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Chordoma is a rare, malignant neoplasm thought to develop from the notochord. It most commonly occurs in the base of the cranium or the sacro-coccygeal region but around 15%-20% affect the vertebral body. Extra-lesional resection with or without adjuvant radiotherapy is generally accepted as the mainstay of treatment for this slow-growing tumor. We present a case whereby a patient with an extensive vertebral body lesion causing caudal compression, treated with spinal decompression and posterior stabilization. This case highlights the importance of pre-operative tissue diagnosis, and that, although rare (0.8 per 100,000), chordoma should always be considered.

Transcranial sonography (TCS) has gained increasing application for diagnosis of Parkinson's disease (PD) in clinical practice in recent years, because most PD patients, even in the early stage of PD, have abnormal hyperechogenicity of the substantia nigra (SN) in brainstem shown in TCS images. Therefore, the region of interest (ROI) for feature extraction should cover the SN region in a computer-aided diagnosis (CAD) system. The ROI size naturally affects the feature representation. However, there currently exist no unified standard for determining the size of ROI. In this work, we quantitatively compare the performance of TCS-based CAD with three sizes of ROIs, namely the entire midbrain (EM) region, the half of midbrain (HoM) region and the SN region. The experimental results on the original extracted features and the features by dimensionality reduction show that ROI covering the EM region achieves the overall best diagnosis performance. The results indicates that the neighboring regions around SN might also have abnormal symptoms, which cannot be clearly observed with naked eyes. It suggests that the large ROI includes more information for feature representation to improve the diagnosis performance of TCS-based CAD for PD.

Parkinson’s disease (PD) is a progressive age-related movement disorder caused by dopaminergic neuron loss in the substantia nigra. Diffusion-based magnetic resonance imaging (MRI) studies—namely, diffusion tensor imaging (DTI)—have been performed in the context of PD, either with or without the involvement of sleep disorders (SDs), to deepen our understanding of cerebral microstructural alterations. Analyzing the clinical characteristics and neuroimaging features of SDs in early PD patients is beneficial for early diagnosis and timely invention. In our present study, we enrolled 36 early PD patients (31 patients with SDs and 5 patients without) and 22 healthy controls. Different types of SDs were assessed using the Rapid Eye Movement Sleep Behavior Disorder Questionnaire—Hong Kong, Epworth Sleepiness Scale, International Restless Legs Scale and PD Sleep Scale-2. Brain MRI examinations were carried out in all the participants, and a region-of-interest (ROI) analysis was used to determine the DTI-based fractional anisotropy (FA) values in the substantia nigra (SN), thalamus (Thal) and hypothalamus (HT). The results illustrate that SDs showed a higher prevalence in the early PD patients than in the healthy controls (86.11% vs. 27.27%). Early PD patients with nighttime problems (NPs) had longer courses of PD than those without (5.097 ± 2.925 vs. 2.200 ± 1.095; p < 0.05), and these patients with excessive daytime sleepiness (EDS) or restless legs syndrome (RLS) had more advanced Hoehn and Yahr stages (HY stage) than those without (1.522 ± 0.511 and 1.526 ± 0.513, respectively; both p < 0.05). Compared with the early PD patients without probable rapid eye movement sleep behavior disorder (pRBD), those with pRBD had longer courses, more advanced HY stages and worse motor and non-motor symptoms of PD (course(years), 3.385 ± 1.895 vs. 5.435 ± 3.160; HY stages, 1.462 ± 0.477 vs. 1.848 ± 0.553; UPDRS, 13.538 ± 7.333 vs. 21.783 ± 10.766; UPDRS, 6.538 ± 1.898 vs. 7.957 ± 2.345; all p < 0.05). In addition, the different number of SD types in early PD patients was significantly inversely associated with the severity of damage in the SN and HT. All of the early PD patients with various SDs had injuries in the SN, in whom the damage was more pronounced in patients with NP than those without. Moreover, early PD patients with NP, RLS or pRBD had worse degrees of HT damage than those without. The current study demonstrated the pathophysiological features and neuroimaging changes in early PD patients with various types of sleep disorders, which will help in early diagnosis and therapy.

Plastic debris and microplastic (MP) have been associated with marine pollution. The present study aimed to assess the MP accumulation in different organs (gut and gill) of 6 economically important fish species from two essential coastal areas, Jakarta Bay and Cirebon Bay. MP was isolated with NaCl, followed by the identification of MP profiles with digital microscope and Fourier Transform Infrared Spectroscopy (ATR-FTIR), respectively. The result showed that MP was found in all samples. Generally, MP concentration in fish from Cirebon Bay was slightly higher than that from Jakarta Bay, with benthic species more concentrated than pelagic fish in both sites. Microplastic was more concentrated on the gill of fish from Jakarta Bay, in contrast with Cirebon Bay. The predominantly MP in Jakarta Bay fish was fiber, while in Cirebon Bay was fragmented with minor granule and film in both locations. Polyethylene (PE), polyvinyl chloride (PVC), and polypropylene (PP) were the most dominant MP in the fish samples from both study areas. Microplastic size showed that the majority (65%) was the small size (1 mm), compared to the bigger one (1-5 mm), while blue, black, and red are the predominantly MP colors. This research supports the need to minimize plastic pollution in aquatic ecosystems to tackle the detrimental impact of MP accumulation to fish and human health. It is suggested to compare MP profiles on fish samples and in water or sediment compartments and identify the chemical constituents of MP.

Eucalyptus species are known to produce metabolites such as essential oils (EOs) that play an important role in the control of weeds, pests and phytopathogenic fungi. The aims of this study were as follows: (i) to determine the chemical composition of the EOs derived from eight Eucalyptus species growing in Tunisia, and (ii) to study their possible antifungal and herbicidal activities. EOs were obtained by hydrodistillation from the dried leaves of eight Eucalyptus species, namely, E. angulosa, E. cladocalyx, E. diversicolor, E. microcoryx, E. ovata, E. resinifera, E. saligna and E. sargentii, and the determination of their composition was achieved by GC and GC-MS. The EOs antifungal activities were tested against four Fusarium strains, and the EOs herbicidal properties were evaluated on the germination and seedling growth of three annual weeds (Trifolium campestre, Lolium rigidum and Sinapis arvensis) and three cultivated crop species (Lepidium sativum, Raphanus sativus and Triticum durum). The EO yields ranged between 0.12 and 1.32%. The most abundant components found were eucalyptol, α-pinene, p-cymene, trans-pinocarveol, α-terpineol and globulol. All EOs showed significant antifungal activity against the four phytopathogenic Fusarium strains. E. cladocalyx EO exhibited the highest level of antifungal activity, and the greatest inhibition of seed germination was obtained even at lowest concentrations used. These findings suggested that E. resinifera, E. ovata and E. cladocalyx EOs could have applications in agriculture as possible biopesticides, as Fusarium antagonists and as bioherbicides.

Facial Expression Recognition (FER) categorizes various human emotions by analyzing the features of the face, so it plays a vital role in recognizing emotions. Prior studies have focused on the issue of recognizing emotions through voices or speech. Addressing the existing method issues, this approach aims to detect voices and three-dimensional images using appropriate datasets and novel deep-learning techniques. In this research, the valid Audio-Visual datasets Ryerson Audio-Visual Database of Emotional Speech and Song (RAVDESS), Acted Facial Expression in the Wild (AFEW), and eNTERFACE’05 datasets are chosen for analysis. RAVDESS dataset contains audio, AFEW, and eNTERFACE and has three-dimensional images of humans, i.e., 3D images. SMOTE technique is presented for solving overfitting problems to balance the dataset by oversampling and under-sampling process. The research employs the Federated 3D-CNN technique to predict the accurate emotions of humans. The 3D Convolutional Neural Network (3DCNN) predicts accurate information of a person at any angle in image processing. Mel Frequency Cepstrum Coefficient (MFCC) is used to extract and fine-tune the voices. A significant contribution of Federated Learning with 3D-Convolutional Neural Network is executed for multiple clients at a time through global and local updates of weights. The proposed framework achieves a prediction accuracy of 95.72 % when compared with existing methods. This approach helps in many applications, such as analyzing emotions, healthcare, etc.

Social networks are often inferred from spatial associations, but other parameters like acoustic communication are likely to play a central role in within group interactions. However, it is currently difficult to determine which individual initiates vocalizations, or who responds to whom. To this aim, we designed a method that allows analyzing group vocal network while controlling for spatial networks, by positioning each group member in equidistant individual cages and analyzing continuous vocal interactions semi-automatically. We applied this method to two types of zebra finch groups, composed of either two adult females and two juveniles, or four young adults (juveniles from the first groups). Young often co-occur in the same social group as adults but are likely to have a different social role, which may be reflected in their vocal interactions. Therefore, we tested the hypothesis that the social structure of the group influences the parameters of the group vocal network. We found that groups including juveniles presented periods with higher level of activity than groups composed of young adults. Using two types of analyses (Markov analysis and cross-correlation), we showed that juveniles were more likely to respond to each other (i.e. they vocalized just after one another or within a short time window), whilst adults respond to each other more. When juveniles turned into adulthood, they showed adult characteristics of vocal patterns. Together our results suggest that vocal behaviour changes during ontogeny, and individuals are more strongly connected with individuals of the same age-class within acoustic networks.

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.

The forecast of the global numerical weather prediction model is often used as the background field to drive the regional mesoscale weather models, and its forecast quality has an important impact on the prediction skill of regional models. The mesoscale operational model in Central China uses the Global Forecast Field (NCEP GFS) of the US Center for Environmental Prediction as the background field, and its forecast accuracy needs to be improved. This paper proposes a method to improve the initial field of the model by using the three-dimensional variational method to assimilate the high-quality European Centre for Medium-range Weather Forecasts (ECMWF) fine-grid forecast field to improve the short-term forecasting ability of the model. At first, the error characters of the 12 h forecast products of NCEP GFS and ECMWF were analyzed by using sounding observations. The RMSE (root mean square error) of temperature, horizontal wind field and relative humidity of ECMWF 12 h forecast are smaller than those of NCEP GFS forecast. Second, sensitivity experiments of ECMWF forecast field assimilation with different resolutions were conducted. Finally, 1°×1° resolution was selected based on the sensitivity experiments and a series of the data assimilation experiments with 1°×1° resolution was performed for August 2021. The results are as follows. (1) The assimilation forecast of heavy rain from 11 to 13 August 2021 shows that after 12 hours of spin-up, the forecast error of the element field has been significantly improved, especially at the bottom of the model. The TS score of 12-36 h, 36-60 h and 60-84 h cumulative precipitation has a certain improvement, especially the forecast of rainstorm magnitude. (2) ECMWF forecast field assimilation sensitivity experiments with different resolutions show that the forecast effect of ECMWF forecast field with 1°×1° resolution is better than 0.5°×0.5° and 0.25°×0.25°. (3) A series of the data assimilation experiments for August 2021 shows that the assimilation of ECMWF 12 h 1°×1° predicted variables has a lower RMSE of the 12 h, 36 h and 60 h forecasted temperature, humidity and wind field in the vertical direction than the control experiments, and the TS score was significantly improved, especially for 50 mm heavy rain precipitation, with an increase of 13.33%, which can effectively improve the forecast skills of the Wuhan Mesoscale Model.

Abstract Background In recent years, patient safety has begun to receive particular attention and has become a priority all over the world. Patient Safety Culture (PSC) is widely recognized as a key tenet that must be improved in order to enhance patient safety and prevent adverse events. However, in gynecology and obstetrics, despite the criticality of the environment, few studies have focused on improving PSC in these units. This study aimed at assessing the effectiveness of an educational program to improve PSC among health professionals working in the obstetric unit of a Tunisian university hospital. Methods We conducted a quasi-experimental study in the obstetric unit of a university hospital in Sousse (Tunisia). All the obstetric unit’s professionals were invited to take part in the study (n = 95). The intervention consisted of an educational intervention with workshops and self-learning documents on patient safety and quality of care. The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture. Normality of the data was checked using Kolmogorov-Smirnov test. The comparison of dimensions’ scores before and after the intervention was carried out by the chi2 test. The significance level was set at 0.05. Results In total, 73 participants gave survey feedback in pre-test and 68 in post-test (response rates of 76.8% and 71.6, respectively). Eight dimensions improved significantly between pre- and post-tests. These dimensions were D2 “Frequency of adverse events reported” (from 30.1 to 65.6%, p

Abstract Background Gestational diabetes mellitus (GDM) is a highly prevalent disease and poses a significant risk to the health of pregnant women. Abdominal adipose tissue (AT) contributes to insulin resistance (IR) associated with GDM. However, the underlying mechanisms remain unclear. Methods In this study, we developed a mouse model of GDM by subjecting mice to a high-fat diet. We collected adipose-derived stem cells (ADSCs) from the abdominal and inguinal regions and examined their role in inducing IR in normal tissues through the secretion of small extracellular vesicles (sEVs). The sEVs derived from ADSCs isolated from GDM mice (ADSC/GDM) were found to inhibit cell viability and insulin sensitivity in AML12, a normal mouse liver cell line. Results Through proteomic analysis, we identified high levels of the thrombospondin 1 (Thbs1) protein in the sEVs derived from ADSC/GDM. Subsequent overexpression of Thbs1 protein in AML12 cells demonstrated similar IR as observed with ADSC/GDM-derived sEVs. Mechanistically, the Thbs1 protein within the sEVs interacted with CD36 and transforming growth factor (Tgf) β receptors in AML12 cells, leading to the activation of Tgfβ/Smad2 signaling. Furthermore, the administration of LSKL, an antagonistic peptide targeting Thbs1, suppressed Thbs1 expression in ADSC/GDM-derived sEVs, thereby restoring insulin sensitivity in AML12 cells and GDM mice in vivo. Conclusions These findings shed light on the intercellular transmission mechanism through which ADSCs influence hepatic insulin sensitivity and underscore the therapeutic potential of targeting the Thbs1 protein within sEVs.

Introduction Although relatively uncommon, osteoradionecrosis (ORN) remains a serious complication following radiotherapy. Various therapeutic approaches, including hyperbaric oxygen therapy (HBOT), are utilized in managing ORN. This study aims to evaluate the role of HBOT in ORN management and to identify predictive factors influencing the evolution of head and neck ORN after HBOT. Methods This retrospective study includes 46 patients who received HBOT for head and neck ORN between 2017 and 2020. The patients were divided into two groups: Group 1 (n=36) included those with regression or stabilization of ORN, while Group 2 (n=10) comprised patients with worsening lesions. We performed a statistical study in order to identify factors influencing ORN progression under treatment. Results ORN affected the mandible in 93.5% of patients, the maxilla in 2 cases, and the skull base in 4 cases. All patients received HBOT, with an average of 44.65 sessions. Pre-operative HBOT was administered in 17% of cases, and post-operative HBOT was given in 42% of cases. After at least 20 sessions, ORN regressed in 33% of cases, stabilized in 45%, and worsened in 22%. Analysis of factors influencing ORN progression on the univariate study revealed significant associations with high blood pressure (p=0.046), larger tumor size (p=0.004), advanced tumor stages (p=0.048), mean radiation dose (p=0.002), delays between dental care and radiotherapy (p=0.045), and the location of ORN within the mandible (p=0.049). Additionally, the number of HBOT sessions significantly affected ORN evolution, with more sessions correlating with better outcomes (p=0.001). In the multivariate analysis, variables such as the average interval between dental care and radiotherapy (p=0.043) as well as the number of HBOT sessions (p=0.040) emerged as significant influencers of ORN evolution. Conclusion Our study provides valuable insights into the management of ORN by identifying key predictors that influence the post-therapeutic evolution of head and neck ORN after HBOT.

ABSTRACT Objective To assess factors associated with hospital self-discharge of patients with tuberculosis in the state of Rio de Janeiro, Brazil, 2011-2018. Methods This was a retrospective cohort study in a referral hospital. Clinical and epidemiological characteristics were compared according to hospitalization outcome (self-discharge, formal discharge, or death). Hazard ratios (HR) with 95% confidence intervals (95%CI) for the association of self-discharge with explanatory variables were estimated using Cox regression. Results Of the 1429 hospitalizations, 10.4% ended in self-discharge. Female sex (HR = 1.47; 95%CI 1.03;2.11), age ≤ 42 years (HR = 2.01; 95%CI 1.38; 2.93), substance use (HR = 1.62; 95%CI 1.12; 2.34), hospitalization after treatment dropout (HR = 2.04; 95%CI 1.37; 3.04), and homelessness (HR = 2.5; 95%CI 1.69; 3.69) were associated with self-discharge. Conclusion Patients with social vulnerability require more careful monitoring during hospitalization.

IntroductionCongenital 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.MethodsNine 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.ResultsAll 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.DiscussionWe 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.

In the process of deep mining, the temperature of mine water is significantly higher than that of shallow coal seams. The erosion of high-temperature hydrothermal fluids affects the physical and chemical characteristics of coal, which in turn affects its spontaneous combustion process. To study the spontaneous combustion characteristics and influencing mechanisms of coal under the influence of hydrothermal erosion in deep mining, through low-field nuclear magnetic resonance, molecular dynamics simulation, mechanical test and C600 trace heat experiment, the influence of hydrothermal erosion on coal porosity, pore size distribution, mechanical strength and oxidation heat characteristic parameters was analyzed. Combined with correlation analysis, the correlation between various parameters was quantitatively described. The study results show that under the dual influence of thermal stress and swelling, the internal pore structure of hydrothermal eroded coal changes significantly. There is a significant positive correlation between hydrothermal temperature and total porosity of coal, and the correlation coefficient is 0.97. With the increase of hydrothermal temperature, the total porosity of coal increases from 0.24% to 1.35%, the proportion of micropores decreases from more than 69% to less than 60%, and the proportion of mesopores and macropores increases. Coal body pore size significantly affects the oxygen diffusion coefficient, which increases exponentially with a linear increase in coal body pore size. Under the influence of hydrothermal erosion, the development of coal pores and the dissolution of some organic matter significantly reduce the mechanical strength of coal. From raw coal to 80 ℃ hydrothermal eroded coal, the average compressive strength decreases from 23 MPa to 11.6 MPa, which is reduced by 50%. Compared with raw coal, the heat release intensity of hydrothermal erosion coal is higher and the heat release is greater. The heat release of TH40, TH50, TH60, TH70 and TH80 increase by 12.61%, 16.63%, 17.32%, 19.36% and 25.02%, respectively. The correlation coefficient between hydrothermal temperature and coal oxidation heat release is 0.92. Hydrothermal erosion significantly affects the porosity and oxidation process of coal. As the hydrothermal temperature increases, the porosity of the coal body increases, the mechanical strength weakens, the oxygen consumption and oxidation rate of the oxidation process accelerate, and the heat release increases. Hydrothermal erosion coal has a higher risk of spontaneous combustion, and the higher the hydrothermal temperature is, the greater the risk is.

Degradation of water quality is an emerging issue in many developing countries. In this context, industrial and domestic effluents heavily contaminate the coast of Moknine Continental Sebkha in Tunisia. The present study aimed to biomonitor the seawater quality of the Moknine Continental Sebkha coast using physicochemical and ecotoxicological approaches. The ecotoxicological assessment was performed using three species representing different trophic levels, namely Vibrio fischeri, Selenastrum capricornutum, and Lepidium sativum. In the physicochemical analysis such as BOD (biochemical oxygen demand), COD (chemical oxygen demand), TSS (total suspended solids), TOC (total organic carbon), NO3− (nitrate), AOX (adsorbable organic halogen), the recorded levels of pH and total suspended solids did not comply with the Tunisian standard (NT.09.11/1983). The ecotoxicological data confirmed that the tested water samples displayed toxicity to two test indicators L. sativum and S. capricornutum. A targeted chemical screening of the Moknine Continental Sebkha coast previously performed revealed the presence of total mercury, four phthalate acid esters, and one non-phthalate plasticizer, a fact that could explain the observed ecotoxicological effects and therefore might harm the biotic area and the health of the surrounding population. HIGHLIGHTS Water quality biomonitoring of the coast of Moknine Continental Sebkha in Tunisia, which is heavily contaminated by industrial and domestic effluents.; Water quality assessment included physicochemical and ecotoxicological approaches.; Ecotoxicity for two target organisms (Selenastrum capricornutum and Lepidium sativum) was detected.; Industrial output affects the water quality and biodiversity.;

Previous research has highlighted bullying as a significant issue in Indonesia, with a notable increase in cyberbullying among adolescents during the COVID-19 pandemic, adversely affecting their psychological well-being. However, there has been limited discussion on bullying in the post-COVID-19 era. This study has three aims. The first is to examine the subjective well-being (SWB) of children who have either experienced bullying or have not been bullied after the pandemic. The second is to assess the occurrence of both traditional bullying (involving siblings and at school) and cyberbullying in Indonesia following COVID-19. The third aim is to investigate the factors linked to these forms of bullying post-pandemic. The participants were middle school students (N = 943; 57.2% girls, 45.0% in grade 7). The Children's Worlds Subjective Well-Being Scale with five items (CW-SWBS5) was employed to assess children's SWB. Separate measures were utilized for traditional and cyberbullying. Six factors—family, school climate, personal satisfaction, friendships, safety, and social media usage—were analyzed as independent variables using linear regression to determine their impact on bullying forms. The structural equation model (SEM) was applied to evaluate how these bullying types affect SWB. The findings revealed that sibling bullying and cyberbullying significantly influenced children’s SWB, with girls reporting lower SWB scores than boys. Cyberbullying emerged as the most prevalent form of bullying post-pandemic. A positive school climate was found to shield children from bullying. Cummins' theory of well-being homeostasis was employed to interpret the results. This study also discussed implications for educators and parents.

This study aims to increase student learning motivation using Augmented Reality (AR) media in the context of science learning. The research method used was collaborative classroom action research with research subjects consisting of XI MIPA 1 students at SMA Negeri 9 Bogor City. This study used learning motivation questionnaires as a measuring tool, with indicators that included confidence in self-ability, learning strategies that activate students, the meaning of science learning, achievement, and learning environment stimuli. Augmented Reality media was developed using the Halo AR application and applied to learning plant tissue structure and function material (KD 3.3 and 4.3) and animal tissue structure and function (KD 3.4 and 4.4). The results showed that the application of AR media in learning has succeeded in increasing the average learning motivation of students by 0.6 points, which increased from 2.41 to 3.01 in the 2nd action cycle. Based on the results of this collaborative classroom action research, it can be concluded that the use of Augmented Reality media is effective in increasing the learning motivation of students in class XI MIPA 1 at SMA Negeri 9 Kota Bogor. These results make an important contribution to developing innovative and more engaging learning strategies and can lay the foundation for developing broader technology-based education in the future.

Isolated aldosterone synthase deficiency is a rare autosomal recessive disorder caused by pathogenic variants in CYP11B2, resulting in impaired aldosterone synthesis. We report on a neonate with isolated aldosterone synthase deficiency caused by a novel homozygous CYP11B2 variant Chr8: NM_000498.3: c.400G>A p.(Gly134Arg). The patient presented shortly after birth with severe signs of aldosterone deficiency. Interestingly, segregation analysis revealed that the patient's asymptomatic father was also homozygous for the CYP11B2 variant. Biochemical evaluation of the father indicated subclinical enzyme impairment, characterized by elevated aldosterone precursors. Apparently, this homozygous variant led to different clinical phenotypes in two affected relatives. In this manuscript we elaborate on the biochemical and genetic work-up performed and describe potential pitfalls in CYP11B2 sequencing due to its homology to CYP11B1.

The quick response (QR) code-based attendance application contributes to reducing paper usage and attendance input errors. However, in its implementation process, the QR-code-based attendance at a Bandung school demonstrates weaknesses. Absent students can fake their attendance for themselves or friends. This type of attack is known as fake QR code generation. This research proposes a security authentication system using the Rivest–Shamir–Adleman (RSA) encryption algorithm and the secure hash algorithm 1 (SHA-1) to secure QR code-based attendance applications from fake QR code generation attacks. The RSA algorithm encrypts QR code data to maintain privacy, while the SHA-1 algorithm ensures data integrity. Based on this method, the mutual authentication process between the QR code data generated by the student and the attendance reading application by the teacher can be established. The results obtained from a series of tests showed that the security system in the student attendance recording application that had been implemented at Madrasah Aliyah (MA) Al-Mukhlishin could detect and prevent fake QR code generation attacks. The test was conducted by changing the impact of the key length on RSA-1024 bits and RSA-2048 bits. The results showed that in RSA-1024 bits, energy consumption of 0.14 J and time of 1.66 s is more efficient than that in RSA-2048 bits, with energy consumption of 0.19 J and time of 2.09 s. Interestingly, if a higher level of security is required, the key length should be increased at the expense of some energy and time efficiency.