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Arich and balanced phonetics corpus for modern standard Arabic ASR systems

10.11591/ijeecs.v41.i3.pp1049-1059
Youssef Boutazart , Naouar Laaïdi , Abderrahim Ezzine , Hassan Satori , Mohamed Taj Bennani
This research delves into the creation of an innovative Modern Standard Ara bic corpus, aiming for a comprehensive balance and richness while adhering to Zipf’s law. Building a phonetically diverse Arabic sentence collection yields significant advantages in terms of efficiency, cost-effectiveness, and storage ca pacity compared to conventional corpora. The corpus undergoes meticulous seg mentation into graphemes, which are then manually converted into phonemes, resulting in a total of 19769 phonemic units. Among these phonemes, conso nants like ’Laam- l’ account for 10%, while ’Fatha- A’ vowels constitute 20%. Evaluation of this corpus using an automatic speech recognition (ASR) system reveals a sentence error rate (SER) of 30% and a word error rate (WER) of 15%. Furthermore, statistical analysis unveils that diacritic marks encompass 47.59% of the corpus, with graphemes comprising the remaining 52.41%. These dia critized marks provide valuable insights into the precise phonetic transcription of the corpus. Additionally, the study provides detailed breakdowns of consonants based on their place and manner of articulation, enhancing our understanding of phonetic structures.
Volume: 41
Issue: 3
Page: 1049-1059
Publish at: 2026-03-10

Classification of DoS/distributed DoS threats in software defined networks using advanced deep belief network-long short term memory architecture

10.11591/ijeecs.v41.i3.pp1000-1016
Manjula Maraiah , Venkatesh Venkatesh
With the evolution of telecommunication core and access networks, the next generation networks leverages software defined networks (SDN) to provide flexi bility, scalability and centralized control. Denial of service (DoS)/distributed DoS (DDoS) attacks have been a major threat to next generation networks especially to the centralized architecture of SDNs. The ever-changing and dynamic nature of the DoS/DDoS attacks makes it challenging to detect and resolve them. The existing models to handle DoS/DDoS attacks often suffer from false positive rates and adaptability. In order to solve these problems, this study aims to create and apply sophisticated deep learning framework namely adversarial DBN-LSTM to accurately detect and classify various DoS/DDoS attack types. The proposed adversarial DBN-LSTM model is based on the generative adversarial networks. The proposed model uses generator to generate the adversarial attack and discrim inator to detect the attacks. The adversarial DBN-LSTM model is evaluated using a dataset specifically generated in a Mininet-based SDN controller environment to ensure relevance and practical applicability. The performance of the adver sarial DBN-LSTM is compared with other prevalent models. The adversarial DBN-LSTMmodelachieves accuracy about 99.4%. The proposed work achieves a breakthrough in identifying and preventing DoS/DDoS threats in relation to SDNenvironment.
Volume: 41
Issue: 3
Page: 1000-1016
Publish at: 2026-03-10

Sex differences on patient safety culture practices among nurses in Karawang, Indonesia: a cross-sectional study

10.11591/ijphs.v15i1.22681
Lilis Suryani , Santhna Letchmi , Faridah Mohd Said
Nurses are critical in enhancing the quality of care and patient safety due to their commitment to caring for patients 24 hours a day and their interaction with families and other health professionals. The role of gender in the interprofessional team is more complex and warrants further investigation, even though it has been increasingly studied at the level of the individual healthcare provider. In this study, we examined sex differences in patient safety culture practices among nurses. This study was conducted using a cross-sectional design at a general public hospital in Karawang, West Java, Indonesia. The hospital survey on patient safety culture (HSPSC) was used. A chi-square test and an independent t-test were used to determine whether there were any differences in patient safety culture practice between the sexes. A total of 75 males and 145 females agreed to join this study. The mean age of female and male participants was 34.21 ± 14.07 and 36.29 ± 12.51 years old, respectively. Age, marital status, and working position were significantly different between males and females (p < 0.05). Females reported to have a higher overall score of patient safety culture practices than males (3.65 (SD = 1.12 vs. 3.11 (SD = 1.43), p-value = 0.001). According to the patient safety culture practice domain, teamwork (4.21 (SD = 1.35) vs. 3.78 (SD = 1.76), p-value = 0.001), response to error (3.56 (SD = 1.93) vs. 3.31 (SD = 1.93), p-value = 0.001), and communication openness (3.881.56 vs. 2.35 (SD = 0.92), p-value = 0.001) were higher among female than male. Nurses must be trained, and professional communication must be improved as a means of ensuring better patient safety. Patient safety cultures vary widely across hospitals, units, and countries, as evidenced by the growing number of studies that have looked at this issue in depth.
Volume: 15
Issue: 1
Page: 126-131
Publish at: 2026-03-05

Spatial analysis of stunting risk factors in Central Java, Indonesia: A geographically weighted regression approach (2023 data)

10.11591/ijphs.v15i1.26881
Sylvia Anjani , Faik Agiwahyuanto , Maulana Tomy Abiyasa
The 2022 Indonesian Nutritional Status Survey (SSGI) reported a stunting prevalence of 20.8% in Central Java. Although various studies have examined its risk factors, few have applied a spatial perspective. This study aims to analyze regional variations in stunting risk factors and their contribution to rising stunting rates. This is a quantitative explanatory study employing the geographically weighted regression (GWR) method. Secondary data were obtained from the Central Java Health Profile and Badan Pusat Statistik Indonesia (BPS) in 2023, using a total sampling of 35 districts/cities. The GWR results indicated that chronic energy deficiency (CED; β = 0.0014, p = 0.068) and exclusive breastfeeding (β = 0.0791, p = 0.087) were marginally positively associated with stunting. Low birth weight (LBW) showed a significant positive association (β = 0.1009, p = 0.041), while access to improved sanitation had a strong negative effect (β = -0.1882, p = 0.004). Iron supplementation (≥90 tablets) was not significant (β = -0.0629, p = 0.134), whereas access to improved drinking water was positively and significantly correlated with stunting (β = 0.3778, p = 0.028). These findings contradict existing theories, particularly where higher rates of exclusive breastfeeding and access to clean water are unexpectedly associated with increased stunting in several regions. This suggests the need for further in-depth investigation in those areas to better understand the underlying factors.
Volume: 15
Issue: 1
Page: 179-189
Publish at: 2026-03-05

Strengthening intensive care training in response to COVID-19: lessons for medical education

10.11591/ijphs.v15i1.22918
Mochamat Helmi , Djayanti Sari , Yenny Sulistyowati , Andreasta Meliala , Tjahja Nurrobi , Tugas Ratmono , Laksono Trisnantoro
Frequent updates to clinical guidelines during the COVID-19 pandemic have posed significant challenges for audit processes, quality improvement, and the preparedness of healthcare professionals, particularly in intensive care settings. This study aimed to explore the impact of COVID-19-related demands on medical education and training from the perspective of healthcare teams working in intensive care units (ICUs) in Indonesia during the first wave of the pandemic. A qualitative design was employed using semi-structured interviews and focus group discussions with medical personnel directly involved in the care of COVID-19 patients at national referral hospitals. Purposive sampling was applied to recruit participants, including general practitioners, interns, residents, anesthesiologists, and ICU consultants. A total of 66 participants were included across eight focus group discussions, each consisting of eight to nine participants. Data collection continued until thematic saturation was achieved. Transcripts were analyzed using content analysis to identify key themes and subthemes. The analysis revealed five major themes: i) the need for continuous upgrading of knowledge and competencies, ii) the importance of innovative education and training approaches, iii) the role of professional organizations, iv) challenges encountered during training implementation, and v) time constraints. These findings highlight the urgent need for adaptive, continuous, and technology-supported training strategies to strengthen intensive care workforce preparedness during public health emergencies.
Volume: 15
Issue: 1
Page: 23-31
Publish at: 2026-03-05

Comparative assessment of knowledge, attitude, and practice toward self-medication among health and non-health students at Daffodil International University, Dhaka (2022–2023)

10.11591/ijphs.v15i1.26866
Md. Mizanur Rahman , Md. Jahir Alam , Ms Tamanna Khatun , Chaity Sutar , Shabnaz Akter , As-Ad Din Mahmood , Sher Mostafa Sadiq Khan
Self-medication, a popular self-care practice, is common throughout the world and is responsible for serious health complications. The present investigation assessed the knowledge, attitudes, and practices of self-medication among healthcare and non-healthcare students at Daffodil International University, Savar, Dhaka, Bangladesh. A cross-sectional survey of 240 students from the Pharmacy and Environmental Science Departments, ages 19 to 24, was carried out between October 2022 and January 2023. Socio-demographics, knowledge, attitudes, information sources, common medications, and diseases treated were all covered in the pre-tested questionnaire used to gather data. SPSS v16.0 with correlations and descriptive statistics was used for the analysis. Among 240 participants, 50.8% were health science students and 49.2% were non-health science students; 45.8% were male, and 54.2% were female. Most (74.2%, p < 0.01) were aged 21-22 years, mainly in the 4th year (43.3%, p < 0.001). Knowledge analysis showed 37.5% knew over-the-counter (OTC) drugs (p < 0.001) and 55% supported self-medication for minor illness. Common conditions treated were headache (49.2%), fever (23.3%), and cold (16.7%). Painkillers were the most used drugs (39.2%), with family members as the main source of advice (50%). Knowledge had a significant correlation with health science students (p < 0.001). Attitudes revealed 70% used self-medication in the last 6 months; 67.5% discouraged peers, 55.8% reused prescriptions, 73.3% read leaflets, and 61.2% consulted doctors for adverse effects. Previous experiences (74.2%) were the main reason for self-medication. Self-medication is widespread among university students. Health science students demonstrated better knowledge and awareness against self medication while contrasted to non-healthcare students. Awareness programs are needed for all groups.
Volume: 15
Issue: 1
Page: 266-273
Publish at: 2026-03-05

Workplace spirituality and nurses’ well-being: integrative review (2015-2025)

10.11591/ijphs.v15i1.26888
M. Fahrin Azhari , Johari Daud Makajil , Fredie Robinson , Muthmainnah Muthmainnah , Dwi Agustina , Winda Maolinda
Occupational well-being and workforce sustainability in post-pandemic healthcare systems are at risk due to increasing emotional, ethical, and workload-related stressors that nurses encounter. Workplace spirituality has also been suggested as a protective factor, but empirical research remains fragmented and insufficiently synthesized. This integrative review aimed to synthesize the recent evidence on the role of workplace spirituality in the occupational well-being of nurses. A systematic search of Scopus, MEDLINE, and Cochrane databases identified English-language quantitative studies published between 2015 and 2025. Nineteen studies met the inclusion criteria and were synthesized using Whittemore and Knafl integrative review framework, with reporting relying on PRISMA 2020. There were five themes that included i) spirituality and burnout reduction, ii) organizational commitment and retention, iii) work engagement and job satisfaction, iv) spiritual congruence and interpersonal care, and v) spiritual leadership and well-being. Most findings demonstrated moderate-to-strong associations between workplace spirituality and decreased burnout, increased engagement, and greater organizational commitment. Nevertheless, these advantages were conditional and mitigated in the conditions of overwork, insufficiency of staffing, moral tension, and insufficient organizational support. This review offers a quantitative integrative synthesis of the first nursing-specific evidence to be published after the pandemic and shows that workplace spirituality serves as a complementary resource, rather than a standalone, to occupational well-being. The findings highlight important implications of nursing policy regarding introducing spirituality-based leadership development, ethical governance, and workforce support as part of the broader structural reforms.
Volume: 15
Issue: 1
Page: 160-170
Publish at: 2026-03-05

Calgary family intervention model enhances dietary compliance and knowledge in T2DM patient

10.11591/ijphs.v15i1.26901
Muhtar Muhtar , Aniharyati Aniharyati , Julhana Julhana , Fadlurahmi Fadlurahmi , Muhammad Arifki Zainaro , Martiningsih Martiningsih
The urgency was in developing a more holistic and sustainable approach to supporting type 2 diabetes mellitus (T2DM) patients. This study evaluated the effectiveness of the Calgary Family Intervention Model (CFIM) in improving dietary adherence and knowledge in patients with T2DM. This study used a quantitative method with a quasi-experimental design, involving 280 patients with type 2 diabetes mellitus at the Bolo Community Health Center from January to October 2025. The sample was divided into two groups: intervention (CFIM education) and control (booklet). Data were collected using a valid and reliable questionnaire to measure knowledge and dietary adherence. Data analysis was performed using the Wilcoxon and Mann-Whitney tests. The analysis showed significant results, with the mean knowledge score in the intervention group increasing from 4.84±1.235 to 8.98±2.851 (p < 0.05), while in the control group, it increased from 4.64±1.120 to 7.06±1.219. For dietary adherence, the intervention group showed an increase from 27.00±6.518 to 61.38±7.171 (p = 0.000), compared to the control group, which increased from 27.28±5.592 to 49.44±10.194(p < 0.05). The implications of these results have the potential to strengthen the family-based health intervention model and improve the overall well-being of T2DM patients. This study contributes significantly to family nursing practice by demonstrating the efficacy of the CFIM in enhancing dietary adherence and knowledge among patients with T2DM.
Volume: 15
Issue: 1
Page: 150-159
Publish at: 2026-03-05

Tacrolimus outcomes in adult kidney transplants: a decade review

10.11591/ijphs.v15i1.26879
Lolita Lolita , Isrovanigoro Isrovanigoro , Metalia Puspitasari , Zijie Wang
Tacrolimus remains a principal immunosuppressive agent in kidney transplantation, yet its reported efficacy and safety vary due to differences in study design, treatment regimens, and patient characteristics. Objectives: To summarize recent evidence on the clinical performance of tacrolimus in adult kidney transplant recipients and identify factors contributing to variability in outcomes. A narrative review was conducted using PubMed as the primary database because of its comprehensive indexing of clinical and pharmacological studies relevant to transplant immunosuppression. Additional databases were screened to ensure completeness. Studies published between 2015 and 2025 were searched using predefined keywords. Of 91 open-access articles identified, 19 met the inclusion criteria and were analyzed. Results: Reported clinical outcomes demonstrated wide variability across studies. Acute rejection ranged from 0-18.8%, while biopsy-proven acute rejection varied substantially (0-85%). Graft loss occurred in 0-15% of recipients and mortality in 0-8%. Major adverse events were also heterogeneous, including cytomegalovirus (CMV) infection (0-16.9%), new-onset diabetes after transplantation (NODAT) (0-22.8%), and tremor (3-28.6%). Variability in findings was largely influenced by differences in study methodology, concomitant immunosuppressive protocols, monitoring practices, population characteristics, and limited ethnic diversity, as most participants were Caucasian. Tacrolimus maintains a strong efficacy-safety profile in adult kidney transplantation. Future studies with more diverse populations, standardized therapeutic drug monitoring, and longer follow-up durations are required to enhance generalizability and support individualized immunosuppressive management.
Volume: 15
Issue: 1
Page: 57-71
Publish at: 2026-03-05

Effects of soy plus zinc supplementation on growth and kidney health in Wistar rats: Implications for childhood stunting prevention

10.11591/ijphs.v15i1.26895
Yuniastini Yuniastini , Purwati Purwati , Antun Rahmadi , Sulastri Sulastri , Wien Wiratmoko , Iradah Lia Prasetio , Hendri Busman , Muhammad Al Hafidz , Fannia Khairani Mz , Mohammad Hafid Hak
Zinc deficiency can cause growth and health problems, whereas protein from soy sources contributes to essential nutritional intake. This study aimed to evaluate the effects of soy plus zinc (SPZ) supplementation on growth and kidney health in Wistar rats. This study used a randomized controlled trial design with 24 rats divided into five treatment groups, including a control group. SPZ supplementation was administered daily for 14 days with varying zinc doses (0.020 mg and 0.035 mg per gram of body weight) and palatability enhancement using vanilla flavoring. Data obtained through measurements of initial and final body weights and kidney weights were analyzed using ANOVA to determine significant differences between groups. The results showed that SPZ supplementation positively contributed to growth, as evidenced by a significant increase in the final weight of rats compared to their initial weight (p < 0.05). Histological analysis of the kidneys indicated no visible structural damage, and the average increase in kidney weight was approximately 26.5%. The combination of soy and zinc in SPZ was shown to have a synergistic effect that benefits the development and kidney health of rats, demonstrating its potential application in the context of animal nutrition.
Volume: 15
Issue: 1
Page: 140-149
Publish at: 2026-03-05

Emotional experiences of Indonesian health science students with self-harm: a phenomenological study

10.11591/ijphs.v15i1.26841
Meidiana Dwidiyanti , Geovanny Serviam Permana Putri Rahamitu , Luky Dwiantoro , Nur Setiawati Dewi , Sri Padma Sari , Alifia Dian Yusriana
Health students often face academic pressure and interpersonal conflicts that can affect their emotional regulation, thereby increasing the risk of self-harm behavior. This study aimed to explore the emotional experiences of health students who have engaged in self-harm through a phenomenological approach. A total of 8 participants (aged 18-25 years) who had engaged in self-harm and came from various health study programs participated in in-depth interviews lasting 45-70 minutes. The results of the study reveal three main themes: i) psychosocial stress as a trigger for negative emotions, ii) the role of social support in the recovery process, and iii) coping mechanisms and the need for professional intervention. These findings reveal emotional dynamics that have not been widely explored in the context of health students in Indonesia, particularly how self-harm is perceived as a strategy to control excessive emotional intensity. This study makes a new contribution by highlighting the need for interventions based on emotional regulation and increased social support that are appropriate to the subjective experiences of health students. Interventions based on empathy and psychological approaches that are more sensitive to the cultural context of the campus are the main recommendations.
Volume: 15
Issue: 1
Page: 283-296
Publish at: 2026-03-05

Analysis of the implementation of the healthy Indonesia program policy with a family approach

10.11591/ijphs.v15i1.26855
Abdul Haris , M. Rizki Aditya
This study evaluates the implementation of the Healthy Indonesia Program Family Approach to improve public health and identify inhibiting and supporting factors. This qualitative research employs a case study approach to investigate healthcare dynamics at the Tambora Community Health Center in Bima City, Indonesia. Twelve informants were purposively selected. Data collection involved in-depth interviews, direct observation, and document review, allowing for a multifaceted perspective. An interactive analysis model by Miles and Huberman was used for data analysis, incorporating data collection, reduction, and presentation iteratively. Results showed that 85% of implementing staff had been trained, but there was a shortage of field surveyors, and family visit coverage only reached 72%, below the national target of 80%. Although the average healthy family index of 0.65 indicates adequate results, the main challenges lie in clean living behavior and nutritious diets. The program for mothers giving birth in health facilities reached 95%, but awareness of improving the management of chronic diseases, such as hypertension and tuberculosis, remained low, with treatment fulfillment at 65% and 70%, respectively. The conclusions highlight the need for adaptation strategies and continuous evaluation for the Healthy Indonesia Program to be successful across communities.
Volume: 15
Issue: 1
Page: 232-241
Publish at: 2026-03-05

Mental health status of healthcare workers in COVID-19 vs non-COVID-19 units: findings from Shariati Hospital, Tehran

10.11591/ijphs.v15i1.23419
Abdolhakim Jorbonyan , Maryam Khosrozadeh , Ali Karimi-rozveh
This cross-sectional study compared the mental health status of healthcare workers in COVID-19 and non-COVID-19 wards at Shariati Hospital, Tehran, Iran. A total of 250 healthcare workers were selected via systematic random sampling and completed the 28-item General Health Questionnaire (GHQ-28). Data were analyzed using descriptive and inferential statistics in SPSS 24.0. Participants had a mean age of 35.5 years (SD = 8.28) and included 52.6% females and 47.4% males. Based on a GHQ score >23, 63 (53.3%) of staff in COVID-19 wards and 51 (44.7%) in non-COVID-19 wards were suspected of having some degree of mental health disorder. Independent t-test results indicated that healthcare workers in COVID-19 wards experienced significantly higher levels of general mental health problems (t = 4.20, P < 0.001), anxiety (t = 5.55, P < 0.001), and somatic symptoms (t = 4.09, P < 0.001) compared to their counterparts in non-COVID-19 wards. The study highlights a relatively high prevalence of mental health disorders among hospital staff, particularly those working in COVID-19 units. Early identification of at-risk personnel, implementation of targeted interventions, and provision of counseling and psychological support are essential to safeguard the mental well-being and performance of healthcare workers during the ongoing pandemic.
Volume: 15
Issue: 1
Page: 1-7
Publish at: 2026-03-05

Compulsive buying behavior and self-esteem among K-pop fan undergraduate medical students in Jakarta

10.11591/ijphs.v15i1.26821
Julia Rahadian Tanjung , Heunice Precious , Mariani Santosa
The rising popularity of K-pop has attracted many teenagers and young adults. Fans tend to purchase idol merchandise as a sign of support and affection, which can lead to compulsive buying behavior. Compulsive buying behavior is one of the coping mechanisms for low self-esteem. This study aimed to investigate the relationship between self-esteem and compulsive buying behavior among undergraduate medical students in Jakarta who are fans of K-pop. A cross-sectional study was conducted involving 97 students, aged 18 to 25, from various medical schools in Jakarta who were actively engaged as members of a K-pop fan club. Data were obtained through the Revised Edwards Compulsive Buying Scale (ECBS-R) and the Rosenberg self-esteem Scale questionnaire. Among the 97 respondents, 35.1% with low self-esteem, and 51.6% with compulsive buying behavior. A significant relationship was found between self-esteem and compulsive buying behavior (p = 0.014). In conclusion, low self-esteem is associated with compulsive buying behavior among K-pop fan medical students, particularly females, which may adversely impact their academic performance.
Volume: 15
Issue: 1
Page: 224-231
Publish at: 2026-03-05

Hepatotoxicity effect of alcoholic beverages on histology and IL-6 gene detection in Rattus norvegicus using polymerase chain reaction

10.11591/ijphs.v15i1.27001
Fitria Diniah Janah Sayekti , Vector Stephen Dewangga , Muhammad Taufiq Qurrohman
The liver is an organ that has an important role in metabolic and detoxification processes. Alcohol consumption will cause metabolic disorders in the liver and can cause changes in histological structures. Interleukin-6 has a profound role in liver pathology and plays an important role in the body's defense mechanism, and contributes to the manifestation of tissue damage. This study was an experimental study using 20 Rattus norvegicus treated with 25% alcohol, and a normal treatment only given distilled water. Histological observations were carried out on each preparation in 5 fields of view. The hepatotoxicity effect of alcohol was observed based on the presence of cell degeneration and necrosis in histological preparations stained with hematoxylin eosin. IL-6 detection with polymerase chain reaction was analyzed qualitatively using electrophoresis. Based on the statistical test results, the sig. (2 tailed) of 0.00 < 0.05 so that it can be seen that there is a significant difference in histological results between the normal control group without treatment and the group induced by alcohol. The administration of alcoholic beverages with 25% ethanol content in vivo for 21 days causes necrosis and bleeding around the hepatocyte cells. IL-6 overview appeared to be stronger in the group with alcohol-induced drinking, it could indicate that giving alcohol causes a higher inflammatory response. This study provides scientific evidence that alcohol consumption significantly damages the liver. Further research can be conducted to increase the sample size and quantitatively assess IL-6 expression.
Volume: 15
Issue: 1
Page: 190-196
Publish at: 2026-03-05
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