bluuebunny/crossref_metadata_2025 huggingface dataset:
Patent Ductus Arteriosus Device Closure with AMPLATZER Duct Occluder-II in a Low Birth Weight Preterm Neonate- First Experience in Pakistan
Authors: Imtiaz Sana , Akhtar Khurrum , Mehmood Amjad
Published: May 2023

We report a successful closure of large patent ductus arteriosus (PDA) in a low-birth weight preterm neonate using an ADO IIdevice for the first time in AFIC/NIHD Rawalpindi. A hemodynamically significant PDA in a preterm neonate carries anincreased risk of morbidity, including chronic lung disease, necrotizing enterocolitis and renal impairment. After the failure ofmedical therapy, successful, timely and safe transcatheter closure of PDA using appropriate equipment is a milestone inmanaging PDA in preterm neonates.
A Survey of Growth Hormone Stimulation Test Efficacy for Workup of Short Stature in a Referral Laboratory
Authors: Munir Muhammad Usman , Aamir Muhammad , Haroon Zujaja Hina , Kirmani Sobia Irum , Yasir Afshan , Habib Hunain
Published: May 2023

Objective: To assess growth hormone (GH) stimulation test efficacy in short stature workup for establishing GH deficiency.

Study Design: Cross-sectional survey.

Place and Duration of Study: Diagnostic Endocrine Section, Department of Chemical Pathology & Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Aug 2020 to Jan 2021.

Methodology: The study was conducted on 129 individuals aged 2-16 years. History, axiological data and biochemical parameters were assessed to establish GH deficiency for short stature workup.

Results: Out of 129 individuals, 76(59%) boys and 53(41%) girls reported GH stimulation tests. 81(62.3%) children were in <3rd percentile, 29(22.3%) in <5th percentile, 9(6.9%) in <10th percentile and 5(3.8%) in <25th percentile. Among the group with bone age difference >2 years, 34(82.9%) fell in <3rd percentile. GH Stimulation test post-Levo Dopa was performed in 102(78.46%) patients. 49(37.4%) patients responded inadequately to the GH stimulation test. The adequate response to the GH Stimulation test improved as the percentile declined from the 50th to the 3rd percentile.

Conclusion: GH stimulation test results can only partially rely upon though their importance remains in combination with other short-stature workup parameters for ruling out growth hormone deficiency.
Clinical Association of Thyroid Eye Disease with Disease Severity and Thyroid Functional Status-an Experience of a Tertiary Care Hospital, Karachi
Authors: Rani Bharta , Ahsan Tasnim , Aijaz Wasfa , Imran Paras , Fouzia Qasim Saeeda , Jabeen Rukhshanda
Published: May 2023

Objectives: To determine the occurrence and severity of thyroid eye disease regarding thyroid function in patients with autoimmune thyroid disease (AITD).

Study Design: Cross-sectional study.

Place and Duration of Study: Endocrinology Clinics, Jinnah Postgraduate Medical Centre (JPMC) and Medicell Institute of Diabetes Endocrinology & Metabolism (MIDEM) Karachi Pakistan, from Jan to Dec 2020.

Methodology: Patients with AITD or the presence of eye disease were included in the study. Socio-demographic, clinical and laboratory parameters, including thyroid function tests (TFTs), thyroid autoantibodies (TRAb, Anti-TPO, Anti-Tg), presence or absence of eye disease and its severity according to NOSPECS, were documented on a predefined proforma.

Results: A total of 220 patients with a mean age of 35.58±13.52 years and female predominance were included. Hyperthyroid, Hypothyroid and Euthyroid states were found in 125(56.82%), 43(19.5%) and 6(2.7%) of patients, respectively. Eye disease was found in 59(26.81%) patients. The mean NOSPECS score for patients with Grave’s Orbitopathy (GO) for males was 2.56±1.08, and for females, 2.59±1.01. Females had a greater number of TED-related signs and symptoms as compared to men (p=0.01). NOSPECS severity score of TED significantly correlated with fluctuating TFTs and overactive thyroid state (p<0.0001).

Conclusion: Patients with TED commonly presented with proptosis, lid retraction, and restricted movements. The severity of GO was significantly related to older age, female gender, smoking, fluctuating TFTs and hyperthyroidism. Endocrinologists and Ophthalmologists should both work in collaboration for appropriate management.
Unmasking of Pre-Existent Hyperglycemia and its Association with Ventilation in COVID-19 Patients: Experience at a Tertiary Care Hospital
Authors: Ali Waqar , Malik Uzma , Waheed Khadija , Khalid Usman , Arshad Waqas , Fatima Anam
Published: May 2023

Objective: To determine the relationship between pre-existent hyperglycemia among patients with COVID-19 pneumonia requiring oxygen supplementation.

Study Design: Cross-sectional study

Place and Duration of Study: COVID-19 isolation wards, High Dependency Units, and Intensive Care Units of Mayo Hospital Lahore Pakistan, from Apr to May 2021.

Methodology: Eighty-one patients with hyperglycemia but without a prior diagnosis of diabetes mellitus were selected for this study. The data was collected from COVID PCR positive patients admitted to the isolation ward and intensive care unit at Mayo Hospital, Lahore. All the patients admitted during a 2-month duration from April to May 2021.

Results: A Total of 81 patients were included, of which 54(66.7%) were males. On the basis of HbA1c, 68(84%), 12(14.8%) and 1 (1.2%) patient(s) were diagnosed diabetic, pre-diabetic and non-diabetic respectively. Of the four patients requiring mechanical ventilation, 3(75%) were diabetic, and 1(25%) was pre-diabetic. Of patients who required non-invasive ventilation, 68(84.4%), 12(14.2%) and 1(1.3%) were diabetic, pre-diabetic and non-diabetic, respectively.

Conclusion: There is a significant burden of undiagnosed diabetes mellitus and pre-diabetes among patients with severe COVID-19 who require oxygen supplementation or admission to high-dependency units. Therefore, all patients should undergo thorough testing to exclude underlying diabetes mellitus.
Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest
Authors: Zafar Saerah Iffat , Nasir Hina , Slehria Atiqur Rehman , Zafar Nadeem , Shahiryar Alina
Published: May 2023

Objective: To determine the effect of thymic response to COVID-19 pneumonia on imaging and its impact on disease severity and outcome.

Study Design: Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi Pakistan, from Mar to Jul 2020.

Methodology: A total of 1620 COVID-19 patients above the age of 18, of either gender, were included in the study. Their findings on High-Resolution CT (HRCT) chest were recorded and graded according to the CT severity score (CTSS) out of a total of 40; less than or equal to 19 was taken as mild while >20 scores were considered as severe disease. The thymic response was assessed by imaging appearance on CT and was graded from 0-3 as follows: fatty, predominantly fatty, mixed density (fat and soft density), and soft density. Fatty replacement implied thymic involution, while soft density depicted a reactivation of thymic tissue after a disease process depictive adequate thymic response.

Results: A significant difference in thymic response was observed in patients of different age groups (p<0.001), with the younger age group demonstrating thymic reactivation/ response in the majority (170/244, 69.7%). CT severity score and mortality were significantly higher in older patients demonstrating poor thymic response to COVID pneumonia.

Conclusion: Response of the thymus to acute viral infection by Sars COVID-19 is impaired as age progresses; this accounts for greater disease severity, morbidity and mortality in older patients.
Development and Validation of Caregiver Social Isolation Scale
Authors: Shafiq Sameera , Anwaar ul Mustafa Muhammad
Published: May 2023

Objective: To develop an indigenous Caregiver Social Isolation Scale (CSIS) in Urdu for caregivers of mental and physical disorders in Pakistan.

Study Design: Mixed method study.

Place and Duration of Study: Department of Psychology, University of Gujrat, Pakistan, from Jan to Jun 2021.

Methodology: An item pool of 48 was generated based on a thematic analysis of structured interviews with six experts and nine caregivers. The content validity was evaluated by three PhDs in Psychology and two Physicians. The reliability calculated on thirty participants for a tryout was 0.95. Item total correlation of item tool was in the acceptable range. A pilot study was done on three hundred individuals. The value of the KMO was 0.952, which showed the adequacy of the data, with the value of Bartlett’s test significant. No item was deducted. The reliability of 48 items on 300 individuals was 0.976, with two factors. First, for the validity of CSIS, data was collected from 120 individuals with standardized Ryff’s psychological well-being scale, Scale of Social Support and Delong Loneliness Scale. Second, confirmatory factor analysis was conducted on 200 caregivers of children with cleft lip and palate.

Results: Exploratory factor analysis yielded two factors, mental agony and lack of social cohesion, with 48 items. Model fit indices of CFA on caregivers......

Conclusion: CSIS is a reliable and valid scale for assessing the social isolation experiences of caregivers of either mental or physical diseases in Urdu.Keywords: Cleft lip, Cleft palate, Caregiver social isolation scale, Exploratory factor analysis.
Comparison of the Diagnostic Accuracy of Doppler Cerebroplacental Ratio Versus Standard Fetal Biometry for Fetal Growth Restriction
Authors: Aziz Sadaf , Humayun Pareesae , Altaf Mariam , Khan Yasser , Andrabi Syed Atif Hussain , Aziz Mubashrah
Published: May 2023

Objective: To assess the diagnostic accuracy of the Doppler Cerebroplacental ratio for fetal growth restriction keeping fetal biometry as the reference standard.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Radiology, Combined Military Hospital, Multan Pakistan, from May to Oct 2020.

Methodology: Two hundred and fifty-six-singleton pregnancies ≥ 30 weeks were included and underwent fetal biometry, including estimated fetal weight (EFW) by trans-abdominal ultrasound. The umbilical artery and middle cerebral artery resistive indices were evaluated using Doppler ultrasound, and Cerebroplacental ratio (CPR) was calculated. The presence or absence of fetal growth restriction (FGR) was noted using cut-off EFW of 10th centile and CPR of 1.0.

Results: Cerebroplacental ratio showed FGR in 145(56.64%) patients. Fetal biometry showed FGR in 141 (55.08%) patients,whereas 115(44.92%) patients revealed none. Of 145 CPR-positive patients, 127(87%) were true positive, while 18(12%) were false positive. Among 111 CPR-negative patients, 14(0.12%) were false negative, while 97(87%) were true negative. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the Cerebroplacental ratio were 90.07%, 84.35%, 87.59%, 87.39% and 87.50%, respectively.

Conclusions: Doppler Cerebroplacental ratio is sensitive for diagnosing fetal growth restriction; however, its role as a stand alone test needs further evaluation and may be enhanced with other tools such as estimated fetal weight.
Neutrophil Lymphocyte Ratio as Screening Tool for Neonatal Sepsis in Developing Countries
Authors: Naseer Nauman , Sheikh Taimur Khalil , Zulfiqar Sughra , Bashir Huma , Haroon Sadaf , Jahangir Junaid
Published: May 2023

Objective: to recognize an alternate method for screening neonatal sepsis in patients while considering the sensitivity and accuracy of the diagnosis.

Study Design: Cross sectional study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun to Dec 2021.

Methodology: Patients admitted to the Neonatal Intensive Care Unit of the Combined Military Hospital were included in the study. Demographic data, including age, weight, gender, and gestational age, were recorded. In addition, a statistical comparison of total leucocyte count, absolute neutrophil and lymphocyte counts, neutrophil-lymphocyte ratio, and C-reactive protein test was carried out for the cases and controls.

Results: It was evident from the results that a significant correlation between the neutrophil-lymphocyte ratio and neonatal sepsis exists. The mean NLR in non-septic individuals was (1.8±1.3) and in septic individuals, it was (2.9±1.9). The p-value was 0.001. Furthermore, ROC showed that at an NLR value of 1.6, sensitivity was 0.594 and 1-specificity 0.295.

Conclusion: Neutrophil lymphocyte ratio was an efficient screening tool for determining sepsis in neonates, with comparable results to the C-reactive protein test.
Association of Umbilical Cord Lactate Levels and Capillary Ph with Hypoxic-Ischemic Encephalopathy in Neonates Born with Intrapartum Asphyxia
Authors: Hassan Shah Syed Awais Ul , Qadir Ehsan , Ahmed Zeeshan , Shahid Farah , Alam Samina Shams
Published: May 2023

Objective: To estimate the association of umbilical cord lactate levels and pH with Hypoxic-Ischemic Encephalopathy in neonates born with intrapartum asphyxia.

Study Design: Comparative cross-sectional study.

Place and Duration of study: Pediatrics Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from February 2021 to April 2022.

Methodology: The study was conducted on neonates born with suspicion of intrapartum asphyxia at our hospital. Umbilical cord lactate levels and capillary pH were performed within the first 30 minutes of birth. Then, neonates were admitted to the neonatal intensive care unit and followed up for three days to look for the presence and severity of Hypoxic-Ischemic Encephalopathy (HIE). Association was ascertained between raised lactate levels and negative base deficit with HypoxicIschemic Encephalopathy.

Results: A total of 1000 neonates were included in the final analysis. From 1000 neonates with intrapartum asphyxia, 790(79%) did not develop any grade of hypoxic-ischemic encephalopathy within the first three days of birth, while 210(21%) developed either Grade-I, II or III encephalopathies. Raised serum lactate and base deficit were significantly associated with the presence and severity of hypoxic-ischemic encephalopathy in neonates born with intrapartum asphyxia (p-value<0.001).

Conclusion: Both umbilical artery lactate levels and capillary pH performed within the first 30 minutes of birth were associated with the presence and severity of Hypoxic-Ischemic Encephalopathy in neonates included in our study. These results favour lactate levels as a predictor of Hypoxic-Ischemic Encephalopathy.
Evaluation of Intraoperative and Post-Operative Benefits of Supraorbital Keyhole Approach for Anterior Circulation Aneurysm Surgery
Authors: Ejaz Memoona , Mushtaq Junaid , Khan Habibullah , Bangash Khurshid Ali , Farooq Umer , Tashfeen Ahmed , Ahmed Ali , Ahmed Zeeshan
Published: May 2023

Objective: To evaluate the intraoperative and post-operative benefits of the supraorbital keyhole approach for anterior circulation aneurysm surgery.

Study Design: Cross-sectional analytical study

Place and Duration of Study: Neurosurgery Department, Combined Military Hospital (CMH), Rawalpindi Pakistan, from Mar 2021 to Apr 2022.

Methodology: Forty patients came for anterior circulation aneurysm surgery during the above said period in the hospital who met the inclusion and exclusion criteria of the study. Ambulation time against all patients was 24 hours. Patients were treated with clipping. After surgery, patients were followed till the resolution of complications.

Results: Of 40 cases, 21(52.5%) were males, and 19(47.5%) were females. The average age of the patients was 51.97±9.73 years. The aneurysm location of patients was not associated with the gender of the patient, with a p-value of 0.115. Similarly, the average age of the patient was not significantly different for the patients' aneurysms location with a p-value of 0.106. Satisfaction appearance was claimed in all 40(100%) cases after surgery. The research study showed no complications in 18(45%) patients out of 40 after treatment, with a p-value of 0.041.

Conclusion: Supraorbital keyhole approach for anterior circulation aneurysm surgery is better regarding intraoperative tissue trauma and post-operative cosmetic outcome. The patient and all post-operative complications will be cured within six months after surgery.
Comparison of Patient Outcomes Before and After the Vascular Surgery Fellowship Program at Tertiary Care Hospital
Authors: Khan Raoon , Arif Anum , Bhatti Ahsin Manzoor , Faisal Mohammad Jamal , Iqbal Maryam
Published: May 2023

Objective : To assess the outcomes in managing patients with chronic kidney disease (CKD) requiring vascular access before and after, a formal vascular surgery fellowship program (VSFP) was introduced in a tertiary care hospital in Punjab.

Study Design : Pilot quasi-experimental study.

Place and Duration of Study: Department of Vascular Surgery and Nephrology at Combined Military Hospital (CMH) ,Lahore Pakistan, from Feb to Oct 2020.

Methodology: Patients meeting the inclusion criteria of ages between 20 to 70 years, either gender and undergoing dialysis due to chronic renal failure were recruited in the study. Data was collected at the initial phase when a VSFP was absent and later when it was present. Outcome variables were current dialysis access, waiting time for permanent dialysis access and failure rate about the duration of chronic renal failure.

Results: A total of 226 patients were recruited in the study. In both pre-vascular surgery fellowship program time (pre-VSFPT) and post-vascular surgery fellowship program time (post-VSFPT), the predominant functional dialysis access at the time of the interview was arterio-venous fistula (AVF). However, they were much higher in the post-VSFPT, i.e., 46(54.1%) as compared to 96 (68.1%) (p= 0.069). In addition, in pre-VSFPT, 24 (28.2%) patients had a “Never Created” AVF status at the time of the interview as compared to 21(14.9%) in post-VSFPT, which was statistically significant.

Conclusion: The establishment of a fellowship program not only benefits the trainee but it improves patient care significantly. This study highlights the improvement in all the benchmarks of the formation
Skeletal Maturity Assessment using Mandibular Canine Calcification Stages
Authors: Nasir Zainab Bint-e- , Jan Abdullah , Khalid Zahra , Tariq Qurat ul ain , Zia Ramsha , Arshad Neha
Published: May 2023

Objective: To determine the correlation between cervical vertebral maturation stages on a lateral cephalo-gram and Dimerijan canine calcification stages on an Orthopan-tomogram for assessment of skeletal maturity

Study Design: Cross-sectional study.

Place and Duration of Study: Orthodontics Department, Armed Forces Institute of Dentistry (AFID), Rawalpindi Pakistan, from Dec 2021 to Apr 2022.

Methodology: The subjects of either gender, aged 9 to 16 years, in good physical, mental and oral health were included in the study. Two radiographs, a lateral cephalogram and Orthopantomogram, were taken for each patient. Hassel and Farman and Demirjian stages were used to asses skeletal maturity and canine classification, respectively.

Results: The mean age of the sample was 13.29±1.86 years. The Hassel and Farman CVM stages on a lateral cephalometric radiograph and Dimerijan canine calcification stages on a panoramic radiograph showed a significant positive correlation (r= 0.785, p= 0.000)

Conclusion: There is a high correlation between CVM stages by Hassel and Farman and Dimerijan canine calcification stages to assess skeletal maturity. Therefore, any of these radiographs can be employed to assess the skeletal maturity status of the patient without exposing the patient to additional radiographic radiation.Keywords: Cervical vertebral maturation (CVM) stages, Canine calcification stages, Dental maturity, Skeletal maturity.
Comparison of Intravenous Tramadol vs Intravenous Morphine in Attenuation of Hemodynamic Stress response to Laryngoscopy and Endotracheal Intubation in Laparoscopic Cholecystectomy
Authors: Khan Basit Mehmood , Ayub Farrukh , Shoukat Sundas , Naseer Syed Khurram , Hayat Umer , Zafar Junaid
Published: May 2023

Objective: To compare the efficacy of intravenous Tramadol and intravenous Morphine in attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation in laparoscopic cholecystectomy.

Study Design: Quasi-experimental study

Place and Duration: Department of Anesthesia, Combined Military Hospital, Mardan Pakistan, from Jun 2021 to Jun 2022.

Methodology: A total of 136 patients were involved in the research. These patients were divided via a lottery method into two groups i.e., Group-T (Tramadol) and Group-M (Morphine) with 68 patients in each group. Patients aged 20-50 years planned for laparoscopic cholecystectomy with American Society of Anesthesiologists (ASA) Grade I or Grade II were included in the study.

Results: Out of a total of 136 patients with equal distribution of 68(50%) patients in each group. Patients with ASA– I Grade from Group–T and Group-M were 52(76.5%) and 41(60.1%), respectively; however, ASA–II Grade patients were 16(23.5%) from Group–T and 27(39.7%) from Group–M. In this study, intravenous Tramadol was effective in 48(70.5%) out of 68 patients, while intravenous Morphine was effective in 60(88.24%) patients, with a p-value of 0.01.

Conclusion: This study concluded that intravenous Morphine is more effective in attenuating hemodynamic stress response to laryngoscopy and endotracheal intubation in laparoscopic cholecystectomy than intravenous Tramadol.
Sol Brain, Pre-Operative Magnetic Resonance Spectroscopy and Surgical Biopsy Yield
Authors: Bangash Khurshid Ali , Yousaf Nasrin , Ilyas Sohail , Mahmood Rashid , Parveen Ishrat , Yousaf Ajmal , Khushdil Arshad , Nathaniel Sharoon
Published: May 2023

Objective: To ascertain the positive predictive value (PPV) of magnetic resonance spectroscopy (MRS) in diagnosing neoplastic intracranial masses by taking histopathology as a benchmark.

Study Design: Cross-sectional study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jan 2019 to Jun 2021.

Methodology: After approval from the Ethical Review Committee, 64 patients with neoplastic intracranial mass lesions on MRI were incorporated into the study. Patients with a history of brain surgery done previously, breastfeeding females, claustrophobia, already diagnosed type of tumour, and contraindication to MRI were excluded. MR Spectroscopy was performed, and findings were correlated with histopathology.

Results: Of 64 patients, 39(60.94%) were males, and 25(39.06%) were females. Magnetic Resonance Spectroscopy (MRS) supported the diagnosis of neoplastic brain lesions in all 64 patients. Histopathology confirmed malignant brain lesions in 59 cases, whereas 05 cases had benign lesions. PPV of MRS in the diagnosis of neoplastic brain lesions was 92.19%.

Conclusion: This study concluded that MRS is a non-invasive option having a very good PPV in determining neoplastic brain lesions.
Peran Dinas Tenaga Kerja Dan Transmigrasi Provinsi DIY Dalam Upaya Mengurangi Angka Pengangguran Pada Era Tatanan Baru di Kota Yogyakarta
Authors: Dwi Maelana Herman Wahyu , Najib Khoiri , Nugroho Himawan Agung
Published: May 2023

During the COVID-19 pandemic, the unemployment rate increased because companies reduced the number of employees. The Labor and Transmigration Office of the DIY Province takes a role in reducing unemployment rate in Kota Yogyakarta. The purpose of this study is to explain the role of the Labor and Transmigration Office of DIY Province in an effort to reduce unemployment in the era of the new normal in the city of Yogyakarta. The research data was collected through observation, interviews, document studies and literature studies.

The role of the Labor and Transmigration Office of DIY Province, as a result of this research, is to create programs and activities for the community of Kota Yogyakarta so that the community has  certified knowledge and abilities, namely the Workforce Certification Activity Program, Apprenticeship Program, Business Assistance Program for Educated Independent Workers ( TKMT) and Technical Guidance for Accreditation and Instructor Accreditation of Job Training Institutes (LPK) and Job Training Centers (BLK).
PENGARUH KUALITAS LAYANAN DAN KUALITAS MAKANAN PEDAGANG KAKI LIMA TERHADAP KEPUASAN KONSUMEN PADA MASA PANDEMI COVID 19 DI KOTA JAKARTA
Authors: Handayani Ch.Dini Ika
Published: May 2023

Dunia telah mengalami pandemi Covid-19 sejak tahun 2019 dan menyebabkan perekonomian di dunia terganggu, baik dari bidang keuangan, operasional dan pendidikan,dll. Di tengah situasi pandemi Covid-19 bertambahnya tingginya tingkat pengangguran perkotaan menumbuhkan usaha di sektor informal.Pedagang kaki lima merupakan salah satu sektor informal yang menjadi alternatif bagi mereka yang tidak mendapat pekerjaan atau menjadi korban PHK akibat Covid 19 ini. Kawasan pedagang kaki lima yang cukup terkenal di Jakarta adalah kawasan Bulungan, Blok M, dimana di daerah tersebut banyak sekali terdapat pedagang kaki lima yang berjualan gulai. Istilah yang terkenal bagi kawasan ini adalah Gultik Bulungan. Adapun singkatan dari Gultik adalah Gulai Tikungan karena memang kawasan berjualan berada di daerah tikungan Jalan Bulungan. Adanya jumlah pedagang yang cukup banyak menyebabkan persaingan antar pedagang. Masing-masing pedagang harus menyediakan pelayanan tempat, karyawan serta rasa masakan yang menarik sehingga pembeli berminat membeli di warung mereka dan merasa puas. Kepuasan pembeli ini yang diharapkan akan disampaikan kepada calon pembeli lainnya sehingga mereka tertarik untuk datang ke warung tersebut atau pembeli yang sama melakukan pembelian ulang di tempat tersebut.Penelitian ini bertujuan untuk mengetahui pengaruh kualitas pelayanan dan kualitas makanan terhadap kepuasan konsumen serta pengaruh antara kepuasan konsumen terhadap niat perilaku beli ulang. Penelitian ini dilakukan menggunakan kuisioner dalam bentuk google form yang disebarkan melalui whatapps  terhadap 50 orang konsumen yang pernah datang berkunjung ke pedagang kaki lima Gultik Tikungan ini. Hasil penelitian menunjukkan bahwa kualitas pelayanan berpengaruh signifikan terhadap kepuasan konsumen. Sedangkan kualitas makanan tidak berpengaruh signifikan terhadap kepuasan konsumen. Adapun untuk variabel kepuasan konsumen berpengaruh signifikan terhadap niat perilaku beli ulang.
Calidad de vida del adulto mayor en el Valle del Mezquital pre y pos apoyo educativo mediante las TIC´ s
Authors: López-Nolasco Benjamín , Álvarez-Corona Magali , Bravo-Hernández Elisa Victoria , Hernández-Hernández Miguel , Maya-Sánchez Ariana
Published: May 2023

Introducción: Según estudios previos en México (2010) señalan que la esperanza de vida era de 75.5 años y de acuerdo con nuevos datos, se estima que esta aumentara a 77.8 años para 2030, por lo cual es necesario fortalecer y fomentar el autocuidado en el adulto mayor, mediante el apoyo educativo, debido a la pandemia a través del uso de las TICs con la finalidad de aumentar su nivel de calidad de vida.
Objetivo: Evaluar el nivel de calidad de vida de los adultos mayores del Valle del Mezquital antes y después del apoyo educativo para fomentar el autocuidado mediante el uso de las TIC`s.
Diseño, metodología: Investigación de tipo cuantitativa de aplicabilidad básica con alcance correlacional, experimental, prolectivo y longitudinal. Se ocupó la prueba estadística paramétrica t de student.
Resultados: De acuerdo al instrumento WHOQOL-BREF pre intervención se obtuvo que el 80% de la población reflejo una calidad de vida media, y posterior a un mes de intervención se obtuvo un 67% de la población reflejo calidad de vida alta, de acuerdo con la prueba estadística t se obtuvo una significan la bilateral de .041 posterior a la intervención.
Conclusiones: Se concluye que la calidad de vida de los adultos mayores mejoró gracias a las intervenciones educativas ofrecidas médiate las TIC’s logrando así una nueva estrategia de acercamiento en tiempos de pandemia demostrando que estas herramientas ayudan a mejorar el autocuidado.
Valoración de las respuestas conductuales al dolor durante el cambio postural en pacientes sedados orointubados
Authors: Galeana-Muzaleno Norma , García-López Ana Sofía , Villegas-Sánchez Eder Alan , Santiago-González Nicolás
Published: May 2023

Introducción: Los pacientes críticos, bajo sedación y apoyo ventilatorio invasivo presentan dolor, la barrera más grande para su detección es la incapacidad de comunicarse, sin embargo, el hecho de que el paciente no pueda referir su dolor, no significa que no lo padezca.
Objetivo: Describir las respuestas conductuales al dolor durante el cambio postural en pacientes sedados oro intubados.
Metodología: Estudio cuantitativo, descriptivo, observacional, longitudinal. Muestra n= 50 pacientes, se utilizó la escala BPS (Behavioral Pain Scale) como instrumento de valoración del dolor, se midió en tres momentos: 1 minuto antes, durante y 10 minutos después Del cambio postural.  
Resultados: El cambio postural del paciente con sedación y ventilación mecánica provoco dolor inaceptable en 56% de los pacientes; antes de realizar el cambio postural se identificó una media del dolor de 4.6, durante el cambio postural aumento a 6.5 y posterior al cambio disminuyo a una media de 4, siendo un factor protector.
Conclusiones: La movilización del paciente sedado oro intubado requiere de la participación del equipo multidisciplinar, para el manejo de la ventilación mecánica, el cuidado de sondas y catéteres, cuidados de la piel, prevención de caídas y aplicación correcta de la técnica de movilización, la cual demanda experiencia clínica del personal que participa en la valoración y manejo de las respuestas conductuales al dolor.
Intervenciones de prevención y tratamiento en recién nacidos con defectos del tubo neural
Authors: Vázquez-Hernández Ariela , Álvarez-Gallardo Laura
Published: May 2023

Introducción: Los defectos de tubo neural son anomalías congénitas del sistema nervioso central; estas malformaciones elevan el grado de morbimortalidad en los recién nacidos durante los diez primeros años de vida.
Objetivo: Definir las intervenciones que el profesional de enfermería puede realizar en el recién nacido con defectos del tubo neural tomando en cuenta aspectos de prevención y tratamiento.
Método: Se realizo una búsqueda sistematizada en las bases de datos de PudMed y BVS durante julio-septiembre de 2021, que incluyo artículos completos relacionados con intervenciones de enfermería a recién nacidos con defectos del tubo neural publicados entre 2016-2021 y artículos médicos de revisión literaria.
Resultados: Se seleccionaron 41 artículos para definir las intervenciones, a saber: a) intervenciones preventivas con el consumo de ácido fólico, control prenatal y educación sanitaria, b) intervenciones relacionadas al tratamiento enfocadas al cuidado de las derivaciones ventriculoperitoneales y cuidado de heridas quirúrgicas, c) intervenciones ante complicaciones.
Discusión: Las tasas de mortalidad y discapacidad infantil han incrementado en los últimos años a pesar de los avances en la medicina preventiva, por lo que toma relevancia el consumo de ácido fólico, la educación sanitaria y los métodos de cuidado hospitalarios.
Conclusiones: la enfermera neonatal puede participar con cuidados estandarizados en beneficio de los recién nacidos considerando intervenciones para evitar retraso en el crecimiento y desarrollo de los hitos motores y cognitivos, reducir complicaciones y mejorar las posibilidades de una óptima condición de vida.
Akıllı Kent Donatıları Üzerine Bir İnceleme: Erzurum Kenti Örneği
Authors: HIRÇIN Feyza , DEMİR Metin
Published: May 2023

Akıllı kent donatıları, değişen dünya koşullarına ayak uydurabilmek ve kentleşmenin getirdiği sorunların çözümüne katkı sağlayabilmek için teknolojiyi kullanan kent öğeleridir. Yapılan çalışmada, Erzurum kentindeki akıllı kent donatılarının mevcut durumunu belirlemek ve akıllı kentler kapsamında ortaya çıkan toplumsal dönüşüm sürecine ve gelecekte yapılması planlanan çalışmalara katkı sağlamak amaçlanmıştır. Çalışma kapsamında Dünya ve Türkiye örnekleri, akıllı kent donatı tiplerine göre incelenmiştir. Bunun yanında Erzurum kentindeki akıllı kent donatıları ile ilgili mevcut durumu belirlemek adına resmî kurumlarla görüşmeler yapılmıştır. Yürütülen literatür araştırması ve saha çalışmalarından elde edilen analizlere göre örnekler karşılaştırılarak, Erzurum kentindeki akıllı kent donatısı uygulamalarının geliştirilebilmesi ve eksikliklerin giderilmesi için çözüm ve iyileştirme önerilerinde bulunulmuştur.
News sharing as a measure of media alignment
Authors: Simonovits Gábor , Vig Ádám
Published: May 2023

In this note we introduce a new approach to measure media alignment derived from the story-sharing behavior of journalists. We use a large corpus of online news stories from two leading Hungarian news sites and estimate alignment scores for a large number of outlets that they cite. To the extent that journalists are more likely to cite ideologically proximate sources, our measure can be used to compare a large number of media outlets on a political — in our case government vs. independent — space. We demonstrate the use of this approach with two empirical applications. First, we show that our alignment scores successfully capture known ideological variation across outlets at a single point in time. Second, we demonstrate that quarterly estimates of alignment for a captured outlet change dramatically following an abrupt change in ownership.
“Buen Vivir” e “Extrativismo”: transformação produtiva no Equador durante o Governo de Rafael Correa
Authors: de Freitas Alexandre Jerônimo , Moura Ferreira Henrique
Published: May 2023

Muitos críticos têm denominado os chamados governos progressistas de neoextrativistas. Teriam apenas reproduzido a tradicional estrutura produtiva orientada pelas atividades primário-exportadoras. Este trabalho analisará o caso do Equador durante o governo de Rafael Correa (2007-2017). O objetivo é mensurar o ritmo e a direção do processo de mudança estrutural do país, principalmente, durante o período de vigência dos planos nacionais para o Buen Vivir (2009 a 2013 e 2013 a 2017). Foi realizada uma análise setorial da manufatura através do uso da classificação por intensidade tecnológica adotada pela OCDE. Os resultados apresentam avanços significativos nos subsetores mais tecnológicos da indústria de transformação equatoriana, contradizendo o argumento de que a estrutura produtiva em nada se modificou.
Carta do Editor
Authors:   INCT-PPED, Gaitán Flavio
Published: May 2023

Esse primeiro número do volume 11 da revista Desenvolvimento em Debate, co-organizado junto com o de Grupo de Trabalho Pobreza e Políticas Sociais do Conselho Latino-Americano de Ciências Sociais, explora a proteção social no mundo pós-pandemia.
CH4Net: a deep learning model for monitoring methane super-emitters with Sentinel-2 imagery
Authors: Vaughan Anna , Mateo-García Gonzalo , Gómez-Chova Luis , Růžička Vít , Guanter Luis , Irakulis-Loitxate Itziar
Published: May 2023

Abstract. We present a deep learning model, CH4Net, for automated monitoring of methane super-emitters from Sentinel-2 data. When trained on images of 21 methane super-emitters from 2017–2020 and evaluated on images from 2021 this model achieves a scene-level accuracy of 0.83 and pixel-level balanced accuracy of 0.77. For individual emitters, accuracy is greater than 0.8 for 17 out of the 21 sites. We further demonstrate that CH4Net can successfully be applied to monitor two superemitter locations with similar background characteristics not included in the training set, with accuracies of 0.92 and 0.96. In addition to the CH4Net model we compile and open source a hand annotated training dataset consisting of 925 methane plume masks.
Machine learning approaches for automatic classification of single-particle mass spectrometry data
Authors: Wang Guanzhong , Ruser Heinrich , Schade Julian , Passig Johannes , Adam Thomas , Dollinger Günther , Zimmermann Ralf
Published: May 2023

Abstract. The chemical composition of aerosol particles is a key parameter for human health and climate effects. Single-particle mass spectrometry (SPMS) has evolved to a mature technology with unique chemical coverage and the capability to analyze the distribution of aerosol components in the particle ensemble in real-time. With the fully automated characterization of the chemical profile of the aerosol particles, selective real-time monitoring of air quality could be performed e.g. for urgent risk assessments due to particularly harmful pollutants. For aerosol particle classification, mostly unsupervised clustering algorithms (ART-2a, K-means and their derivatives) are used, which require manual post-processing. In this work, we focus on supervised algorithms to tackle the problem of automatic classification of large amounts of aerosol particle data. Supervised learning requires data with labels to train a predictive model. Therefore, we created a labeled benchmark dataset containing ~24,000 particles with eight different coarse categories that were highly abundant at a measurement in summer in Central Europe: Elemental Carbon (EC), Organic Carbon and Elemental Carbon (OC-EC), Potassium-rich (K-rich), Calcium-rich (Ca-rich), Iron-rich (Fe-rich), Vanadium-rich (V-rich), Magnesium-rich (Mg-rich) and Sodium-rich (Na-rich). Using the chemical features of particles the performance of the following classical supervised algorithms was tested: K-nearest neighbors, support vector machine, decision tree, random forest and multi-layer perceptron. This work shows that despite the entrenched position of unsupervised clustering algorithms in the field, the use of supervised algorithms has the potential to replace the manual step of clustering algorithms in many applications, where real-time data analysis is essential. For the classification of the eight classes, the prediction accuracy of several supervised algorithms exceeded 97 %. The trained model was used to classify ~49,000 particles from a blind dataset in 0.2 seconds, taking into account also a class of “unclassified” particles. The predictions are highly consistent with the results obtained in a previous study using ART-2a.
ESD Ideas: Arctic Amplification’s Contribution to Breaches of the Paris Agreement
Authors: Duffey Alistair , Mallett Robbie , Irvine Peter J. , Tsamados Michel , Stroeve Julienne
Published: May 2023

Abstract. The Arctic is warming at almost four times the global average rate. Here we reframe this amplified Arctic warming in terms of global climate ambition to show that it causes a breach of the Paris Agreement’s 1.5 °C and 2 °C limits 5 and 8 years earlier, respectively. This outsized influence on global climate targets highlights the need for better modelling and monitoring of Arctic change.
ClinoformNet-1.0: stratigraphic forward modeling and deep learning for seismic clinoform delineation
Authors: Gao Hui , Wu Xinming , Zhang Jinyu , Sun Xiaoming , Bi Zhengfa
Published: May 2023

Abstract. Deep learning has been widely used for various kinds of data-mining tasks but not much for seismic stratigraphic interpretation due to the lack of labeled training datasets. We present a workflow to automatically generate numerous synthetic training datasets and take the seismic clinoform delineation as an example to demonstrate the effectiveness of using the synthetic datasets for training. In this workflow, we first perform stochastic stratigraphic forward modeling to generate numerous stratigraphic models of clinoform layers and corresponding porosity properties by randomly but properly choosing initial topographies, sea level curves, and thermal subsidence curves. We then convert the simulated stratigraphic models into impedance models by using the velocity–porosity relationship. We further simulate synthetic seismic data by convolving reflectivity models (converted from impedance models) with Ricker wavelets (with various peak frequencies) and adding real noise extracted from field seismic data. In this way, we automatically generate a total of 3000 diverse synthetic seismic datasets and the corresponding stratigraphic labels such as relative geologic time models and facies of clinoforms, which are all made publicly available. We use these synthetic datasets to train a modified encoder–decoder deep neural network for clinoform delineation in seismic data. Within the network, we apply a preconditioning process of structure-oriented smoothing to the feature maps of the decoder neural layers, which is helpful to avoid generating holes or outliers in the final output of clinoform delineation. Multiple 2D and 3D synthetic and field examples demonstrate that the network, trained with only synthetic datasets, works well to delineate clinoforms in seismic data with high accuracy and efficiency. Our workflow can be easily extended for other seismic stratigraphic interpretation tasks such as sequence boundary identification, synchronous horizon extraction, and shoreline trajectory identification.
European heat waves 2022: contribution to extreme glacier melt in Switzerland inferred from automated ablation readings
Authors: Cremona Aaron , Huss Matthias , Landmann Johannes Marian , Borner Joël , Farinotti Daniel
Published: May 2023

Abstract. Accelerating glacier melt rates were observed during the last decades. Substantial ice loss occurs particularly during heat waves that are expected to intensify in the future. Because measuring and modelling glacier mass balance on a daily scale remains challenging, short-term mass balance variations, including extreme melt events, are poorly captured. Here, we present a novel approach based on computer-vision techniques for automatically determining daily mass balance variations at the local scale. The approach is based on the automated recognition of colour-taped ablation stakes from camera images and is tested and validated at six stations installed on three Alpine glaciers during the summers of 2019–2022. Our approach produces daily mass balance with an uncertainty of ±0.81 cm w.e. d−1, which is about half of the accuracy obtained from visual readouts. The automatically retrieved daily mass balances at the six sites were compared to average daily mass balances over the last decade derived from seasonal in situ observations to detect and assess extreme melt events. This allows analysing the impact that the summer heat waves which occurred in 2022 had on glacier melt. Our results indicate 23 d with extreme melt, showing a strong correspondence between the heat wave periods and extreme melt events. The combination of below-average winter snowfall and a suite of summer heat waves led to unprecedented glacier mass loss. The Switzerland-wide glacier storage change during the 25 d of heat waves in 2022 is estimated as 1.27 ± 0.10 km3 of water, corresponding to 35 % of the overall glacier mass loss during that summer. The same 25 d of heat waves caused a glacier mass loss that corresponds to 56 % of the average mass loss experienced over the entire melt season during the summers 2010–2020, demonstrating the relevance of heat waves for seasonal melt.
The impact of the Agulhas Current system on precipitation in southern Africa in regional climate simulations covering the recent past and future
Authors: Tim Nele , Zorita Eduardo , Hünicke Birgit , Ivanciu Ioana
Published: May 2023

Abstract. The southern African climate is strongly impacted by climate change. Precipitation is a key variable in this region, as it is linked to agriculture and water supply. Simulations with a regional atmospheric model over the past decades and the 21st century display a decrease in the past precipitation over some coastal areas of South Africa and an increase over the rest of southern Africa. However, precipitation is projected to decrease over the whole southern part of the domain in the future. This study shows that the Agulhas Current system, including the current and the leakage, which surrounds the continent in the east and south, impacts this precipitation trend. A reduction in the strength of the Agulhas Current is linked to a reduction in precipitation along the southeast coast. The Agulhas leakage, the part of the Agulhas Current that leaves the system and flows into the South Atlantic, impacts winter precipitation in the southwest of the continent. A more intense Agulhas leakage is linked to a reduction in precipitation in this region.
ANALISIS KETERBATASAN PANDANGAN VISUAL PADA INTERIOR AREA KERJA WORK FROM HOME PADA MASA PANDEMI COVID-19 TERHADAP PRODUKTIVITAS KERJA
Authors: Laksitarini Niken , Andriani Aninda
Published: May 2023

Pandemi virus covid-19 membuat banyak pergeseran pola pikir dan bekerja pada masyarakat Indonesia. Keterlibatan pemerintah dalam meminimalisir penyebaran virus covid-19 terbilang cukup signifikan dan efektif. Kebijakan tersebut antara lain diberlakukannya Pembatasan Sosial Berskala Besar (PSBB). PSBB yang diberlakukan di hampir seluruh wilayah di Indonesia berdampak pula pada bidang perkantoran. Pekerja dianjurkan untuk melakukan pekerjaan jarak jauh atau yang biasa kita sebut Work From Home (WFH). Work From Home memaksa kita untuk mengerjakan pekerjaan dari rumah yang tidak jarang area kerja yang kita pakai untuk bekerja memiliki banyak keterbatan. Salah satunya adalah keterbatasan pandangan visual. Dalam bekerja, terdapat beberapa aspek yang menjadi syarat agar produktivitas kerja lebih maksimal. Kurangnya interaksi dengan dunia luar menjadi salah satu pemicu suasana hati atau produktivitas kerja menurun. Peran desain interior terhadap produktivitas kerja memiliki andil yang cukup besar. Penempatan area kerja yang memiliki pandangan visual menjadi salah satu solusi agar target produktivitas kerja tercapai. Penelitian ini menggunakan metode deskriptif kualitatif. Diharapkan melalui tulisan ilmiah ini dapat menjadi acuan dan bahan referensi bagi penulis lainnya dan juga bahan pertimbangan masyarakat luas dalam meningkatkan produktivitas bekerja.
SI KABAYAN DALAM KEHIDUPAN MASARAKAT SUNDA
Authors: Ridwan Iwan Muhammad
Published: May 2023

Sosok Si Kabayan selalu diidentikan dengan karakter pandir, pemalas namun cerdik yang sering kali bisa mengalahkan lawan-lawan dalam kehidupannya. Kemunculannya di tengah-tengah masyarakat mendorong para pelaku seni mentransformasikan Si Kabayan pada sejumlah karya baru yakni sastra, drama dan film, baik berupa cerita utuh tentang Si Kabayan maupun spirit komedi yang terinspirasi dari karakter ketokohannya. Hal ini masih terjadi hingga saat ini dan mewarnai media baru Youtube yang kini menciptakan trend baru yakni budaya popularitas. Melalui pendekatan sosiohistoris pada jejak literasi, nyatanya cerita Si Kabayan memiliki nilai-nilai religius yang terkandung baik dalam cerita secara keseluruhan maupun pada penggalan-penggalan cerita dan dialog yang dilontarkan oleh Si Kabayan beserta tokoh yang menyertainya. kontinuitas nilai religi pada setiap genre cerita yang ditemukan dapat terungkap melalui pendekatan deskriptif analisis, mengenai narasi dan simbol-simbol yang digunakan dalam mengkomunikasikan pesan religiusnya. Nilai religius Si Kabayan dapat ditemukan melalui observasi pada sejumlah literatur mulai dari cerita lisan, sastra, drama hingga film yang tersebar pada media baru Youtube. Wawancara para pakar mengenai ketohohan Si Kabayan, hingga studi pustaka pada penelitian-penelitian sebelumnya akan memperkuat informasi mengenai ketokohan Si Kabayan dan nilai religiusnya.