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Introduction: Although many forms of exercise are known to have positive effects on bone metabolism in postmenopausal women, the effect of high-intensity interval training (HIIT) has not been investigated in this setting. This study aimed to evaluate the impact of the 6-week HIIT program on body composition, biochemical parameters, and bone turnover markers in overweight and obese postmenopausal women. Methods: A total of 32 postmenopausal women were randomly assigned to exercise (n=15) or control (n=17) groups. The blood samples and body composition were analyzed. The exercise group participated in a 6-week stationary bike HIIT exercise [(3 days/week; 30 sec work-90 sec resting intervals with 90-95% of the heart rate reserve-12 to 16 min/day)]. The control group was not involved in any exercise program. Results: In the exercise group, significant reductions were noted in waist and hip circumference, low-density lipoprotein, total cholesterol, triglycerides, phosphorus, calcium, albumin, bone-specific alkaline phosphatase, type 1 collagen C-terminal telopeptide, and osteocalcin levels, in addition to significant increases in high-density lipoprotein, free thyroxine, thyroid-stimulating hormone, vitamin D (25-hidroksi vitamin D), and cortisol levels, when compared with the control group (p

Abstract Evaluating high-throughput soil profile information is essential in safflower precision agriculture, as it facilitates efficient resource management and design of an experiment that promotes sustainable production. We collected soil from representative target environments (TE) of safflower cultivation and evaluated 14 soil physio-chemical features for constructing fine-resolution maps. The robustness, versatility, and predictive ability of two statistical learning models in correctly classifying the soil profile to clusters were tested. Calcium, sand, soil organic carbon, phosphorous, potassium, and sodium were found to be most influential in classifying the representative TE. Random Forest model was found to be the best performing with average prediction accuracy above 85% in all test settings which reached 100% in some. The optimal training population size for prediction was found to be 70–80%. The spatial distribution of sodium in Delhi was found to be aligned with the low yield of safflower emphasizing the importance of fine-resolution soil mapping to design a field experiment and optimize the nutrient supply. Fine-resolution mapping not only enhance soil management strategies but also support government initiatives such as soil health cards, delineation of cultivable land, and risk assessments in crop-growing areas.

The use of PPE is an effort to protect or prevent potential work hazards or accidents. Worker compliance in using PPE is determined by worker knowledge and attitudes. Workers' knowledge will change their actions so that this change in attitude will make workers obey the rules at work. The aim of this research is to analyze the relationship between knowledge and attitudes and compliance with the use of PPE among motor vehicle test officers at the Malang Regency Transportation Service. Quantitative analytical method, cross sectional approach. Total sampling was 30 respondents. Data was taken by filling out questionnaires by respondents and observing. Data analysis was carried out univariately and bivariately using the spss program with the Chi-Square statistical test. The Chi-Square test showed that there was a relationship between knowledge and compliance with the use of PPE (p-value = 0.043), and there was a relationship between attitude and compliance with the use of PPE (p-value= 0.027). The higher a person's level of knowledge and attitude, the more compliant they will be in using PPE.

Background: Dinoyo Community Health Center is a health facility in Malang City that must implement fire safety. There have been 4 incidents in 2020 and 8 incidents in 2021 where fire occurred at community health centers. Preparedness is carried out as an effort to deal with fires from a human perspective. Research objective: To determine workforce preparedness for fire management at the Dinoyo Community Health Center. Research type: descriptive quantitative with a population of 55 people using saturation sampling techniques. There are 2 preparedness parameters in this research variable, namely knowledge and attitudes. Results: The preparedness of the workforce is "ready" category for fire management with an index value of 76.10. The level of knowledge scored 66.23 is "ready" category and attitude scored 85.98 is "very ready" category. Conclusion: The attitude value is higher than the knowledge value. This is because attitudes are not only influenced by knowledge, but also influenced by personal experience, the influence of other people, and emotional influence. The workforce has received fire management training and simulations. The interview results show that the workforce understands information related to emergencies. Suggestion: Workers should increase their knowledge through print media or the internet.

This research analyses the political ramifications of Islamophobia in Indonesia, particularly how the apprehension linked to radical Islamic ideologies shapes the responses of government and political entities. Utilising a qualitative library research approach, this paper scrutinises an array of academic books, peer-reviewed journals, and scholarly articles to explore the interplay between religious anxieties and political measures. The findings indicate that the government's approach to combating perceived threats from Islamic movements involves strict enforcement of Pancasila, alleviation of fears regarding the replacement of national ideology by a caliphate, and promotion of religious moderation to deter extremism. The study highlights the politicisation of radicalism and Islamophobia, revealing the strategic use of these concerns to influence public policy and political discourse in Indonesia.

Kondisi peserta didik kelas 2 sebelum program pengabdian masyarakat berjalan, peserta didik dalam berhitung sebagian menggunakan jari, menghafal dan membuat garis-garis dalam kertas yang dikelompokkan dan dihitung jumlahnya. Perhitungan yang dilakukan dengan cara ini, sebagian mengalami kesalahan dan membutuhkan waktu yang cukup lama. Pelatihan dan pendampingan yang dilakukan pada peserta didik ini dimaksudkan untuk memotivasi dan memberi keterampilan dalam berhitung perkalian dasar dari bilangan nol (0) sampai bilangan Sembilan (9) dengan menggunakan jarimatika. Sasaran utama pelaksanaan program pengabdian ini adalah siswa kelas 2 Sekolah Dasar Muhammadiyah Unggulan Al Fatih Patuk Gunungkidul sebanyak 37 siswa. Pelaksanaan kegiatan dilakukan kolaborasi antara dosen dari Universitas Ahmad Dahlan (UAD) dan Institut Teknologi Nasional Yogyakarta (TNY) juga melibatkan tiga mahasiswa pendidikan matematika UAD. Kegiatan dilaksanakan dalam bentuk pelatihan dan pendampingan. Kegiatan dilaksanakan selama dua hari pada tanggal 12 Juni dan 14 Juni 2023 di SD Muhammadiyah Unggulan Al Fatih Patuk. Pelaksanaan Kegiatan terbagi dalam 4 sesi kegiatan: pretes, pelatihan, pendampingan, dan postes. Hasil dari kegiatan pengabdian ini adalah tumbuhnya motivasi siswa dan terjadinya peningkatan keterampilan siswa dalam berhitung dengan jarimatika. Hasil belajar siswa sebelum kegiatan pengabdian diperoleh rata-rata nilai pretest sebesar 70,27 dan setelah kegiatan pengabdian hasil nilai rata-rata postes siswa sebesar 91,80, sehingga terjadi peningkatan sebesar 21,53%.

IntroductionImpaired future fertility potential secondary to gonadotoxic therapies for childhood cancer is a shattering aftermath faced by childhood cancer survivors. Fertility preservation (FP) has emerged as a key to mitigate this unwelcomed sequelae. FP services catering to the needs of children and adolescents (C&A) population in developing countries are limited. Malaysia recently launched its pioneering pediatrics FP services.Aims of studyTo evaluate healthcare providers’ (HCPs) FP knowledge, practice behaviors, attitudes, perceptions, and barriers towards FP counseling/services (C/S) for the C&A cohort.MethodsA questionnaire-based study was conducted utilizing a questionnaire consisting of 51 items which was adapted from G.Quinn et al. The questionnaire was distributed both online and physically amongst HCPs in a tertiary center. Ethical committee approval was granted by the Research Ethical Committee, Universiti Kebangsaan Malaysia.ResultsA total of 102 HCPs completed the questionnaires. The majority of respondents were Malays (74.5%), females (80.4%), gynecology/pediatrics specialty (76.5%), and had children (88.2%). Nearly 72% of HCPs demonstrated good knowledge of FP. Almost 73% of HCPs consulted reproductive specialists (RES) on potential fertility issues and over 80% of HCPs referred patients who enquired on fertility issues to RES. Only 17% of HCPs practiced FP discussion, 12% reported no available person to discuss FP, and 10% of HCPs were unaware of who to discuss FP with. Patients’ inability to afford FP (30.4%) tops the list of barriers to FP C/S, followed by limited available information on FP for patients (17.6%) and patients too ill to delay treatment (12.7%). Most HCPs (88.2%) demonstrated unfavorable attitudes towards FP C/S.DiscussionsIn general, the majority of our HCP respondents demonstrated good current FP knowledge and practice behaviors. Mitigating several controversial issues in FP would improve HCPs’ attitude towards FP. Main barriers to the uptake of FP C/S for C&A were patient and resource barriers. Addressing these issues by funding aid for FP procedures, increasing FP knowledge dispersion, as well as developing age-appropriate FP-related educational materials would improve FP service provision for C&A in the future.ConclusionsIn conclusion, successful corrective action combined with strategic planning points to a promising future for Malaysia's FP services provision for C&A.

Abstract Background Emergency medical services (EMS) are paramount to boosting health indices in lower-middle income countries (LMICs); however, lack of uniform data collection and analysis hinders system improvement efforts. In the present study, we describe patterns of EMS utilization in the Republic of Armenia and provide key insight into the quality of digital data collection methods. Results For calls logged in the capital city, Yerevan, the majority had at least one missing field. The predominant complaint was high blood pressure among adults (34.4%) and fever among pediatrics (65.9%). A majority of patients were female (57.6%), adults (90.2%), and not transported to a hospital (85.0%). In the rural provinces, the data was largely intact. The predominant complaints were unspecified acute condition (27.4%) and high blood pressure (26.2%) among adults, and fever (43.9%) and unspecified acute condition (22.1%) among pediatrics. A majority of patients were female (57.1%), adults (94.2%), and not transported to a hospital (78.9%). Conclusions Our study reveals that the majority of calls to the EMS system are for concerns not needing in-hospital treatment and for acute exacerbation of chronic conditions. Our study also provides a critical foundation for the improvement of EMS systems in Armenia and in other nations in transition. The Locator software has the potential to be a valuable tool to the MoH if it is improved for surveillance purposes, and future synchronization of digital systems would provide easy access to critical information on population health needs and the effectiveness of public health interventions.

Analysing pre-COVID-19 unemployment in West Java is vital for comprehending and tackling Indonesia’s economic challenges. This significance arises not only due to the region’s high unemployment rate, but also from the need to understand unemployment patterns before COVID-19, which has become more relevant now during the country’s post-pandemic recovery phase. This study evaluates four machine learning models (Random Forest, Linear SVM, RBF SVM, and Polynomial SVM) to classify employment status using demographic and job-related variables. The objective is to find the most suitable model, particularly considering the imbalanced nature of the study-case data. Data from the National Labor Force Survey (SAKERNAS) in August 2019 is utilized, comprising 54,429 respondents across districts in West Java. The four models are evaluated using holdout validation with a 70:30 stratified proportion, repeated for 100 times. Results indicate that the random forest model outperforms others in balanced accuracy, F1-score, and computational time. The random forest model also underscores the importance of gender and age in classifying employment status in West Java, suggesting a need for targeted intervention, especially for female citizens and individuals in productive age groups.

A prediction is an estimation of something that has not yet occurred. Its purpose is to minimize uncertainty and reduce errors in planning. Bogor Regency, with the largest population in West Java, requires a substantial amount of food. Rice production must meet the consumption needs of the population. To anticipate potential rice shortages, effective planning, and reduced dependence on rice imports, research is needed to predict rice production. This study aims to predict rice production using Linear Regression and Support Vector Machine (SVM) algorithms. Secondary data from the Department of Food Crops and Horticulture, and the Central Statistics Agency (BPS) of Bogor Regency were utilized. Results show that the Linear Regression method outperformed SVM, with MSE 236202.323, RMSE 486.007, MAE 388.712, and R2 1.000. In contrast, SVM yielded MSE 1461472466.751, RMSE 38229.2.10, MAE 303333.535, and R2 -0.065. In conclusion, the prediction using Linear Regression demonstrated better accuracy than SVM. Keywords: Prediction, Algorithm, SVM. Linear Regression.

Abstract Methyl-CpG-binding domain protein 2 (Mbd2), a reader of DNA methylation, has been implicated in different types of malignancies, including breast cancer. However, the exact role of Mbd2 in various stages of breast cancer growth and progression in vivo has not been determined. To test whether Mbd2 plays a causal role in mammary tumor growth and metastasis, we performed genetic knockout (KO) of Mbd2 in MMTV-PyMT transgenic mice and compared mammary tumor progression kinetics between the wild-type (PyMT-Mbd2 +/+ ) and KO (PyMT-Mbd2 −/−) groups. Our results demonstrated that deletion of Mbd2 in PyMT mice impedes primary tumor growth and lung metastasis at the experimental endpoint (postnatal week 20). Transcriptomic and proteomic analyses of primary tumors revealed that Mbd2 deletion abrogates the expression of several key determinants involved in epithelial-to-mesenchymal transition, such as neural cadherin (N-cadherin) and osteopontin. Importantly, loss of the Mbd2 gene impairs the activation of the PI3K/AKT pathway, which is required for PyMT-mediated oncogenic transformation, growth, and survival of breast tumor cells. Taken together, the results of this study provide a rationale for further development of epigenetic therapies targeting Mbd2 to inhibit the progression of breast cancer.

Panti Werdha Elim is an institution dedicated to elderly care that not only provides services but also recognizes the rights and responsibilities of the elderly. The main task of Panti Werdha Elim is to ensure the fulfillment of the elderly's needs, both in terms of physical and psychological care. One of the most common diseases suffered by the elderly is hypertension. Hypertension is a condition where a person's blood pressure is high and poses a risk of serious health problems. Panti Werdha Elim provides health care facilities in the form of music therapy for the elderly. This research aims to determine the application of music therapy in the elderly and to assess the effectiveness produced after the therapy is conducted. This research uses a descriptive qualitative approach by collecting data through field observations, interviews, and literature studies. The main informants consist of nurses, therapists, and the elderly. The results of this study indicate that therapy is carried out for 15-30 minutes using music provided by the institution. In addition, the effectiveness produced is that the elderly feel a significant change in their health condition when this therapy is performed regularly. Another finding is that therapy is not only conducted in groups but also includes individual therapy for clients in need. Therefore, this research provides a detailed overview of the music therapy conducted and the dynamics of the social conditions of the elderly at Panti Werdha Elim.

This study aims to develop an instrument/scale to measure family resilience. A sample of 265 families in the Special Region of Yogyakarta was established using the random sampling technique, with the criteria of families in the Yogyakarta area served by the Office of Religious Affair (KUA), and those who have the Pusaka Sakinah program (Sakinah Family Service Center). The data analysis used Aiken's V content validity coefficient and construct validity used Rasch model analysis. The results of Aiken's V coefficients by three experts show a value range of 0.802. This means that the items in the instrument have a high coefficient for measuring family resilience. In addition, the results of the Rasch model analysis show that the item person has a reliability of 0.97 and the item separation has a reliability of 6.03, which means that the measuring instrument has a good function because it has a range of varying degrees of difficulty. Meanwhile, the subject has a reliability of 0.91 and a person separation has a reliability of 3.17. This shows that the character of the subject varies according to the profile of the respondents who come from various educational backgrounds. All items are valid and reliable for measuring the right construct.

The role of students as successors to the nation's aspirations for excellence and accomplishment is of great significance, particularly for the younger generation. The weight of this responsibility induces students to neglect their physical well-being, leading to the development of gastritis diseases. Hence, this study aims to investigate the factors that are correlated with the manifestation of gastritis symptoms. The objective of this study is to investigate the correlation between daily physical activity and stress levels with the manifestation of gastritis symptoms among enrolled students at the Islamic University in Makassar. This study examines the characteristics and experiences of college students through a cross-sectional approach. The data collection was facilitated through the use of an online questionnaire. A probabilistic sample method was employed, with a total of 401 respondents included in the study. The students conducted their studies at four universities in Makassar City that are affiliated with religious institutions. The statistical analysis of the data using Spearmen's test showed that there was no statistically significant association between daily physical activity and gastritis symptoms (p value 0.074). However, a significant relationship was observed between stress levels and gastritis symptoms among Islamic students in Makassar City (p value 0.000). The findings of this investigation demonstrated a statistically significant correlation between levels of stress and the manifestation of symptoms associated with gastritis. This study proposes that the implementation of effective stress management strategies among university students is crucial in reducing the occurrence of gastritis symptoms and promoting future academic success and overall well-being.

Nyeri pascaoperasi dapat meningkatkan morbiditas dan mortalitas, mengganggu proses penyembuhan luka, pemulihan yang buruk, dan durasi perawatan lebih lama. Tujuan penelitian ini adalah mengetahui hubungan kecemasan praoperasi dan karakteristik individu dengan intensitas nyeri pascaoperasi. Penelitian ini merupakan studi analitik korelasional dengan pendekatan cross sectional yang dilakukan terhadap 40 pasien bedah non emergensi dengan teknik anestesi spinal. Penelitian dilakukan di Soerojo Hospital Magelang periode September 2022–Februari 2023. Hasil penelitian menunjukkan hubungan yang signifikan antara kecemasan praoperasi dan intensitas nyeri pascaoperasi (ρ=0,000) dengan arah hubungan positif. Usia (ρ=0,003) dan jenis kelamin (ρ=0,017) juga memiliki hubungan yang signifikan dengan intensitas nyeri pascaoperasi, meskipun arah hubungannya negatif, sedangkan tingkat pendidikan (ρ=0,845) dan pengalaman operasi sebelumnya (ρ=0,069) tidak memiliki hubungan yang signifikan terhadap intensitas nyeri pascaoperasi. Dengan demikian, dapat disimpulkan bahwa semakin tinggi kecemasan sebelum operasi, semakin tinggi intensitas nyeri setelah operasi; perempuan dan usia muda cenderung mengalami respons nyeri yang berat setelah operasi dibanding dengan laki-laki dan orang dewasa.

An overall in vitro fertilization (IVF) outcome is dynamic. Good oocyte quality is important for achieving a better IVF pregnancy. Various methods have been used for OQ assessment (OQA). However, due to inconclusive evidence, one method’s superiority has not been proposed over others. Thus, OQA should be consolidated based on the current evidence for this matter. Our study aims to summarize the current OQA used and compare their recommended methods. Our results revealed that the optimal OQA for cost-effectiveness and clinical implementation is still via morphological assessment. The current method most opted for is total oocyte scoring. Although other methods—follicular fluid evaluation, mitochondria spindle assessment, or live zona imaging—can be applied with better precision, due to cost, additional tools, and expertise, and they should cater to research purposes and selected centers. Our results added value as a current strategy for optimizing OQA in IVF practice, aiming at cost-effectiveness and reproducibility for better clinical implementation.

In a time of climate change, population growth, and globalization, the risk of viral spread has significantly increased. The 21st century has already witnessed outbreaks of Severe Acute Respiratory Syndrome virus (SARS-CoV), Severe Acute Respiratory Syndrome virus 2 (SARS-CoV-2), Ebola virus and Influenza virus, among others. Viruses rapidly adapt and evade human immune systems, complicating the development of effective antiviral countermeasures. Consequently, the need for novel antivirals resilient to viral mutations is urgent. In this study, we developed a CRISPR-Cas13b system to target SARS-CoV-2. Interestingly, this system was also efficient against SARS-CoV, demonstrating broad-spectrum potential. Our findings highlight CRISPR-Cas13b as a promising tool for antiviral therapeutics, underscoring its potential in RNA-virus-associated pandemic responses.

Abstract Background Turner Syndrome (TS) is a rare sex chromosome abnormality occurring in 1 in 2500 female live births. To date, there is limited data on TS patients in Malaysia. This study aimed to investigate the quality of life (QoL) and body image disturbances among adult population with TS in comparison to age-matched controls in a tertiary hospital in Kuala Lumpur: Hospital Chancellor Tuanku Mukhriz, Universiti Kebangsaan Malaysia (HCTM, UKM). Methods This was a cross-sectional study carried out in HCTM, UKM, Kuala Lumpur. TS participants who attended clinic in HCTM, UKM and controls who were hospital staff members were recruited via purposive sampling. TS participants’ sociodemographic and clinical profiles were retrieved from medical records. Two validated, translated questionnaires; World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and Body Image Disturbances Questionnaires (BIDQ) were completed by participants. Results A total of 34 TS patients were approached and 24 (70.5%) of them participated in this study. Their median (IQR) age was 24.0 (7.0) years and their responses were compared to 60 age-matched healthy females as controls [median age (IQR) = 24.0 (8.0) years]. The most common medical problem in TS participants was premature ovarian insufficiency (n = 23; 95.8%). There were no significant differences between TS and control groups’ median scores (overall QOL; 4.00 vs. 4.00, general health; 3.50 vs. 4.00, physical health; 14.86 vs. 15.43, psychological health; 14.67 vs. 14.00 and environment; 15.00 vs. 15.50) of the different WHOQOL-BREF domains. However, TS participants were found to score 13.33 against 16.00, lower than the control group (p

Background: Primary dysmenorrhea is associated with poorer quality of life; however, the causal mechanism remains unclear. A vast body of literature supports the use of oral probiotics for relief from the symptoms of endometriosis; however, to our knowledge, no study has prescribed probiotics for primary dysmenorrhea. Objective: The aim of this study is to investigate the effects of 3-month supplementation with oral probiotics on quality of life and inflammatory markers in women with primary dysmenorrhea. Design: Randomized placebo-controlled trial. Methods: A total of 72 patients (36 patients in each arm) were randomized to receive either oral sachets containing 5 billion colony-forming units each of Lactobacillus acidophilus BCMC (BCrobes Microbial Cells) 12130, Lactobacillus casei subsp BCMC 12313, Lactobacillus lactis BCMC 12451, Bifidobacterium bifidum BCMC 02290, Bifidobacterium longum BCMC 02120, and Bifidobacterium infantis BCMC 02129 each or placebo twice daily for 3 months. Main outcome measures were visual analog scale, verbal rating scale, physical and mental health scores using Short-Form 12-Item version 2 questionnaire, frequency of nonsteroidal anti-inflammatory drug use, and changes in inflammatory markers (interleukin-6, interleukin-8, and tumor necrosis factor alpha) before and after treatment. Results: There was no significant difference in the quality of life scores between the probiotic and placebo groups. Both groups showed significant improvement in pain (visual analog scale) and severity (verbal rating scale) scores but the probiotic group had much lower nonsteroidal anti-inflammatory drug use (odds ratio: 0.69, 95% confidence interval: 0.26–1.83) and better mental health scores (mean change: 6.5, p = 0.03 versus 6.1, p = 0.08) than the placebo group. There was a significant confounding effect of nonsteroidal anti-inflammatory drug use on quality of life scores. No significant difference was found in inflammatory cytokines. Conclusion: Tested oral probiotics improved mental health and potentially reduced the use of nonsteroidal anti-inflammatory drugs; however, there was no significant change in inflammatory markers. Further research with a larger sample size is needed to confirm the findings. Registration: This study is registered under ClinicalTrials.gov (NCT04119011).

The leading indicator for successful outcomes in in-vitro fertilization (IVF) is the quality of gametes in oocytes and sperm. Thus, advanced research aims to highlight the parameter in assessing these qualities – DNA fragmentation in sperm and oocyte development capacity (ODC) via evaluation of microenvironments involving its maturation process. Regarding oocytes, most evidence reveals the role of cumulus cells as non-invasive methods in assessing their development competency, mainly via gene expression evaluation. Our review aims to consolidate the evidence of GDF-9 derivatives, the HAS2, GREM1, and PTGS2 gene expression in cumulus cells used as ODC markers in relevant publications and tailored to current IVF outcomes. In addition to that, we also added the bioinformatic analysis in our review to strengthen the evidence aiming for a better understanding of the pathways and cluster of the genes of interest - HAS2, GREM1, and PTGS2 in cumulus cell level. Otherwise, the current non-invasive method can be used in exploring various causes of infertility that may affect these gene expressions at the cumulus cell level. Nevertheless, this method can also be used in assessing the ODC in various cohorts of women or as an improvement of markers following targeted tools or procedures by evaluating the advancement of these gene expressions following the targeted intervention.

Abstract Drought stress leads to a significant amount of agricultural crop loss. Thus, with changing climatic conditions, it is important to develop resilience measures in agricultural systems against drought stress. Roots play a crucial role in regulating plant development under drought stress. In this review, we have summarized the studies on the role of roots and root‐mediated plant responses. We have also discussed the importance of root system architecture (RSA) and the various structural and anatomical changes that it undergoes to increase survival and productivity under drought. Various genes, transcription factors, and quantitative trait loci involved in regulating root growth and development are also discussed. A summarization of various instruments and software that can be used for high‐throughput phenotyping in the field is also provided in this review. More comprehensive studies are required to help build a detailed understanding of RSA and associated traits for breeding drought‐resilient cultivars.

In 2018, the Central Bureau of Statistics noted that the pharmaceutical industry grew 7.36 percent and slowed by 5.59 percent during the Covid-19 pandemic in 2020. Fluctuations in the growth of the pharmaceutical sector before and during the Covid-19 pandemic encouraged increased competition and concentration. This study examines the concentration and competition of pharmaceutical businesses listed on the Indonesia Stock Exchange from the first quarter of 2018 to the third quarter of 2020. The method used in this study is a quantitative approach with a concentration ratio model (CR) and the Hirschman-Herfindahl index (HHI). The calculation results show that the Kalbe Farma company controls over 65 percent of the market share, while 9 pharmaceutical companies contest the other 35 percent. KLBF is a company with the most sustainable competitive advantage compared to others; this can be seen from product differentiation, use of technology, and a superior market share of 65.39%. In addition, from the aspect of market competition, it shows that the pharmaceutical industry before and during the Covid-19 pandemic was in a tight oligopoly market with scores of 99.20 and 99.22. The results show the implications that pharmaceutical sector actors can carry out our policies related to competitive price competition. Another procedure is that companies must constantly observe and analyze the actions of other pharmaceutical companies in making business decisions.

Background: Home Industry Air Minum Darussalam (AMIDAS) Gontor is the only industry that produces mineral water located in Ponorogo, East Java managed by the business unit Pondok Modern Darussalam Gontor Ponorogo. In general, the production process at AMIDAS Gontor is divided into three main activities; packaging, warehousing, and shipping. The three main activities of this work are still done manually by workers, so workers doing repetitive movements or incorrect work postures can pose a risk of Musculoskeletal Disorders (MSDs). Objectives: This study aims to describe the MSDs factor among workers in the Air Minum Darussalam (AMIDAS) Gontor household industry. Research Methods: This research is descriptive research. The population in this study is all workers in the Air Minum Darussalam (AMIDAS) Gontor who require 25 people with data collection techniques using the Quick Exposure Check (QEC) questionnaire and the Nordic Body Map (NBM) instrument.Results: The measurement results of the work posture describe related to the risk of MSDs showed that workers in the Air Minum Darussalam (AMIDAS) Gontor household industry majority as many as 7 people with a percentage (28%) experienced high complaints that received a level 4 action score. In addition, workers have experienced 12 minor complaints (48%), 5 moderate complaints (20%), and 8 high complaints (32%). The average complaints of MSDs in workers in the Home Industry Air Minum Darussalam (AMIDAS) Gontor the majority of which experienced high complaints are found on the back (65%), compared to the lowest complaints found in the left ankle (38%). Conclusion: To overcome the problem of work posture that occurs, it is recommended that the manager or manager of the company provide hand pallets so that they can be used to facilitate workers in doing their jobs, as well as implement a rolling system for workers. Keywords:Work posture, QEC, NBM, AMIDAS Gontor

Archaeological and palaeoenvironmental evidence from the Armenian Highlands and wider southern Caucasus region emphasises the significance of Marine Oxygen Isotope Stage 3 (c. 57–29 ka) as a crucial period for understanding hominin behaviours amidst environmental fluctuations. Ararat-1 cave, situated in the Ararat Depression, Republic of Armenia, presents potential for resolving emerging key debates regarding hominin land use adaptations during this interval, due to its well-preserved lithic artefacts and faunal assemblages. We present the first results of combined sedimentological, geochronological (luminescence and radiocarbon), archaeological and palaeoecological (macrofauna, microfauna and microcharcoal) study of the Ararat-1 sequence. We demonstrate sediment accumulation occurred between 52 and 35 ka and was caused by a combination of aeolian activity, cave rockfall and water action. Whilst the upper strata of the Ararat-1 sequence experienced post-depositional disturbance due to faunal and anthropogenic processes, the lower strata remain relatively undisturbed. We suggest that during a stable period within MIS 3, Ararat-1 was inhabited by Middle Palaeolithic hominins amidst a mosaic of semi-arid shrub, grassland, and temperate woodland ecosystems. These hominins utilised local and distant toolstone raw materials, indicating their ability to adapt to diverse ecological and elevation gradients. Through comparison of Ararat-1 with other sequences in the region, we highlight the spatial variability of MIS 3 environments and its on hominin land use adaptations. This demonstrates the importance of the Armenian Highlands for understanding regional MP settlement dynamics during a critical period of hominin dispersals and evolution.

Abstract Glottic insufficiency is one of the voice disorders affecting all demographics. Due to the incomplete closure of the vocal fold, there is a risk of aspiration and ineffective phonation. Current treatments for glottic insufficiency include nerve repair, reinnervation, implantation and injection laryngoplasty. Injection laryngoplasty is favored among these techniques due to its cost-effectiveness and efficiency. However, research into developing an effective injectable for the treatment of glottic insufficiency is currently lacking. Therefore, this study aims to develop an injectable gelatin (G) hydrogel crosslinked with either 1-ethyl-3-(3-dimethylaminpropyl)carbodiimide hydrochloride) (EDC) or genipin (gn). The gelation time, biodegradability and swelling ratio of hydrogels with varying concentrations of gelatin (6–10% G) and genipin (0.1–0.5% gn) were investigated. Some selected formulations were proceeded with rheology, pore size, chemical analysis and in vitro cellular activity of Wharton's Jelly Mesenchymal Stem Cells (WJMSCs), to determine the safety application of the selected hydrogels, for future cell delivery prospect. 6G 0.4gn and 8G 0.4gn were the only hydrogel groups capable of achieving complete gelation within 20 min, exhibiting an elastic modulus between 2 and 10 kPa and a pore size between 100 and 400 μm. Moreover, these hydrogels were biodegradable and biocompatible with WJMSCs, as > 70% viability were observed after 7 days of in vitro culture. Our results suggested 6G 0.4gn and 8G 0.4gn hydrogels as potential cell encapsulation injectates. In light of these findings, future research should focus on characterizing their encapsulation efficiency and exploring the possibility of using these hydrogels as a drug delivery system for vocal fold treatment.

The symbolic Turiyam matrix is a matrix whose entries contain symbolic Turiyam. Inverse matrices can generally be determined if the matrix is a non-singular square matrix. Currently the inverse of the symbolic Turiyam matrix of size m × n with m 6= n can be determined by the Moore-Penrose inverse. The purpose of this research is to determine the inverse Moore-Penrose algorithm on a real symbolic Turiyam matrix of size m × n with m 6= n. Algebraic operations on symbolic Turiyam is a method used to obtain the Moore-Penrose inverse on real symbolic Turiyam matrices by applying symbolic Turiyam algebraic operations on the concept of Moore-Penrose inverses. The main result obtained is the inverse Moore-Penrose algorithm on the real symbolic Turiyam matrix. The demonstration example given shows that the Moore-Penrose inverse on a real symbolic Turiyam matrix always exists even though the matrix is not a square matrix.

Penelitian ini bertujuan untuk menganalisis pengaruh hubungan antara status pasien COVID-19 terhadap faktor-faktor yang mempengaruhi COVID-19 di Kota Depok dengan regresi logistik multinomial. Pengambilan data dilakukan menggunakan kuesioner dengan teknik snowball sampling. Peubah respon yang digunakan pada penelitian ini adalah suspek, terkonfirmasi, dan kontak erat dimana peubah tersebut merupakan jenis status pasien COVID-19. Peubah prediktor pada penelitian ini adalah usia, jenis kelamin, lokasi tempat tinggal, kondisi tempat tinggal, jenis pekerjaan, informasi, gaya hidup, riwayat kontak, fasilitas kesehatan dimana peubah tersebut merupakan faktor-faktor yang mempengaruhi status pasien COVID-19 di Kota Depok. Hasil uji kesesuaian model menggunakan uji Pearson didapatkan nilai P-value > 5% sehingga dapat dikatakan bahwa tidak ada perbedaan model hasil observasi dengan prediksi atau dengan kata lain model yang dihasilkan layak untuk digunakan. Hasil identifikasi diperoleh peubah yang sangat signifikan antara status pasien COVID-19 terhadap faktor-faktor yang mempengaruhinya di Kota Depok yaitu gaya hidup dengan kategori teratur berolahraga, riwayat kontak dengan kategori kurang dari sama dengan 3 hari. Peluang yang didapatkan dari masing-masing status pasein COVID-19 di Kota Depok sebesar 0,000000036 pada kategori terkonfirmasi, 0,999 pada kategori kontak erat dan 0,00000048 pada kategori suspek.

The synthesis, characterization, optimization and oxidation stability improvement of biodiesel from the seed oil of sesame indicum using a novel nano-heterogeneous bio-catalyst derived from the Chrysophyllum albidium seed coat (CASC) is reported. The heterogeneous catalyst was produced by calcination and activation at 400 °C, 600 °C and 800 °C using acetic acid. The catalyst was characterized using scanning electron monograph (SEM), Fourier transform infrared (FTIR), and x-ray diffraction (XRD). The seed oil was extracted using mechanical press milling and the biodiesel produced were characterized using AOAC 2019 edition and ASTM D-6151, Fourier transform infrared (FTIR) and gas chromatography (GC) methods. The results indicated that calcined Chrysophyllum albidum seed coat contains nano-particles and alkaline elements (75 % graphite). The calcination process improved the size reduction and structural arrangement of the particles. The 600 °C calcination temperature had the highest biodiesel yield of 88 % at 3.0 wt % catalyst concentration, 12:1 M ratio of alcohol to oil and 500 rpm. The reusability of catalyst indicated 71.50 % after fifth (5th) cycle. After 28 days storage duration in the presence of the natural, renewable and eco-friendly antioxidant (1 % turmeric), the oxidation instability of the produced biodiesel was reduced by 50 %. The quality of the biodiesel indicates agreement with standards and literature as well as high potential for effective application in diesel engine.

Introduction Optimal pharmacological treatment of tuberculosis (TB) requires a multidisciplinary team, yet the hospital pharmacist’s role is unclear. We aimed to analyse hospital pharmacist-provided clinical pharmacy services (CPS) implementation in TB care.Method A nationwide survey-based online cross-sectional study was conducted on hospital pharmacists in Indonesia from 1 November 2022 to 22 November 2022. Outcomes were the extent of pharmacists’ involvement in multidisciplinary TB care, TB-related CPS provided and views on TB-related CPS. The probability of pharmacists’ involvement in multidisciplinary TB teams was assessed using logistic regression.Results In total, 439 pharmacists (mean age 31.2±6.22 years, 78% female) completed the survey. Thirty-six per cent were part of multidisciplinary TB care, and 23% had TB-related tasks. Adherence monitoring (90%) and drug use evaluation (86%) were the most conducted TB-related CPS. Pharmacists’ views on TB-related CPS implementation were generally positive, except for financial incentives. Work experience (OR 1.99, 95% CI 1.09 to 3.61), ever received TB-related training (OR 3.51, 95% CI 2.03 to 6.14) and specific assignments to provide TB-related CPS (OR 8.42, 95% CI 4.99 to 14.59) significantly increased pharmacist involvement in multidisciplinary TB care.Conclusion Around one-third of hospital pharmacists are part of multidisciplinary TB care, with medication adherence and drug use monitoring as primary tasks. Pharmacists’ experience, training, assignment to provide TB-related CPS and financial incentives are key elements for further implementation in multidisciplinary TB care. Pharmacists should proactively support current TB care and conduct operational research, sharing data with healthcare peers and fostering a collaborative multidisciplinary TB care team.

This study aims to analyze the contribution of each apparatus' score component to the overall score and to identify the key performance indicators that distinguish medalists from non-medalists among the 10 finalists in rhythmic gymnastics at the 2020 Olympic Games, Tokyo. Medalists (n=3) and non-medalists (n=7) were separated in the sample. Each apparatus (hoop/ball/clubs/ribbon) had seven components [body difficulty (DB), apparatus difficulty (DA), D total, artistic execution (EA), execution technical (ET), E total, total score (TS) of apparatus, and a total final score (TFS-sum of four apparatus scores)]. A total of 350 scores were analyzed. The Mann–Whitney U tests and Cohen's d effect size (ES) calculation were used to calculate differences. The following variables were determined to differentiate the TFS of the medalist and the non-medalist gymnasts: the large effect with Ball-DA/D total/EA/E total/TS (ES=1.550–1.879), Clubs-DA/D total/EA/TS (ES=0.316–2.080), Hoop-DA/D total/TS (ES=1.897–2.316), Ribbon-EA (ES=1.879), and with a low-effect Clubs-AD(ES=0.316) components. Hoop-DA and Hoop-D-TS (ES=2.316, p< 0.05) have the greatest impact, while all DB and ET scores (p>0.05) have no effect on TFS. The impact of apparatus-specific score components on Olympic medal outcomes varies significantly. Notably, difficulty scores (both total and apparatus-specific) and artistic scores emerged as key performance indicators for achieving high total scores and securing a medal in rhythmic gymnastics at the Olympic Games. Coaches should prioritize choreography planning aimed at enhancing difficulty, particularly the apparatus difficulty score, while also focusing on enhancing artistic quality through flawless execution of routines by the gymnasts.

Socio-cultural values that prioritize the formation of noble characters are gradually starting to be considered incompatible with the times, students are more fond of popular culture presented by various media available in the community. In fact, each region has a rich culture that can be developed to become the basis for character education for students in the area. The method used in writing this article is a qualitative method, using a phenomenological approach. The respondents in this study were teachers, community, local government in rural communities. To obtain data, the authors used interviews and observations at the research site. Social and cultural changes in society can affect the educational process as a result of a shift in the educational paradigm, such as changing the way of life, ways of learning, ways of communicating and thinking and others. The process of Islamic education in rural communities schools of South Sumatra must improve by changing the paradigm of sociocultural-based education in order to answer the demands of the times. In addition, Islamic education in schools must develop the values of peace, tolerance, human rights, democracy and justice. Educators in certain ethnic-religious-based schools should teach universal human and justice values that uphold the values of peace. Islamic education in schools with a sociocultural basis must teach students about universal religious values. Educators must teach and instill religious and cultural values that are friendly to differences, non-violence, uphold peace, and justice.

Amyotrophic Lateral Sclerosis (ALS) is characterised by a loss of motor neurons in the brain and spinal cord that is preceded by early-stage changes in synapses that may be associated with TAR-DNA-Binding Protein 43 (TDP-43) pathology. Cellular inclusions of hyperphosphorylated TDP-43 (pTDP-43) are a key hallmark of neurodegenerative diseases such ALS. However, there has been little characterisation of the synaptic expression of TDP-43 inside subpopulations of spinal cord synapses. This study utilises a range of high-resolution and super-resolution microscopy techniques with immunolabelling, as well as an aptamer-based TDP-43 labelling strategy visualised with single-molecule localisation microscopy, to characterise and quantify the presence of pTDP-43 in populations of excitatory synapses near where motor neurons reside in the lateral ventral horn of the mouse lumbar spinal cord. We observe that TDP-43 is expressed in approximately half of spinal cord synapses as nanoscale clusters. Synaptic TDP-43 clusters are found most abundantly at synapses associated with VGLUT1-positive presynaptic terminals, compared to VGLUT2-associated synapses. Our nanoscopy techniques showed no difference in the subsynaptic expression of pTDP-43 in the ALS mouse model, SOD1G93a, compared to healthy controls, despite prominent structural deficits in VGLUT1-associated synapses in SOD1G93a mice. This research characterises the basic synaptic expression of TDP-43 with nanoscale precision and provides a framework with which to investigate the potential relationship between TDP-43 pathology and synaptic pathology in neurodegenerative diseases.

Harapan Jaya Village, Way Ratai Subdistrict, Pesawaran Regency has very promising potential for cultivating trigona bees. Lecture and student from University of Lampung team conducted training on stingless bee cultivation in this village in 2022. At the end of 2022, several stingless bee colonies experienced deaths that were allegedly due to lack of nectar sources. This community service activity was carried out to provide understanding and training on vegetation management and adding stingless bee colonies. Activities are carried out with lectures, discussions, and hands-on practice. The results of the activities that have been carried out include the addition of seven types of nectar source plants and two stingless bee colonies. In addition, the community's understanding of the maintenance of stingless bee colonies and their supporting vegetation also increased. This is very supportive of long-term programmed in the achievement of SDGs, especially in the goals of life on land and no poverty.

In vitro oocyte maturation (IVM) has been used worldwide. Despite the long-term implementation, the uptake of this procedure to complement current in vitro fertilization (IVF) remains low. The main reason is likely due to the non-synchronization of protocol and definition criteria, leading to difficulty in collective proper outcome data worldwide and, thus, lack of understanding of the exact IVM procedure. The review aims to consolidate the current clinical practice of IVM by dissecting relevant publications to be tailored for a current spectrum of clinical practice. Nevertheless, the background theories of oocyte maturation were also explored to provide a comprehensive understanding of the basis of IVM theories. Additional discussion of other potential uses of IVM in the future, such as in ovarian tissue cryopreservation known as OTO-IVM for fertility preservation and among women with diminished ovarian reserve, was also explored. Otherwise, future collaboration among all IVM centers is paramount for better collection of clinical data to provide valid recommendations for IVM in clinical practice, especially in molecular integrity and possible DNA alteration if present for IVM offspring outcome safety purposes.

EFL teachers are currently considering implementing practical strategies to help students make rapid progress in learning English and reach their learning goals. Simultaneous Roundtable is one of the strategies that are familiar to them. In particular, the Simultaneous Roundtable strategy is examined in this study in order to determine whether it is effective for writing English descriptive essays. Indonesian seventh graders were examined in this experiment. The experimental group applied the Simultaneous Roundtable strategy. The control group then received instruction using a teacher's feedback strategy. The Simultaneous Roundtable strategy was more effective than the traditional teacher feedback strategy for improving the students' descriptive writing skills. Simultaneous Roundtable, therefore, is recommended for EFL teachers to implement since it can be one of the practical teaching strategies that significantly improve students' descriptive writing skills and increase their interpersonal and social skills.

Peningkatan kualitas kesehatan masyarakat dapat diaplikasikan melalui dengan penerapan perilaku hidup bersih dan sehat (PHBS). Salah satu masalah yang ditemukan yaitu kondisi dan lingkungan mitra (Rumah Yatim YMAJU) kurang memadai serta belum ada penerapan PHBS. Untuk itu, Program Kemitraan Masyarakat (PKM) ini dilakukan dengan tujuan untuk meningkatkan kemampuan mitra dalam menerapkan PHBS. Solusi yang diberikan berupa edukasi tentang PHBS. Tujuan PHBS menjadikan peningkatan kualitas perilaku hidup bersih dan sehat pada sebagian besar masyarakat. Melalui PHBS tiap individu menjadi sadar dan ikut serta dalam menerapkan perilaku di kehidupan sehari-hari. Sasaran penyuluhan PHBS ini adalah anak yatim dibawah binaan Yayasan Mutiara Abadi Jariah Umat. Peningkatan pengetahuan dan keterampilan peserta dilakukan dengan drill method berupa penyuluhan PHBS, demonstrasi dan simulasi mencuci tangan. Tahap evaluasi diperoleh hasil peningkatan pengetahuan dan keterampilan peserta tentang PHBS dan mencuci tangan. Pengetahuan dan keterampilan PHBS yang baik akan menjadi dasar bagi peserta terhindar dari penularan COVID-19.

Degenerative disease in general has always been a political problem related to how to deal with it and the state is present. This political issue is related to problems and procedures from the very beginning, where from the time of diagnosis of a disease to how to determine the future of people with disabilities or disabilities in the future. Since the parents received an expert diagnosis that their child was suffering from an autistic disease, since then life has changed. The illness suffered by a person after undergoing the process of being diagnosed by an expert will sooner or later affect the dynamics that affect all those affected towards their lives and themselves. Autism, a behavioral disorder that occurs when children are growing and developing, will affect families and family resources, especially when children grow and develop towards school age. This study wants to explore how parents handle it, how the suffering of a mother raising a child with autism, her ups and downs, and her communicative actions in raising her child. This research is a qualitative research, the type of research is case study, the social paradigm is social definition, data collection is through observation, interviews, and documentation. Data analysis using the Interactive Miles and Hubermann model with steps including Data Collection, Data reduction, Data display, data conclusion. The results of communicative social action research are needed to overcome children with disabilities, special needs such as people with autism.

The present article touches upon a series of Ottoman Turkish manuscripts from the Mate-nadaran's Arabic script manuscripts collection, an example of a unique collection in Otto-man Turkish manuscripts known as the "Collection of Verse Dictionaries" MS No. 1467, in order to provide the first detailed study. These collections were compiled at the religious-educational institutions called tekke or dergāh, and the medrese. They were compiled as language textbooks, in order to provide easy learning of languages (Arabic, Persian, Ottoman Turkish) through the simultaneous use of several verse dictionaries and to be engaged in the process of learning languages by heart. The unique copy of the Matenadaran’s "Collection of Verse Dictionaries" includes 3 complete copies of bilingual (Arabic-Ottoman Turkish) and trilingual (Arabic-Persian-Ottoman Turkish) verse dictionaries of the 14th-15th, 17th and 19th-century writers: copies of Ferişteoġlu ʽAbdullaṭīf ibn Melek’s (proper name was ʽAbdullaṭīf ʽİzzeddīn et-Tirevī) "Luġat-i Ferişteoġlū" and Bosnalı Ebū̕ l-Fāżl Muḥammed (Meḥmed) ibn Aḥmed er-Rūmī's "Ṣubha-i Ṣıbyān" Arabic-Ottoman Turkish and also complete copy of Adanalı Ḫōca Meḥmed Ḥayret's (propar name was Meḥmed Behāeddīn Ḥayret) "Tuḥfe-i Zībā" (known with another titles as "Tuḥfe-i Dürrī" or "Tuḥfe-i Ḥayret" or "Tuḥfe-i Se Zebān") Arabic-Persian-Ottoman Turkish verse dictionaries. The article presents in detail the works included in the collection. At the same time, it has touched upon the methodology of writing verse dictionaries in classical Turkish litera-ture, their structural features, the significance and role of dictionaries in Turkish society, religion, literature and education. The purposes of writing verse dictionaries in all cases were to teach languages, to develop and spread literary speech, and to practice in prosody (especially in ʽArūż meter). The comprehensive presentation of the collection is even sufficient for it to become a part of the manuscripts of the four collections, already known in foreign collections as the "Collection of Verse Dictionaries", in order to become a source of new research opportuni-ties for local and foreign specialists.

Synergism between biomass and plastic waste during co-processing reported to produce higher products yield with enhanced quality which thereby solving the problems of high oxygenated compounds and low yields with high viscosity in oil from its individual processing. However, study on synergistic effect (SE) between these feedstocks is considered lacking. In this study, the SE of co-liquefying empty fruit bunch (EFB) and high-density polyethylene (HDPE) in sc-MeOH was investigated using a high-pressure, high-temperature batch-wise reactor system at 260 °C for 30 minutes and at various EFB-HDPE ratios to determine the best ratio for bio-fuel yield and its functional group content. It was found that 25% EFB:75% HDPE (wt/wt %) provides the most significant SE (≈ 8 wt%) for bio-fuel yield and the most considerable reduction in solid residue formation under the studied conditions. The presence of hydroxyl groups from EFB and aliphatic hydrocarbons from HDPE, along with new carbonyl compounds, further highlights the SE resulting from the combined processing of these materials. The findings suggest that optimizing the ratio of biomass to plastic waste in co-liquefaction can significantly enhance the efficiency and yield of bio-fuels while minimizing waste, providing a promising approach for sustainable energy production and waste management.

Skripsi ini membahas tentang kebutuhan dalam menembangkan model pembelajaran kosa kata bahasa arab berbasis kooperatif tipe make a macht pada siswa kelas VI MI Datok Sulaiman Palopo dan validitas model pembelajaran kosa kata bahasa arab berbasis Kooperatif Tipe Make a macht pada kelas VI di MI datok sulaiman palopo. Jenis penelitian yang digunakan yaitu jenis penelitian pengembangan ADDIE denngan pendekatan penelitian Mixed Method. Penelitian ini menggunakan metode pengumpulan data: observasi, pengujian dan pencatatan. Hasil dari penelitian ini adalah pengembangan model pembelajaran bahasa Arab untuk materi kosa kata bahasa Arab yang peneliti bentuk dalam tahap model ADDIE: 1) Tahap Analisis, yang berisi informasi tentang kebutuhan siswa terhadap model pembelajaran; (2) Tahap desain, yang berisi tentang format, desain, dan bahasa model pembelajaran; (3) Tahap pengembangan, yang berisi informasi tentang pembelajaran. model Kritik dan saran penulis untuk memodifikasi hasil model, sehingga untuk memperoleh model pembelajaran yang efektif, model pembelajaran yang dikembangkan dapat dimodifikasi berkali-kali selama tahap validasi. Dengan cara ini peneliti mendapatkan hasil keefektifan untuk ahli materi yang mendapat skor 85,7% dalam kategori sangat efektif, sedangkan dari sisi desain mendapatkan 80% dalam kategori efektif, dan ahli bahasa mendapatkan 80% dalam kategori efektif. nilai berlaku untuk kategori.

Aim. To develop a protocol for ultrasound diagnostics of COVID-19 pneumonia and to assess the diagnostic capabilities of the method in comparison with computer tomography (CT). Materials and methods. The study included 59 patients with a new coronavirus infection. In order to identify changes in the lung tissue characteristic of a new coronavirus infection, we used a special protocol for ultrasound of the lungs, which was developed by us in such a way that the data obtained were compared by segment with the results of CT of the lungs. Results. When comparing the results of lung ultrasound with the data of CT diagnostics, according to the new protocol, the percentage of lung tissue damage during ultrasound of the lungs averaged 70.8% in the group [62.5; 87.5], and according to the results of CT 70.0% [60.0; 72.5] (p=0.427). Thus, the ultrasound of the lung lesions was almost completely consistent with the changes revealed by CT. In order to assess the diagnostic value of lung ultrasound in identifying severe lung tissue lesions corresponding to CT 34, ROC analysis was performed, which showed the high diagnostic value of lung ultrasound in identifying severe lung tissue lesions. Conclusion. A new protocol was developed for assessing the severity of lung tissue damage according to ultrasound data, which showed a high diagnostic value in detecting COVID-19 pneumonia in comparison with CT. The results obtained give reason to recommend this protocol of ultrasound of the lungs as a highly sensitive method in diagnosing the severity of COVID-19 pneumonia. Its application is very important for dynamic examination of patients, especially in conditions of low availability of CT.

Effective school leadership is critical for school success. Teachers as leaders have extraordinary influences not only in their classrooms but also in the general school framework. The aspect of teacher leadership provides self-knowledge and the courage to act on that knowledge. However, there is no consensus on what defines teacher leaders and the specific qualities that characterise them. In this study, the insights of twelve conveniently sampled graduate teacher candidates in one of the teacher training institutions in Brunei Darussalam were explored. They were asked to describe the ideal leadership qualities that a secondary school mathematics teacher leader should possess. There were many variations in their responses. However, the overarching finding was that mathematics teacher leaders should have ideal qualities that make them functional within and outside of the classroom. Key attributes such as effective classroom management, content and pedagogical knowledge, effective communication and problem-solving skills, and the ability to contribute to maintaining a healthy school-community partnership were mentioned. This study concluded that in defining teacher leadership, it is essential to define the concept based on teachers’ ability to influence others to achieve set goals within and outside of the classroom.

The problem in this study is about the mechanism of financing Islamic Banking (iB) working capital products with mudharabah agreements at Bank Sumsel Babel Syariah, Palembang Branch. Then, the strategy was carried out by Bank Sumsel Babel Syariah, Palembang Branch to minimize the risk of iB working capital financing on mudharabah contracts, inhibit and support factors for customers in applying for iB working capital financing at Bank Sumsel Babel Syariah Palembang Branch. This research is field research using qualitative research methods. Primary data sources are data obtained directly from the studied source by systematically observing and recording the problem at hand. Secondary data sources support discussions and are obtained from others in the form of reports, books, and newspapers. The data collection method also uses interview, observation, documentation methods. The results of the study found that the implementation of mudharabah contracts on working capital iB products is under DSN fatwa Number: 07/DSN-MUI/IV/2000 on mudharabah financing. Bank Sumsel Babel Syariah uses risk management implementation strategies, analyzes customer eligibility, conducts surveys, and conducts supervision after conducting searches to minimize financing risks. Some factors inhibiting customers from applying for financing, namely in completing the file, and factors that encourage Islamic banks to use a revenue-sharing system do not use the element of ribâ (interest). Permasalahan dalam penelitian ini adalah mengenai mekanisme pembiayaan produk modal kerja Perbankan Syariah (iB) dengan perjanjian mudharabah di Bank Sumsel Babel Syariah, Cabang Palembang. Kemudian strategi yang dilakukan Bank Sumsel Babel Syariah Cabang Palembang untuk meminimalkan risiko pembiayaan modal kerja iB pada kontrak mudharabah, faktor penghambat dan penunjang bagi nasabah dalam mengajukan pembiayaan modal kerja iB di Bank Sumsel Babel Cabang Syariah Palembang. Penelitian ini adalah penelitian lapangan dengan menggunakan metode penelitian kualitatif. Sumber data primer adalah data yang diperoleh langsung dari sumber yang diteliti, dengan secara sistematis mengamati dan merekam masalah yang dihadapi. Sementara itu, sumber data sekunder adalah data yang mendukung diskusi dan diperoleh dari orang lain dalam bentuk laporan, buku, dan surat kabar. Metode pengumpulan data juga menggunakan metode wawancara, observasi, dokumentasi. Hasil penelitian ditemukan bahwa pelaksanaan kontrak mudharabah pada produk iB modal kerja ini sesuai dengan fatwa DSN Nomor: 07/DSN-MUI/IV/2000 tentang pembiayaan mudharabah. Bank Sumsel Babel Syariah menggunakan strategi penerapan manajemen risiko, menganalisis kelayakan nasabah, melakukan survei, dan melakukan pengawasan setelah melakukan pencarian untuk meminimalkan risiko pembiayaan. Adapun faktor yang menghambat nasabah mengajukan pembiayaan, yaitu dalam melengkapi berkas, dan faktor-faktor yang mendorong bank syariah untuk menggunakan sistem bagi hasil tidak menggunakan unsur riba (bunga).

Background: Doctors are at high risk of burnout, which has far-reaching consequences on an individual and organisational level. Several studies have shown an association between burnout and depression. Aim: This study aimed to determine the rate of burnout and depressive symptoms among doctors, as well as factors associated with both conditions. Setting: Charlotte Maxeke Johannesburg Academic Hospital. Methods: Burnout was measured using the Maslach Burnout Inventory–Human Services Survey and defined as the total score of high emotional exhaustion (≥ 27 points) + high depersonalisation (≥ 13 points). Individual subscales were analysed separately. Depressive symptoms were screened using the Patient-Health Questionnaire-9 (PHQ-9) and a score of ≥ 8 was deemed indicative of depression. Results: Of the respondents (n = 327 for burnout and n = 335 for depression), 46.2% screened positive for burnout, whilst 53.73% screened positive for depression. Factors associated with increased burnout risk were younger age; Caucasian race; internship and/or registrarship; the discipline of emergency medicine; and having a prior psychiatric diagnosis of depressive and/or anxiety disorder. Factors associated with increased risk of depressive symptoms were females; younger age; being an intern, medical officer or registrar; disciplines of anaesthetics and obstetrics and gynaecology; having a prior psychiatric diagnosis of depressive and/or anxiety disorder; and family history of psychiatric disorder. Conclusion: A high rate of burnout and depressive symptoms was determined. Although there is an overlap between the two conditions in terms of both symptomatology and risk factors, specific risk factors were determined for each in this population. Contribution: This study highlighted the rate of burnout and depressive symptoms experienced by doctors at the state level hospital necessitating individual and institutional interventions to address this.

BackgroundAcute stroke care service in Armenia was established in 2019 after the implementation of the National Stroke Program (NSP). This study aimed to provide an up-to-date account of the current image and clinical characteristics of acute stroke service implementation at a tertiary hospital in Armenia by analyzing the quality of care and identifying the areas that need improvement.MethodsWe analyzed patient data from a single hospital in 1 year after the establishment of acute stroke care service (February 2021–January 2022). We selected patients who were within 0–24 h from symptom onset at admission and included patients who benefited from reperfusion therapies (intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT)). A favorable outcome was defined as a drop in the National Institutes of Health Stroke Scale (NIHSS) by more than four points at discharge and a modified Rankin score (mRS) of 0–2 at 90 days.ResultsOf the total 385 patients, 155 underwent reperfusion therapies, 91% of patients (141/155) arrived by ambulance, 79.2% (122/155) had neurological improvement at discharge, and 60.6% (94/155) had an mRS of 0–2 at 3 months. Less than 5% of patients had early direct access to the rehabilitation center.ConclusionOur study demonstrated that the implementation of NSP with organized protocol-driven inpatient care led to significant advancement in acute stroke service performance. We believe that our report will serve as a model for achieving advanced and structured stroke care in a resource-limited context and contribute to the future development of the healthcare system in our country.

Penelitian ini bertujuan untuk menghasilkan suatu produk bahan ajar bangun ruang sisi datar pokok bahasan kubusberdasarkan pendekatan Open Endded yang valid dan praktis dengan bantuan geogebra untuk siswa SMP kelas VIIIberdasarkan model pengembangan ADDIE (Analysis, Design, Development, Implementation, dan Evaluation). Subjek dalam penelitian ini adalah siswa kelas VIII yang berada di Desa Muara Burnai I, Kecamatan Lempuing Jaya, Kabupaten Oki yang mengumpulkan 15 orang. Pengumpulan data dilakukan melalui validasi lembar angket dan lembar angket respons siswa. Teknik analisis data dilakukan secara deskriftif kuantitatif.. Dari proses pengembangan menghasil data kevalidan dan data kepraktisan bahan ajar. Penelitian ini bertujuan untuk menghasilkan produk bahan ajar mata pelajaran sisi datar kubus berbasis pendekatan Open Endded yang valid dan praktis dengan bantuan Geogebra untuk siswa kelas VIII SMP berbasis model pengembangan ADDIE (Analysis, Design, Development, Implementasi dan Evaluasi). Subjek dalam penelitian ini adalah siswa kelas VIII yang berada di Desa Muara Burnai I Kecamatan Lemrub Jaya Kabupaten Oki yang berjumlah 15 orang. Pengumpulan data dilakukan melalui lembar angket validasi dan lembar angket respon siswa. Teknik analisis data dilakukan secara deskriptif kuantitatif. Dari proses pengembangan tersebut menghasilkan data validitas dan kepraktisan bahan ajar. Setelah data dianalisis, Hal ini menunjukkan bahwa bahan ajar yang telah dikembangkan dikategorikan valid dengan rata-rata skor validitas 97,22% dan dikategorikan praktis dengan skor kepraktisan rata-rata 93,6%. Melalui proses pengembangan, dihasilkan dua jenis bahan ajar, yaitu bahan ajar cetak berupa LKS yang berisi langkah-langkah penggunaan dan bahan ajar non-cetak berupa soft file dalam aplikasi geogebra.