bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contracting out of health services improves service utilization and satisfaction: evidence from rural districts of Pakistan
Authors: Naeem Imran Naeem , Fatmi Zafar 
Published: March 2020

Abstract
Background

Contracting out of health services to non-state providers has been widely used in developing countries including Pakistan. Based on three years’ experience of contracting out primary and secondary health services, this paper presents findings of third party evaluation of health services from two rural districts of Sindh Pakistan.

Methods

This was a baseline vs end-line cross sectional assessment of thirteen primary and secondary healthcare facilities from two rural districts (Thatta and Sujawal) of Sindh province that were contracted out in 2016 to a national non-governmental organization. Healthcare facilities included: 8 rural health centres, 4 taluka headquarter hospitals and 1 district headquarter hospital. District health information system was used to extract three years (2016 – 2019) data on key performance indicators (KPIs) as agreed in contract. We conducted record review related to human resource and budget and in-depth interviews with health managers. Health facility assessment survey and client satisfaction exit interviews were also conducted.

Results

KPIs showed significant improvement in service provision from baseline. General outpatient department (OPD) (33%), specialist OPD (91%), accident/emergency consultations (106%), in-patient admissions (≥100%) alongside diagnostic/laboratory service utilization (86%) increased substantially. Facility based deliveries (37%), and major (99%) and minor (172%) surgeries also showed significant increase. Preventive services (maternal tetanus toxoid, child vaccination) showed modest improvement (4-19%) in the district (overall) but slight decline in some healthcare facilities. Slight improvement in specialist workforce care was noticed, however challenges related to staff retention persisted. Adequate supplies and equipment were available except radiology services. Most healthcare facilities were also in need of repair. Delayed and partial release of funds by government was a major barrier. Lack of coordination among different stakeholders delivering healthcare in the district was also noted. Majority of clients (60%) were satisfied with service delivery but unavailability of medicine was their main concern.

Conclusions

Contracting out has the potential to improve service utilization. Autonomy over budget allocation and utilization, appointment of all cadre of staff, and improved coordination among all stakeholders is required to improve service delivery. Quality of care and the longer term health outcomes need further evaluation.
Threshold changeable secret image sharing using bivariate polynomial
Authors: Liu Yanxiao , Wu Ping , Sun Qindong , Zhou Zhili 
Published: March 2020

Abstract
In secret image sharing (SIS) scheme, a conﬁdential image is en-crypted into multiple shadows, any group of shadows that reaches the thresh-old, otherwise nothing can be reconstructed at all. Most existing SIS schemes have a ﬁxed threshold, however in this work, we consider more complicat-ed cases that the threshold may be adjusted due to the changeable security environment. In this paper, we construct a (k ↔ h, n) threshold changeable SIS (TCSIS) scheme using bivariate polynomial, which has h − k + 1 possible thresholds k, k + 1, ..., h. During image reconstruction, each participant can update the his shadow according to the current threshold T only based on his initial shadow. Comparing with previous TCSIS schemes, the proposed scheme achieves unconditional security, and can overcome the information disclosure problem caused by homomorphism.
Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis
Authors: Chen Junheng , Chen Chao , Sun Guoliang , Guo Chunming , Yao Weifeng 
Published: March 2020

Abstract
Background: The aim of this systematic review and meta-analysis was to compare the analgesic efficacy of the quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB). Methods: We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement guidelines. Only trials comparing QLB with TAPB were included. The primary outcomes were visual analog scale (VAS) scores at rest and at movement during the first 48 h after surgery and postoperative analgesic requirements. Secondary outcomes included rates of side effects, such as postoperative nausea and vomiting (PONV) and dizziness, and patient satisfaction. Results: A total of 15 controlled trials, including 1013 patients, were identified. VAS scores at rest at 0–1, 2, 4, 6, 8, 12, and 24 h and at movement at 24 and 48 h were significantly lower in patients who underwent QLB when compared with those in patients who underwent TAPB. QLB performed better in terms of postoperative analgesic requirements, with patients requiring lower levels of intravenous morphine and sufentanil over the first 24 h, fewer patients requiring rescue analgesics, and longer times to first rescue analgesic. Among patients who underwent QLB, rates of PONV and dizziness were lower and the Bruggemann comfort scale (BCS) scores were higher. Conclusion: QLB leads to significantly better outcomes in terms of postoperative VAS scores, opioid consumption, incidence of side effects, and patient satisfaction when compared with TAPB following abdominal surgery.
Identification of lncRNA FAM99A gene as a prognostic biomarker of hepatocellular carcinoma
Authors: Sun Manyi , Lv Shuhua , Zhong Jin 
Published: March 2020

Abstract
Background The complicated pathogenesis of hepatic cancer involves multiple clinical prognosis-associated oncogenes. Methods We utilized the bioinformatics approach to analyze the data from hepatic cancer cases collected by TCGA repository. Results We first found that the FAM99A (Family With Sequence Similarity 99 Member A) gene, a long non-coding RNA (lncRNA), is lowly expressed in hepatocellular carcinoma and closely related to clinical prognosis. We further analyzed the underling molecular mechanism from the perspectives of copy number variation (CNV), DNA methylation, immune cell infiltration, and related cellular pathway. Even though we did not observe a strong correlation between the FAM99A expression and the CNV or immune cell infiltration, the high methylation levels of the five methylated probe sites (cg24218935, cg01745044, cg04353359, cg04938738, cg25356611) were found to be negatively correlated with low expression level of FAM99A. Besides, we performed the enrichment analysis to screen out a group of FAM99A-correlated genes and molecular pathways, such as complement cascade, RNA metabolism, drug metabolic process, PPAR signaling pathway, or cell cycle. Conclusions The liver-specific FAM99A gene was first identified as a prognosis marker of hepatocellular carcinoma, and the underlying molecular mechanism involves DNA methylation and a series of cellular pathways.
A Hybrid Approach for Automatic Licence Plate Recognition System
Authors: Sharma Nitin , Dahiya Pawan Kumar , Marwah Baldev Raj 
Published: March 2020

Background:
Automatic licence plate recognition system is used for various applications
such as traffic monitoring, toll collection, car parking, law enforcement.

Objective:
In this paper, a convolutional neural network and support vector machine-based licence
plate recognition system is proposed.

Method:
Firstly, from the input image of the vehicle, the characters are extracted and segmented. Then
features of the segmented characters are extracted. The extracted features are classified using convolutional
neural networks and support vector machine for the final recognition of the licence plate.

Results:
The obtained recognition rate by the hybridization of the convolutional neural network and
the support vector machine is 96.5%. The obtained results for the proposed hybrid automatic licence
plate system is compared with three other automatic licence plate systems based on neural network,
support vector machine, and convolutional neural network.

Conclusion:
The proposed hybrid ALPR system performs better than NN, SVM, and CNN based
ALPR systems.
Assessment and Adoption Analysis for Smart Governance Using Fuzzy Conjoint Model
Authors: Goyal Mukta , Tyagi Nitin 
Published: March 2020

Background:
In the era of internet, government of each country is thinking about the
role of Electronic governance to facilitate its citizens using Information and Communication Technology
(ICT). To achieve this, every government activities/ procedures are transforming to electronic
medium with the help of websites, mobile applications, government social media accounts
and establishing common service center for rural part of country. But it is matter to assess the satisfaction
level of electronic services launched by government. If the satisfaction level is high then
adoption of government services would be high.

Objective:
This objective of this research is finding the suitable factors for adoption of government
E-services and ranking them accordingly.

Methods:
Thus this paper suggests an intelligent fuzzy conjoint technique to rank the factors that
affects adoption of E-services launched by government. A survey is done to find the factors which
may affect adoption of such electronic governance initiative.

Results:
Result shows that 62.5% are satisfied with services, 25% are dissatisfied and 12.5% are
neutral with respected to e-government services Government has established common service center
with highest ranking. Next finding is that customized government portals and mobile applications
should be multilingual support.

Conclusion:
The people are dissatisfied with the standardization of polices and IT laws and self
guided services. Artificial Intelligent techniques are also required to implement for smart governance.
Currently Citizens are neutral to accept intelligent techniques.
The Study of Structural Changes in the Tissues of the Cornea of Experimental Animals in a Rotating Electric Field by Fractal Parameterization
Authors: Laptev D. S. , Yegorkina S. B. , Stepanov V. A. , Belykh V. V. 
Published: March 2020

В работе изучалось влияние времени полевого воздействия и психотипа животного на формирование мультифрактальных параметров информационной системы роговицы животного и проявления синергизма адаптации. Мультифрактальный анализ изображений дает количественную оценку структурных параметров, а синергетика определяет динамическую устойчивость и адаптационную способность структуры тканей роговицы, вызванные стресс-реакцией экспериментального животного на воздействие вращающимся электрическим полем.После 10 дней воздействия термодинамическая самоорганизация увеличивает информационную энтропию (D1) мезоуровней и стресс, независимо от психотипа. Эти процессы наблюдаются у животного с неустойчивым психотипом и после 20-дневного воздействия.У животного с устойчивым психотипом после 20 дневного воздействия наблюдается новый спектр мезоуровней и динамической устойчивости, динамическая самоорганизация снижает D1 мезоуровней.При значениях структурной стабильности Аm=0,35 наблюдаются два адаптационных уровня: равновесный (в структуре тканей роговицы происходит упорядоченность путем термодинамической самоорганизации, энтропия мезоуровня возрастает (ΔH>0), параметр порядка равен Ks1max=0,115); неравновесный (в структуре тканей роговицы происходит упорядоченность путем динамической самоорганизации, энтропия мезоуровня убывает (ΔН≤0), параметр порядка равен Ks2max=0,075).При увеличении структурной стабильности Аm>0,35 происходит деградация уровней структуры (параметр Ks понижается с увеличением Аm).Предельная адаптивность животного с устойчивым психотипом выше, чем у неустойчивого или амбивалентного.Хроностресс приводит структуру тканей роговицы к бифуркации, когда возможно несколько исходов, относительно «нормы хаотичности». При остром стрессовом состоянии у животного может возникать адаптация с проявлениями патологий: наблюдается рост D1,возрастание энергетических затрат на поддержание равновесия системы. Адаптация без признаков патологии соответствует неравновесному устойчивому состоянию: D1 близка к «норме хаотичности».Если D1 ниже «нормы хаотичности», это хроническое неравновесное состояние. Мезоуровни характеризуются: возрастанием общей энтропии (уровень подсистемы выживания определяется процессами термодинамической самоорганизации, характеристический элемент структуры находится в шоковом состоянии из-за стресса или приучается к существованию в условиях стресса, ограничив метаболические запросы биологической системы); снижением общей энтропии (уровень подсистемы выживания определяется процессами динамической самоорганизации, мобилизующей внутренний резерв адаптации биологической системы).
Development of a Mathematical Model of the Optimal Technological Process for Non-Autoclaved Foam Concrete Obtaining
Authors: Domnina K. L. , Karakulov M. N. , Fedosov S. V. 
Published: March 2020

Технологический процесс получения бетона – это сложная динамическая система, в рамках которой взаимодействуют множество элементов. Рассматривая технологический процесс как систему, необходимо учитывать его взаимодействие с внешней средой и внутренние взаимосвязи отдельных элементов системы. Основным источником информации, раскрывающим сущность технологического процесса как системы, является его математическая модель. В статье построена многофакторная математическая модель технологического процесса получения неавтоклавных пенобетонов. В качестве критериев качества выбраны показатели эксплуатационных свойств, востребованные для заказчиков: прочность на сжатие и теплопроводность. Поиск оптимума осуществлялся по ключевым технологическим факторам: соотношению между портландцементом и песком, водотвердому отношению, расходу пенообразователя и времени цикла смешивания. Для оптимизации технологического процесса получения пенобетонов использовано четырехфакторное математическое планирование в трех уровнях. Представлены результаты экспериментальных исследований и подробная пошаговая методика построения математической модели. Ввиду того, что полученный результат по значениям показателей критериев может не всегда удовлетворять заказчика, авторами предложен метод компромисса между критериями, который достигается путем взаимных уступок, т. е. процентных потерь критериев. Основным способом решения принят лексикографический метод или метод целенаправленного перебора.
Penggunaan Media Plano Kalender Bekas untuk Meningkatkan Prestasi Peserta Didik pada Materi Pidato Persuasif di Kelas IX SMP
Authors: Sarjono Owon Robertus Adi 
Published: March 2020

Penelitian tindakan kelas ini bertujuan untuk (1)mengetahui sejauh mana penggunaan media pembelajaran Plano Kalender Bekas untuk meningkatkan hasil belajar peserta didik dan (2)mengetahui dampak penggunaan media pembelajaran Plano Kalender Bekas pada materi pidato persuasif di kelas IX SMPK Virgo Fidelis Maumere. Jenis penelitian ini adalah penelitian tindakan kelas yang merupakan penelitian kualitatif. Media plano kalender bekas merupakan media non-digital real-visual yang memanfaatkan barang bekas sebagai peantara dalam pembelajaran. Penelitian ini dilaksanakan di kelas IXC SMPK Virgo Fidelis dengan subjek penelitian 30 peserta didik. Instrumen pengumpulan data dalam penelitian ini adalah instrumen observasi dan tes hasil belajar. Data dianalisis secara kualitatif dan kuantitatif sederhana. Hasil penelitian menunjukkan bahwa penggunaan media plano kalender bekas dapat secara signifikan meningkatkan partisipasi (aspek sikap) dan hasil belajar peserta didik. Sikap peserta didik pada siklus I menunjukkan 3 dari 5 kelompok mendapat kategori BAIK dan pada siklus II menunjukkan peningkatan yakni 5 kelompok mendapat kategori BAIK dan AMAT BAIK. Hasil belajar siklus I menunjukkan perentase daya serap mencapai 74,1% meningkat menjadi 80,5% pada siklus II. Persentase ketuntasan belajar pada siklus I mencapai 73% meningkat menjadi 90% pada siklus II.
Early Childhood Antibiotic Treatment for Otitis Media and Other Respiratory Tract Infections Is Associated With Risk of Type 1 Diabetes: A Nationwide Register-Based Study With Sibling Analysis
Authors: Wernroth Mona-Lisa , Fall Katja , Svennblad Bodil , Ludvigsson Jonas F. , Sjölander Arvid , Almqvist Catarina , Fall Tove 
Published: March 2020

OBJECTIVE
The effect of early-life antibiotic treatment on the risk of type 1 diabetes is debated. This study assessed this question, applying a register-based design in children up to age 10 years including a large sibling-control analysis.

RESEARCH DESIGN AND METHODS
All singleton children (n = 797,318) born in Sweden between 1 July 2005 and 30 September 2013 were included and monitored to 31 December 2014. Cox proportional hazards models, adjusted for parental and perinatal characteristics, were applied, and stratified models were used to account for unmeasured confounders shared by siblings.

RESULTS
Type 1 diabetes developed in 1,297 children during the follow-up (median 4.0 years [range 0–8.3]). Prescribed antibiotics in the 1st year of life (23.8%) were associated with an increased risk of type 1 diabetes (adjusted hazard ratio [HR] 1.19 [95% CI 1.05–1.36]), with larger effect estimates among children delivered by cesarean section (P for interaction = 0.016). The association was driven by exposure to antibiotics primarily used for acute otitis media and respiratory tract infections. Further, we found an association of antibiotic prescriptions in pregnancy (22.5%) with type 1 diabetes (adjusted HR 1.15 [95% CI 1.00–1.32]). In general, sibling analysis supported these results, albeit often with statistically nonsignificant associations.

CONCLUSIONS
Dispensed prescription of antibiotics, mainly for acute otitis media and respiratory tract infections, in the 1st year of life is associated with an increased risk of type 1 diabetes before age 10 years, most prominently in children delivered by cesarean section.
Consumers Loyalty Indicator as a Drivers for Satisfaction
Authors: Massoudi Aram Hanna 
Published: March 2020

This study focuses on understanding the leading indicators of loyalty among food and nourishments shoppers in two Syrian Malls, Cham City Centre and Massa Plaza, both located in Damascus, the capital of Syria. The research uses descriptive approach; the data were collected from a questionnaire distributed to 110 shoppers in the two shopping malls, 100 valid responses divided (50 answers from Cham City Centre, and 50 from Massa Plaza Mall). The data were analyzed using Statistical Package for Social Science to test the hypothesis. The result showed that shopper attitudes toward the store positively related to his fulfilment and loyalty. Also, shoppers call to the store is an indicator of his satisfaction and commitment towards the store. Finally, perceived value is positively related to the four loyalty indicators. The novelty of this article comes from the analysis of the four loyalty indicators as an essential factor for the sustainable customer. Loyal customers are free marketing tools that keep business running and can increase market share.
INFLUENCE OF NITROGEN DOSE AND HARVESTING DATE ON THE YIELD AND BIOLOGICAL VALUE OF RAW GARDEN SAVORY (Satureja hortensis L.) OF SATURN CV.
Authors: Skubij Natalia , Dzida Katarzyna 
Published: March 2020

Garden savory (Satureja hortensis L.) is an aromatic spice plant commonly used in the food and pharmaceutical industries. Biological value of this plant is influenced by biotic and abiotic conditions, which include fertilization and date of harvesting. The research was aimed at determining the effect of differentiated nitrogen fertilization (nitrogen doses 0, 4, 8, 12, 16 g·m–2) and different harvesting time (initial flowering and full flowering phase) on yield of fresh plant weight, yield of essential oils, dry matter, protein, L-ascorbic acid contents in the raw material of garden savory of Saturn cv. The highest yield of fresh mass and essential oil was recorded in the herb harvested in the initial flowering phase after applying the highest doses of nitrogen. The obtained results allow to conclude that the greatest influence on the content of L-ascorbic acid in the herb had a dose of 4 g N∙m–2 in both examined dates. The highest amount of protein and dry matter was found in savory raw material after applying the highest dose of nitrogen in the full flowering phase.
A Study of Treatment of Lizard Phobia Using Visible and Invisible Marker-based AR Application
Authors: Nayef Zakiya A. , Ahmad Hawar B. 
Published: March 2020

Augmented reality refers to the combination of computer-generated objects with real world environment. This technology is empowered by the evolution of hardware and software in the past decade. Virtual objects are placed through device screens in a user’s environment relying on the device camera and capability of graphics hardware. This advancement opens a wide horizon for application development in the field of entertainment, education, medical, etc.
One of the main advantages of augmented reality (AR) is in the treatment of various phobias though exposure treatment. A phobia is characterized by irrational fear or reaction to a normal situation. Thus, gradually exposing patients to their phobias helps in reducing their uncontrolled reaction and aids in reducing their fear of their respective phobia. Herpetophobia is the extreme fear from aversion reptiles such as lizards. The lizard phobia is a common form of phobia amongst people.
In this article, an application of lizard phobia exposure treatment is proposed to help patients. The proposed application relies on marker-based AR. This is implemented using Visible marker AR system (VMARS) and Invisible marker AR system (IMARS), comparing the results of both systems to a group a subject to identify the best approach for Herpetophobia treatment.
Peran Kemokin dalam Patogenesis Rinitis Alergi
Authors: Huriyati Effy , Budiman Bestari J , Octiza Ricki 
Published: March 2020

AbstrakLatar belakang: Rinitis alergi merupakan penyakit dengan insiden yang cukup tinggi diseluruh dunia dengan prevalensi yang semakin meningkat setiap tahun. Patogenesis rinitis alergi melibatkan reaksi imun yang cukup komplek. Tujuan: Mengetahui peranan kemotaktik sitokin (Kemokin) dalam patogenesis rinitis alergi. Tinjauan pustaka: Kemokin sebagai kemotaktik sitokin berperan dalam semua tahap reaksi alergi. CC kemokin merupakan subfamili kemokin yang berperan dalam reaksi alergi. Kemokin bekerja pada permukaan sel-sel inflamasi berikatan dengan reseptor. CCR3 merupakan reseptor dengan kadar tertinggi yang ditemukan pada permukaan eosinofil dan eotaxin sebagai ligand yang spesifik bagi CCR3. Kesimpulan: Eotaxin dan reseptor CCR3 adalah faktor yang paling menonjol dalam patogenesis rinitis alergi yang melibatkan eosinophilKata kunci: Reaksi alergi, Th2, CC Kemokin, eosinofil, CCR3 AbstractBackground: Allergic rhinitis such a disease with high incidence among the world and its prevalence appears to be increasing every year. The pathogenesis of allergic rhinitis commit complex imunological reaction. Purpose: To know the role of chemotactic cytokine (chemokine) in pathogenesis of allergic rhinitis. Literature review: Chemokine as a chemotactics cytokine participate to all allergic reaction stage. CC chemokines were subfamilial chemokines which have role in allergic reaction. They working by binding with receptor on the surface of inflamatory cells. CCR3 is the receptor with the highes level could be found on eosinophil cell membran and eotaxin was the spesific ligand to itt. Conclusion: Eotaxin and CCR3 are the major factor in pathogenesis of allergic rhinitis which is involve eosinophil.Keywords: Allergic reaction, Th2, CC Chemokines, eosinophil, CCR3