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Penelitian ini mengkaji penerapan Internet of Things (IoT) dalam sistem monitoring kesehatan melalui tinjauan literatur yang mendalam. Inovasi dalam perangkat wearable, platform cloud, dan algoritma analitik memungkinkan pengumpulan data fisiologis secara real-time, pemantauan jarak jauh, dan deteksi dini anomali kesehatan. Implementasi teknologi ini telah menunjukkan hasil yang menjanjikan, seperti akurasi tinggi dalam pengukuran parameter kesehatan, efektivitas dalam mendeteksi kondisi kritis, dan peningkatan akses terhadap perawatan kesehatan untuk populasi yang kurang terlayani. Namun, adopsi sistem monitoring kesehatan berbasis IoT menghadapi beberapa tantangan, termasuk keamanan data, interoperabilitas, dan validasi klinis. Untuk memaksimalkan potensi teknologi ini, penelitian masa depan perlu difokuskan pada penguatan keamanan dan privasi data pasien. Dengan memanfaatkan kemajuan teknologi seperti Artificial Intelligence (AI), Machine Learning (ML), dan integrasi Electronic Health Records (EHR), sistem monitoring ke6sehatan berbasis IoT dapat mencapai potensi penuh mereka dalam mentransformasi perawatan kesehatan dan memberdayakan individu untuk mengambil peran proaktif dalam mengelola kesehatan. Kata kunci: Catatan Kesehatan Elektronik, Internet of Things, Kecerdasan Buatan, Pembelajaran Mesin, Sistem Pemantauan Kesehatan.

The 21st century requires everyone to adapt to digital culture. Computational thinking skills help deal with digital culture. These skills can be provided to students through teaching and learning. However, there are several obstacles to achieving this goal. First, teachers do not yet understand how to teach students computing skills through classroom learning. Second, there needs to be more teaching skills based on computational thinking. This community service aims to improve teachers' abilities in training students' computational thinking skills. This is done in the context of teaching and learning to provide 21st-century skills through Scratch programming. The approach used in this activity is educational and participatory. Namely, the implementation of the service contains educational elements and is oriented towards efforts to improve the role of teachers. Community service is carried out through three stages: material preparation, program implementation, evaluation, and monitoring. The material preparation stage involves collecting material from various literature. The program implementation stage provides material regarding 21st-century learning and learning design using Scratch programming. Teachers are also engaged in using Scratch and how to involve students with this programming. The monitoring and evaluation stage includes process evaluation at the end of each activity and product evaluation. This community service shows that 91% of all teachers experienced increased skills in making various learning creations such as animations, games, and simulations based on Scratch programming. Additionally, 87% of all teachers who participated in the activity experienced increased skills in integrating scratch-based teaching materials into learning. This service activity aims to increase teacher skills in teaching computational thinking through scratch programming, which is expected to improve the quality of education in the digital era significantly.

This research aims to accumulate the concept of formal education in encouraging and maintaining the existence of the Kajang tribe's cultural traditions. The research approach used is a qualitative with a phenomenological method. The informants in this study were the Kajang tribal leaders, the community, parents of students, and teachers of SDN 351 Kawasan Amma Toa. Data collection techniques used were through observation, interviews and documents. The data obtained were then analyzed through three stages, namely data reduction, data presentation and drawing conclusions. The results of the research show that "Pasang Ri Kajang" or noble values implemented in local content learning from the local wisdom of the Kajang tribal community are: 1) Love for God and the universe and its contents, 2) Responsibility, discipline and independence, 3) Honest, 4) Obey applicable rules and be polite, 5) Care about the environment, 6) Work hard in nature conservation, 7) Justice, 8) Be humble, 9) Love peace and unity. The integration of local wisdom values in learning will be in accordance with the existing environment experienced by students so that students will be more motivated in learning so that it will have an impact on preserving Kajang tribal culture.

This study was conducted to evaluate the response of the double-bottom structure on a ship when a fire phenomenon involves temperature elevation and depreciation. Fire accidents on ships can be very detrimental, especially since ships are the main transportation for export and import activities. Therefore, this research is needed to reduce the risk of fire accidents on ships, especially on double-bottom structures. This study used the finite element modeling method in ABAQUS software. The research results found that the Von Mises stress contour, strain, and displacement values were influenced by the type of material, temperature, and plate thickness. Based on the results evaluated using the multi-attribute decision-making method, model 32 is the best model, while model 95 is the worst. Concurrently, from sensitivity analysis, it was found that temperature plays a significant role in the results of Von Mises Stress, Strain, and Displacement. The results indicated that the main factor influencing the Von Mises stress, strain, and displacement is the loading in the form of temperature, followed by material properties and plate thickness.

Abstract Background Endophthalmitis is a severe inflammation of the internal ocular structures, usually caused by bacterial or fungal infections, and can lead to rapid, irreversible blindness. Fungal endophthalmitis (FE), primarily due to Candida albicans and Aspergillus, is less common than bacterial endophthalmitis but has shown an increase in prevalence over the past two decades. Diagnosing FE is challenging and often delayed due to the time-consuming nature of traditional culture methods. The timely initiation of targeted antifungal therapy based on the specific fungal pathogen identified by molecular method can improve patient outcomes and reduce the risk of vision loss. This study aims to determine the presence of pathogenic fungal infections in patients with endophthalmitis using molecular methods at Hasanuddin University Hospital Makassar. Methods This cross-sectional observational study analyzed 83 intraocular fluid samples from patients with endophthalmitis at Hasanuddin University Hospital, Makassar, Indonesia. Samples were examined using microscopy, culture, and molecular methods, including polymerase chain reaction (PCR) and deoxyribonucleic acid (DNA) sequencing. Results The study population comprised 49 males (59%) and 34 females (41%), with an average age of 45.85 years. The distribution of affected eyes was nearly equal, with 50.6% involving the right eye and 49.4% involving the left eye. Exogenous transmission, primarily related to external risk factors such as ocular trauma or surgical procedures, was identified as the most common mode of fungal transmission in this population (97.6%). No fungal elements were detected through microscopy or culture; however, PCR could identify 5 positive samples (6%); 3 were males and 2 were females; all have exogenous transmission, predominantly showing Candida species. Sequencing revealed Candida parapsilosis, Lodderomyces beijingensis, and Trichophyton rubrum among the findings. Conclusion Cases of fungal endophthalmitis are rare but increasing, posing diagnostic challenges. Our study concludes that PCR is more effective than traditional culture methods in identifying fungal pathogens, with a predominance of Candida species identified in endophthalmitis. Molecular techniques like PCR offer rapid and accurate diagnosis, improving patient treatment outcomes by enabling earlier initiation of targeted antifungal therapy.

Abstract The main two reasons for the shift to renewable energy are the depletion and the harmful effects of non-renewable energy, such as burning coal and fossil fuels. As a result, the use of solar cells as renewable energy resources, that prioritise high efficiency while lowering production costs, can provide a promising future for sustaining energy resources. Solar cells have been developed starting with the monocrystalline and polycrystalline solar cells (first generation), non-crystalline and thin film solar cells (second generation) and organic solar cells (third generation). The dye-sensitized solar cell (DSSC) is a new type of solar cell that has gained popularity due to its ability to convert energy at a low cost, ease of fabrication, and non-toxic nature. This paper explores the use of fungal colours as natural dyes for DSSC due to their wide range of colours, large yields, sustainable supply and non-toxic. Natural fungal colours can be extracted using proper extraction conditions and methods. Although fungal dyes have several limitations like instability, non-resistance to harsh conditions, colour loss during processing or storage and limited profitable yield, they still have promising future prospects to overcome the poor interaction of natural sensitizer with semiconductor together with other advantages of fungal colour. DSSC with dye from crude extracts from Cortinarius fungi exhibited the highest efficiency of 0.64% among reported DSSC with fungal dye.

Abstract A solar photovoltaic (PV) cell, is an electrical device that uses the PV effect to convert light energy into electricity. The application of oyster mushroom dyes in dye sensitized solar cell (DSSC) is a novel strategy to substitute the costly chemical production process with easily extractable, environmentally acceptable dyes. Both dyes of yellow and pink oyster mushrooms were extracted using the same process but dried into powder form using two techniques, warm drying and freeze drying. The characterization was carried out utilizing current-voltage (I-V) characterization for electrical properties, Ultraviolet-Visible (UV-Vis) spectrophotometer for optical properties, Field Emission Scanning Electron Microscopy (FESEM), and Atomic Force Microscopy (AFM) for the structural properties. It was found that freeze-dried pink and yellow oyster mushroom had shown the good properties for DSSC application as it produced energy bandgap which lies within the range of efficient dye sensitizer; 1.7 eV and 2.2 eV, the most uniform distribution of pores and a nearly spherical form in FESEM analysis, and AFM result obtained with the highest root mean square (RMS) roughness value (26.922 and 34.033) with stereoscopic morphologies. The data proved that mushroom dyes can be incorporated in DSSC with the optimization of drying method in the extraction process, dilution of dye and the layer of deposition on the glass substrate. The current density-voltage (J–V) characteristics of fabricated DSSC was characterized using Newport Oriel Sol3A solar simulator under AM 1.5 Sun condition (100 mW/cm2, 25 oC). From the result obtained by solar simulator, the fabricated FTO/TiO2/Pleurotus djamor dye/Pt indicated the V oc of 0.499 V and J sc of 0.397 mA/cm2.

The vertical deviation is one of the important stages in commercial aircraft flights because indications of malfunction can be detected faster by the pilot rather than in other flight phases. The purpose of this study is to investigate whether the PK-LQP airplane experienced unusual altitude movements during the vertical deviation phase since the airplane taking off from Seattle (Boeing Manufacture's home base) until the airplane crash. The airplane, which is of the type B737 MAX8, had operated for 83 days, during which it completed 438 flights using a total of 107 flight codes, and it travelled to 36 airports. According to the findings of an investigation of the data, we found that only 69 (39%) were included in tier 1, which had an ADS-B data update interval message below 10 seconds, complying with ICAO and FAA-AVN standards. With this class 1 and tier 1 dataset, we conducted an EDA to find the data insight, which revealed that there was a disturbance in the speed and altitude indications on the airplane instrumentation, causing a misperception for the pilot and causing the airplane to drastically drop in altitude (more than 100 feet).

Thyroid hemiagenesis (THA) is a rare congenital abnormality in which one of the thyroid lobes fails to develop normally. The prevalence rates range from 0.02% to 0.25%, with no gender preponderance and most commonly involve the left lobe. We report a case of left THA in a 37-year-old female that was found incidentally during total thyroidectomy for right papillary thyroid carcinoma. Most patients with THA are asymptomatic, however, may have subclinically raised thyroid-stimulating hormone levels or be predisposed to developing thyroid disorders such as nodular goiter, hyperthyroidism, Grave’s disease, Hashimoto’s thyroiditis, hyperparathyroidism, or malignancy. Usual imaging techniques such as ultrasonography, computed tomography, and magnetic resonance imaging allow the confirmation of diagnosis and provide clearer glandular and regional visualization. Additional modalities such as thyroid scintigraphy enable the functional assessment and identification of any suspicious nodules and aid in decision-making. THA is a very uncommon condition and the diagnosis is primarily made through imaging. Clinicians should be aware that this condition exists along with documented associations of concomitant thyroid disorders and malignancy.

AbstractIndonesia is a salak producing country with five superior varieties, namely: Salak Pondoh, Salak Madu, Salak Gading, Salak Gula Pasir and Salak Sidempuan. The large number of Indonesian salak which are claimed to be Thai fruit products marketed to China shows the weak legal protection for salak fruit, which has a geographical indication of originating from Indonesia. This study collects data from relevant online literature and then analyzes them based on inductive analogies. By analogizing the concept of marketing communication tetrahedron analysis from Kevin Lane Keller, which considers four factors (consumer, communication, response and situation), through inductive analogy this paper offers steps that must be taken by the Indonesian government to provide protection and development of salak. Fruit products originating from Indonesia need to be protected and developed through legal measures, good marketing communication, and preservation technology so that they can compete in the international market.

Background: Several discoveries about leprosy indicate that Mycobacterium leprae transmission mainly occurs by inhalation, and the nose is a major port of entry and exit. Molecular probes have shown certain potential for the detection and identification of M. leprae in patients. The aim of this study was to identify M. leprae in nasal swab specimens using polymerase chain reaction (PCR)-based assays followed by gene sequencing methods. This observational study examines 64 anterior nasal swab samples taken from pretreatment leprosy patients, on-treatment and completed leprosy treatment in Bulukumba, South Sulawesi, Indonesia. Methods: samples were analyzed by molecular detection methods according to the standard methods at the Clinical Microbiology Laboratory of Hasanuddin University. Descriptive statistics were utilized to summarize patient demographics and outcomes. Results: This study uses PCR to detect the M. leprae deoxyribonucleic acid (DNA) from nasal swab specimens. Data were collected from 64 patients with a percentage of male patients 51.54%. Based on the age category, the group 45–46 years was the most frequent (39.05%). PCR detection proline-rich antigen gene of a 531 bp DNA fragment from M. leprae, was positive in eight patients, and they were multibacillary. Furthermore, PCR was positive in 5 (31.25%) of 16 new leprosy patients, 2 (8.69%) of 23 on-treatment patients, and 1 (4%) of 25 treatment completed patients. Based on the results of the phylogenetic tree and analysis of 8 positive results detected by M. leprae from leprosy patients, almost all samples have a level of similarity, except for sample Ua7. Conclusions: M. leprae cannot grow in vitro, so molecular diagnostic tools were used to confirm the disease. This study predominantly of males with the age above 45 years of age being the most common. Eight M. leprae were positive from nasal swab leprosy patients. The sequencing findings provide insight into the genetic diversity of the genus M. leprae, so it is necessary to consider the detection of whole-genome sequence.

This study aims to determine the role of women with managerial positions in medical clinics and the ways in which they can enhance the performance of their partnerships to optimize business opportunities within the healthcare services sector of Indonesia. The study identified two key challenges: complex requirements from corporate partners and limited partnership capabilities of female employees. The study used entrepreneurial marketing theory as a framework to identify the key factors that can improve partnership performance by strengthening the capabilities of women in these roles. The study gathered data from 113 health clinics in Java, Indonesia, where female managers were responsible for marketing, partnerships, and director roles. The data were analyzed using structural equation modeling. The results reveal a positive impact of intrapreneurship and partnership capabilities on partnership performance. It is noteworthy that relationship quality exerts no influence on partnership performance. Furthermore, relationship quality does not function as a mediating variable for intrapreneurship capability or partnership capability on partnership performance. The healthcare services ecosystem attenuates the relationship between relationship quality and partnership performance. Additionally, the prevalence of medical clinics with female managers in the healthcare services ecosystem significantly affects partnership performance in the Java region, Indonesia.

This study aimed to conduct a strategy analysis to anticipate water scarcity and provide recommendations for the fulfillment of clean water needs through the Regional Drinking Water Company (PDAM) piped-water service in a metropolitan city during the COVID-19 pandemic. Several efforts have been made by PDAM, such as uprating the existing water treatment plant (WTP) and planning to build new ones. The analysis covered the piped-water service target in 2021, customer water consumption, PDAM production efficiency, and the non-revenue water (NRW) in the city before and during the pandemic. Subsequently, the existing strategy and targets were analyzed based on the comparison results. The outcomes would serve as the basis for the recommendations to overcome water scarcity. The results showed that there was an increase in customer water consumption during the pandemic by 5% (147 L/person/day) from the normal condition. Considering the 35% piped-water service coverage target set in 2021, the existing capacity of PDAM has not been able to meet customer needs both under normal condition and during the increase in consumption. Based on the results, technical recommendations include uprating the WTP capacity up to 2.13 times, reducing the water loss by 25%, and utilizing backup unit system to prevent disturbance to water distribution for 24 hours. These recommendations must be synchronized with the Drinking Water Security Plan (RPAM) in the city.

Salma Firdaus,1,&ast; Lívia Figueiredo Pereira,2,&ast; Ge Yang,3 Yumin Huang-Link4 1Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 2Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil; 3Huizhou Aier Eye Hospital, Aier Eye Hospital Group, Huizhou, Guangdong Province, People’s Republic of China; 4Division of Neurology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden&ast;These authors contributed equally to this workCorrespondence: Ge Yang, Huizhou Aier Eye Hospital, Aier Eye Hospital Group, Huizhou, Guangdong Province, People’s Republic of China, Email geyang95@sina.comPurpose: To compare the interocular symmetry and investigate the intermachine reproducibility of optic disc and macular data measured by spectral-domain high-definition optical coherence tomography (HD-OCT) Cirrus HD-OCT 4000 and HD-OCT 5000 from healthy subjects.Patients and Methods: Forty-three volunteers were examined with both HD-OCT 4000 and HD-OCT 5000 at the same visit. Optic nerve head (ONH) and macular data were acquired using ONH Cube 200× 200 scans and macular volume cube 512× 128 scans, respectively.Results: The average age of the participants was 33 ± 8.6 years. Interocular OCT parameters of ONH and macula showed a high correlation between the right and left eyes regardless of HD-OCT models, displaying a low coefficient of variation (CV). However, the average retinal nerve fiber layer (RNFL) was thicker (96.67± 11.19μm vs 95.3± 10.89μm, p< 0.01), and the average central subfield thickness (261.51± 17.45μm vs 262.51± 17.39 μm, p< 0.01) and cube average thickness (283.91± 13.59μm vs 286.55± 13.09μm, p< 0.05) were thinner when measured by Cirrus 4000 compared to 5000. Intermachine reproducibility and reliability of RNFL and macular parameters exhibited a high intraclass correlation coefficient (ICC) (0.985) and low CV (2.4%). Ganglion cell-inner plexiform layer (GCIPL) measured by two OCT models showed similar values with an average thickness of 85 μm and had high intermachine reproducibility with high ICC (0.993) and low CV (1.2%).Conclusion: High interocular symmetry was observed across both HD-OCT models. Intermachine reproducibility for RNFL and all macular parameters was also high. GCIPL showed minimal intermachine differences with high reproducibility and reliability. Thus, the results imply that GCIPL values measured by two Cirrus OCT models may be used interchangeably.Keywords: neuro imaging, optical coherence tomography, interocular symmetry, intermachine reproducibility, retina, ganglion cell-inner plexiform layer, interchangeability

Abstrak Penyakit Jembrana adalah penyakit yang menyerang Sapi Bali (Bos javanicus) dengan penularan dan kematian yang tinggi. Penyakit ini disebabkan oleh Jembrana Disease Virus (JDV) dari famili retroviridae. Pengendalian penyakit Jembrana di Indonesia menggunakan vaksin inaktif yang dibuat dari jaringan limfa sapi terinfeksi JDV sehingga produksinya sangat terbatas. Immunisasi pasif menggunakan antibodi terbukti mampu memberikan perlindungan terhadap berbagai infeksi. Ayam merupakan penghasil antibodi immunoglobulin yolk yang sangat baik. Tujuan penelitian ini adalah melakukan purifikasi dan karakterisasi IgY terhadap Jembrana untuk pengembangan imunisasi pasif. Sebanyak 15 ekor ayam white leghorn umur 24 minggu dibagi menjadi 3 kelompok. Kelompok 1 disuntik dengan 1ml vaksin Jembrana, kelompok 2 disuntik dengan seed virus Jembrana, dan kelompok ke 3 adalah kontrol. Penyuntikan antigen Jembrana dilakukan dua kali dengan interval dua minggu. Telur mulai dikoleksi setelah satu minggu penyuntikan antigen pertama sampai minggu ke lima. Uji antibodi Jembrana dilakukan dengan metode Agarose Gel Precipitaion Test (AGPT). Purifikasi IgY dilakukan dengan pengendapan NaCl, sedangkan untuk melihat karakter IgY Jembrana menggunakan SDS PAGE. Pengendapan NaCl mampu menghasilkan IgY dengan mudah dan biaya yang murah. Pengujian AGPT menunjukkan bahwa IgY muncul pada kelompok ayam yang disuntik dengan vaksin Jembrana, dan tidak muncul pada kelompok yang disuntik dengan seed Jembrana. Pengujian SDS PAGE menunjukkan adanya pita protein dengan berat molekul 67 kDa yang merupakan rantai berat, 46 kDa yang merupakan fragmen Fab, dan 24 kDa yang merupakan rantai ringan.

Ocean Accounts, aligned with the UN System of Environmental Economic Accounting – Environmental Accounting (SEEA EA), bring together economic, social and environmental information in a coherent and standardised manner. Ecosystem extent is a structure to understand environmental assets and uses a basic spatial unit to facilitate the classification and measurement of ecosystems by type. This study tested the impact of grid size and method of designation per grid cell for Marine Basic Spatial Units (MBSU), using Saleh Bay, Indonesia as a case study. The extent of mangrove, seagrass and coral reefs were previously delineated in 2021 for ocean accounting activities. This study tested grids with two different cell sizes (10 x 10 m2 and 25 x 25 m2) and two different methods of designation, namely: (i) dominance (extent-based) and (ii) hierarchy (criteria-based) methods. The results indicated that a larger grid size is related to higher error in estimating both total area per ecosystem and spatial configuration within the study area. The dominance method produced more accurate results than the hierarchy method, although, when considering computational trade-offs, a larger grid size and the hierarchy method observed a much lower computational cost. These results demonstrate the need to carefully consider grid size and method when designating basic spatial units for accounting activities, as they impact linked accounting tables and, in turn, have implications when providing information for management and policy.

A jejunal intussusception as a presentation of retroperitoneal liposarcoma (RLPS) is a rare occurrence. The majority of RLPS are presented as an abdominal mass, however, having a jejunal obstruction is an interesting case. The aim is to describe the management of jejunal intussusception secondary to atypical lipomatous tumours with concurrent RLPS. A 61-year-old lady presented with a sudden onset of intestinal obstruction with 1 month of constitutional symptoms and an enlarging right lumbar mass. Computed tomography showed a small bowel intussusception with diffuse peritoneal and retroperitoneal lipomatosis. Emergency exploratory laparotomy, segmental bowel resection, and partial excision of intraperitoneal mesenteric lipoma were performed. A stage En-bloc resection of the RLPS and right nephrectomy was done later. However, she refused for subsequent surgery. A complete resection is the gold standard in managing RLPS. In this report, the management is rendered not to the standard as the patient first presented with intestinal obstruction requiring emergency reduction with a piecemeal resection. A stage surgery was required to determine a promising prognosis, but the patient refused such surgery. A small bowel intussusception in adults is rare but is mostly caused by a tumor or neoplasm. Early recognition of the complexity of the case should be preempted and referred to the tertiary team for further definitive surgery. Patient exhaustion from the subsequent surgery might hamper the only management available for the case.

BackgroundMedical students are frequently affected by poor sleep quality. Since poor sleep quality has negative physiological and psychological consequences such as on executive function, there is an opportunity to improve sleep quality and executive functions using non-pharmacological intervention such as cognitive behavioural therapy. ObjectiveThe aim of this study therefore is to determine if improving sleep quality could improve executive functions in medical students with poor sleep quality by comparing cognitive behavioural therapy for insomnia (CBT-I) with sleep hygiene education (SHE) in a randomized controlled trial (RCT). MethodsA parallel group, RCT with a target sample of 120 medical students recruited from government-based medical universities in Malaysia. Eligible participants will be randomized to internet group CBT-I or internet group SHE in a 1:1 ratio. Assessments will be performed at baseline, post-intervention, 1 month, 3-months, and 6-months. The primary outcome is between-group differences in sleep quality and executive function post-baseline. The secondary outcomes include pre-sleep worry, attitude about sleep, sleep hygiene and sleep parameters. ResultsThis study received approval from the Research Ethics Committee in Universiti Putra Malaysia (JKEUPM-2023-1446) and Universiti Kebangsaan Malaysia (JEP-2024-669). The clinical trial was also registered in Australian New Zealand Clinical Trial Registry (ACTRN1264000243516). As of June 2024, the recruitment process is ongoing and a total of 48 and 49 students have been enrolled from the universities into the CBT-I and ISHE groups, respectively. All the participants provided signed and informed consent to participate in the study. Data collection has been completed for the baseline (pre-treatment assessment), and follow-up assessments for T1 and T2 for all the participants in both groups, while T3 and T4 assessments will be completed by July 2025. Data analysis will be performed by August 2025 and the research will be completed by December 2025. ConclusionsThis study is the first attempt to design a CBT intervention to ameliorate poor sleep quality and its related negative effects among medical students. This research is also the first large-scale exploring the relationship between health status and CBT-mediated sleep improvement among medical students. Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12624000243516; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=387030 International Registered Report Identifier (IRRID)PRR1-10.2196/59288

ABSTRACT This study aims to explore the role of teachers in instilling moral values in early childhood through the storytelling method, which is regarded as an engaging and effective approach. To achieve this goal, a qualitative descriptive method was employed, utilizing data collection techniques such as observation, interviews, and documentation, providing a comprehensive understanding of the phenomenon under investigation. The research was conducted at TKIT Al-Mumtaz, focusing on teachers in class B2.The findings revealed that during the planning stage, teachers selected teaching modules that incorporated interesting and relevant storytelling methods, with the intention of shaping children's characters in alignment with social norms and religious values. In the implementation phase, the study demonstrated that the effectiveness of these teaching modules significantly increased children's enthusiasm during lessons, enabling them to grasp the commendable morals taught by the last Prophet more easily. Furthermore, in evaluating the role of teachers, the research highlighted that the storytelling method—particularly in sharing captivating stories of the Prophet—was highly effective in enhancing children's morals. Children not only remembered the stories but also applied the lessons in their daily lives. These findings underscore the vital role of teachers in nurturing children to develop good and responsible character traits.

This study analyses the factors of working women in a sandwich generation to decide to work in the non-agricultural sector in East Java Province, Indonesia. The sandwich generation is identical to economic dependents on two families simultaneously: biological children and parents. As a sandwich generation, encouraging women to work develops their careers and for the welfare of their families. The sandwich generation phenomenon has occurred in several countries, including in every region in Indonesia. Many factors, especially structural poverty and economic conditions, can cause sandwich generation. This study uses logistic regression analysis of 2022 National Socioeconomic Data. The research results show that the characteristics of women participating in the non-agricultural sector can be caused by living conditions, education level, digital conditions, and the guarantee of protection from the government.

The aim of this research is to examine the influence of service quality, guanxi, value co-creation and corporate image on customer loyalty of developer in the apartment construction industry. This research used an online survey approach, collecting 316 respondent data from apartment developers. This research uses the structured equation modeling method with SmartPLS to test the hypothesis of the research model. The results of the hypothesis test prove that there is a positive and significant influence of service quality, guanxi, value co-creation and corporate image on customer loyalty. This study is one of the few studies that examines customer loyalty in the context of the apartment construction industry, and moreover, this study examines the influence of service quality, guanxi, value co-creation and corporate image on customer loyalty. This research has managerial implications for building apartment contractor companies on how to build and maintain customer loyalty.

ABSTRACTAn increasing body of research indicates that immunotherapy has demonstrated substantial effectiveness in the realm of metastatic colorectal cancer(mCRC), especially among patients with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H) (dMMR/MSI-H mCRC). This study constitutes the inaugural bibliometric and visual analysis of immunotherapy related to mCRC during the last decade. Between 2013 and the conclusion of 2022, we screened 306 articles from Web of Science and subjected them to analysis using CiteSpace and VOSviewer. The United States stood out as the primary contributor in this area, representing 33.33% of the publications, with China following closely at 24.51%. The most prolific institution has the lowest average citation rate. Sorbonne University were the most highly cited institutions. Notably, Frontiers In Oncology published the largest quantity of articles. Andre, Thierry, and Overman, Michael J. were prominent authors known for their prolific output and the high citation rates of their work. The focus areas in this field encompass “tumor microenvironment,” “liver metastasis,” “tumor-associated macrophages,” “combination therapy” and “gut microbiota.” Some keywords offer promise as potential biomarkers for evaluating the effectiveness of immunotherapeutic interventions.

The current study investigates how sustainable development can be enhanced by the use of natural resources, green investment, digital finance, industrial usage, energy efficiency, and consumption of renewable energy. To the best of the authors’ knowledge, no prior study has analyzed the role of these factors in sustainable economic growth in Belt and Road Initiative countries. Therefore, to fill this literature gap, the present study analyzes the effect of the above mentioned factors on sustainable economic growth in 20 Belt and Road Initiative countries. Taking the data for the period 2010 to 2020, the study employed the Driscoll-Kraay Standard Error model to carry out the empirical estimation. The findings suggest that digital finance and renewable energy consumption are positively, whereas energy intensity, industrial usage and natural resources are negatively associated with sustainable economic growth in BRI countries. Green investment, however, is not found to be significantly associated with sustainable economic growth. On the basis of the findings, the study suggest the selected countries to gain benefits from the opportunities of digital financial inclusion and renewable energy use. Moreover, the results establish the foundation for policymakers to better craft policies to achieve the goals of the Sustainable Development Goals (SDGs).

Background/Purpose: Radiation-induced cardiac toxicity in lung cancer patients has received increased attention since RTOG 0617. However, large cohort studies with accurate cardiac substructure (CS) contours are lacking, limiting our understanding of the potential influence of individual CSs. Here, we analyse the correlation between CS dose and overall survival (OS) while accounting for deep learning (DL) contouring uncertainty, α/β uncertainty and different modelling approaches. Materials/Methods: This single institution, retrospective cohort study includes 730 patients (early-stage tumours (I or II). All treated: 2009–2019), who received stereotactic body radiotherapy (≥ 5 Gy per fraction). A DL model was trained on 70 manually contoured patients to create 12 cardio-vascular structures. Structures with median dice score above 0.8 and mean surface distance (MSD)

Background: Small and medium enterprises (SMEs) are crucial to both global and national economies. They create jobs, boost competitiveness and drive economic growth. In the digital age, SMEs have increased opportunities to expand, enhance their capabilities and compete effectively. Aim: This research explores how environmentally conscious SMEs improve performance using dynamic capabilities (DCs) approach. It specifically examines how e-commerce and management capabilities contribute to SME performance in the Indonesian culinary sector and highlights the role of strategic orientation in this study. Setting: The study focusses on SMEs in the culinary sub-sector located in West Java, DKI Jakarta, and Banten provinces in Indonesia. These regions were selected because of their vibrant culinary industries and the significant role SMEs play in the local economy and gross domestic product (GDP). Methods: A quantitative analysis was conducted using online surveys via Google Forms, collecting 236 responses. The data were analysed with Partial Least Squares Structural Equation Modeling (PLS-SEM) using Smart PLS 3.0 software. Results: Four hypotheses about DCs and SME performance were tested, with three being accepted. The study found that DCs alone do not directly enhance SME performance. Conclusion: The study highlights the importance of strategic orientation in mediating DCs with SME performance. In the digital era, aligning goals with market needs helps SMEs use their DCs more effectively, adapt to changes, innovate and grow sustainably. Contribution: This research contributes to the literature on DCs and strategic management, offering insights into improving SME performance in Indonesia.

Jabatan wakil kepala daerah hanya sebatas pelengkap bagi jabatan kepala daerah. Tugas utama wakil kepala daerah hanya sebatas membantu kepala daerah dalam pelaksanaan tugasnya. Ketidakjelasan kewenangan tersebut menjadi salah satu faktor penting terjadinya disharmonisasi antara kepala daerah dan wakil kepala daerah. Jika isu kewenanagan wakil kepala daerah dibiarkan lebih lanjut dikhawatirkan menjadi bola liar. Seperti banyak muncul ditataran ide dan gagasan untuk menghapus jabatan wakil kepala daerah. Dalam penelitian ini digunakan metode pendekatan yuridis normatif, Adapun data yang digunakan adalah berupa data sekunder yang kemudian dianalisis dengan metode yuridis kualitatif sehingga akan menghasilkan narasi kalimat yang deskriptif. Hasil penelitian menunjukan bahwa. dalam penyelenggaraan pemerintahaan daerah, kepala daerah dibantu oleh wakil kepala daerah yang dipilih secara berpasangan saat Pilkada. Dalam praktik penyelenggaraan pemerintahan, peran kepala daerah lebih dominan dari pada peran wakil kepala daerah. Bahkan wakil kepala daerah sama sekali tidak memiliki peran yang berarti, sehingga sering menyebabkan tidak adanya hubungan harmonis (disharmoni) antara kepala daerah dan wakil kepala daerah. Upaya penguatan kewenangan jabatan wakil kepala daerah dalam menunjang efektivitas penyelenggaraan pemerintahan daerah dapat dilakukan dengan menerapkan Principle-Based Authorization Model. Pemerintah dan DPR disarankan menggunakan Principle-Based Authorization Model dalam upaya penguatan peran jabatan wakil kepala daerah, sehingga diperlukan perubahan terhadap ketentuan mengenai kewenangan jabatan wakil kepala daerah sebagaimana diatur dalam Undang-Undang Nomor 23 Tahun 2014 tentang Pemerintahan Daerah, atau membuat Peraturan Pemerintah tentang kewenanangan yang menjadi tanggung jawab wakil kepala daerah.

The 1945 Constitution of the Republic of Indonesia (UUD 1945) does not explicitly define “election result disputes.” This definition is only found in several laws and Constitutional Court (MK) Regulations, limited to the context of “vote counting errors.” This research aims to reformulate the concept of election results as an object of dispute in the MK to ensure certainty and justice for candidates and/or candidate pairs. This study uses a normative juridical research method. Elections, as an embodiment of the people’s sovereignty, result in the acquisition of votes and the determination of elected candidates and/or candidate pairs to occupy political positions in government. The resolution of election result disputes in the MK relates to objections to the validity of the vote count, both quantitatively and qualitatively. The examination of the validity of vote acquisition maps the MK’s authority into two scopes: absolute competence and relative competence. The MK’s absolute competence relates to resolving disputes over vote acquisition, while relative competence pertains to ensuring constitutionality, including adherence to election regulations by election organizers during the election stages.

Renewable energy has an important role today, one of which is hydroelectric power plants which use water as the main resource. The operation of a hydroelectric power plant generally aims to maximize the water discharge available in the reservoir in order to obtain maximum energy generation. The main driver of hydropower development is the hydraulic turbines. It's a mechanical device that turns the potential energy of water into electrical energy. So researchers are interested in conducting research with the title analysis of the effectiveness of electrical energy based on reservoir conditions. The method used in this research is daily data collection in the form of reservoir elevation level data, outflow, and data on the electrical power generated by the generator. After that, calculate the water volume, hydraulic power, turbine mechanical power along with turbine efficiency, and the efficiency of the generator. Then analyze the values of hydraulic power, turbine mechanical power, electrical power based on water discharge over time. As well as analyzing the efficiency of the generator based on the electrical power that can be generated over a period of one year. Based on research, it is known that an increase in powerplant efficiency occurs after draining the reservoir with a value range of 70% - 72%, because mud deposits accumulate in the reservoir resulting in the reservoir water volume capacity not being optimal.

This study aims to explore the implementation principles of the Maslahah concept in the context of Islamic Family Law, with a specific focus on the case study of a working wife and a husband responsible for household duties. Another purpose for knowing about the family harmonism. Apart from that, to understand that family harmony is when the family is managed by the husband or man. Researched using qualitative methods with a case study approach. The principles of maslahah use for this research about hifz al-mal, hifz al-nafs, hifz al-nasl, hifz al-‘aql, and hifz al-din. The data used is a total of 6 primary data and secondary data from various relevant research. The research instrument is validated through reference validation. Data analysis is carried out by presenting data, reducing data, interpreting data, and drawing conclusions. This research succeeded in finding the existence of maslahah principles that can look at the problem of wives working and husbands taking care of the house from several points of view. Meanwhile, each party's views can be answered through hifz al-mal, hifz al-nafs, hifz al-nasl, hifz al-'aql, and hifz al-din. The family wgom the wives go to work they are trustly always keep the harmonism family, because their reason about the economy.

Sebagai sektor primer, pada faktanya rumah tangga petani masih hidup dalam keterbatasan untuk memenuhi kebutuhan. Penyebab utama keterbatasan rumah tangga petani tersebut adalah kualitas sumber daya manusia dan fenomena kesenjangan digital di dalamnya. Dampaknya, hingga saat ini rumah tangga petani masih belum inklusif secara digital dan cenderung belum sejahtera secara sosial dan ekonomi. Meskipun di lain sisi, pemerintah terus berusaha untuk mengimplementasikan program dan kegiatan hingga menganggarkan bantuan. Permasalahan petani ini juga dialami oleh Provinsi Jawa Timur. Sebagai salah satu daerah dengan kontribusi sektor pertanian terhadap PDRB terbesar, penggunaan teknologi oleh petani masih kurang 50% dari total keseluruhan. Artinya, petani di Provinsi Jawa Timur masih membutuhkan peningkatan untuk adopsi teknologi. Dengan demikian, penelitian ini penting dilakukan guna menganalisis karakteristik rumah tangga yang inklusi digital hingga efektivitas peran bantuan pemerintah pada rumah tangga petani. Penelitian ini menggunakan data SUSENAS 2022 yang dianalisis dengan regresi logit biner. Hasil penelitian menunjukkan bahwa petani yang berusia muda, memiliki pendidikan tinggi, kemampuan literasi digital, dan memiliki akses teknologi yang cukup cenderung inklusi digital, jika dibandingkan dengan petani berusia lanjut dengan keterbatasan kemampuan dan fasilitas teknologi. Selain itu, bantuan pemerintah juga menunjukkan hasil yang positif terhadap kecenderungan rumah tangga petani untuk inklusi digital. Oleh karena itu, dibutuhkan sinergitas antar berbagai pihak guna mewujudkan inklusi digital pada rumah tangga petani di Provinsi Jawa Timur.

Suhrawardi's Isyraqiyah philosophy emerged as a critique of the perceived limitations within Aristotelian peripatetic philosophy. This study investigates the enduring significance of Suhrawardi’s teachings and their relevance in contemporary philosophical discourse. Employing a qualitative research methodology and an extensive literature review, we analyze Suhrawardi's philosophical contributions towards understanding the complexities of existence. Our findings highlight how Isyraqiyah philosophy promotes tranquility and contemplation, offering a blend of philosophical and spiritual reasoning. This philosophy provides profound insights into the multifaceted nature of existence, guiding individuals in navigating contemporary challenges. Thus, Suhrawardi's Isyraqiyah philosophy remains a vital source of enlightenment and guidance, offering a robust framework for philosophical and spiritual contemplation in modern contexts.

Wandering spleen is extremely uncommon, with a reported incidence of

The community-based waste management methods through reduce, reuse and recycle-based temporary disposal sites (3R-TDS) was one of the possible municipal solid waste management strategies for reducing the volume of waste. The aims of this studied were to planned and design 3R-TDS in densely populated areas by combining various 3Rbased waste management methods for obtaining a reducing volume of municipal solid waste to FDS. This studied was conducted into five main steps, that were collected primary data, calculated the density and composition of municipal solid waste, designed the 3R-TDS to determine the appropriate space based on functional processing. The results had identified the waste generation 4,454.72 kg/day or 0.431 kg/person/day, and it was predicted up to 8,930 kg/day within 10 years. The highest percentage of municipal solid waste was organic food waste 58%, and the lowest composition was leather 0.2%. Design of 3R-TDS could been applied to managed municipal solid waste had been the concept of 3R-TDS leads to arrange 973 m2, which provided area for in ordered to facilitate dropping, separating, sorting, waste processing for plastic, inorganic, organic, residue, leachate, and supporting area.

Abstract Background Indonesia has the world’s second-highest tuberculosis (TB) burden, with 969,000 annual TB infections. In 2017, Indonesia faced significant challenges in TB care, with 18% of cases missed, 29% of diagnosed cases unreported, and 55.4% of positive results not notified. The government is exploring a new approach called “strategic purchasing” to improve TB detection and treatment rates and offer cost-effective service delivery. Objectives We aimed to analyze the financial impact of implementing a TB purchasing pilot in the city of Medan and assess the project’s affordability and value for money. Methods We developed a budget impact model to estimate the cost-effectiveness of using strategic purchasing to improve TB reporting and treatment success rates. We used using data from Medan’s budget impact model and the Ministry of Health’s guidelines to predict the total cost and the cost per patient. Results The model showed that strategic purchasing would improve TB reporting by 63% and successful treatments by 64%. While this would lead to a rise in total spending on TB care by 60%, the cost per patient would decrease by 3%. This is because more care would be provided in primary healthcare settings, which are more cost-effective than hospitals. Conclusions While strategic purchasing may increase overall spending, it could improve TB care in Indonesia by identifying more cases, treating them more effectively, and reducing the cost per patient. This could potentially lead to long-term cost savings and improved health outcomes.

This article using discourse theory, popularized by Foucault, is used to examine the production and use of knowledge and practices relevant to the discourse that applies to the film, television, and media studies study program curriculum. This research uses the interpretive phenomenology method (Interpretative Phenomenological Analysis), and the classification and framing of data are carried out through focused group discussions. The purposeful sampling technique was chosen through a maximum variation sampling strategy involving eight research subjects to understand the various experiences of campuses that already have similar programs and are considered the most "oriented" stakeholders. The result is that the curriculum discourse produces four themes: scientific vision and mission, graduate profile, learning outcomes, and curriculum structure. In the experience model, participants express discourse themes with actual social reality. In the end, how discourse speaks is expected to be a critical dimension in forming the Film, Television, and Media Studies program curriculum. Abstrak Artikel ini menggunakan teori Diskursus yang dipopulerkan oleh Foucault digunakan dengan tujuan untuk melihat produksi dan penggunaan pengetahuan dan praktiknya yang relevansinya dengan wacana yang berlaku untuk kurikulum prodi kajian film, televisi, dan media. Penelitian ini menggunakan metode fenomenologi interpretatif (Interpretative Phenomenological Analysis), klasifikasi dan pembingkaian data dilakukan melalui kegiatan diskusi terpumpun/Focus Group Discussion. Teknik purposeful sampling dipilih melalui strategi maximal variation sampling dengan melibatkan delapan subjek penelitian untuk memahami beragam pengalaman dari kampus-kampus yang sudah memiliki program serupa dan dianggap paling "berorientasi" sebagai pemangku kepentingan. Hasilnya bahwa diskursus kurikulum menghasilkan empat tema yaitu visi misi keilmuan, profil lulusan, capaian pembelajaran, dan struktur kurikulum. Model pengalaman, partisipan mengungkapkan tema wacana dengan realitas sosial yang sesungguhnya. Pada akhirnya cara diskursus berbicara diharapkan menjadi dimensi kunci dalam pembentukan kurikulum pada program studi Kajian Film, Televisi, dan Media. Kata Kunci: Diskursus kurikulum; fenomenologi interpretatif; foucault; kajian film, televisi, dan media

Abstract The accurate prediction of in-hospital mortality in Asian women after ST-Elevation Myocardial Infarction (STEMI) remains a crucial issue in medical research. Existing models frequently neglect this demographic's particular attributes, resulting in poor treatment outcomes. This study aims to improve the prediction of in-hospital mortality in multi-ethnic Asian women with STEMI by employing both base and ensemble machine learning (ML) models. We centred on the development of demographic-specific models using data from the Malaysian National Cardiovascular Disease Database spanning 2006 to 2016. Through a careful iterative feature selection approach that included feature importance and sequential backward elimination, significant variables such as systolic blood pressure, Killip class, fasting blood glucose, beta-blockers, angiotensin-converting enzyme inhibitors (ACE), and oral hypoglycemic medications were identified. The findings of our study revealed that ML models with selected features outperformed the conventional Thrombolysis in Myocardial Infarction (TIMI) Risk score, with area under the curve (AUC) ranging from 0.60 to 0.93 versus TIMI's AUC of 0.81. Remarkably, our best-performing ensemble ML model was surpassed by the base ML model, support vector machine (SVM) Linear with SVM selected features (AUC: 0.93, CI: 0.89–0.98 versus AUC: 0.91, CI: 0.87–0.96). Furthermore, the women-specific model outperformed a non-gender-specific STEMI model (AUC: 0.92, CI: 0.87–0.97). Our findings demonstrate the value of women-specific ML models over standard approaches, emphasizing the importance of continued testing and validation to improve clinical care for women with STEMI.

During economic uncertainty following the COVID-19 pandemic, social assistance is vital for alleviating the economic burden on the poor and vulnerable to poverty, particularly those residing in island-based areas. The research aims to measure the performance of social assistance programs in the regional economy of the North Maluku Archipelago Province. The study employs Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA) to measure efficiency values, with input variables including social aid, unemployment, and inflation, while the output variable is poverty. The results reveal that social assistance is ineffective in reducing poverty. Several obstacles, including the minimal budget allocation, inaccuracies in identifying assistance recipients, and insufficient time for aid distribution are identified as primary causes of the inefficiency of social aid programs. Updating poverty data into one unified and integrated dataset is essential for the efficiency distribution of social assistance. Accurate targeting and timely distribution are the keys to the effectiveness of social assistance programs in reducing poverty.

Chrysanthemum flowers (Chrysanthemum indicum L.) have been shown to contain flavonoid compounds and exert antioxidant activity. This brings Chrysanthemum indicum potential to be developed as a nutraceutical product. This study aims to evaluate the antioxidant activity of Chrysanthemum flowers before and after the formulation of Chrysanthemum indicum flower extract as a gummy candy. Gummy candy formulas were developed using variations of gelatin and pectin as gelling agents. In this study, Chrysanthemum flower extract was formulated into gummy candy. The physical characteristics evaluated include organoleptic tests, weight uniformity, elasticity, and moisture content. Optimization was performed using the simplex lattice design (SLD) method with the aid of the Design Expert software Ver. 13. The antioxidant activity of the chrysanthemum flower extract and gummy candy extract was evaluated using the DPPH radical scavenging method. Ascorbic acid was used as a positive control. The optimum formula for preparing the gummy candy was 11.51% of gelatin and 1.24% of pectin. The evaluation of weight uniformity, elasticity, and moisture content suggested that there is no significant difference between the optimum formula and the predicted value. Both the chrysanthemum flower extract and chrysanthemum flower gummy candy had strong antioxidant activity. The IC50 value of the extract was 67.80 ± 2.37 mg/mL while the gummy candy IC50 value was 82.93 ± 2.55 mg/mL. The antioxidant activity of Chrysanthemum indicum was slightly decreased after being formulated into gummy candy. These studies suggested that scientists are expected to anticipate the decrease of Chrysanthemum antioxidant activity in the gummy manufacturing process.

ObjectiveEvaluating the canal-centering and apical transportation ability of endodontic file systems working with different kinematics but of similar cross section. Materials and MethodsSixty human maxillary first molar mesiobuccal (MB) roots were assigned to three experimental groups based on instrumentation techniques: Reciproc Blue (RB), Mtwo (M2), and OneShape (OS). Pre- and post-instrumentation micro-computed tomographic analysis was performed. Centering ability and apical transportation were analyzed at 3 mm, 6 mm, and 9 mm short of the apex. Statistical analysis was conducted using Mann–Whitney U test and Kruskal–Wallis test. ResultsOS showed better canal-centering ability than RB and M2 at 3 mm, 6 mm, and 9 mm. No significant difference among the tested groups was observed during the assessment of apical transportation (P < 0.05). ConclusionThe systems evaluated safely prepared curved MB canals with minimal canal transportation. OS showed superior canal-centering ability compared to the other two groups.

Arief Cahyadi,1,2 Riyadh Firdaus,2 Hansen Angkasa2 1Department of Anestesiology, Univesitas Padjajaran, Hasan Sadikin General Hospital, Bandung, Indonesia; 2Department of Anesthesiology and Intensive Care, Faculty of Medicine University of Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, IndonesiaCorrespondence: Arief Cahyadi, Hasan Sadikin General Hospital, Pasteur Road, No. 38, Bandung, West Java, 40161, Indonesia, Email ariefcahyadi@gmail.comAbstract: Arnold–Chiari malformation is a displacement of the brain into the spinal canal, often leading to hemodynamic distress. Arnold-Chiari malformation type III (CM III) is a rare and severe type that requires early detection to prevent complications. We aim to report this rare presentation of CM III. A 16-month-old girl with a massive tumor of the occiput suspected to be a meningoencephalocele with CM III was referred to the neurosurgery department. The patient was assessed with class 3 American Society of Anesthesiologist classification, posed challenges due to a difficult airway and the presence of a meningoencephalocele. The patient was scheduled for an elective surgery. Preoperative, the patient was lethargic with an abnormal heart rate and blood pressure. Induction was performed while preserving spontaneous ventilation, but was assisted by an oropharyngeal airway due to a short neck and obesity. The patient later developed laryngospasm thus, muscle relaxant and propofol were administered. A rescue laryngeal mask airway was inserted due to desaturation. Intubation was performed with video laryngoscope. When the surgeon opened the cele and removed the cerebrospinal fluid, the blood pressure began to decline. Resection of brain tissue caused the patient started to bleed, fluid and blood products were administered. At the end of surgery, the patient had stable hemodynamics and was transferred to the pediatric intensive care for monitoring. In patients with massive occipital meningoencephalocele and CM III, anesthetic management requires smooth intubation and prevention of excessive manipulation of the cervical joint to prevent increased intracranial pressure. The patient was not extubated because the brainstem could not be sufficiently reduced coupled with significant autonomic dysfunction.Keywords: Chiari malformation, children, management anesthesia, meningoencephalocele

Introduction: A good learning environment (LE) will affect the quality and standard of the learning process, student performance, and the outcome of the curriculum as well as predictor of the quality of health services. Our study aims to assess residents’ perception of the LE in Ophthalmology training programs for future improvement. Methods: Mixed method with an explanatory sequential design was implemented in this study using the Post-graduate Hospital Educational Environment Measure (PHEEM) as a quantitative approach and open-ended questions collaborated with focus group discussion (FGD) as a qualitative measurement. A comparison of the quantitative data was made using parametric and non-parametric analyses. Thematic analyses were performed for qualitative data. Integration of quantitative and qualitative data was done by connecting both data. Results: Fifty-three residents participated in this survey. The mean age was 30.96±2.18 years old, 64.15% were female and 77.36% are at the internship stage. The mean score of overall PHEEM was 123.40 ±12.35, indicated an excellent LE, while the mean score of perceptions of role autonomy, perceptions of teaching, and perceptions of social support were 42.57±4.62, 47.75±4.84 and 33.08±4.15, respectively. There is no significant difference between gender and study period with the perception of LE. Thematic analysis from qualitative data reveals six positive and five negative perception themes. All discovered themes confirmed concordance with the result of LE perception. Conclusion: Learning environment perception in the ophthalmology residency program was excellent and essential for the student's skills and performance quality. Some specific areas still need improvement strategies for institutional development.

A 57-year-old lady presented with symptoms of intestinal obstruction preceded by a 2-day history of lower abdomen pain. Clinically, she had a distended abdomen with tenderness in her lower abdomen. Laboratory investigations were unremarkable. An abdominal radiograph showed a dilated small bowel with no extensive bowel gas. A computed tomography (CT) scan showed suspected intestinal obstruction secondary to herniation into the right broad ligament. The decision was made to proceed with surgery, and the intraoperative results confirmed the CT results. The literature review is outlined here, and this instance illustrates a surprising discovery.

Patients in intensive care unit (ICU) often have multiple vital signs monitored continuously. However, missing data is common in ICU settings, negatively impacting clinical decision-making and patient outcomes. In this study propose a multivariate data imputation method based on simple U-Shaped encoder-decoder network imputation (XU-NetI) method to learn the underlying patterns in the data and generate imputations for missing values of vital signs data with ICU patients. To evaluate the performance of this study's imputation methods, this study employed a publicly available database such the medical information mart for intensive care III (MIMIC III) v1.4. In this study proposed model has been developed to analyze 219.281 vital sign worth of data, focusing on eight essential vital sign features: body temperature, heart rate, respiration rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, oxygen saturation, and glucose. The evaluation results demonstrates the effectiveness of the imputation techniques in improving the accuracy of predictive models. This study compared the XU-NetI approach to other state-of-the-art imputation methods including Autoencoder and Convolutional Neural Networks. As a result found, the technique using XU-NetI architecture outperformed them, in terms of root mean square error (RSME) by approximately 0.01, mean absolute error (MAE) by approximately 0.009, and R square (R2) by approximately 0.99. The XU-NetI method has the potential to enhance clinical decision-making and improve patient outcomes.

Adolescents’ unstable personalities are responsible for poor behavioral choices, which adversely affect their quality of life. Therefore, this study aimed to examine health-related behaviors, such as drinking and smoking, alongside demographic characteristics and basic health knowledge. A total of 100 adolescents aged 11 to 20 were randomly selected as respondents using a cross-sectional observational analytical method. Data collection relied on interviews, which were subjected to univariate analysis using logistic regression and Chi-Square tests. The results showed that there was a significant correlation (p-value 0.003) between smoking and reproductive health behaviors. However, no significant correlation (p-value 0.410) was found between reproductive health behaviors and alcohol consumption. In conclusion, the research uncovered a significant correlation between smoking and reproductive health behaviors. It was necessary to instill healthy lifestyle skills in adolescents early on to deter them from engaging in risky health behaviors.

Diarrhea is a common manifestation of gastroenteritis, affecting both children and adults globally. Subsequently, gastroenteritis is particularly prevalent in developing countries such as Indonesia and Taiwan. This research aimed to analyze the incidence of diarrhea based on socio-demographics and personal hygiene in Indonesia and Taiwan. The method used in this research was a quantitative design with a cross-sectional approach, and the data collection involved interviews with adults, using a structured questionnaire. The primary goal of the analysis was to examine the bivariate relationships between each variable and the incidence of diarrhea, and the logistic regression test was applied for the multivariate test. A result from Taiwan respondents, the statistical tests showed significant relationships with age with a p-value of 0.009, education with a p-value =0.010, and personal hygiene with a p-value =0.010. Factors that influenced diarrhea in Indonesia were education with a p-value =0.038 and income with a p-value =0.08. In summary, several socio-demographics and personal hygiene practices played a significant role in the incidence of diarrhea. The differences in results obtained from Taiwan and Indonesia were attributed to differing respondent characteristics, emphasizing the importance of promoting clean and healthy behaviors, including handwashing with soap before eating and maintaining a clean environment, as effective measures to prevent diarrhea.

Ge Yang,1 Salma Firdaus,2 Lívia Figueiredo Pereira,3 Yumin Huang-Link4 1Huizhou Aier Eye Hospital, Aier Eye Hospital Group, Huizhou, Guangdong Province, People’s Republic of China; 2Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 3Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil; 4Division of Neurology, Department of Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, SwedenCorrespondence: Ge Yang, Huizhou Aier Eye Hospital, Aier Eye Hospital Group, Huizhou, Guangdong Province, People’s Republic of China, Tel +86 15626454300, Email geyang95@sina.com

Stunting pada anak dapat berdampak negatif terhadap perkembangan kognitif, emosi, perilaku, pendidikan, bahkan produktifitas dan penyakit ketika mereka dewasa. Salah satu upaya menurunkan prevalensi Stunting adalah dengan meningkatkan Peningkatan pengetahuan Gizi dan ketrampilan olahan pangan fungsional bagi ibu dari Balita Stunting. Kegiatan ini dilakukan di Kelompok Keluarga di rumah Gizi Kecamatan Padang Timur, bekerjasama dengan Puskesmas Kecamatan Padang Timur. Hasil penelitian sebelumnya diperoleh bahwa kandungan Protein dan Mineral Nugget ber daun Kelor, sebagai salah satu inovasi olahan pagan, telah melebihi Standar Gizi sesuai PP Menkes RI Nomor 51 Tahun 2016 tentang Standar Produk Suplementasi Gizi. Tujuan kegiatan ini adalah untuk meningkatkan pemahaman mengenai gizi bagi orang tua. Sehingga di era digital ini, pendampingan orang tua yang memiliki baduta, terutama baduta dengan kejadian stunting perlu dilakukan, yaitu berupa literasi digital mengenai standar gizi balita dan pelatihan olahan pangan untuk meningkatkan massa tubuh Balita. Metode penerapan teknologi dilakukan 3 tahapan: 1) Sosialisasi; 2) Pelatihan, dan 3) Evaluasi. Hasil Evaluasi pemberian pengetahuan dan pelatihan kepada ibu Balita stunting, terjadi peningkatan pengetahuan dan ketrampilan Ibu-ibu Balita stunting sebesar 86,67%. Pelatihan terhadap Ibu-ibu balita stunting mengenai inovasi olahan pangan berdaun kelor berupa nugget, bakso dan tahu Fantasi, sebagai makanan tambahan bagi Balita stunting telah meningkatkan pengetahuan dan ketrampilan Ibu-ibu sasaran program secara signifikan.

Load shedding is a protection scheme to maintain the stability of the electric power system. When there is an imbalance between the power generated and the load power, load shedding will release the load to restore power balance. This research aims to design and analyze the load shedding system at Private Company to see whether it is running well and meets the PRC-006-5 standard regarding the frequency operating limit, which must be in the range of 49.42 Hz to 50.58 Hz. The method that will be used in this research is to carry out testing with software and then analyze the power and frequency response due to the generator being removed from the system. The testing mechanism that will be carried out is to simulate the effect of a lack of power for the load supply on the load shedding system. From the research results, it is known that the existing load shedding scheme needs to be evaluated. Evaluation is carried out on steps 1 and 2, so that the load shedding limit for step 1 becomes 49.5 Hz and the pickup time for step 4 becomes 400 ms.

Health-related data has a decisive role in disease diagnosis. Collecting relevant information from health-related data in medical records has been facilitated by evaluating the features of the data. Relevant research has shown that outcomes are significantly impacted by the use of feature selection (FS) in different medical domain data. FS provides an analysis of the most significant features to improve classification accuracy. The FS technique aims at minimizing the number of input variables and computational overload to maximize classification performance results. However, identifying the optimal features poses issues due to the high dimensionality of large features and the small sample size of health-related data. The metaheuristics optimization algorithm (MOA) plays an important role in generating the best subset features with exploration and exploitation phases. This study experiments with well-known MOAs and supervised learning from the UC Irvine Machine Learning Repository, PhysioNet, Kent Ridge Bio-Medical Dataset, and MIMIC-III v1.4 Repository with varying feature dimensions. To increase the quality of health-related data, this study proposes missing data imputation based on a deep learning approach, an autoencoder (AE). With AE imputation, the performance results obtain 0.0167 mean squared error (MSE) and 0.129 root mean squared error (RMSE). As a result, MOA shows its excellence in achieving minimal features, but still outstanding performance in low- and high-dimensional data. MOA is successfully applied to varying diverse health-related datasets with low- and high-dimensional data.