President University

Synthesised evidence on the formal recognition of advanced community pharmacists (ACPs) and their practice is limited. This review aims to explore global evidence on the practice of formally recognised ACPs. This scoping review followed the JBI Manual for Evidence Synthesis and PRISMA guidelines. Advanced practice was determined using the International Pharmaceutical Federation framework encompassing four pillars: professional practice, leadership, research, and education. Formal recognition referred to post-registration acknowledgement by authorised bodies. Twelve databases and Google Scholar were searched between 2004 and 2024, without country or language restrictions. Findings were thematically analysed using NVivo 14. Sixty-three studies from six high-income countries were included, predominantly from Canada (n=18) and the United States (n=16). Formally recognised ACPs provided clinical services including prescribing (n=27), vaccination (n=22), and medication review (n=20). Few studies reported ACPs practice within the research and education pillars. There was variation in the definition and formal recognition mechanisms of ACPs between studies. In addition, many studies reported practice corresponding to advanced services but did not describe prerequisite training or formal recognition. Reported challenges included inadequate remuneration, limited access to patient records, and low stakeholder awareness. Key facilitators were availability of formal recognition, interprofessional relationships, and appropriate training. ACPs have expanded public access to clinical services. However, formal recognition and practice of ACPs from low-middle-income-countries are underrepresented in the literature. More work is needed to recognise ACPs' practice in education and research. Future research should clearly operationalise advanced practice within existing frameworks, explicitly report recognition mechanisms, and engage broader stakeholders in the implementation, evaluation, and role development of ACPs.

Pooling layers are essential in convolutional neural networks (CNNs) for reducing data size while preserving key features. Traditional methods such as Max and Average pooling have limitations. Max pooling is sensitive to noise, while Average pooling treats all activations equally. Although T-Max-Avg pooling addresses these limitations through adaptive top-k selection, its rigid decision rule requires multiple threshold comparisons and limits efficiency, motivating a simpler decision mechanism. This study introduces average-thresholding pooling (ATP), a simplified adaptive method that replaces multiple threshold comparisons with a single decision based on the average of the top-k activations. This design improves computational efficiency and reduces sensitivity to outliers. Experiments on the STL-10 dataset using a LeNet-5 architecture show that the proposed method achieves accuracy comparable to T-Max-Avg pooling (~55.5%) while consistently improving both training efficiency and inference speed. These results indicate that ATP provides a lightweight and practical alternative for CNN-based image classification, offering an improved balance between classification performance and computational efficiency.

Background: Breast cancer remains one of the leading causes of cancer mortality worldwide. The tumor microenvironment (TME) plays a crucial role in cancer progression, metastasis, and therapeutic resistance. Melittin, a bioactive peptide derived from bee venom, has demonstrated promising anticancer properties through multiple mechanisms including apoptosis induction, inhibition of angiogenesis, and immune modulation. Objective: This systematic review aims to analyze current evidence regarding the anticancer mechanisms of melittin and its delivery strategies targeting tumor microenvironment in breast cancer. Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Articles were identified through PubMed database searches using keywords related to melittin and cancer therapy. Studies published between 2021 and 2026 investigating melittin-based therapeutic approaches were included. Data extracted included study design, intervention type, molecular targets, and therapeutic outcomes. Results: Six studies met the inclusion criteria. Melittin demonstrated significant anticancer activity through suppression of HIF-1α signaling, induction of apoptosis, modulation of immune response, and remodeling of tumor microenvironment. Advanced drug delivery technologies such as nanocarriers, liposomes, and peptide-based systems significantly improved therapeutic targeting and reduced toxicity. Conclusion: Melittin represents a promising bioactive compound for breast cancer therapy, particularly when combined with advanced delivery systems targeting tumor microenvironment. Future research should focus on clinical trials to evaluate safety and therapeutic efficacy in humans

This study aims to assess the impact of risk management practices on the financial performance of banking sector companies listed on the Indonesia Stock Exchange (IDX) during the period 2021–2023. The banking industry faces various types of risks that can affect financial performance, including credit risk, market risk, liquidity risk, and operational risk. Effective risk management practices are essential for maintaining bank stability and ensuring sustainable profitability. This research employs a quantitative approach using multiple linear regression analysis. The sample consists of 12 banking companies selected through purposive sampling based on specific criteria, including the consistent publication of financial reports during the study period and the completeness of the required data. Data were collected from annual financial reports accessed through the IDX website and the official company websites. The analysis was conducted using SPSS software and included descriptive statistics, classical assumption tests (multicollinearity, normality, heteroskedasticity, and autocorrelation), and hypothesis testing (t-test, F-test, and coefficient of determination). The results indicate that, collectively, credit risk, market risk, liquidity risk, and operational risk have a significant effect on financial performance, with an F-value of 13.160 and a significance level of 0.000. Partially, only liquidity risk shows a significant negative effect on financial performance (t = ?2.308, sig. = 0.028), while credit risk (t = 1.288, sig. = 0.207), market risk (t = 1.409, sig. = 0.169), and operational risk (t = ?1.170, sig. = 0.251) do not have a significant individual effect.

IntroductionDengue severity is influenced by viral load and the host’s immune response. Aedes aegypti saliva increases cellularity at the bite site, which may promote viral replication. Atopic dermatitis (AD) is associated with hypersensitivity to Aedes saliva and Th2-skewed immune response, potentially increasing viral target cells in the skin and impairing the immune response to dengue. This study investigated the association between exposure to Aedes saliva, T-cell function, and dengue severity among dengue patients with AD, particularly in children, in whom the incidence of AD and the severity of dengue are higher.MethodsThis observational cross-sectional study was conducted on 62 secondary dengue patients aged 1–12 years. The ISAAC questionnaire was used to assess the history of AD. T-cell functions were evaluated by measuring the levels of IFNγ, IL10, IL13, and CCL2 cytokines in the PHA-stimulated whole blood cultures exposed to Aedes aegypti salivary gland extract (SGE) using the ELISA.ResultsThe incidence of dengue hemorrhagic fever (DHF) was higher among dengue patients with AD than in those without AD (p=0.010). In the PHA-stimulated whole blood cultures exposed to SGE, higher CCL2 levels were observed in DHF patients than in dengue fever (DF) patients (p=0.044), and higher IL13 levels were found in dengue patients with AD compared to those without AD (p=0.026). In PHA-stimulated whole blood cultures without SGE, lower IFNγ levels were found in DHF patients than in DF patients (p=0.035).ConclusionAD may be associated with a higher incidence of DHF and increased T-cell IL-13 production in response to SGE. DHF may be associated with increased T-cell CCL2 production in response to SGE, which may reflect greater cell infiltration at the bite site, and reduced T-cell IFN-γ production in response to dengue infection.

Background: Childhood stunting and undernutrition remain critical global health challenges. While long-term interventions are common, the efficacy of short-term, community-based intensive nutritional interventions (Pos Gizi) requires further empirical evaluation.Objective: This study aimed to analyze the clinical effectiveness of a 12-day intensive nutritional package on weight and height gain among underweight children under five in Garut District, West Java, using a quasi-experimental one-group pretest-posttest design.Methods: The study included 69 children (aged 10–55 months) meeting the inclusion criteria, who received supplementary feeding and intensive health education over 12 days. Anthropometric data were collected at baseline and endline using standardized instruments. Data were analyzed using the Paired t-test and Cohen’s d effect size calculation.Results: Significant improvements were observed in both weight (p < 0.001) and height (p < 0.001) post-intervention. The mean weight gain was 0.20 kg (95% CI: 0.16–0.25), and the mean height gain was 0.65 cm (95% CI: 0.42–0.88). Effect size analysis indicated a large clinical impact on weight (d = 1.01) and a medium-to-large impact on height (d = 0.68).Conclusion: Short-term intensive nutritional interventions are effective in stimulating rapid weight rehabilitation. While linear growth showed statistical improvement, this likely reflects acute physical recovery rather than permanent structural growth. This model is recommended as an initial acceleration strategy to manage undernutrition.

Abstract Chronic lower back pain (CLBP) is a prevalent occupational problem among hospital workers, primarily caused by prolonged sitting and poor ergonomic posture. This condition contributes to reduced productivity, discomfort, and diminished quality of working life. Ergonomic chair interventions have been introduced as a potential preventive and therapeutic strategy to alleviate pain and improve workplace well-being. A narrative literature review was conducted by searching PubMed, Scopus, and Google Scholar databases from 2015 to 2025 using the keywords low back pain, chair intervention, and hospital workers. Selected studies discussed ergonomic chair modifications, posture correction, and work-related health outcomes. Most reviewed studies demonstrated that ergonomic chair interventions reduced pain intensity and disability scores, while improving posture stability and job satisfaction. Enhanced comfort and reduced fatigue were associated with better concentration and productivity. However, inconsistencies in chair design, user compliance, and study methods remain as limitations. A chair which is pivot adjustable and has adjustable backrest can reduce the muscle activity and also decreases the inter-vertebral disc pressure. Therefore, there is some support that adjustability of the chair can be directly associated with the function of the musculoskeletal system. Ergonomic chair interventions provide a promising approach to reducing CLBP and improving the quality of working life among hospital workers. Further high-quality studies are needed to develop standardized ergonomic recommendations for healthcare workplaces. Keywords: ergonomic chair, hospital worker, low back pain, quality of working life

The critical issue of stunting eradication necessitates innovative solutions for effective monitoring, intervention, and prevention. In this paper, we introduce an innovative integrated information system dashboard that leverages the power of data analytics and real-time data processing to provide comprehensive insights into stunting eradication efforts. This assists healthcare providers and policymakers in accessing actionable information crucial for making informed decisions. Our dashboard utilizes digitalization technology to analyze and visualize stunting data in almost real-time, operating nonstop 24/7. This platform enables users to engage in interactive and data-driven decision-making processes. The personalized and user-friendly interface allows for a tailored experience that meets the specific needs and preferences of different stakeholders. We used the Rapid Application Development method with an object-oriented approach to develop this dashboard. We demonstrate the proof of concept of this dashboard through a series of experiments and evaluations. Based on the results of the trial, the designed platform can be very useful for Zero New Stunting campaigns in Kecamatan Cikarang Timur.

This study aims to examine academic honesty among undergraduate female students in Indonesia, amidst the widespread access to AI-based tools (e.g., ChatGPT, Gemini). Based on the Theory of Planned Behavior (TPB), this study examines the influence of Attitude Toward Behavior (ATB), Subjective Norm (SN), and Perceived Behavioral Control (PBC) on Behavioral Intention (BI) and subsequently impacting Actual Behavior (AB). This study employed a quantitative explanatory cross-sectional design. Data were collected through online questionnaires from 350 female students at various universities in Indonesia. The analysis phase was conducted using Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) in AMOS to assess measurement validity and the strength of causal pathways. The results showed that the three TPB constructs, namely ATB (? = 0.31, p < 0.001), SN (? = 0.27, p < 0.01), and especially PBC (? = 0.39, p < 0.001), significantly predicted BI, and BI, in turn, significantly predicted AB (? = 0.48, p < 0.001). Furthermore, PBC had a direct effect on AB (? = 0.22, p < 0.05). Both the measurement and structural models met the recommended fit criteria (CFI ? 0.95; RMSEA ? 0.05). The findings of this study confirm the application of the TPB to understand female students' academic honesty in the AI era and emphasize the central role of PBC and the influence of Indonesian collectivist cultural norms. Practical implications include the need to strengthen academic skills and AI ethics literacy, integrate local wisdom into integrity-enhancing programs, and implement institutional policies that encourage the responsible use of AI. Future research should consider comparative gender studies and longitudinal designs to explore behavioral dynamics as technology evolves.