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The objective of this study is to show that the combination of the Mel frequency cepstral coefficient (MFCC) and long short-term memory (LSTM) can be an effective approach for voice lie detection. To improve the performance of voice lie detection, a modified MFCC was used to extract important features in voice. An MFCC was modified by adding zero-crossing rate, audio entropy, and energy entropy parameters to detect changes in tone in each voice frame. LSTM was used to detect and classify voice-based lies. Datasets were obtained from the video recordings of the trial of a suspect. A total of 847 voice datasets were obtained after applying the time stretching augmentation technique where the audio duration was changed from 28.0 s to 4 s per video. The lie classification process was performed using the LSTM method that was equipped with additional dropout and dense layers and optimized using the adaptive moment estimation (Adam) optimizer. The results showed that the combination of the MFCC and LSTM achieved a classification accuracy level of 97% and an area under the curve value of 0.97 using epoch parameters of 200, Adam optimizer, and learning rate of 0.0001. This study concluded that the addition of zero-crossing rate, audio entropy, and energy entropy parameters to the MFCC extraction feature and the use of Adam optimizer in LSTM improved the accuracy of voice lie detection.

The coronavirus disease (COVID-19) outbreak has created a global health crisis. Secondary pulmonary bacterial infection is a COVID-19 complication, increasing morbidity and mortality. This study aimed to determine the pathogens, antibiotic susceptibility patterns, and risk factors for mortality in hospitalized COVID-19 patients. This retrospective study used secondary data from patients' electronic medical records at Hasan Sadikin General Hospital and Santo Borromeus Hospital between March 2020 and March 2021. Overall, 2230 hospitalized COVID-19 patients were screened, and 182 of them who were hospitalized ≥48 hours with a procalcitonin level of ≥0.25 ng/mL were enrolled. Culture examination was performed on sputum samples to determine pathogen and antibiotic susceptibilities. Univariate and multivariate analyses were used to determine mortality-related risk factors in hospitalized COVID-19 patients. The prevalence of secondary pulmonary bacterial infections in COVID-19 patients was 8.2%, with 161/182 pathogen growth from sputum samples. Mainly gram-negative bacteria (64.8%) were present, including (31.9%), (19.8%), and (8.8%). High rate of multidrug-resistant (MDR) pathogens was found among isolate (45.9%), ie carbapenem-resistance (CR-Ab) was 84.2%, extended-spectrum β-lactamase (ESBL) among was 61.1%. Secondary infection of MDR pathogens was associated with a higher risk of mortality (AOR 5.63, p = 0.001). Other associated factors were age ≥60 years, ventilator use, and female gender. Gram-negative bacteria are the predominant pathogens causing secondary pulmonary bacterial infection in COVID-19 patients, implying nosocomial infection. High resistance to first-line antimicrobial drugs was observed in Gram-negative bacteria and Gram-positive bacteria. High rate of MDR pathogens was found among isolate and was associated with a significant risk of mortality.

Stunting remains a significant public health issue in low and middle-income nations, including Indonesia. Globally, approximately 151 million children are affected by stunting. This study involved 22 children under five years old from economically disadvantaged families in Kediri Regency. Its aim was to assess the effectiveness of the Lumbung Hidup and Nutritional Rangers mobile applications in reducing stunting. Data analysis included both quantitative paired sample t-tests and qualitative thematic analysis methods. Results revealed significant improvements in children's nutritional status (p<0.05) across all Z-scores (weight-for-age, height-for-age, and weight-for-height), as well as five major qualitative themes. The significant improvements in Z-scores highlight the potential effectiveness of the integrated intervention in enhancing child nutrition. This comprehensive strategy could serve as a sustainable and holistic solution to address malnutrition and stunting, warranting broader implementation in similar settings.

Background There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. Methods This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study. Results Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC ( p  < 0.001) and UMIC ( p  < 0.001) and not HIC ( p  = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC ( p  < 0.001) and UMIC ( p  < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions ( p  < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00–1.18), p  = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h. Conclusions qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions. Graphical Abstract

Amongst the 4826 patients included in the MOSACIS II secondary analysis on qSOFA prognostic value, only 5.9% (283/4826) had withdrawal of life-sustaining treatments and 5.9% (287/4826) had withholding of life-sustaining treatments [3]. Availability of data and materials The data that support the findings of this study are available from the corresponding author upon reasonable request. Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings.

Reflective case discussion (RCD) is a reflective activity conducted by nurses, midwives, and other healthcare workers to enhance their skills, critical thinking, and knowledge. This systematic review follows the PRISMA Guideline checklist and includes articles from various databases, such as Scopus, PubMed, ProQuest, and ScienceDirect. The quality assessment of each article was performed using the Critical Appraisal Skills Program (CASP). During the initial database search, we retrieved 997 articles from Scopus, 700 articles from ProQuest, 357,554 articles from PubMed, and 1,526 articles from ScienceDirect. The search was conducted using relevant keywords, including \"reflective case discussion,\" \"nursing,\" \"critical thinking,\" \"skills,\" and \"knowledge.\" Following the inclusion and exclusion criteria, eight relevant articles were identified, excluding duplicate studies, limited to full papers, open access, conducted in a hospital setting, and written in English. The findings demonstrate that RCD effectively enhances nurses' skills, critical thinking, and knowledge, contributing to their professionalism in patient care. RCD also proved beneficial in preventing repetitive mistakes and promoting teamwork among nurses. Thus, RCD should be embraced as a valuable form of Continuing Professional Development (CPD) and integrated into nurses' ongoing learning processes.

Supercapacitor is a device which is currently being researched. Research on supercapacitors can be done from various aspects, including the supercapacitor electrodes, electronic materials or dielectric materials as well as the electrochemical performance of supercapacitors. In the research that has been done, has been obtained rGO material that has a specific capacitance value of 485.97 F / gram with calcination temperature of 1000°C and an ultrasonication time of 2.5 hours. The reduction of Graphene Oxide has fulfilled the standards as a supercapacitor. Another characteristic that must be fulfilled as a supercapacitor is porosity, to determine the ability of adsorption and desorption, as well as electrochemical performance. The results of BET characterization for rGO produced from coconut shells that the largest distribution in the adsorption process was 0.00192 cc/nm/g at a pore diameter of 35.68 nm, while the largest desorption distribution was at 0.00211 cc/nm/g at pore diameter 35.63 nm. So that it can be categorized that rGO is a mesoporous category with a pore diameter of 35.63 - 35.68 nm. Cyclic Voltammetry characterization results obtained that rGO has a reversible curve and is very wide in rGO with 2.5 hours ultrasonication.

Digital transformation brings new perspectives for companies in managing their businesses. One is about how companies accelerate information and service processes by utilizing technology. Due to security factors, biometric-based self-service technology (SST) is becoming popular and preferred in financial services. However, it is still relatively rare in developing countries like Indonesia, especially those specifically aimed at older adults. This study reveals the unique factors of older adults by investigating the effect of health conditions and facilitating conditions on the sustainable use of biometric-based self-service technology (SST) among older adult users. This research framework is based on the Theory of Planned Behavior and involved 298 elderly respondents in three provinces of Indonesia. The result shows that facilitating conditions and behavioral intentions to use are the main drivers of the continued use of biometric-based SST for elderly users. The declining health conditions of older adults (related to the ability to see, hear, and move limbs) affect their intention to use biometric-based self-service technology. Although health conditions were found not to influence the use behavior significantly, these factors still contribute to the sustainable use of biometric-based SST by elderly users. They are considered a concern in the study and development of future technologies.

Land-use change is a key driver of environmental degradation and increasing drought risk. This study assesses drought dynamics in the South Malang Plateau, East Java, by integrating remote sensing data with the Random Forest (RF) algorithm. Three land use scenarios were developed: Business-as-Usual (BAU) for 2030 (predicted using the CA-ANN method in QGIS), participatory mapping (PM), and land capability classification (LCC). Using 175 stratified random field points (70% for training, 30% for validation), the analysis integrated 25 predictor variables across climatic, anthropogenic, topographic, and vegetation index factors. The RF model used for drought classification achieved an overall accuracy of 92.57%. Based on unsupervised classification of historical satellite imagery, between 2017 and 2023 multistrata agroforestry declined by nearly 50%, natural forest cover decreased by 27.6%, and settlements more than doubled. Under the 2030 BAU scenario, forest cover is projected to decline further to 9,195.16 ha. Drought analysis shows a peak in ‘Severe Drought’ at 18.1% in 2019, dropping to 3.1% by 2030, while ‘Extreme Drought’ steadily rises from 6.2% to 7.0%, particularly in deforested areas. Among the scenarios, the integrated LCCPM approach demonstrated higher potential to reduce drought vulnerability and land degradation. The integrated land capability classification- participatory mapping (LCCPM scenario) is recommended to strengthen landscape resilience and promote sustainable land management.