bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengthening cardiac services in Faridabad District: A facility mapping exercise to explore implementation of a hub-and-spoke model
Authors: Asadullah Md , Amarchand Ritvik , Roy Ambuj , Bhatia Rohit , Kumar Rakesh , Krishnan Anand 
Published: July 2024

Background & objectives
Improving access to acute cardiac care requires remodelling of existing health systems into a service delivery network with an anchor establishment (Hub) offering a full array of services, complemented by spoke establishments that offer limited services. We assessed the availability of cardiac services in the district of Faridabad in the northern State of Haryana, India and explored the feasibility and challenges of implementing a hub-and-spoke model.

Methods
In 2019-2020, we listed all the facilities in private and public sectors in the study-district and mapped their geocoordinates with the help of QGIS (Quantum Geographic Information System) software version 3.20. After consent, we assessed the availability of specific cardiac care-related inputs (medicines, technologies and staff) using a checklist by enquiring from the hospital staff. Each facility was classified as L1 (No ECG) to L5 (cardiac catheterization) as per the national guidelines for the management of ST-elevation myocardial infarction (STEMI).

Results
There were 109 health facilities (66% private) in the district, 1.6 cardiologists and 5.4 coronary care unit beds per 100,000 population (94% private). Only one district hospital running in a public-private partnership mode at the L5 level provided any cardiac services. Private facilities were providing a range of services with a considerable number of them functional at L5. The higher-level facilities were concentrated in the central and urban parts of the district. Only 46 per cent of the ambulances had oxygen cylinders and 14.7 per cent had defibrillators.

Interpretation & conclusions
Implementation of a hub-and-spoke model for cardiac care in Faridabad district will require significant strengthening of public health services, development of a private-sector participation model, and strengthening of ambulance services.
Implementation research on registering cancer cases in primary health centres of Puducherry through community health workers
Authors: Varughese Cincy Merin , Sahu Swaroop Kumar , Karunanithi Gunaseelan , Duraisamy R. , Sriramulu G. , Raghavan Bitty , Thulasingam Mahalakshmy 
Published: July 2024

Background & objectives
Hospital-based cancer registry does not represent the true burden of cancer in the community. Initiating a Primary Health Centre (PHC)-based cancer registry may better estimate population-level data for cancer cases in an area. This study aimed to set up a system for facilitating a PHC-based cancer registry and to assess the registration status of cancer cases in various PHCs of Puducherry. The facilitating and limiting factors while setting up this registry were also assessed.

Methods
A quasi-experimental study with an embedded mixed-method design was conducted in 31 PHCs/Community Health Centres (CHCs) from March 2021 to November 2022. The interventions were implemented in all PHCs/CHCs of Puducherry with the involvement of the State Non-Communicable Diseases (NCD) cell. The line list of cancer cases from the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Hospital-based cancer registry was shared with all PHCs/CHCs. Sensitization sessions for all Community Health Workers (CHWs) were conducted, and feedback on cancer registration status was given to the State NCD cell. Focus group discussion (FGD)/Key informant interview (KII) was undertaken to understand strengths, challenges, and suggestions. The logic model was used to understand the various indicators while setting up this PHC-based cancer registry.

Results
Over a one-year intervention period, 1270 cancer cases were registered at Puducherry’s PHCs/CHCs, 1203 (88%) from the shared list and 67(5%) from other facilities. However, only 53 per cent of the expected living cases were captured in the various PHCs. Major limitations for registration were the COVID-19 pandemic, stigma, inadequate manpower, infrastructure issues, and privacy concerns during screening.

Interpretation & conclusions
It was feasible to set up a PHC-based cancer registry in all PHCs of Puducherry. However, registration of cancer cases was suboptimal, as population-based screening of cancer cases, as recommended in the National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) programme, was weak due to the COVID-19 pandemic. Once this is strengthened, the PHC-based cancer registry will better represent the population.
Hospital level interventions to improve outcomes after injury in India, a LMIC
Authors: Anthony Anna Aroke , Panchal Khushboo , Mathew Fleming , Soni Kapil Dev , Malhotra Ajai K. 
Published: July 2024

Background & objectives
Trauma is one of the leading causes of disability and death, worldwide. Ninety per cent of trauma related mortality occurs in low- and middle-income countries (LMICs). Despite this, there is paucity of literature emanating from LMICs with studies that present and/or evaluate feasible interventions that can have a measurable impact on outcomes after injury, primarily mortality. The current article aims at developing such interventions key elements of implementation and measures of compliance and impact.

Methods
A literature review was conducted to evaluate the status of injury care among LMICs worldwide. Based on this review, interventions were identified/developed, that (i) were feasible to implement within the constraints of available resources; (ii) could be implemented within a two year timespan; and (iii) would improve outcomes primarily, mortality. These interventions were then discussed at a symposium of experts and stakeholders from around the world.

Results
The literature review identified gaps across the entire spectrum of injury care at all levels – primary, secondary and tertiary prevention. Additionally, lack of data systems capable of ensuring quality of care and driving performance improvement was identified. Utilizing the review as the basis and focusing on hospital level interventions, one policy intervention, five in-hospital interventions and one major research question were identified/developed that met the defined criteria.

Interpretation & conclusions
Gaps in trauma care in LMICs at every level and in data systems were identified. Feasible interventions that can be implemented within the resource constraints of LMICs in a reasonable timeframe and that can have a measurable impact on injury related mortality were developed and are presented.
Asthma control among teenagers attending the respiratory outpatient clinic of an academic hospital in Pretoria, South Africa
Authors: Garrach Bhavic , Kalidas Kamlesh , Mpe Matlawene John 
Published: July 2024

Objectives:
Bronchial asthma is characteristically a diverse illness that results from chronically inflamed bronchi. Adolescents are a particularly vulnerable group to asthma, and both its prevalence and death rate have increased in this patient population. Asthma care creates a particular set of difficulties for adolescents who are at a stage where there is a search for greater autonomy and changing social and emotional dynamics. The aim of this study was to describe the clinical characteristics of teenage asthmatics in an academic hospital.

Materials and Methods:
This was a cross-sectional study of patients between the ages of 13 and 18 who had consented to participate. The study consisted of face-to-face interviews and a review of their clinical and laboratory records. Data were analyzed using descriptive statistics and comparisons between groups made using Fisher’s test of exactness.

Results:
Eighty-seven teenagers were studied. The mean age was 15.5 ± 1.5 years. The majority (59%) were male. Ten study subjects (11.5%) were current smokers. A positive family history of asthma was found in 31% (n = 27) of the patients. All patients were on inhaled corticosteroid therapy. The majority of the study subjects (60.9%) had satisfactory asthma control as evidenced by a mean asthma control test score (ACT) of 19.2 ± 2.29. Fifteen patients (26.7%) had had an acute flare-up of the disease requiring hospitalization in the preceding 12 months, and 5.8% had had a previous intensive care unit admission.

Conclusion:
The majority of the teenagers studied had overall satisfactory asthma control, as determined by their ACT scores. The use of inhaled corticosteroids was standard, but the inhaler technique was largely unsatisfactory. The prevalence of tobacco use is a cause for concern.
THE MODERATING EFFECT OF EDUCATION LEVEL ON THE RELATIONSHIP BETWEEN TRADE OPENNESS AND EMPLOYMENT IN NORTH AFRICAN ECONOMIES
Authors: Rachida Naamaoui , Mabrouka Bencherif , Zeyneb Mehdaoui , Abderrahmane Kouidri 
Published: July 2024

Objective: This study explores how education level moderates the relationship between trade openness and employment in North African economies, examining whether higher education levels enhance or mitigate the employment effects of trade openness.

Theoretical Framework: The research draws on economic and educational theories to examine the interplay between human capital and economic policies. It uses trade openness theories to assess the impact of economic integration on employment, and human capital theories to analyze the role of education.

Method: The study uses a quantitative approach with panel data from North African economies (2000-2020). PLS-SEM models with interaction terms evaluate the moderating effect of education on the trade openness-employment relationship, using data from international trade databases and national educational statistics.

Results and Discussion: Findings indicate that trade openness positively influences employment, with the effect amplified by higher education levels. Economies with better education systems benefit more from trade openness in terms of employment. The discussion underscores the importance of educational investment for maximizing these benefits and addresses issues like differing educational quality and labor market conditions across countries.

Research Implications: The study suggests that North African policymakers should enhance educational systems to maximize the employment benefits of trade openness, offering practical insights into how education can help address globalization challenges and drive economic growth.

Originality/Value: This study uniquely combines education and economic policy perspectives to examine the moderation of trade openness effects on employment in North Africa, providing valuable implications for academic research and policy formulation.
Ecossistemas (Trans)formados: Levantamento e avaliação da vegetação em formação por efeito de espigão costeiro na Península da Ponta D’areia, São Luís, Maranhão
Authors: Pinheiro Claudio Urbano Bittencourt , De Aquino Heloísa Helena Vasconcelos 
Published: July 2024

A ação do ser humano sobre a natureza, vem dando origem a novos ambientes. São Luís, capital do estado do Maranhão, tornou-se uma grande aglomeração urbana cujo crescimento demográfico está refletido na intensidade da sua ocupação espacial. Uma das áreas da cidade que sofreu transformações importantes na ocupação de seu solo, foi a região conhecida hoje como Península da Ponta D’Areia, onde o Espigão Costeiro foi construído. Esta obra foi concebida, dentre outras razões, para conter o avanço da erosão do mar na região, bem como recompor a faixa de areia original do local. Por efeito do espigão, um novo ambiente tem sido formado em área lateral à estrutura construída, em sua porção terrestre, atualmente com restinga incipiente. A área de estudo conta com vegetação em estágios. Com o objetivo de entender o caminho da colonização vegetal na área e o desenvolvimento do processo a partir da cobertura vegetal, oito áreas de foram levantadas, registrando-se as tipologias em desenvolvimento e as espécies em instalação. O ambiente natural atual constitui uma estrutura física de arrumação e o ambiente biológico, incluindo microrganismos, flora e fauna, é estimulado pela arrumação física que se desenvolve. Na flora que se estabelece, vegetação herbácea de praias e dunas, vegetação arbustiva tipo escrube e formação arbórea baixa são as tipologias vegetacionais diferenciadas no ambiente em formação. Como esperado em áreas de sucessão, baixo número de espécies com elevado número de indivíduos por espécie. Entre as espécies registradas, naturais do ambiente de restinga, mas também secundárias, invasoras e ruderais.
Propriedades térmicas do solo: estudo de caso em uma região do semiárido alagoano no nordeste brasileiro
Authors: Alves Pericles , Boursheidt Vandoir , Querino Carlos Alexandre , Moura Marcos Antônio 
Published: July 2024

Em um contexto de mudanças climáticas globais, o monitoramento da temperatura do solo é de grande relevância para o entendimento das trocas energéticas do solo com a atmosfera e, portanto, para o balanço energético. Esse estudo foi conduzido em uma área de Caatinga (09º42,664’ S; 37º25,008’ W; 165m) no semiárido alagoano, cujo solo foi classificado como Franco-Argilo-Arenoso. O objetivo deste trabalho foi determinar algumas propriedades térmicas do solo utilizando dados de temperatura do solo e, de maneira indireta, investigar o impacto da precipitação sobre essas propriedades. No intuito de calcular a difusividade térmica do solo (K), foram utilizados três métodos distintos: amplitude, fase e logarítmico, além das variáveis profundidade de amortecimento, velocidade de propagação da onda e inércia térmica aparente. Para isso foram medidas temperaturas do solo nas profundidades de 0,01; 0,05; 0,10; 0,20 e 0,50m utilizando termopares do tipo E (cobre- constantan). A difusividade térmica do solo diária se encontra dentro das faixas relatadas na literatura para o nordeste do Brasil. Constatou-se a influência da chuva na K, a qual alcançou máximos no período chuvoso, independentemente do método e da profundidade da camada considerada. Também foram constatados picos de K na época seca durante ocorrências de chuvas significativas. Em média, a difusividade térmica aumentou em 1,38 vezes com o umedecimento do solo.
Applicability of sediment rating curves: analysis in the state of Rio Grande do Sul
Authors: Dorneles Viviane , Wojahn Victória de Souza , Beskow Samuel , Nunes Maria Cândida Moitinho 
Published: July 2024

The transport of sediments is present in all watercourses, occurring naturally, however, in different ways and characteristics. Its quantification in watersheds becomes extremely important for the planning and management of water resources. The sediment rating curve, which empirically describes the relationship between stream flow and suspended sediment concentration (Css), is an alternative tool to the lack of continuous monitoring of sediment transport. The aim of this research was to evaluate the use of rating curves in sedimentometric stations in Rio Grande do Sul, Brazil. Three Css data handling scenarios were tested for the analytical fitting of sediment rating curves considering a power function as follows: complete data sets, data sets subdivided into 10-year periods and subdivided into stream flow ranges. The approaches adopted in the present study were evaluated taking as reference 58 sedimentometric stations in the state. The goodness-of-fit tests used in this study - coefficient of determination, Relative Average Percentage Error and Nash Sutcliffe coefficient, indicated that the best results of the estimation of sediment transport were observed when the sediment rating curve was fitted to the 10-year period data set.
A snapshot of parallelism in distributed deep learning training
Authors: Romero-Sandí Hairol , Núñez Gabriel , Rojas Elvis 
Published: July 2024

The accelerated development of applications related to artificial intelligence has generated the creation of increasingly complex neural network models with enormous amounts of parameters, currently reaching up to trillions of parameters. Therefore, it makes your training almost impossible without the parallelization of training. Parallelism applied with different approaches is the mechanism that has been used to solve the problem of training on a large scale. This paper presents a glimpse of the state of the art related to parallelism in deep learning training from multiple points of view. The topics of pipeline parallelism, hybrid parallelism, mixture-of-experts and auto-parallelism are addressed in this study, which currently play a leading role in scientific research related to this area. Finally, we develop a series of experiments with data parallelism and model parallelism. The objective is that the reader can observe the performance of two types of parallelism and understand more clearly the approach of each one.
Peningkatan Motivasi Siswa kelas 12 SMAN 1 Tambelang untuk Melanjutkan Jenjang Pendidikan
Authors: Jahrudin Ahmad , Purwanti Popi , Mayanty Sri , Sari Tantry Agnhitya 
Published: July 2024

Minat belajar siswa di Tambelang pada umumnya masih kurang, hal itu dikarenakan berbagai faktor, diantaranya faktor ekonomi dan lingkungan. Selain itu dari yang kami amati di Tambelang merupakan salah satu kecamatan yang berada di kabupaten Bekasi, dimana banyak sekali industri atau pabrik yang merupakan salah satu target atau harapan para siswa dapat bekerja di salah satu kawasan atau pabrik untuk menjadi karyawan di sana, oleh sebab itu kami membuat pengabdian kepada masyarakat guna meningkatkan motivasi untuk jenjang pendidikan yang lebih tinggi atau membangun minat kuliah kepada siswa-siswa kelas 12 di SMAN 1 Tambelang. Adapun metode yang kami terapkan adalah ceramah dan diskusi dan untuk mengukur hasil, kami wawancara langsung para peserta, dari hasil wawancara ternyata masih banyak siswa yang masih ragu untuk melanjutkan kuliah dan lebih memilih untuk bekerja dikawasan karena faktor ekonomi, namun jumlah siswa yang ingin melanjutkan bertambah dibandingkan sebelum kegiatan motivasi.
IMPLEMENTATION OF MANAGEMENT GUIDANCE COUNSELING IN BUILDING SELF ACCEPTACE THROUGH INFORMATION SERVICES AT MADRASAH ALIYAH NEGERI CITY OF BINJAI
Authors: Zamzami Zamzami , Azmi Fachruddin , Yahfizam Yahfizam 
Published: July 2024

This study examines the important role of school principals in improving educational standards at Al-Jihad Private Islamic Middle School, Medan City. This research aims to understand how school principals lead to improve the quality of learning in Islamic educational institutions. In this effort, it is important for school principals to create a learning environment that supports the development of students' creative and innovative talents. This research methodology uses a qualitative approach with data collection techniques including observation, interviews and documentation studies. The findings from this research reveal three related findings: 1) the role of the principal as a leader in improving the quality of learning at Al-Jihad Private Islamic Middle School in Medan City, which includes innovators, motivators and administrators; 2) principal programs to improve the quality of learning at Al-Jihad Private Islamic Middle School in Medan City including active participation in social and community organizations, education and training (diklat), study assignments, seminars, workshops and conferences, as well as the creation of works scientific, and mobilization of the teacher evaluation team; 3) Supporting factors for school principals include: a) government and foundation support, b) internal madrasa support (principals, teachers and students), c) alumni support, d) collaboration with the private sector. Inhibiting factors include: a) lack of mastery of technology and teacher creativity, b) lack of research or scientific work by teachers, c) excessive administrative burden for teachers rather than focusing on developing the quality of learning.<p> </p>
Association of Online Learning Tools and Students’ Health: A Case Study During the COVID-19 Pandemic
Authors: Neamhom Thanakrit , Phosat Chanchira , Chumprasittichok Thanathorn 
Published: July 2024

Objective: This study aimed to determine the health effects on undergraduate students from online learning and connectivity devices, characterizing the association between significant confounding factors and the prevalence of health symptoms among undergraduates.Material and Methods: This cross-sectional study was conducted from July to August 2021 and involved 219 undergraduates selected by simple random sampling from an academic institute within Thailand. Data were analyzed using Chi-square and Kendall’s tau-c tests. All data were collected through a self-administered questionnaire.Results: Among participants, (1) tablets and smartphones were the major devices used (97.7% and 77.2%, respectively), (2) the prevalence of nervous-related and mental symptoms was over 80% for headache, dizziness, fatigue, difficulty concentrating, stress, tiredness and anxiety, (3) the Chi-square test results for laptop devices revealed an association with anxiety and burnout effects (p-value<0.05 for all), while anxiety presented as a positive correlation coefficient of Kendall rank (0.003), with desktop PC devices, and (4) learning media including video, PowerPoint and academic articles, played a major role in affecting health; especially academic articles, which exhibited a positive relationship in all related effects.Conclusion: The use of learning media during the Coronavirus Disease-19 (COVID-19) pandemic has had an impact on students’ mental health. Decisions regarding implementing mitigation measures and monitoring programs should be reconsidered to reduce risks to students’ health.
Radiographic abnormalities and their clinical significance in patients with Parkinson disease who receive deep brain stimulation implants
Authors: Findlay Matthew C. , Tenhoeve Samuel A. , Campbell Justin M. , Yost Samantha , Gautam Diwas , Rahimpour Shervin , Botros David , Liang Allison S. , Alshaikh Jumana T. , Kassavetis Panagiotis , Moretti Paolo , Embree Lindsay M. , Shofty Ben 
Published: July 2024

OBJECTIVE
Preoperative MR images obtained in patients with Parkinson disease (PD) undergoing deep brain stimulation (DBS) often reveal incidental radiographic abnormalities (RAs). These findings range from small changes to gross pathologies. The effect of these findings on patients’ clinical outcomes is unknown. The authors characterized RAs in patients with PD who underwent DBS and assessed clinical outcomes.

METHODS
Records of patients at the authors’ institution with PD who underwent MRI for DBS electrode implantation from 2010 through 2022 were reviewed. RAs were identified from the official preoperative MRI reports. RAs were grouped into four general categories (ischemic changes, atrophy or degenerative changes [ADCs], structural abnormalities, and tumors) and correlated with clinical outcomes (including subjective clinical response, levodopa equivalent dose [LED], and Unified Parkinson’s Disease Rating Scale Part III [UPDRS] score) at the 1-year and last available follow-ups.

RESULTS
In this review, 160 patients were identified for initial analysis, with 135 presenting with ≥ 1 RAs. Of these 135 patients, 69.4% (111/160) had ischemic vascular changes, 39.4% (63/160) had ADCs, 16.9% (27/160) had structural changes, and 1.9% (3/160) had tumors. No differences in preoperative LED or UPDRS score were observed between these groups. After DBS, no differences in outcomes were observed between patients with RAs and those without RAs for both the 1-year and last follow-up time points, including mortality rates and times. Structural lesions were associated with lower mortality rates (OR 0.1, p = 0.04). ADCs were associated with a worse subjective clinical response at the 1-year (OR 0.50, p = 0.04) and last (OR 0.49, p = 0.03) follow-ups, but subjectively worse responses were not correlated with worse objective outcome measures.

CONCLUSIONS
Most RAs have no significant effect on clinical outcomes in PD patients undergoing DBS. Generalized ADCs may be associated with poorer subjective responses and may warrant further discussion with the patient if diagnosed on preoperative MRI.