Low Category Research Articles

TPRO-NET: an EEG-based emotion recognition method reflecting subtle changes in emotion

Emotion recognition based on Electroencephalogram (EEG) has been applied in various fields, including human–computer interaction and healthcare. However, for the popular Valence-Arousal-Dominance emotion model, researchers often classify the dimensions into high and low categories, which cannot reflect subtle changes in emotion. Furthermore, there are issues with the design of EEG features and the efficiency of transformer. To address these issues, we have designed TPRO-NET, a neural network that takes differential entropy and enhanced differential entropy features as input and outputs emotion categories through convolutional layers and improved transformer encoders. For our experiments, we categorized the emotions in the DEAP dataset into 8 classes and those in the DREAMER dataset into 5 classes. On the DEAP and the DREAMER datasets, TPRO-NET achieved average accuracy rates of 97.63%/97.47%/97.88% and 98.18%/98.37%/98.40%, respectively, on the Valence/Arousal/Dominance dimension for the subject-dependent experiments. Compared to other advanced methods, TPRO-NET demonstrates superior performance.

Hubungan Dukungan Keluarga dengan Kemampuan Ibu Postpartum Dalam Perawatan Tali Pusat Bayi Baru Lahir Di Wilayah Kerja Puskesmas Gunung Sari Ulu

Newborn care is care provided to maintain the health of the baby, including proper bathing of the baby and care of the umbilical cord, which can prevent infection and accelerate the release of the umbilical cord. The results of a preliminary study conducted at the Gunung Sari Ulu Health Center obtained data on the number of newborns in 2020: as many as 283 babies; in 2021, there were 216 babies; in 2022, there were 216 babies; and in the January–April 2023 period, there were 72 babies. The results of interviews about family support with 10 postpartum mothers showed that 6 people got good support from their families and 4 people got less support from their families. The results of interviews about umbilical cord care revealed that 3 postpartum mothers understood umbilical cord care and 7 postpartum mothers did not understand umbilical cord care. This study aims to determine the relationship between family support and the ability of postpartum mothers to care for the umbilical cord of newborns in the Working Area of the Gunung Sari Ulu Health Center. This type of research used quantitative research with a descriptive correlational research design and a cross-sectional approach. The study population was postpartum women in the Working Area of the Gunung Sari Ulu Health Center, Balikpapan City, and the sampling technique used a total of 82 people. Collecting data using a questionnaire sheet Data analysis is univariate analysis and bivariate analysis using the chi square test (X2). The description of family support for postpartum mothers is in the high category, namely 42 people (51.2%), and in the low category, namely 40 people (48.8%). The description of the ability of postpartum mothers to care for the umbilical cord of newborns was in the good category, namely 50 people (61%), the sufficient category, namely 28 people (34.1%), and the poor category, namely 11 people (4.9%). Chi square statistical test results (2) obtained a value of (0.017) < α (0.05), indicating that Ha is accepted. Conclusion there is a relationship between family support and the ability of postpartum mothers to care for the umbilical cord of newborns in the Working Area of the Gunung Sari Ulu Health Center.

Razvoj metode bi-normaliziranog omjera opožarenosti na događaju katastrofalnog šumskog požara 14. srpnja 2022. godine kod Vodica, Hrvatska

The use of multispectral sensors, such as MSI, on the Sentinel-2 satellite for rapid assessment of the area and the burning degree after large forest fires utilises standard method of determining the Normalized Burn Ratio (NBR) before and after the fire, from which the difference of the Normalized Burn Ratio (dNBR) is calculated. Applied to areas with sparse vegetation, the standard method of NBR gives poor results. To cope with low vegetation areas, a so-called “relativizing dNBR” was introduced where an empirical expression divides the difference of the NBRs in two channels by a quotient slightly greater than the pre-fire NBR. In this paper, a forest fire near Vodice, Croatia, which occurred on July 14, 2022, and which grew into a catastrophic fire that left about 30 km2 of burnt area, was studied. As this is an area of Mediterranean vegetation, relatively sparse, instead of the relativization, an attempt was made to introduce a new formula for calculating the normalized ratio of burning, which included two differences in spectral radiances (instead of one). In addition to the standard difference in the near-infrared and short-wave infrared part of the spectrum, a difference between the near-infrared and the green visible part of the spectrum was used simultaneously. These new, bi-Normalized Burn Ratio, retain information about the spectral radiance in the green visible band and react to surfaces where at least a little vegetation cover remained after the fire, which ultimately gives lower burn categories, with the same burned area detected compared to the standard method.

Alcohol Interventions on Online Grocery Shopping Platforms

Introduction & BackgroundThere is opportunity to engage light to moderate drinkers in alcohol reduction interventions as a preventative measure. In the space of online grocery shopping there is an added challenge in intervention development in the form of deceptive patterns, which influence consumer behaviour in unhealthy ways including automating behaviour and encouraging overconsumption. Objectives & ApproachThe objectives of this study are to: 1) identify deceptive patterns in the online grocery shopping context, 2) develop interventions which support healthier decision making in this context, 3) apply those interventions to appropriate product categories. The method utilised in the first objective is heuristic analysis which was conducted across eleven major online grocery shopping platforms. The interventions were then developed using the Rapid Iterative Testing and Evaluation (RITE) method, which involved interviewing participants and iterating upon the inventions after every interview. Each interview was analysed using content analysis. When incorporating the interventions into the online grocery shopping environment, interviews were conducted to gain insight into drinking and purchasing habits of consumers. These final interviews were then analysed with inductive thematic analysis. Relevance to Digital FootprintsDigital Footprints underpin the entire intervention development space. The background of the project is built upon human shopping and interaction behaviour online when encountering deceptive patterns. These deceptive patterns have been established using mobile gaming micro-transaction data, online grocery shopping log-in and rewards data, among other data sources. Digital Footprints data can further support the findings from the thematic analysis by further showing cultural and social trends around drinking (e.g., increased purchasing of seasonal beers and ciders in the summer and during sporting tournaments). The purpose of the drinking identified through those social and cultural trends gauge the appropriateness of proposed alcohol interventions. Beyond this, digital footprints data around engagement with health and wellness promoting applications (e.g., active users and app downloads) provides greater insight into the types of health messaging that garner attention and can be used to further inform how to approach those currently outside the health-engaged group. Digital footprints serve to attach larger societal trends to the smaller-scaled interviews and thematic analysis conducted as part of the study. ResultsInitial findings have shown opportunities for nudging light to moderate drinkers who primarily consume beer, wine, or cider. Spirits have been identified as difficult to substitute due to a lack of substitution options in the low alcohol spirit category that are widely available on the consumer market via online grocery retailers. Conclusions & ImplicationsWithout significant change, costs to the National Health Service (NHS) in alcohol related harm are set to rise by over 1 billion GBP. Alcohol consumption is a public health risk and there are opportunities to utilise digital footprint informed interventions to engage the public in preventative interventions.

Excluding sunscald from long-term storage of ‘Granny Smith’ apples

Sunscald is a postharvest apple and pear peel disorder primarily caused by excessive light exposure during the growing season. Symptoms are not apparent at-harvest but develop during storage as superficial brown or gray discolored patches on the exposed portion of the apple. A novel protocol using hyperspectral imaging (HSI) was developed to identify apples at- harvest that are more likely to develop the disorder and reduce sunscald in the cold chain by eliminating at-risk apples from long-term storage. PLS-DA and LOGISTIC models and an index summarizing the chlorophyll to carotenoid ratio were tested for this purpose using two populations selected for different sun exposure levels and four populations harvested from whole trees. The accuracy of models varied seasonally. However, detection of sunburn and estimation of sunscald risk based on index values was a more consistent approach. Summarizing peel area according to this index was the basis for categorizing whole apples as rejected (sunburned), high (sunscald) risk, or low-risk. Categorization segregated apples nearly entirely into these categories with only an insignificant frequency of misclassification. The frequency of high-risk apples without sunburn symptoms in the populations harvested from whole trees fell below 20 %, although actual sunscald incidence within this category ranged from 55 % to 81 % among populations harvested from whole trees, highlighting that other factors beyond elevated sun exposure contribute to sunscald incidence. The classification model for low and high-risk categories had an accuracy of 83–93 % in four independent populations, with 99.9 % sensitivity to classify non-sunscalded fruit into the low-risk category. Sorting by sunburn presence and sunscald risk allows for apples that have sunburn symptoms to be excluded and those that are marketable but most likely to develop sunscald to be pushed to market rather than storage. With the appropriate source/sensor array, this approach is readily adaptable to sorting lines or even robotic harvesters. Challenges include adapting this approach for other apple and pear cultivars and extending capabilities for additional uses, including sorting fruit into additional categories representative of relative sunlight exposure.

Development of Arduino Uno-Based Free Fall Motion Props to Increase Learning Motivation Towards Practicum Results of 11th Grade Students

Research has been conducted on the development of Arduino Uno-based Free Fall Motion (FFM) teaching aids to increase learning motivation towards the results of practicum for 11th grade students of MAN 1 Mataram. This study aims, (1) to design arduino-based teaching aids on free fall motion (FFM) material, (2) to determine the validity level of teaching aids to 3 media experts and 3 material experts, (3) to determine the increase in student learning motivation, (4) to determine the results of student practicum, and (5) to determine the effect of learning motivation on student practicum results. This type of tool development is Research and Development (R&D). the subject model of this research is MAN 1 MATARAM students as many as 35 students. The instrument used was a questionnaire. The development model in this study uses a 3D model. 3D development model (ThreeD). This model is a modification of the Thiagarajan model which includes 4 stages called the 4D (Four-D) model. Based on the research objectives, a student's practicum teaching aid on GJB material was made. Based on the validity test results, the teaching aids are suitable for use as learning media in class 11 MAN 1 Mataram. Furthermore, the results of motivation based on the value before applying FFM props amounted to 51.60% (pretest). While the interpretation after the practicum (posttest) was 90.44% and the N-Gain was 0.46. This means that there are changes in learning activities in students. For the results of student practicum through the satisfaction interval with a very high category of 11 students, a high category of 23 students, a low category of 1 student and very low 0 students. Meanwhile, the correlation of learning motivation to student practicum results shows rcount> table (0.450>0.344) and obtained tcount> table (2.895>2.035). From the truth value of the hypothesis it can be concluded that there is an influence between learning motivation (X) and practicum learning outcomes (Y) on GJB material.

Research on Rural Environments’ Effects on Well-Being: The Huizhou Area in China

The Huizhou region is an important area of traditional Chinese culture, and currently, the state of the village’s surroundings in this area is still not perfect. In this study, seven districts (counties) in the Huizhou region were selected for research. The Rural Habitat Environment (RHES) Indicator Program is based on the concept of Socio-Economic-Natural Complex Ecosystems (SENCE) and constructs 18 metrics in three dimensions. Trends and influencing factors were analyzed using entropy weight TOPSIS and a Grey Relational Analysis (GRA) for the years 2013–2022, and spatial and temporal evolution was measured using Geographic Information Systems (GISs). The findings show that the composite index for the Huizhou region grew from 2013 (0.3197) to 2022 (0.6806). Second, the Tunxi District belongs to the high index–high economy category. The Shexian, Xiuning, and Qimen counties belong to the high index–low economy category. Huizhou District and Huangshan District belong to the low index–high economy category. Yixian County belongs to the low index–low economy category. Third, all districts (counties) show an upward trend, and Huangshan District has the best RHES condition. Shexian County ranks relatively low in the comprehensive index.

Exploring the World of Numeracy: An Analysis of Third-Grade Elementary School Students

Numeracy literacy is a crucial skill that students must master, as strong numeracy skills can support other forms of literacy. However, in some regions, numeracy skills are still at a relatively low level. This is the reason behind conducting research aimed at assessing the numeracy literacy skills of third-grade students in elementary schools. This research is of a quantitative descriptive nature, involving a sample of 32 subjects. Data collection methods include interviews, observations, and tests. The interactive data analysis model consists of three main steps: data reduction, data presentation, and drawing conclusions (verification). The research results indicate that students' numeracy literacy skills are in the low category. This is evident from the calculated scores of each student. The study also identifies, among the six components of numeracy literacy measured in this research, that the indicator requiring the most attention is the use of measurement tools, including topics such as length, time, area, and others. This condition is supported by findings from other methods, which reveal that teachers have relatively low awareness when it comes to using concrete teaching materials. This is one of the factors contributing to the low level of numeracy literacy skills.

Measuring the effective implementation of the GEQIP reform at school level in Ethiopia

This study examines the substantive impact of educational reforms on school and classroom organization worldwide, noting that many reforms have been more rhetorical than practical in enhancing educational quality. It highlights the crucial role of school principals in driving changes to improve student learning, despite the challenges of implementing reforms that have historically not led to significant increases in student achievement. Focusing on the General Education Quality Improvement Programme (GEQIP) in Ethiopia as a case study, this research aims to assess the extent of reform implementation across schools by identifying variations in the level of implementation. Through a quantitative approach using school principal surveys, the study employs a range of methodological strategies—including principal component analysis (PCA), confirmatory factor analysis (CFA), hierarchical cluster analysis, and K-means cluster analysis—to develop scales and indicators that classify schools into high or low categories of policy implementation. The findings reveal a partial and uneven implementation of GEQIP across Ethiopian schools, with notable disparities in reform adoption levels. This paper concludes by discussing the effectiveness of the methodologies used to categorize schools based on reform implementation and the implications of these findings for the successful execution of educational reforms in Ethiopia and similarly situated contexts. The study underscores the necessity of devising targeted strategies to assist principals and schools in fully achieving the goals of educational reforms.

Stress Coping Strategies Among Nurses at Hasanuddin University Hospital Indonesia

Introduction: Nurses have a major contribution in determining the quality of hospital services, but the heavy workload carried by nurses makes them vulnerable to work stress. Work stress that is if not handled properly can result in a decrease in the quality of services provided to the effect on hospital productivity, therefore it is necessary to do a coping strategy so that nurses can deal with and neutralize or overcomereduce the work stress experienced. Objective: This study aims to describe stress coping strategies for nurses in the Inpatient Installation of the Hasanuddin University Hospital Makassar. Method: This research was using quantitative approach. It was conducted at the Hasanuddin University Hospital in July 2022. The population in this study were all nurses who served in the Inpatient Room of Hasanuddin University Hospital with a total sample of 54 nurses. Collecting research data using The Brief COPE Questionnaire. The data were analyzed by using univariate analysis test. Result: The results describe nurses' stress coping strategies based on problem focused coping, that all indicators included in the high category, there are active coping (6.42), followed by planning (6.29) and use of instrumental support (6.02). Then the Nnurse's stress coping strategy based on emotional focused coping, there are 3 indicators that are included in the high category, there are religion (7.39), positive reframing (6.31), and acceptance (6.07), use of emotional support (4 .83) is an indicator that included in the medium category and denial (3.14) is an indicator that included in the low category. While Nnurses' stress coping strategies based on dysfunctional coping, self-distraction (6,16) is the only indicators that included in the high category, then there are 4 indicators that were included in the moderate category, there were namely venting (4,87), humor (4,50), self blame (4.50), and behavioral disengagement (3.24), as well as substance use (2.66) are indicators that are included in the low category. Conclusion: Majority of nurses at Hasanuddin University Hospital applied high problem focused coping and emotional focused coping. Therefore, the management of the Hasanuddin University Hospital may consider opening or holding a communication forum between nurses in each treatment room to discuss problems at work and provide psychological guidance and support in order to overcome the work stress that nurses experienced.

Effect of Stretching Exercise on Reducing Musculoskeletal Disorders for Administration Staff at Hospital

Administrative staff worked with static body posture and repetitive work for more than eight hours a day. They were experiencing musculoskeletal disorders as a risk of using workstation and their posture at work. It is important to reduce the risk of injury caused by their working risks. The purpose of this study was to analyze the effect of stretching on the reduction of musculoskeletal disorders. This research used quasi-experiment approach with one group pre-test post-test only design. The number of research respondents was 60 employees taken by purposive sampling at Lung Hospital Bandung. Musculoskeletal disorders measured using the Nordic Body Map questionnaire before and after interventions. Stretching was giving to employees every day for 3 weeks simultaneously. The result shows majority of respondents were female, 33 respondents (55%), as many as 54 respondents (66.7%) were 24-30 years old. Most of respondents have BMI in obese level as may as 31 respondents (51.7%). Respondents who have worked for more than 2 years were 43 respondents (71.7%). Before the intervention, as many respondents experienced low complaints (86.7%). After the intervention, all respondents had decreaced in complaints become the low category (p=0,001). Recommendation for hospital was to carry out stretching exercise to prevent MSDs for administrative workers.

ANALYSIS OF BLACK SPOTS ON JL. RAYA KAKAP KUBU RAYA DISTRICT WITH Z-SCORE METHOD

Kubu Raya is a district in West Kalimantan Province. It is directly adjacent to Pontianak City, the province's capital. This condition increases mobility and vehicle traffic, resulting in a relatively high accident rate.Traffic accident data came from the Kubu Raya Regency Police Station, and field observations obtained data on road condition and completeness. The analysis methods used are weighting, Z-Score, and CUSUM (Cumulative Summary).The number of accidents in Jalan Raya Kakap during 2020 - 2022 amounted to 26 incidents. The characteristics of traffic accidents on Jalan Raya Kakap for three years (2020 - 2022) are that victims with minor injuries are more than victims of death and serious injuries, namely seven victims in 2020, 8 victims in 2021, and 18 victims in 2022. STA points 0 - 1 have the highest number of accidents during the 3-year period, which is 152 STA points. 2-3 by 129, and point STA. One black spot falls into the high accident vulnerability category: point STA. 0-1. Two black spots fall into the high accident vulnerability category: STA points. 2-3 and STA. 7-8. Four black spots fall into the medium category. Three black spots fall into the low category. Moreover, four points are categorized as not accident-prone.

Evidence-based definition of hypoprolactinemia in European men aged 40-86 years: the European male ageing study.

Empirical evidence for a low normal or reference interval for serum prolactin (PRL) is lacking for men, while the implications of very low PRL levels for human health have never been studied. A clinical state of "PRL deficiency" has not been defined except in relation to lactation. Using data from the European Male Ageing Study (EMAS), we analyzed the distribution of PRL in 3,369 community-dwelling European men, aged 40-80 years at phase-1 and free from acute illnesses. In total, 2,948 and 2,644 PRL samples were collected during phase-1 and phase-2 (3 to 5.7 years later). All samples were analysed in the same centre with the same assay. After excluding individuals with known pituitary diseases, PRL ≥ 35 ng/ml, and PRL-altering drugs including antipsychotic agents, selective serotonin reuptake inhibitors, or dopamine agonists, 5,086 data points (2,845 in phase-1 and 2,241 in phase-2) were available for analysis. The results showed that PRL declined minimally with age (slope = -0.02) and did not correlate with BMI. The positively skewed PRL distribution was log-transformed to a symmetrical distribution (skewness reduced from 13.3 to 0.015). Using two-sigma empirical rule (2[]SD about the mean), a threshold at 2.5% of the lower end of the distribution was shown to correspond to a PRL value of 2.98ng/ml. With reference to individuals with PRL levels of 5-34.9 ng/ml (event rate = 6.3%), the adjusted risk of developing type 2 diabetes increased progressively in those with PRL levels of 3-4.9 ng/ml: event rate = 9.3%, OR (95% CI) 1.59 (0.93-2.71), and more so with PRL levels of 0.3-2.9 ng/ml: event rate = 22.7%, OR 5.45 (1.78-16.62). There was also an increasing trend in prediabetes and diabetes based on fasting blood glucose levels was observed with lower categories of PRL. However, PRL levels were not associated with cancer, cardiovascular diseases, depressive symptoms or mortality. Our findings suggest that a PRL level below 3 ng/ml (64 mlU/l) significantly identifies European men with a clinically-important outcome (of type 2 diabetes), offering a lower reference-value for research and clinical practice.

Body mass index–adjusted calf circumference is associated with mortality in hospitalized older patients with excess weight

Given the innovative nature of the method, our study aimed to assess the prognostic significance of body mass index (BMI)-adjusted calf circumference (CC) in older patients who are hospitalized. This was a unique analysis as part of other cohorts comprising general hospitalized patients aged 60 years or older of both sexes. Only patients with excess weight (BMI ≥ 25 kg/m2) were included. CC was adjusted by reducing 3, 7, or 12 cm for BMI (in kg/m2) within 25-29.9, 30-39.9, and ≥40 kg/m2, respectively. CC was considered low if ≤ 34 cm for males and ≤ 33 cm for females. Clinical outcomes included prolonged length of hospital stay (LOS) and mortality. A total of 222 patients were included. After BMI adjustments, 72.1% of the patients were reclassified from a normal CC category to a low CC category. The frequency of low CC increased from 33.8% to 81.9% following BMI adjustments. Among those reclassified to the low CC, 11 died, compared to only 2 patients in the group that maintained a normal CC classification. BMI-adjusted CC was inversely associated with mortality (HR adjusted 0.84, 95% CI 0.73 to 0.95), but not with prolonged LOS. Our novel study highlights the prognostic value of BMI-adjusted CC. As an anthropometric marker of muscle mass, it proved to be a predictor of mortality in older patients with high BMI. This adjustment is further important because it may help to better detect low muscle mass in these patients where such conditions might be masked.

Stress-Induced Autonomic Dysfunction is Associated With Mental Stress-Induced Myocardial Ischemia in Patients With Coronary Artery Disease.

Mental stress-induced myocardial ischemia (MSIMI) is associated with adverse cardiovascular outcomes in individuals with coronary artery disease, but the mechanisms underlying this phenomenon are unknown. We examined the relationship between stress-induced autonomic dysfunction, measured by low heart rate variability (HRV) in response to stress, and MSIMI in patients with stable coronary artery disease. We hypothesized that stress-induced autonomic dysfunction is associated with higher odds of MSIMI. In 735 participants with stable coronary artery disease, we measured high- and low-frequency HRV in 5-minute intervals before and during a standardized laboratory-based speech stressor using Holter monitoring. HRV at rest and stress were categorized into low HRV (first quartile) versus high HRV (second to fourth quartiles); the low category was used as an indicator of autonomic dysfunction. Multivariable logistic regression models were used to examine the association of autonomic dysfunction with MSIMI. The mean age was 58 (SD, ±10) years, 35% were women, 44% were Black participants, and 16% developed MSIMI. Compared with high HRV during stress, low HRV during stress (both high and low frequencies) was associated with higher odds of MSIMI after adjusting for demographic and clinical factors (odds ratio for high-frequency HRV, 2.1 [95% CI, 1.3-3.3]; odds ratio for low-frequency HRV, 2.1 [95% CI, 1.3-3.3]). Low-frequency HRV at rest was also associated with MSIMI but with slightly reduced effect estimates. In individuals with coronary artery disease, mental stress-induced autonomic dysfunction may be a mechanism implicated in the causal pathway of MSIMI.

Characteristics and quality of clinical practice guidelines for diabetic kidney disease: a systematic review.

To assess the quality of Clinical practice guidelines (CPGs) in the context of diabetic kidney disease (DKD) and determine whether any factors affect the quality. We searched eight databases along with five international and national organizations to develop or archive guidelines from their inception to July 2023, with an additional search of medlive.cn. And the authoritative organizations related to nephrology. CPGs and consensus statements created using direct differential diagnosis or therapy for DKD were included without language restrictions. Their quality was evaluated by four reviewers using the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) instrument. Along with the item and domain scores, the guideline was also allocated an overall quality score, which ranged from 1 (lowest possible quality) to 7 (highest possible quality). Moreover, an overall recommendation for use was also assigned ("recommended", "recommended with modifications" or "not recommended"). A total of 16 CPGs were included, of which 14 were from Asia and the remaining two from Europe. These two CPGs were updated in the third version. Six CPGs were recommended for use because their primary domains scored in the medium or high category. Furthermore, five CPGs were recommended with modifications as the stakeholder involvement, applicability, and editorial independence domains were evaluated as low categories. In all domains, the lowest average score was for rigour of development (33%), followed by application (36%), and stakeholder involvement (51%). The highest average score was for scope and purpose (79%), followed by clarity of presentation (75%). None of the CPGs considered the patient's viewpoint, and six of 16 CPGs did not use any grading system to translate the evidence into recommendations. Additionally, only three of 16 CPGs shared search strategy, and eight of 16 CPGs did not declare a funding source. According to the AGREE II evaluation, more than one in four CPGs for DKD had poor methodological quality. Enhanced efforts are needed to advance the rigour of development, application, and editorial independence of DKD guideline panels for most guidelines. Stakeholders, CPG developers, and CPG users should consider methodological quality while choosing CPGs, and interpret and implement their issued suggestions.

Financial Inclusion Index and its Determinants among Asian Countries

The study assesses financial inclusion level and its determinants across 30 Asian countries from 2010 to 2020 using the Wroclaw taxonomy method (WTM). A comparative analysis of financial inclusion indexes was conducted, and a panel fixed-effect model was employed to explore influencing factors. Findings revealed high financial inclusion levels in China, Israel, Japan, Singapore, and South Korea, contrasting with low levels in Azerbaijan, Bangladesh, Kyrgyz, Pakistan, Tajikistan, and Timor-Leste. Fourteen countries ranked in the high-middle category, with six in the low category, and only four achieved high financial inclusion in 2020. GDP and bank credit positively impact financial inclusion, while broad money, population, and density contribute positively but insignificantly. Conversely, literacy rate, inflation rate, employment, female ratio, rural ratio, and internet access showed negative effects on financial inclusion

Cost effective utilization of apheresis for stem cell transplantation in multiple myeloma.

e19528 Background: Salvage autologous stem cell transplantation (ASCT) is an effective and feasible treatment option for patients with relapsed multiple myeloma (MM). It is standard practice to collect stem cells adequate for two transplants for ASCT eligible patients with newly diagnosed MM (NDMM). Stem cell collection is an expensive procedure due to the cost of granulocyte-colony stimulating factor, plerixafor, apheresis, chemotherapy in select cases and finally cryopreservation. However, the rate of utilization of second ASCT is not known. Methods: We conducted a single institution, retrospective study of 511 consecutive patients with NDMM who underwent ASCT to identify the proportion of patients receiving second ASCT. Patients received ASCT as front-line therapy between 1/1/2015-2/13/2019. Demographic and disease characteristics were summarized using median and range for continuous variables, and frequency and percentages were calculated for categorical variables. The cumulative incidence of second ASCT was estimated using the Fine and Gray method, and competing risk regression models were used to estimate the hazard ratios for risk of second ASCT. All statistical tests were two-sided with a type 1 error of < 0.05 indicating statistical significance. All estimates were reported with 95% confidence intervals (95% CI). Results: At a median follow-up of 4.7 years, 25 out of 511 patients received a second ASCT. The cumulative incidence rate at 5 years was 2.6% (95% CI 1.4-4.4%).Age at diagnosis, age at first ASCT and Charlson comorbidity index (CMI) were significantly associated with the risk of second ASCT in univariable analysis (UVA). In multivariable analysis (MVA) age at first ASCT was the only factor that was predictive of a second ASCT. We devised a predictive score for utilization of second ASCT using hazard ratios for each of the three significant factors noted in the UVA. Scoring was done as follows: age < 65 years – 1 point, > 65 years – 7 points; 1 point for CMI 0-1, 2 points for CMI 2 or higher; serum creatinine ≤1.2 – 1 point, > 1.2 – 3 points. Based on the total score, patients are grouped into low ( < = 3), medium (4-6) and high (7+) likelihood categories, with cumulative incidence rates of receiving second ASCT at 4.0% (95% CI: 1.3-9.1%), 3.4% (95% CI 1.4-7.0%) and 0.6% (95% CI 0.1-3.1%) respectively. Patients older than 65 years were 87% less likely to receive a second ASCT compared with those younger than 65 years (HR = 0.13, 95% CI 0.02-0.98). Conclusions: Using this predictive score, goal of stem cell collection for patients with MM could be determined more efficiently. This could avoid extra days of apheresis, chemo mobilization, hospitalizations and need for cryopreservation at least for patients with a low likelihood of second ASCT, translating into cost effective utilization of resources. We plan to validate this score prospectively in a larger group of patients with NDMM undergoing ASCT in the future.

Application of Machine Learning in Clustering Maize Producing Regions in Indonesia

Maize is considered an important commodity with promising market prospects. Given the importance of maize, there is a need to increase maize production to meet people's needs and maintain price stability. This study aims to group maize production in Indonesia by region, with the hope of finding areas that have the potential to become maize production centers to reduce dependence on imports. The data used in this research was obtained from the Central Statistics Agency, covering information from 34 provinces during the 2017-2021 period. This analysis uses the K-Means method with the Python programming language. The number of groups is determined using the Elbow Method. The results of this research show that there are three categories of maize production regions: regions with low maize production (below average), regions with medium maize production, and regions with high maize production. A total of 25 provinces are in the low production category, eight provinces are in the medium category, and only East Java is in the high production category.

Analysis of Students' Physics Literacy Skills in Solving HOTS Problems and Self-Regulated Learning

The purpose of this research is to examine the physics literacy skills of students solving HOTS questions and self-regulated learning (SRL) on measurement material at private high schools in Maju Village, through descriptive research using a qualitative approach. The instruments used include questionnaires, and HOTS test questions on Measurement material. The results showed that the low SRL category (score 98) was unable to reach the questions at C4. The medium group (score 120), could not fulfill all level 4 indicators. In high SRL, students are able to fulfill the indicators, by solving the problem completely, using the right information, applying numeracy skills, and being able to provide conclusions and their reasons, but cannot fulfill the indicators at level 5 and 6. The learning independence factor plays a significant role in determining the level of HOTS student.