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Abstract Background Healthcare simulation is critical for medical education, with traditional methods using simulated patients (SPs). Recent advances in artificial intelligence (AI) offer new possibilities with AI-based simulators, introducing limitless opportunities for simulation-based training. This study compares AI-based simulators and SPs in undergraduate medical education, particularly in history-taking skills development. Methods A randomized controlled trial will be conducted to identify the effectiveness of delivering a simulation session around history-taking skills to 67 fifth-year medical students in their clinical years of study. Students will be assigned randomly to either an AI-simulator group (intervention) or a simulated patient group (control), both will undergo a history-taking simulation scenario. An Objective Structured Clinical Examination (OSCE) will measure the primary outcomes. In contrast, secondary outcomes including student satisfaction and engagement, will be evaluated following the validated Simulation Effectiveness Tool-Modified (SET-M). The statistical approach engaged in this study will include independent t-tests for group performance comparison and multiple imputations to handle missing data. Discussion This study’s findings will provide valuable insights into the comparative advantages of artificial intelligence-based simulators and simulated patients. Results will guide decisions regarding integrating AI-based simulators into healthcare education and training programs. Hybrid models might be considered by institutions in the light of this study, providing diverse and effective simulation experiences to optimize learning outcomes. Furthermore, this work can prepare the ground for future research that addresses the readiness of AI-based simulators to become a core part of healthcare education.

Fiber optic research continues to develop due to the need for fast information technology. The input signal in an optical fiber is in the form of a soliton wave that propagates in the fiber with a balanced index of refraction, dispersion, and diffraction. Fiber optics may lose some of the signal over time if they solely use a nonlinear refractive index. This study aims to examine into the dynamics and decoherence of multi-peak solitons caused by electromagnetic signal attenuation and potential trap in the propagation via optical fibers. The methods used start with the stationary solution of the nonlinear Schrödinger Cubic Quintic equation, the Newton-Raphson method, and the fourth-order Runge-Kutta. In stationary solutions, the p (state energy) and ρ (Lèvy index) values affect the number, pulse width, and height of soliton peaks. Increased p and ρ values lead to increased instability, causing the data transmitted into the optical fiber to collapse and become unreadable by the receiver. In the excited state (p > 0), the decoherence phenomenon occurs and causes wave instability and destruction. In term of energy intensity, a stable form of transmission in the ground state has a pattern of continuously weakening, decreasing, and smoothing, while in the excited state there is a spike in the intensity of the electromagnetic wave. Based on this study, multi-peak solitons can only be applied for propagation distances, which tend to be short due to their dynamics and decoherence.

Abstract Background Hypertensive disorders of pregnancy (HDPs) are common complications encountered in pregnancy that affect between 5% and 15% of pregnancies worldwide. Some studies have associated adherence to a diet with a high acid load with an increased risk of HDPs. This study investigates the association between Dietary Acid Load (DAL) and the incidence of preeclampsia, chronic hypertension (HTN), and gestational hypertension (GHTN). Methods Pregnant women aged 18 to 45 in the first trimester of pregnancy were selected and followed up until delivery. Diet was evaluated using a 168-question semi-quantitative food frequency questionnaire (FFQ). After calculating the DAL score, the inverse probability weight of the propensity scores, estimated from augmented generalized models, was used to obtain a causal risk ratio (RR) adjusted for potential confounders. Results Out of 1,856 women, 92 (4.95%) developed preeclampsia. The potential renal acid load (PRAL) score ranged from − 16.14 to 0.58, while the net endogenous acid production (NEAP) score ranged from 34.61 to 50.15. Multivariable analysis revealed a significant association between PRAL and preeclampsia in the first (aRR: 1.87, 95% CI: 1.01, 3.49, p = 0.048) and third (aRR: 2.01, 95% CI: 1.07, 3.81, p = 0.030) quartiles compared to the reference group (Q2). No significant linear association was found in continuous analyses. For chronic HTN, significant associations were observed in the first (aRR: 2.56, 95% CI: 1.21, 5.42, p = 0.014) and fourth (aRR: 4.79, 95% CI: 2.37, 9.71, p

Abstract Background The encapsulation of metagenome-derived multi-enzymes presents a novel approach to improving poultry feed by enhancing nutrient availability and reducing anti-nutritional factors. By integrating and encapsulated enzymes such as carbohydrate-hydrolyzing enzymes, protease, lipase, and laccase into feed formulations, this method not only improves feed digestibility but also potentially contributes to animal health and productivity through antimicrobial properties. Results This study investigates the encapsulation of metagenome-derived enzymes, including carbohydrate-hydrolyzing enzymes, protease, lipase, and laccase, using Arabic and Guar gums as encapsulating agents. The encapsulated multi-enzymes exhibited significant antimicrobial activity, achieving a 92.54% inhibition rate against Escherichia coli at a concentration of 6 U/mL. Fluorescence tracking with FITC-labeled enzymes confirmed efficient encapsulation and distribution, while physical characterization, including moisture content and solubility assessments, along with Atomic Force Microscopy (AFM) imaging, validated successful encapsulation. The encapsulated enzymes also effectively hydrolyzed poultry feed, leading to an increase in phenolic content and antioxidant activity, as confirmed by 2,2’-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays. Conclusions The encapsulated multi-enzymes improved the overall feed quality by increasing reducing sugars and enhancing physical properties such as solubility and water-holding capacity. The encapsulated multi-enzymes improved the overall feed quality by increasing reducing sugars, antioxidant activity and enhancing physical properties such as solubility and water-holding capacity. Scanning Electron Microscopy (SEM) and Fourier-Transform Infrared Spectroscopy (FTIR) analyses confirmed the enzymatic breakdown of the feed structure. These results suggest that supplementing poultry feed with encapsulated multi-enzymes can enhance its physical, nutritional, and functional properties, leading to improved digestibility and overall feed quality.

Di Indonesia, mahasiswa perantau sudah lazim ditemui. Hal ini disebabkan oleh fakta bahwa banyak mahasiswa yang menempuh pendidikan di luar daerah tempat tinggalnya, dan tinggal terpisah dari orang tua, keluarga, dan teman – temannya di kampung halaman. Berada jauh dari orang yang disayangi dan cintai dapat menyebabkan perasaan loneliness. Loneliness adalah respon emosional dan kognitif yang disebabkan oleh kurangnya hubungan yang memadai dan memuaskan dengan individu lain. Memiliki hewan peliharaan dan terjalinnya pet attachment pada hewan peliharaan merupakan salah satu cara untuk mengurangi loneliness. Penelitian ini bertujuan untuk mengetahui hubungan antara pet attachment dengan loneliness pada mahasiswa pemilik hewan peliharaan yang tinggal di kost. Metode penelitian yang digunakan dalam penelitian ini adalah kuantitatif dengan desain korelasional. Sebanyak 220 partisipan terlibat dalam penelitian ini menggunakan teknik incidental sampling. Instrumen dalam penelitian ini menggunakan Lexington Attachment to Pet Scale (LAPS) dan skala 6-Item Cross Cultural Social Isolation Scale. Hasil analisis koefisien korelasi untuk variabel pet attachment dengan loneliness = 0,332 dengan signifikansi sebesar 0,000 (p0,05). Hasil analisis data menunjukkan terdapat hubungan yang positif signifikan antara pet attachment dengan loneliness pada mahasiswa pemilik hewan peliharaan yang tinggal di kost.

Penelitian ini bertujuan untuk mengembangkan aplikasi SPARKS (Sistem Pusat Akses Program Kerja dan Kegiatan Mahasiswa) sebagai solusi strategis untuk mengatasi kendala penyebaran informasi, kekurangan dan kendala pada sistem Satuan Kredit Poin Mahasiswa (SKPM), serta inefisiensi pengelolaan kegiatan ormawa di Universitas UPN Veteran Jawa Timur. Dengan menggunakan metode Goals Directed Design (GDD), penelitian ini melibatkan tahapan research, modeling, requirement, framework, refinement, dan support dalam perancangan antarmuka aplikasi. Hasil penelitian menunjukkan bahwa keterbatasan akses informasi dan ketidakjelasan kategori SKPM merupakan masalah utama yang dihadapi. Pengembangan aplikasi SPARKS diharapkan dapat memberikan dampak positif terhadap pengelolaan kegiatan ormawa, memfasilitasi penyebaran informasi, dan meningkatkan efisiensi proses klaim SKPM. Hasil pengujian menunjukkan bahwa desain antarmuka SPARKS telah memenuhi kebutuhan pengguna dengan tampilan yang menarik, mudah digunakan, dan relevan dengan kebutuhan mahasiswa dengan skor SUS sebesar 80,3%.

Abstract In recent years, biologists and clinicians have witnessed prominent advances in in vitro 3D culture techniques related to biomimetic human/animal tissue analogs. Numerous data have confirmed that unicellular and multicellular (tumoroids) tumor spheroids with dense native cells in certain matrices are sensitive and valid analytical tools for drug screening, cancer cell dynamic growth, behavior, etc. in laboratory settings. Angiogenesis/vascularization is a very critical biological phenomenon to support oxygen and nutrients to tumor cells within the deep layer of solid masses. It has been shown that endothelial cell (EC)-incorporated or -free spheroid/tumoroid systems provide a relatively reliable biological platform for monitoring the formation of nascent blood vessels in micron/micrometer scales. Besides, the paracrine angiogenic activity of cells within the spheroid/tumoroid systems can be monitored after being treated with different therapeutic approaches. Here, we aimed to collect recent advances and findings related to the monitoring of cancer angiogenesis using unicellular and multicellular tumor spheroids. Vascularized spheroids/tumoroids can help us in the elucidation of mechanisms related to cancer formation, development, and metastasis by monitoring the main influencing factors.

This research is based on the importance of entrepreneurial skills and leadership style in influencing business performance, especially for women entrepreneurs. In the age of globalization and increasingly intense competition, women entrepreneurs must possess sufficient skills and apply efficient leadership styles in order to achieve the best business outcomes. The purpose of this study is to determine the extent to which entrepreneurial skills and leadership styles impact the business performance of women entrepreneurs. This study involved women entrepreneurs in Bekasi district with 100 respondents randomly selected as the research sample. Information was collected using a questionnaire and analyzed using the Smart PLS (Partial Least Squares) technique to test the research model and hypotheses. The analysis found that entrepreneurial ability and leadership style have a major impact on firm performance. The entrepreneurial capability has been shown to make a significant contribution to improving operational efficiency and the ability to innovate, while a flexible and inspiring leadership style is able to improve team motivation and performance. It was found that it is important for women entrepreneurs to develop appropriate competencies and leadership styles to support their business success.

Infant mortality rate (IMR) is one of the indicators to measure public health status and community welfare. In the last 3 years (2014-2016), the infant mortality rate in Sampang Regency has increased. The purpose of this study is to develop spatial-based modeling of factors affecting infant mortality rates in Sampang. Researchers used an ecological study design where secondary data came from the Health Office and the Central Bureau of Statistics in Sampang Regency. The dependent variable is infant mortality rate, while the independent variables are delivery assisted by health workers, exclusive breastfeeding coverage, neonatal complications handled, K4 visit coverage, LBW percentage, midwife to population ratio, percentage of clean and healthy household behavior. Data has been analyzed and processed using Geoda and Quantum GIS applications. Based on statistical tests, the spatial model is obtained: ŷi= -21.82+0.706 ∑(i=1,i≠j)^n wijyi-0.61* childbirth attended by health worker+0.10* neonatal complications attended by health worker+1.89* LBW babies. Each variable of childbirth assisted by health workers increased by 10, it can decrease the infant mortality rate by 6.1 cases. Each variable of neonatal complications not handled by health workers rises 10 units, it can increase the infant mortality rate by 1 case. each variable of LBW babies rises 1 unit and it can increase infant mortality cases by 1.89 cases. The results of this study can be used to reduce infant mortality rates that occur by intervening in existing factors.

Elections are one of the key moments in a country's democracy. Indonesian elections have a significant impact on regional and global politics. Twitter being one of the popular social media platforms becomes a powerful tool for political campaigns. This makes it an ideal source to analyze public opinion during the 2024 general election, particularly the upcoming Presidential Election (Pilpres). IndoBERT is the model chosen to analyse the sentiment from the dataset in this study using a zero-shot learning approach. Based on the evaluation results, the accuracy value of the 2024 presidential election classification is 0.60 (60%), tends to predict with a good value in the positive label of 0.74 (74%) for F1-Score. This model is considered quite good at predicting negative labels but the results are not too optimal with a value of 0.49 (49%). Confusion Matrix in this IndoBERT model is more likely to label tweets with positive things, by detecting negative labels quite well.

Kaempferia galanga L. rhizomes contain ethyl trans-p-methoxycinnamate as a major secondary metabolite compound and biomarker. Various extraction methods with different solvents can isolate ethyl trans-p-methoxycinnamate with potential bioactivities. This paper reported the isolation of ethyl trans-p-methoxycinnamate from two varieties of K. galanga L. rhizomes by maceration in n-hexane. The small and large varieties of K. galanga samples produced ethyl trans-p-methoxycinnamate in 1.43% and 1.84% yields, higher than other methods and polar solvents of previous research. Structural elucidation of the obtained ethyl trans-p-methoxycinnamate was performed by FTIR, MS, and 1H NMR spectroscopies.

Abstract Background Phytochemicals are non-nutritive bioactive compounds with beneficial effects on the metabolism of glucose. This study aimed to clarify the possible causal effect of the pre-pregnancy dietary phytochemical index (DPI) on gestational diabetes mellitus (GDM). Methods In this prospective cohort study 1,856 pregnant women aged 18–45 years who were in their first trimester, were recruited and followed up until delivery. The dietary intakes of participants were examined using an interviewer-administered validated 168-item semi-quantitative food frequency questionnaire (FFQ). Inverse probability weighting (IPW) of propensity scores (PS), estimated from the generalized boosted model (GBM) were used to obtain a adjusted risk ratio (aRR) for potential confounders. Results During the follow-up period, 369 (19.88%) women were diagnosed with GDM. DPI scores ranged from 6.09 to 89.45. There was no association between DPI scores and GDM (aRR: 1.01, 95% confidence interval [CI]: 0.92, 1.08; p trend = 0.922). When comparing DPI quartile 4 (most pro-phytochemical content) to quartile 1 (few phytochemical contents), there was no significant difference between them (aRR: 0.97; 95% CI: 0.75, 1.25; p = 0.852). Also, there was no significant difference between DPI quartile 3 and quartile 1 (aRR: 1.04; 95% CI: 0.81, 1.34; p = 0.741) as well as DPI quartile 2 and quartile 1 (aRR: 0.92; 95% CI: 0.71, 1.21; p = 0.593). Conclusions Although this data did not support the association between pre-pregnancy DPI scores and GDM, further cohort studies to ascertain the causal association between them are warranted.

Youth homelessness represents a persistent and significant challenge for service sectors with limited best practice guidance. Housing supports, in particular, are widely deployed, with the practice-oriented literature providing little detail regarding service design beyond broad domains such as employment support and life skills coaching. The present multiple case study investigation was designed to develop a preliminary understanding of the guiding principles that attend the development of interventions that support youth exiting homelessness in the Canadian context. These case studies were conducted with a diverse group of five organizations recognized as sector leaders, with findings considered in light of practice standards from the better-established adult housing literature. Key findings with respect to service models included the strategies used to provide flexible, culturally responsive, tailored services with an emphasis on specialist support. Implementation factors included the navigation of strategic partnerships, the use of data in capacity-building, and the benefits and drawbacks of larger, centralized service environments versus smaller, dispersed environments. Youth-specific considerations in housing stabilization models are highlighted. This work contributes to a growing body of literature that seeks to articulate best practices in the effort to address and prevent youth homelessness.

Abstract Extracellular vesicles (EVs) harbor several signaling molecules to maintain intercellular communication. Based on the exosomal cargo type, metabolic, genomic, and proteomic status of parent cells can be investigated. Due to the existence of trivial levels of target molecules inside EVs, the application of accurate and sensitive detection methods is mandatory. Here, we used an electrochemical immunosensor using a biotinylated monoclonal CD63 antibody as the capturing element for the detection of EVs isolated from MDA-MB-231 cells and cancer patients. Simultaneously, breast cancer biomarker CA-15-3 was detected in isolated EVs using a sandwich method to increase specificity. Data indicated a linear dynamic range of 2000–10000 EVs/µL and a lower limit of quantification of 2000 EVs/µL. Based on data from real sample analysis, the levels of exosomal CA-15-3 can differ according to the severity and systemic content of this factor. Pd-perovskite-based immunosensor provides a platform for quick and in-depth analysis of EVs isolated for cancer cells.

Abstract Background Anxiety and depression can seriously undermine mental health and quality of life globally. The consumption of junk foods, including ultra-processed foods, fast foods, unhealthy snacks, and sugar-sweetened beverages, has been linked to mental health. The aim of this study is to use the published literature to evaluate how junk food consumption may be associated with mental health disorders in adults. Methods A systematic search was conducted up to July 2023 across international databases including PubMed/Medline, ISI Web of Science, Scopus, Cochrane, Google Scholar, and EMBASE. Data extraction and quality assessment were performed by two independent reviewers. Heterogeneity across studies was assessed using the I2 statistic and chi-square-based Q-test. A random/fixed effect meta-analysis was conducted to pool odds ratios (ORs) and hazard ratios (HRs). Results Of the 1745 retrieved articles, 17 studies with 159,885 participants were suitable for inclusion in the systematic review and meta-analysis (seven longitudinal, nine cross-sectional and one case-control studies). Quantitative synthesis based on cross-sectional studies showed that junk food consumption increases the odds of having stress and depression (OR = 1.15, 95% CI: 1.06 to 1.23). Moreover, pooling results of cohort studies showed that junk food consumption is associated with a 16% increment in the odds of developing mental health problems (OR = 1.16, 95% CI: 1.07 to 1.24). Conclusion Meta-analysis revealed that consumption of junk foods was associated with an increased hazard of developing depression. Increased consumption of junk food has heightened the odds of depression and psychological stress being experienced in adult populations.