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Coffee is a leading commodity in Indonesia's agricultural sector, possessing high economic value and providing a livelihood for many farmers. However, coffee plant productivity often declines significantly due to various diseases affecting the leaves, stems, and berries. This situation is exacerbated by the lack of knowledge among most farmers in recognizing early disease symptoms, resulting in delayed treatment. Consequently, crop losses are unavoidable. Based on these challenges, this study aims to design and build an expert system capable of diagnosing coffee plant diseases quickly, precisely, and accurately using the Bayesian Theorem method. This method was chosen because it can calculate the probability of a disease occurring based on observed symptoms in plants. The Bayesian approach allows the system to provide more reliable diagnostic results by updating the probability values ​​as new evidence is introduced. The developed expert system is web-based, making it easily accessible to users, both farmers and other interested parties. Users simply select the symptoms observed in coffee plants, and the system will then provide a diagnostic result in the form of possible diseases and their probability levels. Test results indicate that the system is capable of providing fairly accurate diagnostic results and can be used as a basis for farmers in making initial decisions regarding coffee plant disease management. With this expert system, farmers are expected to improve their ability to detect coffee plant diseases early, thereby maintaining crop productivity. This expert system is expected to be an effective decision support tool for farmers to reduce crop losses and improve agricultural sustainability.

Auditory hallucinations are one of the main symptoms experienced by patients with schizophrenia. Non-pharmacological interventions, such as spiritual therapy, serve as important alternatives to support treatment. One increasingly used method is the recitation of Qur’anic verses (murottal therapy), which provides psychological and spiritual calming effects.  To determine the impact of murottal audio therapy of Surah Ar-Rahman on the intensity of auditory hallucinations in patients with schizophrenia at Gramesia Nursing Home, Cirebon.  This scientific paper is presented in the form of a nursing care report focusing on the application of murottal audio therapy using Surah Ar-Rahman as an intervention.  Before the therapy, the patient experienced moderate auditory hallucinations, accompanied by intense emotional reactions and difficulty controlling behavior. After undergoing murottal audio therapy, there was a decrease in hallucination intensity and improvement in the patient’s emotional condition. Murottal audio therapy of Surah Ar-Rahman is effective as a non-pharmacological approach to reduce auditory hallucinations and support psychological recovery in patients with schizophrenia. Following the intervention, patients reported a significant decrease in the intensity of their hallucinations. Emotional reactions were notably less intense, and patients displayed improved emotional regulation and greater behavioral control. The results suggest that murottal audio therapy using Surah Ar-Rahman is an effective non-pharmacological intervention that not only reduces the intensity of auditory hallucinations but also plays a supportive role in the psychological recovery of patients with schizophrenia. The findings emphasize the importance of integrating spiritual therapies into comprehensive treatment plans, as they offer a holistic approach to managing schizophrenia. This intervention can complement traditional pharmacological treatments, providing patients with a sense of spiritual calm and emotional stability, which can enhance their overall mental health and well-being.

The purpose of this study was to determine: 1) the effect of mocaf flour substitution on the level of likeability of elephant ear cake; 2) the effect of addition of carrot puree on the level of likeability of elephant ear cake; 3) the effect of the interaction between mocaf flour substitution and the addition of carrot puree on the level of likeability of elephant ear cake; and 4) the nutritional value of the best elephant ear cake product based on the results of chemical tests. This study is an experimental research type with a 3 x 2 factorial design with 6 treatments. The data collection technique in this study was in the form of observations carried out by 3 trained panelists, 31 semi-trained panelists, and 19 untrained panelists with data collection instruments using a hedonic test assessment sheet with criteria for color, aroma, crispiness, taste, and overall. The data analysis technique used was two-way ANOVA assisted by SPSS version 22 software and continued with Duncan's follow-up test if a significant interaction was found. The results showed that 1) mocaf flour substitution affected on the level of likeability of elephant ear cake in terms of crispiness and taste; 2) the addition of carrot puree did not have a significant effect on all aspects of preference; 3) the interaction between the two only affected the crispiness; and 4) the best nutritional content of elephant ear cake was obtained from 4.81% fat, 1.25% ash, 7.88% protein, 1.02% water, 82.01% carbohydrate, 2.82% fiber, and 86.50 mg/100g beta-carotene

Elevated blood cholesterol levels are known to be a major risk factor for cardiovascular disease. Hypercholesterolemia can trigger atherosclerosis, which in turn increases the risk of coronary heart disease and stroke. One approach to managing cholesterol levels is through the use of natural ingredients with antihyperlipidemic activity. White turmeric (Curcuma zedoaria Rosc) is an herbal plant long used in traditional medicine and contains bioactive compounds such as curcuminoids and essential oils. These compounds are reported to have antioxidant and anti-inflammatory activities, as well as potential as agents for lowering blood lipid levels. Herbal-based therapies are increasingly considered as safe alternatives to synthetic drugs in managing hyperlipidemia. This study aims to evaluate the effectiveness of a microencapsulated preparation of white turmeric ethanol extract in reducing total cholesterol levels in male rats (Rattus norvegicus) induced by a high-fat diet. The study was conducted experimentally using 25 rats divided into six treatment groups. The groups consisted of normal controls, negative controls, positive controls using simvastatin, and three treatment groups given white turmeric extract microcapsules at concentrations of 0.25%, 0.50%, and 0.75%. The microencapsulation technique was applied to improve the stability and bioavailability of the turmeric extract. Cholesterol levels were measured before and after treatment. The results showed that the treatment group with the 0.25% concentration produced the most significant cholesterol reduction, from 110 mg/dL to 59 mg/dL. These findings indicate that even at a relatively low concentration, microencapsulated turmeric extract can significantly reduce cholesterol levels in vivo. Therefore, it can be concluded that white turmeric extract in microcapsule form is effective in lowering total cholesterol levels, especially at the 0.25% dose. This suggests that Curcuma zedoaria microcapsules hold promise as a natural therapeutic option for managing hypercholesterolemia and reducing cardiovascular risk.  

Dyslipidemia is a lipid metabolism disorder characterized by elevated levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL) accompanied by decreased levels of high-density lipoprotein (HDL). This condition is a major risk factor for atherosclerosis, coronary heart disease, and stroke. One plant with potential as an antidyslipidemic agent is bay leaves (Syzygium polyanthum). These leaves are known to contain active compounds such as flavonoids, saponins, tannins, alkaloids, and polyphenols that have antioxidant and hypolipidemic activities. The potential of natural compounds from medicinal plants to reduce blood cholesterol levels has gained significant attention in recent years. This study aims to evaluate the effectiveness of microencapsulated ethanol extract of bay leaves in reducing total cholesterol levels in white rats (Rattus norvegicus) induced by a high-cholesterol diet. The experimental study design employed was a laboratory-based true experimental method with a post-test control group design. A total of 25 male rats were used and divided into six groups: normal control, negative control (high cholesterol diet without therapy), positive control (simvastatin), and three groups treated with bay leaf extract microencapsulates at doses of 0.25%, 0.5%, and 0.75%. The treatment was given for 14 days, then total cholesterol levels were measured using an enzymatic method. The results showed that the group with a dose of 0.75% experienced the highest decrease in total cholesterol levels, namely -70 mg/dL, greater than the simvastatin group (-49 mg/dL). Statistical analysis using One Way ANOVA showed a significant difference compared to the negative control (p < 0.001). These findings indicate that the 0.75% dose of microencapsulated Syzygium polyanthum extract demonstrated an effect equal to or greater than simvastatin. Thus, it can be concluded that bay leaf ethanol extract microencapsulates are effective in reducing total cholesterol levels in hypercholesterolemic rats. This suggests that Syzygium polyanthum microencapsulation has the potential to be developed as an alternative phytotherapy for cholesterol reduction.

Dyslipidemia is a health problem characterized by impaired fat metabolism in the body, characterized by changes in blood lipid levels, either increasing or decreasing. This condition is generally seen through increased levels of total cholesterol, low-density lipoprotein (LDL), triglycerides, and decreased levels of high-density lipoprotein (HDL). This imbalance in the lipid profile, if persisted over the long term, has the potential to accelerate the formation of atherosclerotic plaque on artery walls, which can lead to cardiovascular disease. This study aims to determine the effectiveness of papaya leaf (Carica papaya L.) ethanol extract microcapsules in reducing cholesterol levels in white rats induced by a high-fat diet. The high-fat diet is formulated from a mixture of beef fat, eggs, and lard to increase cholesterol levels in a controlled manner. After the induction phase, the rats were divided into six treatment groups: a negative control group, a positive control group (simvastatin 0.36 mg), and three treatment groups with doses of papaya leaf ethanol extract microcapsules of 0.25%, 0.50%, and 0.75%. The treatment was given orally for 14 consecutive days. Total cholesterol levels were measured before and after treatment to evaluate the effectiveness of the intervention. The results showed that administration of papaya leaf extract microcapsules significantly reduced cholesterol levels. The 0.50% dose provided the most optimal effect, with a reduction reaching 77 mg/dL, greater than the simvastatin group. However, increasing the dose to 0.75% did not show a significant additional reduction effect, indicating an optimal dose-response point. Therefore, the 0.50% concentration can be considered the most effective dose and has the potential to be developed as an alternative natural cholesterol-lowering therapy. These findings also strengthen the potential use of papaya leaves as a bioactive source to support efforts to prevent and control dyslipidemia.  

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disease characterized by hyperglycemia due to insulin resistance, decreased insulin secretion, or a combination of both. The burden of this disease continues to increase globally, making effective, safe, and affordable management an urgent need. One widely used therapeutic strategy is the fixed-dose combination (FDC) of metformin and glimepiride. This combination is considered beneficial because the two drugs complement each other in their mechanisms of action: metformin reduces hepatic glucose production and increases insulin sensitivity, while glimepiride stimulates insulin secretion from pancreatic β-cells. Furthermore, the use of FDC can simplify the treatment regimen, thereby improving patient adherence to long-term therapy. Article searches were conducted through Google Scholar and PubMed with the keywords "((Metformin) AND (Glimepiride)) AND (T2DM) AND (Fixed Dose Combination)", covering publications from 2020–2025 in both English and Indonesian. Of the total articles found, 15 studies met the inclusion criteria for further analysis. The review results showed that the use of metformin–glimepiride FDC was able to reduce HbA1c levels between 0.33% and 2.45%, reducing fasting plasma glucose (FPG) levels by 32–65 mg/dL, and postprandial plasma glucose (PPG) by 38–103 mg/dL. Most studies reported achieving glycemic targets as recommended by the American Diabetes Association (ADA). The most commonly reported side effects were mild hypoglycemia with an incidence of 4.8%–34.5% and gastrointestinal disturbances, but the overall safety profile of this combination was still acceptable. In terms of cost, FDC was considered more economical than the use of separate single drugs. Thus, metformin–glimepiride FDC was proven to be effective, relatively safe, and affordable in glycemic control in T2DM patients, especially in countries with limited resources. These findings support its use as a primary choice in clinical practice.

Dyslipidemia is a lipid metabolism disorder characterized by an increase or decrease in blood plasma fat levels. This condition includes high levels of total cholesterol, low-density lipoprotein (LDL), and triglycerides, as well as decreased levels of high-density lipoprotein (HDL). In general, dyslipidemia is divided into two types: primary, which is influenced by genetic factors, and secondary, which is caused by other diseases or an unhealthy lifestyle. Dyslipidemia is one of the major risk factors for cardiovascular disease, making its prevention and treatment very important. In this study, male white mice were used and induced with a high-fat diet to trigger dyslipidemia. The test animals were then divided into six groups: a negative control, a positive control (given simvastatin at a dose of 0.36 mL/day), and three treatment groups with microcapsules of Chinese betel leaf herb ethanol extract (EEHSC) at concentrations of 0.25%, 0.5%, and 0.75%. The treatment was administered orally for 14 days. Cholesterol levels were measured before and after treatment using a digital cholesterol tester and laboratory analysis to ensure more accurate results. The results showed a decrease in cholesterol levels with varying percentages in each group. The negative control decreased by 24.8%, the positive control by 36.1%, the 0.25% EEHSC by 24.1%, the 0.5% EEHSC by 34.7%, and the 0.75% EEHSC by 45.5%. This indicates that the 0.5% EEHSC treatment produced cholesterol reductions almost comparable to simvastatin. Interestingly, the highest effect was observed in the 0.75% group, indicating a dose-dependent response. In contrast, the 0.25% concentration only produced a less than optimal effect. Thus, microcapsules of ethanol extract of the Chinese betel leaf herb have potential as an alternative agent for lowering cholesterol levels, particularly in dyslipidemia. These findings suggest that natural-based therapies could complement conventional treatments in managing lipid disorders.

Introduction: Periodontitis treatment depends on the severity of the disease, pocket depth, and bone damage. It consists of (1) emergency phase, (2) non-surgical phase, (3) surgical phase, and (4) maintenance or restorative phase. Each phase plays a crucial role in ensuring healing and controlling periodontitis. The non-surgical phase involves scaling and root planing to remove plaque and tartar, while the surgical phase addresses bone damage and pocket reduction. The maintenance phase is critical to preventing disease recurrence. Objective: The purpose of this case report is to demonstrate the success of curettage in a patient with chronic localized periodontitis stage II grade A and stage I hypertension, within a two-week post-treatment period. Case: A 52-year-old female patient presented at RSGM Soelastri with complaints of bleeding gums during tooth brushing. The patient reported gum bleeding around the lower front teeth for the past six months, without any pain. She was regularly taking antihypertensive medication (amlodipine). Examination revealed deep periodontal pockets in teeth 41 and 42, accompanied by gum swelling, indicating chronic localized periodontitis stage II grade A. The patient also had a history of stage I hypertension, which required careful management during treatment. Conclusion: The treatment for chronic localized periodontitis stage II grade A on teeth 41 and 42 with stage I hypertension was curettage. After two weeks of treatment, the patient showed significant improvement, including reduced bleeding and a decrease in pocket depth, with stable hypertension control. Curettage proved effective in managing the condition, with careful consideration of the patient's hypertension risk factors.

This research explores the legal protection of domestic doctors in Indonesia in response to the increasing utilization of foreign doctors (FDs) within the framework of knowledge transfer aimed at improving healthcare services. With the enactment of Law No. 17 of 2023 on Health, the Indonesian government provides space for foreign doctors to practice with simplified licensing procedures, raising legal concerns regarding legal certainty, professional equality, and the rights of patients to clear and honest communication. This study uses normative juridical methods with statutory and conceptual approaches to analyze the legal framework surrounding this issue. The findings show that the implementation of simplified requirements for foreign doctors potentially threatens the professional standing of local doctors and risks violating patient rights. Recommendations include strengthening legal instruments and monitoring mechanisms to ensure that knowledge transfer objectives are met without compromising legal protection and healthcare quality. The legal framework provided by Law No. 17 of 2023 allows foreign doctors to practice with more straightforward licensing processes, but it raises concerns regarding the adequacy of regulatory oversight. Local doctors fear that the simplified procedures for foreign doctors may not guarantee the same level of competency, accountability, and ethical standards. Furthermore, the presence of foreign doctors could lead to a disparity in professional treatment and recognition, undermining the integrity of the medical profession in Indonesia. This study explores how these legal issues intersect with the broader goals of patient protection, ensuring that all medical practitioners, regardless of nationality, adhere to the highest standards of care and ethical conduct. The role of patient rights in this context is critical, as patients must receive clear and honest communication about the qualifications of the doctors treating them, ensuring their right to informed consent is upheld.

Dysmenorrhea is pain that occurs before, after, or during menstruation. The occurrence of dysmenorrhea in adolescents, especially college students, often hinders the activities that these students must perform and can lead to diseases of the reproductive system. However, dysmenorrhea is often considered a common disease, and its effects are not well understood. This study aims to analyze the effect of education using flashcards related to high calcium and magnesium diets, as well as exercise, on the severity of dysmenorrhea and knowledge levels among health and non-health students at Airlangga University. The method used in this study is experimental with a Quasi-Experimental design and a pretest-posttest control group design among health and non-health students at Airlangga University. The instruments used in this study include questionnaires, flashcards, and a recipe book. The results of this study indicate significant changes in knowledge before and after education, and significant differences in knowledge between the treatment group and the control group. The conclusion of this study is that education using flash cards can be used to improve knowledge and behavior in both groups, both health and non-health students. Therefore, it is recommended that universities conduct regular education programs related to diseases that are still underestimated by the general public

Antimicrobial resistance (AMR) poses a major global health threat, with severe impacts in developing countries due to weak health systems, poor regulation, and low sanitation standards. This review summarizes 12 studies from Asia and Africa on AMR’s clinical, social, economic, and environmental effects. AMR leads to first-line treatment failure, prolonged hospital stays, increased morbidity and mortality, and necessitates costly, toxic last-line antibiotics. Economic consequences include higher treatment costs, productivity loss, and poverty risk from high medical expenses. Environmental contributors such as contamination from medical waste, livestock, and the food industry accelerate resistant bacteria spread. Effective control requires integrated strategies, including Antimicrobial Stewardship Programs (ASP) based on AWaRe classification, laboratory strengthening, One Health approaches, public education, strict antibiotic distribution regulations, and cross-sector monitoring. These measures aim to curb AMR progression and reduce health burdens in developing nations. The rise of AMR further complicates healthcare delivery in countries already struggling with limited resources and underfunded healthcare systems. The growing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) organisms threatens the effectiveness of current medical treatments, including those for common infections such as tuberculosis and pneumonia. Infections that were once easily treatable with antibiotics are now leading to longer and more complicated hospitalizations, greater healthcare costs, and higher death rates. Additionally, the lack of access to newer, more effective antibiotics and diagnostic tools makes managing resistant infections in these regions even more challenging. Environmental factors, particularly contamination from healthcare facilities and agricultural practices, play a key role in the proliferation of resistant pathogens.  

Sleep is a vital state of rest for humans to maintain a healthy body. After a day of activity, the body requires adequate sleep to recover and regain energy. One common sleep disorder is insomnia, characterized by difficulty sleeping both in terms of quality and quantity. Insomnia has traditionally been treated with sedatives, drugs that reduce anxiety and provide a calming effect with little or no impairment to motor and mental function. However, long-term use of chemical drugs can cause side effects, necessitating alternatives, one of which is the use of traditional medicine. Areca nut (Areca catechu L.) is known to possess antioxidant, antimutagenic, astringent (tightening), and intoxicating properties that have long been used in traditional medicine. This study was conducted experimentally in a laboratory to determine the sedative-hypnotic effects of areca nut ethanol extract. The observed parameter was survival time on the rotarod, and the data were analyzed using one-way ANOVA for homogeneity testing and Shapiro-Wilk for normality testing. If the data were not homogeneous or normal (p < 0.05), the analysis was continued with the nonparametric Kruskal-Wallis and Mann-Whitney tests. The results showed that administration of areca nut ethanol suspension as a positive control with varying doses did not produce significant differences, meaning that all three doses had the same sedative-hypnotic effect. In the treatment groups with areca nut ethanol extract doses of 0.52 mg/kgBW and 0.78 mg/kgBW, significant differences were observed compared to the negative control, indicating a clear sedative-hypnotic effect. Therefore, it can be concluded that areca nut (Areca catechu L.) ethanol extract at doses of 0.52 mg/kgBW and 0.78 mg/kgBW has the potential to provide sedative-hypnotic effects and can therefore be used as an alternative treatment for sleep disorders.

The purpose of this study was to understand the impact of using the digital educational tool Educaplay on student learning outcomes, specifically in learning the concept of energy sources and their transformations in third-grade students at Brumbungan Lor Elementary School. The main question examined was whether the use of this interactive platform significantly impacts student learning outcomes. The method used was a quantitative approach with a pre-experimental one-group pretest-posttest design. The subjects were all 17 third-grade students at Brumbungan Lor Elementary School. The research instrument consisted of a pretest and a posttest, consisting of 15 multiple-choice questions structured according to basic competencies regarding energy sources and their transformations. Data were analyzed using a paired sample t-test. The analysis showed a two-tailed significance value of 0.000, less than 0.05. This finding indicates that the null hypothesis (H0), which states there is no difference in learning outcomes before and after the treatment, is rejected. Conversely, the alternative hypothesis (H1), which states there is a significant difference after the treatment, is accepted. Thus, the study proves that the interactive learning media Educaplay has a significant impact on improving student learning outcomes. Students experienced improved understanding and academic achievement after participating in learning using this media. This demonstrates that technology integration, specifically Educaplay, can create engaging, interactive learning experiences and motivate students to be more active in the learning process. The final results of the study confirm that Educaplay is a suitable alternative learning media for improving student academic achievement. Therefore, educators and teachers are encouraged to utilize it as part of their learning strategies to support improved student learning outcomes.  

Preeclampsia is one of the most serious complications in pregnancy, characterized by hypertension and proteinuria, and it poses a significant risk of maternal and fetal morbidity and mortality if not detected and managed promptly. Early detection is crucial, yet clinical diagnosis often faces challenges due to the variability of symptoms and uncertainty in medical decision-making. To address this issue, this study aims to develop an expert system for diagnosing preeclampsia by employing the Dempster-Shafer method, which is known for its ability to handle uncertainty and incomplete information in complex domains such as healthcare. A case study was conducted at Bidadari General Hospital, where data on clinical symptoms and patient medical records were collected and analyzed. The development process of the expert system followed systematic stages, including knowledge acquisition from obstetrics specialists, designing the knowledge base, constructing inference rules, and integrating the Dempster-Shafer algorithm for decision support. The system was subsequently tested using real-case scenarios of pregnant women suspected of having preeclampsia. Evaluation results demonstrated that the system achieved an accuracy rate of 92% in differentiating between preeclampsia and eclampsia, based on belief and plausibility measures combined with symptom analysis. These findings indicate that the proposed system can effectively support medical personnel by providing diagnostic recommendations with a high degree of reliability. In addition, the system offers efficiency in the clinical workflow by minimizing diagnostic errors and reducing delays in treatment initiation. Therefore, this expert system has the potential to become a valuable clinical decision support tool for early detection, risk assessment, and management of preeclampsia. Future development may focus on expanding the knowledge base, integrating real-time patient monitoring data, and enhancing usability to ensure broader applicability in diverse healthcare settings.

Background: HIV/AIDS is an infectious disease that attacks the immune system and is a global health problem. Pregnant women are among the vulnerable groups for HIV infection, so HIV testing during pregnancy is an important step in preventing mother-to-child transmission. However, the utilization of HIV testing by pregnant women is still low in various regions, including at the Peureulak Community Health Center, East Aceh Regency. HIV testing in pregnant women can reduce the risk of vertical transmission and provide an opportunity for appropriate treatment. Objective: This study aims to analyze the relationship between pregnant women's knowledge about HIV/AIDS and the utilization of HIV testing at the Peureulak Community Health Center. Methods: This study used an observational analytical design with a cross-sectional approach. The study sample consisted of 50 pregnant women selected by purposive sampling. Data were collected through a questionnaire consisting of questions about knowledge about HIV/AIDS and utilization of HIV testing. The collected data were analyzed using the chi-square test to see the relationship between the two variables. Results: The results showed that the majority of pregnant women had insufficient knowledge about HIV/AIDS (56%). Utilization of HIV testing is also still low, with 52% of pregnant women not undergoing testing during pregnancy. Bivariate analysis showed a significant association between pregnant women's knowledge of HIV/AIDS and their utilization of HIV testing (p = 0.002). Mothers with good knowledge were more likely to undergo HIV testing (72.7%) than mothers with poor knowledge (28.6%). Conclusion: Good knowledge of HIV/AIDS influences the utilization of HIV testing by pregnant women. Further education is needed to increase pregnant women's awareness of the importance of HIV testing to prevent transmission to the baby.  

One of the key indicators of nation’s health development is life expectancy, which reflects the overall quality of public health. As life expectancy increases, the prevalence of non-communicable diseases (NCDs) also tends to rise, with Type 2 Diabetes Mellitus (DM) being one of the most common. In Indonesia, the number of individuals with Type 2 DM has reached approximately 10.7 million, and this figure is projected to increase significantly to 21.3 million cases by 2030, posing a serious public health challenge. This study aimed to describe the process of clinical nutrition care based on the Nutrition Care Process (NCP) for a patient diagnosed with Radiculopathy accompanied by Non-Insulin-Dependent Diabetes Mellitus (without complications), Essential (Primary) Hypertension, Spondylosis, and Spinal Stenosis, through the application of a regulated diabetic diet (DM RG) during hospitalization. The case study was conducted in November 2024 at RSI Ayani Surabaya and involved systematic monitoring of food intake and clinical outcomes during treatment. Findings indicated that within three days of observation, the patient’s dietary intake reached the target goals, demonstrating effective implementation of the prescribed meal plan. From physical and clinical monitoring, a notable decrease in blood pressure was observed on the second and third days, suggesting improvements in cardiovascular response to dietary management. Additionally, the patient’s temperature, pulse, respiratory rate, and oxygen saturation remained within the normal range throughout the treatment period, further supporting the effectiveness of the intervention. These results emphasize the importance of structured nutrition care in managing patients with multiple comorbidities, particularly those with diabetes and hypertension, as dietary regulation plays a central role in stabilizing health conditions. Overall, the study demonstrates that the application of the NCP framework combined with consistent monitoring can lead to positive patient outcomes and highlights its potential as a model for improving clinical nutrition management in hospital settings.

This study aims to analyze the effect of grated carrot addition on muffin quality, including aspects of shape, color, aroma, texture, and taste. Muffins are a popular bakery product due to their soft texture and varied flavors, which can be enhanced by the addition of nutritious ingredients such as carrots. Carrots are rich in vitamin A, fiber, and beta-carotene which can improve the nutritional value as well as the sensory characteristics of muffins. This study used an experimental method with a completely randomized design (CRD) and four treatments (0%, 10%, 20%, and 30% grated carrot substitution) with three replications. Sensory quality tests and hedonic tests were conducted with untrained panelists, and data were analyzed using one-way ANOVA. The results showed that muffins with 20% grated carrot substitution had the best scores in terms of shape and aroma, while 30% substitution produced the best color, texture, and taste in the sensory quality test. The hedonic test showed that 20% substitution was most preferred for shape and color, while 30% substitution was preferred for aroma, texture, and taste. Furthermore, the addition of grated carrots to muffins not only improves the organoleptic quality but also provides additional beneficial nutritional content, such as vitamin A and fiber. This study concluded that the addition of grated carrots can improve the overall quality of muffins and recommends using a 30% substitution for optimal results, as it can enhance the aroma, taste, and texture that consumers prefer without reducing the overall quality of the muffins.

The increasing number of mental health disorders in various countries has created an urgent need for innovation in the diagnosis and treatment process. This problem not only impacts individuals' quality of life but also creates a significant social and economic burden. One solution that is beginning to be widely researched is the use of artificial intelligence (AI) in the field of mental health. This research used a literature review of various previous studies discussing the role, application, and impact of AI. The results of the review indicate that AI technology, particularly in the form of digital applications such as chatbots, has great potential to support the recovery process for patients with mental disorders. AI-based chatbots can provide responsive, two-way interactions, so users feel heard and receive initial emotional support. One technical approach used is Natural Language Processing (NLP), which enables the system to understand natural human language. Simultaneously, Long Short-Term Memory (LSTM) algorithms are used to analyze language patterns and detect symptoms of depression more accurately. Various studies have reported that the application of NLP and LSTM can improve the reliability of diagnoses and provide responses tailored to user needs. Furthermore, AI can provide personalized recommendations, tailor interventions to the user's condition, and monitor mental health developments in real time. This has the potential to assist mental health practitioners in making faster and more informed decisions. However, the adoption of AI among practitioners remains relatively low. Influencing factors include limited technological understanding, limited infrastructure, and debates over ethical aspects and data privacy. Therefore, while AI has significant potential to improve the quality of mental health services, regulations, ethical guidelines, and synergy between technology and healthcare professionals are needed to ensure safe and effective implementation.

Warfarin (commonly known by its trade name, Coumadin) is an oral anticoagulant that has been widely used for the prevention and treatment of thromboembolic disorders. Despite its clinical benefits, warfarin therapy is complicated by a very narrow therapeutic index and wide inter-individual variability in dose requirements. This variability represents a major challenge for clinicians, as inappropriate dosing may lead to serious adverse outcomes such as bleeding or thrombotic events. A growing body of evidence suggests that genetic polymorphisms are among the most important factors contributing to this variability, particularly those involving the Vitamin K Epoxide Reductase Complex Subunit 1 (VKORC1) gene. VKORC1 encodes a key enzyme that functions as a bottleneck in the vitamin K cycle, playing an essential role in the regeneration of reduced vitamin K (VKH). This active form of vitamin K is required for the γ-carboxylation of vitamin K–dependent clotting factors, including prothrombin and other coagulation proteins. Polymorphisms within VKORC1 can significantly alter the enzyme’s expression and activity, thereby modifying an individual’s sensitivity to warfarin. One of the most clinically relevant variants is the -1639G>A (rs9923231) polymorphism, which reduces VKORC1 transcription and subsequently decreases enzyme activity. Patients carrying the A allele often exhibit increased sensitivity to warfarin and therefore require lower maintenance doses compared to those with the G allele. Understanding these genetic influences not only improves our knowledge of warfarin pharmacogenomics but also highlights the importance of personalized medicine in anticoagulant therapy. Incorporating VKORC1 genotyping into clinical practice could optimize dose prediction, minimize adverse events, and enhance the safety and effectiveness of warfarin therapy. This narrative review aims to provide an in-depth discussion of the complex role of VKORC1 in vitamin K metabolism and its impact on warfarin sensitivity, thereby underscoring the critical relevance of genetic factors in guiding individualized anticoagulation therapy.