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Background: Sleep disorders are a common medical problem and can affect health and quality of life. There are multiple types of sleep disorders such as obstructive sleep apnea, insomnia, narcolepsy, restless legs/periodic limb movement disorder, circadian rhythm disorders, sleepwalking and nightmares. Medical students appear to be more liable to develop sleep disorders due to their high academic load. Design and Methods: This study seeks to estimate the prevalence of sleep disorders among Umm Al-Qura University medical students and associated risk factors. This cross-sectional study was conducted at the Faculty of Medicine of Umm Al-Qura University in Makkah, Saudi Arabia. A self administrated questionnaire was used to collect the data including socio-demographic data and sleep-50 questionnaire. Four hundred and thirty-eight (438) medical students from the second year to the sixth year were recruited to the study. Results: Three hundred and twenty-three participants (73.8%) complained of at least one sleep disorder. The most prevalent sleep disorder among students was narcolepsy at 226 (51.6%). Female students, second year students and students spending significant time watching television or on smartphones were more affected than others with p values of 0.001, 0.005, and 0.004, respectively. Conclusions: Sleep disorders are common among medical students. It is essential to detect and address them before their condition deteriorates.

Indonesia’s 2014 health reforms advocated for universal health coverage for all Indonesians. The reforms made provision for integrated human immunodeficiency virus (HIV) programmes, with testing available at community health centres and hospitals for pregnant women and women of childbearing age. The question remains, though, as to whether testing has been effective. This article focuses on barriers women face accessing HIV testing and presents findings from the experiences of 18 HIV-positive women. To triangulate findings, interviews were conducted with 26 health workers, 9 non-governmental organisation workers and 12 HIV stakeholders. The article examines barriers to pregnant women’s access to HIV tests, showing that barriers relate to women not having reproductive health rights. It highlights reproductive rights noted in the Respectful Maternity Care Charter, and violations to them relevant to HIV testing in pregnancy. Five reported rights violations include: women being unable to access information; being unable to make informed decisions; having no right to confidentiality and privacy; experiencing ongoing discrimination; and having no right to timely HIV testing. The failure of Indonesia to protect these rights contributes to women being denied HIV testing. Findings show the need for increased HIV testing services for pregnant women and assert that health personnel and programme policy-makers need to be held accountable for the protection and fulfilment of women’s rights in respect of HIV testing. The findings show that policy makers must make changes to ensure health services improve, health professionals must be better trained, and women’s socio-cultural and political contexts must be considered.

Introduction: Giant cell tumors (GCT) are benign lesions that are generally locally aggressive tumors with occasional malignant behavior. These tumors are most frequently encountered in long bones; however, they also occur rarely in the spine. GCT of the spine are rare pathological entities, and spinal involvement shows a sacral predilection, with only a few cases involving the supra-sacral segment (mobile spine). Only a few cases of thoracic spinal GCT are reported in the literature; these tumors are particularly uncommon in the thoracic segment. Presentation of Case: A 29-year-old man presented with a complaint of neck pain over the previous six months that radiated to his left hand. GCT of the upper thoracic spine was diagnosed, which was surgically managed using a 2-stage approach involving total resection of the tumor followed by spondylectomy and multilevel spinal fixation. Discussion: Accurate diagnosis of vertebral column lesions, and choosing an optimum management plan are crucial. In the majority of cases, En-bloc resection of GCTs is not feasible ought to the close contact of the lesion with the spinal cord. Larger studies are encouraged to ascertain the efficacy of variable management approaches, particularly compared with piecemeal resection techniques. Conclusion: Spinal GCT are a unique group of tumors with an uncommon and unexpected presentation. Although surgery is the mainstay of treatment for spinal GCT, the management of this tumor can be challenging. No clear management algorithm has been established, and the tumor displays an unpredictable course. Therefore, each case needs tailored treatment.

Introduction: Simultaneous subcutaneous emphysema, spontaneous pneumothorax, and pneumomediastinum are complications rarely observed synchronously during an acute exacerbation of bronchial asthma. Although spontaneous pneumothorax has already been reported in asthma patients in the literature, its concurrence with subcutaneous emphysema and pneumomediastinum is extremely rare except for iatrogenic conditions. Case Study: We describe a patient who presented to the emergency room with progressive dyspnea and chest pain. Three days before, she consulted her general physician with a history of violent dry cough and wheezing. An acute asthma exacerbation was diagnosed, and an inhaled short-acting beta 2 agonist and oral prednisone were prescribed. The patient developed simultaneous subcutaneous emphysema, spontaneous pneumothorax, and pneumomediastinum, a rare complication of an asthma attack. Conclusions: Our aim is to emphasize that occult pneumothoraces should be considered in a patient presenting with an acute asthma attack failing to respond to conventional medical therapy.

Integrated crop and livestock system is an alternative to increase animal and crop production simultaneously and improve land quality through efficient use of natural resources. One application of crop-livestock integration is organic agriculture. Organic agriculture provides an alternative integration of livestock and plants in realizing sustainable agriculture and zero waste. However, farmers find it is not easy to implement organic agriculture due to several barriers to the adoption of this technology both in terms of external and internal factors of farmers. The aim of this study was to investigate the barriers that occur in organic farmers in Surakarta, Central Java, Indonesia. This study selected 130 farmers as the sample for this research by using convenience sampling method. The study found that based on factor analysis the main barriers to the implementation of organic agriculture among farmers were: production, natural resources, attitude and knowledge, infrastructure, organizational and market barriers.

Fortification of foods with fish oil rich in n–3 fatty acids improves the nutritional value, but creates challenges with flavor and oxidative stability, especially during storage. Pea, soy, and sunflower proteins were used in combination with whey protein or maltodextrin to encapsulate fish oil by spray-drying. The use of whey protein compared with maltodextrin as wall material improved oxidative stability of spray-dried emulsions, although the use of whey protein increased the number of observed cracks in outer shell of the particles. Non- and encapsulated oil were used in cookies and chocolates to examine flavor characteristics by generic descriptive analysis and volatile products by solid-phase microextraction with gas chromatography-mass spectrometry. A long-term storage test at room temperature was conducted to evaluate the oxidative stability of the food models. Fortification changed the texture, odor, and flavor of the food models with fishy flavor being the most impactful attribute. For both food models, use of pea protein with maltodextrin resembled attributes of control the best. Fortification and encapsulation material also affected volatile profiles of food models. Both non-encapsulated oil and whey protein formulations performed well in regard to oxidative stability for both food models. Generally, the cookie model showed more potential for fortification than the chocolate one.

The aim of this study was to investigate the prevalence of maxillary sinus mucosal thickening and compare it to the presence of odontogenic pathology of adjacent teeth. Three hundred and twenty-one full maxilla cone-beam computed tomography scans were examined. The parameters investigated included signs of maxillary sinus mucosal thickening and the diagnosis and proximity of the adjacent teeth. Statistical analysis was conducted using IBM SPSS version-16.0 (SPSS Inc., Chicago, IL, USA). Out of the 2001 teeth examined, 888 (44.4%) were associated with mucosal thickening with a significant difference between the different tooth types (p = 0.04). Mucosal thickening in a maxillary sinus was more likely if the neighboring teeth had apical disease. Interruption of the maxillary sinus floor was noticed more in specific teeth, particularly the first and second molars (p < 0.001). Sinusitis of odontogenic origin can be more prevalent than clinicians expect. The treatment of odontogenic sinusitis should be straightforward, whereby the diseased tooth is root treated or extracted. The sinusitis will then resolve if there are no other etiological factors.

This study examined the effects of cognitive and affective-based trust on knowledge sharing among students, which influences learning performance during the COVID-19 pandemic. A survey was conducted with 730 participants, and analysis was carried out using structural equation modeling (SEM) based on the uses and gratifications (U&G) theory. The results showed that cognitive and affective trust significantly affects students' knowledge sharing behavior on Facebook, which further influences learning performance. This study also showed that social media had become a tool for social interaction and learning, which is crucial to students during the COVID-19 pandemic.

This study aimed to explore the perceptions of English Language Teaching (ELT) students regarding 21st century skills and learning environments. A qualitative content analysis method was used, which involved conducting semi-structured interviews with 62 ELT students. The findings of the study revealed that ELT students perceive critical thinking, problem-solving, collaboration, creativity, and effective communication as essential 21st century skills. They also believe that these skills can be developed through engaging and dynamic learning environments that incorporate technology, project-based learning, and real-world applications. The results of this study have important implications for ELT educators and curriculum developers, as they suggest the need to create learning environments that are engaging, dynamic, and incorporate technology, project-based learning, and real-world applications. The findings also highlight the importance of preparing ELT students for success in the 21st century by developing 21st century skills. This study provides valuable insights into ELT students' perceptions of 21st century skills and learning environments, which can inform the design of ELT curricula and the development of teaching practices.

Porcupines are unique mammals, their upper body is covered with hard hair resembling sharp cylindrical spines and belongs to the order Rodentia. It has long been used as a source of animal protein. Javan porcupine (Hystrix javanica) is an endemic animal on Java and its population is estimated to continue, due to habitat destruction, poaching, and its use without a conservation. Observations on the growth of young javan porcupines were carried out for 12 months in Small Mammal Captivity, Research Center Biology - Indonesian Institute of Sciences. This study aims to determine the growth performance of young porcupines in captivity based on number of births, namely singles, twins, and triplets. The young will be with their mother for 3 months, they will be placed in individual cages. Weighing porcupines is done once a week. The results suggest that porcupines continue grow until they are 12 months old and probably continued. The average weight gain of single born was 30.31 g/day; birth of twins 29.65 g/day, 29.72 g/day; and birth of triplets were 29.57 g/day, 28.14 g/day, and 29.79 g/day. Prediction of 12-month-old porcupine carcass production for single, twins, and triplets, respectively, was 6740.86 g; 6593.15 g; and 6470.50 g.

This research aims to analyze the influence and relationship of entrepreneurial competence to entrepreneurship orientation of beef cattle business. The research was conducted in Tasikmadu, Karanganyar, Central Java Indonesia at February-April 2021. Methods of data collection using survey method with questionnaire as primary data retrieval tool. The method of determining the respondents using census method on all farmers who attended the training with the number of respondents 42 people. Method of determining the location by purposive sampling. Data analysis used was test of validity and reliability, multiple linear regression analysis continued test of determination (R2), F test, t test and classical assumption test. Validity test results show valid results rhitung> rtabel is 0.304 and reliability value α > 0.6 on all variables. Multiple linear regression analysis obtained value of equation Y = 0.741 + 0.350X1 + 0.246X2 + 0.264X3 + 0.047X4 + 0.011X5 + 0.038X6. The value of determination coefficient (R2) is 0.608, which means that entrepreneurship competence variable can explain the entrepreneurship orientation variable equal to 60.8%. The entrepreneurial competence variable affects together toward the orientation with the value Fcount> Ftable. It can be concluded that entrepreneurial competence consisting of communication, problem solving, initiative, planning and organization, self-awareness and technology simultaneous influence to entrepreneurial orientation.

INTRODUCTION: Oral pre-exposure prophylaxis (PrEP) for HIV-1 infection is over 99% effective in protecting against HIV acquisition when used consistently and appropriately. However, PrEP uptake and persistent use remains suboptimal, with a substantial gap in utilization among key populations who could most benefit from PrEP. In Latin America specifically, there is poor understanding of barriers to PrEP uptake and persistence among transgender (trans) women. METHODS: In April-May 2018, we conducted qualitative interviews lasting 25-45 min as part of an end-of-project evaluation of TransPrEP, a pilot RCT that examined the impact of a social network-based peer support intervention on PrEP adherence among trans women in Lima, Peru. Participants in the qualitative evaluation, all adult trans women, included individuals who either (1) screened eligible to participate in the TransPrEP pilot, but opted not to enroll (n = 8), (2) enrolled, but later withdrew (n = 6), (3) were still actively enrolled at the time of interview and/or successfully completed the study (n = 16), or (4) were study staff (n = 4). Interviews were audio recorded and transcribed verbatim. Codebook development followed an immersion/crystallization approach, and coding was completed using Dedoose. RESULTS: Evaluation participants had a mean age of 28.2 years (range 19-47). When describing experiences taking PrEP, participant narratives highlighted side effects that spanned three domains: physical side effects, such as prolonged symptoms of gastrointestinal distress or somnolence; economic challenges, including lost income due to inability to work; and social concerns, including interpersonal conflicts due to HIV-related stigma. Participants described PrEP use within a broader context of social and economic marginalization, with a focus on daily survival, and how PrEP side effects negatively contributed to these stressors. Persistence was, in some cases, supported through the interventions educational workshops. CONCLUSION: This research highlights the ways that physical, economic, and social side effects of PrEP can impact acceptability and persistence among trans women in Peru, amplifying and layering onto existing stressors including economic precarity. Understanding the unique experiences of trans women taking PrEP is crucial to informing tailored interventions to improve uptake and persistence.

Congenital diarrheas and enteropathies (CODE) are a group of rare, heterogenous, monogenic disorders that lead to chronic diarrhea in infancy. Definitive treatment is rarely available, and supportive treatment is the mainstay. Nutritional management in the form of either specialized formulas, restrictive diet, or parenteral nutrition support in CODE with poor enteral tolerance is the cornerstone of CODE treatment and long-term growth. The evidence to support the use of specific diet regimens and nutritional approaches in most CODE disorders is limited due to the rarity of these diseases and the scant published clinical experience. The goal of this review was to create a comprehensive guide for nutritional management in CODE, based on the currently available literature, disease mechanism, and the PediCODE group experience. Enteral diet management in CODE can be divided into 3 distinct conceptual frameworks: nutrient elimination, nutrient supplementation, and generalized nutrient restriction. Response to nutrient elimination or supplementation can lead to resolution or significant improvement in the chronic diarrhea of CODE and resumption of normal growth. This pattern can be seen in CODE due to carbohydrate malabsorption, defects in fat absorption, and occasionally in electrolyte transport defects. In contrast, general diet restriction is mainly supportive. However, occasionally it allows parenteral nutrition weaning or reduction over time, mainly in enteroendocrine defects and rarely in epithelial trafficking and polarity defects. Further research is required to better elucidate the role of diet in the treatment of CODE and the appropriate diet management for each disease.

Rechargeable multivalent-ion batteries are attractive alternatives to Li-ion batteries to mitigate their issues with metal resources and metal anodes. However, many challenges remain before they can be practically used due to the low solid-state mobility of multivalent ions. In this study, a promising material identified by high-throughput computational screening is investigated, ε-VOPO4, as a Mg cathode. The experimental and computational evaluation of ε-VOPO4 suggests that it may provide an energy density of >200 Wh kg-1 based on the average voltage of a complete cycle, significantly more than that of well-known Chevrel compounds. Furthermore, this study finds that Mg-ion diffusion can be enhanced by co-intercalation of Li or Na, pointing at interesting correlation dynamics of slow and fast ions.

PurposeHigh blood glucose (hBG) in patients undergoing [18F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations.Materials and methodsOncologic patients with elevated blood glucose (≥ 8.0 mmol/l) and normal blood glucose ( 11 mmol/l). Tracer uptake in the liver, muscle, and tumor was evaluated. Furthermore, image quality was compared between long acquisitions (ultra-high sensitivity mode, 360 s) on a LAFOV PET/CT and routine acquisitions equivalent to a short-axial field-of-view scanner (simulated (sSAFOV), obtained with high sensitivity mode, 120 s). Tumor-to-background ratio (TBR) and contrast-to-noise ratio (CNR) were used as the main image quality criteria.ResultsThirty-one hBG patients met the inclusion criteria and were matched with 31 nBG patients. Overall, liver uptake was significantly higher in hBG patients (SUVmean, 3.07 ± 0.41 vs. 2.37 ± 0.33; p = 0.03), and brain uptake was significantly lower (SUVmax, 7.58 ± 0.74 vs. 13.38 ± 3.94; p  11 mmol/l) patients examined with LAFOV PET/CT showed no statistical significant difference in CNR (19.84 ± 8.40 vs. 17.79 ± 9.3, p = 0.08).ConclusionWhile elevated blood glucose (> 11 mmol) negatively affected TBR and CNR in our cohort, the images from a LAFOV PET-scanner had comparable CNR to PET-images acquired from nBG patients using sSAFOV PET/CT. Therefore, we argue that oncologic patients with increased blood sugar levels might be imaged safely with LAFOV PET/CT when rescheduling is not feasible.

PURPOSE: Long axial field-of-view (LAFOV) positron emission tomography (PET) systems allow to image all major organs with one bed position, which is particularly useful for acquiring whole-body dynamic data using short-lived radioisotopes like 82Rb. METHODS: We determined the absorbed dose in target organs of three subjects (29, 40, and 57 years old) using two different methods, i.e., MIRD and voxel dosimetry. The subjects were injected with 407.0 to 419.61 MBq of [82Rb]Cl and were scanned dynamically for 7 min with a LAFOV PET/CT scanner. RESULTS: Using the MIRD formalism and voxel dosimetry, the absorbed dose ranged from 1.84 to 2.78 μGy/MBq (1.57 to 3.92 μGy/MBq for voxel dosimetry) for the heart wall, 2.76 to 5.73 μGy/MBq (3.22 to 5.37 μGy/MBq for voxel dosimetry) for the kidneys, and 0.94 to 1.88 μGy/MBq (0.98 to 1.92 μGy/MBq for voxel dosimetry) for the lungs. The total body effective dose lied between 0.50 and 0.76 μSv/MBq. CONCLUSION: Our study suggests that the radiation dose associated with [82Rb]Cl PET/CT can be assessed by means of dynamic LAFOV PET and that it is lower compared to literature values.

This study aims to examine the influence of the role of immersive technology on perceived learning's effectiveness by considering the cognitive load of users when using VR-based learning media. This study involved a total of 91 respondents who had attended virtual reality-based learning training. In this research, SmartPLS was used to test the measurement and structural models. This research was conducted through virtual reality-based learning training, to measure the effect of using VR on perceived effectiveness, with cognitive load as the moderator. The research results support all the hypotheses. Ultimately, cognitive overload moderates the relationship between reflective thinking and perceived learning's effectiveness. The lower the cognitive load of the user when using VR, the greater the positive effect reflective thinking has on perceived learning's effectiveness, and vice versa. There are still many contradictions regarding the effectiveness of VR in learning, so this research fills the gap by examining the effect immersive technology has on learning outcomes, by considering the cognitive load of users when using VR-based learning media. This research has several practical implications. First, VR could be proposed as a valuable investment for educational institutions as a learning tool. Second, it is very important to develop VR that is adapted to the context and learning objectives, to optimize its effectiveness. Third, VR developers should focus on creating simplified menus that are easy to use. By reducing the cognitive overload, users will find VR more comfortable and enjoyable to use.

Social media platforms have transformed how students and educators "share" information about school experiences. In this paper, we translate Leah Plunkett's sharenting concept (a portmanteau of "share" and "parent") to address the phenomenon of "overposting" in education. Overposting (a portmanteau of "overreach" and "post") designates the digital distribution of information about others that is invasive, harmful, exploitative, or illegal. We describe instances where students or teachers post about others on social media in ways that are illegal, invasive, harmful, or exploitative. Examples of overposting range from cyberbullying to sharing photos or videos of others' without their permission, including from school accounts. We conclude by offering an educational approach to address overposting through education, conversation, and negotiation among students, teachers, and administrators.

The aim of this study was to describe the design process of an educational board game, the Planet-Dart. This board game design is based on the science curriculum and aims to enhance middle school students' basic concepts about solar system. The purpose of developing this educational game was to provide an entertaining way for learning science. A pre-service art teacher designed the game with the support of two pre-service science teachers. The pilot study was conducted with two middle school students, and with the feedback based on the pilot study the pre-service art teacher made modifications to the game. Then, the main implementation of the game was conducted in a real-classroom environment with 60 middle school students by one pre-service science teacher and two science teachers. The qualitative results revealed that this game was an enjoyable and effective learning tool to play among middle school students. In addition, the pre- and in-service science teachers emphasized that there was an entertaining learning environment during the play. Based on these findings, the developed educational board game could enhance students' learning outcomes and entertainment.