Analisis Sentimen pada Komentar Sosial Media Instagram Layanan Kesehatan BPJS Menggunakan Naïve Bayes Classifier

Abstrak - Instansi Pelayan Kesehatan Pemerintah seperti BPJS Kesehatan membutuhkan feedback dari masyarakat yang merupakan sumber informasi untuk meningkatkan kinerja. Umpan balik yang didapatkan dari masyarakat tidak hanya yang bersifat positif, melainkan juga bersifat negatif. Tujuan penelitian ini adalah menganalisis sentimen berdasarkan komentar masyarakat terhadap akun sosial media pemerintahandengan mengklasifikasikan secara otomatis menggunakan algoritma naïve bayes classifier. Hasil implementasi dapat membantu pemilih akun menganalisis respon masyarakat terhadap suatu postingan berupa respon positive, negative atau netral. Metode klasifikasi berbasis pencocokan teks boyer moore berhasil diimplementasikan untuk melakukan klasifikasi teks komentar di postingan instagram. Metode yangdiusulkan memiliki performa baik dengan akurasi mencapai 73 persen.Kata Kunci: Instagram, Text Mining, Sentiment Analysis, Naïve Baye

Spatial estimation of groundwater quality, hydrogeochemical investigation, and health impacts of shallow groundwater in Kabul city, Afghanistan

The management of groundwater in densely populated areas with no centralized water treatment is critical for the prevention of diseases and maintaining sanitation. Here, we determine the bacteriological and chemical characteristics of groundwater in Kabul city, a resource that 4.1 million individuals rely on. Groundwater samples were analyzed from 41 newly established piezometric wells across Kabul, and data were compared with the last detailed study, undertaken in 2007, to understand contamination trends in an area that has undergone significant development and social changes. Piper diagrams, Gibbs diagrams, correlation analysis, and bivariate plots examine the hydrogeochemical and natural occurring processes of groundwater. The average concentration of cations followed the order Na+  > Mg2+  > Ca2+  > K+, and anions HCO3− > NO3− > Cl− > SO42− > F with Gibbs diagrams indicating mainly rock-weathering influence groundwater chemistry. An increase in nitrate (NO3−) and E. coli indicates anthropogenic activities impacting the shallow groundwater quality, with significantly elevated nitrate (over 50 mg/L) and E. coli (up to 250 CFU/100 mL). The increasing presence of E. coli and NO3− in the shallow groundwater of Kabul city in turn suggests problematic links to the prevalence of waterborne diseases. Additionally, the water quality index (WQI) was used to assess groundwater quality, and rank its suitability for drinking purposes. The WQI analysis showed that less than 35% of shallow groundwater samples had good water quality. The findings of this study are crucial for the development and sustainable management of groundwater in the city. In short term, we propose interventions such as point-of-use (POU) water purification which may offer temporary respite for waterborne disease prevention. Kabul city requires immediate attention to developing sustainable groundwater management policies, expansion of the water supply network, groundwater quality monitoring, and wastewater management

Tensor Trust: Interpretable Prompt Injection Attacks from an Online Game

While Large Language Models (LLMs) are increasingly being used in real-world applications, they remain vulnerable to prompt injection attacks: malicious third party prompts that subvert the intent of the system designer. To help researchers study this problem, we present a dataset of over 126,000 prompt injection attacks and 46,000 prompt-based "defenses" against prompt injection, all created by players of an online game called Tensor Trust. To the best of our knowledge, this is currently the largest dataset of human-generated adversarial examples for instruction-following LLMs. The attacks in our dataset have a lot of easily interpretable stucture, and shed light on the weaknesses of LLMs. We also use the dataset to create a benchmark for resistance to two types of prompt injection, which we refer to as prompt extraction and prompt hijacking. Our benchmark results show that many models are vulnerable to the attack strategies in the Tensor Trust dataset. Furthermore, we show that some attack strategies from the dataset generalize to deployed LLM-based applications, even though they have a very different set of constraints to the game. We release all data and source code at https://tensortrust.ai/pape

Comparing single-best-answer and very-short-answer questions for the assessment of applied medical knowledge in 20 UK medical schools: Cross-sectional study.

OBJECTIVES: The study aimed to compare candidate performance between traditional best-of-five single-best-answer (SBA) questions and very-short-answer (VSA) questions, in which candidates must generate their own answers of between one and five words. The primary objective was to determine if the mean positive cue rate for SBAs exceeded the null hypothesis guessing rate of 20%. DESIGN: This was a cross-sectional study undertaken in 2018. SETTING: 20 medical schools in the UK. PARTICIPANTS: 1417 volunteer medical students preparing for their final undergraduate medicine examinations (total eligible population across all UK medical schools approximately 7500). INTERVENTIONS: Students completed a 50-question VSA test, followed immediately by the same test in SBA format, using a novel digital exam delivery platform which also facilitated rapid marking of VSAs. MAIN OUTCOME MEASURES: The main outcome measure was the mean positive cue rate across SBAs: the percentage of students getting the SBA format of the question correct after getting the VSA format incorrect. Internal consistency, item discrimination and the pass rate using Cohen standard setting for VSAs and SBAs were also evaluated, and a cost analysis in terms of marking the VSA was performed. RESULTS: The study was completed by 1417 students. Mean student scores were 21 percentage points higher for SBAs. The mean positive cue rate was 42.7% (95% CI 36.8% to 48.6%), one-sample t-test against ≤20%: t=7.53, p<0.001. Internal consistency was higher for VSAs than SBAs and the median item discrimination equivalent. The estimated marking cost was £2655 ($3500), with 24.5 hours of clinician time required (1.25 s per student per question). CONCLUSIONS: SBA questions can give a false impression of students' competence. VSAs appear to have greater authenticity and can provide useful information regarding students' cognitive errors, helping to improve learning as well as assessment. Electronic delivery and marking of VSAs is feasible and cost-effective

Elevated Cocaine-and Amphetamine-Regulated Transcript Immunoreactivity in the Circulation of Patients with Neuroendocrine Malignancy

Context: Cocaine-and amphetamine-regulated transcript (CART) codes for a peptide widely distributed in nervous and endocrine tissues. CART immunoreactivity (CART-LI) has been detected in human insulinomas. Objective: The objective of the study was to investigate the measurement of plasma CART-LI as a tumor marker of neuroendocrine malignancy. Design and Subjects: Plasma CART-LI levels were measured in 401 patients with a range of diagnoses: neuroendocrine malignancy (n ϭ 131), after removal of neuroendocrine malignancy (n ϭ 27), without any form of tumor or renal impairment (n ϭ 192), with renal impairment (n ϭ 17) and with nonneuroendocrine tumors (n ϭ 34). Chromatography methods were used to investigate CART-LI circulating in human plasma. Results: The upper limit of normal calculated for CART-LI was 150 pmol/liter. Mean circulating plasma CART-LI among neuroendocrine tumor patients was 440 pmol/liter, 56% of subjects having levels greater than 150 pmol/liter. Measuring CART-LI in addition to chromogranin (Cg)-A improved the sensitivity for neuroendocrine malignancy from 85 to 91%, whereas combined use of CgA and CgB had a joint sensitivity of 89%. Of 38 patients with pancreatic neuroendocrine tumors, 71% had plasma CART-LI levels greater than 150 pmol/liter, increasing to 95% in those classified with progressive disease (n ϭ 20, mean CART-LI 625 pmol/liter), compared with 80% for CgA. Chromatographic analysis suggests that circulating CART-LI is present as one major form, which may correspond to CART (62-102) or another unknown form. Conclusions: We demonstrate CART-LI as a specific tumor marker in patients with a range of neuroendocrine tumors. Used in combination with CgA, CART-LI measurement has the potential to improve sensitivity in diagnosis and follow-up of neuroendocrine tumors, in particular progressive pancreatic neuroendocrine tumors

The World Health Organization was born as a normative agency: Seventy-five years of global health law under WHO governance

The World Health Organization (WHO) was born as a normative agency and has looked to global health law to structure collective action to realize global health with justice. Framed by its constitutional authority to act as the directing and coordinating authority on international health, WHO has long been seen as the central actor in the development and implementation of global health law. However, WHO has faced challenges in advancing law to prevent disease and promote health over the past 75 years, with global health law constrained by new health actors, shifting normative frameworks, and soft law diplomacy. These challenges were exacerbated amid the COVID-19 pandemic, as states neglected international legal commitments in national health responses. Yet, global health law reforms are now underway to strengthen WHO governance, signaling a return to lawmaking for global health. Looking back on WHO’s 75th anniversary, this article examines the central importance of global health law under WHO governance, reviewing the past successes, missed opportunities, and future hopes for WHO. For WHO to meet its constitutional authority to become the normative agency it was born to be, we offer five proposals to reestablish a WHO fit for purpose: normative instruments, equity and human rights mainstreaming, sustainable financing, One Health, and good governance. Drawing from past struggles, these reforms will require further efforts to revitalize hard law authorities in global health, strengthen WHO leadership across the global governance landscape, uphold equity and rights at the center of global health law, and expand negotiations in global health diplomacy

Using prescribing very short answer questions to identify sources of medication errors:a prospective study in two UK medical schools

Objective To assess the utility and ability of the novel prescribing very short answer (VSA) question format to identify the sources of undergraduate prescribing errors when compared with the conventional single best answer (SBA) question format and assess the acceptability of machine marking prescribing VSAs. Design A prospective study involving analysis of data generated from a pilot two-part prescribing assessment. Setting Two UK medical schools. Participants 364 final year medical students took part. Participation was voluntary. There were no other inclusion or exclusion criteria. Outcomes (1) Time taken to mark and verify VSA questions (acceptability), (2) differences between VSA and SBA scores, (3) performance in VSA and (4) SBA format across different subject areas and types of prescribing error made in the VSA format. Results 18 200 prescribing VSA questions were marked and verified in 91 min. The median percentage score for the VSA test was significantly lower than the SBA test (28% vs 64%, p<0.0001). Significantly more prescribing errors were detected in the VSA format than the SBA format across all domains, notably in prescribing insulin (96.4% vs 50.3%, p<0.0001), fluids (95.6% vs 55%, p<0.0001) and analgesia (85.7% vs 51%, p<0.0001). Of the incorrect VSA responses, 33.1% were due to the medication prescribed, 6.0% due to the dose, 1.4% due to the route and 4.8% due to the frequency. Conclusions Prescribing VSA questions represent an efficient tool for providing detailed insight into the sources of significant prescribing errors, which are not identified by SBA questions. This makes the prescribing VSA a valuable formative assessment tool to enhance students’ skills in safe prescribing and to potentially reduce prescribing errors

Comparison of treatment outcomes of new smear-positive pulmonary tuberculosis patients by HIV and antiretroviral status in a TB/HIV clinic, Malawi

Background: Smear-positive pulmonary TB is the most infectious form of TB. Previous studies on the effect of HIV and antiretroviral therapy on TB treatment outcomes among these highly infectious patients demonstrated conflicting results, reducing understanding of important issues. Methods: All adult smear-positive pulmonary TB patients diagnosed between 2008 and 2010 in Malawi's largest public, integrated TB/HIV clinic were included in the study to assess treatment outcomes by HIV and antiretroviral therapy status using logistic regression. Results: Of 2,361 new smear-positive pulmonary TB patients, 86% had successful treatment outcome (were cured or completed treatment), 5% died, 6% were lost to follow-up, 1% failed treatment, and 2% transferred-out. Overall HIV prevalence was 56%. After adjusting for gender, age and TB registration year, treatment success was higher among HIV-negative than HIV-positive patients (adjusted odds ratio 1.49; 95% CI: 1.14-1.94). Of 1,275 HIV-infected pulmonary TB patients, 492 (38%) received antiretroviral therapy during the study. Pulmonary TB patients on antiretroviral therapy were more likely to have successful treatment outcomes than those not on ART (adjusted odds ratio: 1.83; 95% CI: 1.29-2.60). Conclusion: HIV co-infection was associated with poor TB treatment outcomes. Despite high HIV prevalence and the integrated TB/HIV setting, only a minority of patients started antiretroviral therapy. Intensified patient education and provider training on the benefits of antiretroviral therapy could increase antiretroviral therapy uptake and improve TB treatment success among these most infectious patients. © 2013 Tweya et al

Combination protein biomarkers predict multiple sclerosis diagnosis and outcomes

Establishing biomarkers to predict multiple sclerosis diagnosis and prognosis has been challenging using a single biomarker approach. We hypothesised that a combination of biomarkers would increase the accuracy of prediction models to differentiate multiple sclerosis from other neurological disorders and enhance prognostication for people with multiple sclerosis. We measured 24 fluid biomarkers in the blood and cerebrospinal fluid of 77 people with multiple sclerosis and 80 people with other neurological disorders, using ELISA or Single Molecule Array assays. Primary outcomes were multiple sclerosis versus any other diagnosis, time to first relapse, and time to disability milestone (Expanded Disability Status Scale 6), adjusted for age and sex. Multivariate prediction models were calculated using the area under the curve value for diagnostic prediction, and concordance statistics (the percentage of each pair of events that are correctly ordered in time for each of the Cox regression models) for prognostic predictions. Predictions using combinations of biomarkers were considerably better than single biomarker predictions. The combination of cerebrospinal fluid [chitinase-3-like-1 + TNF-receptor-1 + CD27] and serum [osteopontin + MCP-1] had an area under the curve of 0.97 for diagnosis of multiple sclerosis, compared to the best discriminative single marker in blood (osteopontin: area under the curve 0.84) and in cerebrospinal fluid (chitinase-3-like-1 area under the curve 0.84). Prediction for time to next relapse was optimal with a combination of cerebrospinal fluid[vitamin D binding protein + Factor I + C1inhibitor] + serum[Factor B + Interleukin-4 + C1inhibitor] (concordance 0.80), and time to Expanded Disability Status Scale 6 with cerebrospinal fluid [C9 + Neurofilament-light] + serum[chitinase-3-like-1 + CCL27 + vitamin D binding protein + C1inhibitor] (concordance 0.98). A combination of fluid biomarkers has a higher accuracy to differentiate multiple sclerosis from other neurological disorders and significantly improved the prediction of the development of sustained disability in multiple sclerosis. Serum models rivalled those of cerebrospinal fluid, holding promise for a non-invasive approach. The utility of our biomarker models can only be established by robust validation in different and varied cohorts

The World Health Organization was born as a normative agency: Seventy-five years of global health law under WHO governance

The World Health Organization (WHO) was born as a normative agency and has looked to global health law to structure collective action to realize global health with justice. Framed by its constitutional authority to act as the directing and coordinating authority on international health, WHO has long been seen as the central actor in the development and implementation of global health law. However, WHO has faced challenges in advancing law to prevent disease and promote health over the past 75 years, with global health law constrained by new health actors, shifting normative frameworks, and soft law diplomacy. These challenges were exacerbated amid the COVID-19 pandemic, as states neglected international legal commitments in national health responses. Yet, global health law reforms are now underway to strengthen WHO governance, signaling a return to lawmaking for global health. Looking back on WHO’s 75th anniversary, this article examines the central importance of global health law under WHO governance, reviewing the past successes, missed opportunities, and future hopes for WHO. For WHO to meet its constitutional authority to become the normative agency it was born to be, we offer five proposals to reestablish a WHO fit for purpose: normative instruments, equity and human rights mainstreaming, sustainable financing, One Health, and good governance. Drawing from past struggles, these reforms will require further efforts to revitalize hard law authorities in global health, strengthen WHO leadership across the global governance landscape, uphold equity and rights at the center of global health law, and expand negotiations in global health diplomacy