The 2020 Tokyo Olympics has been postponed due to the novel coronavirus (COVID-19) pandemic. The implications for industries related to the Olympics—tourism, hotels and restaurants, and others—are expected to be affected by reduced demand. Japanese workers in these industries were prepared to offer their hospitality to visitors from around the world. They would be satisfied from not only an increase in income but also in offering visitors a taste of Tokyo’s great hospitality if the Olympics had been held in 2020. However, postponement of the sporting event is likely to have a significant impact on their happiness level. We independently collected individual-level panel data from March to April 2020. Based on this, we found that the happiness level of workers in the tourism and restaurant sectors declined drastically after the announcement of the postponement. Only two weeks later, their happiness level did not alter from the pre-announcement level. This tendency was strongly observed in Tokyo and the surrounding prefectures, but not in other prefectures. However, workers engaged in the tourism and restaurant sectors did not predict a decrease in their income even after the postponement. Combined, these findings indicate that loss of extending hospitality, rather than reduction in income, temporarily reduces the happiness level of workers.

Sensory integration is an essential function of human life, and its decline causes difficulties in the quality of life, especially in older adults. In this study, we proposed an arm-reaching task based on a virtual reality head-mounted display (VR-HMD) system to assess sensory integration in daily life, and examined whether reaching task performance was associated with age and resting-state functional connectivity (rsFC) between the brain regions of interest involved in sensory integration. We hypothesized that performance during a reaching task with multiple cognitive loadings would be affected by aging. The gap angle between the reaching hand and target positions was compared between older and middle-aged adults as a measure of sensory integration function. In addition, rsFC, which was significantly correlated with the gap angles of individual participants in the older adult group, was identified using resting-state functional magnetic resonance imaging data. The mean gap angle was significantly larger in the older adults than in the middle-aged group and was also significantly correlated with connections between the left primary motor area and the left inferior temporal gyrus, temporo-occipital part. Because the connectivity between the areas is known to be related to visuomotor integration, the results suggest the involvement of visuomotor integration in the decline of sensory integration function in old age and the validity of the gap angle during the proposed VR-HMD task as an index for the decline in function.

Objective On the eve of the summer Olympic Games in Tokyo research focus has shifted on the core temperature responses of elite athletes competing in the heat. In the absence of the field data of core temperature during Olympic sailing competition aim of the present study was to identify core temperature response during the Tokyo 2020 Olympic Test Event. Methods Four elite athletes from Olympic sailing (177.5±5.2 cm, 71.1±7.4 kg, body mass index 22.5±1.4 kg/m2, 24.8±3.7 yrs, VO2max 50.6±7.2 mL/min/kg)): 2 males and 2 females participated in the study. Core temperature was recorded using e-Celsius ingestible capsules, heart rate using a heart rate monitor. Ambient conditions in direct sunlight were measured using portable meteo station. Results Core temperature was recorded at water environment via an ingestible capsule in 4 sailors during the training (T), and competition (C), respectively. Ambient conditions in direct sunlight were hot and humid: during training temperature were 30.9°C±1.7°C and relative humidity 81.4%±2.8%, corresponding to a wet-bulb globe temperature of 41°C±4°C and during competition temperature was 31.2°C±2.3°C and relative humidity 87.2%±4.4%, corresponding to a wet-bulb globe temperature of 45.2°C±8.9°C. Core temperature increased during training reaching higher peak values (38.6°C±0.4°C) and during competition (38.9°C±0.4°C). The highest temperature recorded was 39.4°C (C). Conclusion The current study provides unique information into the core temperature parameters under heat stress in elite Olympic sailors during training and race event.

Utilization of wasted heat instead of fuel combustion is effective to reduce primary energy consumption for mitigating global warming problem. Because wasted heat sources are not necessarily located close to areas of heat demand, one of the difficulties is that wasted heat has to be transferred from heat source side to heat demand side, which may require heat transportation over long distance. From this point we proposed and have examined new idea of heat transportation using ammonia-water as the working fluid which system is named Solution Transportation Absorption chiller, in short STA. Our previous studies of STA were mainly the experimental investigation with STA facility which cooling power was 25RT (90kW). As a result, the COP of STA was found almost same value 0.65 with the conventional absorption chiller without depending on the transportation distances. The simulation using AspenHYSYS also examined with same experimental condition. The experimental data showed good agreement with the simulation calculation. In this study, we examined the large-scale cooling power STA on simulation. The examination cooling powers were from 90 kW(25RT) to 3517 kW(1000RT). All cooling power achieved around COP 0.64 including pump power consumptions. In addition, we performed the dynamic simulation. As the results, there was no effect of pipeline size on the cooling capacities and mass flow rates. Furthermore, the stability time of the cooling capacities and mass flow rates were almost same regardless of the pipeline size and cooling capacity. In other words, STA may be achieved the same COP even though having various complex conditions compared with the conventional absorption chiller.

In steel structures, oblique thin steel plates serve as panel zones in structures spanning large spaces (e.g., warehouses and gymnasiums). Considerable research has been conducted on the shear buckling of panels due to seismic loads acting on a structure. Conversely, under snow or wind loads, the panel zone may experience compressive and tensile stresses simultaneously from two directions. Considering the economic preference for thin steel plates, evaluating the elastic critical local buckling stresses in the panel zone under biaxial normal stress may provide essential information to structural engineers. In this study, an elastic buckling analysis based on the energy method is performed to clarify the impact of panel geometry and boundary conditions on the elastic local buckling stresses of oblique panel zones. As confirmed, the buckling stresses derived from the energy method could simulate the local buckling stresses with accuracy comparable to that of finite element analysis, and an engineer-friendly design formula was proposed. Finally, we determined the correlation of the buckling stresses under biaxial stresses and presented a method for evaluating this correlation. Engineers can utilize the provided design equations to more efficiently and accurately calculate buckling loads, facilitating safer and more economical design of structures with oblique plates.

(1) Background: Foot strike pattern and cadence are two important variables that are related to sport performance and injury risks; the objective of this study is to analyse the foot strike pattern and cadence of the male elite athlete that participated in the Tokyo Olympic Games marathon. (2) Methods: Two independent researchers analysed the foot strike pattern of the first 51 participants in the 5km, and the cadence of the finalists in three different segments of the race. Descriptive statistics were presented for the main variables of this study. A repeated measures ANOVA was used to study the differences in cadence between different sections of the race (p<0.05). (3) Results: Average of the cadence of the eight finalists was 185.5 steps per minute (SD ± 5.1). No differences between sections of the race were found. The more most common foot strike pattern was midfoot strike pattern, followed by rearfoot strike pattern, and forefoot strike pattern. The results of cadence are in line with previous studies that analysed elite athletes, with the values being higher than other research involving recreational runners. (4) Conclusions: elite marathon runners mostly run with a running non-rearfoot strike pattern and a cadence of over 185 steps per minute.

The recent increase in global consumption of rice has led to increased demand for sustainable water management in paddy cultivation. In this study, we propose an enhanced paddy simulation module to be introduced to Soil and Water Assessment Tool (SWAT) to evaluate the sustainability of paddy cultivation. The enhancements added to SWAT include: (1) modification of water balance calculation for impounded fields, (2) addition of an irrigation management option for paddy fields that are characterized by flood irrigation with target water depth, and (3) addition of a puddling operation that influences the water quality and infiltration rate of the top soil layer. In a case study, the enhanced model, entitled SWAT-Paddy, was applied to an agricultural watershed in Japan. The results showed that the SWAT-Paddy successfully represented paddy cultivation, water management, and discharge processes. Simulated daily discharge rates with SWAT-Paddy (R² = 0.8) were superior to the SWAT result (R² = 0.002). SWAT-Paddy allows the simulation of paddy management processes realistically, and thus can enhance model accuracy in paddy-dominant agricultural watersheds.

Urinary tract diseases are common in cats, and often require surgical reconstruction. Here, to explore the possibility of urinary tract reconstruction in cats using in-vivo tissue architecture (iBTA), biosheets fabricated using iBTA technology were implanted into the feline bladder and the regeneration process was histologically evaluated. The biosheets were prepared by embedding molds into the dorsal subcutaneous pouches of six cats for 2 months. A section of the bladder wall was removed, and the biosheets were sutured to the excision site. After 1 and 3 months of implantation, the biosheets were harvested and evaluated histologically. Implantable biosheets were formed with a success rate of 67%. There were no major complications following implantation, including tissue rejection, severe inflammation, or infection. Urinary incontinence was also not observed. Histological evaluation revealed the bladder lumen was almost entirely covered by urothelium after 1 month, with myofibroblast infiltration into the biosheets. After 3 months, the urothelium became multilayered, and mature myocytes and nerve fibers were observed at the implantation site. In conclusion, this study showed that tissue reconstruction using iBTA can be applied to cats, and that biosheets have the potential to be useful in both the structural and functional regeneration of the feline urinary tract.

With the progression of AI, embedding advanced AI technologies into small robotics and mobile devices has become essential, driving research towards lightweighting AI models. Our study enhances the EPINET depth estimation model for light field images, aiming for compactness and faster inference while preserving accuracy. We conducted two-step experiments aimed at enhancing inference efficiency: Initially, by adjusting input streams and convolution layers, we simplified the CNN model, achieving faster inference times at the cost of reduced accuracy. To address this reduction in accuracy, we then applied knowledge distillation, allowing the simplified model to learn from the original model’s more complex patterns. In our quantitative experiments using two error metrics, MSE (Mean Squared Error) and BadPix, we identified optimal knowledge positions and evaluated the required complexity for the student model. As a result, our method improved MSE by 21% and BadPix by 14% compared to training without it. Furthermore, the student model achieved an inference speed 13% faster than the teacher model and surpassed its accuracy by 10% in MSE. Additionally, we demonstrated that repeatedly applying our approach could further enhance both model compactness and accuracy.

A Cu₂ZnSnS₄ (CZTS) film with a thickness of approximately 1.5 μm was fabricated on a Mo-coated glass substrate by annealing a CZTS precursor fabricated from nanoparticle ink. The chemical states of the elements in the CZTS thin film in the depth direction were studied to identify the presence of secondary phases, which are detrimental to the performance of solar cells containing CZTS. X-ray diffraction was unable to detect any secondary phases in CZTS because of their small relative amount. Instead, X-ray photoelectron spectroscopy (XPS), which is highly sensitive to chemical state, was conducted at different depths in the CZTS film to further check the presence of secondary phases. XPS analysis revealed peaks shift consistent with the presence of secondary phases. For the CZTS film annealed in a S atmosphere at 575 °C for 3 h, the film surface consisted of a secondary-phase layer composed of CuS, ZnS, and SnSx (x=1 or 2) originating from the decomposition of CZTS. At depths below 80 nm, the film was pure CZTS. Formation of MoS2 at the CZTS–Mo interface was confirmed by XPS analysis of Mo and S.

Rotational jumps are crucial techniques in sports competitions. Estimating ground reaction forces (GRFs), one of the components constituting jumps, through a biomechanical model-based approach enables analysis even in environments where force plates or machine learning training data cannot be utilized. In this study, rotational jump movements involving twists on land were measured using inertial measurement units (IMUs) and estimated GRFs and body loads using a 3D forward dynamics model. Our estimation method, based on forward dynamics and optimization calculations, generated and optimized body movements using cost functions defined by motion measurements and internal body loads. To reduce the influence of the dynamic acceleration in the optimization calculation, the 3D orientation using sensor fusion composed of acceleration and angular velocity data obtained from IMUs and an extended Kalman filter was estimated. As a result, by generating movements based on the cost function, it was possible to calculate biomechanically valid GRFs while following the measured movements even if not all joints are covered by IMUs. This estimation method allows for 3D motion analysis independent of measurement conditions or training data.

The objective of this study was to determine how application with dolomitic limestone and grazing type (continuous or deferred) affect sheep grazing location and feed preference when the pasture growth rate is maximum. A 4ha field was divided into 4 plots: P1 and P2- without application of dolomitic limestone, continuous (CG) and deferred grazing (DG), respectively; P3 and P4- with application of dolomitic limestone, DG (1AUE), and CG (2.4 AUE), respectively. In DG, animals were placed and removed from the plots depending on the height of the pasture. In each plot, 12 georeferenced sampling points were identified. Throughout the pasture's vegetative cycle (autumn, winter, spring, and early summer) several measurements of pasture height and cut were carried out. From the beginning of March to the beginning of June, animal behavior was observed, by trained observers, through binoculars on six dates. Animals' activity grazing and location was recorded. The results show that: (i) the application of dolomitic limestone combined with CG provided higher values of pasture height; (ii) there were no significant differences in pasture quality between treatments; (iii) Deferred grazing led to 50% more sheep grazing days than continuous grazing; (iv) there were no significant differences in soil compaction between CG and DG; (v) the type of grazing and the treatment with dolomitic limestone did not seem to change the grazing pattern between treatments. This work contributes to understanding the relationships between different types of grazing in dryland pastures, with and without application of dolomitic limestone, and preferred grazing locations for sheep. This work could help agricultural managers make more informed decisions with the aim of promoting the sustainable intensification of livestock production in the Montado ecosystem.

In Japan, the prevalence of low birth weight (LBW) has been estimated to be approximately 10%, which is the highest among developed countries. This high prevalence might affect the prevalence of LBW-associated diseases in the adult population of Japan. Recently, LBW has been recognized as a contributing factor to post-adaptive focal segmental glomerulosclerosis (FSGS) in adulthood; however, few reports to date have evaluated the clinical and pathological characteristics of post-adaptive FSGS. A 13-year-old girl was referred to our hospital owing to mild proteinuria, which was detected at a school urinary screening. She was born at a gestational age of 23 weeks, with a very LBW of 630 g. Dipstick urinalysis revealed grade (2+) proteinuria. Her serum creatinine level was 1.02 mg/dL, and she was diagnosed as having stage 2 chronic kidney disease (CKD). Her serum uric acid level was 7 mg/dL. Her mother and 16-years old brother had hyperuricemia, too. A percutaneous renal biopsy leads to a diagnosis of FSGS. After 3 years of treatment with an angiotensin receptor blocker, her proteinuria decreased. However, her serum creatinine level was 1.07 mg/dL, and she still had stage 2 CKD. We considered that in this patient, the first hit was her LBW, and the second hit was hyperuricemia. The second hit might be associated with the development of CKD. The birth history of patients is not usually confirmed by nephrologists. Our case demonstrates that obtaining information regarding the preterm birth and LBW of patients is important in the diagnosis of noncommunicable diseases, because school urinary screening is not routinely performed in countries other than Japan.

Objectives: The study aimed to develop a deep learning-based edge AI model deployed on electrocardiograph (ECG) devices for real-time detection of atrial fibrillation (AF)-risk during sinus rhythm (SR) using standard 10-second 12-lead electrocardiograms (ECGs). Methods: A novel approach was used to convert standard 12-lead ECGs into binary images for model input, and a lightweight convolutional neural network (CNN)-based model was trained using data collected by the Japan Agency for Medical and Research Development (AMED) between 2019 and 2022. Patients over 40 years old with digital, SR ECGs were retrospectively enrolled and divided into AF and non-AF groups. Data labeling was supervised by cardiologists. The dataset was randomly allocated into training, validation, and internal testing datasets. External testing was conducted on data collected from other hospitals.　Results: The best-trained model achieved an AUC of 0.82 and 0.80, sensitivity of 79.5% and 72.3%, specificity of 77.8% and 77.7%, precision of 78.2% and 76.4%, and overall accuracy of 78.6% and 75.0% in the internal and external testing datasets, respectively. The deployed model and app package utilized 2.5MB and 40MB of the available ROM and RAM capacity on the edge ECG device, correspondingly. Processing time for AF-risk detection was approximately 2 seconds.　Conclusion: The model maintains comparable performance and improves its suitability for deployment on resource-constrained ECG devices, thereby expanding its potential impact to a wide range of healthcare settings. Its successful deployment enables real-time AF-risk detection during SR, allowing for timely intervention to prevent AF-related serious consequences like stroke and premature death.

The purpose of this study was to determine the maximum tolerated dose (MTD) for stereotactic body radiation therapy (SBRT) in the treatment of non-metastatic prostate cancer. This study was a phase 1 dose escalation trial conducted in Japan. Patients with histologically proven prostate cancer without lymph node or distant metastasis were enrolled. The prescribed doses were 42.5, 45, or 47.5 Gy in five fractions. Dose-limiting toxicity (DLT) was defined as grade (G) 3+ gastrointestinal or genitourinary toxicity within 180 days after SBRT completion and a 6 plus 6 design was used as the method of dose escalation. A total of 16 patients were enrolled, with 6 in the 42.5 Gy group and 10 in the 45 Gy group. No DLT was observed in the 42.5 Gy group. In the 45 Gy group, one patient experienced G3 rectal hemorrhage, and another had G4 rectal perforation, leading to the determination of 42.5 Gy as the MTD. None of the patients experienced biochemical recurrence or death during the follow-up period. We concluded that SBRT for non-metastatic prostate cancer at 42.5 Gy in 5 fractions could be safely performed, but a total dose of 45 Gy increased severe toxicity.

Predicting ground reaction forces (GRFs) and ground reaction moments (GRMs) through a biomechanical model-based approach offers advantages for biomechanical analysis, particularly in situations where the application of a statistical model is limited by insufficient training data. However, the current prediction method is unsuitable for clinical applications due to its long computational time. The present study developed a new optical motion capture (OMC)-based method to predict GRFs, GRMs, and joint torques. The proposed approach performed the estimation process by distributing external forces, as determined by the equation of motion, between the left and right feet based on foot deformations, thereby predicting the GRFs and GRMs without relying on machine learning or optimization techniques. We investigated the prediction accuracy during walking by comparing a conventional analysis using a force plate with the OMC results. The comparison revealed excellent or strong correlations between the prediction and measurement for all GRFs, GRMs, and lower limb joint torques. The proposed method, which provides practical estimation with low computational cost, facilitates efficient biomechanical analysis and rapid feedback of analysis results, thereby increasing its applicability for kinetics estimation in clinical settings.

Health and well-being are a major concern for the elderly who experienced evacuation due to the 2011 Fukushima Daiichi Nuclear Power accident. This study examined the feasibility of a picture sound book with Ninja-essence to maintain or improve exercise habits and physical and mental conditions of the elderly affected by the Fukushima Daiichi Nuclear Power plant accident. We conducted a pre–post intervention study to evaluate a picture sound book with Ninja-essence for returnees and evacuees post lifting evacuation restrictions. In total, 29 people participated in this study. Residents in two groups, returnees and evacuees, were provided with the tool. Results of the pre–post changes were analyzed using descriptive statistics, i.e., Fisher’s exact test and t-test, and a significant difference was observed in both groups of participants between their left and right hand-grip strength, the maximum phonation time in the participants of the group that regularly engaged in exercise, and in the questions regarding swallowing exercises and singing songs or practicing words (p < 0.013 and 0.033); 16 of 29 participants reportedly enjoyed the program. The results demonstrated the future possibility of determining the improved outcome of this program in larger samples.

Quantum tunneling in a two-dimensional integrable map is studied. The orbits of the map are all confined to the curves specified by the one-dimensional Hamiltonian. It is found that the behavior of tunneling splitting for the integrable map and the associated Hamiltonian system is qualitatively the same, with only a slight difference in magnitude. However, the tunneling tails of the wave functions, obtained by superposing the eigenfunctions that form the doublet, exhibit significant difference. To explore the origin of the difference, we observe the classical dynamics in the complex plane and find that the existence of branch points appearing in the potential function of the integrable map could play the role for yielding non-trivial behavior in the tunneling tail. The result highlights the subtlety of quantum tunneling, which cannot be captured in nature only by the dynamics in the real plane.

Choline and choline metabolites are essential for all cellular functions. They have also been reported to be crucial for neural development. In this work, we studied the functional characteristics of the choline uptake system in human neural stem cells (hNSCs). Additionally, we investigated the effect of extracellular choline uptake inhibition on the cellular activities in hNSCs. We found that the mRNAs and proteins of choline transporter-like protein 1 (CTL1) and CTL2 were expressed at high levels. Immunostaining showed that CTL1 and CTL2 were localized in the cell membrane and partly in the mitochondria, respectively. The uptake of extracellular choline was saturable and performed by a single uptake mechanism, which was Na+-independent and pH-dependent. We conclude that CTL1 is responsible for extracellular choline uptake, and CTL2 may uptake choline in the mitochondria and be involved in DNA methylation via choline oxidation. Extracellular choline uptake inhibition caused intracellular choline deficiency in hNSCs, which suppressed cell proliferation, cell viability, and neurite outgrowth. Our findings contribute to the understanding of the role of choline in neural development as well as the pathogenesis of various neurological diseases caused by choline deficiency or choline uptake impairment.

Advances in gastric cancer screening and endoscopic technology have made it possible to detect and treat gastric cancer at an early stage. As a result, about 40% of all gastric cancers have now been resected by endoscopic treatment in Japan. In endoscopic diagnosis, magnifying endoscopic observation using band-limited light such as narrow band imaging (NBI) has significantly improved the accuracy of gastric cancer diagnosis. At the same time, in endoscopic treatment, endoscopic submucosal dissection (ESD) has contributed to increase explosively the number of gastric cancers which could be resected endoscopically. In recent years, the construction of algorism for endoscopic diagnosis and treatment with a view to personalized medicine has been explored, and endoscopic use for gastric cancer managements is expected to develop further in the future. Keywords (5 words):

SOC stock (SOCS) changes caused by land use changes are still unclear, and understanding this response is essential for many environmental policies and land management practices. In this study, we investigated the temporal-spatial and vertical distribution characteristics of SOCS on the Western Sichuan Plateau (WSP) using the sparrow search algorithm-random forest regression (SSA-RFR) models with excellent model applicability and accuracy. The temporal-spatial varia-tions in the SOCS were modeled using 1080 soil samples and a set of nine environmental covariates. We analyzed the effect of land use changes on the SOCS on the WSP. The total SOCS increased by 18.03 Tg C from 1990 to 2020. The results of this study confirmed that the SOCS in the study area has increased significantly since 2010, with an increase of 27.88 Tg C compared to the total SOCS in 2010. We found that the spatial distribution of the SOCS increased from southeast to northwest, and the vertical distribution of the SOCS in the study area decreased with increasing soil depth. Forest and grassland are the main sources of SOCS, the total SOCS in the forest and grassland accounted for 37.53 and 59.39% of the total SOC pool in 2020, respectively. Expansion of the wetlands, forest, and grassland areas could increase SOCS in the study area.

Many of the wide-ranging symptoms of COVID-19 have not been associated previously with a respiratory illness. A similarity between these atypical symptoms and the symptoms of malnutrition was observed. To investigate, a comparison of COVID-19 symptomatology with recognised states of malnutrition showed a significant relationship that was further explored in a review of the literature. This hypothesis links the atypical symptoms to the effects of increasing protein malnutrition. The rapid appearance of malnutrition symptoms at the beginning of the COVID-19 infection is concurrent with the rapid cell proliferation of the immune system. Although previous work has, in general, assumed that the body is capable of providing for the needs of the immune system during infection, heightened immune activity from the commencement of COVID-19 could require an early increase in energy yielding sources. Should insufficient availability of protein resources occur, this could quickly lead to malnutrition. Any continuing insufficiency, during the active phase of the virus, might result in widespread depletions in the tissues and the consequential malfunctioning of many organs. A new appraisal of the immune system requirements needed to counteract the impact of the novel virus, COVID-19, could show the potential benefit for earlier protein intervention in the disease process. This hypothesis could also have relevance for other life situations where a rapid cell proliferation might occur.

Background: Endoscopic sphincterotomy (EST) has been employed for the endoscopic treatment of common bile duct stones (CBDSs), and a high success rate of stone removal has been reported. However, EST is associated with the risk of bleeding, perforation, and sphincter of Oddi function disruption. To avoid these risks, endoscopic papillary balloon dilation (EPBD) is an option for CBDS. Sphincter of Oddi function preservation decreases long-term biliary infection and gallstone recurrence. EPBD may have advantages in children who require a long follow-up. However, there have been few reports on pediatric cases, particularly in infants. Methods: From September 2017 to December 2023, we performed EPBD for four pediatric CBDSs. The patients were aged from 5 months to 8 years; including two infants aged 5 and 6 months. Furthermore, we reviewed the stone removal rate and complications of 545 ESTs performed at high-volume centers and 13 EPBD-reported cases in children with CBDSs. Results: CBDSs of all patients who underwent EPBD in our institution were successfully removed. No bleeding or perforation was noted, and pancreatitis was observed in three patients. In an analysis of 545 ESTs in children, the stone removal rate was high, ranging from 83% to 100% (mean, 96%). The incidence of pancreatitis was 0%–9.6% (mean, 4.4%), and the grade of pancreatitis was almost mild. The bleeding frequency was 1.3%–5.4% (mean, 2.7%). According to the grade of bleeding, seven and four cases were mild (64%) and moderate (36%), respectively, Compared with adult cases who underwent EST, the frequency of pancreatitis and bleeding was almost similar in children.; however once bleeding occur, it has a higher risk of leading to blood transfusion in children. Stone removal by EPBD in children was 100% successful. All complications were pancreatitis, and its frequency was 46% (6/13 patients, including five mild cases and one moderate case), which is higher than that of EST and adult cases who underwent EPBD. In most children with pancreatitis, pancreatic enzyme levels returned to normal within 2–3 days following EPBD, and no severe cases caused by EPBD were reported. Conclusions: CBDS removal by EPBD in children has a high success rate with very low risk of bleeding and perforation. Although pancreatitis frequently occurs, most cases are mild. Sphincter of Oddi function preservation by EPBD is expected to prevent long-term stone recurrence and biliary tract infection, and EPBD is considered an effective method for CBDS removal in children.

This paper addresses challenges and solutions in urban development and infrastructure resilience, particularly in the context of Japan's rapidly urbanizing landscape. It explores the integration of smart city concepts to combat land subsidence and liquefaction, phenomena highlighted by the 2011 Great East Japan Earthquake. Using advanced technologies such as smart sensing and predictive analytics through kriging and ensemble learning, the study aims to improve the accuracy of geotechnical investigations and urban planning. By analyzing data from 433 geotechnical surveys in Setagaya, Tokyo, it develops predictive models to accurately determine the depth of bearing layers critical to urban infrastructure. The results demonstrate the superiority of ensemble learning in predicting the depth of bearing layers, with significant implications for smart city development and the sustainability of urban environments. This interdisciplinary approach not only seeks to mitigate risks associated with geological disturbances, but also promotes sustainable urban growth that prioritizes safety and prosperity. Through advanced technology and comprehensive research, the study underscores the potential of smart cities to address urban complexities and ensure a resilient, sustainable future.

Pancreatic neuroendocrine neoplasms (pNENs) are rare tumors accounting for only 1-2% of all pancreatic tumors. pNENs are pathologically heterogeneous and are categorized into three groups (neuroendocrine tumor: NET G1, NET G2 and neuroendocrine carcinoma: NEC) on the basis of Ki-67 proliferation index and mitotic count according to the 2010 WHO classification of gastroenteropancreatic NENs. NEC in this classification includes both histologically well-differentiated and poorly differentiated subtypes, and modification of the WHO 2010 classification is under discussion based on genetic and clinical data. Genomic analysis has revealed NETs G1/G2 have genetic alterations in chromatin remodeling genes such as MEN1, DAXX and ATRX, whereas NECs have an inactivation of TP53 and RB1, and these data suggest that different treatment approaches would be required for NET G1/G2 and NEC. While there are promising molecular targeted drugs, such as everolimus or sunitinib, for advanced NET G1/G2, treatment stratification based on appropriate predictive and prognostic biomarkers is becoming an important issue. The clinical outcome of NEC is still dismal, and a more detailed understanding of the genetic backround together with preclinical studies to develop new agents, including those already under investigation for SCLC, will be needed to improve the prognosis.

Ophthalmological services face global inadequacies, especially in low- and middle-income countries, which are marked by a shortage of both practitioners and equipment. This study employed a portable slit-lamp microscope with video capabilities and cloud storage for a more equitable global diagnostic resource distribution. To enhance accessibility and quality of care, this study targeted corneal opacity, a global cause of blindness. To boost the online diagnosis efficiency, an AI pipeline was developed using anterior segment videos to detect corneal opacity. First, we extracted image frames from videos and learned them using a Convolutional Neural Network(CNN) model. Second, we manually annotated to extract only the corneal margins, adjusted the contrast with CLAHE, and learned using the CNN model. Finally, we performed semantic segmentation of the cornea using the annotated data. The results showed an accuracy of 0.8 for image frames, and 0.96 for corneal margins. Dice and IoU were 0.94 for semantic segmentation of corneal margins. While corneal opacity detection from video frames seemed challenging in the early stages of this study, manual annotation, corneal extraction, and CLAHE contrast adjustment significantly improved accuracy. Integrating manual annotation into the AI pipeline through semantic segmentation achieved a high accuracy in detecting corneal opacity.

In this study, the friction factor of turbulent pipe flow for dried rice malt extract solutions is reduced experimentally to that of a Newtonian fluid. The friction factor is measured for four types of solutions at different culture times and concentrations. The results indicate that the experimental data points of the test solutions diverge from the maximum drag reduction asymptote at and above Re√f ≅ 200 and align parallel to those of Newtonian fluids. This drag reduction phenomenon differs from that of artificial high molecular polymer solutions. It is classified as a Type B drag reduction phenomenon of biopolymer solutions and fine solid particle suspensions. The order of drag reduction corresponds approximately to that of 5–50 ppm xanthan-gum solutions reported previously. Furthermore, the velocity profile in a turbulent pipe flow was predicted using a semi-theoretical equation, in which the friction factors were determined using the difference between the experimental results of the tested solutions and Newtonian fluids. The results indicate a more considerable thickening of the viscous sublayer in the turbulent pipe flow of the test solutions than that of Newtonian fluids.

Emerging autologous cellular therapies that utilize platelet-rich plasma (PRP) applications have the potential to play adjunctive roles in a variety of regenerative medicine treatment plans. There is a global unmet need for tissue repair strategies to treat musculoskeletal (MSK) and spinal disorders, osteoarthritis (OA), and patients with chronic complex and recalcitrant wounds. PRP therapy is based on the fact that platelet growth factors (PGFs) support the three phases of wound healing and repair cascade (inflammation, proliferation, remodeling). Many different PRP formulations have been evaluated, originating from human, in vitro, and animal studies. However, recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, progress has been made in understanding PRP technology and the concepts for bioformulation, and new research directives and new indications have been suggested. In this review, we will discuss recent developments regarding PRP preparation and composition regarding platelet dosing, leukocyte activities concerning innate and adaptive immunomodulation, serotonin (5-HT) effects and pain killing. Furthermore, we discuss PRP mechanisms related to inflammation and angiogenesis in tissue repair and regenerative processes. Lastly, we will review the effect of certain drugs on PRP activity, and the combination of PRP and rehabilitation protocols.

In a densely populated country like Bangladesh, universities grapple with the challenge of efficiently addressing myriad queries from a large student body, leading to a heightened workload for university stakeholders. To tackle these challenges, we introduce PixieGPT, a tailor-made Generative Pre-Trained Transformer for Bangladeshi universities. PixieGPT significantly mitigates workload by adeptly handling common university-related queries, thereby enhancing user experience. The hierarchical structure plays a crucial role in managing diverse queries from thousands of students about the university system. The solution introduces a modular hierarchical knowledge base (KB) with simpler complexities, addressing the intricacies of efficiently managing large volumes of queries. PixieGPT is designed in a modular way so that the solution is also adaptable for the implementation of other universities worldwide based on the requirements of a particular administrative system. The modular nature facilitates easy adaptation with minor changes based on specific university requirements, ensuring a seamless integration process. This paper delves into the intricacies of PixieGPT's design, emphasizing its pivotal role in mitigating workload challenges for university stakeholders in Bangladesh. The incorporation of BERT for Natural Language Understanding(NLU) and GPT models for Natural Language Generation(NLG) enhances PixieGPT's capabilities, contributing to the scalability and efficiency of the system. The presented use case underscores the practical benefits of PixieGPT, positioning it as a promising solution for universities globally with similar operational frameworks.

This paper presents a novel dynamic camera parameter control method for position and posture estimation of highly miniaturized AR markers (micro AR markers) using a low cost general camera. The proposed method performs iterative calculation of the marker’s position and posture to converge them to specified accuracy with dynamically updating the camera’s zoom, focus and other parameter values based on the detected marker’s depth distances. For a 10 mm square micro AR marker, the proposed system demonstrated recognition accuracy of better than ±1.0% for depth distance and 2.5∘ for posture angle with a maximum recognition range of 1.0 m. In addition, the iterative calculation time was at most 0.7 seconds in an initial detection of the marker. These experimental results suggest that the proposed method and system can be applied to a robotic precise handling of small objects with low cost.

History is part of the social sciences or humanities. In history, it studies events in the past which also determine what happens in the present and the future. With history, we can find out events and incidents in the past by reading books or by watching movies. Historical science provides many benefits for all circles. However, in this 21st century, which is a modern era, history is less desirable among millennials for various reasons. The purpose of writing this paper, the first is to find out what are the benefits of historical science in this millennial era, the second is to find out whether history is in demand or not among millennials, then what is the benefit of history in this millennial era. The third is to find a solution related to historical science learning so as not to be boring while maintaining its benefits. This research is to solve a common problem among millennials, namely whether millennials are interested in studying history and what can increase millennial interest in studying history. Researchers collect data to compile this paper with a qualitative method, which is to collect the latest journals for reference between 2019 and 2021 which are related to the urgency of 21st-century history for millennials. In addition, the researchers also looks for the latest data related to interest in studying historical science which is used to find out whether history is in demand or not among millennials. Thus, this research can find out what causes millennials to be less interested in history and find a solution, namely by using film media to increase millennial interest. This article is very useful in providing information about the urgency of learning history in the 21st century so that readers can use this article as material to conduct further research on this matter. As for this research, it has limitations, namely this research is only limited to millennials in relation to the urgency of historical science.

Abstract Background: Premature babies have a greater risk for having health issues after being discharged from the hospital whilst the mother ability to provide premature baby care still has many issues as well. Interventions are needed to be given to mothers at home to improve the ability of mothers to care their premature babies. Methods: Search for articles used the bolean operator of “or” and “and” with the keywords used were “preterm or premature”, “intervention or program”, and “mother and home”. Data based used were Sciencedirect, Ebscohost, PubMed, SAGE, Proquest and Scopus with inclusion criteria using full text in English from 2018 to 2021. There were 428 articles obtained, the articles were then screened by reading the main focus of articles with paying attention to the topic and the suitability of article content and we obtained 13 suitable articles. Results: The interventions at home carried out for mothers and premature babies were divided into two namely the follow-up interventions from the hospital and the interventions carried out at the patient's home. Seven articles about research of interventions that were as a combination from hospital intervention with follow-up hospital intervention plus five full interventions at the patient's home. Interventions were provided through home visits (12 articles) and by telephone (1 article). The results of the article analysis resulted in 4 main themes of intervention for mothers and premature babies, they were health education, counceling, support, and care for premature babies. Conclusion: Quality care is essential for the best health, growth and development of premature babies. Interventions need to be carried out by health workers to ensure the readiness and ability of mothers to care for their babies. Maternal readiness and abilities can be improved by providing health education, counseling, support and care for premature babies.

The emergence of an external campus student organization (ormek) is very influential for the progress of the millennial generation, especially among students as the nation's successor. In addition to being a forum for developing self-potential and training student soft skills, ormek is a hope for the surrounding community in solving societal problems. It takes understanding and the role of all millennial generations to think critically about organizations that have various impacts in the cadre process. This research analyzed how intelligent efforts can be made by the millennial generation to respond, sort, and choose and recognize the impact. The method used is a qualitative method through literature review and a quantitative method through a survey (35 respondents). The findings showed that the existence of ormek is very influential by being a forum for the student movement since the era of Indonesian independence in various aspects such as social and political. Students had various opinions about the existence of ormek and its influence on the millennial generation. Brilliant efforts must be made in addressing the existence of ormek so that they are wise in the organization and benefit the people.

Collaborative action between families and health professionals, in this case nurses, doctors, nutritionists, pharmacies in forming harmonious support is the philosophy of family centered nursing care which aims to involve families as the main focus in care. The aim of this literature review is to identify family-centered family member care: a literatu review. This language method uses literature reviews which are summaries of 10 articles in the publication years of 2020-2021 on search 4 databased electronic searches containing namely Scopus, ProQuest, Pubmed, and Scient Direct. This review used prisms. The eligibility of these studies were from its title, abstract, research methodology, results and discussion. The results of the review were presented in narrative form. The results of a review of 10 articles found that the form family centered care Conclusion: The family is considered a partner in the care of other family members. The concept of family centered care is a philosophy in nursing where the role of the family is very important in caring for family members who are sick.

History learning is often regarded as something that is considered unimportant and boring to be taught in the modern era like now. The existence of history learning itself is still important enough to be studied in the 21st century with all its benefits and uses. One of the uses of history is as a reasoning education. The research questions are how do we take advantage of history learning as reasoning and critical thinking education in the 21st century and how the usage of new media can make historical learning looks more interesting. The method used in this article is literature review with data obtained and analyzed from several journals and research results related to history learning and reasoning education, especially forms of critical thinking in the 21st century. From the results of the research, it was found that there was a link between learning history and its relation as a form of critical thinking in the 21st century, in several ways, such as teaching history based on historical thinking, and the usage of new media in history learning.

Objective: Surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain-tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence-guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we developed an intraoperative rapid fluorescence cytology system, and evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: Twenty-five selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence.Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was a useful to evaluate the presence of tumor cells in the resection cavity walls, and provides surgical implications for the more complete resection of malignant gliomas.

In modern times like today, technology and science are developing very fast. This has resulted in a condition known as globalization. This era has had a significant impact on every country globally, including in Indonesia, such as the spread of culture is solid. This flow has many benefits and advantages. However, this globalization can also have a negative impact. One of them is the erosion of native Indonesian culture compared to foreign cultures. Therefore, this research to find the origin, causes, and impacts of the influx of cultural globalization on the current culture of East Java because it is the province of origin of the researchers. Here the researchers asks about the impact of this modern culture and how influential culture is to the people of East Java. The method used by the researchers in making this paper is Literature Review using qualitative descriptive writing with quantitative data. The researchers findings as material in this paper amounted to 24 materials with the provisions of 20 journal article materials, 2 article materials online provided that they were published in the last three years, and 2 E-books for methods on this paper. This study's boundaries are a modern culture that the researchers takes about western culture (western) and South Korean culture (Hallyu). In addition, this study only discusses cultures originating in East Java, such as Javanese.

Cardiovascular disease is the first leading cause of death in the world. Patients with cardiovascular disease may experience various problems, including physiological and psychological problems. Apart from pharmacological therapy, complementary therapy is necessary as a support to conventional medicine. This review aims to describe complementary and alternative therapies for pain and anxiety in patients with cardiovascular disease. This review utilized data from ProQuest, ScienceDirect, and PubMed with search keywords of "Complementary" AND "Nursing" AND "Pain" AND "Anxiety" AND "Coronary artery disease". Ten articles that met the inclusion criteria were analyzed. The results show that nursing actions increasingly develop along with the patient needs. One form of holistic nursing action is complementary and alternative therapy (CAT) that consists of three categories: body-based methods, mind therapies, and sensory therapies. CAT has positive impacts on patients with heart disease. It can reduce anxiety and pain, lower blood pressure, and improve the quality of life. This review also shows that CAT has a positive impact on the recovery of patients with heart disease. Proper therapeutic management should be implemented to reduce the risks of physiological and psychological problems in patients.

Prestressed concrete sleepers (or railroad ties) are principally designed in order to carry wheel loads from the rails to the ground of railway tracks. Their design takes into account static and dynamic loading conditions. In spite of the most common use of the prestressed concrete crossties in railway tracks, there have always been many demands from rail engineers to improve serviceability and functionality of concrete crossties. For example, signaling, fiber optic, equipment cables are often damaged either by ballast corners or by tamping machine. There has been a need to re-design concrete crosstie to cater cables internally so that they would not experience detrimental or harsh environments. Also, many concrete crossties need a retrofit for automatic train control device and similar signaling equipment. In contrast, the effects of holes and web openings on structural capacity of concrete crossties have not been thoroughly investigated. This paper accordingly highlights the effect of holes and web openings on the toughness and ductility of concrete crossties. The outcome of this research enables better decision making process for retrofiting prestressed concrete crossties with holes and web opening in practice.

Background: Recurrent approximation of retention parameters in reversed-phase HPLC is effective for revealing anomalies difficult to detect otherwise, namely, the reversible hydration of analytes. This was demonstrated previously for restricted sets of analytes with acetonitrile–water eluents. Expanding the number of analytes and eluents seems to be a topical problem. Two kinds of derivatives of aromatic carbonyl compounds were characterized: unsubstituted hydrazones and oximes. Methods: If analyte demonstrates no anomalies in dependences of retention times vs. concentration of organic modifier, the recurrent approximations of these dependences are linear. To explain the features of recurrent approximations, the numerical experiments were proposed and considered. The artificial shifting of one, two, or more points allows modeling the different kinds of deviations of approximations from linearity. Results: It was shown that hydrazones are the class of analytes having no anomalies of retention parameters. On the contrary, several anomalies were detected for oximes. Downward deviations of points in the plots of recurrent approximations of retention times are the signs of reversible hydration. This effect for methanol–water eluents was detected for the first time. Some of oximes underwent hydrolysis. Conclusion: Recurrent approximation of retention times allows detecting chemical transformations of analytes during RP HPLC analysis.

ABSTRACTIntroduction:Human Immunodeficiency Virus (HIV) is a global health problem that is almost recorded in every country. The long-term and long-term negative impacts of HIV cases are stigma and discrimination in people with HIV (PLHIV). The purpose of this study is to find out the stigma and discrimination felt by PLHIV.Method:This study design of systematic review from 4 electronic databases namely Scopus ScienceDirect, Sage and ProQuest by using keywords tailored to Medical Subject Headings (MeSH) including "Stress", "covid", "nursing", "hospital". This study uses PICOS framework to prevent research bias and analysed using descriptive analysis.Results:The results of the analysis of the article showed from 761 articles have been identified title, abstract and full-text so that recorded 15 articles that can be reviewed. The article consists of various designs, namely RCT, cross sectional and qualitative studies. Analysis shows that stigma and discrimination are social phenomena that manifest in several social areas.Conclusion:Stigma and discrimination in people with HIV (PLHIV) is still common, stigma is carried out by the wider community to their own families. The family approach is necessary to improve well-being as well as improve the social community of the family.

Introduction: Corona Virus Disease 2019 causes health problems in the world in the form of a health crisis that results in psychological problems as fear and anxiety. The purpose of this study to determine the factors that influence psychological and stigma during the Covid-19 pandemic.Methods: This study is a literature review with five databases (Scopus, CINAHL, ScienceDirect, PubMed, and ProQuest), studies design used a cross-sectional or quasi-experimental, with a date of March 2021. The Center for Review and Dissemination and the JBI Guide are used to measure the Quality and Prism checklist for guide reviews. A feasibility study based on title, abstract, full text, and research methodology. The data analysis used narrative analysis based on the research findings.Results: Eleven articles met the predefined review inclusion criteria. Research is base on related factors psychology, related factors stigma, and factors related to psychological and stigma. Most of the factors associated with psychological conditions and stigma have a quasi-experimental and cross-sectional design. Participants averaged over a thousand for each study and discussed psychology factors related to the stigma. Conclusion: Factors related to psychological are age, education, symptoms and health conditions, gender, information, economy, exposure duration, and social support, while factors related to stigma are environment, history of comorbid diseases, discrimination, and public perceptions.

We present a first formal analysis of specific and complete local integration. Complete local integration was previously proposed as a criterion for detecting entities or wholes in distributed dynamical systems. Such entities in turn were conceived to form the basis of a theory of emergence of agents within dynamical systems. Here, we give a more thorough account of the underlying formal measures. The main contribution is the disintegration theorem which reveals a special role of completely locally integrated patterns (what we call ι-entities) within the trajectories they occur in. Apart from proving this theorem we introduce the disintegration hierarchy and its refinement-free version as a way to structure the patterns in a trajectory. Furthermore we construct the least upper bound and provide a candidate for the greatest lower bound of specific local integration. Finally, we calculate the i-entities in small example systems as a first sanity check and find that ι-entities largely fulfil simple expectations.

Background: The incidence of fracture and surgery of the hip and lower extremities is still high. Long postoperative bed rest has the potential to increase the incidence of various complications that may increase the morbidity and mortality rate of patients after hip and lower extremities surgery. Aim: This literature review aimed to identify the effects of early mobilization in hip and lower extremity postoperative. Method: Search for articles on several databases such as ProQuest, ScienceDirect, CINAHL, Medline, Wiley Online and Scopus, using the Boolean operator by combining several keywords according to the literature review topic, with inclusion criteria are published in the last 3 years (2019-2021), used a quantitative design, written in English and full text articles. A total of 435 articles were obtained, then screened and reviewed, so that there were 16 (sixteen) eligible articles.Result: There were 11 (eleven) effects of early mobilization, i.e. reducing length of stay, reducing the risk of deep vein thrombosis (DVT), reducing pulmonary infections (pneumonia), reducing urinary tract infections, reducing the risk of wound infection, improving extremity function and ability to walk, reducing postoperative pain, reducing the risk of pressure sores, reducing postoperative delirium, reducing readmission and lowering hospitalization costs. Conclusion: This literature review showed that early mobilization is safe and effective in postoperative patients to reduce the risk of complications and adverse events. Nurses and health workers who care for patients could implement early mobilization and motivate patients to be cooperative in undergoing early mobilization.

Bacground, the increasing number of elderly is a new challenge for health care systems around the world. The phenomenon of the complex health problems experienced by the elderly encourages families to bring the elderly to a nursing home. The purpose of this study was to describe the condition of the elderly living in nursing homes and their care needs. Methodology, this research design is a literature review, article search using 5 databases, namely Scopus, ProQuest, Pubmed, CINAHL and Scient Direct. Articles reviewed from 2019 to 2021. Protocol and evaluation of literature review using the PRISMA checklist, and the assessment guide using the Joanna Briggs Institute Guideline. Results, the health conditions of the elderly who live in the orphanage are mostly aged 60 years and over, physically experiencing disturbances in their daily activities and dependence. Psychologically experiencing anxiety, depression, loneliness and even mental disorders and socially need family support. The care needs of the elderly in nursing homes include services by competent and culturally sensitive staff and nurses, safe and comfortable nursing home environmental services, privacy needs and social interactions, spiritual needs services, social guidance services, and skills guidance services. Conclusion, based on the literature review, it can be seen that nursing services should be provided in a humanistic and holistic manner, the elderly are clients who have both bio-psycho-socio-cultural and spiritual needs. So that nursing services are aimed at meeting the needs of the elderly in a comprehensive manner.

Hypertension is a chronic non-communicable disease which is one of the main causes of serious cardiovascular disease death in the community. The level of treatment and health control for hypertensive patients is still not optimal due to lack of information. Aim was to identify various current methods of health education by nurses and their impact on hypertensive patients. Method Literature review research. The literature was obtained from the Scopus, Sage and PubMed databases with the keywords "Intervention" OR "Methods" AND "Nursing" AND "Hypertension". There are seven literatures that are determined to meet the requirements of the inclusion criteria. Results found three types of health education methods performed by nurses: 1) direct health education methods; nurses meet and meet face to face with patients in the form of individual teaching or training, 2) indirect health education methods; nurses are not face-to-face but use telephone or mobile communication aids to convey information and send SMS about health, and use internet-based websites to convey health information, 3) combined health education methods; nurses face to face with patients and follow-up care is carried out by indirect health education methods. The impact of health education methods carried out by nurses on hypertensive patients is that the level of patient adherence increases in treatment, increased knowledge levels, better blood pressure control, healthy lifestyle practices, adherence to diet, improved quality of life, and positive nurse-patient feedback occurs. in fulfilling mutually agreed upon treatment appointments. Conclusion health education methods carried out by nurses have a very positive impact on disease management and prevention of risk factors for complications in hypertensive patients.

Introduction: The imbalance between technological development and ideological strengthening has resulted in the fading of the Pancasila ideological values of millennials. Technology that accompanies everyday life seems to be the main character in human life. Yet if humans themselves do not use technology wisely, technology can be a threat to both individuals and the life of the nation and state. If technology is increasingly out of control, threats to the Pancasila ideology are very likely to occur, such as in the G 30S PKI incident. Therefore, it is necessary to take action both from the government and the community as individuals to safeguard the development of technology to be used wisely. That way, we can prevent the threat to the Pancasila ideology together. Writing this article aims to analyze how the role and influence of the Pancasila ideology on the millennial generation in the 4.0 industrial revolution and to find solutions so that the values of Pancasila remain attached to the next generation of the Indonesian nation. Method: Writing This article uses a qualitative method by using literature reviews from the results of related research journals that have been published online through websites and other online media. Results: Thirteen journals and one book have met the criteria for the inclusion of a predetermined review. Research is based on the stigma of society regarding technological developments in the Industrial revolution 4.0. Therefore, the government is expected to be more severe in implementing human capital management. Conclusion: By procuring human capital management, it will be possible that Human Resources (HR) in Indonesia will be able to carry out the ideals of a golden Indonesian generation with Pancasila values inherent in the hearts of the people and the nation's future generations.

Postpartum hemorrhage is a complication during the puerperium that requires serious management, because it risks on threatening the mother's death. Currently, postpartum hemorrhage is still the main cause of maternal morbidity and mortality in the world. There is a need for a fast, precise and comprehensive handling effort involving all elements, such as the entire health team including doctors-nurses and families. The form of nursing intervention in postpartum hemorrhage patients can be in the form of nursing treatment or collaboration. The purpose of this review literature is to identify nursing treatment and nursing collaboration in postpartum hemorrhage patients as an effort to prevent maternal death. The writing method uses literature reviews by summarizing 10 articles publicated in 2019, 2020 and 2021 in 4 search data bases including Sciencedirect, Scopus, Proquest and Thompson. The review guidelines used are based on Prisma and the Joanna Briggs Institutute. The level of eligibility is identified through the title, abstract, research methodology and full text. The results of the reviews found are presented in a narrative form. The results of the review study found that there were 10 articles on postpartum hemorrhage management measures both in the effort of snoring treatment and collaboration including: optimizing the competence of service providers based on E_Learning , foot reflexology since the 4th stage of labor, 800 mcg sublingual Misoprostol, the use of the Digital Postpartum Hemorrhage Management Device ( DPHMD), bilateral-contralateral cervical clamps, suction tube uterine tampons, bilateral hypogastric artery (BHAL), evaluation of Shock Index, Carbetocin drugs and administration of Tranexamic acid 1 gram IV within 10 minutes of vaginal delivery. The conclusion of this review literature is that nursing treatment and nursing collaboration are proven to have a positive impact as an effort to prevent death in postpartum hemorrhage patients.

Background: Breast cancer is the second type of cancer diagnosed in women and is the first cancer in women worldwide. Breast cancer also causes high morbidity and mortality in women and becomes a heavy burden due to the incidence of disability due to the disease. Purpose: This literature review aims to examine how social support affects anxiety, depression and quality of life in breast cancer sufferers. Method: The data were obtained by searching for reputable and trustworthy journals. have high quality criteria, namely Scopus, Proquest, Science Direct, Elsevier, Pubmed. Journals or articles used in this review literature are searched using keywords and Boolean operators (AND, OR NOT, or AND NOT). Keywords in this review literature are as follows: social support OR family support, quality of life OR Quality, anxiety OR depression, AND Cancer OR cancer treatment OR Chronic disease. Results: The results of this literature review show that there is a significant influence between the social support received by breast cancer patients on the improvement of their quality of life. The social support provided is also able to reduce anxiety and depression in breast cancer sufferersConclusion: Social support given to breast cancer patients is proven to have an effect on improving the quality of life, reducing anxiety and depression.

The issue of being pro-gender is still a controversial topic to be debated in Indonesian society. However, in the 21st Century, many women have been able to break through barriers and participate in the public sphere. It is a form of self-existence as proposed by Simone de Beauvoir on existentialist feminism. Based on these problems, this study aims to find out and answer questions about how Indonesian women exist in the public sphere in the 21st Century and find out how Indonesian women exist in the public sphere through Simone de Beauvoir's existentialist feminism paradigm. The research method used is descriptive-qualitative through a literature review of 23 journal articles, websites, and data reports with a range of 2019-2021. This study found that based on Simone de Beauvoir's feminist paradigm, Indonesian women in the 21st Century are no longer a figure other than complete. Furthermore, the data collected by the researcher shows that several gender indicators have shown that Indonesian women have been able to occupy public spaces in various aspects. Based on these results, it is hoped that it can provide information about Simone de Beauvoir's existentialist feminism thought and its relevance to the existence of Indonesian women in the public sphere in the 21st Century. However, this research has limitations, those are only about women in Indonesia, and the paradigm of feminism is limited to Simone de Beauvoir's existentialist feminism.

Background: A person living with HIV / AIDS bargains with stressors such as discrimination, stigma depression, and several psychological impacts. The stressors experienced by people with HIV/ AIDS will certainly have an impact on daily activities, welfare, and management of medications which in general will have an impact on the quality of life. To deal with these stressors, it is necessary to have good and proper coping from within the PLWHA. Coping strategies need to be owned and carried out by PLWHA in order to respond adaptively to the stressor conditions experienced. Purpose: The aim of this review is to describe the stress experienced and the coping strategies used among PLWHA. Methods: This literature review used keywords in the search for international references are coping strategy, stressor, HIV-AIDS. Inclusion criteria: selection of titles that are relevant to the formulation of the problem and objectives, full-text articles in English, articles published from 2019 to 2021. The exclusion criteria used were coping strategy articles that did not involve HIV patients. Search references from electronic database sources namely ProQuest, CINAHL, and ScienceDirect.Six articles that are deemed worthy of analysis are then discussed or analyzed. Results: Age, gender and sexual orientation have contributed to the emerging stressor among PLWHA. The internal and external coping strategies focusing on the problem are important for PLWHA in handling the stressor. Conclusion: People with HIV-AIDS have many stressors in their lives, but they also have proper coping strategies depending on their internal and external conditions.

The World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic in 2020, following which a global genetic vaccination program has been rapidly implemented as a fundamental solution. However, it has been reported worldwide that the modified mRNAs encoding spike proteins and lipid nanoparticles, which are used as drug delivery systems, not only cause thrombosis and cardiovascular disorders post vaccination, but might also cause diverse diseases involving all organs and systems, including the nervous system. Furthermore, the toxicity and pathogenicity of spike proteins may necessitate defining these proteins as nonbiological infective material. Based on these reports and the abundant evidence that has come to light in the past few years, this paper aims to draw the attention of medical professionals to the various risks associated with transfusion using blood products derived from long COVID patients or from genetic vaccine recipients, and to make proposals regarding specific inspection items, testing methods, regulations, etc. This paper provides insights to address the post-vaccination syndrome and its consequences following such genetic vaccination programs.

Background: Nursing services provided by nurses are based on knowledge and competence in the field of nursing science developed in accordance with Client needs, scientific developments, and the demands of globalization. These health services include nursing services that are carried out responsibly, accountably, with quality, and safely by nurses who have obtained registration and permission to practice. Nursepreneur is innovation and courage to take risks and is ready to work hard to achieve goals with optimism. Which has important components namely: 1) quality, 2) role, 3) option and success. The post-pandemic new world, especially in the health care system, continues to grapple with the demands of costs to provide patient care and safety. By using the application of the nursing theory model. Purpose :. Assessing scientific studies on the application of evidence-based intervention in wound care using nursing theory, identifying the important role of telenursing in improving nursing services in Nerspreneurship, Method: literature study Conclusion: Telenursing in nursing focuses on providing nursing care through information technology, such as telephone, computers, and the Internet that can be used to improve treatment outcomes among older people, especially those with low literacy skills and low financial status (Esmaeilpour-BandBoni et al., 2020). The statement from the results of the study refutes that Telenursing is intended for patients who have higher education and middle and upper economic states.

In this modern era, continuous change is the first step in forming a new structure between theory and practice. The idea of ​​a juggernaut is very relevant to the theory of structuration with current conditions in the 21st century, where technology becomes a reference that can crush anyone who is not responsive to its power. This technology takes one path and takes many roles from various fields: economic, social, political, legal, and educational. This 21st century is marked by great momentum for changes in human behavior and civilization, namely the industrial revolution 4.0 and the arrival of Covid-19, which have changed many social structures and human activities. This makes history a means of connecting the problems in the 21st century with past events. By using a descriptive qualitative method, this paper will reveal how technological developments are very influential on educational and political developments and what are the challenges faced based on historical perspective?. In this case, the study aims to discuss the history and challenges of Indonesia's education system and government system in the 21st century and give a solution. The data used are from 2 books, 14 journal articles, and 4 websites with a span of 2019-2021. The research results are expected to be used as a further study in the face of the development of the modern era in the fields of education and government. This study also has limitations, namely only on the face of the development of the modern era in the fields of education and government.

This paper proposes the application of force-projecting bilateral control to a master-follower teleoperation system with a pneumatic manipulator on the follower side, and evaluates its effectiveness. The proposed method directly projects the operating force on the master side to the driving force on the follower side, eliminating the need for both position control and external force detection on the follower side, thereby solving the problem of low rigidity and response delay of pneumatic manipulators and providing highly stable sensor-less force presentation against variable environments. In this study, dynamic response analyses of a 1-DOF master-follower system were performed by numerical simulation using a linear system model, followed by experimental verification by implementing an actual system with an external force estimator. The results showed that the proposed force-projecting bilateral control has significantly higher positioning rigidity and better force control stability than the conventional force-reflecting bilateral control. A theoretical consideration was also given using equivalent transformation of force transfer functions to provide evidence for the high stability.

Indonesia is an archipelago with diverse ethnicities, races, languages, cultures, beliefs, and customs. As Indonesians, with these differences, they should respect each other, or what is commonly known as tolerance. However, in the 21st century, tolerance between people in Indonesia is starting to fade. This is due to the development of the times accompanied by technology development, which causes globalization to enter quickly. The culture of tolerance typical of Indonesian society is starting to fade due to the influence of globalization. Based on these problems, this study aims to determine what causes the decline intolerance of Indonesian society in the 21st century and answer what solutions can be given to prevent the decline intolerance of Indonesian society in the 21st century. The research method used is descriptive-qualitative through literature review by analyzing data following the topic to be discussed. The data used are from 20 journal articles with a span of 2019-2021. The results of this study are in the form of a decline in intolerance that the Indonesian people own due to technological advances in the form of adverse use of social media. However, with the existence of moral education and the role of teachers and the government to overcome the decline intolerance, it is hoped that the Indonesian people will understand the meaning and importance of tolerance. This study also has limitations, namely only on the causes of the fading of tolerance in Indonesian society.

The process of sexual reproduction in eukaryotes starts when gametes from two different sexes encounter each other. Paramecium, a unicellular eukaryote, undergoes conjugation and uses a gametic nucleus to enter the sexual reproductive process. The molecules responsible for recognizing mating partners, hypothetically called mating-type substances, are still unclear. We have identified an O3-type mating substance polypeptide and its gene sequence using protein chemistry, molecular genetics, immunofluorescence, RNA inter-ference, and microinjection. The O3-type substance is a polypeptide found in the ciliary membranes, located from the head to the ventral side of cells. The O3-type substance has a kinase-like domain in its N-terminal part located outside the cell and four EF-hand motifs that bind calcium ions in its C-terminal part located inside the cell. RNA interference and immunofluorescence revealed that this polypeptide positively correlated with the expression of mating reactivity. Microinjection of an expression vector incorporating the O3Pc-MSP gene induced additional O3 mating type in the recipient clones of different mating types or syngen. Phylogenetic analysis indicates this gene is widely present in eukaryotes and exhibits high homology among closely related species. The O3Pc-MSP gene had nine silent mutations compared to the complementary mating type of the E3 homologue gene.

Site environments and instrumental characteristics of carbon dioxide (CO₂) measurements operated by local governments in the Kanto Plain, the center of which is Tokyo were summarized for this study. The observation sites were classified into environments of three types: urban, suburban, and woodland. Based on a few decades of accumulated hourly data, the diurnal and seasonal variations of CO₂ concentrations were analyzed as a composite of anomalies from annual means recorded for each site. In urban areas, the highest concentrations appear before midnight in winter. The second peak corresponds to the morning rush hour and strengthening of the inversion layer. Suburban areas can be characterized as having the highest concentration before dawn and the lowest concentration during the daytime in summer in association with the activation of respiration and photosynthesis of vegetation. In these areas, concentration peaks also appear during the morning rush hour. Woodland areas show background features, with the highest concentration in early spring: higher than the global background by about 5 ppmv.

Character education is essential for the current millennial generation and must be applied in everyday life in the surrounding community. The character of the millennial generation is different from the previous generation, which requires us to pay more attention to character education which is starting to erode along with the times. The Millennial generation is a generation that in everyday life can never be separated from science and technology. In this digital era, the millennial generation has a social function of strength in technology. In this study, there are research questions that will be discussed in this article, namely the first regarding what problems occur in the millennial generation who occupy the digital era?. Second, what is the important role and influence of the digital era on character education for the millennial generation in Indonesia?. Writing this article uses a qualitative research method, namely a literature review study, where researchers use or look for references from journals or books. Samples of respondents were taken randomly from each region, and there were ten respondents. From this research, it is found that the millennial generation in the digital era chooses to use social media to access the latest news and information rather than reading print media that contains education. This article aims to find out the importance of character education for the millennial generation, which is starting to erode with the times in the digital era. Many people underestimate character education, especially for the current millennial generation. Therefore, we must implement educational programs at any level, especially in Indonesia, because the character shows the national identity. This article will discuss the vital role and influence of character education for millennials who live in the digital era to be aware of the importance of character education in citizenship.

This article aims to examine the concept of historical thinking by looking at the development of historical learning from colonialism to reformation, as well as some examples of innovations in history learning through technology media. The development of history learning in Indonesia has a long story from the colonialism era to the reformation that changed from time to time. However, changes and reforms in the education system do not make students more interested in history. The 21st century, known as the digital century, makes students' attention more focused on the present and the development of the times. Therefore, there are many innovations that are in line with technological media to support and maintain history learning in this era. The question from this research is how is history learning not favored by students when technological innovations to support this learning have developed? By using the literature review method and a qualitative approach, this article provides a new perspective through existing data. Because innovation cannot run effectively before it is accompanied by historical thinking, so the results of the research are historical thinking must be instilled from the start to support innovations that develop and attract students' interest. Based on the study, it is recommended that have historical thinking to further optimize technology develops innovation more effectively and ask for more interest in history. Keywords: 21st Century, Historical Development, Paradigm

Background: The rapid flow of globalization makes the world free from barriers so that the existence of globalization gives birth to a new concept of "World Without Borders". This situation puts the character of millennials on the brink of collapse and needs to be straightened out. Based on the problems above, the researcher determines the question: How is the role of civic education in shaping millennial character in the era of globalization? Purpose: The purpose of this study is to determine the impact of the current globalization on society, as a form of knowledge of the importance of citizenship education as a shield in the era of globalization, knowing the role of civic education in shaping the character of the millennial generation. Method: The method used in this research is literature review. The search for journals was carried out using the google scholar database with the keywords “citizenship educations”, “millennial generation”, and “globalization”. Feasibility studies are assessed based on title, abstract, and full text. Data analysis using qualitative analysis based on research findings. Results: The results of this study show the influence of globalization causes character problems in millennials increasing every year. The high nature of individualism, consumerism, and westernization shows the characteristics of Indonesia began to erode and eventually also impacted the moral damage. Therefore, prevention is necessary through citizenship education as the basis for character formation by the values of Pancasila.

Backgroud. To improve mortality in patients with sepsis and septic shock, anticoagulant and acute blood purification therapies are performed depends on their severity of organ failure including coagulopathy. Therapeutic approach is required in clinical settings. Material and Methods. We evaluated anticoagulant and acute blood purification therapy in 2,007 patients with sepsis-induced disseminated intravascular coagulation (DIC) in a post-marketing survey examining plasma-derived antithrombin (AT) concentrate. Results. The 28-day mortality rate was 24.2%; before AT administration, there was a significant difference in proportion to the severity of the Sequential Organ Failure Assessment (SOFA) score (p<0.001). The median SOFA score was 9. In patients with SOFA scores >9, the mortality rate was lower in AT combined therapy with recombinant thrombomodulin (rTM) than in AT monotherapy if their JAAM DIC score was >6 (28.5% and 40.0%, respectively; p =0.031). In multiple logistic regression analysis, endotoxin adsorbed polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) before AT administration was correlated with reduced 28-day mortality (odds ratios: 2.071; 95% confidence intervals 1.374–3.121, p=0.001). Conclusions. To improve mortality in patients with sepsis, if patients with endotoxin-induced septic shock, PMX-DHP would undergo, and further development to DIC, AT concentrate administer, followed by rTM if their SOFA and JAAM DIC scores are >9 and 6, respectively. Further prospective study is needed.

Poverty is one of the indexes that can see how a country succeeds in development. In Indonesia, the poverty rate is high as the impact of the Covid-19 pandemic increases over time. Therefore, a solution is embraced in the form of government policies in tackling poverty in Indonesia. The purpose of this study is to analyze the poverty caused by the Covid-19 pandemic.What is the current state of poverty caused by the Covid-19 pandemic in Indonesia? and what are the previous government policies that have succeeded in reducing poverty in Indonesia? The method used in this study is the literature review method based on the results of critical analysis of journal articles that are relevant to the topic of discussion. The results showed that three government policies have succeeded in lowering the poverty level in Indonesia, namely the PKH program policy, the zakat policy as an indicator of poverty reduction, and the Bank Wakaf Mikro policy. Therefore, this study focuses on the policy as a study for government policy in lowering poverty levels due to the Covid-19 Pandemic.

Jakarta is the capital city of Indonesia, which has its own problems in building transportation facilities, especially on land routes. For private vehicle users, congestion is a common thing, given the very dense number of people living in Jakarta, both natives and migrants from outside the region. And for users of public transportation services such as city transportation (angkot) and transjakarta, convenience is the main obstacle. And even though it is a public vehicle, it cannot avoid congestion because it is in one lane with private vehicles except for the transjakarta bus which has its own lane. Meanwhile, for train-based public transportation such as MRT (Mass Rapid Transit), LRT (Light rail Transit), and electric railroad (KRL), the problem is the lack of integration, namely that many stations are not yet integrated with other transportation. Various policies have been implemented to overcome these problems. This study aims to determine the level of effectiveness and efficiency of public transportation in DKI Jakarta today. The method used in this research is qualitative-descriptive through a literature review on 16 journal articles and 4 websites. The results of this study indicate that congestion is a major problem in the means of transportation in Jakarta. This is due to the increase in population due to urbanization which is also accompanied by an increase in the number of private vehicles. Therefore, to overcome this, the Jakarta Provincial Government has made improvements, reforms, and developments in public transportation. And it is hoped that people who originally used private vehicles will switch to using public transportation. But in reality, various problems in public transportation in Jakarta have not been resolved properly. Especially why traffic jams still occur?, and what are the solutions to overcome them?. It is hoped that the results of the findings of this study can be used as a reference in making or designing policies and can contribute to overcoming problems in the transportation sector, especially in the DKI Jakarta area. The limit of this research is that it only focuses on land transportation facilities in Jakarta.

Aim: This study aimed to evaluate the effectiveness of a plyometric training program designed to enhance agility, speed, and social interaction among boys with mild intellectual disability (ID) aged 10-12, within the Special Olympics framework. Participants: Thirty-two boys (mean age = 10.69 ± 0.8 years; mean IQ = 61 ± 7) from three inclusive education centers participated in the study. Methods: The intervention consisted of a 10-week plyometric training program, conducted twice a week. Pre- and post-intervention assessments included the Reaction Time Test, 4-Corner Agility Test, 10-Meter Speed Run, 4x5 Meter Relay Test, and the Friendship Activity Scale (FAS). Results: The study found significant improvements across all measures. Reaction time decreased by 0.83 seconds (t = 7.44, p < 0.001), 4-corner agility improved by 0.77 seconds (t = 11.93, p < 0.001), 4x5 meter speed improved by 0.61 m/s (t = 17.37, p < 0.001), and 10-meter run speed improved by 1.55 m/s (t = -12.76, p < 0.001). Additionally, the FAS score increased by 0.81 points (t = 9.59, p < 0.001), indicating enhanced social interactions. Conclusion: The plyometric training program significantly improved agility, speed, and social interaction in children with mild ID, demonstrating the effectiveness of inclusive, adaptive physical education strategies within the Special Olympics framework.

Background: The rapid flow of globalization makes the world free from barriers so that the existence of globalization gives birth to a new concept of "World Without Borders". This situation puts the character of millennials on the brink of collapse and needs to be straightened out. Based on the problems above, the researcher determines the question: How is the role of civic education in shaping millennial character in the era of globalization? Purpose: The purpose of this study is to determine the impact of the current globalization on society, as a form of knowledge of the importance of citizenship education as a shield in the era of globalization, knowing the role of civic education in shaping the character of the millennial generation. Method: The method used in this research is a literature review. The search for journals was carried out using the google scholar database with the keywords “citizenship educations”, “millennial generation”, and “globalization”. Feasibility studies are assessed based on title, abstract, and full text. Data analysis using qualitative analysis based on research findings. Results: The results of this study show the influence of globalization causes character problems in millennials increasing every year. The high nature of individualism, consumerism, and westernization shows the characteristics of Indonesia began to erode and eventually also impacted the moral damage. Therefore, prevention is necessary through citizenship education as the basis for character formation by the values of Pancasila.

Introduction: Pancasila was born as the ideology of the Indonesian nation, which reflects the values cultural values, ethics, morals, and the spirit of the nation. Pancasila was born as a form of national character, which reflects divinity, nationality, unity, togetherness, and justice. The purpose of this research is to know the practice of Pancasila values ​​in the life of the nation and the state. Especially, the implementation of the life of the younger generation in the 21st century today. Methods: This study is literature research where data is collected using keywords in the database. Literature source search carried out with the help of Boolean operators and using the PICOS format. The results of selecting articles, using PRISMA Flow Diagrams. The search results found 125 articles that match the research theme. After checking for duplication, 82 articles were excluded because of the similarity in the results of the discussion. In the end, there were 43 articles used as a literature source. Results: Based on the analysis of research findings, which are supported by literature sources, it shows that the current values ​​of Pancasila are worrying. This can be seen, where people's behavior has been contaminated by external cultures due to technological sophistication. At present, it can be said that the ethics and morals of society do not reflect the values ​​of Pancasila. Conclusion: In order to re-install the values ​​of Pancasila in people's lives, the participation of all parties is necessary. This is especially so, for today's younger generation. Therefore, it is necessary to develop a model for teaching Pancasila to be carried out by schools and colleges. So that later, it can produce a generation of ethics and morals who love the country.

Patient safety is one of the indicators of the quality of health services in the hospital, for that, it is necessary to have efforts from the hospital to create a system that can minimize the occurrence of errors and unexpected events that can harm patients, nurses as health workers who are the most numerous in the home. sick and with the patient for 24 hours, has an important role in maintaining patient safety. This study aims to explain how the role of nurses and cooperation between health workers in implementing patient safety measures in the hospital. The method used in this study is a literature review by analyzing and exploring relevant articles and focusing on interprofessional collaboration to improve patient safety. The articles used in this study were taken from 3 direct, Proquest, Pubmed science databases published in the last 3 years, namely between 2019-2021, nurses as part of the health team are required to be able to work together with other health professionals in hospitals with various characteristics, including education, gender, age, employment status and length of work, nurses are required to be committed to maintaining patient safety in the hospital.

ABSTRACT Background: Nearly two-thirds of acute stroke patients have dysphagia. Dysphagia defined as difficulty in swallowing of liquids or food, vary in severity with symptoms ranging from mild throat discomfort to inability to eat. It’s well known that dysphagia is associated with aspiration pneumonia, dehydration, malnutrition, prolonged length of stay, and increased mortality. Early screening reduces pneumonia rates in stroke and it is usually performed by nurses. Dysphagia screening is recommended but no protocol or tool is pointed.Aim: the aim of this study is to conduct a literature review of dysphagia screening for stroke patient Methods: Literature search three databases (Scopus, Proquest, and Science Direct), with the keywords "Dysphagia" AND "Stroke" AND "Nursing", published in English between 2019 and 2021. Result: Twenty five publications relating to dysphagia screening met the inclusion criteria. There are five methods of dysphagia screening performed by nurses or other health workers: 1) a simple Questionnaire Test (4QT) method, which is by asking the following four questions: does the patient cough or choke while eating or drinking; whether the patient takes longer than usual to eat; does the patient change the thickness of the food to be able to swallow, and whether the voice turns hoarse after eating or drinking; 2) Water Swallow Test (WST) method; 3) Bed Side Screening Tool for Dysphagia (BSTD) method; 4) Volume Viscosity Swallow Test (V-VST) method, namely modification of feeding with first pudding, nectar and finally water; 5) Simplified Cough Test Method. The five screening methods for dysphagia above have been tested for sensitivity and specificity, as well as positive and negative predictive valuesConclusion: screening is a first step in the identification of swallowing impairment or dysphagia of stroke patient. Dysphagia is an independent predictor of poor patient outcome and prolonged recovery time. Nurse has an important role to conduct a screening and must ensure that the selected tools has high reliability and concurrent validity. Key Words: Stroke, Dysphagia, Screening, Nursing

Background Pregnancy is a process of maturity for women that requires adaptation to the changes in their new roles. Adjustment to a new role is not easy, especially if the pregnancy is accompanied by risks, so it is necessary to get treatment to minimize complications. Dyad models that optimize husband or family support are very important to prevent the risk of complications and adapt mothers to their new roles. The purpose of this study was to determine the effect of the dyad model on high-risk pregnancies. The method used with a literature review is through the collection of articles from Scopus, ebsco, ProQuest and PubMed. The results obtained were articles from Scopus 9, Ebsco 107, PubMed 214 and ProQuest 85 which carried out identification, screening and eligibility for 25 articles. Overall results mention. Journals are categorized into 4 groups, Dyad Model and social support, high-risk pregnancy, maternal role and Self Efficacy. Conclusion, there is an effect of the dyad model on care for high-risk pregnancies.

Client or patient satisfaction is a very important indicator in determining service quality, patient satisfaction with various factors, but the main determining factor for patient satisfaction is the nurse, because nurses are medical personnel who are always near the patient and almost approaching the treatment that the client receives always involves the nurse. In it, therefore, nursing services, namely in the form of nursing care, are important to penetrate patient satisfaction. The purpose of this paper is to determine the effect of the quality of nursing services in increasing patient satisfaction. The method used in this research was a literature study which is analyzed from 25 articles searched through Google Scholar and Pubmed and selected based on indexes, namely Scopus, Sinta 1, and 2 and the topics discussed. The results showed that if the quality of service of nursing or nursing care can significantly increase patient satisfaction.

Nursing is a part of health services that serves individuals, groups and communities. In this 21st century the need for nursing services has changed rapidly and in a complex manner. Physical limitations, is on should to be considered, while the implementation and maintenance of patient-centered service infrastructure still have to be recked. The aim of this literature review is to identify the role of telenursing in nursing services for patients. This language method uses literature reviews which are summaries of 10 articles in the publication years of 2019, 2020, and 2021 on 3 search databases, namely Scopus, Science Direct, and SAGE. This review used the new Joanna Briggs Institute and Prisma. The eligibility of these studies were from its title, abstract, research methodology, results, and discussion. The results of the review were presented in narrative form. The results of a review of 10 articles found that the form of nursing services with telenursing could prove long-distance service, time efficiency and funding allocation, but in terms of quality it had been not satisfactory related to its physical implementation of nursing service. Conclusion: The nursing paradigm in the 21st century global era has been developed with the help of technology to meet the needs of distance efficiency and cost limitations. Thus, telenursing is a solution to answer these challenges.

Many agonists for the estrogen receptor are known to disrupt endocrine functioning. We have developed a computational model that predicts agonists for the estrogen receptor ligand-binding domain in an assay system. Our model was entered into the Tox21 Data Challenge 2014, a computational toxicology competition organized by the National Center for Advancing Translational Sciences. This competition aims to find high-performance predictive models for various adverse-outcome pathways, including the estrogen receptor. Our predictive model, which is based on the random forest method, delivered the best performance in its competition category. In the current study, the predictive performance of the random forest models was improved by strictly adjusting the hyperparameters to avoid overfitting. The random forest models were optimized from 4,000 descriptors simultaneously applied to 10,000 activity assay results for the estrogen receptor ligand-binding domain, which have been measured and compiled by Tox21. At this time, our model delivers the highest predictive power on estrogen receptor agonists in the world. Furthermore, analysis of the optimized model revealed some important features of the agonists, such as the number of hydroxyl groups in the molecules.

Globalization plays a very important role in the advancement of science and technology today, especially in Indonesia. Globalization has also succeeded in changing all aspects of human life. In addition to having a positive impact on the development of science and technology in Indonesia, globalization also has a negative impact that is quite visible on the character of today's youth. The crisis of the character of Indonesian youth is a serious matter and is reflected in the behavior of Indonesian youth today which does not coincide with the identity of the Indonesian nation and the values ​​of Pancasila. This paper examines the lack of implementation of Pancasila values ​​in the life of the globalization era and also how globalization affects moral decadence among the younger generation. The method used is the Literature Review method, which is a qualitative research method by collecting data from the literature. The lack of practice of Pancasila values ​​and the emergence of globalization is increasingly diminishing the character of Indonesian youth. The implementation of Pancasila values ​​among teenagers needs to be increased so that the nation's moral character is not eroded by the currents of globalization.

Introduction: Industrial revolution 4.0 in the current era of globalization plays an active role in the modern era in Indonesia. The influence of increasingly advanced technology affects the millennial generation as the nation's next generation to make Pancasila the basis of the State or the foundation of a State. In addition, the millennial generation has begun to shift the guidelines of life from Pancasila so that the appreciation of Pancasila values is starting to disappear along with the development of the times and in line with the progress of Science and Technology (IPTEK). If this continues, then the values of Pancasila will be replaced by a new ideology that will cause behavioural changes in society. Purpose: this study aims to provide the proper application to millennial life using Pancasila values, knowing the behaviour of the millennial generation towards the implementation of Pancasila values, and making Pancasila a way of life. Methods: the method used in this research is Literature Review and takes sources from journals published in 2019 to 2021 related to the Pancasila theme and the millennial generation. Results: the study results show that with the existence of Pancasila as the ideology and principle of the State, it is expected to strengthen the attitude and nature of the community in accepting things outside the norms that exist in Indonesia. In addition, the younger generation is expected to be able to apply Pancasila values along with the development of science and technology in the modern era and current globalization. The research question is how to make the millennial generation implement Pancasila in life in the contemporary period and what solutions can continue to instil Pancasila values ​​in the 4.0 industrial revolution. Recommendation: the conclusion drawn is that Pancasila can become a unifying tool for the nation if the current generation or millennial generation still desires to maintain its values ​​, even though they are in a modern era and many influences from its outside cultures. Limitation: the limitation of this research is not getting all the data directly from the source. The researcher recommends using primary data for the following study to ensure its truth and accuracy better because the researcher directly obtains it.

ABSTRACT Education is the most important instrument in human life because education can increase human dignity. In addition, education can also be a benchmark for human quality and an example of the progress of a nation. The history of education in Indonesia has evolved from the colonial era to the digital era. These developments have influenced government policies in every era. In the 21st century, the development of education in Indonesia is starting to show progress. This is because it is supported by the rapid growth of information and technology. This research article aims to analyze the educational policies carried out by the government from the colonial era to the digital era to be used as evaluation material at this time so that in the future education in Indonesia is even better. To achieve this goal, this research focuses on the question of how is the transformation of education in Indonesia from the colonial era to the digital era? and what is the paradigm of education in Indonesia when viewed from a historical perspective?. The research method used is the Literature Review method from 27 sources in journal articles, websites, and data reports for 2019-2021. The results of this study found that changes in the Indonesian education system from time to time have a positive influence on the progress of the Indonesian nation. The development of education in Indonesia also has an impact on increasing the Human Development Index (HDI). This shows that the quality of Indonesian society is increasing. Based on the results obtained, it is hoped that it can provide information about the transformation of education in Indonesia from the colonial era to the digital era from a historical perspective. This article is suitable as a reference source for education observers in Indonesia to know the history of education and its policies from the colonial era to the digital era and useful for academics to know the history of education in Indonesia. This research has limitations, namely this research is only limited to the development of education in Indonesia from the colonial era to the digital era and the paradigm of education development in Indonesia from a historical perspective.

Pancasila is the identity of the Indonesian nation, which means that Pancasila is a national characteristic that cannot be found in any country. Pancasila points are taken from the noble values of the Indonesian state. These principles contain culture, customs, and national character known as manners, cooperation, and high nationalism. As the successor to Indonesian culture, the young generation must be able to preserve and develop Pancasila. In this era of globalization, there are many challenges for the younger generation in preserving Pancasila. This study aims to provide an overview of the decline of Pancasila identity among the younger generation due to the impact of globalization. The research question that has been determined is how the practice behaviour of the younger generation towards the implementation of Pancasila, the solutions and efforts that all Indonesian people can make regarding the crisis of Pancasila identity in the era of globalization. This research method uses a literature review. The research sources were conducted from the latest journals and books published in 2019 until 2021 related to the theme of Pancasila and the millennial generation. The results showed that globalization has greatly facilitated foreign cultures to enter Indonesia. The younger generations use this foreign culture as a lifestyle without filtering it, whether it contains Pancasila values or not. This causes Pancasila has been forgotten and no longer applied in their everyday life. Young people can make various efforts to preserve the national identity, namely Pancasila. Apart from the role of the young generation itself, Indonesian society can also play an essential role in supporting the younger generation to continue implementing Pancasila in their lives. By conducting this research, it is hoped that Indonesia's young generation can understand, select, and stay away from the negative impacts of globalization that enter Indonesia freely. The solution that can be given from this research is that the younger generation must love their own culture more and practice every principle in Pancasila. Parents, educational institutions, and the government must also support the younger generation to maintain national identity, Pancasila values. The limitation of this research is that the researcher did not conduct any primary data, which means the data were not directly from the source. This causes the accuracy of this study to be less guaranteed. The recommendation that the researchers can give for further research is to obtain primary data to ensure accuracy and explore research topics regarding the fading of Pancasila identity in the younger generation in this era of globalization.

Because of the covid-19 pandemic, world development has de-escalated, and some have come to a halt because there are many new problems that this era never faced before. Especially in Indonesia's education, every student in this millennial era who is already used to face-to-face lectures and teachers and professors are going through massive changes where every task will be done virtually. These actions are being done to prevent the spread of Covid-19. With online meetings, there will be many changes in the curriculum to find an effective way of studying, and the former curriculum will not fit because it was made for the offline lecture. Also adapting to it will take time. This article will bring up Indonesia’s education progress in this era while Covid-19 pandemic is happening and give an insight on how to anticipate this problem. Questions that arise from this topic are the effect of government effort on holding the pandemic, is it safe if school will be opened soon, and how education after this pandemic is. This research uses literature review methods where it’s done by search, gather, compile and interpret data that is being used. The data are from the latest research, namely from 2019 to 2021 published through Google Scholar, totaling 11 articles, and few online news to keep relevancy of the topic. The results of this study indicate that Covid-19 produces a change that is worse than the good. Even so, the government has allowed face-to-face and online learning according to the consent of students and parents. Thus, the community, especially students, teachers, and others, are expected to uphold education even though it is required to adapt according to existing protocols. From the research, literature review methods proved to be effective to study this topic while Covid-19 is happening to keep safety measures, but it does not give many details and specific information well. This method is recommended to researchers who don’t want to risk their life by being exposed to the pandemic.

Introduction: Indonesia consists of a plural society with different ethnic, religious, racial, skin color, and other cultures. The difference must be understood by everyone, especially the younger generation in the digital age. If the younger generation does not have a sufficient understanding of multicultural education values, it will impact the moral crisis of the Indonesian nation. This research emphasizes the importance of multicultural education to the younger generation to understand the differences (pluralism) in society and respect them. Method: The method uses a qualitative method with the literature review method by collecting data on ten journals published in 2019, 2020, 2021. Results: The rise of socio-cultural conflicts in Indonesia is why applying multicultural values to the younger generation. Multiculturalism is needed to establish morals and sensitivity for a young person in the face of various social problems and symptoms at a growing age. Conclusion: Multicultural education is vital to the younger generation considering Indonesia has diverse nations and cultures. The efforts that can make to improve the morale of the nation's children, namely by learning citizenship education and religious education and utilizing information technology to spread things related to the values of multicultural education to the broader community

Babies born prematurely are at risk of experiencing visual disturbances, hearing loss, disabilities, the risk of infection and even death. Care for premature babies requires serious attention for both health workers and parents. The role of parents is very important both during hospitalization and at home. Therefore, in order to improve the abilities of parents, it is necessary to make educational efforts with the right method.ObjectivesThis literature review aims to provide an overview of educational methods that nurses can use to improve the ability of parents to care for or care for the development of premature babies. The method used is to search for literature that fits the established theme using 5 data based, namely Scopus, ProQuest, Science Direct, Elsevier Clinicaly for Nursing and Web of Science. The strategy used in finding literature that fits the theme and is used in this literature review uses the PICOS framework. Then conducted a review with the PRISMA method. The literature selection results obtained 572 publications, after going through the selection obtained 11 literatures that match the theme, with 11 educational methods. These methods can be grouped into ideas, namely increasing parental involvement during treatment, using technology, stress management and continuous monitoring. The ability of parents to care for premature babies is needed in order to minimize complications in infants, reduce morbidity, avoid disabilities, increase growth and development of premature babies optimally and reduce parental stress levels, increase parental confidence and good parents' self-efficacy. Choosing the right educational method can improve the ability of parents to properly care for and provide developmental care for premature babies.

Play therapy is an approach to providing assistance in overcoming problems using media such as toys, art media, games, and communication. The purpose of this paper is to find out that play therapy can reduce anxiety in children. The research design used in this study was a study-literature review. The data used in this research comes from the results of research that have been conducted and published in national and international online journals. The method of analysis used in this study is the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) method.

Resilience is an adaptive coping mechanism needed by health workers, especially nurses who have longer working hours than other health workers to provide care to patients in the era of the Covid-19 pandemic which is a global health problem. The aim of this literature review is to identify the resilience of nurses during the covid-19 pandemic the 21 st century global nursing paradigm. This language method uses literature reviews which are summaries of 10 articles in the publication years of 2020-2021 on search 4 databased electronic searches contain namely Scopus, ProQuest, Pubmed, and Scient Direct. This review used prisms. The eligibility of these studies were from its title, abstract, research methodology, results and discussion. The results of the review were presented in narrative form. The results of a review of 10 articles found that the form of psychological factors during the covid-19 pandemic, mental distress and influencing factors in nurses caring for patients with COVID-19, resilience nurses during the covid-19 pandemic. Conclusion: The 21 st century global nursing paradigm, one of the global problems in the health sector, with the outbreak of the corona virus disease (Covid-19), the role of nurses as the front guard is needed by the community to provide health services in line with the increasing incidence of covid-19 cases. Strong nurses need an adaptive inner coping mechanism.

Background Tuberculosis is a type of infectious disease that can cause death if treatment is not completed. the duration of tuberculosis treatment can reach 6 to 8 months so it really requires discipline when doing treatment. This makes tuberculosis patients in dire need of health information and social support which is very helpful in providing motivation, health information, and monitoring treatment from nurses. Aim of this literature review is to provide an overview of the The Role Of Nurses In Providing Social Support In Tuberculosis Treatment: Literature Review. Method is a literature review research, this study uses electronic database searches using keywords according to research questions from the online library PubMed, Content Science, and Science Direct. Result it was found that the role of nurses in the aspect of social support, namely in providing motivation, supervision, comfort, empathy, and information. this is very necessary for patients with tuberculosis at the time of treatment. Conclution social support is needed by tuberculosis patients who are currently undergoing treatment to provide motivation, health information, and as a nurse's supervision of patient adherence to tuberculosis treatment.

Background: Indonesia is an archipelago with various cultured, will bee affects all aspects of people's lives, including beliefs related to health behavior and health care. One problem that needs serious attention is the elderly group because the elderly are a vulnerable group who have a high risk of experiencing health problems, such as anemia with hypertension, so they need good care management. The research objective was to determine self-management intervention for hypertensive elderly. Methods: This research is a literature review with five databases (Scopus, CINAHL, ScienceDirect, PubMed, Proquest), the study design used is an experimental, descriptive, cross-sectional, and review systematic, in March 2021. Guidelines for using JBI to measure quality and listing check out Prisma in this review guide. A feasibility study based on title, abstract, full text, and research methodology. The data analysis used narrative analysis based on the research findings. Results: Twelve articles met the predefined review inclusion criteria. The study found eight interventions for self-management in elderly hypertension, namely: 1) Knowledge of hypertension, 2) Regulation of physical activity, 3) Limitation of alcohol and cigarette consumption, 4) Sleep rest and stress management, 5) Diet and body weight management, 6) Blood pressure control, 7) Family and social support, 8) Adherence to therapy regimens. Conclusion: The conclusion of the study results obtained eight elderly self-management interventions, this done properly will affect compliance in optimizing the health of the elderly.

Background: In the current era of globalization, the Indonesian government's problem today is the weakening of nationalism and patriotism among the millennial generation. The large number of foreign cultures that have entered Indonesia has caused a sense of nationalism and patriotism. In addition, Indonesia is also facing the problem of spreading the Covid-19 virus. During the pandemic, various policies set by the government received protests from some circles because they felt their freedom was restricted. Therefore, the awareness of millennial generation nationalism is needed, especially during the Covid-19 pandemic like today. This research aims to make millennials aware of nationalism sense, which mainly to prevent the spread of Covid-19. This research is used to answer the questions of what the problems that arise due to the waning of the spirit of nationalism during the pandemic are? and what efforts should be made to maintain the spirit of nationalism? Methods: This research is a qualitative study using the literature review method. The articles used are research published in 2019 to 2021 in Google Scholar, with keywords that match the topic of millennial generation nationalism in the Covid-19 pandemic. Results and Discussion: The results of the study found that the spirit of Indonesian nationalism during the Covid-19 pandemic was decreasing. The decline in the sense of nationalism is due to several government policies that impact the psychology of society and the Indonesian economy. As a result, society, particularly the millennial generation, must play a role in breaking the chain of the Covid-19 virus's propagation by following the government's health standards. Conclusion: The government and society need to work together to understand nationalism in the millennial generation, especially in dealing with problems caused by the Covid-19 pandemic. Based on this, various efforts need to be made to foster the spirit of nationalism and overcome the Covid-19 pandemic. So that later, it can produce a generation that upholds the value of nationalism in everyday life.

Technological developments, as a result of globalization, indirectly affect human lifestyles, one of which is the Indonesian people. In a situation of change towards the Industrial Revolution 4.0, Pancasila has a role as a guide for the Indonesian people to be what by the noble values ​​of the nation. However, the role of the millennial generation in maintaining these noble values ​​is important considering that they are the spearhead of the country's development. From this statement, this study aims to identify and formulate steps to maintain the noble values ​​of Pancasila among the millennial generation so that it does not eliminate national identity and understand the urgency of implementing the Pancasila lifestyle in the era of globalization. By using the literature review method, it can be seen that "grounding" and strengthening the essence of Pancasila values ​​can be a solution so that the existence of Pancasila continues to shine. The Pancasila lifestyle deserves to be implemented because it regulates all behaviors of speech, thought, behavior, action, and good manners so that it must be expressed in the life of the nation and state as well as our everyday life.

Background: The level of students' understanding of the knowledge of patient safety concepts in infection prevention and control and awareness of treatment is in the low category. Clinical education that provides problem-based learning models in real areas helps students to better understand patient safety. This study is designed to analyze the evaluation and reflection of the role of nursing education institutions in the achievement of patient safety competencies by nursing students.Method: "Searching for articles in research journals is obtained from Sciencedirect, Ebscohost, Garuda, Proquest and Scopus. As many as 228 articles were obtained consisting of nursing journals and health journals with the keywords clinical education, competence, and patient safety. After that, the screening process was carried out based on the inclusion criteria and obtained 25 articles that met the criteria. "Results: the results of the evaluation show that there is a big role in educational institutions in designing curricula, learning models, and clinical education models in an effort to achieve patient safety competencies in nursing students.Conclusion: the learning model about patient safety organized by many educational institutions is considered ineffective in producing the achievement of patient safety competencies for nursing students. This makes it necessary to develop models, reform the patient safety curriculum that is embedded in real areas in clinical education practice

Holistic care in the nursing care consists of physical, psychological, socio-cultural, developmental and spiritual aspects. However, the spiritual has received less attention than the other four aspects. The aim of this study was to review paper related to spiritual care in nursing care practices. The method in this study is a review using the CINAHL database. CINAHL was used because the articles focus on nursing topics. The keywords used were "Spirituality" OR "Spiritual care" OR "Spiritual" AND "Nurse". The inclusion criteria for the article were English language and published from 2019-2021, for adult range between 18-44 years old. Exclusion criteria were article not in English language, not full paper article, not in Human and not psychometric study also master thesis. This study recorded 64 articles, screened according to the topic, then the final results recorded 19 articles. This article focuses on the use of spiritual care in patients, nurses and caregivers, as well as both of patients and caregivers. The results of the review showed that spiritual care was important for mental health, physical health, and well-being, quality of life, increasing expectations for patients, nurses or caregivers. The significance of the study was spiritual care should be addressed in nursing care practices and it must include in the nursing curriculum, because spiritual care has many benefits for patients and nurses.

Coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached a global epidemic across the world after first reported in Wuhan, China’s Hubei province in December 2019. The pandemic is also associated with acute respiratory distress syndrome (ARDS) characterized by excess inflammation, progressive arterial hypoxemia and dyspnea. Mesenchymal stem/ stromal cells (MSCs) have been investigated as treatment for ARDS due to immunomodulatory property. Exosomes derived from MSCs play an important role in paracrine signaling of MSCs, thereby contributed to immunomodulation of the immune microenvironment. Exosomes are emerged as potential alternative to MSC cell therapy with superiority of safety. In this review, we will introduce MSC-derived exosomes and briefly discuss current progress on MSCs and exosomes in ARDS, which may have clinical implications in pathogenesis and treatment of COVID-19.

Aquaporin-11 (AQP11) is an intracellular water channel expressed at the endoplasmic reticulum (ER) of the kidney proximal tubule. Its gene disruption in mice leads to intracellular vacuole formation at one week old and the subsequent development of polycystic kidneys at three week old. As the damaged proximal tubular cells with intracellular vacuoles later form cysts, autophagy may play a role in their survival. We examined the autophagy activity before and after the development of cysts in AQP11(-/-) kidneys. We first observed an enhanced expression of LC3 gene (Map1lc3b) as well as other autophagy-related genes in AQP11(-/-) mice by quantitative PCR analysis. We then examined the formation of autophagosomes visualized by a green fluorescent fusion protein, GFP–LC3 in its transgenic mice. The expression of GFP-LC3 puncta was increased in the proximal tubule of AQP11(-/-) mice before the cyst formation. Interestingly, they were also observed in the cyst-lining epithelial cell. Further PCR analyses revealed the enhanced expression of apoptosis- and ER stress-related caspase genes before and after the cyst formation suggesting that ER stress may have enhanced autophagy. We conclude that autophagy will play an important role in the development and the survival of the kidney cysts in AQP11(-/-) mice.

Velvet worms, or onychophorans, include placental species and, as a phylum, have survived all mass extinctions since the Cambrian. They capture prey with an extraordinary adhesive net that appears in an instant. The first naturalist to formally mention them was Lansdown Guilding (1797-1831), a British priest from the Caribbean island of Saint Vincent. His life is as little known as the history of the field he initiated, onychophorology. This is the first general history of onychophorology, and I have divided it into half century periods. The beginning, 1826-1879, was defined by former students of great names in the history of biology, like Cuvier and von Baer. This generation included Milne-Edwars and Blanchard, and the greatest advances came from France, with smaller but still important contributions from England and Germany. In the 1880-1929 period, work concentrated in anatomy, behavior, biogeography and ecology, but of course the most important work was Bouvier’s mammoth monograph. The next half century, 1930-1979, was important for the discovery of Cambrian species; Vachon’s explanation of how ancient distribution defined the existence of two families; Pioneer DNA and electron microscopy from Brazil; and primitive attempts at systematics using embryology or isolated anatomical characteristics. Finally, the 1980-2020 period, with research centered in Australia, Brazil, Costa Rica and Germany, is marked by an evolutionary approach to everything, from body and behavior to distribution; for the solution of the old problem of how they form their adhesive net and how the glue works; the reconstruction of Cambrian onychophoran communities, the first experimental taphonomy; the first country-wide map of conservation status (from Costa Rica); the first model of why they survive in cities; the discovery of new phenomena like food hiding, parental feeding investment and ontogenetic diet shift; and for the birth of a new research branch, Onychophoran Ethnobiology, founded in 2015. While a few names appear often in the literature, most knowledge was produced by a mass of researchers who entered the field only briefly.

Background: Industry revolution 4.0 (IR.4.0) paradigm, nurses were required to have adequate competencies to carry out their professional duties. Digital information should be mastered by the nursing student. Purpose: This study aims to explain digital literacy competencies on nursing students in the era of IR 4.0 in the Indonesian context. Methode: A literature review was conducted in this study using Rayyan Systematic Reviews Software. Results: There was 14 literature analyzed describing Student’s Information literacy competency and Internet of Thing. Conclusion: Digital literacy for nursing students today is an inevitability, and nursing students who have digital literacy competencies have the potential to be able to increase nursing knowledge and skills as ontological competencies in their learning process.

Background: Indonesia is one of the multicultural countries in the world. The diversity that exists in Indonesia is reflected in differences in race, ethnicity, culture, and religion. It is not surprising that Indonesia will face the threat of national disintegration due to differences. Therefore, Indonesia needs a concept in fostering diversity to create national resilience. Purpose: This study aims to explore how the role of archipelago insights in shaping national geostrategy resilience. Method: The method used in this research is literature review. The search for journals was carried out using the google scholar database with the keywords "archipelago insight" and "geostrategy" and "national resilience". Feasibility studies are assessed based on title, abstract, full text, and research methodology. Data analysis using narrative analysis based on research findings. Result: insight into the archipelago can be used as a basis in shaping a national geostrategy. The perspective in the concept of archipelago insight by fostering the diversity in Indonesia can create unity and integrity to form national geostrategic resilience. Conclusion: The concepts that exist in the archipelago perspective and national geostrategy can foster the diversity that exists in Indonesia. The creation of existing unity and integrity, understanding the perception of seeing differences, is not a threat to realizing national resilience in the Indonesian nation.

Covid-19 has become a non-natural national disaster that affects the national resilience of the Indonesian state. In maintaining national resilience, the implementation of state defense is needed. This research aims to describe the awareness of defending the state of millennials during the current situation of the Covid-19 pandemic in Indonesia by using a quantitative approach with descriptive analysis methods with survey techniques. The results of this study indicate that most millennials are aware of the obligation to defend the state amid the current Covid-19 pandemic, namely by implementing health protocols such as preparing cleaning equipment, conducting social distancing, and working from home. However, there are still millennials who cannot run it for some reason. Based on the results of this study, it concluded that most millennials are aware of the obligation to defend the state during a pandemic by complying with health protocols as a form of state defense character.

Some global difficulties in the modern period include energy storage conversion. Researchers have looked to renewable energy resources to discover long-term answers to this dilemma. Fuel cells are one example of prospective energy producing technology. Although these technologies appear to be very enticing, they are known to be expensive due to high expenses. Catalyst costs, as well as concerns concerning energy density. Pt based Electrocatalysts have traditionally been used to drive ORR and offer efficient power outputs. However, cost constraints have limited the use of these electrocatalysts, rendering them inefficient. Apart from the high price, Pt-based Electrodes are prone to time-dependent drift and CO deactivation, both of which occur gradually. Electrocatalysts deteriorate over time, reducing the efficiency of fuel cells. This is why alternative electrocatalysts are in high demand for future energy applications. This review covers the comparative study of Platinium and Non-Platinium based electrocatalyst in fuel cells, their shortcomings and recent advancement for efficient and optimized electrocatalyst.

Mind-body interaction and its manifestations at the brain level has been studied extensively in the field of consciousness research. Fara-darmani Consciousness Field, as claimed by Mohammad Ali Taheri (the founder), is a method of connecting with the Cosmic Consciousness Network through human mind and his brain has a detective role in this process. As a result of this connection, the scanning process of the state of a being, e.g., the health status of the cells and consequently organs is performed. This study was conducted to evaluate the effects of the Fara-darmani Consciousness Field connection on electroencephalogram (EEG) features as an important biomarker of the brain functioning. The results showed that there was a significant increase in the gamma2 frequency band (35-40 Hz) power in the frontal lobe in medial frontal gyrus (BA6) and paracentral lobule (BA31) of the brain during the task condition compared to the rest condition in a Fara-therapist population. Considering the cortical electrical activity of Fara-therapist’s brain during Fara-darmani Consciousness Field connection, characterizing increase in the power of gamma wave and the activity of the areas affecting on memory, attention, perception and default mode network intrinsic activity. This manifestation distinguishes Fara-darmani Consciousness Field connection from other known methods dealing with the mind-body interaction criterion mainly different types of mediation.

Sublingual vaccines offer the benefits of inducing mucosal immunity to protect against respiratory viruses, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and influenza, while also enabling needle-free self-administration. Previously, we developed a sublingual vaccine formulated with the SARS-CoV-2 receptor binding domain antigen and Poly(I:C) adjuvant in nonhuman primates, cynomolgus macaques. This study examined the immune and inflammatory responses elicited by the sublingual influenza vaccine containing hemagglutinin (HA) antigen and Poly(I:C) adjuvant and assessed the safety of this vaccine in nonhuman primates. The Poly(I:C)-adjuvanted sublingual vaccine induced both mucosal and systemic immunities. Specifically, the sublingual vaccineproduced HA-specific secretory IgA antibodies in saliva and nasal washings, and HA-specific IgA and IgG were detected in the blood. This vaccine appeared to be safe, as judged from the results of blood tests and plasma C-reactive protein levels. Notably, sublingual vaccination neither increased the production of inflammation-associated cytokines—IFN-alpha, IFN-gamma, and IL-17—in the blood, nor upregulated the gene expression of proinflammatory cytokines—IL12A, IL12B, IFNA1, IFNB1, CD69, and granzyme B—in white blood cells. Moreover, DNA microarray analyses revealed that sublingual vaccination evoked both enhancing and suppressing expression changes in genes associated with immune-related responses in cynomolgus monkeys. Therefore, the sublingual vaccine with Poly(I:C) adjuvant is safe and creates a balanced state of enhancing and suppressing the immune-related response.

Detection of pancreatic cancer (PC) at a resectable stage is still difficult because of the lack of accurate detection tests. The development of accurate biomarkers in low or non-invasive biofluids is essential to enable frequent tests, which would help increase the opportunity of PC detection in early stages. Polyamines have been reported as possible biomarkers in urine and saliva samples in various cancers. Here, we analyzed salivary metabolites, including polyamines, using capillary electrophoresis-mass spectrometry. Salivary samples were collected from patients with PC (n=39), chronic pancreatitis (CP, n=14) and controls (C, n=26). Polyamines, such as spermine, N1-acetylspermidine, and N1-acetylspermine, showed a significant difference between PC and C, and the combination of four metabolites including N1-acetylspermidine showed high accuracy in discriminating PC from the other two groups. These data showed the potential of saliva as a screening test for PC.

In light of the critical and emerging global challenge posed by the increasing frequency and severity of heatwaves in recent decades, this study demonstrates a practical and robust workflow that bridges the gap in understanding how the effective integration of remote sensing data with ground-based observations can facilitate a comprehensive assessment of spatiotemporal heatwave patterns and trends in the central region of Thailand. This research transcends traditional methods, utilizing air temperature (Tair) and satellite-derived land surface temperature (LST) data from 1981 to 2019. Results exhibit that an analysis of Tair indicates increasing daytime heatwaves in peri-urban areas, with significant trends in heatwave number (HWN), heatwave frequency (HWF), and heatwave duration (HWD), heatwave amplitude (HWA) rises in urban settings while nighttime heatwaves significantly intensify in rural locales. Notably, LST trends reveal varied patterns, with peri-urban areas showing marked daytime increases in heatwave magnitude (HWM), HWA, and HWF. Correlation analysis (p=0.05) highlights strong daytime associations between Tair and LST in rural (HWN, HWF, HWD, r&gt;0.90) and peri-urban (HWM, HWA, r&gt;0.65) regions. Overall, this study advances approaches to the adaptable measurement and spatial-temporal pattern of heatwave-related risk areas, providing insights for decision-makers to develop sustainable practices and strategies for climate change adaptation.

This study aimed to elucidate the similarities and differences between amyloid-forming corpora amylacea (CA) in the prostate and lung, examine the nature of CAs in cystic tumors of the atrioventricular node (CTAVN), and clarify the distinctions between amyloid-forming CA and spheroid-type amyloid deposition. We conducted proteomics analyses using liquid chromatography–tandem mass spectrometry with laser microdissection and immunohistochemistry to validate the characteristics of CAs in the lung and prostate. Our findings revealed that CAs in these organs primarily consist of common proteins (β2-microglobulin and lysozyme) and locally produced proteins. Moreover, we observed a discrepancy between the histopathological and proteomic analysis results in CTAVN-associated CAs. In addition, while the histopathological appearance of amyloid-forming CAs and spheroid-type amyloid deposits were nearly identical, the latter deposition lacked β2-microglobulin and lysozyme, and exhibited evident destruction of surrounding tissue. A literature review further supported these findings. These results suggest that amyloid-forming CAs in the lung and prostate are formed through a shared mechanism, serving as waste containers (wasteosomes) and/or storage for excess proteins (functional amyloids). In contrast, we hypothesize that while amyloid-forming CA and spheroid-type amyloid deposits are formed, in part, through common mechanisms, the latter are pathological.