Variation In Quality Research Articles

Mediation of customer satisfaction: E-service quality, brand trust, and reuse intention

The purpose of this study is to explain the role of customer satisfaction in mediating e-service quality and brand trust on reuse intention in the Traveloka application. The theories used are the Techlonogy Acceptance Model (TAM) and Expectancy Disconfirmation Theory (EDT). This research is a type of quantitative research that is associative in nature. The population in this study are all Traveloka application users who have transacted at least three (3) times in one year. The sampling technique used purposive sampling with a total sample member of 205 respondents. Respondent data collection was carried out by distributing questionnaires. The data analysis technique in this study used PLS-based SEM. The results showed that all variables had a positive and significant effect. Customer satisfaction acts as a partial mediation in mediating the effect of e-service quality and brand trust on reuse intention on the Traveloka application. The results of this study can provide an empirical contribution about the relationship between the variables of e-service quality, brand trust, customer satisfaction, and reuse intention for the development of the Technology Acceptance Model (TAM) and Expectancy Disconfirmation Theory (EDT). Traveloka management can implement a marketing strategy that emphasizes service quality and information accuracy to increase customer intention to reuse the Traveloka application.

The Influence of Mobile Banking Service Quality on Customer Satisfaction

This study aims to determine the effect of BSI Mobile Banking Service Quality on Customer Satisfaction (Case Study of Students of the Faculty of Islamic Economics and Business, UIN SUMATRA UTARA). The research method used is quantitative. The data source for this research is Bank Syariah Indonesia (BSI) mobile banking customers who are Fakultas Ekonomi Dan Bisnis Islam Students at Uin Sumatra Utara, and uses primary data. By using a collection technique through a questionnaire (questionnaire). The data analysis technique used in this study is to test the quality of the data, namely validity and reliability tests, multiple linear regression tests, and t tests. After going through quantitative procedures, this study obtained the reSumatra Utaralts that Mobile Banking Service Quality had an effect on Customer Satisfaction as evidenced by the correlation test which obtained reSumatra Utaralts of 0.000) <0.05. This means that the service quality variable has a positive and significant effect on customer satisfaction variables. Based on the reSumatra Utaralts of this study, the independent variable (Service Quality) of BSI Mobile has a significant effect on the dependent variable (Customer Satisfaction) of Faculty of Islamic Economics and Business Uin Sumatra Utara students.

Barriers to Offering Organ Preservation for Rectal Cancer in a Predominantly Hispanic Safety Net Hospital.

Total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC) has shown promise in achieving pathologic complete response (pCR) and enabling organ preservation through watch-and-wait (WW) strategies. However, implementation of WW protocols in diverse patient populations and safety-net hospitals faces unique challenges. The objective of this study is to evaluate TNT outcomes and identify barriers to WW implementation in a predominantly Hispanic safety-net hospital in South Texas. A retrospective review was conducted of 40 LARC patients treated with TNT at an academic tertiary referral center in South Texas between 2018 and 2023. Patient demographics, disease characteristics, and pCR rates were analyzed. A survey of multidisciplinary providers assessed perceived institutional and patient-related barriers to WW implementation. The cohort was 70% Hispanic, with a median age of 54 years. Most patients had advanced disease at diagnosis (57.5% T4, 65% N2). The pCR rate was 18.5% (5/27) among patients undergoing surgery. Re-review of MRIs for pCR patients revealed that 2/5 had minimal residual disease. The provider survey identified MRI quality variability, lack of dedicated treatment coordinators, and concerns about patient compliance and financial barriers as key obstacles to WW implementation. Despite advanced disease presentation in a predominantly Hispanic population, TNT achieved pCR rates comparable to international trials. Institutional and patient-level barriers to WW were identified, informing the development of a tailored WW protocol for this unique patient population.

A longitudinal test of relational turbulence theory and serial arguments in romantic relationships

Abstract Relational turbulence theory (RTT) suggests that people perceive their romantic relationships as turbulent when they experience interactions that manifest the deleterious effects of relational uncertainty and altered patterns of interdependence. RTT also positions communication in these episodes as associated with subsequent relational uncertainty and qualities of interdependence. Using three-wave panel data collected at three-week intervals, this study evaluates (a) how communication in serial argument episodes predict relationship parameters (i.e., relational uncertainty and qualities of interdependence), (b) how relationship parameters predict serial argument occurrence, directness, and valence, and (c) whether over time variability in qualities of serial argument communication predict subsequent relational turbulence. Results indicated limited support for reciprocal, between-wave associations between relationship qualities and serial argument communication; however, over time variability in the valence of serial argument communication was associated with higher levels of relational turbulence after 6 weeks. Implications for RTT and research on serial arguments are discussed.

Comparative Analysis of the Health Status of Heart Transplant Patients with Different Levels of Physical Activity

This study’s goals were to determine the health status of a group of heart transplant recipients (HTRs) and their level of physical activity and to compare the health status among them and with a group of healthy sedentary individuals. Fifty-four HTRs and eighteen sedentary individuals (S) were assigned to four groups, according to their level of physical activity (determined with the International Physical Activity Questionnaire); patients with a low, moderate, and high level of physical activity (HTRL, HTRM, and HTRH, respectively) and S participants underwent a basic blood analysis and several tests to assess their cardiovascular, neuromuscular, and functional mobility condition and their quality of life. The S and HTRH were very similar in terms of BP, HR, and blood analysis while HTRM and HTRL differed from both S and HTRH in these parameters. Regarding the cardiovascular, neuromuscular, functional mobility, and quality of life variables assessed in this study, HTRH showed the best results across all of them, followed by S, HTRM, and HTRL. It is suggested that the weekly level of physical activity of HTRs should be high, which might help them to enhance their health and quality of life.

Climate variability impact on groundwater quality in Small Island Developing States: Mauritius Island as a case study

This study investigates the impact of climate variability on groundwater quality in Mauritius. This is achieved by analyzing the physical and chemical water quality of the five main aquifers over eleven years. Temporal variations in water quality properties were compared to the Standardised Precipitation Index (SPI), Dry Spells, the Standardised Evapotranspiration Index (SPEI), and other climate variables to gain insights into how precipitation controls groundwater quality. The results reveal that the SPI and the SPEI correlate minimally with water quality indicators. Sulphate is the only water quality indicator that showed correlations above 0.4 in aquifers 2 and 3 against a 12-month SPI. Sulphate, alongside chloride, showed what is termed ”notable correlation,” a concept defined in this paper to accommodate correlations that fall above 0.3 when assessed against global climate modes ENSO and AAO, respectively. These results signify that sulphate is the most sensitive water quality indicator to water quantity changes, notwithstanding the modesty of the correlations. Heavy storms occurring during cyclones impact groundwater quality with respect to conductivity, TDS, salinity, and nitrate, although this could not be statistically tested given the lack of water quality indicators collected on the days surrounding the storm. Therefore, the conclusion is made based on one storm event. The study revealed that individual correlations between climate indices and water quality variables are present but weak. However, the long-term trend in water quality is visible.

Agroecological Assessment of Arable Lands in the Leningrad Region of Russia under the Influence of Climate Change

The paper presents an analysis of the influence of climatic characteristics on the rating of land suitability for agricultural use. Soil fertility is one of the most important factors in land productivity and crop capacity; it is a complex value that depends not only on agrophysical and agrochemical soil properties but also on other natural factors, such as climate. There are different methodical approaches for a quantitative assessment of fertility level. The objectives of the research were to understand whether the distributions of active temperature sums and annual precipitation sums have a significant effect on the spatial and temporal heterogeneity of the rating assessment of land suitability for agricultural use in the example of the Leningrad region. The estimation and comparison between Semenov–Blagovidov’s method of quality land estimation and Karmanov’s method of appraisal of soils are given in this article. Karmanov’s method is highlighted in this paper for its ability to assess soil’s ecological indices more effectively than traditional methods. The research suggested that climate change may lead to increased variability in soil quality, with potential benefits for agriculture under certain climate scenarios, but at the same time, excessive temperatures in summer and precipitations might become a limiting factor, pushing down yields. The results of such assessment show that the performed calculation models can be used to forecast crop yields for future periods.

Multiphase time-varying batch process monitoring based on stage moving model migration

To improve product qualities and obtain maximum comprehensive economic benefits from batch process production, it is of great practical significance to optimize the operation of batch production processes. Considering the multiphase and slow time-varying characteristics, a multiphase time-varying batch process monitoring method is proposed based on stage moving model migration technology. Firstly, the sliding windows are constructed with moving phases, where the moving of different phases is decided by the influence of the process variables to the final product. And time slices are the basic units for building the regression models. Secondly, to analyze and capture the relationship between the process variables of both the old mode and new mode and the final quality variable, the JY-PLS algorithm is utilized on each time slice within sliding windows for quality prediction. Then, monitoring indexes and corresponding control limits are calculated and used for process monitoring. The application to a real multiphase time-varying batch process, the start-up process of injection molding process, proved the effectiveness of the proposed method.

Clinical and Cardiometabolic Effects of Reducing Sedentary Behavior in Postmenopausal Women with Rheumatoid Arthritis.

We investigated the effects of a 4-month intervention targeting sedentary behavior on sedentary time and physical activity level, clinical parameters, cardiometabolic risk factors, inflammatory markers, and health-related quality of life in post-menopausal women with rheumatoid arthritis. This was a 4-month, parallel-group, randomized controlled trial (ClinicalTrials.gov identifier: NCT03186924). One-hundred-and-three postmenopausal rheumatoid arthritis patients were randomized (1:1) to either a newly developed intervention targeting sedentary behavior (Take a STAND for Health; TS4H) or standard of care (SOC). Sedentary behavior (primary outcome) and physical activity levels, clinical parameters, anthropometric parameters and body composition, blood samples and oral glucose tolerance test, blood pressure, muscle function, and health-related quality of life were assessed at baseline (Pre) and after 4 months (Post). Between- and within-group differences were tested using linear mixed models following the intention-to-treat principle. Total sedentary time, time in prolonged sitting bouts, standing, and stepping did not change in either group (all p ≥ 0.337). No significant between- and within-group differences were detected for any of the clinical parameters, markers of cardiometabolic health and inflammation, and health-related quality of life variables (all p ≥ 0.136). Among responders in TS4H group (those who reduced sedentary time by ≥30 min/d), Pre to Post IL-10 concentrations tended to reduce (group*time: p = 0.086; estimated mean difference [EMD]: -12.0 pg/mL [-23.5 to -0.6], p = 0.037), and general health (group*time: p = 0.047; EMD: 10.9 A.U. [-1.1 to 22.9], p = 0.086) and overall physical health tended to improve (group*time: p = 0.067; EMD: 7.9 A.U. [-0.9 to 16.6], p = 0.089). TS4H did not change sedentary behavior, physical activity levels, clinical, cardiometabolic, inflammatory or health-related quality of life outcomes. However, TS4H tended to reduce IL-10 levels and improve health-related quality of life in responders.

Image based Modeling and Control for Batch Processes

This manuscript addresses the problem of leveraging thermal images for modeling and feedback control, specifically tailored for terminal quality control of batch processes. The primary objective, common in many batch processes, is to produce products with quality variables aligning with user specifications, available for measurement only at batch termination, precluding the direct use of classical control strategies. Furthermore, in many instances, traditional online sensors such as thermocouples may not be available, but instead spectral inputs like thermal images or acoustic data may be more readily available for feedback control. The challenge is to not only use the non-traditional sensor data for building a dynamic model but also to use that model for terminal quality control. The proposed approach involves a multi-layered modeling strategy. Initially, a dimensionality reduction technique is employed to condense the high-dimensional image into a set of representative outputs. Subsequently, subspace identification (SSID) is applied to develop a Linear Time-Invariant (LTI) State Space (SS) model between the inputs and the reduced outputs. Finally, a Partial Least Squares (PLS) model is constructed linking the terminal states of a batch (identified using SSID) with the product qualities obtained for that specific batch. This model is then incorporated into a Model Predictive Control (MPC) formulation. The effectiveness of the MPC is illustrated by showcasing its capability to generate products of high quality by deploying the MPC on a bi-axial lab-scale rotational molding setup.

76 Camera vision grading and objective tenderness outcomes of steers fed lubabegron fumarate for the final 56 d of the feeding period

Abstract Limited research has compared no beta-agonist, ractopamine and lubabegron in feedlot cattle. We evaluated carcass quality and yield variables using a camera grading instrument and also examined objective tenderness outcomes. Treatments were negative control (no beta-ligand; CON), Optaflexx (ractopamine hydrochloride, 300 mg·steer-1·d-1 for 35 d; OPT), and Experior (lubabegron fumarate, 36 mg·steer-1·d-1 for 56 d + 4 d removal; 0EXP) fed for 198 d. Additional EXP treatments investigated total days on feed (DOF) of 184 d (-14EXP), 212 d (+14EXP) and 226 d (+28EXP). Carcasses (n = 2,517) were instrument graded 24 h post-mortem. Longissimus tenderness and lipid content were evaluated in a subset (n = 361) of carcasses via slice shear force and ether extract. Statistical analyses were conducted using mixed models; pen was the experimental unit, treatment was the fixed effect, block was a random effect, and means were separated with the Tukey-Kramer adjustment. Longissimus muscle area (LMA) was 4.0 to 6.2 cm2 larger (P < 0.01) for steers fed EXP compared with CON, which did not differ from OPT. Weight corrected LMA (LMA:HCW) was 1.3 cm2/100 kg larger (P < 0.01) for -14EXP compared with CON. Marbling score was 31 to 39 points lower (P < 0.01) for -14EXP compared with CON and OPT, whereas 0EXP, +14EXP and +28EXP were similar to CON and OPT. Total number of fat pieces within the longissimus did not differ (P = 0.11) across treatments, however number of fat pieces in the lateral one-half of the longissimus decreased (P ≤ 0.03) for -14EXP and +28EXP, whereas +14EXP tended (P = 0.09) to decrease compared with CON. Total meat area was 3.7 percentage points greater (P < 0.01) for -14EXP compared with CON; +14EXP and +28EXP tended (P = 0.07) to be greater than CON. Total fat area was 1.6 to 1.8 percentage points less (P ≤ 0.02) for 0EXP, +14EXP, and +28EXP when compared with CON. Compared with CON, dorsal-ventral longissimus distance increased (P < 0.01) by 3.3 to 5.4% for -14EXP, 0EXP, +14EXP and +28EXP. Medial-lateral longissimus distance increased 1.9 to 2.5 % (P < 0.01) for +14EXP and +28EXP compared with CON, whereas -14EXP tended (P = 0.08) to increase. Percentage intramuscular fat (IMF) was similar (P ≥ 0.44) for +14EXP, +28EXP, and OPT compared with CON, whereas 0EXP tended (P = 0.09) to be less. Marbling score and IMF were moderately correlated (r = 0.66). Slice shear force values were 20.1% greater (P < 0.02) for +14EXP compared with CON, whereas 0EXP tended (P = 0.09) to be greater and +28EXP, -14EXP and OPT were similar (P ≥ 0.28) to CON. These findings illustrate the effect of EXP on carcass traits and tenderness in feedlot cattle.

Repeated prefrontal tDCS for improving mental health and cognitive deficits in multiple sclerosis: a randomized, double-blind, parallel-group study

BackgroundMultiple Sclerosis (MS) is an autoimmune disease associated with physical disability, psychological impairment, and cognitive dysfunctions. Consequently, the disease burden is substantial, and treatment choices are limited. In this randomized, double-blind study, we conducted repeated prefrontal electrical stimulation in 40 patients with MS to evaluate mental health variables (quality of life, sleep difficulties, psychological distress) and cognitive dysfunctions (psychomotor speed, working memory, attention/vigilance), marking it as the third largest sample size tDCS research conducted in MS to date.MethodsThe patients were randomly assigned (block randomization method) to two groups of sham (n = 20), or 1.5-mA (n = 20) transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (F3) and right frontopolar cortex (Fp2) with anodal and cathodal stimulation respectively (electrode size: 25 cm2). The treatment included 10 sessions of 20 min of stimulation delivered every other day. Outcome measures were MS quality of life, sleep quality, psychological distress, and performance on a neuropsychological test battery dedicated to cognitive dysfunctions in MS (psychomotor speed, working memory, and attention). All outcome measures were evaluated at the pre-intervention and post-intervention assessments. Both patients and technicians delivering the stimulation were unaware of the type of stimulation being used.ResultsRepeated prefrontal real tDCS significantly improved quality of life and reduced sleep difficulties and psychological distress compared to the sham group. It, furthermore, improved psychomotor speed, attention, and vigilance compared to the sham protocol. Improvement in mental health outcome variables and cognitive outperformance were interrelated and could predict each other.ConclusionsRepeated prefrontal and frontopolar tDCS ameliorates secondary clinical symptoms related to mental health and results in beneficial cognitive effects in patients with MS. These results support applying prefrontal tDCS in larger trials for improving mental health and cognitive dysfunctions in MS.Trial registrationClinicalTrials.gov Identifier: NCT06401928.

Unveiling nitrate contamination and health risks: Insights from groundwater quality assessment and Monte Carlo simulation along the Southern Caspian Sea Coasts

Groundwater resources are at great risk of contamination due to increased industrial and agricultural activities, population growth and urban expansion. This study investigated factors controlling spatio-temporal variability in groundwater quality and nitrate concentration at the southern coast of Caspian Sea, Iran to provide public health risk assessment. Na-Cl (44.8%) and Ca-HCO3 (58.6%) types water were the dominant hydrogeochemical facies in dry and wet seasons, respectively. Most of the examined groundwater samples were found unfit for drinking but appropriate for agricultural irrigation. The chemistry of groundwater predominantly influenced by combination of local lithology and ion exchange in aquifer as well as seawater intrsuin. Nitrate concentration varied from 0.05 to 200 mg/L with a mean value of 33.1 mg/L in which 13.7% and 27.5% of samples showed concentration higher than WHO's recommended value in dry and wet seasons, respectively. The highest nitrate concentrations were observed at locations in proximity to human settlements including cities, villages as well as agricultural lands. The identified pollution hotspots confirm nitrate contributions from un-treated wastewater effluents and agricultural practices with minimum contribution from industrial activities. The result of Monte Carlo simulation revealed that children were at highest risk from drinking of groundwater containing nitrate. This study highlights the urgent need for action to address the growing threat to groundwater quality and public health posed by contamination from various sources in the southern coasts of Caspian Sea.

B - 107 Is the Flynn Effect Present in a Veteran Outpatient Clinic Sample?

Abstract Objective The Flynn Effect refers to improvement in cognitive scores over time due to advancements in education quality, nutrition, and socioenvironmental variables. Recent studies suggest cognitive scores may plateau or decline over time. Characterization of cohort effects in cognitive performance has implications for normative group selection and identification of brain illness. This study examines cognitive performances of veterans using older and newer versions of normative data to determine if a Flynn effect is present. Method Veterans (N = 189) who passed TOMM and completed the Trail-Making Test (TMT), Animal Naming, and California Verbal Learning Test-II (CVLT-II) were selected for inclusion. The sample was 81% male, racially diverse (49% White/Caucasian, 31% Black/African American, 16% Hispanic/Latino, 4% other), and diagnostically diverse (13% no diagnosis, 33% cognitive disorder, 54% psychiatric diagnosis). Normative scores were calculated from CVLT-II/CVLT-3 manuals for Trial 1, Trial 5, and LDFR; ADC Uniform Data Sets (UDS) were used for TMT-A/B and Animals. Wilcoxon matched-pairs signed rank tests examined differences in z-scores across older and newer normative data. Results Median z-scores were significantly lower using updated UDS norms for TMT-A (z = −11.60, p < 0.001), TMT-B (z = −10.41, p < 0.001), and Animals (z = −11.76, p < 0.001), while CVLT Trial 1 z-scores were significantly higher using CVLT-3 norms (z = 11.24, p < 0.001). CVLT Trial 5 and LDFR medians did not differ. Conclusion Findings demonstrate the need to examine cohort differences in normative reference groups to ensure accurate detection of brain illness. Furthermore, the Flynn Effect may not apply uniformly across domains within a period.

South-Tyrolean pinot blanc identity: Exploration of chemical and sensory profile changes ascribed to vineyard locations and winemaking variables

The sensory and chemical properties of ‘Pinot Blanc’ wine from South Tyrol were studied in relation to vineyard location and winemaking technique. Musts and wines were collected from a local producer. Wines made with the same control vinification but from different vineyards (Aldino 800, Montagna 450, and Klaus 550 m.a.s.l) were analyzed. Then wines from grapes of the same vineyard but made with different vinifications (grape freezing and co-inoculation of yeast with malolactic bacteria, both compared against controls) were compared. The highest-altitude vineyard (cooler temperatures, increased UV radiation, and increased airflow) impacted positively the wine quality. The different vinifications produced differences at various storage times. Finally, sensory attributes predictors for the overall quality and related chemical variables were identified. As climate change pushes growers to increasingly high-altitude viticulture, if/when allowed by the environmental conditions, these results can contribute to understand which winemaking techniques are best in these more challenging conditions.

Nexus between natural resource endowments and economic growth in selected African countries

Africa began implementing the Sustainable Development Goals (SDGs) in 2015 emphasizing on sustainable management and effective use of natural capital to spur economic growth (Goals 12, 14, and 15). This study using World Bank data sets from 46 African countries selected for the years 2000 to 2022, examined the nexus between natural resource endowments and economic growth in Africa. We used the system generalized method of moments (sys-GMM) and dynamic panel threshold regression (DPTR) to analyze the data. The findings of the two-step sys-GMM estimation using 'xtabond2' revealed that when the institutional quality variable is added and excluded from the model, natural resource dependence negatively impacts economic growth, but the impact is greater when the institution is excluded. In the estimation of the interaction variable of natural resource dependence and institutional variable included in the model, natural resource dependence positively impacts economic growth. The results of the DPTR using "xthenreg" showed that when the threshold value of natural resource dependence is ≤ 1.73% of gross domestic product, natural resource dependence has a positive impact on economic growth and a negative impact when the threshold value is above 1.73%. Similarly, when the institutional quality threshold is ≤ 0.277, natural resources dependence impacts economic growth negatively; above the threshold (0.277), the impact is positive. In conclusion, natural resource endowment is a curse with no or low-quality institutions and a blessing with high-quality institutions. Thus, building strong institutions and proper utilization of natural resources helps to minimize the adverse impact of resource endowments on economic growth.

Light quality and spatial variability influences on seedling regeneration in Hawaiian lowland wet forests

Abstract Tropical forest understories tend to be light‐limited. The red‐to‐far‐red ratio (R:FR) is a useful and reliable index of light quality and its spatial variability can influence competition between native and non‐native seedlings. While per cent light transmittance has been quantified in some Hawaiian lowland wet forests (HLWF), no information exists on how the spatial distribution of understorey light varies in relation to species invasion, or if patterns of seedling regeneration and light are linked. We measured the R:FR of light in the understorey to assess light quality in three HLWF forest types: native‐dominated, partially invaded and Psidium cattleyanum‐ (strawberry guava) dominated to quantify light quality in the understorey (0–50 cm height). We also identified relationships between light quality and native and non‐native seedling presence, diversity and abundance. Together, these data can help to determine the restoration potential of HLWF. Linear mixed‐effect modelling showed that native‐dominated forests had significantly greater R:FR than P. cattleyanum‐dominated forests, demonstrating a transformation in the light environment with increased invasion. Heterogeneity in R:FR varied more across sites than among forest types. In both native‐dominated and partially invaded forests, there were more native seedlings in the low‐quality R:FR (0.0–0.40) category and fewer in the medium‐ (0.41–0.70), and high‐quality (≥0.71) light categories than would be expected by chance, and there were no native seedlings in the P. cattleyanum‐dominated forests. Native‐dominated forests had greater species richness and abundance of native seedlings than the partially invaded forests, likely due to propagule availability. However, the spatial clustering of seedlings, the mismatch of native seedlings in light environments less suitable, and a considerable proportion of open high‐quality microsites, highlights that conditions are not optimal for native species in HLWF in the long term. Synthesis and applications. The native‐dominated and partially invaded forests still hold conservation value, despite variation among sites. Seedling additions could be targeted to different R:FR environments and at different spatial scales, but the lack of a strong relationship between R:FR and seedling number suggests that other factors besides light quality should be considered in seedling enrichment or other management activities.

Pediatric obstructive sleep apnea-related risk factors: A cross-sectional study.

This study investigated obstructive sleep apnea (OSA)-related risk factors in children and adolescents. Records of 187 subjects from a private medical clinic were reviewed. Overnight polysomnography recordings and self/parent reports were gathered. Descriptive analysis of sociodemographic, anthropometric, sleep quality and sleep architecture variables and OSA diagnosis were performed. Associations between independent variables and OSA diagnosis were assessed through multivariable logistic regression with robust variance, with a significance level of 5%. Results: 132 participants were diagnosed with OSA, and 55 were classified as "no OSA" (29.41%). Those overweight or obese were 4.97 times more likely to have OSA than those with normal weight (P= 0.005). Those who reported loud snoring were 2.78 times more likely to have OSA than those who reported mild or moderate snoring intensity. A one-unit increase in arousal index leads to 1.39 increase in the odds ratio (OR) of individuals diagnosed with OSA (P < 0.001), and each one-unit increase in sleep efficiency leads to 1.09 higher odds of not having OSA (P= 0.002). Significantly increased OSA-related risk factors among overweight/obese children and adolescents and among those who had a parental/self-report of loud snoring were found.

KUALITAS PELAYANAN DAN PEMBAYARAN NON TUNAI: DAMPAKNYA TERHADAP OMSET PENJUALAN PADA GEROBAK KREATIF DI KOTA DENPASAR

This research is descriptive and analytical, utilizing a quantitative approach. The sample was selected using purposive sampling, with a total of 30 respondents. Data were collected using a Likert scale questionnaire and processed with SPSS software. The results of the study indicate that: (1) Service quality has a positive and significant effect on the sales turnover of creative cart traders in Denpasar City's MSMEs, as evidenced by a t-value of 9.159 and a significance level of 0.000 &lt; 0.05, suggesting that improving service quality will increase the sales turnover of these traders. (2) The non-cash payment system does not have a significant effect on the sales turnover of creative cart traders in Denpasar City's MSMEs, as shown by a t-value of 1.385 and a significance level of 0.177 &gt; 0.05, indicating no influence of non-cash payments on sales turnover. (3) Service quality and the non-cash payment system collectively have a significant simultaneous effect on the sales turnover of creative cart traders in Denpasar City's MSMEs, with an F-value of 42.037 and a significance level of 0.000. The determination test results show that the variables of service quality and the non-cash payment system affect sales turnover by 73.9%, while the remaining 26.1% is influenced by other variables outside of this study, such as price, product quality, and promotion.

Implementing Patient-Centered Outcomes Research Institute Stakeholder Engagement Principles in Models of Palliative Care Delivery and Advance Care Planning Research.

Given the many challenges of conducting research that addresses the palliative and end-of-life care needs of patients with serious illnesses, stakeholder engagement starting from the moment of study conceptualization and design is critical to ensure successful participant recruitment, data collection, intervention delivery, data analysis, and dissemination. Guided by a conceptual model published by the Patient-Centered Outcomes Research Institute (PCORI) entitled, "Measuring What Matters for Advancing the Science and Practice of Engagement"14 and with the support of a PCORI Engagement Officer, representatives from 9 PCORI-funded study teams formed a working group to survey team members and review, outline, and describe key lessons learned and best practices for promoting stakeholder engagement in palliative care research. Almost all study teams engaged with patients/caregivers, clinicians, researchers, and health care system experts as stakeholder partners. About half the teams also included payers and training institutions as part of their stakeholder advisors as well as a range of content experts. Study teams relied on a variety of support structures and resources, and they employed 10 distinct methods for maintaining engagement. All engagement methods were generally considered to be effective by teams who used the method, though there was some variability in team-rated engagement quality of each method. Nine barriers to stakeholder engagement were identified across the 9 studies as well as 9 strategies (or facilitators) to overcome these barriers. We share examples of how stakeholder engagement impacted studies in all phases, including the preparatory phase, study initiation phase, execution phase, and data analysis/dissemination phase. Teams utilized a variety of resources and support structures as well as capitalized on multiple engagement methods for fostering stakeholder engagement, resulting in a high level of collaboration and integration.