bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Learning Based Efficient Pneumonia Detection in Chest X-Ray Images
Authors: Soundararajan Mr. K , J.Jeshmitha  , N. Kannika  , V. Karthika
Published: May 2023

Medical motion plays an essential role in clinical treatment. The deep neural network is an emerging machine learning method that has proven its potential for different classification tasks. Notably, the convolutional neural network dominates with the best results on varying image classification tasks. However, medical image datasets are hard to collect because it needs a lot of professional expertise to label them. Although it can be detected and treated with very less sophisticated instruments and medication. Therefore, this paper how to apply the Convolutional Neural Network (CNN) based algorithm on a chest X-ray dataset to classify pneumonia. The objective and automated detection of pneumonia represents a serious challenge in medical imaging because the signs of the illness are not obvious in CT or X-ray scans. Further on, it is also an important task, since millions of people die of pneumonia every year. Deep learning-based methods have shown good generalization traits over various problem domains, which prompts researchers around the globe to work tirelessly and come up with more efficient and effective models than earlier. However, this robust nature comes at the cost of high computational resources and, in general, it requires a huge amount of data to train the model efficiently. The latter requirement sometimes cannot be fulfilled, especially in the biomedical field. The main goal is to propose a solution for the above-mentioned problem, using a novel deep neural network architecture. The proposed novelty consists of the use of dropout in the convolutional part of the network. The proposed method was trained and tested on a set of labeled images. This project aims to introduce a deep learning technology based on the computational neural network, which can realize automatic diagnosis of patients with pneumonia in X-ray images.
PENGARUH LINGKUNGAN KERJA DAN DISIPLINKERJA TERHADAP KINERJA PEGAWAI DINAS PENDIDIKAN KABUPATEN KARO
Authors: Barus Hernayanti Br , Giawa Henida
Published: May 2023

Penelitian ini bertujuan untuk mengetahui pengaruh parsial maupun simultan disiplin kerja dan lingkungan kerja terhadap kinerja pegawai Dinas Pendidikan Kabupaten Karo.Penelitian ini termasuk penelitian kuantitatif, dimana instrumen penelitian ini berupa kuesioner. Populasi dan sampel dalam penelitian ini adalah seluruh pegawai Dinas Pendidikan Kabupaten Karo yaitu sebanyak 42 orang.Uji instrumen pada penelitian ini dilakukan dengan menggunakan uji validitas dan reliabilitas.Teknik analisis data dalam penelitian ini menggunakan teknik analisis regresi linier berganda. Hasil penelitian diperoleh bahwa lingkungan kerja berpengaruh positif dan signifikan terhadap kinerja pegawai, dimana nilai thitung (2,452) lebih besar dari nilai ttabel (2,015), dan nilai signifikansinya sebesar 0,019 lebih kecil dari 0,05.Disiplin kerja berpengaruh positif dan signifikan terhadap kinerja pegawai, dimana nilai thitung (6,670) lebih besar dari nilai ttabel (2,015), dan nilai signifikansinya sebesar 0,000 lebih kecil dari 0,05.Lingkungan kerja dan disiplin kerja secara bersama-sama berpengaruh positif dan signifikan terhadap kinerja pegawai, dimana nilai F hitung (33,789) lebih besardari nilai F tabel (2,83), dan nilai signifikansinya sebesar 0,000 lebih kecil dari 0,05. Besarnya pengaruh variabel bebas (lingkungan kerja dan disiplin kerja) terhadap variabel terikatnya (kinerja pegawai) sebesar 63,4%, sedangkan sisanya sebesar 36,6% dipengaruhi oleh faktor lain yang tidak diteliti dalam penelitian ini.
PENGARUH KEBIJAKAN HARGA DAN KUALITAS PRODUK TERHADAP KEPUTUSAN PEMBELIAN SABUN MEREK LIFEBUOY PADA PT. MITRA ANDAL SEJATI MEDAN
Authors: Laia David Walterus , Napitupulu R.B. , Simatupang Sabar L.T.
Published: May 2023

Penelitian ini bertujuan untuk mengetahui secara parsial dan secara simultan Pengaruh Kebijakan Harga dan Kualitas Produk terhadap Keputusan Pembelian Sabun Merek Lifebuoy pada PT. Mitra Andal Sejati Medan. Penelitian ini menggunakkan metode deskriptif dengan pendekatan kuantitatif, dengan teknik pengambilan sampel menggunakan metode Accidental sampling (sampling peluang). Jumlah sampel dalam penelitian ini adalah 150 orang responden yang telah melakukan pembelian sabun merek lifebuoy pada PT. Mitra Andal Sejati Medan. Kemudian, dalam analisis data penelitian menggunakan statistical product and service solution (SPSS) versi 25.0 dan Microsoft Excel 2007. Hasil Koefisien determinasi penelitian ini menunjukkan bahwa Kebijakan Harga dan Kualitas Produk terhadap Keputusan Pembelian dengan nilai R sebesar 92,4% dan nilai R square sebesar 85,3% artinya memiliki hubungan sangat kuat. Kemudian, secara parsial Kebijakan Harga terhadap Keputusan Pembelian thitung > ttabel (5,601 > 1,976) pada taraf signifikan 0,000 < 0,05, dan Kualitas Produk Terhadap terhadap Keputusan Pembelian thitung < ttabel (4,935 < 1,976) pada taraf signifikan 0,000 < 0,05 kemudian secara simultan Kebijakan Harga dan Kualitas Produk terhadap Keputusan Pembelian sebesar Fhitung 431,801 > Ftabel 3,060 Dengan hasil tersebut, secara simultan Kebijakan Harga dan Kualitas Produk berpengaruh positif dan signifikan terhadap Keputusan Pembelian Sabun Merek Lifebuoy pada PT. Mitra Andal Sejati Medan. Secara parsial Kebijakan Harga berpengaruh positif dan signifikan terhadap Keputusan Pembelian, dan serta secara parsial kualitas produk menunjukkan pengaruh positif dan signifikan terhadap Keputusan Pembelian sabun Merek Lifebuoy pada PT. Mitra Andal Sejati Medan.
PENGARUH ETIKA KERJA DAN BUDAYA KERJA TERHADAP PRESTASI KERJA KARYAWANPADA PERUM BULOG KANTOR CABANG MEDAN
Authors: Hasugian Edi Arianto , Pandiangan Poppi Natalia , Tarigan Jenni , Hutabarat Lamminar
Published: May 2023

Dengan meningkatkan kualitas sumber daya manusia dalam perusahaan diharapkan dapat meningkatkan prestasi kerja, karena prestasi kerja sangat penting bagi perusahaan yang merupakan indikator utama seberapa baik kinerja perusahaan. Penelitian ini dilakukan dengan tujuan untuk mengetahui pengaruh etika kerja dan budaya kerja terhadap prestasi kerja karyawan pada Perum Bulog Kantor Cabang Medan. Sampel yang digunakan berjumlah 32 responden. Penelitian ini menggunakan metode  kuantitatif dengan teknik pengumpulan data melalui penyebaran kuesioner. Teknik analisis data yang digunakan adalah analisis regresi linear berganda menggunakan program SPSS Versi 22. Hasil penelitian menunjukkan bahwa persamaan regresi Y = 6,473 + 0,323X1 + 0,502X2. Etika  Kerja berpengaruh positif dan signifikan terhadap prestasi kerja. Hasil diketahui berdasarkan nilai (thitung 4,358>ttabel 2,045) dengan nilai signifikansi (0,000<0,05). Budaya kerja berpengaruh positif dan signifikan terhadap prestasi kerja. Hasil diketahui berdasarkan  nilai (thitung 5,273>ttabel 2,045) dengan nilai signifikansi (0,000<0,05). Etika Kerja dan  Budaya Kerja berpengaruh signifikan terhadap prestasi kerja. Hasil diketahui dari nilai (Fhitung 43,485>Ftabel 3,33) dengan nilai signifikansi (0,000<0,05). Koefisien Determinasi Adjusted R Square sebesar 0,733 artinya sebesar 73,3% Prestasi kerja karyawan Perum Bulog Kantor Cabang Medan dipengaruhi oleh variasi Etika Kerja dan Budaya Kerja.
PENGARUH MOTIVASI DAN PELATIHAN TERHADAP PRESTASI KERJA KARYAWAN PADA PT. CAREFASTINDO MEDAN
Authors: Laia Odima Darmawati , Halawa Morli , Taringan Jenni , Simatupang Sabar L.T
Published: May 2023

Penelitian ini bertujuan untuk mengetahui bagaimana pengaruh Motivasi dan Pelatihan terhadap Prestasi Kerja Karyawan secara simultan. Jenis penelitian yang digunakan adalah penelitan penjelasan (explanatory research) dengan pendekatan kuantitatif. Populasi dalam penelitian ini adalah sejumlah karyawan PT. Carefastindo Medan. Sampel berjumlah 50 responden dan teknik pengumpulan data dalam penelitian ini adalah daftar pertanyaan (Quesioner) dan wawancara. Teknik analisis menggunakan uji asumsi klasik, regresi berganda dan uji hipotesis. Hasil regresi linier berganda diperoleh nilai Y = 3,452 + 0,372X1 + 0,676X2. Berdasarkan Hasil Uji t parsial diperoleh nilai thitung>ttabel untuk Motivasi (X1) = 4,482>2,011 dan Pelatihan (X2) = 10,024>2,011 dengan tingkat signifikansi 0,000<0,05, hal ini menunjukkan bahwa Motivasi dan Pelatihan secara parsial berpengaruh signifikan terhadap Prestasi Kerja Karyawan. Hasil F hitung sebesar 151,580 > nilai F-tabel 3.19, sedangkan nilai koefisien determinasi (R2) diketahui nilai R Square  yang diperoleh adalah sebesar 0,866 (86,6%), Sedangkan sisanya sebesar 13,4 % dipengaruhi oleh variabel lain yang tidak diteliti, seperti merek, harga, produk dan lain-lain. Berdasarkan hasil dari penelitian ini, maka dapat disimpulkan bahwa Motivasi dan Pelatihan secara simultan berpengaruh signifikan terhadap Prestasi Kerja Karyawan pada PT. carefastindo Medan. Disarankan agar perusahaan lebih meningkatkan Motivasi bagi karyawan serta pelatihan yang baik dalam perusahaan agar tecapainya prestasiKerja Karyawan.
PENGARUH GAYA KEPEMIMPINAN DAN KEDISIPLINAN KERJA TERHADAP KINERJA PEGAWAI PADA DINAS KANTOR PERKEBUNAN PROVINSI SUMATERA UTARA
Authors: Girsang Jonathan Keriahenta , Simatupang Sabar. L. T
Published: May 2023

Penelitian ini bertujuan untuk mengetahui pengaruh kepemimpinan dan disiplin kerja terhadap kinerja pegawai pada kantor perkebunan di Sumatera Utara. Metode pengambilan sampel adalah 67 orang, dan alat pengumpulan datanya adalah metode angket (kuesioner). Metode analisis dalam penelitian ini meliputi pengujian instrumental (uji validitas dan reliabilitas), pengujian hipotesis klasik, analisis regresi berganda, pengujian parsial (uji-t), pengujian gabungan (uji-F), dan koefisien determinasi (R²). Berdasarkan model multilinear yang dihasilkan, kami memiliki persamaan berikut:Y = 7,68 + 0,343X1 + 0,698X2 Uji hipotesis parsial (uji-t) menghasilkan t-number sebesar 3,143 untuk variabel gaya kepemimpinan dan t-number sebesar 2,458 untuk variabel disiplin kerja dengan nilai signifikansi < 1. Ditunjukkan bahwa ada 0,05 agar hipotesis diterima. Hasil uji hipotesis simultan (Uji F) menunjukkan F-hitung = 33.144 dengan nilai signifikansi = 0,00 < 1. 0,05 artinya gaya kepemimpinan dan disiplin kerja berpengaruh terhadap kinerja pegawai secara simultan (bersama-sama). Koefisien determinasi R-kuadrat adalah 0,809. Hal ini menunjukkan bahwa 80,9% variabel gaya kepemimpinan (X1) dan disiplin kerja (X2) dapat menjelaskan varians variabel kinerja karyawan (Y). Disiplin kerja (X2) terhadap kinerja pegawai (Y) sebesar 80,9, sisanya sebesar 19,1% dipengaruhi oleh variabel lain yang tidak diteliti. Kesimpulan dari penelitian ini adalah gaya kepemimpinan dan disiplin kerja secara simultan atau sebagian berpengaruh signifikan terhadap kinerja pegawai di Dinas Perkebunan Sumatera Utara.
ANALISA PERANAN PENDIDIKAN DAN PELATIHAN KERJA DALAM RANGKA PENINGKATAN PRODUKTIVITASKERJA KARYAWAN PADA PT.BIMA GOLDEN POWERINDO MEDAN
Authors: Gultom Tressia , Simamora Saut Pangidoan Mauliate , Tobing Chainar Elly Ria , Silaen Novia Ruth
Published: May 2023

Pendidikan dan pelatihan sangat penting untuk meningkatkan produktivitas kerja karyawan. Penelitian ini mengkaji tentang analisa produktivitas kerja karyawan melalui pendidikan dan pelatihan karyawan pada PT Bima Golden Powerindo Medan. Batasan masalah pada penelitian ini: “Pendidikan, pelatihan kerja dan peningkatan produktivitas kerja” dengan rumusan masalah: apakah peranan pendidikan dan pelatihan kerja sudah teranalisa secara optimal terhadap produktivitas kerja karyawan pada PT Bima Golden Powerindo Medan? Penelitian ini menggunakan metode penelitian kualitatif, dengan sumber data yakni data primer (informan). Pengumpulan data melalui observasi dan wawancara. Populasi dan sampel dalam penelitian ini adalah karyawan PT Bima Golden Powerindo Medan berjumlah 63 orang. Teknik penentuan informan dilakukan secara purposive berdasarkan kapasitas yang memberikan kemudahan dan kesediaan dalam wawancara. Analisis data menggunakan metode deskriptif analisis. Kesimpulan dari hasil penelitian ini adalah peranan pendidikan dan pelatihan kerja teranalisa secara optimal terhadap produktivitas kerja karyawan. Saran penelitian ini adalah: pelaksanaan pendidikan dan pelatihan kerja karyawan hendaknya diselenggarakan sesering mungkin dan dipantau oleh pimpinan serta diberikan kompensasi untuk karyawan yang produktivitasnya meningkat setelah mengikuti pendidikan dan pelatihan kerja.
PENGARUH KINERJA KEUANGAN TERHADAP KEBIJAKAN DIVIDEN PADA PERUSAHAAN MANUFAKTUR YANG TERDAFTAR DIBURSA EFEK INDONESIA
Authors: Ndruru Sixtus Sadar Budi , Sirumapea Nasip Ratama , Napitupulu R.B , Damanik Hormaingat
Published: May 2023

Penelitian ini bertujuan untuk mengetahui pengaruh kinerja keuangan yang terdiri dari Current Ratio (CR), Return On Invesment (ROI), Debt to Equity Ratio (DER) terhadap kebijakan dividen yang diukur dengan Dividend Payout Ratio (DPR). Penelitian ini dilakukan pada perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia periode 2019-2021 sektor makanan dan minuman. Populasi dalam penelitian ini berjumlah 32 perusahaan manufaktur, metode pengambilan sampel menggunakan purposive sampling, dan diperoleh sampel sebanyak 11 perusahaan manufaktur sektor makanan dan minuman. Data yang diperoleh dari Bursa Efek Indonesia diuji melalui Uji Asumsi Klasik yang terdiri dari Uji Normalitas, Uji Multikolonieritas, Uji Atokorelasi, dan Uji Heteroskesdastisitas. Jenis regresi yang digunakan adalah Regresi linear berganda dan Uji Hipotesis terdiri dari Uji t, Uji F dan Koefisien Determinasi ( ), dan hasil penelitian berdasarkan Uji t menunjukkan bahwa CR tidak berpengaruh, ROI dan DER berpengaruh. Berdasarkan Uji F menunjukkan bahwa CR, ROI, dan DER bepengaruh terhadap kebijakan dividen pada perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia periode 2019-2021. Berdasarkan Uji Koefisien Determinasi ( ) menujukkan bahwa CR, ROI, dan DER hanya 30,4% nilai DPR dipengaruhi oleh CR (Current Ratio), ROI (Return On Invesment), dan DER (Debt to Equity Ratio), sedangakan sisanya sebesar 69,6% dipengaruhi oleh variabel lain yang tidak diteliti. “
Etiopathogenesis of Yakruth Vriddi w.s.r ALD
Authors: Ashwini Cholin C  , Nandesh Mohan P  , Mahesh Hirulal
Published: May 2023

Yakruth plays an important role in the Chayapachay and Ranjana of Rasa Dhatu. Yakruth and Pleeha are formed by the Raktadhatu. Yakruth is situated at the Dakshina bhaga and Pleeha at the Vaama bahga. Yakruth and Pleeha are the Moola Sthana of the Raktavaha Srothas. Madya is considered as alcohol it’s having qualities of Amla Usha laghu Tikshna, Sukshma, Vyavayi Ruksha Vikasi and Vishada. Madya vitiates Pitta as well as Rakta and that leads to Yakruth Vriddi. Rakta is one of the main Dushyas in Yakruth Vriddi. Diet and lifestyle are major factors that influence susceptibility to liver disorders. Alcohol use is quite common in India. According to recent data published by NHPI 74% of men and 48% of women are alcoholics. Alcohol disorders cover the spectrum of disorders beginning from the fatty liver, jaundice, hepatomegaly, ascites, and cirrhosis advanced and irreversible forms of liver injury related to the consumption of alcohol. There are three histopathological stages of alcoholic liver disease alcoholic fatty liver, alcoholic hepatitis, and, alcoholic cirrhosis. These alcoholic liver disorders’ pathogenesis can be understood in Ayurveda with the help of Kamala, Yakruth Vriddhi, Shchutha, and Ashchutha Yakruthodara. Hence an attempt is made to understand the etiopathogenesis of ALD w.s.r Yakruth Vriddi.
Right to Property and Cultural Heritage Protection in the Light of the Practice of the European Court of Human Rights
Authors: Szabados Tamás
Published: May 2023

This article presents the relationship between the protection of property and cultural heritage protection under the ECHR system. Most often, state measures aimed at the protection of cultural heritage appear to interfere with private parties’ right to the peaceful enjoyment of possessions. Those dissatisfied with the outcome of domestic court proceedings regarding such interferences often want to reverse unfavorable domestic court decisions by bringing their case before the ECtHR. This article outlines the relevant case law of the ECtHR, distinguishing deprivation of property cases from controls on the use of property, in accordance with the structure of Article 1 of Protocol No. 1. At the same time, it demonstrates the limits of property protection and, thereby, the success of claims by applicants before the ECtHR in cases involving cultural heritage. First, the limited temporal scope of the application of the ECHR and Protocol No. 1 excludes many cultural heritage disputes from the jurisdiction of the ECtHR. Second, the applicant has to prove that (s)he has possessions as interpreted by the ECtHR; the lack of possessions bars in particular restitution claims regarding property expropriated before the ratification of the Convention. Third, cultural heritage protection is considered a legitimate aim by the ECtHR, which can justify a deprivation or restriction of the use of property. States have a wide margin of appreciation in determining whether and how they will ensure the protection of cultural heritage in public interest. In particular, the ECtHR seems to endorse policies underlying both cultural nationalism and internationalism without giving a priori preference to any of them. Finally, the application of the flexible proportionality test by the ECtHR often makes the outcome of the procedure difficult to predict.
Report on International Scientific Conferences: ‘The Right to Privacy in the Digital Age – in general terms’ and ‘Content of the right to parental responsibility in the legal orders of Central and Eastern Europe : Selected Problems’
Authors: Bojanowski Tomasz , Łuniewska Klaudia , Wróbel Agata , Kosecki Alan
Published: May 2023

The report concerns two international scientific conferences organized by the Institute of Justice in Warsaw within the framework of the Central European Professors’ Network coordinated by Miskolc University, Central European Academy. The conferences discussed the following topics: ‘The Right to Privacy in the Digital Age – in general terms’ and ‘Content of the right to parental responsibility in the legal orders of Central and Eastern Europe – Selected Problems.’ The conferences were attended by prominent legal researchers from Central Europe, whose papers presented contribute to deeper research into the problems of law in the realities of the twenty-first century.
Photographing People in Public and the Protection of Privacy: The Jurisprudence of the European Court of Human Rights and Some Comparisons with England
Authors: Koltay András
Published: May 2023

This study examines certain aspects of privacy protection, addressing the questions of whether it is possible to consider a person’s image (most often a photograph) as part of their private life and whether the protection of privacy can be claimed in public spaces. A thorough examination of the European Court of Human Rights (ECtHR) and English case law reveals that these questions can be answered affirmatively. Certain general principles emerge from this case law, which take into account the freedom to discuss public affairs, namely, the protection of freedom of speech and freedom of the press. Based on an examination of these, it seems that a connection with a matter that qualifies as a public affair justifies the protection of the freedom of the press, meaning that purely tabloid content does not enjoy such protection. This creates widespread protection for freedom of expression and freedom of the press and may also result in numerous frustrated privacy plaintiffs.
The Role of Innovation in Technology Capacity of Enterprises in the Manufacturing Industries in Viet Nam
Authors:   Hanoi University of Business and Technology, Pham Van Hieu , Nguyen Thi Trang ,   Hanoi University of Business and Technology
Published: May 2023

This research aims to assess the role of innovation in technology capacity of enterprises in the manufacturing industries in Viet Nam by building index assessmenting technology capacity of enterprises performed by The General Statistics Office (GSO). The Technology Capability Index (TCI) is composite index based on five component indexes including innovation index (I). The results reveal that TCI of enterprises in the manufacturing industries Viet Nam in the period from 2014 to 2018 on a rather low level averaged 1.427 on a 5 point scale. In the component indexes, contribution of innovation and R&D index are too low level. On that basic, the paper suggests some policy implications on innovation for Vietnam.
Revisiting the formation of universal competencies of foreign students
Authors: Spichak Nikolay Grigorievich , Fedorova Irina Valerievna
Published: May 2023

Foreign citizens study at Russian universities according to educational programs in accordance with the Federal State Educational Standard, designed for pre-university training of Russian citizens. This is especially evident in the formation of universal competencies (UC). The identification and search for the solution to the problems that arise in this case determine the relevance of the research. We set a goal to determine how significant the differences were between the content of pre-university Russian and foreign education, which is necessary for the formation of UC-11 – citizenship and UC-9 associated with it – inclusive culture, using the method of comparative analysis. Documents  on foreign education served as the material.When developing an educational program in terms of the formation of UC-11, universities take into account continuity with the general educational subject of social science, which Russian students study at a basic or advanced level. In this regard, the content of foreign education was assessed from the standpoint of the presence of the disciplines of the subject area «Social sciences». The analysis carried out showed their complete or partial absence in pre-university foreign education. Meanwhile, it turned out that the inclusive position of many foreign students, unlike Russian students, was practically formed. Thus, the university needs to develop individual educational programs for foreign students, providing for the expansion of the list of variable and optional disciplines, changing the ratio of contact work with a teacher and student’s independent work. The optimal form remains the previous or parallel development of a specially designed additional educational program.
Training professional skills using the Latin language (the case of medical specialties)
Authors: Bibikova Elvira Vitalievna
Published: May 2023

The relevance of the research is due to the fact that the study of the Latin language in a medical university has a purely professional orientation. The main goal of mastering this discipline is to train competent specialists to be proficient in professional terminology. Within the framework of this research, an attempt has been made to demonstrate the possibilities of the Latin language in teaching professional skills of future doctors and pharmacists. The article discusses three subsystems of medical terminology: anatomical-histological, clinical and pharmaceutical ones. As for the anatomical and histological section, typical mistakes and difficulties faced by students have been analyzed, and examples of tasks used by the author to solve these problems given. In the clinical section, the emphasis is made on the tasks that allow you to create an atmosphere of professional activity in the classroom and bring it closer to practical activity. The development of the pharmaceutical section is aimed at forming the terminological competence of future medical workers in the field of pharmaceutical terminology and general formulation. The author gives a brief overview of the material studied at this stage, and gives examples of practical tasks for its better assimilation. All the materials and exercises described in the article are used by the author in the process of teaching Latin in a medical university. Empirical methods, methods of comparison and analysis have been used in the research.

As a result, it has been shown that successful teaching professional skills at a medical university is largely possible due to the study of the Latin language.
The 5A model for non- communicable disease advocacy
Authors: Sanjay Karla  , Madhur Verma  , Rakesh Sahay
Published: May 2023

We share a comprehensive 5A model which puts in perspective a clear-cut method to approach and address non communicable disease (NCD) advocacy. We suggest that the first step towards NCD control is awareness amongst health care professionals, and acceptance of their responsibility towards public health.  Once this is done, active assertion follows, and leads to action on the ground. Regular audit, however, is necessary, to ensure effective and efficient advocacy for NCD. This model should be followed in all health care settings, including primary care diabetes.

Keywords: Cardiovascular disease, diabetes, heart disease, obesity, public health
The etiopathogenesis and management of obesity: The quintessential quincunx
Authors: Sanjay Kalra  , Jubbin Jacob  , Saurabh Arora  , Nitin Kapoor
Published: May 2023

This communication uses the quincunx, i.e, a quadruple  surrounding a central point, to create a model that describes the etiopathogenesis, as well as informs the management strategy of obesity.

With the energy fulcrum (mismatch between energy intake and expenditure) at its centre, the model lists two external influencers-the physical environment and psychosocial environment, and two internal influencers- the hypothalamo-bariatric axis and the endocrine system, to explain the etiopathogenesis of obesity. Genetics factors are included with the hypothalamo-bariatric axis. The same model can be used to explain the five pillars of management: lifestyle and nutritional modification at the centre, along with environmental optimization, behavioural therapy, baro-thalamic modulation, and endocrine optimization

Keywords: Anti-obesity medication, bariatric medicine, bariatric surgery, barocrinology, obesity, person-centred care, semaglutide, tirzepatide
Intracranial metastasis of testicular germ cell tumours
Authors: Zara Shah  , Hafiza Hifza Bashir  , Saqib Kamran Bakhshi  , Muhammad Shahzad Shamim
Published: May 2023

Brain metastasis from testicular germ cell tumour (TGCT) is rare and represents only 2% of metastatic brain tumours. Although TGCTs have a good survival rate, the prognosis of brain metastasis is poor. Due to the rarity of the diagnosis, there are limited studies on the topic and a standardized treatment protocol does not exist. Surgical management has long been considered a positive prognostic factor; however, recent studies have investigated the impact of chemotherapy and radiotherapy in these patients. Current literature suggests multiplicity of brain lesions and treatment with chemotherapy or radiotherapy alone can have a poor impact on the prognosis of the disease. However, studies with larger cohorts are required to understand and develop the optimal treatment protocol for patients with brain metastasis from TGCT.
Primary intracranial alveolar soft part sarcoma in a 22 years old female: a rare case report with literature review
Authors: Muhammad Saad Babar  , Qadri Haseeb Mehmood , Ammara Tabassam  , Muhammad Imran  , Muhammad Hassan Raza
Published: May 2023

Alveolar soft part sarcoma is a very rare malignant neoplasm of peripheral muscular, adipose or neural tissue. Its occurrence, as a primary intracranial tumour, is even rarer. To the best of our knowledge, only nine cases of primary intracranial alveolar soft part sarcoma exist in English scientific literature. We attempt to write a comprehensive review on this poorly understood intracranial malignancy, with no evident systemic lesions, such as in the case of our 22 years old patient. In addition to absent definitive proof of benefit of radiologic or chemotherapeutic management, we highlight the role of surgery as the primary treatment. Younger patients with this tumour may have a worse prognosis than elderly patients.
Key words: alveolar soft part sarcoma, intracranial, headache, radiosurgery.
Frequency of human papilloma virus (HPV) vaccination among female health care providers and reasons for non-immunization at a public sector hospital
Authors: Muhammad Hamza Shafiq  , Mansoor Misha , Arshad Azal , Mansoor Shanzay , Sana Iftikhar
Published: May 2023

Objective: To assess the knowledge and attitude of female healthcare providers about human papilloma virus and its vaccination, to determine the frequency of respondents vaccinated against the virus, and to evaluate the reasons for non-immunisation.
Method: The cross-sectional study was conducted at the Jinnah Hospital, Lahore, Pakistan, from January 7 to February 20, 2022, and comprised female health care providers aged 20-60 years. Data was collected using a self-assessing questionnaire. Data was analysed using SPSS 22.
Results: Of the 250 individuals approached, 210(84%) took part in the study. The mean age was 28.9+/-7.99 years. Most of the subjects were house officers, medical officers or senior registrars 138(65.7%), and 126(60%) were unmarried. Overall, 170(81%) respondents knew about human papilloma virus and 174(82.9%) were aware of its link with cervical cancer. Even though 128(61%) respondents knew that the virus can be prevented by vaccine, 14(6.7%) were actually vaccinated. The vaccinated individuals had better knowledge about HPV, its spread, complications, its association with cervical cancer, prevention by vaccination and availability of vaccine compared to the non-vaccinated (p =0.05)
Conclusion: The trend of human papilloma virus vaccination among female health professionals was found to be low, and lack of awareness and counselling was the leading cause.
Key Words: Human papillomavirus, Cervical cancer, Vaccination.
Paternity leave: it’s okay to leave
Authors: Beena Kumari  , Memon Areeba , Moniba Tehrim
Published: May 2023

N/A for letter to the editor
Baricitinib for alopecia areata
Authors: Hamza Imran  , Hoda Fatimah , Shakil Firzah
Published: May 2023

Alopecia areata is a disease in which an active immune response is triggered against the hair follicles, causing hair loss. The extent of this hair loss is proportional to the number of hair follicles attacked. Alopecia areata is classified into three types depending on the area of hair fall: alopecia areata, alopecia totalis, and alopecia universalis.
Alopecia areata has an approximate worldwide prevalence of 1 in 1000 people1. The current, well-known treatment of alopecia areata is intralesional corticosteroid injections, with 60-70% of patients reporting some form of hair growth afterward, while other treatments include topical immunotherapy, Minoxidil, and Anthralin2. Similar treatment methods, along with hair transplants and platelet-rich plasma (PRP) therapy, are used in Pakistan, which has been effective to some extent in controlling or stopping the progression of the condition3.
Baracitinib, which has already been approved for rheumatoid arthritis and atopic dermatitis, is a Janus kinase (JAK) inhibitor that blocks the proteins known as JAK enzymes, which are involved in immune signalling and inflammation. It is unclear as to how the immune system of the body causes alopecia areata. A possible mechanism is by sending out signals that interrupt the events of hair growth. Baracitinib stops the communication among the immune cells responsible for causing hair loss which ultimately inhibits the signals mentioned above and lessens the response to injury, resulting in hair regrowth4. Thus, it can be thought of as a potential treatment for severe alopecia areata.
Recently, in June 2022, FDA approved baricitinib as the first systematic treatment for alopecia areata after two clinical trials were conducted by Brett King et al. The trial showed promising results regarding the use of barticinib as after 36 weeks of exposure, oral baricitinib outperformed placebo in terms of promoting hair growth in patients with severe alopecia areata. The proportion of participants that achieved at least 80% scalp hair coverage at 36 weeks was estimated to be 38.8% with 4-mg baricitinib, 22.8% with 2-mg baricitinib, and 6.2% with placebo in trial 1 and 35.9%, 19.4%, and 3.3%, respectively, in trial 25.
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Desensitisation of Pakistani Population to a Global Health Emergency
Authors: Minal Anum , Khan Maimoona
Published: May 2023

No abstract required for letter to editor.
Floods in Pakistan; are pregnant women at a greater risk?
Authors: Warsi Aimen , Mansoor Noman
Published: May 2023

Dear madam,
The destructive floods in Pakistan have wreaked havoc, leading to increased mortality and morbidity rates among people. More than 1,100 people, including the excess of 350 children, have passed away, and the number is expected to grow [1]. The infrastructure is destroyed with no food or shelter. A halt in conveyance has made the necessities to life unattainable on people, and pregnant women are no exception.
In Pakistan, about 500,000 pregnant women were affected by the 2010 floods, and 1.5 million women required emergency obstetric care [2]. Of the pregnant women during the disaster, 1,700 gave birth and hundreds suffered from complications during childbirth. Retained placenta, obstructed labour and fetal distress are some of the complications that pregnant women are at risk of during disaster. The scarcity of healthcare facilities and providers makes it difficult to manage maternal health problems, and delivery in these conditions often leads to maternal death [3]. The maternal mortality rate in Pakistan is 186 deaths per100,000, with rural areas having a 26% higher ratio [4].
Reproductive health is also affected by disasters through spontaneous abortion, birth defects, and low birth weight of babies [3] [5]. Pregnant women, breastfeeding mothers, and women with various disabilities have suffered the most. Sometimes women cannot express their problems which may lead to psychological issues. In addition, delay in transport and medical help affect maternal mortality in rural areas.
Pakistan has limited healthcare resources in flood affected areas, making it difficult for pregnant women to help. An obstetrics field hospital must be established with trained staff with concerning disaster protocols. An experienced obstetrician should be taken on board to assess the emergency and set-up of prerequisite healthcare resources. Social media, mass media and public campaigns should be popularized to put an impact on this topic. Furthermore, public awareness for both genders and setting up medical camps in remote areas might help. Telecommunication must be established with field operators in coordination with other disaster relief providers to initiate the need of medicines like folic acid and other vitamins. Portable ultrasound must be arranged. The usage of alcohol-based cleanser instead of water to eradicate contamination. The impact that floods have on lives of pregnant women is an issue that is not given much attention. More studies are required in this area to understand the full extent of the problem.
It's time to foster Pride and let go of Prejudice. Disability Pride Month: Why Pakistan needs it?
Authors: Siddiqui Rida Asim
Published: May 2023

Respected Madam,
Since the beginning of time, disability, in any form, has always had an enormous amount of stigma attached to it and Persons with Disabilities (PWDs) are made to suffer hardships and injustices every day. Pakistan has a population of roughly 207 million people.1 Around 31 million people in Pakistan are anticipated to be living with a disability. According to the disability evaluation report conducted by Pakistan Poverty Alleviation Fund (PPAF), eight out of every 100 people have a handicap of some kind, and one out of every 130 people has a severe condition.2
July celebrates the Disability Pride Month honouring the signing of the Americans with Disabilities Act, which occurred 32 years ago.3 Yet, this day has a deeper meaning; This month empower PWDs to proudly own their identities and reinvent the power dynamic designed to work against them. PWDs in Pakistan are often marginalized, made to feel inferior, and rarely seen actively participating in society alongside those who can. Our community still has archaic views such as, disability is a source of shame for the family, a form of punishment for crimes, and a detachment from religion.4 According to estimates, 24.9 to 41% of persons with disabilities experience depression, compared to 22.8 to 27.5% of adults without disabilities.5
Madam, this is a painful reality, but we must face it together. All of these injustices have left Pakistani PWDs feeling lost and disempowered. When they are constantly let down and made to feel inferior, it demoralizes them before they can muster the courage and determination to seek opportunities and demand justice. Pakistan desperately needs Disability Pride Month as a platform and reminder that every member of society, able-bodied or not, is equally important and has something unique to offer. Given that Pakistan is a developing country and that the government frequently overlooks their fundamental rights and demands, Disability Pride Month will allow them to celebrate all that they have overcome and accomplished, providing them a platform to draw attention to their issues and shed light on their concerns. A revolutionized change can occur in the practices of this archaic society. Awareness is essential, but Pride stems from within. A man who has faith in himself will strive to conquer his goals. That is when a true change will occur.
A Study on Consumers' Perceptions of Omakase and Imokase Using Text Network Analysis
Authors:   The Foodservice Management Society Of Korea, Moon Sung-Sik , Kwon Yong-suk , Lim Hyun-Cheol
Published: May 2023

This study analyzed consumer awareness of 'Omakase' and 'Imokase', which have rapidly increased consumer interest in the last 2 to 3 years, using big data. Through this, it was intended to be used as basic data to interpret the meaning of consumer behavior for these two restaurant businesses. From January 1, 2022 to December 31, 2022, text data containing Omakase or Imokase were collected from Naver and Daum, and text mining, keyword frequency analysis, centrality analysis, semantic network analysis, and CONCOR analysis were performed. The results of this study are as follows. First, consumers have a positive perception of omakase and imokase. Second, Second, consumers perceive Omakase as follows. ① Region(Gangnam) ② Menu(sushi, Korean beef, sushi, Japanese food, beef) ③ How to use(dinner, lunch, course) ④ Important attributes(price, value for money, friends, use for the first time). Third, consumers perceive imokase as follows. ① region(Gangneung, Euljiro, Seomyeon) ② menu(yang-gobchang, sulsang, danji) ③ How to use(pub, anju) ④ important attribute (omakase, dongsang-imong, imo).
Analysis of Structural Relationships among ESG management of Food Service Franchise Corporate, Brand Image and Consumer Behavior Intention
Authors:   The Foodservice Management Society Of Korea, Lee Chae-Eun , Lee Jin-Young
Published: May 2023

This study identified the influence between consumers’ perception of ESG management, brand image, and consumer behavior intentions. This study was conducted as a structural equation modeling(SEM) using SPSS 26.O and AMOS 20.0 to confirm the causal relationship between ESG management, brand image, and consumer behavior for consumers who have used a food service franchise corporate. As a result of the study, first, in the relationship between ESG management and brand image of restaurant franchise corporate, governance did not show a significant effect on brand image, but eco-friendly activities and corporate social responsibility had a significant positive (+) effect on brand image. Second, it was confirmed that the brand image of the food service franchise company had a significant positive (+) effect on consumer behavioral intention. This study aims to confirm whether ESG management plays an important role in improving competitiveness of brand image and consumer behavioral intention, and to provide practical information for sustainable management by suggesting marketing plans for restaurant franchise corporate.
The Effects of Management Consulting Service Quality on Consulting Utilization and Management Performance in Small Food Service Businesses
Authors:   The Foodservice Management Society Of Korea, Kim Hong-Sook , Kim Seon-Jung , Lim Hyun-Cheol
Published: May 2023

The purpose of this study was to analyze the effects of management consulting service quality on consulting utilization and management performance in small food service businesses and test for variation in consulting service quality by the demographic characteristics. A total of 247 Questionnaires were used for this study. The results are as follow: First, among the sub-areas of management consulting service quality in small food service businesses, outcome quality and physical environment quality significantly affected consulting utilization, and interactional quality had no significant effect on consulting utilization. Second, consulting utilization significantly affected non-financial performance among the sub-areas of consulting utilization but had no significant effect on financial performance. Third, interactional quality among the sub-areas of management consulting service quality significantly affected financial performance. Both interactional quality and physical environmental quality significantly affected non-financial performance.
Hygiene Sanitation Snack Selling and Snack Consumption Behavior of Middle School Students
Authors: Chantou Saeteurn
Published: May 2023

The purpose of this research was to examine how educating middle school students about cleanliness and sanitation, enforcing laws on vendors, and implementing school policies affects the students' views and attitudes regarding buying snacks. Methods such as surveys, evaluations of vendors, and discussions in small groups were all part of the overall strategy. While teaching about proper cleanliness and sanitation is crucial, the research found that it may not be enough to get kids to rethink their snack-buying habits on its own. Assessments of vendors also found that many were not in complete compliance with applicable hygiene and sanitation laws, potentially endangering the health of customers. Middle school children may benefit greatly from school regulations that make healthy snack selections more accessible and restrict access to less healthy ones, according to the research. Researchers also found that vendors operating in close proximity to schools with stringent standards were more likely to follow those laws' guidelines for cleanliness and sanitation. Based on these results, it seems that school regulations may be a useful tool for fostering a culture of healthy snacking and assuring the security of school food. This research may help shape public health and food safety regulations and instructional programs that target middle school children and their snacking habits.
Magnitude and associated factors of Pityriasis Versicolor among patients attending Dermatovenereology Outpatient Department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia
Authors: Tilaye Mengistu , Sinknew Abebe , Mekuriaw Alemneh , Tsehay Asmamaw Ketemaw
Published: May 2023

Pityriasis versicolor (PV) is a chronic superficial fungal infection caused by Malassezia species. It is the most common dermatologic disorder in tropical countries including Ethiopia and skin discoloration is the principal morbidity resulting from pityriasis versicolor. Therefore, this study assess the prevalence and associated factors of PV among patients attending Dermatovenereology clinic at the University of Gondar Comprehensive Specialized Hospital. Hospital based cross sectional study design was employed. Systematic random sampling was used and a total of 406 participants who attended Dermatovenereology OPD were included in the study. Data were collected by interview and physical examination. Then it was checked, coded, entered into Epi-Info version 7 and analyzed using Stata version 14. Both bivariable and multivariable logistic regression were employed to identify factors associated with PV. Adjusted odds ratio with their corresponding 95% CI and P-value were calculated. A P-value less than 0.05 was used to declare statistically significant variables. The overall magnitude of PV among patients attending Dermatovenereology OPD at the UGCSH was 12.6% (95%CI; 9.2%, 15.0%).Those who had a diploma and above education  [AOR: 95% CI; 4.67 (1.18, 18.47)], excessive sweating [AOR: 95% CI; 4.75 ( 1.92, 8.76)] being male [AOR: 95%CI; 4.19 (1.92, 9.14)], practicing regular exercise [AOR: 95% CI;  4.11 (1.93, 8.76)] and wearing heavy clothes [AOR: 95% CI; 2.53 (1.24, 5.15)] were found to be statistically significantly associated with PV. This study found that the magnitude of Pityriasis versicolor was relatively lower. The study revealed that educational status (diploma and above), male gender, habit of regular exercise, excessive sweating and wearing heavy cloths were significantly associated with Pityriasis Versicolor. It is recommended that high risk patients receive close follow up and health professionals should provide health education sessions in waiting rooms about the identified risk factors.
Lived Experiences of the Bereaved in the COVID-19 Era in Harare East, Zimbabwe
Authors: Rudadiso Nyandoro , Tichaenzana Nyashanu , Christina Siwawa , Obey Mukorera
Published: May 2023

Introduction: The aim of this study was to learn about the lives of people who lost loved ones to the coronavirus and were unable to carry out the customary funeral rituals or practices due to restrictions imposed by authorities. This study investigated the meanings that the bereaved assigned to funeral practices during the COVID-19 era, investigating the experiences of the bereaved in COVID-19 deaths, and to determine which alternative rituals could assist in copying with the loss of a loved one, and to investigate the concept of delayed rituals. Methods: Qualitative method was used for this study, employing snowballing and purposeful sampling. Results: The study came up with three different phases that were experienced by the bereaved families during the covid-19 pandemic, and these were, the phase before death and during illness; the phase after death and the initial rituals and the phase during the period of mourning. Conclusion: There is need for people to draw a leaf from the lesson portrayed by COVID-19, the pandemic revealed that, once mourning has passed, most people are able to bounce back and move on with their lives.