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Background: The diagnosis of thyroid neoplasms necessitates the identification of distinct histological features. Various education/hospital centers located in cities across Indonesia likely result in discordances among pathologists when diagnosing thyroid neoplasms., Methods: This study examined the concordance among Indonesian pathologists in assessing nuclear features and capsular and vascular invasion of thyroid tumors. Fifteen pathologists from different centers independently assessed the same 14 digital slides of thyroid tumor specimens. All the specimens were thyroid neoplasms with known BRAFV600E and RAS mutational status, from a single center. We evaluated the pre- and post-training agreement using the Fleiss kappa. The significance of the training was evaluated using a paired T-test., Results: Baseline agreement on nuclear features was slight to fair based on a 3-point scoring system (k = 0.14 to 0.28) and poor to fair based on an eight-point system (k = -0.02 to 0.24). Agreements on vascular (κ = 0.35) and capsular invasion (κ = 0.27) were fair, whereas the estimated molecular type showed substantial agreement (κ = 0.74). Following the training, agreement using the eight-point system significantly improved (p = 0.001)., Conclusions: The level of concordance among Indonesian pathologists in diagnosing thyroid neoplasm was relatively poor. Consensus in pathology assessment requires ongoing collaboration and education to refine diagnostic criteria.

Purpose: This study was performed to investigate the pattern of condylar pressure distribution in the discs of a patient diagnosed with disc displacement without reduction., Materials and Methods: This research consisted of a pre- and post-test observational clinical study. A patient diagnosed with disc displacement without reduction underwent treatment with an occlusal splint for 3 months. Finite element analysis employed a 3-dimensional model constructed from magnetic resonance images of the patient, taken both before the application of the splint and 3 months after its use., Results: The post-test model demonstrated a decrease in condylar pressure on the disc, with measurements dropping to 72 MPa from the pre-test level of 143 MPa. In the pre-test, the pressure distribution pattern was concentrated on the lateral posterior border, whereas in the post-test, it shifted toward the intermediate zone of the disc., Conclusion: Utilization of a stabilization splint for 3 months resulted in decreased pressure and a marked change in the pressure distribution pattern on the temporomandibular disc., Competing Interests: Conflicts of Interest: None, (Copyright © 2024 by Korean Academy of Oral and Maxillofacial Radiology.)

Objective: Twenty percent of all classical Hodgkin lymphoma (CHL) cases relapse and recur, especially in advanced stages with a high International Prognostic Score (IPS). Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is a regulatory molecule that can inhibit the immune response and is related to tumor aggressiveness. This study aimed to determine the relationship between CTLA-4 expression in advanced-stage CHL and IPS, identifying it as a potential therapy target., Results: In advanced-stage CHL, the group with a high IPS exhibited significantly higher mean CTLA-4 expression compared to the group with a low IPS (p = 0.003).The group with Hb level < 10.5 g/dl, leukocyte count > 15,000/µL, lymphocyte count < 8%, albumin level < 4 g/dl, and stage 4 exhibited higher CTLA-4 expression than the other group, although only leukocyte count and stage showed statistical significance (p = 0.004 and p = 0.020). Mean CTLA-4 expression was 239.84 ± 76.36 for nodular sclerosis, 293.95 ± 147.94 for mixed cellularity, 271.4 ± 23.56 for lymphocyte depleted, and 225.2 for lymphocyte-rich subtypes. The results suggest that CTLA-4 expression is associated with adverse prognostic factors in the IPS for advanced-stage CHL, supporting the notion that immune checkpoints play a role in cancer progression., (© 2024. The Author(s).)

Psoriatic lesions on the scalp, face, intertriginous, genitals, palms/soles, and nails are often delay diagnosed, hard-to-treat, and cause disability. Metabolic syndrome (MetS) is one of the most frequent and significant comorbidities in psoriasis. Many studies have discovered a link between psoriasis and MetS, but none have specifically assessed the hard-to-treat psoriasis in Indonesian population. This is a multicenter study involving four dermatology referral hospitals to investigate the association between psoriasis severity that has hard-to-treat lesions with the prevalence of MetS in Jakarta, Indonesia. Data was collected from April to October 2022. The severity of 84 hard-to-treat psoriasis patients was measured by Psoriasis Area Severity Index (PASI) scores. The participants divided into PASI score >10 (severe) and ≤ 10 (mild-moderate) groups. MetS was identified based on the modified National Cholesterol Education Program Adult Treatment Panel III. MetS was found in 64.3% of patients. Patients with a PASI score>10 had a significantly higher risk of metabolic syndrome compared to those with a score ≤ 10 (78.6% vs 50%, OR 3.667; 95% CI 1.413-9.514; p = 0.006). The prevalence of hypertension (p = 0.028), low levels of high-density lipoprotein (HDL) cholesterol (p = 0.01), mean fasting blood sugar (p = 0.018), and triglyceride levels (p = 0.044) between the two groups differed significantly. This study found most frequent components of MetS were abdominal obesity, decreased levels of HDL cholesterol, hypertension, hyperglycemia, and hypertriglyceridemia respectively. Individuals with severe hard-to-treat psoriasis had a 3.67 times more likely to have MetS rather than the mild-moderate group., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Evyana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Untreated topical infections can become chronic, posing serious health issues. Optimal skin adherence is crucial in addressing such infections. In this context, chitosan and alginate emerge as promising candidates for use as a foundation in the development of topical hydrogels. The aim of this review is to examine the literature on topical hydrogel formulations that use chitosan and alginate as foundations, specifically in the context of topical antibacterial agents. The research methodology involves a literature review by examining articles published in databases such as PubMed, Scopus, ScienceDirect, and Google Scholar. The keywords employed during the research were "Alginate", "Chitosan", "Hydrogel", and "Antibacterial". Chitosan and alginate serve as bases in topical hydrogels to deliver various active ingredients, particularly antibacterial agents, as indicated by the search results. Both have demonstrated significant antibacterial effectiveness, as evidenced by a reduction in bacterial colony counts and an increase in inhibition zones. This strongly supports the idea that chitosan and alginate could be used together to make topical hydrogels that kill bacteria that work well. In conclusion, chitosan and alginate-based hydrogels show great potential in treating bacterial infections on the skin surface. The incorporation of chitosan and alginate into hydrogel formulations aids in retaining antibacterial agents, allowing for their gradual release over an optimal period. Therefore, hydrogels specifically formulated with chitosan and alginate have the potential to serve as a solution to address challenges in the treatment of topical bacterial infections., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Wathoni et al.)

Objective: This study aimed to describe the determinant factors of men's involvement in antenatal care and childbirth place preference in Indonesia., Method: Secondary data from the 2012 Indonesia Demographic and Health Survey was used to identify factors determining men's presence during antenatal care and childbirth place preference. All factors were analyzed utilizing bivariate and multivariate logistic regression., Result: Men living in urban areas, having a sufficient economy, having higher educational levels, and having more interaction with mass media were more likely present during the antenatal care of their wives. Men in Sulawesi and Maluku showed lower involvement in accompanying wives during antenatal care than those in Papua. In terms of delivery place preference, men in age 15-19 and 35-49 years, living in urban areas, having a more stable economy, reading newspapers or magazines as well as watching television at least once a week, and living in Java and Nusa Tenggara, were more likely having wife giving birth in healthcare facilities., Conclusions: Type of residence, economic situations, lower educational level, and fewer interactions with mass media and electronics are essential barriers to men's involvement in wives' antenatal care visits and childbirth place preference in Indonesia. Particular attention should be put to Sulawesi and Maluku to enforce the men and women as those islands underutilized antenatal care services and health facilities for childbirth., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

The Cancer Genome Atlas (TCGA) has classified papillary thyroid carcinoma (PTC) into indolent RAS-like and aggressive BRAF-like based on its distinct driver gene mutations. This retrospective study aimed to assess clinicopathology and pERK1/2 expression variations between BRAF-like and RAS-like PTCs and establish predictive models for BRAF V600E and RAS -mutated PTCs. A total of 222 PTCs underwent immunohistochemistry staining to assess pERK1/2 expression and Sanger sequencing to analyze the BRAF and RAS genes. Multivariate logistic regression was employed to develop prediction models. Independent predictors of the BRAF V600E mutation include a nuclear score of 3, the absence of capsules, an aggressive histology subtype, and pERK1/2 levels exceeding 10% (X 2 = 0.128, p > 0.05, AUC = 0.734, p < 0.001). The RAS mutation predictive model includes follicular histology subtype and pERK1/2 expression > 10% (X 2 = 0.174, p > 0.05, AUC = 0.8, p < 0.001). We propose using the prediction model concurrently with four potential combination group outcomes. PTC cases included in a combination of the low- BRAF V600E-scoring group and high- RAS -scoring group are categorized as RAS-like (adjOR = 4.857, p = 0.01, 95% CI = 1.470-16.049). PTCs included in a combination of the high- BRAF V600E-scoring group and low- RAS -scoring group are categorized as BRAF-like PTCs (adjOR = 3.091, p = 0.001, 95% CI = 1.594-5.995). The different prediction models indicate variations in biological behavior between BRAF-like and RAS-like PTCs.

Direction-of-arrival (DoA) estimation methods are highly versatile and find extensive applications in satellite communication. DoA methods are employed across a range of orbits, from low Earth orbits (LEO) to geostationary Earth orbits (GEO). They serve multiple applications, including altitude determination, geolocation and estimation accuracy, target localization, and relative and collaborative positioning. This paper provides a framework for modeling the DoA angle in satellite communications with respect to the elevation angle. The proposed approach employs a closed-form expression that incorporates various factors, such as the antenna boresight angle, satellite and Earth station positions, and the altitude parameters of the satellite stations. By leveraging this formulation, the work accurately calculates the Earth station's elevation angle and effectively models the DoA angle. To the authors' knowledge, this contribution is unique and has not been previously addressed in the available literature. Furthermore, this paper studies the impact of spatial correlation in the channel on well-known DoA estimation techniques. As a significant part of this contribution, the authors introduce a signal model incorporating correlation in satellite communication. Although selected studies have presented spatial signal correlation models in satellite communications to analyze the performance metrics, such as the bit error or symbol error probability, outage probability, and ergodic capacity, this work stands out by presenting and adapting a correlation model in the signal specifically for studying DoA estimations. Accordingly, this paper evaluates DoA estimation performance using root mean square error (RMSE) measurements for different satellite communication link conditions (uplink and downlink) through extensive Monte Carlo simulations. The simulation's performance is evaluated by comparing it with the Cramer-Rao lower bound (CRLB) performance metric under additive white Gaussian noise (AWGN) conditions, i.e., thermal noise. The simulation results demonstrate that incorporating a spatial signal correlation model for DoA estimations significantly improves RMSE performance in satellite systems.

Introduction: BRAF V600E and RAS mutations are the most common gene mutations in papillary thyroid carcinoma (PTC) that may be correlated with its biological behavior. There are still limited data about BRAF V600E and RAS mutations in Indonesia. This study aims to determine the prevalence of BRAF V600E and RAS mutations, and their association with clinicopathologic characteristics., Methods: Patients who had total thyroidectomy from 2019 to 2021 and those who met our study criteria underwent PCR and DNA sequencing analysis for BRAF V600E, BRAF K601E, exon 2 and 3 of NRAS, HRAS , and KRAS . Analyses were performed to determine the associations of BRAF V600E and RAS mutations with clinicopathologic characteristics., Results: Of 172 PTC patients, BRAF V600E mutation was observed in 37.8% of the patients and RAS mutations were found in 21.5%. One patient harbored BRAF K601E mutation. There was a significant association of BRAF V600E with a high-stage (p = 0.033, OR: 3.279; 95% CI: 1.048-10.259), tall-cell variants (p ≤0.001, OR: 41.143; 95% CI: 11.979-141.308), non-encapsulated (p = 0.001, OR: 4.176; 95% CI: 2.008-8.685), lymphovascular invasion (p = 0.043, OR: 1.912; 95% CI: 1.018-3.592), extrathyroidal extension (p = <0.001, OR: 3.983; 95% CI: 1.970-8.054), and lymph node metastasis (p = 0.009, OR: 2.301; 95% CI: 1.224-4.326). Follicular variant (p = 0.001, OR: 7.011; 95% CI: 2.690-18.268), encapsulated (p = 0.017, OR: 2.433; 95% CI: 1.161-5.100), and absent of extrathyroidal extension (p = 0.033, OR: 2.890; 95% CI: 1.052-7.940) were associated with RAS mutations., Conclusion: A significant association between BRAF V600E mutation and high clinical stage, tall-cell variants, non-encapsulated morphology, lymphovascular invasion, extrathyroidal extension, and lymph node metastasis in PTC was observed. RAS mutations were associated with the follicular variant, encapsulated tumor, and no extrathyroidal extension. HRAS -mutated PTC frequently exhibited tumor multifocality., Competing Interests: The authors declare no conflict of interest., (© 2023 Harahap et al.)

High-photoluminescence carbon dots (CDs) were synthesized from various sources and various methods using two approaches, namely bottom up and top down, with emission-dependent excitation wavelength. Electronic transition from the higher-occupied molecular orbital (HOMO) state to the lowest-unoccupied molecular orbital(LUMO) state, surface defect states, wider excitation spectrum, higher quantum yield, efficient energy transfer, and element doping affected the fluorescence properties of CDs. Using 102 references listed in this review, the authors studied the relationship between fluorescence mechanism and reactive oxygen species (ROS) produced for photodynamic therapy (PDT) and materials anticancer applications. We described how the radical atom or ROS work as anticancer therapy and PDT and described the chemical reaction of high-resolution fluorescence CDs. We summarized experimental techniques that are used for producing CDs and discussed their characteristics. Finally, conclusions and future prospects in this field are also discussed. The important characteristics of CD-based design for high ROS may usher in new prospects and challenges for high efficiency and stability of PDT and anticancer therapy. In conclusion, we have provided perspectives and challenges of the future development of CD s., (© 2022 John Wiley & Sons Ltd.)

Exercise in the form of physical activity can provide neuroprotective benefits. The purpose of this study is to determine the effect of the task balance training program (TBT program) on the glial cell-derived neurotrophic factor levels, cognitive function, and postural balance in old people. The population of this study was the old people members of the Batara Hati Mulia Gowa Foundation who were willing to participate in the study ( n = 66). The sample of this study was obtained through a random sampling technique to determine the treatment ( n = 32) and control ( n = 34) groups. Before and after implementing the TBT program, glial cell-derived neurotrophic factor (GDNF) level measurement and cognitive function and postural balance assessment were performed. Cognitive function was measured by using Montreal cognitive assessment (MoCA). Postural balance was measured in two ways by using the timed up and go (TUG) test and Tinetti performance-oriented mobility assessment (POMA). The treatment group showed significantly greater changes than the control group in GDNF levels (2.24 (±0.63) vs. 1.24 (±0.43), P = 0.001), cognitive function (24.66 (±3.42) vs. 19.18 (±2.67), P = 0.001), and postural balance (TUG [14.00 (±4.04) vs. 18.68 (±3.98)]; POMA [26.53 (±1.74) vs. 23.47 (±3.06)], P = 0.001) after training. The treatment group also showed a significant relationship between GDNF levels and cognitive function ( r = 0.840, P = 0.001) and postural balance (TUG [ r = 0.814, P = 0.001]; POMA [ r = 0.630, P = 0.001]). The TBT program affects the levels of GDNF in old people. The TBT program involves cognitive function improvement and affects postural balance changes in old people., Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper., (Copyright © 2022 Meutiah Mutmainnah Abdullah et al.)

Gelatin-free capsules are possibly produced through an innovation which involves utilizing environmentally friendly materials derived from plants such as bagasse which are produced into nanocrystalline cellulose (NCC). This research was conducted to report the extraction and characterization of NCC from the abundant industrial plantation waste of sugarcane and its application as the base material for gelatin-free capsule shell material. The process involved using different concentrations of NCC at 1%, 2%, 4%, and 7% (in wt. %) with the addition of 1% hydroxypropyl methylcellulose (HPMC) (in wt. %) and 1% carbopol (in wt. %). Moreover, the NCC capsules obtained from sugarcane bagasse were tested for moisture content, tensile strength, elongation, solubility, and pH. The results showed that sugarcane bagasse contains 40-50% cellulose, 6.15%-9.5% moisture content which indicates they are potentially better in terms of storage, 7.25-7.85 pH, and 0.05-0.136 MPa gel strength, and the elongation value ranges from 7.19 to 87.51%. These values were discovered to have satisfied the standard requirements as indicated by the optimal concentration of 4% NCC +1% HPMC, which is in line with the Japanese Industrial Standard (JIS), thereby leading to the consideration of the material safe to be used as raw material in making capsule shells., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article and confirmed that the data and paper are free of plagiarism., (Copyright © 2022 Zakir Sabara et al.)

Background: Chronic suppurative otitis media (CSOM) is the most common infectious disease in the world and the leading cause of hearing loss in children in developing countries. Iron deficiency anemia (IDA) is often found in children with CSOM., Objective: This study was conducted to determine the association between IDA and the incidence of CSOM in children., Method: This research is a case-control study using consecutive sampling. Participants were divided into case group which are children diagnosed with CSOM (n = 42) and control group which are children with normal ear (n = 42). All participants were examined for serum iron (FE), hemoglobin (Hb), total iron-binding capacity (TIBC), and ferritin levels. The analysis used in this study includes the chi-square test or fisher extract test and independence t -test or Man Whitney test with p  < 0.05., Result: The measurement results obtained values of Hb (13.00 ± 1.34 g/dL; p  < 0.001), FE (95.13 ± 40.84 g/dL; p  < 0.001), TIBC (354.18 ± 62.44 g/dL; p  = 0.016), and ferritin levels (17.57 ± 8.55 g/dL; p  < 0.001). Participants who experienced IDA were 21.43% which in the case group was 31.0% and control group was 11.9% ( OR  = 3.32; p  = 0.033)., Conclusion: IDA can increase the incidence of CSOM in children., Competing Interests: The authors declare that they have no conflict of interest., (© 2021 The Authors.)

Background: This study aimed to determine the relationship between Deficiency of vitamin D and hyperglycemia in children with obesity., Methods: This cross-sectional study was carried out between February and April of 2020. This study's subject population consisted of high school students aged 11 to 17 who were obese. The 25 (OH) level of Vitamin D was determined using the Chemiluminescence Immune Assay method. Subjects were divided into 4 groups; vitamin D deficiency with hyperglycemia, vitamin D deficiency without hyperglycemia, normal vitamin D with hyperglycemia, and normal vitamin D without hyperglycemia., Results: The prevalence of hyperglycemia was 28 (54.9%) in the vitamin D deficiency group and 17 (378%) in the normal vitamin D group, respectively. Statistical analysis revealed no statistically significant difference between the two groups (p = 0.093). With p = 0.031, there was a significant difference in the mean value of fasting blood sugar levels between the two groups. The frequency of hyperglycemia was 54.9 percent in the vitamin D deficiency group and 37.8 percent in the normal vitamin D group. Fasting blood sugar levels were lower in obese children with vitamin D deficiency than in children with normal vitamin D., Conclusion: Fasting blood sugar levels were correlated with vitamin D levels in obese children, but clinically insignificant. However, the research is ongoing, so, it is critical to conduct early screening for Vitamin D and fasting blood sugar levels in order to reduce the risk of metabolic and cardiovascular diseases., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Exopolysaccharides, or extracellular polysaccharides (EPS, sPS), represent a valuable metabolite compound synthesized from red microalgae. It is a non-toxic natural agent and can be applied as an immunostimulant. The toxicity test of exopolysaccharides from Porphyridium has been done in vivo using zebrafish ( Danio rerio ) embryonic model, or the ZET (zebrafish embryotoxicity test). The administration of extracellular polysaccharides or exopolysaccharides (EPS) from microalgae Porphyridium cruentum (synonym: P. purpureum ) to shrimps Litopenaeus vannamei was investigated to determine the effect of this immunostimulant on their non-specific immune response and to test if this compound can be used as a protective agent for shrimps in relation to Vibrio infection. For immune response, exopolysaccharides were given to shrimps via the immersion method on day 1 and booster on day 8. Shrimp hemocytes were taken on day 1 (EPS administration), day 7 (no treatment), day 8 (EPS booster) and day 9 (Vibrio infection) and tested for their immune response on each treatment. The result shows that the EPS is not toxic, as represented by the normal embryonic development and the mortality data. In the Pacific white shrimps, an increase in the values of all immune parameters was shown, in line with the increasing EPS concentration, except for the differential hemocyte count (DHC). In detail, an increase was noted in total hemocytes (THC) value, phagocytotic activity (PA) and respiratory burst (RB) in line with the EPS concentration increase. These results and other previous studies indicate that EPS from Porphyridium is safe, enhances immune parameters in shrimp rapidly, and has the ability to act as an immunostimulant or an immunomodulator. It is a good modulator for the non-specific immune cells of Pacific white shrimps, and it can be used as a preventive agent against vibriosis.