack of technical support. Conclusion: The results of the study showed that participants are poised in knowledge regarding RBBs but they are reluctant to use this confidently because of lack of practical skills. Modest use of RBB in clinical practice is a question mark and a food for thought. Keywords: Resin Bonded Bridges, Conservative Dentistry, Minimally Invasive Dentistry.
Outcomes of Uncemented Bipolar Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients with Cardiac Dysfunction
Authors: Dar Usman Zafar , Muqaddas Ali , Shahid Mohammad Nauman , Ahmed Sameer , Ahmed Muhammad , Hussain Naeem
Published: April 2023

Objectives: Cementless hemiarthroplasty is advised because it reduces the risk of morbidity and mortality in older individuals who use cement. For older patients with high-risk clinical issues who had femoral neck fractures, we assessed the effectiveness of cementless hemiarthroplasty. Materials and Methods: The design of this study was a cross sectional study design and this study was conducted in DHQ Teaching Hospital Gujranwala. 48 patients, including 19 male and 29 female, with an average age of 88-years. using cementless hemiarthroplasty to treat patients with femoral neck fractures. 30 patients (62%) had porous-coated femoral stems, while 18 patients had modular femoral revision stems (38 percent). All patients had bipolar femoral heads. Following surgery, the follow-up radiologically was performed at yearly intervals. Results: The average number of followup years was 4.2. There were no hospital-related deaths among the patients. Six patients (12%) experienced medical difficulties during the period of follow-up, and 4-patients (8%) passed away. Due to acetabular degradation, only the 2 hips were changed to the total hip replacements. One patient was scheduled for a femoral revision due to a sinking of greater than 3 mm. No patients developed heterotopic ossification or acetabular protrusion. The HHA (Harris-hip average) score is 84. One patient experienced dislocation (2 percent). Practical Implication: The advantages of the cemented technique seem to be offset by its mortality risk and the advantages of the cementless option by its increased morbidity. Thus, in some of these very elderly morbid patients the orthopedic surgeon is faced with a dilemma regarding the correct surgical choice, which should be one that can promise pain relief and rapid resumption of function and, at the same time, prevent mortality and reduce morbidity Conclusion: An appropriate form of therapy for fractures in femoral neck in older individuals with risk of clinical issues, particularly those of the cardiopulmonary character, is cementless hemiarthroplasty. With this technique, after cemented hemi-arthroplasty the risk of fat embolism and hypotension is reduced. Keywords: Uncemented Bipolar Hemiarthroplasty, Uncemented Femoral Prosthesis, Hemiarthroplasty In Elderly, Cardiac Dysfunction, Femoral Neck Fracture.
Posteromedial Buttress Plate for Schatzker 6 Fractures as Double Column Fixation
Authors: Dar Usman Zafar , Muqaddas Ali , Shahid Mohammad Nauman , Ahmed Muhammad , Ahmed Sameer , Hussain Naeem
Published: April 2023

Objective: Treatment of Schatzker Type 6 fractures is to use a posteromedial buttress plate as part of a double-column fixation technique. Materials & Methods: The design of this study was a cross sectional study design and this study was conducted in DHQ Teaching Hospital Gujranwala. patients with posterior medial fracture of Schatzker type 6 and having associated damage of some soft tissue present within the joint underwent surgery at our institutional operation theatre. In this Study setting we included total 20 patients (14 male [70%] and 6 females [30%]) who came with Bicondylar fractures having Comminuted Posteromedial Fragments of tibia. Results: Of the Patients, 12 (60%) had excellent results, 5(25%) had good results , and 3 (15%) had fair results. In total, 17 patients (85%) achieved cheering results. Walking, Stability, and motion were good or excellent in all cases. Practical Implication: One of the main advantages of the posteromedial buttress plate fixation technique is that it provides support to the medial column of the tibia, which is an important weight-bearing structure in the lower extremity. By restoring the structural integrity of the medial column, the technique can help promote early weight-bearing and facilitate early rehabilitation. All displaced posteromedial tibial plateau fractures should be surgically stabilized and buttressed using plate to restore joint congruity and prevent late subluxation and early arthritis. The aim is to study the role of posteromedial plating in the management of complex tibial plateau fractures with a posteromedial fragment Conclusion: Use of a posteromedial buttress plate as part of a double-column fixation technique can be an effective approach for treating Schatzker Type 6 fractures. Keywords: Fixation of Posterior Column, Buttress plate, Schatzker 6 fracture