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Abstract Background Malnutrition and sarcopenia significantly increase the risk of intra-hospital delirium, particularly among older adults. Given the potential correlation between calf circumference (CC) and these conditions, CC emerges as a promising predisposing factor for delirium. This study aims to investigate the independent association between delirium and anthropometric parameters, focusing on evaluating CC’s predictive capacity for intra-hospital delirium risk. Additionally, it aims to compare CC’s predictive performance with the widely used Mini Nutritional Assessment (MNA), while also considering potential gender disparities. Methods This is a retrospective study which enrolled patients aged ≥ 65 years from September 2021 to March 2022 at the Padova Hospital (Italy). Physical characteristics, intra-hospital delirium incidence, and body composition were assessed. Sarcopenia was diagnosed using the 2019 European Consensus criteria. Results Among 207 subjects, delirium affected 19% of patients. CC showed a significant association with intra-hospital delirium among the analyzed anthropometric parameters. ROC curves indicated that CC’s predictive capacity for delirium onset was comparable to MNA (p = 0.98), particularly in women. In a multivariable logistic regression model, female gender and higher cognitive and CC scores emerged as protective factors against delirium onset, with each unit increase in CC associated with a 24% reduction in the odds of delirium. Conversely, sarcopenia did not significantly influence delirium onset. Conclusions CC shows promise as a predisposing factor for intra-hospital delirium, similar to MNA, albeit with significant gender differences. CC could serve as a valuable tool for assessing delirium risk among female patients. Further validation of these findings is necessary through larger-scale studies.

Objective: Although researchers in higher education have focused more attention on transgender individuals, gaps remain, particularly related to aspects of health and wellness. Participants: Participants were a nationally representative sample of college students. Methods: Anova and follow up post hoc tests were utilized to examine measures of transgender college students' mental health in comparison to their cisgender peers who identify as heterosexual, lesbian, gay, and bisexual. Results: Findings indicate that transgender students were more likely to report physically harming themselves or attempt suicide, but responded similarly to peers on other measures. Conclusions: Individuals who work with transgender college students can benefit from this research by understanding how to support and avoid marginalizing these students.

Sense of belonging among undergraduate college students improves the likelihood of retention and graduation, along with the overall association with positive mental health and well-being. College students build a sense of belonging with their peers through various forms of involvement opportunities, including informal campus recreation activities. This qualitative study investigated the relationship between sense of belonging and participation in informal recreation activities among 18 undergraduate college students. Findings from semi-structured interviews indicate that participation in informal recreation helped participants to create, build, and maintain friendships, and improved participants' sense of belonging. Recommendations for practice include facilitating greater participant interaction among peers and faculty with similar recreational interests, utilizing existing facilities to incorporate informal activities, and increasing and centralizing various campus services.

ABSTRACT Sicyopus zosterophorus (Gobiidae) has a habitat in clear and fast-flowing rivers. This fish species is found in several rivers in Banggai Regency, Central Sulawesi, one of which is the Bohi River. Studies on the type of food S. zosterophorus in the Bohi River have never been carried out. Therefore, it is necessary to conduct research that aims to determine the type of food S. zosterophorus in nature as important information for life history and feeding in controlled habitats. This research was carried out from December 2019 to January 2020. The fishing was done using a scoop net by snorkeling to get fish at the bottom of the river. The fish obtained were then preserved using 5% formalin and then taken to the laboratory for identification of digestive tract contents. Data on the composition and percentage of types of food in the digestive tract were processed using Microsoft Excel 2010 and analyzed descriptively. The results showed that the contents of the digestive tract of S. zosterophorus were dominated by insects (74%), crustaceans (7%), plants (5%), and phytoplankton (3%). The contents of the digestive tract were not identified as much as 11%. Based on this, S. zosterophorus in the Bohi River is categorized as stenophagic and is a carnivorous fish, especially insectivorous and phytobenthic eaters. This research can be used as a basis for providing natural food for S. zosterophorus in aquaculture. Keywords: Goby fish, insectivorous, phytobenthic, stenophagic

Diabetes Mellitus (DM) is a long-term medical condition characterized by increased blood glucose levels caused by abnormalities in the insulin metabolism process. Various types of antihyperglycemic drugs are available, both as single and combination therapy. Recent research shows that single or combination therapy can impact glycemic control differently, especially when looking at changes in HbA1C levels. This research is descriptive-analytical with a cross-sectional design using medical record data from Type 2 DM patients in the 2022-2023 period. Data was analyzed using SPSS. In this study, there was a significant relation between single and combination anti-hyperglycemic drug therapy. Bivariate analysis showed that both single and combination therapy were associated with a reduction in HbA1C levels, with a p-value of 0.019. There is a correlation between HbA1C levels and single and combination therapy in type 2 DM patients at the Prolanis Clinic.

Mobilitas manusia dan perubahan gaya hidup telah mendorong industri makanan cepat saji berkembang pesat di Kota Denpasar dan salah satunya adalah Richeese Factory. Tujuan penelitian untuk menjelaskan pengaruh ekuitas merek, harga, dan kualitas layanan terhadap keputusan pembelian. Penelitian dilakukan pada pelanggan Richeese Factory di Denpasar dengan jumlah sampel 150 responden dan ditentukan dengan metode purposive. Pengumpulan data dilakukan melalui penyebaran kuesioner berupa google form dan diukur dengan skala likert. Data dianalisis dengan teknik analisis regresi linier berganda. Hasil penelitian menunjukkan bahwa ekuitas merek, harga, dan kualitas layanan secara parsial dan simultan berpengaruh positif dan signifikan terhadap keputusan pembelian. Artinya, peningkatan keputusan pembelian pelanggan, dapat disebabkan oleh peningkatan ekuitas merek, harga dan kualitas layanan yang disajikan. Oleh karena itu, Richeese Factory harus mengelola dengan baik kebijakan terkait faktor-faktor tersebut untuk mempertahankan pelanggan dalam jangka panjang. Faktor-faktor tersebut adalah ekuitas merek, harga, dan kualitas layanan yang diterapkan, karena secara statistik terbukti mampu meningkatkan keputusan pembelian.

Framing through the concept of precarity, we share our arts-based research on the experiences of creating a collaborative performance-making project focused on connecting students from different education levels, to create a film-dance integrated performance to advocate for social justice issues in education. We, as instructors and researchers, embarked on an arts-based research journey creating sketches, poems, videos, and a dance performance to analyze and represent our research findings. Our performance from the performative inquiry shows our understanding of the collaboration project through the same art form we required our students to utilize: film and dance-integrated arts performance.

Identifying the onset of patient deterioration is challenging despite the potential to respond to patients earlier with better vital sign monitoring and rapid response team (RRT) activation. In this study an ECG based software as a medical device, the Analytic for Hemodynamic Instability Predictive Index (AHI-PI), was compared to the vital signs of heart rate, blood pressure, and respiratory rate, evaluating how early it indicated risk before an RRT activation. A higher proportion of the events had risk indication by AHI-PI (92.71%) than by vital signs (41.67%). AHI-PI indicated risk early, with an average of over a day before RRT events. In events whose risks were indicated by both AHI-PI and vital signs, AHI-PI demonstrated earlier recognition of deterioration compared to vital signs. A case-control study showed that situations requiring RRTs were more likely to have AHI-PI risk indication than those that did not. The study derived several insights in support of AHI-PI's efficacy as a clinical decision support system. The findings demonstrated AHI-PI's potential to serve as a reliable predictor of future RRT events. It could potentially help clinicians recognize early clinical deterioration and respond to those unnoticed by vital signs, thereby helping clinicians improve clinical outcomes.

ABSTRACTThe materials sector has grown significantly over the last few decades. One from the community worldwide has embraced using natural fibers and biopolymers in many products due to significant problems with petroleum supplies and concerns about using synthetic plastics as biomaterials. The availability of lignocellulosic fiber polymer composites worldwide, in addition to their low carbon emissions and biodegradability, has caught the enthusiasm of scientists and engineers. One of the main crops grown in Indonesia is oil palm, which has the potential to provide lignocellulosic fibers for composites. The increase in fiber increased the mechanical properties of the composite. The compatibility of OPEFB with other materials in the composite is essential to ensure specific applications. There is still a little detailed examination of the mechanical properties of OPEFB biocomposite and factors, including polymer type and fiber size, that can impact mechanical performance. However, according to various articles, OPEFB is a potential raw material for reinforcing material in composites without being continuously developed, so research innovations on OPEFB composites are needed.

Background and objectives: Anorexia of aging (AoA) is a prevalent geriatric syndrome characterized by a multifactorial decline in appetite and reduced food intake associated with the aging process. This systematic review aims to investigate the use and outcomes of cannabinoids in addressing AoA, with the goal of providing a comprehensive understanding and discussing their potential integration into daily clinical practice. Methods: A thorough search of databases (Embase Ovid, Scopus, PubMed, Cochrane Library, and Web of Science) identified 6100 studies. After eliminating duplicates and screening titles and abstracts, 25 studies underwent full appraisal. Two reviewers assessed inclusion suitability, and study methodologies were evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies and the modified Jadad Scoring Scale for randomized controlled trials. Ultimately, six studies published between 2002 and 2019, involving 869 participants, were included in the review. Results: Out of the 6 fin. l papers selected, 5 were randomized trials, and 1 was a prospective study. Megestrol acetate (800 mg/d) proved to be more effective than dronabinol 2.5 mg twice a day in increasing appetite. Nabilone (at a dosage of 0.5 mg per day) did not show superiority over placebo in alleviating symptoms such as pain, nausea, loss of appetite, and weight. However, with a double dosage followed by 1.0 mg/6 weeks, after eight weeks of treatment, patients recorded a significant increase in calorie intake and carbohydrate consumption compared to the placebo group, with some patients also experiencing substantial weight gain. Regarding delta-9-tetrahydrocannabinol (THC), a weight increase of ≥10% was observed in 17.6% of patients with doses of 5 mg or 10 mg capsules daily, without significant side effects. Additionally, patients treated with THC 2.5 mg reported improved chemosensory perception and increased appetite before meals compared to placebo. No significant side effects were reported in older adults taking cannabinoids. Conclusions: Cannabinoids offer promise in enhancing the quality of life for older individuals with active neoplastic disease. However, to establish comprehensive guidelines, further research with larger sample sizes is essential. Only through this approach can we fully grasp the potential and application of cannabinoids in addressing the nutritional concerns associated with neoplastic diseases.

The development of transforming Belulang grass (Eleusine indica) fiber into high-value-added products has not been explored. Microcrystalline cellulose (MCC) is a promising natural material that has been widely used in several sectors. This study is focused on the MCC isolation from Belulang grass fibers using alkalization, bleaching, and acid hydrolysis. The effects of these treatments on the chemical composition, surface morphology, crystallinity, and thermal stability of the fibers were evaluated using various techniques. Fourier-transform infrared (FTIR) analysis confirmed the removal of lignin and hemicellulose content through treatments like alkalization and acid hydrolysis. Scanning electron microscopy (SEM) revealed a transformation in the fiber surface from a bundled structure to individual rods with average lengths of 15.64 μm after acid hydrolysis. Acid hydrolysis significantly increased the cellulose content by 119.2 %, while simultaneously reducing hemicellulose and lignin contents by 72.6 % and 84.1 %, respectively. X-ray diffraction (XRD) analysis demonstrated a remarkable increase in crystallinity index from 51.87 % to 75.76 % following hydrolysis. Moreover, thermogravimetric analysis (TGA) confirmed the enhanced thermal stability of MCC, with a decomposition temperature reaching up to 366.53 °C. These findings suggest that MCC derived from Belulang grass has the potential to be a sustainable alternative to synthetic materials for reinforcing biocomposites.

Background/Aim: Emprit ginger (Zingiber officinale var. amarum) is an Indonesian natural plant with various bioactivities, including antidiabetic properties. Several studies have shown that bioactivities can be attributed to the presence of flavonoids and also melatonin which playing a role in carbohydrate metabolism and blood sugar levels regulation. Ginger also has an effect on the lipid profile in studies in experimental animals. Therefore, this study aimed to determine the in vivo antidiabetic activity of melatonin-rich extract of Emprit ginger using blood sugar and lipid profiles parameters. Methods: The study procedure comprised 30 male white rats of Wistar strain, which were divided into 5 groups. These included: I - K-: negative control; II - K+: injected with streptozotocin (STZ) - nicotinamide (NA); III - P1: given STZ-NA + 100 mg/kg body weight (BW)/day ginger extract; IV - P2: given STZ-NA + 200 mg/kg BW/day ginger extract; and V - P3: injected with STZ-NA + metformin 300 mg/kg BW/day. In addition, the treatment was carried out for a total of 21 days, followed by the measurement of random blood sugar (RBS) levels and lipid profiles. Results: The highest pre-treatment RBS, triglyceride, cholesterol, HDL and LDL levels were 426.8 ± 55.8 mg/dL (P2), 142 ± 39.8 mg/dL (P2), 130.8 ± 21.7 mg/dL (K+), 53.4 ± 4.92 mg/dL (P1) and 61.67 ± 17.69 mg/ dL (K+), respectively. The results showed that the largest decrease in RBS was obtained in P3 by 262.8 ± 70.6 mg/dL, while P2 experienced the highest decrease in triglyceride levels by 83.66 ± 52.04 mg/dL. In addition, the largest decrease in cholesterol was in P3 by 50.2 ± 26.30 mg/dL, with P1 possessing the highest reduction in HDL by 15.4 ± 15.88 mg/dL. In terms of LDL, the largest decrease was obtained in P3, 20.44 ± 16.68 mg/dL. Based on the results, changes in biochemical parameters levels between all groups showed significant differences except for HDL. Conclusion: STZ-NA injection caused an increase in RBS and cholesterol in rats. Administration of melatonin-rich ginger extract led to a decrease in RBS, cholesterol and LDL and was more effective in the group given metformin. Melatonin-rich ginger extract at a dose of 200 mg/kg BW/day was more effective in reducing triglycerides compared to other clinical parameters.

Pada era pandemi Covid-19 terjadi peningkatan perilaku sedentari akibat dari pembatasan aktivitas di luar rumah misal dengan melakukan isolasi mandiri. Kondisi ini terjadi pada semua orang tidak terkecuali pada remaja. Salah satu dampak dari perilaku sedentari adalah penurunan prestasi belajar. Pada tahun 2020, prevalensi remaja Indonesia dengan perilaku sedentari tinggi tercatat sebesar 24,5%. Penelitian bertujuan untuk menganalisis hubungan perilaku sedentari dengan prestasi belajar pada remaja. Penelitian ini menggunakan desain potong lintang dengan subjek 180 responden remaja di salah satu SMA negeri di Jakarta. Teknik pengumpulan data perilaku sedentari menggunakan kuesioner dan prestasi belajar dinilai melalui rapor ujian tengah semester pada bulan Mei-Juni 2022. Data yang diperoleh dianalisis menggunakan uji Chi square. Hasil pada penelitian menunjukan bahwa prevalensi perilaku sedentari tinggi sebesar 98,3% dan tidak terdapat hubungan antara perilaku sedentari dengan prestasi belajar (p=0.243). Hal ini menunjukan bahwa perilaku sedentari tidak berpengaruh terhadap prestasi belajar pada remaja di salah satu SMA negeri di Jakarta.

Abstract Background Prostein (P501S), also termed solute carrier family 45 member 3 (SLC45A3) is an androgen regulated protein which is preferentially expressed in prostate epithelial cells. Because of its frequent expression in prostate cancer, prostein was suggested a diagnostic prostate cancer marker. Methods In order to comprehensively assess the diagnostic utility of prostein immunohistochemistry, a tissue microarray containing 19,202 samples from 152 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. Results Prostein immunostaining was typically cytoplasmic, granular and perinuclear. Prostein positivity was seen in 96.7% of 419 prostate cancers including 78.3% with strong staining. In 16,709 extra-prostatic tumors, prostein positivity was observed in 7.2% of all cases but only 0.3% had a strong staining. Overall, 50 different extra-prostatic tumor categories were prostein positive, 12 of which included at least one strongly positive case. Extra-prostatic tumors with highest rates of prostein positivity included different subtypes of salivary gland tumors (7.6-44.4%), neuroendocrine neoplasms (15.8-44.4%), adenocarcinomas of the gastrointestinal tract (7.3-14.8%), biliopancreatic adenocarcinomas (3.6-38.7%), hepatocellular carcinomas (8.1%), and adenocarcinomas of other organs (up to 21%). Conclusions Our data provide a comprehensive overview on prostein expression in human cancers. Prostein is a highly sensitive prostate cancer marker occurring in > 96% of prostate cancers. Because prostein can also be expressed in various other tumor entities, classifying of a tumor mass as a prostate cancer should not be based on prostein positivity alone.

Insurance is a contract made by an insurance company with a policy holder. One way to assess the stability of company is its financial performance. The aim of this study is to predict the financial performance of sharia insurance company using two factors, namely ROA (Return on Assets) and ROE (Return on Equity). The secondary data used in this research is derived from the quarterly financial reports of an Islamic insurance company from the year 2013 to 2022. The study used ARIMA (Autoregressive Integrated Moving Average), Exponential Smoothing (ETS), and Hybrid methods. The results showed that the ARIMA model is the best way to better predict both ROA and ROE. Compared to other methods that have been evaluated, the ARIMA model showed more accurate results in predicting financial performance measured through ROAs and ROEs. Predictions show that the ROA value is relatively stable, indicating that the company is efficient in managing resouces while the ROE value tends to fail, which indicates that the identified company is less good at delivering returns to shareholders. Therefore, it can be one of considerations for people who wants to buy insurance or invest

Efforts to increase rice production to maintain food security, especially rice, continue to be improved, among others by planting superior varieties of rice that can increase IP 100 to IP 200. Efforts to increase production are also carried out by utilizing the optimization of tidal swamps that are widely available in South Kalimantan, especially in Batola Regency which is known as one of the rice granaries in South Kalimantan. In Batola Regency, tidal swamp land has long been used for rice farming, but the varieties planted are local varieties that produce only once a year. With the implementation of the production increase program using superior rice varieties, it is also expected to have an impact on increasing income which in turn can improve the welfare of farmer households, especially farmers in the tidal swampland area of Batola Regency. This study aims to: 1) to analyze the cost, revenue and income of rice farmers who grow superior varieties and local variances; 2) analyzing the welfare of farmer households that grow superior and local rice varieties in tidal swamplands of Batola Regency. The research site in the Batola Regency area was selected for each village in the sub-district whose farmers grow superior varieties of rice and local varieties. Each village was randomly taken by 20 respondents so that the total respondents were 40 people. This classification of prosperous families uses indicators compiled by Euis Sunarti from the Faculty of Human Ecology IPB and commonly used by BKKBN, namely as many as 21 indicators who will be divided into prosperous family groups (KS) I, KS II, KS III and KS III Plus. The results showed that the income of local varieties rice farmers of IDR 21,187,355 was greater than the income of superior varieties rice farmers of IDR 17,039,743. Furthermore, in terms of welfare measured in terms of meeting physical needs, social needs, psychological needs and development needs, it seems that there is not much difference between farmers who farm rice with local varietals and superior varietals, which are both more in the Prosperous Family II stage, although for farmers who plant superior varietals the percentage is higher and some are even in the Prosperous Family III stage. It can be said that by carrying out better farming will be able to achieve a better business that can finally feel a more prosperous life or better living.

The agricultural sector plays a pivotal role in life as a provider of sustenance, contributing to the national economy, particularly in enhancing competitiveness, workforce absorption, and poverty alleviation. Through agriculture, there is potential to stimulate downstream agro-industrial growth, boost agricultural commodity exports for increased foreign exchange, and realize food sovereignty. The research aims to discern the resilience of farmers in the Village of Sungai Rangas in confronting flood disasters. The data employed consists of both primary and secondary sources. Primary data is acquired through interviews using prepared questionnaires, while secondary data is obtained from relevant institutions. A mixed-methods approach is employed for data analysis. Qualitative analysis is utilized to provide a profound description of resilience, while quantitative methods are employed to calculate gains based on the possessed social capital. The study reveals that human capital comprises factors such as age, educational level, and experience. Physical capital encompasses land ownership and boat possession. Natural capital involves the utilization of forest resources by extracting wood for sale. Financial capital includes investments in forms such as gold, which can be resold. Social capital comprises the social networks possessed. Livelihood structure comprises agricultural activities broadly categorized as On Farm (42%), Non-Farm (32%), and Off Farm (27%). The resilience constructed emphasizes the effective maximization of all available social capital.

The literature on COVID-19 continues to increase daily. Cognitive sequelae associated with COVID-19 infection still draw the attention of the scientific community given the lack of consensus about their existence, etiology, characterization and reversibility. The aim of this study is to provide a neuropsychological identikit for younger (

Cronobacter sakazakii can cause severe illnesses in infants, predominantly in preterm newborns, with consumption of contaminated powdered infant formula (PIF) being the major vehicle of infection. Using a dynamic human gastrointestinal simulator called the SHIME, this study examined the effects of gastric acidity and gastric digestion time of newborns on the survival and expression of stress genes of C. sakazakii. Individual strains, inoculated at 7 log CFU/mL into reconstituted PIF, were exposed to gastric pH values of 4.00, 5.00 and 6.00 for 4 h with gradual acidification. The survival results showed that C. sakazakii grew in the stomach portion of the SHIME during a 4-h exposure to pH 4.00, 5.00 and 6.00 by 0.96–1.05, 1.02–1.28 and 1.11–1.73 log CFU/mL, respectively. The expression of two stress genes, rpoS and grxB, throughout gastric digestion was evaluated using reverse transcription qPCR. The upregulation of rpoS and grxB during the 4-h exposure to simulated gastric fluid at pH 4.00 showed that C. sakazakii strains may be experiencing the most stress in the pH 4.00 treatment. The gene expression results also suggest that C. sakazakii strains appeared to develop an acid adaptation response during the 4-h exposure that may facilitate their survival. Altogether, this study highlights that a combination of low gastric acidity, long digestion time in the presence of reconstituted PIF, created a favorable environment for the adaptation and survival of C. sakazakii in the simulation of a newborn’s stomach. This study gives directions for future research to further advance our understanding of the behavior of C. sakazakii in the GI tract of newborns.

Abstract Objective The Mental and Substance Use Disorders Prevalence Study (MDPS) builds upon previous epidemiologic studies to provide estimates of prevalence and treatment rates of mental and substance use disorders among adults aged 18–65 in the U.S. The study background and methods are described. Method The MDPS employed novel techniques such as the inclusion of household, prison, homeless and state psychiatric hospital populations, a semi‐structured clinical interview administered by trained clinical interviewers to assess disorders, the assessment of both past year and lifetime schizophrenia spectrum disorder (SSD) using full Diagnostic and Statistical Manual 5 criteria, as well as other mental and substance use disorders, and video‐based interviewing. Population specific and combined sample weights were developed to estimate nationally representative prevalence and treatment rates. Results Data collection was conducted between October 2020 and October 2022 resulting in 5679 clinical interviews. The statistical weighting and analytic plan are described. Weighted response rates and reasons for non‐response are provided for each study population. Conclusions The MDPS successfully developed and employed novel techniques to estimate the prevalence and treatment rates of mental and substance use disorders in both household and non‐household populations, including some of the most impairing disorders such as SSD.

Background: Coronavirus Disease-2019 (COVID-19), driven by the SARS-CoV-2 virus, has disproportionately affected the elderly, with comorbidities like sarcopenia worsening prognosis. Considering the significant impact of RNA vaccines on survival rates in this population, our objective is to investigate the impact of vaccination on the survival of hospitalized elderly patients with COVID-19, considering the presence or absence of sarcopenia. Methods: Prospective study conducted on 159 patients aged>65 years from September 2021 to March 2022. Data about clinical and body composition, and mortality at 12-months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria. Results: At the twelfth month post-discharge, vaccinated sarcopenic individuals exhibited a mortality risk similar to vaccinated non-sarcopenic individuals, and lower than unvaccinated non-sarcopenic patients. Cox regression analysis, adjusted for age, gender, comorbidity, functional and vaccinal status, showed that the presence of sarcopenia did not significantly impact the risk of death within 12-months post-discharge. Discussion: Vaccination emerges as a protective measure for sarcopenic patients, countering the potential adverse effects of sarcopenia on COVID-19 outcomes, underscoring the importance of immunization in the frail elderly with a call for meticulous monitoring of its benefits. Conclusions: Our study represents the first attempt to analyze the vaccine's effect on survival in sarcopenic hospitalized older adults with COVID-19. The administration of vaccination to sarcopenic patients proves pivotal, as its omission could lead to notably unfavorable outcomes within this specific population.

Background: Osteoarthritis (OA), the leading cause of disability among adults, has no cure and is associated with significant comorbidities. The premise of this randomized clinical trial is that, in a population at risk, a 48-month program of dietary weight loss and exercise will result in less incident structural knee OA compared to control. Methods/design: The Osteoarthritis Prevention Study (TOPS) is a Phase III, assessor-blinded, 48-month, parallel 2 arm, multicenter randomized clinical trial designed to reduce the incidence of structural knee OA. The study objective is to assess the effects of a dietary weight loss, exercise, and weight-loss maintenance program in preventing the development of structural knee OA in females at risk for the disease. TOPS will recruit 1230 ambulatory, community dwelling females with obesity (Body Mass Index (BMI) ​≥ ​30 ​kg/m2) and aged ≥50 years with no radiographic (Kellgren-Lawrence grade ≤1) and no magnetic resonance imaging (MRI) evidence of OA in the eligible knee, with no or infrequent knee pain. Incident structural knee OA (defined as tibiofemoral and/or patellofemoral OA on MRI) assessed at 48-months from intervention initiation using the MRI Osteoarthritis Knee Score (MOAKS) is the primary outcome. Secondary outcomes include knee pain, 6-min walk distance, health-related quality of life, knee joint loading during gait, inflammatory biomarkers, and self-efficacy. Cost effectiveness and budgetary impact analyses will determine the value and affordability of this intervention. Discussion: This study will assess the efficacy and cost effectiveness of a dietary weight loss, exercise, and weight-loss maintenance program designed to reduce incident knee OA. Trial registration: ClinicalTrials.gov Identifier: NCT05946044.

Abstract Hyperlysinemia is a rare autosomal recessive deficiency of 2‐aminoadipic semialdehyde synthase (AASS) affecting the initial step in lysine degradation. It is thought to be a benign biochemical abnormality, but reports on cases remain scarce. The description of additional cases, in particular, those identified without ascertainment bias, may help counseling of new cases in the future. It may also help to establish the risks associated with pharmacological inhibition of AASS, a potential therapeutic strategy that is under investigation for other inborn errors of lysine degradation. We describe the identification of a hyperlysinemia case identified in the Provincial Neonatal Urine Screening Program in Sherbrooke, Quebec. This case presented with a profile of cystinuria but with a very high increase in urinary lysine. A diagnosis of hyperlysinemia was confirmed through biochemical testing and the identification of biallelic variants in AASS. The p.R146W and p.T371I variants are novel and affect the folding of the lysine‐2‐oxoglutarate domain of AASS. The 11‐month‐old boy is currently doing well without any therapeutic interventions. The identification of this case through newborn urine screening further establishes that hyperlysinemia is a biochemical abnormality with limited clinical consequences and may not require any intervention.

This study aims to explore the views of pre-service chemistry teachers on the nature of science and technology. Pre-service chemistry teachers' view of nature of science and technology (VNOST) is very important to help their students later in understanding the concepts of science. This research is the initial stage in didactical design research involving 48 pre-service chemistry teachers from Sriwijaya University. The descriptive method is used to explain the results of the analysis of pre-service chemistry teachers' VNOST. Student views were assessed using the VNOST questionnaire, consisting of 8 questions and guided by the discourse of ionic liquid technology. Data collection uses a survey containing the views of pre-service chemistry teachers on VNOST and where each statement grouped according to three categories, namely "Realistic" (R), "Has Merit" (HM), and Naïve (N). The results showed that in general, students have the view of Has Merit (HM), or the belief that they chose is not entirely correct even though there are parts of statements that are still by the general view of science. The results of this student VNOST exploration are the basis for developing learning designs that are oriented to the realist answers of each question so that learning designs are produced based on aspects of the Nature of Science and Technology.

This retrospective study aimed to analyze antibiotic utilization and trends in urinary tract infection (UTI) patients without comorbidities at a Provincial Public Hospital in Indonesia. The data of 183 eligible patients who received antibiotics for UTI treatment from 2017 to 2021 were analyzed using the anatomical therapeutic chemical (ATC) classification system. Antibiotic utilization was measured in Defined Daily Dose (DDD) per 100 patient-days and Drug Utilization 90% (DU 90%) index. The study revealed fluctuating utilization, with 2018 (51.32 DDD/100 patient-days) and 2017 (37.22 DDD/100 patient-days) showing the highest and lowest antibiotic utilization, respectively. The most frequently prescribed antibiotics were ceftriaxone injection, cefixime oral, and levofloxacin injection, while ampicillin and amoxicillin oral were the least utilized. These findings provide valuable insights into antibiotic prescribing patterns for UTIs, highlighting fluctuating antibiotic utilization and the need for appropriate antibiotic stewardship strategies in primary care settings.

This study aims to investigate NK cell number and cytokines level in various degrees of severity in COVID-19 cases. A total of 63 COVID-19 patient aged >18 y were divided into mild-moderate and severe-critical groups. Patient characteristics and peripheral blood count were obtained from medical records. NK cells number, levels of IFN-?, IL-10, and IL-12 in peripheral blood were examined by means of flow cytometry. The severe-critical group had leukocytosis, neutrophilia, lymphopenia, higher Neutrophil Lymphocyte Ratio, lower NK cell number and higher level of IL-10. In severe-critical group, those aged >60 years had higher IL-10. In both groups, patients with diabetes comorbidities had a higher number of NK cells (p

Penelitian ini akan membahas mengenai upaya Irlandia dalam mengimplementasikan kebijakan Renewable Energy Directive UE untuk memenuhi target Energi Terbarukan Uni Eropa di tahun 2030. Penelitian ini menggunakan metode kualitatif, dengan menggunakan teori keamanan energi (energy security). Sumber data diperoleh dari studi terdahulu atau yang sering disebut kajian literatur atau kajian pustaka. Hasil dari penelitian ini menyebutkan bahwa Irlandia sebagai salah satu negara anggota EU telah menetapkan target bauran energi terbarukan sebesar 34,1% pada tahun 2030, sedangkan UE menetapkan target sebesar 45% pada tahun 2030. Untuk mencapai target tersebut, Irlandia melakukan kerja sama baik secara regional maupun bilateral. Irlandia juga membentuk komunitas energi yang berdistribusi dalam pemenuhan target energi terbarukan. Selain itu, adanya perusahaan pemasok energi sebagai penyedia energi terbarukan bagi masyarakat dengan harga yang terjangkau.

Stock investment is one option of investment choice with risks. Investors can reduce their risk by combining several stocks and then forming a portfolio. One method to form an optimal portfolio is by using the Constant Correlation Model (CCM) method. The CCM method focuses on the correlation between stocks and the Excess Return to Standard Deviation (ERS) value. Calculation of risk in the portfolio can use the Expected Shortfall (ES) method. ES is defined as a loss with a value exceeding VaR. ES is considered appropriate for measuring portfolio risk compared to VaR because it fulfils the subadditivity property. The subadditivity shows the advantage of portfolio formation. The object of this research is to form an optimal portfolio using the CCM method and ES risk measure on the Indonesian Stock Market Indices, that is IDX30 index. The daily return of IDX30 Index is analysed for the period January 2021 - December 2022. The formed portfolio contains 3 stocks, namely BMRI with a weight of 46.263%, KLBF of 39.255%, and MDKA of 14.482%. The Expected Shortfall value at a trust level of 95% is 5.408% for the next week.

This study aims to analyze the personality ethics of teachers in the perspective of Islamic education philosophy. This type of research uses a qualitative approach with a literature study method. Data sources are quoted from credible pages such as Google Scholar and SINTA. Then the data were analyzed and checked for validity through data triangulation. The results of this study concluded that as an educator, it is very necessary to understand the personality that becomes his character. The personality of the educator will become the competence of an educator in building and educating the personality of students through exemplary and authority that emanates from the character and personality of the educator. Thus, educators are not only responsible for educating cognitive and psychomotor competence, but educators are also responsible for shaping the affective of students through exemplary personality. Educators are a reflection and role model in behaving for students.

IntroductionPoor comprehension and medication adherence are common in older people, especially after hospitalizations, in case of changes or prescriptions of new therapeutic regimes. This randomized controlled trial aims to evaluate the effectiveness of an integrated approach in improving older individuals' adherence to medical recommendations after hospital discharge.MethodsData from an expected sample of 360 older inpatients (and their caregivers) will be collected. Medical recommendations' understanding will be tested before and after the routine explanation received by in-charge physicians. Participants will be randomized in the control (usual care) and intervention group. The intervention consists of educational training by a multidisciplinary team (occupational therapist, dietician, and physician, in consultation with a pharmacologist) at hospital discharge and, after hospital discharge, receiving a phone recall checking for therapy adherence and having the possibility to contact the study team for potential related concerns. After 7 days, medication adherence will be assessed through structured phone interviews comparing ongoing and prescribed medications and by administering the 4-item validated Morisky, Green, Levine scale and the Medication adherence report scale (MARS-5). At 30 and 90 days from discharge, data on medication adherence, falls, rehospitalizations, and vital status will be collected through phone interviews and hospital records.Trial registrationRegistration: NCT05719870 (clinicaltrial.gov). https://classic.clinicaltrials.gov/ct2/show/NCT05719870.

Colleges and universities are under increasing pressure to retain students and increase degree completion amid multiple social and economic threats to undergraduate student enrollment. A sense of belonging, motivation, and confidence are foundational to student success and essential components of strategic approaches to enrollment challenges. Microaffirmations, brief acts communicating care, listening, and support, can be a powerful tool within these efforts for promoting belonging. This study examined how 350 undergraduate students experienced microaffirmations and the meaning of the microaffirmations to their educational lives. Findings indicate that students identify multiple forms of microaffirmations and that these promote positive benefits, including perceived improvement in academic performance, persistence to remain in college, and assistance in navigating challenges. In short, microaffirmations provide students with the confidence to continue by influencing their perspectives on self-efficacy and support.

AbstractIndonesia’s hate speech provision under Article 28(2) of the Electronic Information and Transaction Law lacks an objective threshold. This article presents a case study of twenty-seven judicial decisions to investigate whether such lack had consequently limited or instead broadened the judiciary’s discretion in determining hate speech. The results of the study show that the construction of Article 28(2) has led to a broad determination of hate speech, as it reveals an inconsistency in considering the harm of hate speech. This paper discusses where the inconsistencies are found and why they are problematic when assessing harm. Furthermore, in light of the case studies, the paper took into perspective the recent development of the Criminal Code to suggest the way forward for Indonesia’s law on hate speech.

This study aims to analyze the mathematical literacy ability of SMK students in solving the minimum competency assessment (AKM) problem in the opportunity material in terms of mathematical cognitive ability. The subjects in this study were students of class XI MM 2 SMKN 1 Wonoasri with high, medium and low mathematical cognitive abilities of 1 subject each. This type of research is qualitative research. Data collection techniques based on the results of cognitive tests, AKM and interviews. Data validity techniques with engineering triangulation. Data analysis is carried out by reducing, presenting and verifying data and drawing conclusions. The conclusion of the study is that the cognitive subjects of high mathematics at level 1 write down information in detail, level 2 uses coding and solves problems by dividing them, level 3 solves problems by simplification and multiplication. The cognitive subject of mathematics is at level 1 writing down information briefly, level 2 uses coding and solves problems by simplification, level 3 solves problems by simplification and division. The cognitive subject of low mathematics at level 1 writes down the information briefly, level 2 problem solving performed has not been completed, level 3 problem solving is not in accordance with the command.

Background: Recognizing sport-related concussion (SRC) is challenging and relies heavily on subjective symptom reports. An objective, biological marker could improve recognition and understanding of SRC. There is emerging evidence that salivary micro-ribonucleic acids (miRNAs) may serve as biomarkers of concussion; however, it remains unclear whether concussion-related miRNAs are impacted by exercise. We sought to determine whether 40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports. Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise. Methods: This case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites. Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing. Within-subjects testing was used to identify and exclude miRNAs that changed with either (a) a single episode of exercise (166 samples from 83 individuals) or (b) season-long participation in contact sports (212 samples from 106 individuals). The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression (172 samples from 75 concussed and 97 non-concussed individuals). Results: Two miRNAs (miR-532-5p and miR-182-5p) decreased (adjusted p < 0.05) after a single episode of exercise, and 1 miRNA (miR-4510) increased only after contact sports participation. Twenty-three miRNAs changed at the end of a contact sports season. Two of these miRNAs (miR-26b-3p and miR-29c-3p) were associated (R > 0.50; adjusted p < 0.05) with the number of head impacts sustained in a single football practice. Among the 15 miRNAs not confounded by exercise or season-long contact sports participation, 11 demonstrated a significant difference (adjusted p < 0.05) between concussed and non-concussed participants, and 6 displayed moderate ability (area under curve > 0.70) to identify concussion. A single ratio (miR-27a-5p/miR-30a-3p) displayed the highest accuracy (AUC = 0.810, sensitivity = 82.4%, specificity = 73.3%) for differentiating concussed and non-concussed participants. Accuracy did not differ between participants with SRC and non-SRC (z = 0.5, p = 0.60). Conclusion: Salivary miRNA levels may accurately identify SRC when not confounded by exercise. Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive, sideline adjunct for SRC assessment.

Penelitian ini bertujuan untuk mengetahui efektivitas pemberian salep ekstrak etanol daun kelor 20% (EEDK 20%) pada penyembuhan luka berdasarkan gambaran histopatologi yang meliputi jumlah leukosit pada jaringan luka dan ketebalan epitel. Enam belas ekor tikus Sprague-Dawley betina, umur 3-4 bulan dengan berat 150-200 g, dibagi menjadi 4 kelompok perlakuan (A,B,C dan D) secara acak. Seluruh tikus diovariektomi dan diberi perlakuan pakan selama 8 minggu. Kelompok A dan C diberi pakan normal, sedangkan kelompok B dan D diberi pakan tinggi lemak. Setelah 8 minggu, dilakukan pengambilan darah untuk analisis kadar lemak (kolesterol dan trigliserida) dan pembuatan luka di area punggung dengan biopsy punch (8 mm). Perawatan dilakukan dengan pemberian salep selama 7 hari dan injeksi antibiotik. Kelompok A dan B diberi salep basis, sedangkan C dan D diberi salep EEDK 20%. Hari ke-7 dilakukan pengambilan jaringan kulit untuk analisis histopatologi dengan pengecatan Hematoksilin Eosin. Kadar lemak darah (kolesterol dan trigliserida) dianalisis secara statistik dengan one way ANOVA, sedangkan jumlah leukosit di jaringan dan ketebalan epitel dianalisis dengan two way ANOVA. Hasil penelitian menunjukkan bahwa jumlah leukosit di jaringan dipengaruhi oleh jenis salep (P