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Sustainable natural resource management is a high priority in the 21st century as it plays a crucial role in mitigating climate change and preventing some of its consequences like loss of biodiversity, land degradation, desertification, and the exhaustion of natural resources. This concern is reflected in the United Nations Sustainable Development Goals (SDGs), which emphasize, among other factors, sustainable cities and communities, responsible production and consumption, and climate action. Achieving sustainable natural resource management begins with raising awareness and educating the next generation. Therefore, it is essential to develop educational initiatives that prepare young people to become responsible and proactive adults in promoting environmental sustainability across industries and communities. Additionally, these initiatives should develop critical and analytical thinking skills, nurture innovative mindsets for creating environmentally sound solutions, and enhance the ability to collaborate within multidisciplinary teams. The NATURE project addressed these needs by designing and developing a serious educational game that fosters this set of skills. The results of the pilot testing show that the game is an effective tool and contributes to the education and awareness of the younger generation.

Abstract Background The COVID‐19 pandemic led to care disruptions across the cancer continuum. It is unknown if immunosuppressed patients with cancer, who may be at higher risk for complications of SARS‐CoV‐2 infection, are disproportionately impacted. Thus, we aimed to compare delays in cancer treatment initiation between people living with HIV (PLWH) and cancer, the general cancer population (GCP), and patients with cancer and a history of solid organ transplant (SOT). Comparisons were made across the period 2 years preceding the pandemic versus the first year of the pandemic. Methods We used data from a real‐world electronic health record‐derived de‐identified database (2018–2021) comprised of US patients with cancer from 800 sites of care across the country. We included patients with 19 different cancer types. We calculated time to cancer treatment initiation (TTI) as the difference between the date of cancer diagnosis and the earliest date that cancer treatment was recorded. Results The sample included 181 PLWH, 65,073 GCP patients, and 195 patients with a SOT. Difference‐in‐difference regression models adjusted for age, sex, and presence of metastatic disease at cancer diagnosis revealed a significant increase in delayed TTI among PLWH compared to the GCP during COVID‐19 versus prior to COVID‐19, with delays increasing by approximately 1 month during the pandemic (DID: 32.6 days [8.9–56.3]; p = 0.007). The increase in TTI for PLWH was observed across treatment modalities, including surgery (DID: 55.1 [28.8–81.3], p

Abstract Many arthropods harbour bacterial symbionts, which are maintained by vertical and/or horizontal transmission. Spiroplasma is one of the most well-known symbionts of ticks and other arthropods. It is still unclear how Spiroplasma infections have spread in tick populations despite its high prevalence in some tick species. In this study, Ixodes ovatus, which has been reported to harbour Spiroplasma ixodetis at high frequencies, was examined for its vertical transmission potential under experimental conditions. Next, two isolates of tick-derived Spiroplasma, S. ixodetis and Spiroplasma mirum, were experimentally inoculated into Spiroplasma-free Haemaphysalis longicornis colonies and the presence of Spiroplasma in their eggs and larvae was tested. Our experimental data confirmed that S. ixodetis was transmitted to eggs and larvae in a vertical manner in the original host I. ovatus. In the second experiment, there was no significant difference in engorged weight, egg weight, and hatching rate between Spiroplasma-inoculated and control H. longicornis groups. This suggested that Spiroplasma infection does not affect tick reproduction. Spiroplasma DNA was only detected in the eggs and larvae derived from some individuals of S. ixodetis-inoculated groups. This has demonstrated the potential of horizontal transmission between different tick species. These findings may help understand the transmission dynamics of Spiroplasma in nature and its adaptation mechanism to host arthropod species.

Abstract The term “geriatric giants” refers to the chronic disabilities of senescence leading to adverse health outcomes. This study aimed to investigate the prevalence and predictors of geriatric giants in Southern Iran. The participants were selected from Bushehr city using a multistage cluster random sampling method. Demographic data were collected through interviews. Frailty, incontinence, immobility, depression, cognitive impairment, and malnutrition were measured by questionnaires and instruments. Finally, data from 2392 participants were analyzed. The prevalence of fecal incontinence was less than 1% among all participants and similar in men and women. In contrast, compared with men, women had higher prevalence of urinary incontinence (36.44% vs. 17.65%), depression (39.05% vs. 12.89%), anorexia and malnutrition (2.35% vs. 0.82%), immobility (8.00% vs. 2.5%), frailty (16.84 vs. 7.34), and pre-frailty (54.19 vs. 38.63%). The prevalence of dependence and cognitive impairment was also higher in women and considerably increased with the age of participants. In total, 12.07% of subjects were frail, and 46.76% were pre-frail. The prevalence of frailty exponentially increased in older age, ranging from 4.18% among those aged 60–64 years to 57.35% in those aged ≥ 80 years. Considering 95% confidence interval (CI), multivariate logistic regression revealed that low physical activity [odds ratio (OR) 31.73 (18.44–54.60)], cancer (OR 3.28 (1.27–8.44)), depression [OR 2.42 (1.97–2.98)], age [OR 1.11 (1.08–1.14)], waist circumference [OR 1.03 (1.01–1.06)], BMI [OR 1.07 (1.01–1.14)], MNA score [OR 0.85 (0.79–0.92)], polypharmacy [OR 2.26 (1.30–3.95)] and male gender [OR 0.63 (0.42–0.93)] were independently associated with frailty. White blood cell count (WBC), smoking, marital status, and number of comorbidities were not independently associated with frailty. Low physical activity was the strongest predictor of frailty, which may need more attention in geriatric care. Frailty, its predictors, and other components of geriatric giants were considerably more common among women and older ages.

Stabilization of the tibia when moving forward and rotational movements of the knee joint will be assisted by one of the ligaments in the knee joint, namely the Anterior Cruciate Ligament (ACL). This study aims to present physiotherapy management strategies to help reduce pain, prevent stiffness, increase muscle strength, decrease muscle spasms, increase the joint scope of motion, and overcome edema. The method used in this study is a case report. Primary data are obtained through auto anamnesis and physical examination. Holistic diagnosis assessment is carried out quantitatively from the study's beginning, process, and end. The result is that a 33-year-old male patient with a postoperative diagnosis of ACL underwent surgery on November 14, 2022, and has done therapy 7 times; the patient has experienced significant changes. It can be concluded that postoperative ACL rehabilitation can reduce edema and pain, increase muscle strength, and increase ROM. Finding interventions that can be applied to learning and modification of interventions is also recommended to assist in post-ACL reconstruction recovery to return to daily activities. The diagnosis and treatment of physiotherapy in patients are by the latest theories and research. In the evaluation, clinical improvement of patients and increased knowledge were obtained

The surface area and volume of cubes and cuboids are mathematical concepts related to everyday life. However, many students need help learning this concept. This study aims to analyze the learning obstacles junior high school students encounter when solving mathematical representation problems on the concept of surface area and volume of cubes and cuboids. This study uses an interpretive paradigm which is part of Didactical Design Research (DDR). Students at one of the public junior high schools in Jambi City were given six questions related to mathematical representation after the researchers conducted classroom observations, which were then followed by interviews with students with high, moderate, and low representation abilities. Data analysis techniques include data reduction, display, and conclusion drawing and verification. The results showed that students experienced three learning obstacles: ontogenic, epistemological, and didactical. Furthermore, the results of this study can be a consideration for teachers to create learning designs for surface area and volume of cubes and cuboids that can anticipate student learning obstacles and develop students' mathematical representation abilities.

PURPOSEWe aimed to examine the impact of different conference formats (in-person, virtual, and hybrid) of the ASCO conference on greenhouse gas (GHG) emissions and to recommend sustainable options for future conferences.MATERIALS AND METHODSThis study used data on the number of attendees, their departure locations, and the type of attendance (in-person v virtual) provided by ASCO between 2019 and 2022. The GHG emissions resulting from air and ground travel, remote connectivity, conference space utilization, hotel stays, distributed conference materials, and electricity use were estimated for each year. Emissions were stratified by attendee country of origin, type of attendance, and year. Simulations were conducted to evaluate how changes in conference size, location, and format impact emissions, as well as estimate the resulting mitigations from adopting the proposed changes.RESULTSThe highest estimated GHG emissions, calculated in carbon dioxide equivalents (CO2e), were associated with the 2019 in-person conference (37,251 metric tons of CO2e). Although international attendees had the largest contribution to emissions in all years (>50%), location optimization models, which selected conference locations that most minimized GHG emissions, yielded only minimal reductions (approximately 3%). Simulations examining changes to the conference format, location, and attendance percentage suggested that hub-and-spoke, where multiple conference locations are selected by global region, or hybrid models, with both in-person and virtual components, are likely to cause the largest drops in emissions (up to 86%).CONCLUSIONUsing historical conference data, this study identifies key aspects that can be modified to reduce emissions and consequently promote more sustainable and equitable conference attendance. Hybrid conferences may be the best solution to maintain the networking opportunities provided by conferences while balancing out their environmental footprint.

As the population ages, the number of older people with various geriatric diseases is increasing. Sarcopenia is one of the important geriatric diseases with high mortality and morbidity. Some research needs to understand risk factors, diagnosis, and prevention, and develop treatment options with high safety and efficacy for sarcopenic people. To reduce the risks involved with sarcopenic people in clinical research, it is necessary to consider the ethical review of research on this issue. Therefore, this study aimed to guide on the ethical issues of sarcopenia research.

This research aims to analyze the implementation of human-based media in learning Islamic religious education at SMA Pertiwi 1 Padang. The main source of this research, researchers took from one Islamic religious education teacher and ten students. Research data was taken using observation, in-depth interviews, and documentary evidence. Furthermore, the data were analyzed through data reduction, data display, and making research conclusions. This research proves that human-based media by Islamic religious education teachers at Pertiwi 1 Padang High School has been used for a long time and works well. Because the teacher already has sufficient insight regarding human-based media. The application of human-based media is divided into two, namely in the classroom by showing good gestures and public speaking and outside the classroom by exemplifying the style of speech, dress, and teaching respect to the teacher. The use of human-based media also has a positive impact on students, seen from the increasing learning outcomes during the use of human-based media. The inhibiting factors in the use of human-based media are the condition of the teacher, the condition of the students, and the environment. The supporting factors are the teacher's ability and the support of the school principal

Abstract Objectives Identification the optimal management intervention of sarcopenia is a concern of health systems. We aimed to analyze the cost-effectiveness of sarcopenia management strategies in Iran. Methods We constructed a lifetime Markov model based on natural history. The strategies comparedincluded exercise training, nutritional supplements, whole body vibration (WBV), and various exercise interventions and nutritional supplement combinations. A total of 7 strategies was evaluated in addition to the non-intervention strategy. Parameter values were extracted from primary data and the literature, and the costs and Quality-adjusted life years (QALYs) were calculated for each strategy. Deterministic and probabilistic sensitivity analysis, including the expected value of perfect information (EVPI), was also performed to determine the robustness of the model. Analyses were performed using the 2020 version of TreeAge Pro software. Results All seven strategies increased lifetime effectiveness (QALYs). The protein and Vitamin D3 (P + D) strategy had the highest effectiveness values among all strategies. After removing the dominated strategies, the estimated ICER for the P + D compared to Vitamin D3 alone (D) strategy was calculated as $131,229. Considering the cost-effectiveness threshold ($25,249), base-case results indicated that the D strategy was the most cost-effective strategy in this evaluation. Sensitivity analysis of model parameters also demonstrated the robustness of results. Also, EVPI was estimated at $273. Conclusions Study results, as the first economic evaluation of sarcopenia management interventions, showed that despite the higher effectiveness of D + P, the D strategy was the most cost-effective. Completing clinical evidence of various intervention options can lead to more accurate results in the future.

Abstract Cancer is one of the important health problems in Iran, which is considered as the third cause of death. Endocrine cancers are rare but mostly curable. Thyroid cancer, the most common endocrine tumors, includes about one percent of malignant cancer. In this study, we examined the 15-year national trend of endocrine cancer incidence in Iranian men and women. The data in each province were evaluated based on age, gender, and cancer type according to International Classification of Disease Codes version 10 (ICD-10) from 2005 to 2020 in Iran. All data were obtained from the reports of the Statistics Center of Iran (SCI), 6 phases of the step-by-step approach to monitoring the risk factors of chronic diseases over 18 years old (STEPs), and 3 periods of the CASPIAN study (survey of non-communicable diseases in childhood and adolescence). Statistical analyzes and graph generation were done using R statistical software. Poisson regression with mixed effects was used for data modeling and incidence rate estimation. The incidence of thyroid gland malignancy is higher in women than in men. On the other hand, the incidence of adrenal gland cancer is slightly higher in men than in women. The same pattern is observed for other endocrine neoplasms and related structures. The incidence rate of these types of cancers has generally increased from 2005 to 2020 in Iran. This increase is more in women than in men. In addition, in the middle of the country, there is a strong region in terms of the occurrence of these types of cancers. The incidence rate in these provinces is relatively higher for both sexes and all studied periods. We conducted a study to observe the changing trends for various types of endocrine cancers over 15 years in men and women. Considering the increasing trend of thyroid cancers in Iran, therefore, creating essential policies for the management of these types of cancers for prevention, rapid diagnosis, and, timely treatment is particularly important.

Abstract Background Cancer is a major health problem and cause of mortality worldwide. Despite the prevalence of other cancers in males and females, genital cancers are especially important because of their psychological effects on individuals. Currently, cervical cancer, corpus uteri neoplasm, and ovarian cancer are the most common gynecological cancers in Iran. Prostate cancer has increased in Iranian men in the last decade. Therefore, this study aimed to investigate the 15-year national trend in the incidence of genital cancers in the Iranian population. Methods In this study, we used Iranian cancer registration data collected by the Ministry of Health and Medical Education, demographic information from the reports of the Statistics Center of Iran, STEPs (STEPwise approach to non-communicable diseases risk factor surveillance), and Caspian (childhood and adolescence surveillance and prevention of adult non-communicable disease). A list of potential auxiliary variables and secondary variables at all levels of the province-age-sex were evaluated during the years. We used mixed-effects Poisson regression to model the data and calculate the incidence of each cancer. Results Our results show an enhancement in the outbreak of all types of male cancers, but the most important are prostate (11.46 in 2005 to 25.67 in 2020 per 100,000 males) and testicular cancers (2.39 in 2005 to 5.05 per 100,000 males). As for female cancers, there has been an increase in ovarian and corpus uteri neoplasm incidence with 6.69 and 4.14 incidences per 100,000 females in 2020, making them the most occurring female genital neoplasms. While the occurrence of cervical cancer has decreased over the years (4.65 in 2005 to 3.24 in 2020). In general, the incidence of genital cancers in men and women has amplified in the last 15 years. Conclusions Our study examined the trend of change for each malignant genital neoplasm for 15 years in Iranian men and women in each province. Considering the growing trend of the elderly population in Iran, patient awareness and early screening are essential in reducing mortality and costs imposed on patients and the health care system.

Introduction: Musculoskeletal complaints are often caused by accidents and occupational diseases. High heels that are often used by women workers in various companies can cause abnormalities in the shape of the feet. The purpose of this study was to detect the effect of using high heels on the foot arch of female workers in Makassar. Methods: This is a quantitative research using a cross-sectional research design. The sample in this study was 30 female workers who use high heels in Makassar who were selected using a non-probability sampling method with purposive sampling type. The data are primary data obtained through the measurement of the medial longitudinal arch with grid paper measurement which was analyzed using the Meyer line and the wet footprint examination which was analyzed by the Clarke index. Furthermore, the measurement of musculoskeletal complaint was analyzed using Nordic body map. Results: From research conducted on 30 respondents, more than 50% of respondents have pes cavus. The results of data analysis also showed the effect of heel height on increasing the height of the medial longitudinal arch of the sample based on the correlation of heel height and Clarke index. Conclusion: It found that the measurement of the soles of the feet on grid paper with the Meyer line parameter was not directly related to musculoskeletal complaints, on the contrary the Clark index could be used as a specific parameter in detecting an increase in the median longitudinal arc in the form of pes cavus.

Antioxidant and anticancer activities of sand sea cucumber Holothuria scabra (dried and fresh) extracts were studied. The highest extraction yield of sea cucumber H. scabra (3.9%) was obtained using dried H. scabra at 60oC. The highest antioxidant activity was found in fresh H. scabra extract at 60°C with an IC50 value of 629.89 ± 0.15 µg/mL using the ABTS method, and the highest antioxidant activity by DPPH method was found in dried H. scabra extract at 70°C with an IC50 value of 32017.18 ± 0.82 µg/mL. The best antioxidant activity based on FRAP and TBARS methods was found in fresh H. scabra extracts at 80°C, respectively. The highest total phenol and flavonoid contained in dried H. scabra extract were 317.54 ± 8.91 mg GAE/100 g sample and 247.56 ± 11.70 mg QE/100 g sample. H. scabra extracts inhibited more than 50% of the growth of the MDA-MB-231 cell line at concentrations of 25 and 50 μg/mL except for dried H. scabra extracts at 80°C. Similarly, the extracts showed the highest cytotoxic effect up to 100% at the highest concentration (100 μg/mL) except for dried H. scabra extracts at 70°C and 80°C.

Purpose: To evaluate the efficacy of liposomal amphotericin B (L-AMB) for the treatment of fungal keratitis. Methods: Patients with fungal keratitis confirmed by potassium hydroxide (KOH) smear and/or confocal microscopy were administered topical L-AMB and randomized into three groups treated with three different formulations. The medication was administered two hourly till clinical improvement was achieved, followed by six hourly till complete resolution. The outcome measures were time to clinical improvement, resolution of epithelial defect, stromal infiltrate, hypopyon, extent and density of corneal opacity, neovascularization, and best corrected visual acuity (BCVA) at 3 months. Results: Mean age of the patients was 46.6 ± 14.8 years, and trauma with vegetative matter was the most common predisposing factor. Aspergillus flavus (36%) was the most common fungus cultured, followed by Fusarium (23%). Mean time to clinical improvement, time to resolution of epithelial defect, mean time to resolution of infiltrate, and time to resolution of hypopyon were 3.45 ± 1.38, 25.35 ± 8.46, 37.97 ± 9.94, and 13.33 ± 4.90 days, respectively, and they were comparable among the three groups. There was a significant difference between treatment failure and success cases in terms of days of presentation (P < 0.01), size of the epithelial defect (P-value 0.04), and infiltrate size at presentation (P-value 0.04). At 3 months follow-up, no statistically significant difference was noted in BCVA and mean scar size among groups. Conclusion: L-AMB in a gel form is an effective antifungal agent that promotes the healing of fungal ulcers with notably least vascularization and better tolerance. Trial registration number: CTRI/2020/04/024550

Introduction: Patients on central lines are often having multiple morbidities, and invasive devices provide a niche for biofilm formation, which makes central line-associated bloodstream infections (CLABSIs), a serious concern in health-care settings, as the infections difficult to treat. In this study, we evaluated the common bacteria causing CLABSI, and various patient and pathogen factors affecting the clinical outcome. Methods: In the prospective observational study, patients diagnosed with CLABSI were recruited. Extensive clinical, microbiological, and other laboratory workup was done, and observations were recorded. Congo red agar method, tube test, and microtiter plate assay were used for eliciting the biofilm-forming attributes of the bacterial pathogens. Results: Klebsiella pneumoniae was responsible for 48% of CLABSI, followed by Coagulase-negative Staphylococci (16%) and Staphylococcus aureus and Acinetobacter baumannii (12% each). Fifty-six percent of the isolates produced biofilms. The median (interquartile range) duration of hospital stay till death or discharge was 30 (20, 43) days. The all-cause mortality was 44%. Patients having a deranged liver function on the day of diagnosis (P value for total bilirubin 0.001 and for aspartate transaminase 0.02), and those infected with multidrug-resistant organisms (P value = 0.04) had significantly poor prognosis. The difference in the demographic, clinical, laboratory profile, and outcome of patients infected with biofilm producers and nonproducers was not found to be statistically significant. Conclusion: The study throws light on various host and pathogen factors determining the cause and outcome of CLABSI patients. To the best of our knowledge, this is the first study trying to decipher the role of biofilm formation in the virulence of pathogens and the prognosis of CLABSI.

Objective: The objective of this study was to assess the test–retest reliability and inter-rater agreement between the traditional Chinese medicine (TCM) pulse diagnosis between two Indian TCM practitioners. Methods: A total of 300 participants were evaluated for their bilateral pulse based on TCM independently by two investigators with similar years of experience but who graduated from different medical schools. The investigators who were blinded diagnosed the participants as per TCM based on the depth, rate, and strength of their pulse. Cronbach α and weighted kappa were used for assessing the reliability and repeatability. Results: The data of all the 300 participants were included in the analysis. The test–retest reliability computed using Cronbach's alpha indicated high reliability between the investigators (α =0.963). There were a total of 37 different types of diagnoses identified by both investigators. The investigators diagnoses matched for 116 participants out of 300 participants; whereas 184 cases were not matched between the investigators. The inter-rater agreement for the TCM diagnosis tested by weighted Kappa did not returned any significant agreement (Kappa = 0.370). Discussion: The present study shows higher reliability between the pulse diagnoses between the investigators. However, the inter-rater agreement for TCM diagnosis based on pulse diagnosis was not significant probably due to the variation in subjective assessments. This calls for the standardization of training in TCM diagnostic methods among practitioners. Future studies should include the differences in training, medical education, and experience among the practitioners while determining the reliability of pulse diagnosis.

Background: Dengue hemorrhagic fever (DHF) is a viral infection transmitted by mosquitoes and is one of the health problems in community. DHF is currently still a health problem in Indonesia because the incidence of DHF cannot be reduced. The DHF morbidity in Indonesia in 2015 reached 50.75 per 100,000 populations, and the Incidence Rate (IR) in 2016 reached 78.85 per 100,000 populations, exceeding the national IR target (49 per 100,000 populations). The presence of mosquito larvae is an indicator of mosquitoes in an area. As a matter of fact, there are many factors that affect the presence of mosquito larvae. Objective: To determine the house environment factors related with the presence of mosquito larvae Method: Observational analytic with cross-sectional design. The sampling used cases and controls of 285 houses. The sample filled out the informed consent agreement, then the researchers gave the questionnaire, and made observations, next the researchers filled out the checklist according to the observation. The data were analyzed in bivariate technique with chi-square test, followed by multivariate test using logistic regression test. Results: The results of the multivariate test showed 7 factors that influenced the presence of larvae, consisting of the variables of PSN (Mosquito Breeding Ground Eradication) action (p = 0.012; OR = 0.022; CI = 0.001-0.435), PSN attitude (p = 0.005; OR = 1658247.9; OR: CI = 0.000-0.014), Number of people in the house (p = 0.013; OR = 0.071; CI = 1.731-113.550), Frequency of cleaning containers (p = 0.006; OR = 1139.1; CI = 0.000-0.080), Mosquito breeding sites (p = 0.006; OR = 0.006; CI = 0.424-6148.76), Fish in containers (p = 0.003; OR = 434.272; CI = 0.000-0.134), container location (p = 0.007; OR = 0.006 ; CI = 4.047- 4653.77). Conclusion: Many factors affect the presence of mosquito larvae, both in the home environment and containers owned by residents of the house. The presence of fish in containers is the most influential factor. Breeding fish as mosquito larva predators is included as parts of 3M Plus which is quite easy to do by the community. Thus, it requires maximum effort to increase knowledge of the community about these steps.

The paper aims to develop an e-module for learning Pancasila education using the flipbook application at SMP Negeri 6 Bukittinggi that is valid, practical, and effective. This type of research is development research with a 4D development model design, namely define, design, develop, and disseminate. The population in this research is class VII of SMP Negeri 6 Bukittinggi, and the sample is 30 students. The instruments used in this development are validation sheets, e-module practicality test sheets, and effectiveness sheets. In contrast, the data collection techniques used in this e-module development research use three types of data collection techniques: interviews, questionnaires, and tests. This research uses two types of data, namely quantitative and qualitative. Quantitative data is data in the form of material, media, and language expert validation sheets. The data and data sources used in this research are primary and secondary. Primary data was obtained directly from the source by observing the implementation of learning and conducting interviews with teachers and students. Secondary data are written sources, such as books, documents, and journals related to research. The data analysis technique in this research is testing the validity, practicality, and effectiveness obtained through the instruments that have been developed. The results of validation by media experts obtained an average score of 83%, material experts obtained an average score of 92%, and language experts obtained an average score of 98%. For practicality results by teachers, the average was 92%, while the effectiveness of teaching materials was 3.77. From the results of this research, using the Pancasila education learning e-module with the flipbook application is suitable for use in the learning process.

This workshop set out the process of collaborative writing explored by the JLDHE editorial teams in partnership with the ALDinHE community at and following ALDCon’22 through The Collaborative Conference Proceedings and Reflections. We discussed how the collaborative writing venture gave presenters an opportunity to open up their work to community responses and to document their experience of this dialogue with the LD community. We described how, using their conference abstract and Google docs, presenters engaged with their audiences to record live responses to their work, to reflect and respond to these responses, and to generate ideas in respect to taking their research forward or enhancing their practice. We examined how working with the JLDHE on this collaborative writing venture gave presenters an innovative way to open up a dialogue with our community of readers, providing a unique opportunity to extend their conference conversations in a way that shapes LD practice for the future. In the session, we shared the steps involved in the collaborative writing process and invited questions and reflections. Using testimonials from writers who participated last year, we opened up discussion and sought to reassure and address any concerns in community with editors and writers who have previously negotiated some of these challenges. We welcomed community input into how to make the Collaborative Proceedings more inclusive and open, to benefit all those who wish to be involved in the future. Attendees participated in shaping the collaborative partnership going forwards; they left with an understanding of what it means to be involved, a sense of how this innovative work enriched their conference experience, and how it is being received across the sector.

Introduction: Patient-Centered Care is a clinical practice concept that uses communication skills to strengthen the patient-provider relationship to optimize patient safety, outcomes, and satisfaction with health care. In India, there are no standard medical education curricula to teach patient-centered care skills. The Patient First Skills Program, hosted by the Asian Centre for Medical Education, Research, and Innovation, conducted a workshop to introduce and demonstrate patient-centered care principles among medical trainees in Jodhpur. Methods: The Patient First leadership facilitated a 3- hour, voluntary, free-of-cost workshop with oversight by Jodhpur-based senior academic faculty and practicing clinicians. Using small group discussions, role play, and faculty-guided peer reflection and feedback, the workshop enabled trainees to practice specific communication skills which would improve their diagnostic capability as well as the patient's experience. Workshop evaluation included pre- and post-workshop administration of the internationally-validated Patient-Provider Orientation Scale (PPOS), which measures the respondent's doctor-centric versus patient-centric orientation by assessing agreement with a set of eighteen statements. Results: Ten medical undergraduate and house-staff trainees participated and uniformly rated the workshop highly on clarity and usefulness for future clinical practice. The PPOS demonstrated a shirt from doctor centric or neutral orientation, pre-workshop, to a more patient centric orientation post-workshop. Conclusion: The Patient First program demonstrated high approval and acceptability among participants, and feasibility to be adapted and integrated with existing medical education programs in India. Future programs will include new modules and topics of training, and continuing use of the PPOS findings to guide the adaptation and definition of Patient-Centered Care training in the Indian context.

Background and Purpose: Chitosan, a chitin deacetylation product, has been applied in nanoparticle or nano-chitosan for medical applications. However, the chitin extraction from crustacean shells and other natural resources, chitin deacetylation, and crosslinking of the chitosan forming the nano-chitosan mostly involve hazardous chemical and physical processes. The risks of these processes to human health and the environment attract the attention of scientists to develop safer and greener techniques. This review aims to describe the progress of harmless chitosan synthesis. Experimental Approach: All strongly related publications to each section, which were found on scientific search engines (Google Scholar, Scopus, and Pubmed), were studied, selected, and then used as references in writing this review. No limitation for the publication year was applied. The publications were searched from April 2022 - June 2023. Key Results: Nano-chitosan could be synthesized in harmless techniques, including the preparation of the chitosan raw materials and crosslinking the chitosan polymer. Enzymatic processes in shell deproteination in the chitin extraction and deacetylation are preferable to reduce the negative effects of conventional chemical-physical processes. Mild alkalines and deep eutectic solvents also provide similar benefits. In the nano-chitosan synthesis, naturally derived compounds (carrageenan, genipin, and valinin) show potency as safer crosslinkers, besides tripolyphosphate, the most common safe crosslinker. Conclusion: A list of eco-friendly and safer processes in the synthesis of nano-chitosan has been reported in recent years. These findings are suggested for the nano-chitosan synthesis on an industrial scale in the near future.

The paper discusses users’ activities in the period 2011-2022, mostly types of searches, in an electronic encyclopaedia on saints. The e-product contains information in Bulgarian on orthodox church calendar and texts dedicated to saints as preserved in medieval Slavonic manuscripts and in popular Bulgarian culture (as represented in fieldwork interviews). The most frequently used options are “view object” and “view date”. Most often articles on popular saints amongst Bulgarians were read, such as St. Basil the Great, St. Kliment of Ohrid, St. George, and St. Petka of Tarnovo. Less often are searches by combined parameters and an increase of their frequency is observable in 2019-2021.

Background: Supplementation of iron (Fe) tablets are essential to prevent pregnant women from iron deficiency anemia. Several other factors, such as knowledge, attitude, side effects, and personal access to information about iron tablet supplements, reduce the compliance of pregnant women to consume iron tablets. This study uses a combination of interventions, Short Message Service (SMS) reminders, and counseling. Purpose: This research aims to discover the effects of SMS reminders and counseling as well as factors that influence pregnant women's compliance in consuming Fe tablets. Methods: 170 pregnant women in Balowerti Public Health Center were divided into control and intervention groups. Each group received pre and post-test. The intervention group was given the treatment of SMS reminders and counseling for seven days before the post-test. The data analysis was using McNemar's paired test. Results: McNemar test results obtained the effects of the SMS Reminder and counseling on knowledge (p = 0.01), attitude (p = 0.00), and adherence (p = 0.00) of pregnant women in the intervention group as compared to the control group at the time of the post-test. The logistic regression analysis found that the factors that influence the compliance of pregnant women to consume Fe tablets (p

Abstract Background This paper presents the protocol of the 4th round of Iranian Multi-center Osteoporosis Study (IMOS), a national survey with the primary objective of estimating the prevalence of osteoporosis and sarcopenia and their risk factors in a representative sample of urban and rural populations. Methods The target population of the survey is all individuals ≥ 50 years in Iran. A multi-stage random sampling method has been used in the study. We stratified the 31 provinces of the country into 5 strata based on the distribution of their potential risk factors for osteoporosis and randomly selected one or two provinces from each stratum. Then, we invited 2530 people aged ≥ 50 years recruited in the 8th National Survey of None Communicable Diseases (NCD) Risk Factors (STEPs-2021) in the selected provinces to participate in IMOS. Body composition measurements including bone mineral density, muscle mass, and fat mass are measured through Dual-energy X-ray Absorptiometry (DXA) method using HOLOGIC (Discovery and Horizon) devices; and Trabecular Bone Score (TBS) is measured on the DXA scans using iNsight software. Anthropometric measurement and physical examinations are made by a trained nurses and other required information are collected through face-to-face interviews made by trained nurses. Laboratory measurements are made in a central lab. The prevalence of osteoporosis and sarcopenia will be estimated after applying sampling design, non-response, and post-stratification weights to the data. Discussion IMOS will provide valuable information on the prevalence and determinants of osteoporosis and sarcopenia at the national level, and the results can be used in evaluating health system interventions and policymaking in the field of musculoskeletal diseases.

This research aimed to develop "I Am Smart" media and evaluate its effectiveness in increasing the learning motivation of students with autism spectrum disorders. In order to accomplish this objective, this form of investigation was created. Consequently, the R&D model was utilized in this investigation. Potential problems, data collection, product design, design validation, product design revision, and trial use were the phases of the development model. Twenty autistic third-graders from SD Muhammadiyah 01 Tanjung Enim made up the sample for this investigation. This study's sample consisted of one pupil. The sampling method utilized was non-probability sampling. Observation, assessments, interviews, and questionnaires were employed as methods for data collection. This development research employs descriptive analysis, learning content analysis, and test results analysis. This study's primary data came from questionnaires, assessments, and interviews with field informants, so they conveyed pertinent information. These data were collected from students and their teachers. This study's secondary data were books, journals, and mass media about learning media. The average score for the "I Am Smart" media validation assessment by media experts was 90% (very valid). In comparison, the average score for the validation assessment by material experts was 80% (valid), and the average score for the validation assessment by field test experts was 87% (very valid). Based on these results, it can be concluded that the "I Am Smart" learning media is valid for students with autism. Before receiving "I Am Smart" learning media on the first to third trials, the subject received a score of 30; however, after receiving "I Am Smart" learning media, the subject demonstrated that "I Am Smart" learning media could help the subject increase in value by achieving the highest score of 75. According to the initial and final trial results, "I Am Smart" learning media effectively encourages or motivates students with autism spectrum disorders to engage in learning activities, making it appropriate for students with autism spectrum disorders.

Background: The high incidence of hypertension among older adults requires the efforts of healthcare workers to prevent complications that can worsen the condition. Hypertension can also lead to anxiety and depression due to a combination of factors, such as a physiological decline in physical condition. One of the non-pharmacological therapies considered for reducing blood pressure, anxiety, and depression is slow stroke back massage (SSBM). Objectives: The study aimed to examine the effectiveness of SSBM in reducing blood pressure, anxiety, and depression among older adults with hypertension. Methods: This study utilized a quasi-experimental pretest-posttest control group design. The research was conducted in March 2023 with 50 respondents aged 60-74. Aneroid Sphygmomanometer, Geriatric Depression Scale (GDS), and Geriatric Anxiety Scale (GAS) were used for data collection. Mann-Whitney and Wilcoxon tests were used to analyze data. Results: The SSBM therapy in the experimental group was effective compared to the standard therapy in the control group in reducing blood pressure, anxiety, and depression. Conclusion: SSBM therapy is an effective complementary therapy for reducing blood pressure, anxiety, and depression in older adults. Therefore, it can be utilized as a preventive measure against complications that may arise in the older adult population.

El auge de los bancos de datos internacionales en la economía digital exige una investigación sobre cómo contextos enormemente diferentes se hacen comparables. El método de formular las mismas preguntas o, según la terminología del siglo XXI, de utilizar el mismo conjunto de indicadores combinados con la información sobre variables del sistema, es clave para entender el despliegue de la comparación. El artículo examina la investigación sobre indicadores durante tres periodos de tiempo centrándose en sus actores influyentes: el Esquisse d’un ouvrage sur l’Éducation Comparée de Jullien de Paris (1817); las “encuestas” de Paul Monroe en Filipinas (1912-1914) y el trabajo de Isaac Kandel en torno a la comparabilidad y la Teoría de la Civilización; la colaboración del Instituto de Estadística de la UNESCO con otras partes interesadas en el desarrollo de indicadores educativos para los Objetivos de Desarrollo Sostenible 2030 (2015-2016). Estos tres periodos reflejan los cambios en el uso de los indicadores educativos: modernización / construcción nacional, colonización / desarrollo y estandarización / globalización. Jullien de Paris propuso preguntas estandarizadas para comparar características claves de los sistemas educativos, dio forma al método comparativo de investigación transnacional y contribuyó a justificar la necesidad de la comparación para extraer lecciones, tomar prestadas políticas o aprender de las “buenas prácticas” y las normas internacionales. Este enfoque mantiene su pertinencia en el contexto actual, marcado por el auge de los regímenes de cuantificación que promueven el uso de evidencia derivada de la investigación para la política y la planificación.

This study aims to determine how big the relationship between the signs in the library and the speed of information retrieval at the Malang State University Library. This type of quantitative research with correlation analysis method. The population of all students of the 2019 State University of Malang with a sample of 100 students who use library services. The results of the study indicate that there is a moderate relationship between existing signs and information retrieval at the Malang State University Library as seen from the correlation coefficient value of 0.583 with a significance level of 0.000 which means that the application of signs in the Malang State University Library has a relationship with the speed in the retrieval of information that is used as a guide in searching for information.

Background and Aims: Extracytoplasmic oocyte abnormalities such as Large Perivitelline Space (LPVS) and Fragmented Polar Body (FrPB) are frequently detected in human oocytes during IVF procedures. The purpose of this research is to determine the relationship of LPVS, FrPB, and their combination on embryo quality and pregnancy loss. Method: The 36 positive pregnancy cases from under 40 years old patients that underwent ICSI using normospermia at RS Pondok Indah IVF Centre were observed. Patients were stimulated with r-FSH utilizing an antagonist protocol for 10-11 days, then r-HCG was administered as a trigger 36 hours before retrieval. Oocytes were classified as follows: (a) normal, (b) large perivitelline space (LPVS), (c) polar body fragmentation (FrPB), and (d) a combination of LPVS and FrPB. The Shapiro-Wilk and Kruskal-Wallis tests were used to determine the effect between each of the categories of oocyte with D3 and D5 embryo quality, along with pregnancy loss. Results: The results indicate that there was no significant distinction among the groups in terms of embryo quality on D3 and D5, as well as pregnancy loss (p=0.187, 0.881, and 0.561, respectively). Conclusion: It could have been concluded that LPVS, FrPB, and their combination have no impact on embryo quality and pregnancy loss.

Introduction: Concentration is a way of focusing the mind on something by putting aside other things that are not related. Students who concentrate on learning can be seen from some of their behavior during the teaching and learning process. Methods: This study uses a quantitative descriptive method using a quasi-experimental research design. Sampling in this study used a time series design, by comparing the post-test and pre-test scores with the number of respondents 30 school-age children who were in the Sindang Panon residence. Results: The results in the pre-test and post-test control groups obtained an average value of 102.07 with a standard deviation (pre-test) of 10.215 and (post-test) of 9.903. In the experimental group, the pre-test got an average value of 67.47 with a standard deviation of 9.862, the post-test got a value of 97.73 with a standard deviation of 13,541. In this study, a p value of 0.000 was obtained which can be concluded that there is an influence between learning concentration before and after being given murotal Qur'an therapy. Conclusions: In this study, it was explained that the administration of murotal Al-Qur'an therapy had an effect which was found in the experimental group of students who did not have a low level of concentration, as well as in the control group most of the students had a high level of concentration currently.

Acne vulgaris (AV) is an inflammatory disease that caused by excessive activity in sebaceous glands and aggravated by Propionibacterium acnes infection. Synthetic antibiotics such as clindamycin are often used in the treatment of acne vulgaris, but its use can cause irritation, resistance, organ damage, and immunohipersensitivity. This study was performed to determine the antibacterial concentration of Lerek leaf ethanolic extract to P. acnes as involved in acne inflammation and pathogenesis. The phytochemical screening of the ethanolic extract of lerek leaf was performed using standard procedures. The extracts were tested for determining minimum inhibitory concentration value (MIC) using macrodilution method. Evaluation of its antibacterial effect to P. acnes growth inhibition was conducted using a plate count method with varying extract concentrations as follows: 4, 8, 16, and 32% w/v. The phytochemical analysis of the lerek leaf extract revealed the presence of flavonoids, tannin, alkaloid, terpenoid, saponin, and polyphenolic compounds. The MIC concentration of testing extracts against P. acnes ranged from 32% w/v to 16% w/v. The results showed that the extract at 32% w/v was obtained P. acnes survival of 1.71%. It can be concluded that the lerek leaf ethanolic extract is a potential antibacterial to P. acnes.

Abstract Background Sarcopenia is a progressive age-related skeletal muscle disorder associated with harmful impacts on health. The present study aimed to investigate the relation between sarcopenia, platelet (PLT), white blood cell (WBC), and PLT to WBC ratio (PWR) due to the importance of early sarcopenia diagnosis. Methods This cross-sectional study was conducted based on the second stage of the Bushehr Elderly Health (BEH) Program. Sarcopenia was defined based on the revised edition of the European Working Group on Sarcopenia in Older People (EWGSOP2) in accordance with the Iranian cut-off point. Univariate and adjusted multivariate logistic regression and linear regression were used to evaluate the associations. Results The prevalence of sarcopenia among participants was 35.73%. PLT count and PWR were statistically higher in severe sarcopenic participants, while no differences were seen in WBC. In crude analysis, sarcopenia was not associated with quartiles of PLT, WBC, and PWR, while after adjusting for age, marital status, and sex, the association was seen in the fourth quartile of PLT and PWR [OR (95%CI) = 1.40 (1.08 to 1.81), p-value = 0.009 for PLT; OR (95%CI) =1.55 (1.20 to 2.00), p-value =0.001 for PWR]. This association remained significant in the fully adjusted model [OR (95%CI) =1.82 (1.20 to 2.78), p-value =0.005 for PLT; OR (95%CI) =1.57 (1.03 to 2.40), p-value =0.035 for PWR]. Among sarcopenia parameters, PLT count was more likely to be associated with handgrip strength and muscle mass. After stratifying the participants by gender, sarcopenia parameters were no longer statistically significant in men. Conclusion This study showed that PLT and PWR were associated with sarcopenia after considering confounding factors, while this association was not seen in WBC. Moreover, results showed that gender had an important impact on sarcopenia parameters.