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A 55-year-old male patient presented to our outpatient clinic with complaints of dark urine and fatigue. The laboratory parameters were as follows: alanine aminotransferase 821 IU/L, aspartate aminotransferase 1042 IU/L, alkaline phosphatase 412 IU/L gamma-glutamyl transferase 268 IU/L and the complete urinalysis revealed hematuria, while other laboratory parameters were normal. The patient's abdominal ultrasonography (USG) and Doppler USG showed no pathological finding. Hepatitis and the other serologies were negative. The patient, who did not exhibit any symptoms of Coronavirus disease-2019 (COVID-19) initially, exhibited bilateral opacities in the middle zones on chest X-ray taken after the development of fever and dyspnea on the third day of hospitalization. The computed tomography scan revealed segmental consolidation across the subpleural regions, mostly in the middle zones, and was evaluated to be consistent with COVID-19. COVID-19 treatment was planned for the patient whose nasopharyngeal swab tested positive for severe acute respiratory syndrome-Coronavirus-2.
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The face is one of the biometrics utilized to learn information from a person, such as gender. Gender classification study is expanding daily as a result of how important it is and how many other sectors, like forensics, security, business, and others, employ it. However, in order to protect themselves and stop the spread of Covid-19 during this epidemic, everyone must wear a face mask. Because many crucial facial features that help determine a person's gender are obscured by masks, using one creates an issue for the gender classification system. To obtain optimal performance outcomes, suitable hyperparameters are also required. As a result, the objective of this study is to develop a gender categorization system based on mask-covered faces utilizing a novel technique that combines several features in the Gray Level Co-occurrence Matrix (GLCM), which is then fed into the Bagging classifier.A Hybrid Bat Algorithm (HBA) is used to optimize the bagging hyperparameters. With 97% accuracy, precision, recall, and f1-score values, the suggested model is demonstrated to have greater performance than before the hyperparameters were tuned using HBA. © 2023 IEEE.
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Introduction: After COVID-19 infection, symptoms last for weeks or months. In this study, it was aimed to examine the relationship between functional status and fatigue and the associated factors in patients with COVID-19. Method(s): Patients with COVID-19 infection who applied to 13 centers were included into the study according to the inclusion criteria. Age, gender, height, body weight, body mass index (BMI), marital status, smoking status and amount, presence, duration of chronic disease, Charlson comorbidity index, regular exercise habit, time of diagnosis with COVID-19, presence of hospitalization,length of hospital stay, intubation status, home oxygen therapy need, participation in PR program, presence of dyspnea, cough, sputum, mMRC score, post-COVID functional status scale, fatigue severity scale, EQ-5D-5L Questionnaire scores were recorded. Result(s): Of the 1095 patients, 603 (55%) were male and 492 (45%) were female. Their mean age was 50+/-14 years. The most common chronic lung disease was COPD (11%), while 266 patients (29%) had non-pulmonary systemic disease. The median time of COVID-19 diagonosis was 5 months ago with 47% hospitalization rate. The median value of post-COVID functional status scale was 1 (0:4), and fatigue severity scale score was 4.4 (1:7). There was a significant correlation between post-COVID functional status and fatigue severity scale (r=0.43, p <0.01). Conclusion(s): Functional status and fatigue were found to be related primarily to quality of life and then patients' age, BMI, presence of chronic and systemic lung disease, regular exercise habits before COVID-19, hospitalization and its duration, home oxygen therapy and symptoms.
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Telepharmacy is an online application used to provide pharmaceutical services in the modern era. Therefore, this study aims to develop a questionnaire on a research model that integrates three well-known theories, namely the unified theory of acceptance and use of technology (UTAUT), the protection motivation theory (PMT), and the DeLone and McLean information success model, to determine factors that influence people's behavior towards the adoption of telepharmacy services. A cross-sectional observational method was used with the purposive sampling technique. A total of 118 participants who were at least 18 years old received the questionnaire. They were selected using convenience sampling from a variety of population groupings. Data analysis was then performed with the exploratory factor analysis (EFA). Factor extraction was carried out using principal component analysis and varimax rotation. The results show 8 factors consisting of social influence and support 15.54%;understanding of proficiency, confidence and quality of information 11.06%;condition of facilities and skills 6.64%;severity and suffering 7.87%;time opportunity support and system quality 7.74%;intention to adopt telepharmacy 7.34%;perceived vulnerability 6.80%;and attitude 6.37%. Furthermore, the overall construct formed can explain 72.40% of the total variance. These results indicate that the telepharmacy service adoption behavior questionnaire is valid and reliable. © 2023, Intelektual Pustaka Media Utama. All rights reserved.
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Introduction: During COVID-19, health students should learn human anatomy online. By learning online, students have difficulty understanding the subject material. This study aims to explore the experiences of health students learning the anatomy of the human body during the COVID-19 pandemic. Methods: This study used a qualitative study with a phenomenological study approach. This study's participants were seven health students from two private universities in Pekanbaru city, which were taken by purposive sampling. Data collection used in-depth interviews and was analyzed using the phenomenological method developed by Colaizzi. Results: Researchers found five main themes, namely the learning process during the COVID-19 pandemic, obstacles to the online learning process, obstacles for students to learn the anatomy of the human body during the COVID-19 pandemic, student efforts to find references, and expectations of students learning anatomy during the COVID-19 pandemic. Conclusion: Students experience several obstacles during participating in online learning while the pandemic occurs, especially in understanding the anatomy of the human body. Students make several efforts to add learning resources and hope there will be digital learning applications with animation and image features and detailed explanations of human anatomy. This study recommends that educational institutions use digital applications to support learning to make it easier for students to understand the anatomy of the human body. © 2022 Academia Nacional de Medicina. All rights reserved.
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Objectives: The novel coronavirus pandemic has become a real challenge for provision of dental education. The aim of this survey study was to evaluate the opinions of dental faculty educators and students about online education after e-learning experience. Materials and Methods: The research was conducted on educators and 4th and 5th grade students at Ankara University, Faculty of Dentistry. Questionnaire items for educators and students were categorized into the following factors: educators'/students' personal and professional skills and attitudes towards online education, online theoretical education, online practical training, online exams, handling and quality of education during pandemic. The data obtained was recorded as percentage (%) and interpreted. Results: 281 undergraduate students and 52 educators participated in this survey study. 36.7% of the students and 24.5% of the educators stated that online courses were as successful as face-to-face education. In addition, 84.2% of the students stated that online learning was not sufficient to acquire clinical skills. 55.9% of the students reported that the educators' effective use of communication methods (videos, surveys, etc.) increased their motivation. 89% of students and 69.8% of educators thought that students should attend in a postgraduate program to acquire clinical skills that they have not acquired due to the pandemic. Conclusions: The results of this study showed that academicians hold a negative view of distance learning as they think online theoretical courses, practical training and exams impaired the quality of learning. On the other hand, dentistry students have a positive attitude towards online theoretical education but are concerned about clinical skill acquisition © This work is licensed under Creative Commons Attribution 4.0 International License
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High price disparity is an economic problem that causes the welfare level of the population to be low. The government through the Sea Highway program tries to reduce price disparities through subsidized and scheduled sea transportation to serve several ports in Indonesia, one of which is in the province of Riau Islands. The Strait of Lampa Port is one of the marine transportation nodes which is a stopover point for Sea Toll boats on the T-3 route serving Natuna Regency. This port has the status of a regional feeder port with the hinterland area of Natuna Regency with Ranai as the district capital. This study aims to provide input related to the clustering of the Marine Highway program in Natuna from several perspectives, namely from the potential of regional commodities and infrastructure for Sea Toll services in the Natuna region. The analysis method used is descriptive qualitative and comparative. The results showed that for the cluster of the western region of Indonesian waters, in this case represented by a sample of the T-3 Natuna Islands Sea Toll route service, in terms of supply and demand from the homebase of Tanjung Priok Port, it is sufficiently balanced even though there are several superior commodities in the Natuna archipelago that have not yet optimally distributed, due to the low development and increase in added value of commodities. Based on the sample Sea Toll service route that has been selected for the Western Region of Indonesia, namely the T-3 route for the Natuna Islands region, several criteria that need to be considered in the future regarding the Sea Toll service cluster include regional commodities, Port infrastructure facilities and infrastructure, hinterland transportation facilities and infrastructure, and ship type and capacity.
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Introduction: Coronavirus disease 2019 has been decreed as a global pandemic due to the levels of spread and fatality. People who do not believe this disease will ignore health protocols that lead to a higher spreading rate. It is expected that nursing students should have health literacy to decrease the virus spreading by providing health promotion. However, they do not comply with implementing the precautions. The research aimed to examine the correlation between the students' health literacy and attitudes and the prevention action of the spread of COVID-19 among nursing students. Methods: A correlational study with a cross-sectional design was utilized in this research. As many as 294 nursing students took part in this research, which was chosen by accidental sampling. A questionnaire was used to collect the data. The Chi-square test was used to find out the correlation between students' health literacy and students' attitude toward preventive action against the spread of COVID-19. Results: : The findings revealed no correlation between the students' health literacy and preventive action on the spread of COVID-19 (p-value 0,325) was found, but there is a significant correlation between students' attitudes toward preventive action (p-value 0,001). Conclusion: Students' attitude has a relation to preventive action meanwhile, the students' health literacy did not correlate with the preventive action against COVID-19. © 2022 UPM Press. All rights reserved.
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Facial expression teaching has been replaced by virtual due to the coronavirus (COVID-19) epidemic. The government's policy of homeschooling has led to the practice of virtual learning. Teachers' low readiness in planning, designing, and developing has shaped learners' perceptions of virtual education. This study explores how students perceive online education as a result of attending classes at home during the COVID-19 epidemic. There are 57 students involved in this case study, which uses a qualitative approach. Data was gathered using online surveys and semi-structured interviews. Thematic analysis in NVIVO 12 Plus was used for data analysis. This research reveals that teachers, students, learning resources, instruction, and technology have all impacted how students perceive online learning. As a consequence, teachers must improve their abilities. This research is meaningful in developing teaching and learning in the study program. ©2022 Birlesik Dunya Yenilik Arastirma ve Yayincilik Merkezi. All rights reserved.
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Background: Serious infections are more frequently seen in patients with infam-matory rheumatic diseases, being treated with immunosuppressive or biologic disease-modifying antirheumatic drugs (b-DMARDs). Potential harmful effects of immunosuppressive drugs as well as b-DMARDs were a major concern during the early phases of the Coronavirus disease 2019 (COVID-19) pandemic, and preliminary data documented the worse outcome of COVID-19 associated with B cell depleting treatments (1). On the other hand, limited information has been shared about the course of COVID-19 in patients with monogenic autoinfamma-tory disorders using IL-1 inhibitors. Objectives: We herein aimed to evaluate the course of COVID-19 in adult patients with the most common form of infammasomopathy, Familial Mediterranean Fever (FMF), who were on biologic agents. Methods: In this cross-sectionally study, FMF patients were evaluated by screening their clinical and electronic records in our database in October 2021. The FMF patients with a record of PCR-confrmed COVID-19 were investigated in more detail in our hospital. Characteristics of FMF fndings as well as clinical and laboratory fndings associated with COVID-19 were recorded from the outpatient follow-up cards. Results: We identified 184 FMF patients using biologic agents, and their baseline characteristics are summarized in Table 1. Among them, 36 had PCR-confirmed COVID-19;32 of them were currently on b-DMARD along with colchicine (31 anti-IL-1, 1 anti-TNF), and 4 of them had a previous history of b-DMARD treatment. Data about the course of COVID-19 could be reached in 34 patients. Four (11%) patients had an asymptomatic course. Remaining patients with symptomatic COVID-19 had the following symptoms: cough (50%), headache (47.2%), fever (44.4%), loss of taste and smell (41.6%), myalgia (0.6%), dyspnoea (27.8%), diarrhea (25%) abdominal pain (5.6%). Thorax computed tomography was performed in 10 patients, and findings of pneumonia were documented in 6 (16.7%). The mean values of the laboratory parameters were as follows: C-reactive protein 99.48 ± 112.66 mg/L;ferritin 316 ± 208.3;D-Dimer 2445 ± 3917, Lactate Dehydroge-nase 253 ± 61, troponin T 26 ± 20, procalcitonin 0.348 ± 0.53. Lymphopenia was detected in 5 (13.9%) patients;mean lymphocyte count was 1080 ± 363. Data about the treatment could be reached in 34 patients. Antiviral therapy was prescribed in 25 (69.4%) patients (favipiravir, n=22;and oseltamivir, n=3). Antibiotics were given to 6 (16.7%) patients, and 6 (16.7%) received hydroxychloroquine. Parenteral steroids were administered to 2 patients during the hospitalization. Six (16.7%) patients required hospitalization, and 2 (5.6%) required oxygen support, non-invasive mechanical ventilation, and one of them followed in the intensive care unit. Twenty-two patients were on anakinra treatment, and none of them required additional dose. Only 1 patient, a 61-year-old male patient with a history of lung lobectomy and renal transplantation, received tocilizumab due to macrophage activation syndrome, and he later died of sepsis. This patient was on anakinra until 2 years before, and it was discontinued due to an allergic reaction. Only 4 patients had a history of vaccination before COVID-19, and none of them developed pneumonia and required hospitalization. Six patients had FMF attacks after recovering from COVID-19. None of the patients developed thromboembo-lism and secondary bacterial infections. Conclusion: This survey identified 36 biologic b-DMARD receiving FMF patients, who had COVID-19. All but 1 patient had complete recovery, and b-DMARD usage did not negatively affect the COVID-19 course. None of the patients currently on anti-IL-1 or anti-TNF had a worse outcome. Based on these observations, it can be suggested that refractory FMF patients can continue their b-DMARD treatments when they had COVID-19.
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Background: Several anti-inflammatory drugs which were targeted different mechanisms and investigated for both prevention and treatment for COVID-19. Objectives: The current study aimed to investigate whether patients regularly using colchicine or hydroxychloroquine (HCQ) have an advantage of protection from COVID-19 or developing less severe disease. Methods: Patients who were taking colchicine or HCQ regularly for a rheumatic disease including Familial Mediterranean Fever, Behçet's syndrome, Systemic Lupus Erythematosus, Rheumatoid Arthritis and Sjogren's syndrome as well as their healthy household contacts as the control group were included into the study. The clinical data regarding COVID-19 were collected using a standard form, and serum samples were analyzed for anti-SARS-COV-2 nucleocapsid IgG. Patients treated with any biologic or immunosuppressive treatments were not included into the study. Results: A total of 635 regular colchicine users with their 643 household contacts and 317 regular HCQ users with their 333 household contacts were analyzed. Anti-SARS-Cov2 IgG was positive in 43 (6.8%) regular colchicine users and 35 (5.4%) household contacts (OR=1.3;95% CI:0.8-2;p=0.3) (Table 1). COVID-19 related symptoms were described by 29 (67.4%) of the patients and 17 (48.6%) household contacts (OR=2.2;95% CI:0.9-5.5;p=0.09), and hospital admission was observed in five (11.6%) and one (2.9%) of these subjects (OR=4.5;95% CI:0.5-40.2;p=0.1), respectively (Figure 1). Seropositive subjects were observed in 22 (6.9%) regular HCQ users and 24 (7.2%) household contacts (OR=1.1;CI:0.6-1.9;p=0.8) (Table 1). COVID-19-related symptoms occurred in 16 (72.7%) of the 22 patients and 12 (50%) of 24 household contacts (OR=2.7;95% CI:0.8-9.1;p=0.1). Three patients (13.6%) were admitted to hospital, while one household contact (4.2%) was hospitalized (OR=3.6;95% CI:0.3-37.8;p=0.2) (Figure 1). Disease-specific analyses disclosed that there was no significant difference in terms of COVID-19 frequency and severity between a particular disease subset and household contacts (Table 1). Univariate logistic regression analysis showed no effect of age and gender on the SARS-CoV-2 seroprevalence rate among regular colchicine or HCQ users and household contacts (p=0.2 and p=0.7, respectively for colchi-cine users versus contacts, p=0.7 and p=0.3, respectively for HCQ users versus contacts). Conclusion: Being on a regular treatment of colchicine or HCQ was not resulted in the prevention of COVID-19 or amelioration of its manifestations.
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The existence of this workload is due to an imbalance between the capacity or ability of workers and the demands of the work that must be faced. As is the case with the conditions of workers in MSMEs, the demands of work are greater than the capacity of workers. Hence, the emergence of workload can not be avoided. Many studies on the workload of MSMEs have been carried out in Indonesia, however none of existing works has employes the Fishbone approach. This study evaluates the workload of three indicators, namely mental workload, physical workload, and Covid-19 pandemic. The novelty of this work is that, unlike the existing work that use different methods, we focus Fishbone method in our work. Furthermore, we used a large sample size of 341 respondents who are MSMEs employees in Malang, Indonesia, where the survey method was used for data collection. The results of the t-test analysis showed that the average mental workload score was not the same as the average physical workload score, the positive t-count results showed that the average physical workload score was higher than the mental workload. The results of the analysis with frequency describe that the response given to each indicator is mental workload in the underioad category, physical workload in the optimal category, and the Covid-19 in the overload category. The main factors causing the workload are the Covid-19 pandemic factor where respondents feel always bothered about the pandemic, the physical workload factor where respondents often feel tired, and the mental workload factor where respondents have personal problems that interfere with work. The workload for MSME workers is in line with previous predictions that the physical load is more dominant than the mental load. However, during this Covid-19 period, a higher workload is felt due to the impact of the government's restrictions on activities.
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Objective: Coronavirus disease-2019 (COVID-19) is a global pandemic that affects worldwide. Most patients who need intensive care due to COVID-19 develop acute respiratory distress syndrome and patients need long-term mechanical ventilation. This situation increases the risk of dysphagia, aspiration, and aspiration pneumonia in patients. Information about COVID-19-associated dysphagia is still limited. Thus, this study aimed to evaluate the frequency of postextubation dysphagia (PED) and its effect on clinical outcomes. Materials and Methods: Patients with COVID-19 in the adult intensive care unit (ICU) who were left on a mechanical ventilator for at least 24 h and are extubated were retrospectively screened. Gugging swallowing screen (GUSS) test was performed 24 h after extubation to evaluate swallowing function. Patients were examined in two groups as with and without dysphagia. Results: This study included 40 patients who were followed up on a mechanical ventilator and extubated due to COVID-19. According to the bedside GUSS test results, patients were divided into two groups as dysphagia group (n=24) and the non-dysphagia group (n=16). The mean age was higher in the dysphagia group (p<0.001). Re-intubation rate and ICU, and in-hospital mortality were higher in the dysphagia group (p<0.001 for all), whereas the length of stay in the ICU and mechanical ventilation time were longer (p=0.005 and p=0.001). ICU mortality was higher in patients with severe dysphagia (p=0.026). Conclusion: Our study revealed that the risk of PED increased with the age of patients with COVID-19 and PED increased the incidence of re-intubation, which was an important prognostic parameter that indicates mortality. Recognizing dysphagia with the early evaluation of swallowing in extubated patients with COVID-19 diagnosis is important to minimize the risk of aspiration pneumonia with proper nutrition, reduce the increased health cost, and prevent poor clinical outcomes. © 2021 by Turkish Neurological Society.
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Detection of SASR-CoV-2 plays a significant role in reducing the transmission of COVID-19. Antigen swab test is widely used for screening due to its low processing time and cost, while RT-PCR is used in patient monitoring since it is quite expensive. Although the antigen swab test is more affordable than the RT-PCR, it only generates a discrete result: positive or negative. Thus, it cannot be used for patient monitoring. A method using antigen-antibody binding and surface plasmon resonance (SPR) principle was developed in this research to create an affordable, instant, and quantified SARS-CoV-2 detection method. In this study, modified scFv is tested as a potential bioreceptor since it is easier to be expressed than the whole antibody. The results show that the scFv with the best potential was harvested from the periplasm of E. coli and purified. It has a maximum response at 8.02 RU, LOD at 8.34 ng/mL, linearity at 1.38 in the range of 25-200 ng/mL, and a determination coefficient at 92 percent.
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The coronavirus disease 2019 (COVID-19) pandemic has caused a global impact. It also affected Indonesia. There had been tens of thousands of positive cases and thousands of deaths. Many paramedics also died to heal people from this disease. The Indonesian government determined this condition as a Social Emergency Condition and issued the Governmental Decree No. 21 of 2020 on Large-Scale Social Restrictions (LSSR) in 2020 (and Community Activity Restriction Enforcement [CARE] in 2021 with the Instruction of the Minister of Internal Affairs on Emergency CARE in Java and Bali islands). The Instruction of the Minister of Internal Affairs No. 15 of 2021 regulated the Application of the Emergency CARE due to the COVID-2019. In its implementation, the LSSR are ineffective in preventing the spread of the COVID-19 as there are some anomalies in the field, as this law is not strictly enforced. The spread of the COVID-19 becomes uncontrollable as there are no strict sanctions against violators of the LSSR. Meanwhile, the law-enforcing apparatus tend to ignore violations. This condition is different from the application of the CARE as it was more effective in decreasing the number of Covid-19 cases. This is because its implementation is equipped with supervision and strict sanctions. The strictness and the seriousness in applying the CARE yielded positive results, namely, the significant decrease of COVID-19 sufferers.
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Businesses relies on information technology to retrieve data and store data. The data is used for making business decisions at all levels of an organization. Due to the COVID-19 pandemic, the reliance on information technology has risen to help companies connect their employees and their supply chain partners. Since Indonesia emerging market is growing, there is a need to investigate the growing intention to adopt information and communication technology. The reason is that Indonesian companies' survivability relies on their competitiveness and sustainability in business during the COVID-19 pandemic. This study investigates intention to use information technology through user satisfaction, Confirmation, perceived ease of use, and perceived usefulness. Data were collected from 45 employees working in the industry. The findings show that there is a difference between before pandemic and during the pandemic. After benchmarking the result with the literature, perceived usefulness and satisfaction were not significant to adopting information technology. The reason is due to pandemic forced employees to embrace technology and change employees' work ethic. The result contributes to the literature extending the empirical evidence and providing future direction to investigate pre- and post-pandemic situations. Practically, companies should introduce information technology in phases so that it will not increase user dissatisfaction. © 2021 IEEE.
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Background: Coronavirus (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) virus. This disease is transmitted from human to human, where most of (COVID-19) infected people experience mild to moderate respiratory disease and recover without requiring special care. Health education is a top priority and is one of the effective nursing interventions to improve knowledge level and public awareness about the importance of correct understanding regarding COVID-19. The researcher was aimed to analyze knowledge level differences of Posbindu (Integrated guided care) participants in Puskesmas (Community Health Center) Gesi regarding COVID-19 disease before and after the implementation of health education. Methods: It was a queasy experimental quantitative research with a one-group pretest-post-test control design. There were 40 participants with ages ranging from 15 to 50 years old. Result: The Posbindu participants' knowledge level about Covid-19 before receiving health education was categorized as poor. Meanwhile, Posbindu participants' knowledge level about Covid-19 before receiving health education was average. The Independent Sample T-Test showed that the sig. (2-tailed) value was 0.009 <0.05, then Ho was rejected, and Ha was accepted. Therefore, it could be concluded that there are differences in Posbindu participants' knowledge level before and after being given the health education about Covid-19 in Puskesmas Gesi. Conclusion: The health education given in Puskesmas Gesi affects Posbindu participants'knowledge level about Covid-19. It is hoped that the public health center regularly puts more consent to increase the community's knowledge about COVID-19.
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Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2), which causes Coronavirus disease-2019 (COVID-19), has rapidly spread all over the world and has become a public health emergency. Coronavirus disease-2019 has a wide clinical spectrum, from asymptomatic infection to Acute respiratory distress syndrome, sepsis, metabolic acidosis, coagulation disorder, multi-organ failure and even death. The dysregulated and hyperimmune response to SARS-CoV-2 could possibly explain the highly variable disease manifestations and play an important role in the pathogenesis of COVID-19. Since there is no specific antiviral treatment in the treatment of COVID-19, treatments for inflammation against the virus and sharing experience are important. Mesenchymal stem cells (MSCs) have potent anti-inflammatory and immunomodulatory abilities that can migrate to damaged tissues, promote tissue regeneration, and inhibit tissue fibrosis. Today, MSCs are widely used in many clinical studies on immune-mediated inflammatory diseases such as Graft-versus-Host disease, systemic lupus erythematosus, and perianal Crohn's disease. MSC treatment in COVID-19 is a promising option. In this study, we would present four patients with COVID-19 who were treated with MSCs and who were found to be positive for real-time polymerase chain reaction tests on nasopharyngeal swab or tracheal aspirate. All patients were critically ill were followed up with mechanical ventilator due to severe hypoxemia. One patient was extubated and discharged. Other patients died. In this study, MSCs were used as salvage therapy in the late period, so benefit might not be seen. In previous studies, this treatment was used earlier and there were results showing the benefits of MSCs. Based on this study, MSCs can be a promising treatment option when used in the appropriate patient at the appropriate time.
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Now, this is referred to as the industrial era 4.0, which is present simultaneously as the era of disruption. Therefore, this study aims to produce Electronic Student Worksheets of Physics (eSWoP) with the help of Sway to use PhET Simulations on physics learning about temperature and heat. This research was conducted using ADDIE (Analyze, Design, Development, Implementation, and Evaluation) research methods. The sample for the application of eSWoP used in the study was 86 students aged 16-18 years from a province in Indonesia. The result of this study is a PhET-assisted eSWoP teaching material that can be used through various electronic devices, using PhET simulations that can help students understand physics subjects at temperature and heat. In the questionnaire given to students, information was obtained that eSWoP media is useful, easy to use and can increase students' learning motivation. It was suggested that eSWoP technology could be a powerful and effective tool to enable students from the physics lesson into the inquiry process. Moreover, the implications of using eSWoP for teaching physics and recommendations for further studies are also discussed in this study. © 2021 Institute of Physics Publishing. All rights reserved.