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Introduction: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) or 11-hydroxylase deficiency (11OHD) is characterized by underproduction of cortisol and overproduction of adrenal androgens. These androgens lead to a variable degree of virilization of the female external genitalia in 46,XX individuals. Especially in developing countries, diagnosis is often delayed and 46,XX patients might be assigned as males. This study aims to describe the clinical and biochemical characteristics of a unique cohort of untreated male-reared 46,XX classic CAH patients from Indonesia and discusses treatment challenges., Methods: Nine untreated classic CAH patients with 46,XX genotype and 21OHD (n=6) or 11OHD (n=3), aged 3-46 years old, were included. Biometrical parameters, clinical characteristics, and biochemical measurements including glucocorticoids, renin, androgens, and the pituitary-gonadal axis were evaluated., Results: All patients had low early morning serum cortisol concentrations (median 89 nmol/L) without significant increase after ACTH stimulation. Three patients with salt wasting 21OHD reported one or more periods with seizures and/or vomiting in their past until the age of 6, but not thereafter. The remaining patients reported no severe illness or hospitalization episodes, despite their decreased capacity to produce cortisol. In the 21OHD patients, plasma renin levels were elevated compared to the reference range, and in 11OHD patients renin levels were in the low-normal range. All adult patients had serum testosterone concentrations within the normal male reference range. In 21OHD patients, serum 11-oxygenated androgens comprised 41-60% of the total serum androgen concentrations. Glucocorticoid treatment was offered to all patients, but they refused after counseling as this would reduce their endogenous androgen production and they did not report complaints of their low cortisol levels., Discussion: We describe a unique cohort of untreated classic 46,XX male CAH patients without overt clinical signs of cortisol deficiency despite their cortisol underproduction and incapacity to increase cortisol levels after ACTH stimulation. The described adolescent and adult patients produce androgen levels within or above the normal male reference range. Glucocorticoid treatment will lower these adrenal androgen concentrations. Therefore, in 46,XX CAH patients reared as males an individual treatment approach with careful counseling and clear instructions is needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Adriaansen, Utari, Westra, Juniarto, Ariani, Ediati, Schröder, Span, Sweep, Drop, Faradz, van Herwaarden and Claahsen – van der Grinten.)

Statement of Problem: Information regarding facial landmark measurement using machine learning (ML) techniques in prosthodontics is lacking., Purpose: The objective of this study was to evaluate and compare the reliability, validity, and accuracy of facial anthropological measurements using both manual and ML landmark detection techniques., Material and Methods: Two-dimensional (2D) frontal full-face photographs of 50 men and 50 women were made. The interpupillary width (IPW), interlateral canthus width (LCW), intermedial canthus width (MCW), interalar width (IAW), and intercommissural width (ICW) were measured on 2D digital images using manual and ML methods. The automated measurements were recorded using a programming language (Python), and a convolutional neural network (CNN) model was trained to detect human facial landmarks. The obtained data from the manual and ML methods were analyzed using intraclass correlation coefficients (ICCs), the paired sample t test, Bland-Altman plots, and the Pearson correlation analysis (α=.05)., Results: Intrarater and interrater reliability values were greater than 0.90, indicating excellent reliability. The mean difference between the manual and ML measurements of IPW, MCW, IAW, and ICW was 0.02 mm, while it was 0.01 mm for LCW. No statistically significant differences were found between the measurements obtained by the manual and ML methods (P>.05). Highly significant positive correlations (P<.001) were obtained between the results of the manual and ML methods: (r=0.996[IPW], r=0.977[LCW], r=0.944[MCW], r=0.965[IAW], and r=0.997[ICW])., Conclusions: In the field of prosthodontics, the use of ML methods provides a reliable alternative to manual digital techniques for carrying out facial anthropometric measurements., (Published by Elsevier Inc.)

Kaempferia galanga rhizome is traditionally used as a treatment for various diseases. Ethyl p -methoxycinnamate (EPMC), which constitutes up to 31.77% of the total essential oil, is the main/marker compound. EPMC is responsible for various pharmacological activities of Kaempferia galanga rhizome. According to the existing research, the isolation yield of EPMC is still meager, namely 0.50-2.50%; thus, a new EPMC isolation method is needed to produce better results. In this study, after determining the association constant and obtaining the Jobs plot between methacrylate derivative monomers and EPMC, a molecularly imprinted polymer for solid phase extraction (MI-SPE) was synthesized through bulk polymerization with EPMC as a template, methacrylic acid as a monomer, TRIM/EDGMA as a crosslinker in a ratio of 1 : 4 : 20 (MIP1) or 1 : 7 : 20 (MIP2). BPO was used as an initiator and n -hexane was used as a porogen. The synthesis of the NIP was also conducted using the same ratio but without the template. The MIPs were then characterized using Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and Brunauer-Emmett-Teller (BET) measurements, and their analytical performance was evaluated through adsorption capacity and selectivity. The results indicate that MIP2 exhibits better analytical performance with an adsorption capacity value of 0.0813 mg g -1 . The selectivity of MIP2 was tested using EPMC analog compounds, namely ethyl cinnamic (EC), cinnamaldehyde (CD), and kaempferol (KF), with imprinting factor (IF) values of 17.436, 1.539, and 0.06, respectively. Lastly, MIP2 was applied to the SPE cartridge for the isolation of EPMC from Kaempferia galanga rhizome extract, and showed a percentage recovery of 82.40% for the ethanol extract, 68.05% for the ethyl acetate extract, and 65.27% for the n -hexane extract. MI-SPE 2 gives high purity results for the ethanol, ethyl acetate, and n -hexane extracts, with purities of 97.00%, 97.63%, and 99.59%, respectively. These results indicate that the MI-SPE technique shows great potential as a new method for isolating EPMCs with high yield and purity., Competing Interests: There are no conflicts to be declare., (This journal is © The Royal Society of Chemistry.)