bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interface region imaging spectrograph (IRIS) observations of the fractal dimension in the solar atmosphere
Authors: Aschwanden Markus J. , Vilangot Nhalil Nived 
Published: November 2022

We focus here on impulsive phenomena and Quiet-Sun features in the solar transition region, observed with the Interface Region Imaging Spectrograph (IRIS) at 1,400 Å (at formation temperatures of Te ≈ 104–106 K). Summarizing additional literature values we find the following fractal dimensions (in increasing order): DA = 1.23 ± 0.09 for photospheric granulation, DA =1.40 ± 0.09 for chromospheric (network) patterns, DA = 1.54 ± 0.04 for plages in the transition region, DA = 1.56 ± 0.08 for extreme ultra-violet (EUV) nanoflares, DA = 1.59 ± 0.20 for active regions in photospheric magnetograms, and DA = 1.76 ± 0.14 for large solar flares. We interpret low values of the fractal dimension (1.0 ≲ DA ≲ 1.5) in terms of sparse curvi-linear flow patterns, while high values of the fractal dimension (1.5 ≲ DA ≲ 2.0) indicate quasi-space-filling transport processes, such as chromospheric evaporation in flares. Phenomena in the solar transition region appear to be consistent with self-organized criticality (SOC) models, based on their fractality and their size distributions of fractal areas A and (radiative) energies E, which show power law slopes of αAobs=2.51±0.21 (with αAtheo=2.33 predicted), and αEobs=2.03±0.18 (with αEtheo=1.80 predicted). This agreement suggests that brightenings detected with IRIS at 1,400 Å reveal the same nonlinear SOC statistics as their coronal counterparts in EUV.
Laparoscopic vs. open colectomy for T4 colon cancer: A meta-analysis and trial sequential analysis of prospective observational studies
Authors: Chen Peng , Zhou Hang , Chen Chuwen , Qian Xin , Yang Lie , Zhou Zongguang 
Published: November 2022

BackgroundTo evaluate short- and long-term outcomes of laparoscopic colectomy (LC) vs. open colectomy (OC) in patients with T4 colon cancer.MethodsThree authors independently searched PubMed, Web of Science, Embase, Cochrane Library, and Clinicaltrials.gov for articles before June 3, 2022 to compare the clinical outcomes of T4 colon cancer patients undergoing LC or OC.ResultsThis meta-analysis included 7 articles with 1,635 cases. Compared with OC, LC had lesser blood loss, lesser perioperative transfusion, lesser complications, lesser wound infection, and shorter length of hospital stay. Moreover, there was no significant difference between the two groups in terms of 5-year overall survival (5y OS), and 5-year disease-free survival (5y DFS), R0 resection rate, positive resection margin, lymph nodes harvested ≥12, and recurrence. Trial Sequential Analysis (TSA) results suggested that the potential advantages of LC on perioperative transfusion and the comparable oncological outcomes in terms of 5y OS, 5y DFS, lymph nodes harvested ≥12, and R0 resection rate was reliable and no need of further study.ConclusionsLaparoscopic surgery is safe and feasible in T4 colon cancer in terms of short- and long-term outcomes. TSA results suggested that future studies were not required to evaluate the 5y OS, 5y DFS, R0 resection rate, positive resection margin status, lymph nodes harvested ≥12 and perioperative transfusion differences between LC and OC.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022297792.
A novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) to prevent postoperative leg-length discrepancy for femoral neck fractures in hip arthroplasty
Authors: Zhang Jin-shan , Zheng Yong-qiang , Liu Xiao-feng , Xu Yong-quan , Fang Yang-zhen , Lin Zhen-yu , Lin Liang , Xu You-jia 
Published: November 2022

ObjectiveTo determine whether the two lower extremities are of equal length after hip arthroplasty for femoral neck fractures, we developed a novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) in hip arthroplasty.MethodsPatients with femoral neck fractures requiring hip arthroplasty from July 2020 to March 2022 in the orthopedic department of Jinjiang Municipal Hospital, Fujian Province, China were recruited. Hip arthroplasty was performed using the proposed “shoulder-to-shoulder” method of manual positioning based on anatomical mark in 52 patients with femoral neck fractures who met the inclusion criteria. “Shoulder-to-shoulder” was achieved by alignment of the marked femoral “shoulder” and the “shoulder” of prosthesis stem. There were 16 male and 36 female patients, with 27 undergoing total hip arthroplasty (THA) and 25 undergoing hip hemiarthroplasty (HA). The fractures were categorized according to the Garden classification: type II, type III, and type IV in 5, 11, and 36 patients, respectively. The vertical distance from the apex of the medial margin of the femoral trochanter to the tear drop line on both sides which was regarded as the length of both limbs were compared via postoperative imaging, and the apex–shoulder distance on the ipsilateral side measured via postoperative imaging was compared with those measured intraoperatively.ResultsAll patients completed the surgery successfully. The measurement results for the lower extremities after THA were as follows: contralateral group, 43.87 ± 5.59 mm; ipsilateral group, 44.64 ± 5.43 mm. The measurement results for the lower extremities after HA were as follows: contralateral group, 45.18 ± 7.82 mm; ipsilateral group, 45.16 ± 6.43 mm. The measurement results for the lower extremities after all arthroplasties were as follows: contralateral group, 44.50 ± 6.72 mm; ipsilateral group, 44.89 ± 5.90 mm. The results for the apex–shoulder distance were as follows: postoperative imaging, 19.44 ± 3.54 mm; intraoperative apex–shoulder distance, 27.28 ± 2.84 mm. Statistical analysis results indicated no statistically significant difference in the postoperative bilateral lower extremity length after hip arthroplasty (P = 0.75), while a statistically significant difference was found between the intraoperative and postoperative imaging measurements of the apex–shoulder distance (P &lt; 0.01).ConclusionThe novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) for femoral neck fractures in hip arthroplasty is simple and accurate, making it effective for preventing postoperative bilateral leg length discrepancy.
Effect of perioperative steroids application on dysphagia, fusion rate, and visual analogue scale (VAS) following anterior cervical spine surgery: A meta-analysis of 14 randomized controlled trials (RCTs)
Authors: Zhang Xiang , Yang Yi , Shen Yi-Wei , Zhang Ke-Rui , Ma Li-Tai , Liu Hao 
Published: November 2022

ObjectiveTo conduct a high-level meta-analysis of the RCTs to evaluate perioperative steroids use in the management of fusion rate, dysphagia, and VAS following anterior cervical spine surgery for up to 1 year.MethodsWe searched the database PubMed, EMBASE, Web of Science, Cochrane Library, Google Scholar, Ovid, and ClinicalTrials.gov without time restriction to identify RCTs that evaluate the effectiveness of perioperative steroids after anterior cervical spine surgery. A subgroup analysis was undertaken to investigate the effects of intravenous and local steroids. This study was registered in the PROSPERO database prior to initiation (CRD42022313444).ResultsA total of 14 RCTs were eligible for final inclusion. This meta-analysis showed that steroids could achieve lower dysphagia rate (p &lt; 0.001), severe dysphagia rate within 1 year (p &lt; 0.001), lower VAS scores at both 1 day (p = 0.005), 2 weeks (p &lt; 0.001) and shorter hospital stay (p = 0.014). However, there was no significant difference between the two groups regarding operation time (p = 0.670), fusion rates (p = 0.678), VAS scores at 6 months (p = 0.104) and 1 year (p = 0.062). There was no significant difference between intravenous and local steroid administration regarding dysphagia rates (p = 0.82), fusion rate (p = 1.00), and operative time (p = 0.10).ConclusionSteroids intravenously or locally following anterior cervical spine surgery can reduce incidence and severity of dysphagia within 1 year, VAS score within 2 weeks, and shorten the length of hospital stay without affecting fusion rates, increasing the operating time, VAS score at 6 months and 1 year.
Clinicopathological Features and Prognostic Evaluation of UBR5 in Liver Cancer Patients
Authors: Huo Qi , Hu Junjie , Hou Binfen , Zhao Mei , Han Xue , Du Yulin , Li Yao 
Published: November 2022

Background: Typically, liver cancer patients are diagnosed at an advanced stage and have a poor prognosis. N-recognin 5 (UBR5), a component of the ubiquitin protein ligase E3, is involved in the genesis and progression of several types of cancer. As of yet, it is unknown what the exact biological function of UBR5 is in liver cancer.Methods: A Kaplan-Meier survival curve (OS) was used to examine the effect of UBR5 expression on overall survival based on the TCGA database. To determine the molecular functions of UBR5 in liver cancer, we used the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. A protein-protein interaction (PPI) network was established for the screening of UBR5-related proteins in liver cancer. Western blot analysis was used to determine the expression levels of UBR5 and YWHAZ (tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein zeta), and in order to detect cell proliferation, an MTT assay was used.Results: The expression of UBR5 in liver cancer patient samples is significantly higher than in adjacent normal tissues. A high level of UBR5 expression was associated with older patients, a higher tumor grade, lymph node metastasis, and poor survival. We discovered YWHAZ with high connectivity, and UBR5 expression correlated positively with YWHAZ expression (r = 0.83, p &lt; 0.05). Furthermore, we found that elevated UBR5 levels directly correlated with YWHAZ overexpression, and that UBR5 promoted cell proliferation by affecting YWHAZ expression. Additionally, the TCGA databases confirmed that patients with liver cancer who expressed higher levels of YWHAZ had poorer outcomes.Conclusion: This suggests that UBR5 associated with YWHAZ may influence prognosis in patients with liver cancer, and that UBR5 may be a candidate treatment target for liver cancer. Therefore, UBR5 associated with YWHAZ may influence prognosis in patients with liver cancer, and UBR5 could serve as a potential target for liver cancer treatment.
Turismo, natureza e segurança: estudo de caso sobre segurança do turismo em Brotas (SP)
Authors: Baldi Moreira Raissa Vitoria , Gonçalves Sabrina Saltori , Guizi Alan Aparecido 
Published: November 2022

Devido ao cenário de retorno gradativo da atividade turística à normalidade, materiais de mídia indicam uma possível demanda reprimida em busca de atividades ligadas à natureza, possibilitando o retorno de atividades como o ecoturismo e o turismo de aventura, sendo estas atividades ligadas à fuga da rotina urbana e de conexão com a natureza, sendo caracterizadas pela busca de atividades ao ar livre, seja para observação da fauna ou da flora, ou para realização de atividades com algum tipo de risco. Desse modo, e com vistas à popularização de atividades de turismo de aventura, estabelece-se como objetivo geral de estudo, constatar a importância das normas que determinam a segurança no turismo de aventura e no ecoturismo no município de Brotas. Uma vez definido o objetivo geral de estudo, adota-se como problemática: Qual é a importância das normas que determinam a segurança do turismo de aventura e do ecoturismo no município de Brotas? Conforme já apresentado por meio do objetivo e problemática de estudo, este estudo de característica qualitativa, possui o município de Brotas como estudo de caso, onde se buscou conhecer as atividades turísticas desenvolvidas nesta localidade, bem como as medidas de segurança adotadas. Entrevistas com profissionais do turismo de Brotas, e posteriores análises de conteúdos tendo como base Bardin (2011), mostrou a importância das normas para o turismo local, priorizando-se a segurança do visitante ou do turista, a segurança também dos profissionais que atuam na região e, por fim, a boa reputação o município no desenvolvimento de sua atividade turística.
A reincidência de obesidade em pacientes que realizaram cirurgia bariátrica: uma revisão de literatura
Authors: Barbosa Ana Cláudia Mendes , Santos Millena Cardoso Sales , Neto Pedro Paulo Martins Ferreira , Zuim Nicoli Lindissey , Ruy Bruna Tainah , Teixeira Vanessa da Silva Moreira , Pazmiño Alice Gabriela Gaibor , Brito Isadora Pereira 
Published: November 2022

Introdução: A obesidade afeta a qualidade de vida das pessoas no âmbito locomotor, interação social,além de restringir acesso ao mercado de trabalho. Com isso, esses indivíduos apresentam baixa autoestima, sendo mais suscetíveis a apresentarem comorbidades em sincronia. Nesse sentido, muitas pessoas se tornam adeptos à cirurgia bariátrica, contudo, em determinados casos, passado-se alguns anos do procedimento, ocorre a reincidência de peso, fato frequentemente notado nos prontos atendimentos. Objetivo: Apresentar os pilares envolvidos no reganho de peso nos pacientes submetidos ao procedimento bariátrico. Método: O presente estudo é uma revisão integrativa da literatura de caráter quantitativo. Foram utilizados o PubMed e o Medline como base de dados. Utilizaram- se os descritores em Ciências da Saúde (DeCS): “Weight regain” AND “Bariatric surgery”, “reganho de peso'', "cirurgia bariatrica”. Desta busca foram encontrados 54 artigos, posteriormente submetidos aos critérios de seleção. Resultado: Foi-se analisado os conteúdos do ano de 2013 a 2022 , o que tornou possível o entendimento e a interpretação das informações. Com reganho de peso, os estudos afirmam que, embora tenha sido observado esse fato na maioria dos pacientes entre 12 a 24 meses após a cirurgia, houve também casos no período de 5 até 10 anos após o procedimento. Os indivíduos em questão possuem dificuldade em administrar sentimentos emocionais e fazem dos alimentos sua válvula de escape. Esse comportamento os levam às sensações de derrota, vergonha, culpa e tristeza em relação à recidiva do peso. Analisando-se a alimentação, foi-se observado que, hábitos alimentares errôneos após a realização da cirurgia bariátrica , é um grande fator para a recidiva de peso. Geralmente, esses pacientes apresentam interesse em alimentos hiperosmolares, ou seja, ricos em açúcar e lipídios após as alterações de humor. Essa recorrência de hábitos prejudiciais, ocorre, frequentemente, nos 12 primeiros meses do pós-operatório. Além disso, a falta de interesse em uma rotina de atividades físicas e o não cumprimento das consultas médicas de acompanhamento contribuem para que esse reganho se torne comum na maioria dos casos de cirurgias bariátricas.
DAMPAK PROMOSI PRODUK PADA PEMASARAN ONLINE
Authors: Maulidasari Cut Devi , Damrus Damrus Damrus 
Published: November 2022

Perkembangan globalisasi yang ditandai dengan pesatnya kemajuan teknologi sangat berpengaruh di hampir semua bidang kehidupan, terutama bidang ekonomi. Pelaku bisnis harus mampu menghadapi tantangan tersebut dengan cara memanfaatkan teknologi untuk memasarkan produk mereka demi mempertahankan kelangsungan hidup perusahaannya. Pemasaran Online dinilai lebih memungkinkan, sebab mampu menjangkau konsumen dalam cakupan yang lebih luas. Meskipun demikian, hal ini tentu saja akan efektif ketika didukung dengan promosi produk. Pemanfataan pemasaran online menggunakan media sosial Facebook merupakan salah satu cara yang bisa dilakukan. Adapun dampak promosi produk pada pemasaran online Facebook terdiri dari; pengehematan biaya, sebab biaya yang dibutuhkan tidak terlalu besar. Selanjutnya sasaran atau target pasar yang hendak di tuju tepat sasaran. Selain itu, Jangka waktu promosi memiliki jangka waktu yang panjang.Kata Kunci: Promosi Produk, Pemasaran Online, Media Sosial, Facebook
PENERAPAN PEMASARAN RELASIONAL DALAM PEMBELIAN SECARA ONLINE TERHADAP KEPUASAN PELANGGAN PADA MAHASISWA PROGRAM STUDI MANAJEMEN UNIVERSITAS MEDAN AREA
Authors: Amelia Wan Rizca , Damrus Damrus Damrus 
Published: November 2022

Perusahaan yang mengikuti perkembangan teknologi informasi melakukan promosi produk dan jasa ya g di hasilkan menggunakan media internet melalui situs toko online. Situs Toko online yang merebak saat ini memberikan kemudahan bagi konsumen untuk berbelanja kebutuhannya sehingga tidak perlu datang secara langsung. Sama halnya seperti Mahasiswa Manajemen Universitas Medan Area dalam memenuhi kebutuhan dan keinginnanya, mereka menggunakan situs toko online untuk berbelanja seperti buku, pakaian, dan produk lainnya. Riset ini bertujuan 1) mengenali hubungan variabel X terhadap variabel Y. Tipe riset ini merupakan deskriptif dengan pendekatan kuantitatif Populasinya merupakan mahasiswa Manajemen Universitas Medan Area yang sudah melaksanakan pembelian secara online. Responden dalam penelitian ini berjumlah 93 orang. Metode pengambilan sampel yang digunakan merupakan accidental sampling. Tata cara pengumpulan informasi dicoba dengan wawancara, serta catatan persoalan. Tata cara analisis informasi dicoba dengan analisis regresi linier berganda. Hasil riset menampilkan bahwa Komitmen, empati, timbal balik serta keyakinan secara serempak bermakna positif serta relevan terhadap kepuasan pelanggan dalam pembelian secara online yang di tunjukkan dengan hasil uji F hitung > F tabel sebesar 23.318 > 2,47, siginifikan sebesar 0,000 < 0,05. Hasil pengujian secara parsial (uji t) menunjukkan bahwa berpengaruh positif dan signifikan untuk masing- masing variabel independen terhadap variabel dependen dengan hasil T hitung > T tabel. Variabel komitmen -2,379 > -1,986, variabel empati 3,514 > 1,986, Variabel Umpan Balik 2,522 > 1,986, variabel kepercayaan 4,772 > 1,986, Dan dengan nilai R Square sebesar 0,515. Kata kunci : Pemasaran Relasional, Komitmen, Empati, Timbal Balik, Kepercayaan, Kepuasan Pelanggan
Pengaruh Kemampuan Kreativitas Pegawai Terhadap Keberhasilan Kerja Di Kantor Camat Mila
Authors: Muzakir Muzakir , Damayanti Cici 
Published: November 2022

Tujuan dari penelitian ini adalah untuk mengetahui pengaruh Kemampuan Kreatifitas terhadap Keberhasilan kerja pegawai. Variabel Kemampuan Kreatifitas dan variabel keberhasilan kerja pegawai diuji dengan cara membagikan kuesioner kepada pegawai kantor Camat Mila. Penelitian ini dilakukan di kantor Camat Mila Kabupaten Pidie. Metode penelitian yang digunakan adalah penelitian kualitatif, teknik pengumpulan data dilakukan dengan membagikan kuesioner kepada responden. Sampel penelitian dalam penelitian ini adalah 18 orang pegawai pada Kantor Camat Mila Kabupaten Pidie. Hasil analisis menunjukkan bahwa Kemampuan Kreatifitas mempunyai pengaruh positif dan signifikan terhadap Keberhasilan kerja pegawai pada Kantor Camat Mila Kabupaten Pidie. Berdasarkan penelitian maka terbukti bahwa Adanya Pengaruh yang positif dan signifikan Antara Kreatifitas Pegawai Dengan Keberhasilan Kerja di Kantor Camat Mila Kabupaten Pidie yang di buktikan dengan jawaban responden yaitu sebanyak 12 orang responden (66,7%) yang menjawab dengan kategori sangat Setuju bahwa adanya pengaruh antara kreatifitas pegawai dengan keberhasilan kerja, diikuti dengan jawaban responden yang menjawab setuju yaitu sebanyak 4 orang (22,2%), sedangkan yang menjawab tidak setuju sebanyak 2 orang (11,1%) Kata Kunci : Kreativitas, Kesuksesan Kerja
PENGARUH RISIKO BISNIS, RESIKO FINACIAL DAN UKURAN PERUSAHAAN TERHADAP RETURN SAHAM PADA PT. INDOFOOD SUKSES MAKMUR TBK PERIODE 2016-2019
Authors: Wiyati Rita , Maryati Sri , Thamrin Muhammad 
Published: November 2022

Penelitian ini bertujuan untuk mengetahui pengaruh antara Risiko bisnis, Risiko finansial dan Ukuran Perusahaan terhadap Return Saham baik secara parsial maupun simultan pada PT. Indofood Sukses Makmur Tbk periode 2016-2019. Data yang digunakan dalam penelitian ini adalah data sekunder yang bersumber dari laporan keuangan. Analisa data yang digunakan adalah data kuantitatif. Teknik analisis data yang digunakan yaitu regresi linear berganda. Berdasarkan analisis regresi linier berganda yang telah diuji risiko bisnis, risiko finansial dan ukuran perusahaan tidak berpengaruh secara signifikan terhadap return saham. sementara secara simultan diperoleh Fhitung 6.341 lebih besar dari Ftabel 2.90 dengan nilai signifikan 0,003 lebih kecil dari 0,05 yang berarti variabel bebas meliputi, risiko bisnis, risiko finansial dan ukuran perusahaan secara simultan berpengaruh signifikan terhadap return saham.
ANALISIS KELAYAKAN INVESTASI PADA DEPOT AIR MINUM ISI ULANG DITINJAU DARI ASPEK FINANSIAL PADA VIO WATER DI KECAMATAN SUKAJADI PEKANBARU
Authors: Murnawati Murnawati , Erti Lili , Tasril Tasril 
Published: November 2022

Usaha depot air minum merupakan salah satu usaha yang banyak diminati saat ini salah satunya adalah usaha depot air minum Vio water yang ada dikecamatan sukajadi pekanbaru yang berdiri pada tahun 2014. Usaha ini cukup diminati oleh masyarakat karna harga yang relative murah dan juga mudah didapat. Penelitian ini menggunakan metode deskriptif dengan pendekatan survey menggunakan data sekunder, Populasi dan Sampel dalam penelitian ini adalah Laporan Keuangan dan informasi dari Pimpinan dan Karyawan di UMKM Depot Air Minum VIO Water di Kecamatan Sukajadi Pekanbaru berjumlah 3 Orang. Tujuan penelitian ini mengetahui kelayakan investasi dengan menggunakan dengan menggunakan beberapa metode , Metode PP (Payback Periode), Metode ARR(Average Rate Of Return)Metode NPV ( Net Present Value ), Metode IRR ( Internal Rate Of Return). Hasil penelitian dengan menggunakan Metode PP (Payback Periode),investasi telah kembali selama 1 Tahun, 1 Bulan, 24 hari dengan menggunakan metode ini UMKM Vio water layak dilaksanakan karna investasi telah kembali lebih cepat dari yang telah ditentukan selama 5 tahun dengan menggunakan metode Metode ARR(Average Rate Of Return) diperoleh selama 5 tahun sebesar sebesar 136,51 % hal ini memberikan dampak yang positif kepada investasi yang ditanam kan pada depot Air Minum Vio water sangat baik. Dengan metode Net Present Value (NPV) yang didapatkan senilai Rp 259.578.217,5 dengan tingkat discount faktor sebesar 15 % Investasi pada Depot Air vio water layak untuk dilaksanakan karna Npv yang didapatkan bernilai Positif yaitu NPV > 0 Internal Rate Of Return (IRR) sebesar 84,55 % hal ini tingkat Discount Rate yang dihasilkan lebih besar dari tingkat keuntungan yang telah di tentukan , maka investasi yang ditanamkan dapat diterima dengan kata lain 84,55 > 15 %
PENGARUH KEPUASAN KONSUMEN DAN KUALITAS PELAYANAN TERHADAP KEPUTUSAN PENGGUNAAN JASA STUDI JNE KABUPATEN MAJALENGKA
Authors: Istiono Deni , Hernita Nita 
Published: November 2022

Penelitian ini bertujuan untuk mempelajari bagaimana kepuasan konsumen dan kualitas layanan mempengaruhi keputusan yang melibatkan layanan j&t di majalah kota. Ini termasuk jenis penelitian untuk survei menggunakan pendekatan deskriptif dan dapat diverifikasi. Populasi dalam penelitian ini adalah seluruh pengguna jasa pengiriman j&t dengan jumlah sampel 100 orang. Teknik pengambilan sampel dalam penelitian ini adalah nonsampling sampling dengan incidental sampling. Teknik pengumpulan data dalam penelitian ini adalah kuison skala likert. Analisis data pada penelitian ini MENGGUNAKAN asumsi klasik, analisis regresi, koefisien determinasi, uji kelayakan pemodelan, dan uji hipotesis parsial atau simultan. Studi telah menunjukkan bahwa kepuasan konsumen termasuk dalam kategori rendah, kualitas layanan tinggi, dan keputusan penggunaan layanan termasuk dalam kategori rendah. Uji hipotesis menunjukkan secara parsial bahwa kepuasan konsumen berpengaruh positif dan signifikan terhadap keputusan penggunaan jasa. Kualitas layanan berpengaruh positif dan tidak signifikan terhadap keputusan penggunaan layanan. Kepuasan konsumen dan kualitas layanan secara simultan berpengaruh positif dan signifikan terhadap keputusan penggunaan layanan.