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Atrial septal defect (ASD) kompleks yang tidak didiagnosis dan dikoreksi hingga usia dewasa dapat menyebabkan hipertensi pulmonal. Manajemen perioperatif operasi penutupan defek pasien ASD dewasa dengan hipertensi pulmonal memberikan tantangan tersendiri karena dikaitkan dengan tingginya komplikasi perioperatif serta peningkatan morbiditas dan mortalitas. Kami melaporkan seorang wanita berusia 23 tahun dengan ASD dan hipertensi pulmonal yang menjalani operasi tutup defek. Pemeriksaan ekokardiografi praoperasi menunjukkan ASD sekundum right-to-left shunt dengan diameter 25–30 mm dan kateterisasi jantung kanan yang menunjukkan rerata tekanan arteri pulmonal 58 mmHg dan pulmonary vascular resistance 8,1 WU. Induksi anestesi dilakukan dengan balanced opioid, dosis kecil agen induksi, dan pelumpuh otot. Hemodinamik selama operasi stabil, dan periode penyapihan cardiopulmonary bypass berjalan lancar dengan topangan dobutamin dan norepinefrin. Pascaoperasi, pasien dirawat di Intensive Care Unit dengan keadaan umum baik, hemodinamik stabil, nyeri pascaoperasi terkontrol dan tanpa kejadian komplikasi. Penilaian praoperatif yang tepat, manajemen intraoperatif yang berhasil menjaga stabilitas hemodinamik, dan manajemen pascaoperatif yang dapat mencegah dan mengatasi komplikasi pascaoperasi dapat menghasilkan luaran yang baik pada pasien ini.

Abstract KRAS belongs to a family of small GTPases that act as binary switches upstream of several signalling cascades, controlling proliferation and survival of cells. Mutations in KRAS drive oncogenesis, especially in pancreatic, lung, and colorectal cancers (CRC). Although historic attempts at targeting mutant KRAS with small molecule inhibitors have proven challenging, there are recent successes with the G12C, and G12D mutations. However, clinically important RAS mutations such as G12V, G13D, Q61L, and A146T, remain elusive drug targets, and insights to their structural landscape is of critical importance to develop novel, and effective therapeutic concepts. We present a fully open, P-loop exposing conformer of KRAS G13D by X-ray crystallography at 1.4–2.4 Å resolution in Mg2+-free phosphate and malonate buffers. The G13D conformer has the switch-I region displaced in an upright position leaving the catalytic core fully exposed. To prove that this state is druggable, we developed a P-loop-targeting monoclonal antibody (mAb). The mAb displayed high-affinity binding to G13D and was shown using high resolution fluorescence microscopy to be spontaneously taken up by G13D-mutated HCT 116 cells (human CRC derived) by macropinocytosis. The mAb inhibited KRAS signalling in phosphoproteomic and genomic studies. Taken together, the data propose novel druggable space of G13D that is reachable in the cellular context. It is our hope that these findings will stimulate attempts to drug this fully open state G13D conformer using mAbs or other modalities.

Considering the global climate change and anticipation of water needs, this can pose significant problems. Trees play a crucial role in mitigating climate change, with the ability to assimilate carbon dioxide (CO2) and certain air pollutants, purify rainfall, and act as a barrier against soil erosion. This research focuses on the Bekasi River, which has a length of 6 km and a cross-sectional width of 65 meters. The data used is directly extracted from project data utilized for cost estimation, and data collection is conducted through interviews and questionnaires. The research methodology integrates Structural Equation Modeling-Partial Least Squares (SEM-PLS) as a data processing tool for survey and factor identification, along with Blockchain-Building Information Modeling (BIM) to assess the cost performance improvement of environmentally friendly reinforcement. Based on the test results, the utilization of BIM combined with blockchain technology can result in cost savings of 3.69% for the Improved level, 3.72% for the Enhanced level, 4.39% for the Superior level, 4.92% for the Conserving level, and 5.17% for the Restorative level in terms of cost enhancement.

Background and Study Aim. The elderly represent a growing age group and an integral part of modern society. The aging process introduces significant health challenges, making exercise an essential component in maintaining quality of life and well-being among the elderly. This study reviews the impact of physical exercise interventions on the physical and cognitive functions of the elderly population. Material and Methods. The search for this study was conducted using the ScienceDirect and PubMed databases. The search strategy employed a combination of keywords ("Elderly Physical Exercise" AND "Physical Exercise Intervention" AND "Elderly Fitness and Cognitive" AND "Physical Exercise for Physical and Cognitive Functions" AND "Physical and Cognitive Benefits" AND "Elderly Physical Exercise Prevalence"). This search adhered to the PRISMA guidelines. Initially, 1,854 publications were identified through the database searches (ScienceDirect: 981 articles; PubMed: 873 articles). After applying the exclusion criteria, only 11 articles remained. Results. It has been found that physical exercise interventions for the elderly significantly impact their physical and cognitive functions. In the first group, exercises such as home-based e-Health programs, multicomponent exercises, moderate aerobic exercises, dance training, and balance training have been identified. All these have been shown to provide substantial benefits. These programs enhanced not only physical function but also cognitive performance and the overall quality of life for older adults without physical and cognitive health complaints. This showcases the potential of physical exercise interventions to prevent morbidity and reduce disability. The second group focused on physical exercise interventions for older adults with degenerative disease complaints, such as type 2 diabetes and multiple sclerosis. Dual-task exercise programs and tai chi chuan exercises have demonstrated improvements in cognitive function for this demographic. They also improved physical fitness. The research also points out some limitations related to the implementation and budgeting for these programs. Conclusions. The literature review suggests that physical exercise interventions play a crucial role in maintaining physical and cognitive functions in older adults. Exercise programs tailored to the specific health conditions of individuals can significantly improve the quality of life and reduce the risk of declining physical and cognitive functions in the elderly population.

This study discusses the implementation of mediation in handling territorial boundary conflicts between the Mee and Danoi tribes in Nabire Regency. Territorial boundary conflicts in Nabire have become a serious concern, leading to horizontal and social conflicts. Mediation is one of the best alternatives for conflict resolution. Therefore, this study aims to analyze the dynamics of the conflict and the mediation efforts carried out by the government and other stakeholders. The research method used is descriptive qualitative, with data collection from literature, the internet, and applicable legislation. The findings of this study indicate that this conflict is a social conflict affecting regional stability. However, the role of the government as a mediator is crucial in resolving land disputes. The mediator functions as a neutral party with experience, capability, and integrity in problem-solving. It is recommended that territorial boundaries be recognized as triggers for horizontal conflicts between communities. Therefore, it is suggested that local and regional governments coordinate to form a working team to issue a Regent or Regional Regulation on Village Boundary Determination in cooperation with local village and traditional authorities.

Pendidikan yang inovatif dan berkualitas sangat dibutuhkan untuk menciptakan generasi masa depan yang kompetitif, terutama di era digital saat ini. Pelatihan desain grafis menggunakan Canva di SMPN 5 Parepare bertujuan untuk meningkatkan kreativitas guru dalam mendukung program Merdeka Belajar. Melalui pelatihan yang melibatkan 24 guru dan staf, peserta diperkenalkan pada fitur-fitur Canva, diikuti dengan demonstrasi, diskusi, dan praktek langsung. Hasil pelatihan menunjukkan peningkatan keterampilan guru dalam membuat materi ajar yang lebih menarik dan efektif. Dengan didukung oleh buku panduan, pelatihan ini berhasil mendorong penggunaan Canva secara berkelanjutan dalam proses pembelajaran, sehingga meningkatkan kualitas pengajaran di sekolah tersebut.

This research explores the complexities of cesarean section in the context of family, health, and Islamic law. The main objective is to understand the views and experiences of Muslim families regarding cesarean sections, as well as analyze the health impacts and legal implications associated with them. The research enriches understanding of the role of cesarean section in Muslim communities, provides comprehensive insight into aspects of family, health, and Islamic law, and offers a framework to support informed decision-making in medical practice and health care policy. This study uses qualitative methods in describing family perspectives, Islamic health, and legal aspects regarding cesarean sections. The research approach used is a legal and sociological approach. The analysis method used is content analysis to explore family perspectives, Islamic health, and legal aspects regarding cesarean sections. The findings reveal a range of perspectives among Muslim families regarding caesarean sections, with health and safety considerations being major factors in decision-making. The health impact of cesarean section on mother and baby, including risks and benefits, is also examined in depth. In Islamic law, caesarean section is permitted if necessary, to protect the life of the mother or baby. Ethical and clinical recommendations should reflect relevant religious values and views. To make a decision regarding a cesarean section, it is important to consider a variety of factors, including family views, aspects of health, and Islamic law.

Abstract The mitoribosome translates mitochondrial mRNAs and regulates energy conversion that is a signature of aerobic life forms. We present a 2.2 Å resolution structure of human mitoribosome together with validated mitoribosomal RNA (rRNA) modifications, including aminoacylated CP-tRNAVal. The structure shows how mitoribosomal proteins stabilise binding of mRNA and tRNA helping to align it in the decoding center, whereas the GDP-bound mS29 stabilizes intersubunit communication. Comparison between different states, with respect to tRNA position, allowed us to characterize a non-canonical L1 stalk, and molecular dynamics simulations revealed how it facilitates tRNA transitions in a way that does not require interactions with rRNA. We also report functionally important polyamines that are depleted when cells are subjected to an antibiotic treatment. The structural, biochemical, and computational data illuminate the principal functional components of the translation mechanism in mitochondria and provide a description of the structure and function of the human mitoribosome.

Abstract Age-related diseases pose great challenges to health care systems worldwide. During aging, endothelial senescence increases the risk for cardiovascular disease. Recently, it was described that Phosphatase 1 Nuclear Targeting Subunit (PNUTS) has a central role in cardiomyocyte aging and homeostasis. Here, we determine the role of PNUTS in endothelial cell aging. We confirm that PNUTS is repressed in senescent endothelial cells (ECs). Moreover, PNUTS silencing elicits several of the hallmarks of endothelial aging: senescence, reduced angiogenesis and loss of barrier function. Findings are validate in vivo using endothelial-specific inducible PNUTS-deficient mice (Cdh5-CreERT2;PNUTSfl/fl), termed PNUTSEC-KO. Two weeks after PNUTS deletion, PNUTSEC-KO mice present severe multiorgan failure and vascular leakage. Transcriptomic analysis of PNUTS-silenced HUVECs and lungs of PNUTSEC-KO mice reveal that the PNUTS-PP1 axis tightly regulates the expression of semaphorin 3B (SEMA3B). Indeed, silencing of SEMA3B completely restores barrier function after PNUTS loss-of-function. These results reveal a pivotal role for PNUTS in endothelial homeostasis through a SEMA3B downstream pathway that provides a potential target against the effects of aging in ECs.

ABSTRACT. This study aims to explore the differences between beef cattle farming systems in Java and Sumba. The research was conducted using a survey method in three districts, two districts in Central Java and one district in Sumba Island, NTT. Data analysis used a descriptive qualitative approach, with the CATWOE Analysis framework to determine the perspectives of stakeholders involved in the beef cattle farming business system. Beef cattle farming in Java has been characterized by a cut and carry system, while in Sumba with a pasture grazing system. The research shows that the main purpose of cattle rearing in Java is to generate income for the family, so more and more are running enlargement and fattening businesses. Cattle rearing in Sumba is prioritized for savings for traditional purposes. Farmers in Sumba predominantly breed cattle without additional feed to save on maintenance costs. Farmers are still faced with the problem of unfairness in pricing. The study concluded that farmers show adaptive ability in allocating their resources to obtain profits. Differences in farming paradigms need to be considered in the preparation of livestock development programs. (Studi eksploratif pada sistem pemeliharaan sapi potong: analisis komparatif pada sistem cut and carry di jawa dengan sistem penggembalaan pastura di pulau Sumba, Indonesia) ABSTRAK. Peternakan sapi potong di Jawa selama ini dicirikan dengan cut and carry sistem, sedangkan di Sumba dengan sistem penggembalaan di pastura. Penelitian ini bertujuan untuk melakukan eksplorasi lebih mendalam tentang perbedaan sistem usaha peternakan sapi potong di Jawa dengan di Sumba. Penelitian dilakukan dengan metode survey di tiga kabupaten, dua kabupaten di Jawa Tengah dan satu kabupaten di Pulau Sumba, NTT. Analisis data menggunakan pendekatan deskriptif kualitatif, dengan kerangka CATWOE Analysis untuk mengetahui perspektif dari para stakeholders yang terlibat dalam sistem usaha peternakan sapi potong. Penelitian menunjukkan bahwa tujuan utama pemeliharaan sapi di Jawa adalah untuk menghasilkan pendapatan untuk keluarga, sehingga semakin banyak yang lebih menjalankan usaha pembesaran dan penggemukan. Pemeliharaan sapi di Sumba lebih diutamakan untuk tabungan untuk keperluan adat. Peternak di Sumba didominasi pembiakan sapi tanpa tambahan pakan untuk menghemat biaya pemeliharaan. Peternak masih dihadapkan pada permasalahan ketidakadilan dalam penentuan harga. Penelitian menyimpulkan bahwa peternak menunjukkan kemampuan adaptif dalam mengalokasikan sumber daya yang dimiliki untuk memperoleh keuntungan. Perbedaan paradigma beternak perlu untuk diperhatikan dalam penyusunan program pembangunan peternakan.

During the unprecedented COVID-19 pandemic, anticoagulant drugs have emerged as a crucial component of treatment alongside antivirus medications. Patients with severe COVID-19 frequently have critical conditions marked by blood clot development, necessitating the administration of anticoagulants. This review aims to provide a comprehensive overview of various anticoagulant drugs, their synthesis methods, and assays employed to predict their anticoagulant activity. Notable anticoagulant categories frequently utilized include oral anticoagulants heparin, non-vitamin K antagonists, and vitamin K antagonists. In recent years, the development of new anticoagulants has seen a shift towards a multifaceted approach that combines in silico prediction with in vitro and in vivo assays. In silico prediction techniques play a pivotal role in the initial screening process. This integrated approach has yielded promising results, paving the way for the synthesis of novel anticoagulant candidates, as substantiated by a battery of in vitro, in vivo, and ex-vivo tests.

Blockchain technologies have recently garnered substantial attention in research and industry sectors due to their potential advantages across various industries. Blockchain provides an effective solution to address challenges by offering distributed, secure, and permissioned transactional ledgers. This paper introduces an innovative conceptual framework that integrates blockchain technology with building information modeling, specifically designed for digital transactions and smart contracts in the retrofitting of green buildings within the chemical industry. The core objectives include enhancing cost efficiency, fortifying cybersecurity measures, improving information management and sharing, simplifying payment transactions, and promoting sustainability in this specific context. The research, conducted at a chemical facility in Cilegon, Banten, Indonesia, utilizes Structural Equation Modeling-Partial Least Squares (SEM-PLS) to analyze questionnaire data and identify influential factors. Results indicate that incorporating Blockchain-BIM leads to cost savings of 4.42%, 4.45%, and 4.40% for low-level, medium-level, and high-level retrofitting categories, respectively, highlighting the significant role of Blockchain-BIM in enhancing cost efficiency throughout the retrofitting process.

Cancer remains a formidable health challenge worldwide, with complex molecular mechanisms driving its initiation, progression, and therapeutic resistance. In this study, we employed bioinformatics analyses to elucidate the molecular underpinnings of cancer biology, focusing on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Our GO analysis revealed the enrichment of key biological processes such as protein phosphorylation, regulation of programmed cell death, and transmembrane receptor signaling pathways, underscoring the critical roles of signaling cascades and regulatory mechanisms in tumorigenesis. Similarly, molecular functions such as protein kinase activity and ATP binding were identified as significantly enriched, highlighting the importance of protein kinases and molecular interactions in cancer development and progression. The KEGG pathway analysis further delineated dysregulated signaling pathways associated with cancer, including the MAPK and PI3K-Akt signaling pathways, implicating these pathways as central regulators of cancer progression. These findings deepen our understanding of cancer biology and offer potential targets for therapeutic intervention. Integrating multi-omics data and systems biology approaches may provide deeper insights into the intricate networks underlying cancer pathogenesis, paving the way for developing more effective treatments for cancer patients.

Post-disaster recovery in Central Sulawesi Province covering Sigi District, Donggala District, Parigi Moutong District and Palu City which occurred in 2018 is a national priority program, because the impact is so great. The incident caused damage and losses to various important sectors in people's lives, such as housing, infrastructure, economy, social and cross-sector sectors. Rehabilitation and reconstruction efforts carried out by both central and regional governments and various related parties are certainly needed and have been running for the last 5 years. This study aims to evaluate the efforts that have been made in restoring all affected sectors. The methodology of this study is based on a literature study with the scope of a literature search study through secondary data obtained from where the researcher works, namely BNPB and other sources. The results show that there are 2 areas that have not fully recovered, namely Palu City and Parigi Moutong District. In both areas, there are still sectors that require further attention and action, namely the economic sector in Parigi Moutong District and all sectors in Palu City because they are below the pre-disaster baseline value. Therefore, a sustainable program involving all stakeholders is needed to improve the condition of these sectors.

This research was conducted to analyze and study the influence of the Brancless Banking business on PT Bank Negara Indonesia (Persero), Tbk. In the Regional Office 12 Work Area which consists of service quality and system quality on satisfaction and its impact on agent loyalty. The research method used is quantitative research with data analysis techniques using SEM PLS. The research results show that partially or directly (direct effect) everything has a positive and significant influence, namely service quality has an influence on loyalty, system quality has an influence on loyalty, satisfaction has an influence on loyalty, service quality has an influence on satisfaction, and system quality has an influence on satisfaction. Indirectly, satisfaction can mediate significantly positively between service quality and loyalty and satisfaction can mediate significantly positively between system quality and loyalty.

Tujuan utama dari kegiatan ini adalah untuk mensosialisasikan peluang karir dalam industri pariwisata kepada siswa jurusan perhotelan dan tata boga. Metode yang digunakan meliputi pretest untuk mengukur pemahaman awal siswa, penyampaian materi oleh praktisi pariwisata, serta postest untuk mengevaluasi efektivitas sosialisasi. Hasil kegiatan menunjukkan bahwa siswa memperoleh wawasan baru mengenai berbagai jalur karir di industri pariwisata, yang sebelumnya tidak mereka pertimbangkan. Evaluasi dan umpan balik dari siswa dan pihak sekolah menunjukkan respon yang positif terhadap program ini. Rekomendasi untuk perbaikan di masa mendatang juga disertakan dalam laporan ini, dengan harapan dapat meningkatkan kualitas dan dampak dari program sosialisasi serupa di masa depan.

Flood disasters are the third cause of economic loss of all natural disasters throughout the world. Jakarta, as a waterfront city, is often hit by floods every year, especially during the rainy season. This research is focused on identifying and analyzing community responses and their relationship with their knowledge, preparedness and level of action towards disasters. This research is an exploratory case study research based on primary and secondary data. Research findings show that people in coastal areas have a high level of knowledge about floods (64%). This knowledge is high relative to the sum of their past experiences; However, they are less prepared (43%) because most of the residents are fishermen with low incomes so they don't have to make much effort to adapt to flood-affected houses. On the other hand, people in the interior, they lack knowledge (18%), but they have a good level of preparedness (24%) because of their relatively high-income level. Furthermore, both communities in coastal and inland areas had a high level of action due to high levels of knowledge and experience for coastal residents and good preparedness for inland residents.

Indonesia’s success in disaster management cannot be detached from the role of the military. The military plays a strategic role by mobilizing military resources on a massive scale through a military command system. This research aims to map the disaster management implemented by the Indonesian military in disaster emergency response. This research used descriptive qualitative methods to provide the author with the flexibility to explore data in-depth and comprehensively. Data collection was conducted interactively through qualitative methods with in-depth interviews with the military unit Pusbekangad. The research results show that the Indonesian military has competent resources in disaster response, involving the Army's Supply and Transportation Center (Pusbekang), which has primary skills and capabilities in logistics and transportation. These capabilities are facilitated by the Incident Management System, which is structured, systematic, and well-organized. The Incident Management System built by the Indonesian military involves an Incident Commander, Operation section, Planning section, Logistics section, Finance/Administration section, driver section, and cooking team as a trained, capable, experienced, and ready-todeploy ad-hoc organization in all operational areas. The Incident Management System is used by the military in responding to disasters such as earthquakes in Cianjur, floods in South Kalimantan, and floods in West Sulawesi. The Incident Management System serves as the driving force for the military to fulfill its role in disaster management, thus becoming a key to success in disaster management in Indonesia.

Motor Educability Merupakan perbendaharaan gerak yang berfungsi untuk mempelajari gerak yang baru hal ini dilihat dari bagaimana kemampuan Motor Educability yang dilakukannya. Tujuan penelitian ini dilakukan untuk mengetahui perbandingan kemampuan motor educability siswa sekolah dasar kelas 1,2, dan 3 sekolah di Desa. Penelitian ini menggunakan metode survei, penelitian kuantitatif. Sampel yang berjumlah 138 siswa pada siswa sekolah Desa kelas 1,2, dan 3 siswa sekolah Desa. Tes pengukurannya menggunakan IOWA BRACE TEST yang terdiri dari 21 jenis tes. Data hasil penelitian dianalisis menggunakan excel yang disajikan dalam bentuk ukuran tendensi sentral. Berdasarkan hasil perhitungan yang diperoleh sebagai berikut, kemampuan motor educability siswa sekolah desa berada pada kategori sedang.

Abstract In an era focused on value-based healthcare, the quality of healthcare and resource allocation should be underpinned by empirical evidence. Pragmatic clinical trials (pRCTs) are essential in this endeavor, providing randomized controlled trial (RCT) insights that encapsulate real-world effects of interventions. The rising popularity of pRCTs can be attributed to their ability to mirror real-world practices, accommodate larger sample sizes, and provide cost advantages over traditional RCTs. By harmonizing efficacy with effectiveness, pRCTs assist decision-makers in prioritizing interventions that have a substantial public health impact and align with the tenets of value-based health care. An international network for pRCT provides several advantages, including larger and diverse patient populations, access to a broader range of healthcare settings, sharing knowledge and expertise, and overcoming ethical and regulatory barriers. The hypothesis and study design of pRCT answers the decision-maker’s questions. pRCT compares clinically relevant alternative interventions, recruits participants from diverse practice settings, and collects data on various health outcomes. They are scarce because the medical products industry typically does not fund pRCT. Prioritizing these studies by expanding the infrastructure to conduct clinical research within the healthcare delivery system and increasing public and private funding for these studies will be necessary to facilitate pRCTs. These changes require more clinical and health policy decision-makers in clinical research priority setting, infrastructure development, and funding. This paper presents a comprehensive overview of pRCTs, emphasizing their importance in evidence-based medicine and the advantages of an international collaborative network for their execution. It details the development of PRIME-9, an international initiative across nine countries to advance pRCTs, and explores various statistical approaches for these trials. The paper underscores the need to overcome current challenges, such as funding limitations and infrastructural constraints, to leverage the full potential of pRCTs in optimizing healthcare quality and resource utilization.

The ability to dribble is one of the skills needed to play basketball. Elementary school age, especially the lower grades (1,2, 3) can already be introduced to basic dribbling movements and techniques. Between boys and girls at the age of the lower classes should have the same abilities if they get the same opportunity to learn motion. The purpose of this study was to reveal differences in the dribbling ability of elementary school students. The samples were elementary school students grades 1 to 3 in SDN 10 Anjungan elemantery school. With a total of 52 male and 65 female students. The instrument used was a zigzag dribbling ability test by recording the speed of completing drible assignments. Data were analyzed with no parametric statistics. The results showed that there was no difference in the ability to dribble in male and female elementary school students

This research aims to ascertain the work environment, work motivation, and employee performance at CV Britanindo Bandung and to find out how much influence the work environment, work motivation, and employee performance at CV Britanindo Bandung. Since the location is in an industrial area, where the weather is quite hot and there is a high risk of air pollution that can cause illness for employees, CV Britanindo is considered to be inappropriate. The work motivation of the employees at CV Britanindo Bandung tends to be low since the employees get a work environment that follows the amount of production that can be generated and the income earned by the company, so employees feel unmotivated to work. It impacts the achievement of production produced by employees who cannot achieve production targets properly. The research method used is descriptive-verificative. The sample used in this study was all employees of CV Britanindo Bandung. Data processing is conducted using multiple linear regressions, analysis of the coefficient of determination, and hypothesis testing. Based on the results of the study, it can be concluded that influence does emerge in the work environment on employee performance at CV Britanindo Bandung and there is an influence between work motivations on employee performance at CV Britanindo Bandung; and there is a mutual influence between work environment and work motivation on employee performance at CV Britanindo Bandung.

Coffee silver skin flour can be effortlessly converted into various items, and its nutritional quality remains constant. Thus, exploring novel methods of utilizing it could result in sustainable and innovative products with consistent nutritional advantages. This study investigated the impact of using coffee silver skin flour on the quality of biscuits. This study used a completely randomized design (CRD) consisting of 5 levels of treatment and three replications. The percentages of wheat flour substituted with coffee silver skin flour were 0, 20, 40, 60, and 80%. Observation data were analyzed using ANOVA with F test and continued with Duncan's New Multiple Range Test (DNMRT) test at 1% significance level. The result showed that substituting wheat flour with coffee silver skin flour considerably altered the flour's moisture, ash, protein, and fat content. With increasing amounts of coffee silver skin flour, the moisture and ash contents increased, while the protein and fat contents decreased. Biscuits that were most favored by panelists were in treatment A (100% wheat flour with 0% coffee silver skin flour) with moisture, ash, protein, and fat content of 1.31, 0.25, 18.50, and 19.45%, respectively. Biscuits made from coffee silver skin flour meet the quality requirements set by SNI 2973:2011, except for treatment E (0% wheat flour with 100% coffee silver skin flour), as the moisture content exceeds the specified criteria.

Toxocariasis is an infectious disease caused by Toxocara sp. in cats that lead to deterioration of the condition and can even cause death, especially in kittens. Pyrantel pamoate is an anthelmintic that is currently being abandoned for toxocariasis. The purpose of this paper is to report the success of toxocariasis treatment in a cat using pyrantel pamoate. Female domestic cat, 3 months old, weighing 1.3 kg suffering diarrhea was used in this study. The cat examined including a physical examination, followed by laboratory examination of fecal and blood samples. The results showed the cat's body condition was thin, eye was dirty, anemic mucous membranes, dull hair/loss, and diarrhea with watery stool consistency. The cat examination revealed the presence of Toxocara sp. egg as much as 2,400 EPG in fecal sample, and the results of blood tests found that the cat had normochromic normocytic anemia. The cat was diagnosed toxocariasis with dubious prognosis. A cat treated with kaolin-pectin with 1-2 ml/kg BW orally 2 times a day for 3 days, multivitamin injection at a dose of 0.5 ml intramuscularly, and the anthelmintic pyrantel pamoate at a dose of 20mg/kg BW orally once. After 28 days of treatment, the cat was declared healthy based on better physical conditions, no diarrhea, no worm eggs in the fecal sample, and did not anemia. It concluded that cats with toxocariasis successfully cured by administering the anthelmintic pyrantel pamoate, so this drug is still recommended for the treatment of toxocariasis in cats.

Islamic boarding schools are one of the traditional Islamic-based educational institutions that study Islamic religious sciences as their main study and apply them as daily charity. In terms of the curriculum, Islamic boarding schools no longer only provide religious education, but currently Islamic boarding schools provide additional subjects such as scouting, martial arts and entrepreneurship; both in the field of plantations, catering, sewing, cooperatives and others. Fishery product processing training is one of the methods to support economic independence in the form of entrepreneurship in Islamic boarding schools. Processing of fishery products is an activity that is carried out in stages, sequentially, cleanly and hygienically, and fulfills the quality requirements in order to convert raw fishery products into final products. The target of this community service activity is to form a fishery product processing business activity at the Nurul Huda Islamic Boarding School in Surabaya that is solid and able to compete in the market continuously so as to make the Islamic boarding school an independent institution and have a sustainable business. The method used is the method of approach that is carried out, among others, namely the Participatory method. The results that have been obtained from this activity are the increased knowledge of Islamic boarding school students on the importance of sanitation and handling of fishery products (processed products in the form of fish nuggets and dragon feet). The activity was attended by 40 students, with education levels, namely junior high and high school. As many as 90% of the participants in the Fishery Products Handling Technique training wanted further activities to increase their knowledge in the field of handling fishery products.

المخلص: أهداف البحث: هدفت الدراسة إلى تقييم فعالية مغلي أوراق الشجرة المعروفة بالمورينجا في إزالة الطبقة السميكة مقارنة بمادتين أخريين وكذلك الأنشطة المضادة للميكروبات. طرق البحث: تم استخراج أوراق الشجرة باستخدام مغلي الماء الساخن بتركيزين مختلفين. تم تحضير ما مجموعه ثلاثين سنا بشريا مستخرجا ذو جذر واحد لتقييم فعالية إزالة الطبقة السميكة. تم حساب وجود الطبقة السميكة في الثلث الأوسط من قناة الجذر باستخدام الميكروسكوب الليزري الماسح الضوئي الحويصلي. ثم تم إجراء النشاط المضاد للبكتيريا على نوعين من البكتيريا باستخدام طريقة تشتت الأغار. النتائج: وجدنا أن التراكيز 2,5% و 5% من المغلي أكثر فعالية بشكل ملحوظ في إزالة الطبقة السميكة، ومع ذلك، لم يتم ملاحظة فرق ملحوظ عند المقارنة مع المادتين الأخريين. أظهرت نتائج اختبار المضادات الحيوية المختبرية أن خمسة بالمائة من المغلي يظهر نشاطا مضادا للميكروبات أعلى ضد كلا المسارين التجريبيين. الاستنتاجات: تشير هذه النتائج إلى أن مغلي أوراق الشجرة يمكن اعتباره محلولا فعالا في علاج الجذور. Abstract: Objective: This study evaluated the effectiveness of moringa (Moringa oleifera) leaves decoction for removing a smear layer compared to sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as its antimicrobial activities. Methods: The moringa leaves were extracted using hot water decoction at two different concentrations (2.5% and 5.0% w/v). A total of 30 extracted human single-rooted teeth were prepared to assess the smear layer removal efficacy. The presence of a smear layer in the middle third of the root canal was detected by confocal microscopy. Then the antibacterial effects were assessed against Enterococcus faecalis and Streptococcus mutans bacteria using the agar diffusion method. Results: The 2.5% and 5.0% decoction were significantly more effective than 0.25% NaOCl in removing the smear layer (p 0.05). The in vitro antimicrobial assay showed that 5.0% decoction had higher antimicrobial activity against both of the test pathogens. Conclusion: The findings of this study suggest that moringa leaves decoction can be considered an effective irrigant in endodontics.

In the past 30 years, the number of years lived with disability due to osteoarthritis (OA) has doubled, making it an increasing global health burden. To address this issue, interventions that inhibit the progressive pathology driven by age-related low-grade inflammation, the primary mechanism of OA, are being actively pursued. Recent investigations have focused on modulating the age-related low-grade inflammatory pathology of this disease as a therapeutic target. However, no agent has successfully halted the disease’s progression or reversed its irreversible course. Reynoutria japonica Houtt. (RJ), a promising East Asian herbal medicine, has been utilized for several diseases due to its potent anti-inflammatory activity. This study aims to determine RJ’s capacity to inhibit OA symptoms and associated inflammation, exploring its potential for further development. In vivo and in vitro experiments demonstrated RJ’s anti-OA activity and modulation of multifaceted inflammatory targets. RJ significantly inhibited pain, gait deterioration, and cartilage destruction in a monosodium iodoacetate-induced OA rat model, with its analgesic effect further confirmed in an acetic acid-induced writhing model. RJ exhibited consistent anti-inflammatory activity against multiple targets in serum and cartilage of the OA rat model and lipopolysaccharide-induced RAW 264.7 cells. The inhibition of inflammatory cytokines, including interleukin-1β, interleukin-6, matrix metalloproteinase-13, tumor necrosis factor-α, and nitric oxide synthase 2, suggests that RJ’s alleviation of OA manifestations relates to its multifaceted anti-inflammatory activity. These results indicate that RJ merits further investigation as a disease-modifying drug candidate targeting OA’s inflammatory pathology. To further characterize the pharmacological properties of RJ, future studies with expanded designs are warranted.

Objective: To evaluate mortality and morbidity in HF patients receiving sodium restriction. Study Design: Systematic Literature Review (SLR) of RCTs and Cohort studies worldwide published between Jan 2013 to Jan 2023. Methodology: We systematically selected RCTs and Cohort studies with sodium restriction as an intervention published within the last decade from five databases (PubMed, Scopus, Cochrane Library, Embase, and Medline). The full texts retrieved were assessed for risk of bias, and then a systematic review was performed. The endpoints analyzed were mortality and morbidity. Result: Five RCTs and two cohort studies were included in this study, with 2,505 participants. The endpoints retrieved were mortality and morbidity (hospitalization, NYHA functional class, BNP or NT-proBNP level, quality of life, and congestion). No improvement was seen in mortality and hospitalization, but sodium restriction improved the rest of the morbidity indicators. Over-restricted and overconsumption of sodium intake might worsen HF presentation. When analyzed based on the HF groups, there was not enough evidence to recommend sodium dose based on ejection fraction; however, there was potentially more benefit for patients with higher NYHA classes. However, more evidence is still needed. Conclusion: Sodium restriction did not benefit mortality and hospitalization but improved quality of life, systolic blood pressure, and BNP or NT-pro BNP levels in all HF classes.

Purpose – This research aims to determine the effect of using Canva media as a means of delivering material on students' ability to write negotiation texts. This is motivated by students' low writing skills, especially in negotiation text material. Method – This research uses a quantitative experimental method, namely the method used to find out how the independent variable, or in this research the use of Canva media influences the dependent variable, namely the student's ability to write negotiation texts. The population in this study was all class The data collection technique used is an assignment test to determine students' ability to write negotiation texts. Findings – The results of this research obtained an average of 78.78 for the experimental class and 66.12 for the control class. The results of the data requirements test show that the data for both classes are normally distributed and homogeneous. In the t-test, tcount > ttable = 6.3618 > 1.6698. Thus, it can be concluded that there was a significant effect of using Canva media on the ability to write student negotiation texts. Research Implications – This research proves that learning media is one of the important aspects of the success of teaching and learning activities. Interesting learning media will make it easier for teachers to convey material and students can also more easily understand and master learning. The Canva Application media which can stimulate images, and videos can make it easier for students to understand the material in searching for information and topics in written material, besides this, students play a more active role in learning activities to write negotiation texts.

This study aimed to find out the differences between the effects of plyometric and conventional exercises on the explosive power of the spark. This study used an experimental method where the sample is given treatment. The subjects in this study were 4th semester students of the STKIP Setiabudhi Sports Education study program. The sampling technique used cluster random sampling, so a sample of 40 students was obtained. The study was conducted for 14 meetings with a training frequency of twice a week. The sample was given treatment in the form of plyometric training to increase the explosive power of the sickle kick. The data obtained was analyzed using the SPSS version 26 application. The results of the comparison between plyometric and conventional exercises for low hand-foot coordination were reviewed. The study indicated that the value of Qcount = 12.96 exceeded Qtable = 4.90, or Qcount > Qtable, suggesting significant differences, with the plyometric exercise method proving superior to conventional exercise. Further, the results of the comparison of plyometric and conventional exercises were reviewed for high hand-foot coordination and the results showed that the value of Qcount = 6.65 was greater than Qtable = 4.90, or Qcount > Qtable, indicating significant differences favoring the plyometric exercise method over conventional exercise. The plyometric training method and the conventional training method have an influence on the explosive power of the sickle kick. However, the plyometric training method is more influential, effective, and good for the explosive power of the sickle kick than the conventional training method.

Lower Back Pain (LBP) presents as discomfort in the lumbar region, leading to movement limitations. Addressing LBP requires specialized treatment to alleviate pain. The aim of this study was to demonstrate the effectiveness of combining deep tissue massage and stretching in healing low back pain injuries. This study adopted a pre-experimental design, employing a one-group pretest and posttest approach. The initial assessments (pretests) gauged LBP severity using VAS, Modified Schober Test, Fingertip to Floor, and ODI. Subsequently, a combination therapy of deep tissue massage and stretching is administered three times weekly over three weeks. Final assessments (posttest) are conducted. Participants, recruited from the LKP Rumah Sehat Mandiri clinic over the past five months, consisted of 20 individuals aged 20-60 years, sampled purposively. The study revealed significant improvements in pain, flexion, extension, right flexion, left flexion, and functional indicators following the combination therapy, with a significance value of 0.000, indicating a profound effect (p < 0.05). Notably, left flexion demonstrated a significance value of 0.001, further affirming the treatment's efficacy. The findings support the effectiveness of combining deep tissue massage and stretching in reducing LBP severity and promoting healing. Thus, this combined approach holds promise for managing LBP injuries effectively.

The aim of this study was to assess the BMI and cholesterol levels of athletes selected for preparation for the National Sports Week in Indonesia. The study used a quantitative approach through a survey with researchers giving a test and measurement. The subjects used as research samples were all athletes in the sports of Weightlifting, Fencing, Aero Modeling, Bicycle Racing, Billiard, Handball, Badminton, Parachuting, Judo, Karate, Kempo, Muay Thai, Archery, Wall Climbing, Pencak Silat, Petangque, Swimming, Sepak Takraw, Taekwondo, Tarung Derajat, Table Tennis, Boxing, Volly Beach, Wushu. Additionally, following the selection test, a total of 328 athletes were included in the study. Instruments utilized in this study included the Omron Karada Scan HBF-328 scales for weight measurement, and the OneTouch device for cholesterol testing. The data were analyzed using Microsoft Excel and IBM SPSS Statistics version 26. The results revealed that the mean BMI and cholesterol levels were 22.85 and 171.38, respectively. Among the athletes, 11% were categorized as underweight, 63.11% as normal weight, 21.65% as overweight, 2.74% as obese I, 0.91% as obese II, and 0.61% as obese III. In terms of cholesterol levels, 80% were within the normal range, 10% were low, and 10% were high. Non-parametric correlation analysis demonstrated no significant relationship between BMI and cholesterol levels among the athletes, with a significance value of 0.815. This study concluded that the athlete's BMI was normal, as well as the average athlete's cholesterol condition in normal conditions.

Most of the river basins in Indonesia are categorized as crisis, one of them is Jeneberang. This condition is caused by human behavior and activities that do not pay attention to environmental aspects such as the conversion of forest land into fields and there are still people who still throw their garbage into the river even though the river has a very important function for human life and livelihood. This research will focus on discussing how the Jeneberang River School instills an attitude of environmental care and disaster awareness for the community. The method used is qualitative with a descriptive design. The data was collected through interviews with the founder and principal of Sungai Jeneberang School and document/literature study. The result of this research is Jeneberang River School as a non-formal education forum that provides strengthening of knowledge and understanding related to the function of rivers and efforts to preserve them through various activities such as Focus Group Discussion (FGD), river tracing, river cleaning, tree planting, and Waste Bank socialization. Community participation in these activities is one of the keys to the effectiveness of the Jeneberang River School in instilling an attitude of environmental care and disaster awareness to the community. Based on the results of the research, it was also found that there are still some obstacles for the Jeneberang River School, namely in terms of human resources, human resources, and human resources.

The 2022 earthquake in Cianjur Regency has claimed many lives, caused damage and large material losses. In addition, there are findings of new active faults in the Cugenang area that can potentially threaten the safety of the population. Therefore, it is necessary for the Government to reduce physical and material losses and reduce the number of casualties if a similar incident occurs again. BNPB is the leading sector in disaster management in Indonesia, one of which is disaster risk reduction efforts. This study aimed to analyze the role of BNPB in the efforts of nonstructural mitigation activities in the Cugenang Fault area of Cianjur Regency. The research method used was qualitative with an exploratory design. The data in this study were obtained from interviews, documentation, and observation in Cugenang District. The results of this study showed that BNPB's role in nonstructural mitigation efforts was carried out through activities: Policy Recommendation for post-disaster spatial plan of Cianjur 2022, Dissemination of information about the risk of natural disasters in Cugenang, Preparation of disaster risk assessment 2023. Conclusion The Cugenang Fault is an active fault that is prone to earthquake threats. Therefore, the government is obliged to protect the community from the threat of earthquakes through nonstructural mitigation activities. The research suggestion is for the local government to make a RTRW policy to protect the community from earthquakes through nonstructural mitigation activities.

In this article, we present a mathematical model for human immunodeficiency virus (HIV)/Acquired immune deficiency syndrome (AIDS), taking into account the number of CD4+T cells and antiretroviral treatment. This model is developed based on the susceptible, infected, treated, AIDS (SITA) framework, wherein the infected and treated compartments are divided based on the number of CD4+T cells. Additionally, we consider the possibility of treatment failure, which can exacerbate the condition of the treated individual. Initially, we analyze a simplified HIV/AIDS model without differentiation between the infected and treated classes. Our findings reveal that the global stability of the HIV/AIDS-free equilibrium point is contingent upon the basic reproduction number being less than one. Furthermore, a bifurcation analysis demonstrates that our simplified model consistently exhibits a transcritical bifurcation at a reproduction number equal to one. In the complete model, we elucidate how the control reproduction number determines the stability of the HIV/AIDS-free equilibrium point. To align our model with the empirical data, we estimate its parameters using prevalence data from the top four countries affected by HIV/AIDS, namely, Eswatini, Lesotho, Botswana, and South Africa. We employ numerical simulations and conduct elasticity and sensitivity analyses to examine how our model parameters influence the control reproduction number and the dynamics of each model compartment. Our findings reveal that each country displays distinct sensitivities to the model parameters, implying the need for tailored strategies depending on the target country. Autonomous simulations highlight the potential of case detection and condom use in reducing HIV/AIDS prevalence. Furthermore, we identify that the quality of condoms plays a crucial role: with higher quality condoms, a smaller proportion of infected individuals need to use them for the potential eradication of HIV/AIDS from the population. In our optimal control simulations, we assess population behavior when control interventions are treated as time-dependent variables. Our analysis demonstrates that a combination of condom use and case detection, as time-dependent variables, can significantly curtail the spread of HIV while maintaining an optimal cost of intervention. Moreover, our cost-effectiveness analysis indicates that the condom use intervention alone emerges as the most cost-effective strategy, followed by a combination of case detection and condom use, and finally, case detection as a standalone strategy.

Japan is an island nation prone to floods and tsunamis. The mountains that dominate Japan form short rivers with steep slopes. The rivers transport sediment to the plains, creating medium-sized floodplains. Japan's rivers are prone to flash floods due to their steep basin slopes and relatively short lengths. The ratio of peak discharge to watershed area is relatively large, ranging from 10 to 100 times that of major rivers in other countries. The water level rises and falls very quickly. This research aims to find out the Japanese Government's Efforts in Flood Disaster Risk Reduction. The method used in this research is descriptive qualitative research using purposive sampling technique on the activities of the Overseas Work Lecture (KKLN). Informants appointed as samples are Dr. Aulia Fabianda Anwar Tinumbang from Asisstant Professor. Graduate School of Engineering Kyoto University. KKLN activities are organized by the Defense University Disaster Management Study Program online through the Zoom application. KKDN activities were attended by all 26 Disaster Management Study Program students and also attended by the Head of the Disaster Management Study Program and Disaster Management study program staff. The results showed that the Japanese Government's efforts to reduce flood disaster risk and increase national security.

BackgroundAdolescents can be especially vulnerable to various stressors as they are still in their formative years and transitioning into adulthood. Hence, it is important for them to have effective stress management strategies. ObjectiveThis systematic review investigates current well-being interventions that are aimed at reducing stress among young adults. In particular, interventions using the medium of virtual reality (VR) are explored. MethodsThis mixed methods systematic review follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines, and papers were gathered from databases such as PsycINFO, PubMed, Science Direct, Web of Science, OpenGrey, and Edutopia. Predetermined criteria and specific keywords were used to search for the papers. Search results were screened and extracted with all article screening or extraction delegated among all authors. Any disagreements after reconciliation were settled by a third author. The quality and risk of bias of included studies were assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) Tool for Quantitative Studies. Studies were analyzed qualitatively. ResultsIn total, 20 studies were included, and qualitative analysis was performed to evaluate the effectiveness of VR-based interventions in 3 domains: nature, stress, and academics. ConclusionsStudies using VR interventions, overall, promoted a reduction in stress and an increase in well-being. The findings suggest that VR may serve as an accessible and affordable medium of stress reduction for students and young adults. Larger sample sizes, and a greater number of included studies, may be required in future directions.

Latar Belakang: Plasenta akreta dapat terjadi selama kehamilan karena implantasi plasenta yang tidak normal, dengan anestesi neuraksial saat ini lebih umum digunakan dalam persalinan seksio sesarea untuk kasus ini. Tujuan: Penelitian bertujuan untuk menilai hubungan antara kegawatdaruratan dan teknik anestesi pada kasus plasenta akreta di RSUP H. Adam Malik Medan. Subjek dan Metode:Melibatkan analisis deskriptif kohort retrospektif menggunakan data sekunder dari rekam medis pasien plasenta akreta di RSUP H. Adam Malik Medan dari 2020 hingga 2023. Hasil: Hasil dari 200 sampel terungkap adanya hubungan antara kegawatdaruratan dan teknik anestesi. Ditemukan bahwa kasus emergensi terjadi pada 70,6% dari pasien yang menggunakan anestesi umum dan 44,9% dari pasien yang menggunakan anestesi neuraksial. Sedangkan kasus elektif terjadi pada 29,4% dari pasien yang menggunakan anestesi umum dan 55,1% dari pasien yang menggunakan anestesi neuraksial. Simpulan: Pemilihan teknik anestesi, baik anestesi umum maupun neuraksial, dipengaruhi oleh kegawatdaruratan dalam persalinan seksio sesarea pada kasus plasenta akreta.

ABSTRACT A new species of Philcoxia (Plantaginaceae) from Serra do Cachimbo, eastern Amazon, Brazil, is described and discussed. Philcoxia cachimboensis sp. nov. is mainly characterized by the corolla with asymmetrically obovate (liver-shaped) lateral lobes, with truncate to sub-emarginate apex. This is the first record of the genus in the Brazilian Amazon. A morphological description, illustration and photographs, conservation status assessment, an updated identification key for the recognized species of Philcoxia, and comparative taxonomic comments are provided.