Background Simulation-based education can equip healthcare providers with the ability to respond to and manage stressors associated with rapidly deteriorating patient situations. However, little is known about the benefits of using virtual reality (VR) for this purpose. Objective To compare between desktop VR and face-to-face simulation in stress responses and performance outcomes of a team-based simulation training in managing clinical deterioration. Design A randomised controlled study Method The study was conducted on 120 medical and nursing students working in interprofessional teams. The teams were randomly assigned to participate in a 2-h simulation using either the desktop VR or face-to-face simulation with simulated patient (SP). Biophysiological stress response, psychological stress, and confidence levels were measured before and after the simulation. Performance outcomes were evaluated after the simulation using a deteriorating patient scenario. Results The systolic blood pressure and psychological stress response were significantly increased among participants in VR and SP groups; however, no significant differences were found between the groups. There was also no significant difference in confidence and performance outcomes between participants in the VR and SP groups for both medical and nursing students. Although the psychological stress response was negatively correlated (r = −0.43; p < 0.01) with confidence levels, there was no association between stress response and performance score. Conclusion Despite being less immersive, the desktop VR was capable of inducing psychological and physiological stress responses by placing emotional, social, and cognitive demands on learners. Additionally, by ensuring close alignment between the simulation tasks and the clinical tasks (i.e. functional fidelity), the desktop VR may provide similar performance outcomes as conventional simulation training. This evidence is timely given the rise in the use of virtual learning platforms to facilitate training during the COVID-19 pandemic where face-to-face training may not be feasible. Trial Registration The study was registered at ClinicalTrials.gov NCT04330924.
BackgroundCatechin is one of the secondary metabolites in Camellia sinensis L. that is alternatively produced through in vitro cultures. The in vitro culture product is possibly improved by optimizing the culture medium with the addition of growth regulators and precursors. The purpose of this study was to confirm the success of the secondary catechin metabolite production through the in vitro culture of C. sinensis L in a relatively short time.MethodsThe secondary catechin metabolite product is obtained in about 40 days. The study was conducted by (1) leaf cutting for inoculation in Murashige and Skoog media with 1 μg/mL of 2,4-dichlorophenoxyacetic acid growth regulator; (2) the inoculation of callus multiplication on the same medium as a partially modified inoculation media condition with the addition of 1 μg/mL of 6-benzylaminopurine (BAP) and 2 μg/mL of 2,4-dichlorophenoxyacetic acid at concentration; (3) callus multiplication developed on a new medium containing phenylalanine precursors (300 μg/mL); (4) testing growth by harvesting the callus and weighing the wet weight of its biomass and (5) identification of the callus qualitatively and quantitatively by using high-performance liquid chromatography (HPLC).ResultsThe level of secondary catechin metabolite produced was 2.54 μg/mL and 12.13 μg/mL in solid and suspension media, respectively.ConclusionsIt is concluded that the method is effective and efficient in producing catechin product from C. sinensis L.
BACKGROUND: Opportunistic infection (OI) is the most significant complication of the human immunodeficiency virus (HIV). Differences in the characteristics of HIV patients make the prevalence of Opportunistic infection different between regions. The study aimed to identify variables associated with OI incidence among HIV-infected patients in Semarang City, Indonesia.METHODS: This study uses secondary data sourced from special HIV surveillance for 2019-2021 with a cross-sectional method. 1362 HIV patients with variables health care facilities; year of diagnosis; area of residence; age; sex; pregnancy status; occupation; risk factors; risk group determined based on purposive sampling were included in the chi-square analysis and logistic regression.RESULTS: This study showed 12.3% (n=167) of HIV patients experienced OI, where OI was more common in HIV patients with risk groups of sex workers (28.70%), high-risk partners (18.60%), and Male Sex with Men (MSM) (15.40). The most common types of OI were tuberculosis infection (43%), candidiasis (21%), and diarrhea (9%). Age was the variable most associated with the incidence of OI (p-value 0.001).CONCLUSIONS: Age groups 45-54 years and 55-64 years have the most influential association with Opportunistic infection incidence in HIV patients, so planning an appropriate intervention program for this subpopulation is necessary.
Hydropower is a renewable energy source with a lot of potential in Southeast Asian countries, with a total energy potential of 152,257 MW in Southeast Asia. The development of a hydro-turbine design is required due to the enormous hydropower potential. The turbine's runner is critical for converting fluid internal energy into kinetic energy. A cross-flow turbine that has gained popularity recently is the banki-turbine. The research that has been done is three-dimensional modeling of the banki-turbine with the CFD method. This study aims to determine the effect of the blade's angle on turbine performance. This research's steps are design, mesh independence, validation, simulation, and analysis. Modeling research was conducted with variations of blade angles 10˚, 15˚, and 20˚. Schematic modeling using a steady state condition, the turbulent type Shear Stress transport (SST), and the tetrahedral mesh method. The modeling consists of a rotating zone and a stationary zone. The water inlet velocity is 3 m/s, and the outlet pressure equals the room pressure (1 atm). Simulation of bankiturbine operated in 50 RPM until 350 RPM of angular velocity. One of the analyzes used is Factorial Design. The best performance Cpmax is obtained from the variation of the blade's angle of 15˚ on 0.28.
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