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Abstract Coronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE). Overall, 148 stable patients underwent STDE of the left anterior descending arteries (LAD), before and after elective PCI. Coronary flow velocity reserve (CFVR) was measured using basal and hyperemic diastolic peak velocity (hDPV). Vessels were classified into four CFC categories: severely, moderately, or mildly reduced CFC, and normal flow. Changes in hDPV and CFC status post-PCI, as well as predictors of hDPV increase, were assessed. Despite improvements in fractional flow reserve (FFR) in all cases, 31 cases (20.9%) showed a decrease in hDPV following PCI. Vessels with ischemic CFC, defined as moderately or severely reduced CFC, decreased from 46.6% (69/148) to 19.6% (29/148) post-PCI. Conversely, CFC worsened in 15.5% of patients. Multivariable analysis showed lower pre-PCI hDPV and ischemic CFC were independently predictive of higher-level (> 50%) hDPV increase after PCI. Approximately 20% of FFR-guided LAD PCI resulted in decreased hDPV. CFC deterioration was not uncommon despite FFR improvement. Preprocedural non-invasive STDE may help identify lesions that benefit from revascularization.

Abstract Background Although the in silico predictive ability of the Ames test results has recently made remarkable progress, there are still some chemical classes for which the predictive ability is not yet sufficient due to a lack of Ames test data. These classes include simple heterocyclic compounds. This study aimed to investigate the mutagenicity and structure-mutagenicity relationships for some heterocycles in the Ames test. In the present study, we selected 12 quinoline analogues containing one or two nitrogen atoms in the naphthalene ring and 12 indole analogues containing one to three nitrogen atoms in the indole ring, without any side moiety. Results The Ames test was performed with five standard bacterial strains (TA100, TA1535, TA98, TA1537, and WP2uvrA) using the pre-incubation method with and without rat liver S9. Five quinoline and two indole analogues were mutagenic. Among the five quinoline analogues, four were mutagenic in the presence of S9 mix with TA100, whereas cinnoline was mutagenic in the absence of S9 mix with TA1537. Among the two indole analogues, indazole was mutagenic in the presence and absence of S9 mix with WP2uvrA and 4-azaindole was mutagenic in the absence of S9 mix with TA1537. The mechanisms underlying the induction of mutagenesis appear to differ between quinoline and indole analogues. In addition, we performed in silico analysis of the mutagenicity of all these analogues using DEREK Nexus 6.1.1 (Lhasa Limited) and GT_EXPERT from CASE Ultra 1.8.0.5 (MultiCASE Inc.) as knowledge-based models and GT1_BMUT from CASE Ultra 1.8.0.5 (MultiCASE Inc.) as a statistical-based model. The knowledge-based model showed low sensitivity for both the quinoline and indole analogues (DEREK Nexus and GT_EXPERT: 20% for quinolines and 0% for indoles). Conversely, the statistical model showed high sensitivity (100% for both quinolines and indoles) and low specificity (43% for quinolines and 10% for indoles). Conclusion Based on the Ames test results, we proposed structural alerts noting that quinoline analogues were mutagenic when they had nitrogens in any of the positions 2, 5, 7, or 8 in addition to 1, and indole analogues were mutagenic when they had nitrogens at positions 2 or 4 in addition to 1.

Abstract This report is of a systematic review and meta-analysis evaluating the efficacy and safety of transcatheter arterial embolization (TAE) for nonvariceal gastrointestinal bleeding (GIB) with n-butyl cyanoacrylate (NBCA) or coils as the primary embolic agent. The primary outcome was the clinical success rate. The secondary outcomes were technical success rates, 30-day rebleeding rates, major complication rates, and 30-day overall mortality rates. A systematic search was performed in PubMed, Embase, and Cochrane Library. Articles included had been published in English from January 2000 to August 2023 and assessed patients with nonvariceal upper and lower GIB (UGIB and LGIB) who received TAE with NBCA or coils. Single-arm meta-analyses were performed for these outcomes. Subgroup analyses comparing NBCA and coils were conducted if there were more than 10 articles selected for each outcome. Thirty-seven articles were selected for analysis. The pooled rates of TAE for UGIB and LGIB were clinical success 73.0% and 76.5%, technical success 94.9% and 91.4%, 30-day rebleeding 25.0% and 17.1%, major complications 3.5% and 10.0%, and 30-day overall mortality 20.7% and 11.4%, respectively. The subgroup analysis showed a significant difference only for the technical success rates of LGIB between NBCA and the coils (p

A bidirectional approach is necessary for treating critical limb ischemia with complex, multiple lesions. We report an ultrasound-guided bidirectional puncture through an occluded vessel to treat an obstruction extending from the anterior tibial artery to the dorsal foot artery in a patient with toe gangrene and rest pain. This technique effectively restored arterial patency and is a promising approach for managing challenging critical limb ischemia occlusions.

Color-coded circulation is a display method that generates dynamic color-coded images based on the time of arrival of contrast agents using parametric imaging to create video displays. By cyclically displaying information in color according to the arrival time of the contrast agent at each pixel, anatomical blood vessel paths and blood flow information can be simultaneously visualized. Three-dimensional (3D) helical stents increase wall shear stress due to swirling flow and prevent intimal hyperplasia. To the best of our knowledge, there are no reports on the visualization of this swirling flow using color-coded circulation.Here, we report the use of color-coded circulation to visualize the swirling flow following the placement of a 3D helical stent in the left superficial femoral artery. Color-coded circulation may facilitate the evaluation of contrast agent distribution and blood flow, which may otherwise go undetected with digital subtraction angiography.

Context: Hyperuricemia is the cause of gout in the inflammatory joint condition. The xanthine oxidase enzyme is a therapeutic target for gout treatment because it plays a role in the generation of uric acid. Allopurinol is used to treat gout. It prevents the xanthine oxidase enzyme from producing as much uric acid. When selecting a medication, one must consider the various adverse effects of allopurinol. Phyllanthus emblica plants are among the medicinal plants that can be used as an alternative treatment for gout. Aims: To evaluate isolated compounds from the Phyllanthus emblica as antihyperuricemia candidates. Methods: The isolated compounds were characterized using High-Performance Liquid Chromatography Analysis and Thin Layer Chromatography-Densitometry. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) and cupric ion (CUPRAC) antioxidant capacity procedures were used to develop the antioxidant activity index. The ability to inhibit xanthine oxidase was determined using a spectrophotometer. Results: Compound 1 was indicated as rutin having antioxidant capacity with an antioxidant activity index (AAI) DPPH value of 7.89 ± 0.03 and AAI CUPRAC value of 15.83 ± 0.04 stronger than compound 2 (quercitrin) with an AAI DPPH value of 3.72 ± 0.01 and AAI CUPRAC 3.24 ± 0.03. The IC50 for quercitrin's inhibition of xanthine oxidase is 23.85 ± 2.04, which was higher than rutin’s IC50 value of 32.77 ± 4.49 µg/mL. Conclusions: Flavonol glycosides present in the ethanol extract of Phyllanthus emblica leaves gave potent xanthine oxidase inhibitory activity stronger than the extract. Quercitrin gave stronger xanthine oxidase inhibitory activity, but this compound has weaker antioxidant capacity compared to rutin.

Abstract Background In patients with chronic obstructive pulmonary disease (COPD), the clinical use of the minute ventilation-carbon dioxide production ( $$\rm{\dot V}$$ E- $$\rm{\dot V}$$ CO2) slope has been reported as a measure of exercise efficiency, but the oxygen uptake efficiency slope (OUES), i.e., the slope of oxygen uptake ( $$\rm{\dot V}$$ O2) versus the logarithmically transformed $$\rm{\dot V}$$ E, has rarely been reported. Methods We hypothesized that the $$\rm{\dot V}$$ E- $$\rm{\dot V}$$ CO2 slope is more useful than OUES in clinical use for the pathophysiological evaluation of COPD. Then, we investigated the cardiopulmonary exercise testing parameters affecting each of these slopes in 122 patients with all Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD grades selected from our database. Results Compared with the GOLD I-II group (n = 51), peak $$\rm{\dot V}$$ O2 (p

Abstract Underground coal gasification (UCG) is process of directly recovering energy as combustible gases such as hydrogen and carbon monoxide by combusting unmined coal resources in situ. During UCG process, the temperature in the gasification zone can exceed 1,300 °C, raising concerns about the potential melting of the steel pipe for oxidant injection. To control the temperature in the gasification zone, the use of water injection as an injection agent can be an option. Injecting water during UCG process serves two purposes: it decreases the temperature in the reaction zone by the endothermic effect of water, and it enhances the production of H2 by the reduction reaction of water. However, injecting excessive amounts of water may lead to a significant decrease in the temperature in the reaction zone, consequently cannot maintain the temperature range required for the UCG reaction. This study discusses the effects of water injection on the temperature of the gasification zone and the product gas by developing a chemical reaction model of UCG using COMSOL Multiphysics® software. The model was developed based on the temperature and produced gas results obtained from laboratory-scale artificial coal seam UCG experiments. Our findings reveal that water injection significantly influences the gasification process, controlling temperature in the reaction zone and promoting H2 production through steam gasification and water-gas shift reactions. Moreover, under the experiment and analysis conditions of this study, it is revealed that water injection up to an H2O/O2 molar ratio of 3.9 can effectively control the temperature of the gasification zone with enhancing H2 production.

This research addresses the need to enhance critical thinking skills in junior high school students through effective instructional design, particularly in the context of learning news texts. The study is based on the premise that problem-based learning (PBL) can significantly improve students' critical thinking by engaging them in real-world problem-solving scenarios. Given the growing emphasis on critical thinking as a core educational objective, it is essential to develop instructional models that not only teach content but also foster higher-order thinking skills. The primary aim of this research is to design an instructional model for teaching news texts in junior high school and to assess its validity and effectiveness. The study employed a Research and Development (R&D) approach, utilizing the ADDIE model, which involves five stages: Analysis, Design, Development, Implementation, and Evaluation. Following the development of the instructional design, it underwent validation by both learning experts and practitioners. The validation process yielded high scores, with learning experts rating it at 95.83% and practitioners at 88.89%, resulting in an overall average validity score of 92.36%, categorizing the design as highly valid. In practice, the problem-based learning model was implemented in classrooms, and its impact on students' learning outcomes was evaluated. The students achieved an average learning score of 86%, indicating the instructional design's effectiveness in delivering content. Furthermore, the assessment of students' critical thinking skills showed an average score of 79%, placing it in the "good" category. These findings suggest that the PBL-based instructional design is effective in not only teaching news texts but also in enhancing students' critical thinking skills, making it a valuable approach for junior high school education.

This research is motivated by the tendency of netizens to convey psychological attitudes on social media. The delivery of these psychological attitudes sometimes needs attention to language politeness. This research is necessary because it answers the challenge of understanding how politeness of language changes in the context of social media supported by digital technology, which is rarely discussed in conventional pragmatic studies. The problem in this study is how politeness of expressive speech acts from a cyber pragmatics perspective. This study explores and elaborates on the realization of politeness maxims politeness principles based on the perspective of cyber pragmatics. The approach used in this study is qualitative, and the content analysis method was applied. This study's data source is netizens' language activity on the comments page of the Instagram account @detikcom on June 9, 2023, totaling 2509 comments. The data in this study amounted to 511 data, which are expressive speech. The data collection techniques used are documentation techniques and reading techniques. The data analysis technique is carried out in three stages: identification, classification, and interpretation of research results. Regarding the principle of politeness, netizens' comments are considered impolite based on the maxim of tact, the maxim of approbation, and the maxim of agreement, which significantly impact online communication behavior. The reason is that netizens do not maximize their benefits, approbation, and conformity with other parties but instead express their psychological attitudes by throwing out insults, ridicule, and rejections that can cause harm to other parties. Meanwhile, netizens are considered polite for the maxim of modesty and sympathy. Most sympathy is directed at the Indonesian people who must bear the country's debt.

Abstract Background Dengue virus remains a major public health problem with one of the hallmark pathologies is the vascular leakage caused by endothelial dysfunction which can lead to Dengue Hemorrhagic Fever (DHF) manifestation. In the status quo, no specific therapy has been discovered but rather heavily relies on judicious and frequent monitoring of intravenous fluids administration. The current guideline has discussed the roles of fluid therapy during the Dengue Shock Syndrome (DSS) stage, however, administration of early fluid intervention for DHF grade I and II remains uncharted territory. In addition, the choice and timing of colloid administration remains underexplored. As one of the widely available colloids, 5% albumin has known physiological properties that potentially minimize plasma leakage. Therefore, this study aimed to evaluate the benefit of early intervention of 5% albumin in adults with DHF in the hope of preventing the lethal progression to DSS and further, shorten the length of stay (LOS) for patients. Methods We conducted a multicenter, open-labeled, randomized controlled trial in Jakarta and Banten to compare the effect of early intervention with 5% albumin in adult patients with DHF compared to Ringer’s Lactate (RL). Statistical analyses were conducted using unpaired t-test and Mann-Whitney for normally and abnormally distributed data respectively. Results Adult patients with a diagnosis of DHF grade I and II that being hospitalized to receive the early intervention of 5% albumin had significantly lower levels of hemoconcentration 4, 12, and 24 h (p = 0.002, 0.001, 0.003, respectively), higher platelet counts 4 h (p = 0.036), higher serum albumin levels 48 h (p = 0.036), lower proteinuria 24 and 48 h post-albumin administration (p

Abstract Background Multi-locus imprinting disturbance (MLID) with methylation defects in various differentially methylated regions (DMRs) has recently been identified in approximately 150 cases with imprinting disorders (IDs), and deleterious variants have been found in genes related to methylation maintenance of DMRs, such as those encoding proteins constructing the subcortical maternal complex (SCMC), in a small fraction of patients and/or their mothers. However, integrated methylation analysis for DMRs and sequence analysis for MLID-causative genes in MLID cases and their mothers have been performed only in a single study focusing on Beckwith-Wiedemann syndrome (BWS) and Silver-Russell syndrome (SRS) phenotypes. Results Of 783 patients with various IDs we have identified to date, we examined a total of 386 patients with confirmed epimutation and 71 patients with epimutation or uniparental disomy. Consequently, we identified MLID in 29 patients with epimutation confirmed by methylation analysis for multiple ID-associated DMRs using pyrosequencing and/or methylation-specific multiple ligation-dependent probe amplification. MLID was detected in approximately 12% of patients with BWS phenotype and approximately 5% of patients with SRS phenotype, but not in patients with Kagami-Ogata syndrome, Prader-Willi syndrome, or Angelman syndrome phenotypes. We next conducted array-based methylation analysis for 78 DMRs and whole-exome sequencing in the 29 patients, revealing hypomethylation-dominant aberrant methylation patterns in various DMRs of all the patients, eight probably deleterious variants in genes for SCMC in the mothers of patients, and one homozygous deleterious variant in ZNF445 in one patient. These variants did not show gene-specific methylation disturbance patterns. Clinically, neurodevelopmental delay and/or intellectual developmental disorder (ND/IDD) was observed in about half of the MLID patients, with no association with the identified methylation disturbance patterns and genetic variants. Notably, seven patients with BWS phenotype were conceived by assisted reproductive technology (ART). Conclusions The frequency of MLID was 7.5% (29/386) in IDs caused by confirmed epimutation. Furthermore, we revealed diverse patterns of hypomethylation-dominant methylation defects, nine deleterious variants, ND/IDD complications in about half of the MLID patients, and a high frequency of MLID in ART-conceived patients.

Fallopian tube carcinoma, presenting as an inguinal hernia, is a rare entity. We report the case of a woman in her 70s with a history of hysterectomy and right oophorectomy 29 years prior who presented with left cervical lymphadenopathy and elevated CA125 levels. Imaging revealed a tubular structure in the left pelvic region extending into the inguinal hernia sac. Contrast-enhanced computed tomography revealed a tubular structure with solid components in the left pelvic region that herniated through the left inguinal canal. Magnetic resonance imaging further characterized the solid component within the tubular structure and revealed features suggestive of malignancy. Fluorodeoxyglucose positron emission tomography/computed tomography revealed fluorodeoxyglucose uptake in the solid component and multiple enlarged lymph nodes, indicating lymph node metastasis. Subsequent laparoscopic resection confirmed high-grade serous carcinoma originating from the fallopian tube. Fallopian tube carcinoma typically presents nonspecific symptoms but elevated CA125 levels. Imaging often shows sausage-shaped masses. The mechanism in this case involved increased mobility of the left adnexa after hysterectomy and tumor infiltration near the inguinal canal. This case highlights the importance of considering fallopian tube carcinoma as a differential diagnosis when evaluating inguinal hernias, particularly in high-risk patients.

Leprosy is still a health problem in several countries, including Indonesia. Disability due to leprosy is a health threat for sufferers and causes quality-of-life problems that can disrupt the productivity of leprosy patients. Ocular involvement in leprosy is joint, but little data has been reported. Apart from multi-drug treatment (MDT), leprosy sufferers must also be able to carry out continuous self-care to prevent further disability. This is a collaborative activity between the Department of Ophthalmology and Dermatology Venereology of the Faculty of Medicine, the University of Andalas in Puskesmas Pauh Kamba district of Padang Pariaman. This is an advocacy activity on self-care (3M: Seeing, Examining, and Protecting) and eye examination. The activity was followed by interactive discussions and continued with a direct examination for skin abnormalities and disabilities, eye examination, and fundoscope. The activity results were obtained from 24 respondents, 11 men and 13 women. The age range is 16-59 years (67%), with the highest level of education being Elementry School graduates, which is 11 people (46%). In the self-care questionnaire of patients, 40% behaved well, and the results of eye examinations almost suffered from dry eye complaints without disabilities.

Abstract Background Absolute lymphocyte count (ALC) is a predictive and prognostic factor for various tumor types, including breast cancer. Palbociclib is a CDK4/6 inhibitor widely used for the treatment of metastatic estrogen receptor (ER)-positive, HER2-negative breast cancer. However, predictive biomarkers of the efficacy of palbociclib remain unelucidated. We conducted a retrospective study to examine the predictive value of the baseline ALC in patients treated with palbociclib. Methods The medical records of patients with ER-positive, HER2-negative breast cancer treated with palbociclib plus hormonal therapy between December 2017 and December 2021 were analyzed retrospectively. The cutoff value of ALC was set at 1800 cells/μL at the initiation of palbociclib treatment. The clinical benefit rate (CBR) was defined as the rate of complete or partial response or stable disease for at least 6 months. Progression-free survival (PFS) rates were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using Cox proportional hazards regression. Results All of the 202 patients were women, with a median age of 59 years and a performance status (PS) of ≤ 2. The median numbers of lines of chemotherapy and endocrine therapy before palbociclib treatment were 0 (range, 0–9) and 1 (range, 0–7), respectively. Fifty-one patients had liver metastases. Forty-six patients tested negative for progesterone receptor (PgR) expression. The median follow-up time was 9.1 months. The CBR was significantly higher in the ALC-high group than in the ALC-low group (79% vs. 60%; P = 0.018). The median PFS was significantly longer in the ALC-high group than in the ALC-low group (26.8 months vs. 8.4 moths, respectively; P = 0.000013). ALC, age, PS, PgR status, prior chemotherapy, prior endocrine therapy, and liver metastasis were entered into the multivariate analysis. ALC was identified as an independent factor for PFS (P = 0.00085), along with liver metastasis (P = 0.0020), PS (P = 0.026), and prior endocrine therapy (P = 0.019). Conclusion ALC can serve as a predictor of palbociclib efficacy in patients with metastatic ER-positive, HER2-negative breast cancer.

This research addresses the need for more engaging and interactive methods to improve elementary students' understanding of complex scientific concepts, particularly the respiratory system. To overcome the limitations of traditional teaching methods, an educational Role-Playing Game (RPG) incorporating the A* (A-Star) algorithm was developed for optimal game navigation. The study followed the ADDIE development model, which involves Analysis, Design, Development, Implementation, and Evaluation. During the analysis phase, learning needs were determined through interviews and classroom observations. The design phase involved creating game scenarios and integrating educational content with interactive elements. The A* algorithm was applied during development to ensure efficient navigation. The game was implemented in a 5th-grade classroom in Kuningan, and its effectiveness was evaluated using pre-tests, post-tests, and student questionnaires. Results demonstrated a significant increase in students' understanding, with average post-test scores rising from 58 to 85. Feedback from both students and teachers was very positive, with the game receiving a 94.2% acceptance rate. The study suggests that RPG-based educational games with intelligent algorithms like A* can greatly enhance science education by offering a more engaging and effective learning experience, contributing to advancements in technology-based learning and setting a standard for future educational game development.

Abstract Mosquito-borne diseases such as dengue and filariasis are a growing public health concern in endemic countries. Biological approaches, such as the trans-infection of Wolbachia pipientis in mosquitoes, are an alternative vector control strategy, especially for arthropod-borne viruses such as dengue. In the present study, the effect of Wolbachia (wMel strain) on the vectorial capacity of Aedes aegypti for Dirofilaria immitis was studied. Our results showed that Wolbachia does not affect the phenotype of mosquito survival or the prevalence, number, and molting rate of third-stage larvae in both susceptible and resistant strains of Ae. aegypti. RNA-seq analysis of Malpighian tubules at 2 days post-infection with D. immitis showed the differentially expressed genes (DEGs) with and without wMel infection. No characteristic immune-related gene expression patterns were observed among the DEGs. No significant change in the amount of Wolbachia was observed in the Ae. aegypti after D. immitis infection. Our results suggest that infection of D. immitis in Ae. aegypti populations will not interfere with Wolbachia-based vector control strategies in dengue-endemic areas where cases of D. immitis are present. This study demonstrated the veterinary medical validity of a dengue control program using Wolbachia.

This study aimed to compare calcium oxide (CaO) and calcium chloride (CaCl2) as calcium sources for coconut fatty acid distillate (CFAD) calcium soap (Ca-soap) production and to evaluate the supplementation ratios of unprotected and protected CFAD in dairy rations to optimize rumen function. This research included two steps: (1) assessing the protection strength of Ca-soap made with CaO and CaCl2 at mole ratios of Ca to CFAD of 1, 1.5, 2, and 2.5; (2) evaluating CFAD supplementation in an in vitro dairy ration study using a 5 × 4 randomized factorial block design. Factor A compared unprotected and protected CFAD ratios of A1 = 100:0, A2 = 75:25, A3 = 50:50, A4 = 25:75, and A5 = 0:100, and factor B compared supplementation levels of B1 = 0%, B2 = 1%, B3 = 2%, and B4 = 3%. CaCl2 at a 2.5-mole ratio to CFAD produced the lowest acid value and the carboxylic acid (C=O) chemical bond. Complete protection (0:100) exhibited the highest densities of Bacteroides and nutrient digestibility (p < 0.05) without significantly affecting rumen fermentability (p > 0.05). Higher CFAD levels significantly reduced methanogens and protozoa (p < 0.05) without significantly affecting estimated methane production. In conclusion, CaCl2 at a 2.5-mole ratio to CFAD provided the best protection, and its complete protection in CFAD supplementation optimized rumen function.

Abstract Most patients with advanced cancer develop cachexia, a multifactorial syndrome characterized by progressive skeletal muscle wasting. Despite its catastrophic impact on survival, the critical mediators responsible for cancer cachexia development remain poorly defined. Here, we show that a distinct subset of neutrophil-like monocytes, which we term cachexia-inducible monocytes (CiMs), emerges in the advanced cancer milieu and promotes skeletal muscle loss. Unbiased transcriptome analysis reveals that interleukin 36 gamma (IL36G)-producing CD38+ CiMs are induced in chronic monocytic blood cancer characterized by prominent cachexia. Notably, the emergence of CiMs and the activation of CiM-related gene signatures in monocytes are confirmed in various advanced solid cancers. Stimuli of toll-like receptor 4 signaling are responsible for the induction of CiMs. Genetic inhibition of IL36G-mediated signaling attenuates skeletal muscle loss and rescues cachexia phenotypes in advanced cancer models. These findings indicate that the IL36G-producing subset of neutrophil-like monocytes could be a potential therapeutic target in cancer cachexia.

A woman in her 90s presented with loss of appetite, lower back pain, abdominal pain, and fever. Physical examination and subsequent blood tests indicated an inflammatory process, and computed tomography (CT) scans revealed gallbladder torsion with necrosis and abscess formation. The case involved successful management of this rare condition through percutaneous drainage without the need for surgical intervention, avoiding complications during follow-up. Remarkably, post-treatment CT showed complete resolution of the gallbladder abscess and the gallbladder itself was no longer visible. This case highlights the effectiveness of minimally invasive treatment for gallbladder torsion in elderly patients and underscores the potential for non-surgical intervention in managing complex abdominal conditions.

This research explores the role of food taboos in Kampung Adat Cireundeu, focusing on the community’s prohibition against rice consumption and its significance in maintaining cultural identity and food security. Using a qualitative descriptive approach, data were collected through in-depth interviews with key informants and direct observations of the community’s food practices. Historical and secondary data were also reviewed. The study found that the food taboos in Cireundeu are deeply connected to the community's historical resistance to colonisation and their religious beliefs in Sunda Wiwitan. These taboos serve as a cultural safeguard and a strategy for ensuring food resilience by relying on cassava as a staple crop. The findings suggest that indigenous knowledge systems and food taboos can play a critical role in promoting sustainable food security and cultural preservation. This has implications for policy development in areas of food sovereignty and ecological sustainability. This research offers a novel perspective on the intersection of historical, cultural, and ecological factors in shaping food practices, contributing to the broader understanding of how food taboos function within indigenous communities to maintain resilience against modern challenges.

Introduction: This study aimed to determine the association of physical activity and self-efficacy in patients with coronary heart disease. Methods: A cross-sectional study was conducted among outpatients of coronary heart disease at a cardiovascular center. A total of 238 coronary heart disease patients were included in the study using a purposive sampling technique. The self-efficacy was measured using the cardiac self-efficacy scales (CSE), and the physical activity was measured using the long form International Physical Activity Questionnaire (IPAQ). Data analysis used the Chi-square test, Spearman correlation test and multivariate linear regression. Results: Self-efficacy was strongly positively correlated with physical activity in coronary heart disease patients (r = 0.956; p = 0.001). Domain-specific correlations included domestic (r=0.419, p

Background Since children are more likely than adults to become infected with Mycobacterium tuberculosis or suffer from tuberculosis (TB), it is important to identify the risk factors of TB in children with adult household TB contacts. Objective To identify the risk factors of TB in children with adult household TB contacts. Methods This cross-sectional study was conducted at the Pediatric Respirology Inpatient Ward and Outpatient Clinic at Dr. Soetomo Hospital, Surabaya, Indonesia, using medical records of hospitalized patients from 2010 to 2018. Patients were children below 18 years of age who had a history of adult TB household contact(s). We analyzed age at TB diagnosis, nutritional status, BCG vaccination status, and HIV status as possible risk factors of TB. Results A total of 367 children with adult household TB contacts were included in our study. Age of

Background: Up to 50% of pregnant women in low-income and middle-income countries are affected by anemia, and 30.43% of maternal deaths in Indonesia occur during the postpartum period. One of the predisposing factors for postpartum hemorrhage is anemia in pregnancy. Purpose: To investigate the experience of anemia during pregnancy and its influence on a postpartum hemorrhage. Method: This is an observational analysis with a case-control study design. A total of 30 postpartum mothers took part in this research (15 case groups and 15 control groups). The anemia during pregnancy and incident of postpartum hemorrhage observed—data analysis with chi-square. Results: As many as 76.5% of mothers who were anemic during pregnancy experienced postpartum hemorrhage. The analysis results found that anemia during pregnancy had a significant effect on the incidence of postpartum hemorrhage (p

Community Service held by FKIP-UT at SDN Sukamaju I Cianjur aims to increase students' knowledge about earthquake disaster mitigation. This activity requires media that is appropriate to the level of development of students. Researchers created earthquake disaster mitigation comics as an interesting information medium equipped with colorful illustrations, communicative dialogue and easy to understand for elementary school students. Data collection was carried out quantitatively and qualitatively. Qualitative data was taken from expert input including educational technology lecturers and BNPB staff. Comics are revised based on expert input. Quantitative data was obtained from the results of expert validation tests and a score of 91% was obtained from all aspects including material, media, and language design. Comics were tested during Community Service and were assessed by teachers and students at 92% from all aspects, namely material, media, and language design. This score shows that the comic is suitable for use in the very good category.

Abstract Ticks are blood-sucking ectoparasites that act as vectors for transmission of various pathogens. The purpose of this study was to assess tick-borne bacteria, whether pathogenic or not, in ticks distributed in Korea using 16S rRNA metabarcoding and to confirm the results by PCR. Questing ticks were collected from four provinces in Korea in 2021 using the flagging method. After pooling the DNAs from the 61 tick pools (including 372 ticks), the bacterial 16S rRNA V3–V4 hypervariable region was amplified and sequenced using the MiSeq platform. Rickettsia, Ehrlichia, and the endosymbiont Wolbachia were confirmed by conventional PCR and molecular analysis. In total, 6907 ticks (534 pools) were collected and identified as belonging to five species (Haemaphysalis spp., H. longicornis, H. flava, I. nipponensis, and A. testudinarium). Through 16S rRNA metabarcoding, 240 amplicon sequence variants were identified. The dominant taxa were Rickettsiella and Coxiella. Additionally, pathogenic bacteria such as Rickettsia and Ehrlichia, endosymbiotic bacteria such as Wolbachia and Spiroplasma were identified. Polymerase chain reaction (PCR) was performed to confirm the presence of Rickettsia, Ehrlichia, Bartonella, and Wolbachia in individual ticks. Overall, 352 (65.92%) of 534 pools tested positive for at least one of the screened tick-borne bacteria. Rickettsia was the most prevalent (61.42%), followed by Wolbachia (5.05%). Ehrlichia was detected in 4.86% of tested samples, whereas Bartonella was not detected. In this study, 16S rRNA metabarcoding revealed the presence of Rickettsia, Wolbachia, and Ehrlichia, in that order of abundance, while showing absence of Bartonella. These results were confirmed to exhibit the same trend as that of the conventional PCR. Therefore, large-scale screening studies based on pooling, as applied in this study, will be useful for examining novel or rare pathogens present in various hosts and vectors.

This article analyzes oppression of black women in Octavia E Butler’s novel entitled Kindred. The primary source is the novel Kindred by Octavia Butler while the secondary sources used are books and articles.The aim of this research to identify the oppression experienced by the black women represented by the black female characters in Kindred. In revealing the issue of oppression of the black women, the writers refer to Black Feminism Theory proposed by Patricia Hill Collins . The result of the study shows that the black women experience the regulation of black women’s bodies as the form of oppression. In this sense, black women face physical violence that leads to psychological violence. Furthermore, the other body regulation is rape.The study also shows that both white men and white women can be the perpetrators of the oppression towards black women.

Copyright infringement on e-commerce platforms is a growing concern, especially with the unauthorized use of individuals' photos for commercial purposes. Eliska's case highlights the negative consequences of uploading product photos without permission, violating the moral and economic rights of the original owners. Indonesia's Copyright Law No. 28 of 2014 imposes serious legal sanctions on such violations, holding individuals and e-commerce platforms like Tokopedia accountable for monitoring and enforcing copyright rules. This research uses normative legal methods to analyze regulations, licensing, and copyright protection related to photography and portraits in e-commerce, focusing on Tokopedia. A descriptive-analytical approach is employed to explain legal regulations concerning copyright in product sales on the platform, with data collected through theoretical literature review, legislative analysis, and online studies. Findings indicate that copyright infringement on e-commerce platforms significantly impacts original owners and the integrity of online commerce. Eliska's case shows how unauthorized photo use can lead to financial loss and reputation damage. Law No. 28 of 2014 provides for criminal sanctions and fines for such violations, while e-commerce platforms must ensure compliance with copyright regulations. Legal certainty and collaboration between copyright owners and platforms are essential for a safe and fair online trading environment.

The conversion of fatty acids into bio-hydrocarbons can be carried out through a deoxygenation (DO) reaction. Catalytic deoxygenation of fatty acids can occur through three reaction pathways: decarbonylation, decarboxylation, and hydrodeoxygenation. In this study, three kinds of silica were prepared: (i) silica obtained from the rice husk ash (RHA); (ii) synthetic mesoporous silica SBA-16; and (iii) commercial silica. All prepared silica was used as supported nickel (Ni) catalyst for bio-hydrocarbon production through DO reaction of oleic acid. The objective of this study was to investigate the effect of variations of silica on the reaction pathway and final products composition of DO reaction of oleic acid. The catalysts were characterized by X-ray fluorescence (XRF), X-ray diffraction (XRD), surface area analysis, and NH3-temperature-programme desorption. Based on XRF and XRD analysis results, it can be concluded that nickel was successfully impregnated into all silica. All samples of catalysts were used in a reaction carried out at temperature of 285 °C under a pressure of 40 bar H2 for 2h. The results showed that all catalysts were able to convert oleic acid to bio-hydrocarbon with differences in products composition. The highest oleic acid conversion of 98.25% was achieved with Ni/RHA catalyst but the obtained liquid products was the lowest among other catalysts. It is found that this phenomenon was closely related to the acidity properties of the catalyst.

Health services in the health professions can be used as business opportunities, building a culture of entrepreneurship and expanding professional roles into entrepreneurial health workers. Independent nursing practice is the practice of individual or group nurses in independent practice settings outside of health care facilities. Independent practice is a form of nursing that aims to standardise care for clients who need assistance because of ignorance, inability or unwillingness to meet their basic needs and care for themselves. Through the implementation of independent practice, nurses carry out their roles and functions in accordance with their authority. The purpose of this systematic review is to describe the opportunities and challenges of independent nursing practice. Methods: The research design used PRISMA systematic review. Journals were obtained from ProQuest and Google Scholar 2019-2023 database searches, full text, open access. Results: Based on the collected journals, independent nursing practice is a form of building an entrepreneurial culture and expanding professional roles to become entrepreneurial health workers. The motivation of nurses in independent practice is to improve the welfare of nurses, which can increase motivation. Nurses in independent practice face challenges because they are limited by the authority, responsibility and accountability that must be carried out in order to provide professional care.

Coronavirus Disease 2019 (COVID-19) is a novel disease previously unidentified in humans. The COVID-19 pandemic has necessitated that all medical personnel and health workers wear personal protective equipment (PPE) while serving patients. The pandemic has caused a global shortage of PPE, especially in Indonesia, leading to the closure of many health service facilities, including several in the Kuranji District, to prevent COVID-19 transmission. In response, the community service team of the Faculty of Medicine, Andalas University (FK UNAND), initiated a PPE procurement project for health workers. This activity aimed to supply PPE to medical personnel at the First Level Health Facility (FLHF) in Kuranji District, Padang City. The PPE, including masks, face shields, and gowns/hazmats, was produced following a feasibility study to ensure safety for health workers. The procurement involved collaboration between the FK UNAND community service team and Micro, Small, and Medium Enterprises (MSMEs). The team designed models of masks, face shields, and gowns/hazmats that met health safety standards, sourced the necessary materials, and passed these designs and materials to MSMEs for production. Prior to production, a meeting with MSMEs was held to discuss the designs. Eight MSMEs were selected to produce the PPE over approximately one month. A total of 400 masks, 180 face shields, and 20 gowns were produced and distributed to 8 FLHFs in Kuranji sub-district. The handover of PPE was met with an extraordinary response from health workers, as it significantly addressed the PPE shortage and allowed FLHFs in Kuranji District to resume operations and provide medical services to the community.

Abstract Most of essential thrombocythemia (ET) patients have the clone harboring a mutation in one of the JAK2, CALR, or MPL gene, and these clones generally acquire additional mutations at transformation to acute myeloid leukemia (AML). However, the proliferation of triple-negative clones has sometimes been observed at AML transformation. To clarify the clonal evolution of ET to AML, we analyzed paired samples at ET and AML transformation in eight patients. We identified that JAK2-unmutated AML clones proliferated at AML transformation in three patients in whom the JAK2-mutated clone was dominant at ET. In two patients, TET2-mutated, but not JAK2-mutated, clones might be common initiating clones for ET and transformed AML. In a patient with JAK2-mutated ET, SMARCC2, UBR4, and ZNF143, but not JAK2, -mutated clones proliferated at AML transformation. Precise analysis using single-cell sorted CD34+/CD38- fractions suggested that ET clone with JAK2-mutated and AML clone with TP53 mutation was derived from the common clone with these mutations. Although further study is required to clarify the biological significance of SMARCC2, UBR4, and ZNF143 mutations during disease progression of ET and AML transformation, the present results demonstrate the possibility of a common initial clone involved in both ET and transformed AML.

Abstract Background This study aimed to examine whether online interactive communication education using video materials was as effective as face-to-face education among healthcare college students. Methods The participants were healthcare college students who were enrolled in study programs to obtain national medical licenses. They participated in lectures and exercises on healthcare communication, both online (n = 139) and face-to-face (n = 132). Listening skills, understanding, and confidence in healthcare communication were assessed using a self-assessed tool. Results From the two-way ANOVA result, the interaction effects between group (online, face-to-face) and time (Time 1, Time 2, Time 3) were not statistically significant. The main effect of time increased significantly from Time1 to Time 3 on understanding of communication with patients (Hedges’g = 0.51, 95%CI 0.27–0.75), confidence in communication with patients (g = 0.40, 95%CI 0.16–0.64), and confidence in clinical practice (g = 0.49, 95%CI 0.25, 0.73), while the score of listening skills had no significant change (Hedges’g = 0.09, 95%CI − 0.03 to 0.45). Conclusions The results show that online communication education with video materials and active exercises is as effective in improving students’ confidence as face-to-face. It will be necessary to modify the content of this educational program to improve skills as well as confidence in communication. Trial registration Not Applicable.

Bromo Tengger Semeru National Park (BTS-NP) in East Java, Indonesia showcases a breathtaking volcanic landscape and cultural allure, drawing hundreds of thousands of domestic and international visitors. Recreational activities involving human and animal trampling and motorized-vehicle traffic caused soil disturbance along their networks of paths, trails, or roads, potentially having a detrimental long-term effect on the tourism industry and environmental services provided by the national parks. However, the extent of the impact of these disturbances on soil properties remains unclear. This study assessed the impact of different disturbance intensities, consisting of undisturbed locations as a control (zone 1), low to medium- (zone 2), and high- (zone 3) disturbance intensities on five different BTS-NP tourism hotspots, including Entrance Wonokitri (EW), Whispering Sand (WS), Parking Temple (PT), Teletubbies Hill (TH), and Entrance Bromo Stairs (EB), on soil properties, including soil compaction represented by soil penetration resistance, and soil infiltration. This study revealed that the higher severity impact of recreational activities on soil compaction was parallel with higher disturbance intensity, particularly in EW and TH. In these particular locations, higher soil compaction is significantly linked to lower soil infiltration, thus needing extra attention and protection. Meanwhile, in WS, PT, and EB, soil infiltration was more controlled by the establishment of a cemented topsoil layer consisting of mixed sand, sulfur, and water. Better management strategies, such as the use of proper trails and road infrastructures, particularly on EW and TH, might be relevant to minimize the impact of recreational activities on these ecologically, economically, and culturally important areas.

Agroforestry systems have significant potential for development in increasing coffee production in Indonesia. Besides providing economic benefits, agroforestry can also have ecological impacts, such as improving soil structure, reducing erosion, and other environmental services. There is a complex interaction between trees, soil, and crops in agroforestry systems, making modeling a valuable approach to unraveling these processes. We utilized the spatial and temporal explicit model WaNuLCAS to (i) evaluate the model's performance in depicting actual events (through coffee production and soil water content), (ii) assess the dynamic processes influencing coffee production and the environmental impact of management patterns, (iii) formulate and simulate optimal scenarios for coffee production optimization. Data from a one-year period involving five agroforestry management patterns for coffee-pine in UB Forest were used as input for the model. The model validation results showed satisfactory and acceptable outcomes for coffee production and groundwater dynamics. WaNuLCAS simulation results indicated that pruning and thinning management are crucial factors in increasing coffee production and are related to creating optimal conditions for coffee plants (light, humidity, and inter-plant competition). Additionally, fertilization management can be combined as a supporting factor to meet the nutritional needs of coffee plants. WaNuLCAS simulation results also suggested that pruning and thinning can improve soil physical properties, but thinning increases surface runoff within the system. This research provides insights into how modeling can be used as a decision-making tool.

BackgroundStudies have shown that tumor cell amino acid metabolism is closely associated with lung adenocarcinoma (LUAD) development and progression. However, the comprehensive multi-omics features and clinical impact of the expression of genes associated with amino acid metabolism in the LUAD tumor microenvironment (TME) are yet to be fully understood.MethodsLUAD patients from The Cancer Genome Atlas (TCGA) database were enrolled in the training cohort. Using least absolute shrinkage and selection operator Cox regression analysis, we developed PTAAMG-Sig, a signature based on the expression of tumor-specific amino acid metabolism genes associated with overall survival (OS) prognosis. We evaluated its predictive performance for OS and thoroughly explored the effects of the PTAAMG-Sig risk score on the TME. The risk score was validated in two Gene Expression Omnibus (GEO) cohorts and further investigated against an original cohort of chemotherapy combined with immune checkpoint inhibitors (ICIs). Somatic mutation, chemotherapy response, immunotherapy response, gene set variation, gene set enrichment, immune infiltration, and plasma-free amino acids (PFAAs) profile analyses were performed to identify the underlying multi-omics features.ResultsTCGA datasets based PTAAMG-Sig model consisting of nine genes, KYNU, PSPH, PPAT, MIF, GCLC, ACAD8, TYRP1, ALDH2, and HDC, could effectively stratify the OS in LUAD patients. The two other GEO-independent datasets validated the robust predictive power of PTAAMG-Sig. Our differential analysis of somatic mutations in the high- and low-risk groups in TCGA cohort showed that the TP53 mutation rate was significantly higher in the high-risk group and negatively correlated with OS. Prediction from transcriptome data raised the possibility that PTAAMG-Sig could predict the response to chemotherapy and ICIs therapy. Our immunotherapy cohort confirmed the predictive ability of PTAAMG-Sig in the clinical response to ICIs therapy, which correlated with the infiltration of immune cells (e.g., T lymphocytes and nature killer cells). Corresponding to the concentrations of PFAAs, we discovered that the high PTAAMG-Sig risk score patients showed a significantly lower concentration of plasma-free α-aminobutyric acid.ConclusionIn patients with LUAD, the PTAAMG-Sig effectively predicted OS, drug sensitivity, and immunotherapy outcomes. These findings are expected to provide new targets and strategies for personalized treatment of LUAD patients.

Salt production in Indonesia primarily concentrates on the North Coast of Java and Madura Island, necessitating substantial salt imports despite the country’s extensive coastline. However, the deteriorating ecosystem on the North Coast impedes the expansion of salt ponds. Conversely, the South Coast of Malang Regency offers a cleaner environment yet still needs to be tapped for salt production due to topographical constraints. This study assesses the South Coast’s potential for salt production and underscores the crucial role of technological innovations in this process. Potential locations are analysed using the Salt Suitability Index method, identifying viable sites meeting salt production criteria. The study recommends adopting the continuous dynamic mixing production method, facilitated by the Greenhouse Salt Tunnel construction, to enable salt production in this region. This innovative approach, with its potential to significantly enhance Indonesia’s salt output and provide additional livelihood opportunities, underscores the urgent need for action in salt production.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated disease that mainly affects the peripheral nerves and nerve roots and typically presents with distal dominant motor and sensory disturbances as clinical symptoms. Central nervous system (CNS) demyelination with inflammation occurs infrequently in patients with CIDP. Here, we present a unique autopsy report of CIDP causing severe demyelination along the entire spinal cord. A Japanese woman exhibited progressive muscle weakness, muscle atrophy, sensory disturbances, and tremors in her upper and lower extremities, which began in her 60s. A nerve conduction study revealed a marked prolongation of distal latencies and very low or no compound muscle action potential amplitudes, and cerebrospinal fluid protein levels were prominently elevated. Following the diagnosis of CIDP, a combination of methylprednisolone pulse therapy, high-dose intravenous immunoglobulin therapy, and plasma exchange mildly improved her symptoms. The patient died of septic shock at the age of 74 years. Neuropathological examination revealed demyelinating lesions with inflammation in the peripheral regions of the anterior, lateral, and posterior funiculi along the entire spinal cord (from the cervical to the sacral cord), and axons and neurons were well preserved in these lesions. The nerve roots in the cervical and lumbar plexuses, cauda equina, sciatic nerve, and sural nerve showed prominent swelling and edema with infiltration of inflammatory cells. Many onion bulbs were visible in the fascicles of the sciatic and sural nerves. Our results suggest that demyelination with inflammation can occur in the CNS and peripheral nervous system in CIDP, especially in patients with specific conditions, such as severe intrathecal inflammation.

Penelitian ini bertujuan untuk menganalisis pengembangan produk berupa Lembar Kerja Peserta Didik berorientasi Keterampilan Proses Sains materi keanekaragaman hayati sub materi klasifikasi makhluk hidup pada peserta didik SMA kelas X yang valid dan praktis serta dapat digunakan dalam kegiatan pembelajaran. Jenis penelitian ini merupakan penelitian pengembangan dengan model pengembangan ADDIE yang terbatas dengan tahapan Analyze, Design, dan Development. Penelitian ini dilaksanakan pada semester ganjil tahun ajaran 2023/2024 di kelas X SMA Gajah Mada 3 Palembang. Penelitian ini dilakukan pada uji coba kelompok kecil dengan subjek penelitian sebanyak 12 peserta didik pada kelas X. Indikator KPS yang dipilih adalah mengelompokan/klasifikasi, menafsirkan/interpretasi, berkomunikasi dan mengamati/observasi. Hasil persentase dari tiap indicator KPS adalah 91,6%; 89,5%; 85,4%; dan 83,3%.

Background: To evaluate the effect of the type and codetection of respiratory viruses on admission requirements among children with respiratory infections in the post-COVID-19 pandemic era. Methods: In this retrospective study, we analyzed patients with acute respiratory symptoms using FilmArray® Respiratory Panel between December 2020 and March 2024. The viruses were classified into eight groups: adenovirus, seasonal coronavirus, human metapneumovirus, human rhinovirus/enterovirus, influenza virus, parainfluenza virus, respiratory syncytial virus, and severe acute respiratory virus coronavirus-2. The impact of the detected viral groups and viral codetection on hospitalization rates were examined using multivariable regression analysis in three pediatric age groups (

This study aims to examine the direct and indirect effects of greenwashing on negative green word of mouth, with green skepticism as a mediator, in the fast fashion industry in Indonesia. This study is quantitative in nature, with data being collected using a survey. The non-probability, purposive sampling method was employed with criteria including respondents being of Generation Z, currently aged 17 to 28 years, and aware of fast fashion companies. A total sample size of 397 was utilized, and analysis was conducted using partial least squares structural equation modeling. The results suggested that greenwashing significantly positively affects green skepticism and negative green word of mouth. Green skepticism has a significant positive effect on negative green word of mouth. Furthermore, green skepticism mediates the effect of greenwashing on green word of mouth. To the authors’ knowledge, this study extends the literature that discusses the effect of greenwashing on negative green word of mouth through green skepticism. This research provides a new perspective, especially on the stimulus-organism-response theory seen from negative antecedents, which is rarely discussed in developing countries. This research will provide useful information for companies to avoid greenwashing practices in promoting sustainability. For the government, issuing consumer protection laws regarding greenwashing rules is suggested. This study has several limitations, including that it was only conducted in Indonesia. Therefore, future research can be developed involving other countries for comparison.

ABSTRACTThe current solutions offered by Western sustainability science to address prevailing global environmental destruction and social injustice are still largely embedded in the Western knowledge system established by colonisation, limiting the efficacy of these solutions for a large part of the planet. Conversely, it may be reasonable to imagine that the concept of relationality is beneficial in all cultures and knowledge systems. Relationality, elementally referring to a web of relationships, as considered from an African Indigenous and local knowledge perspective, could play an important role in decolonising Western sustainability science. Two valuable approaches, namely ubuntu (humanness) and ukama (relatedness), as predominantly observed in southern Africa, are essentially immersed in human-nature relationality. This type of relationality considers everything as interconnected, and therefore that nothing happens in isolation, and that the well-being of humans is inextricable from the well-being of nature. The way relationality is approached in African Indigenous knowledge systems is inclusive, holistic and perpetual, broadening its usefulness to a large audience, making it a sensible contributor to decoloniality in sustainability science. A collective knowledge could emerge, including cooperative, multidirectional interactions with different types of information from diverse human and non-human sources, increasingly eradicating the relational divide among knowledge systems caused by persistent colonial discourse and attitudes.

Penentuan rute objek wisata di Pekanbaru tidak hanya bergantung pada penentuan rute terpendek, tetapi juga pada rute terbaik, mengingat adanya berbagai kendala di lapangan, seperti jalan berlubang, kemacetan, dan kurangnya penunjuk arah menuju destinasi wisata. Pemilihan rute terbaik menjadi sangat penting untuk meningkatkan kenyamanan dan efisiensi perjalanan wisatawan, mengurangi waktu tempuh, serta menghindari potensi risiko yang dapat mengganggu pengalaman wisata. Oleh karena itu, penelitian ini bertujuan untuk menentukan rute terbaik menuju objek wisata menggunakan metode Ant Colony Optimization (ACO) dan melakukan perangkingan rute wisata dengan metode Analytic Hierarchy Process (AHP). Penelitian ini memadukan dua pendekatan, yakni ACO, yang meniru perilaku koloni semut dalam mencari rute optimal, dan AHP, yang menghasilkan skor numerik untuk menentukan peringkat alternatif berdasarkan seberapa baik masing-masing alternatif memenuhi kriteria pembuat keputusan. Hasil penelitian ini diharapkan membantu wisatawan untuk menemukan fasilitas yang tersedia di objek wisata serta menyediakan rute alternatif yang dapat dijadikan acuan dalam menentukan rute terbaik menuju lokasi wisata, sehingga dapat meningkatkan kepuasan wisatawan dan kualitas pengalaman perjalanan.

Tailing from mining activities affects soil fertility resulting in poor soil conditions that are challenging for plants to grow. Plants can interact with rhizosphere bacteria to enhance their growth in harsh environments. Rhizospheric bacteria possess numerous mechanisms that promote plant growth and induced resistance to various abiotic stress. This study aims to determine the diversity of rhizobacteria and their potential as plant growth-promoting rhizobacteria (PGPR) agents. Bacterial communities from rhizosphere soil samples from kaolin mining sites in Perawas, Tanjung Pandan district, Belitung Regency, Bangka Belitung Island, Indonesia were analyzed using Next Generation Sequencing based on the V3-V4 region of the 16S rRNA gene, while culturable bacteria were isolated from samples and screened for PGP activity. The results showed that the rhizosphere bacterial community was mostly dominated by Pseudomonadota, Acidobacteria, and Verrumicrobiota. There were 15 bacteria isolated from the sample and RKB-5 bacterial isolate had the potential to be PGP agent. The RKB-5 bacterial isolate was identified as Burkholderia cenocepacia based on its 16S rRNA sequence. The bacterial isolate produced IAA, utilized ACC, dissolved phosphate up to 209,5 mg/L, and formed a high potassium solubilizer index value of 5.00. Therefore, the B. cenocepacia RKB-5 has potential application as the PGPR to support plants growth by obtaining nutrients in ex-mining lands with poor soil conditions.

Background Gastric cancer (GC) is one of the most common and deadly malignant diseases worldwide. Despite revolutionary advances, the therapeutic efficacy of anti-PD1/PDL1 monoclonal antibodies in advanced GC is still low due to the emergence of innate and acquired resistance to treatment. Myeloid cells represent the majority of human immune cells. Therefore, their increase, decrease, and abnormality could have a significant impact on the patient’s immune system and the progression of cancer, and reprogramming, inhibiting, and eliminating the tumor-supportive types may improve the immunological situation and efficacy of immunotherapy. However, the significance of myeloid cells in anti-PD1/PDL1 therapy remains unclear in GC. In the WJOG10417GTR study on GC, we sought to identify myeloid determinants that could predict anti-PD1 therapeutic efficacy and also serve as potential therapeutic targets.Methods We collected tumor tissues and peripheral blood from 96 patients with advanced GC before and 1 month after anti-PD1 nivolumab monotherapy, and the isolated whole leucocytes were analyzed by flow cytometry for various immune cell populations, including many myeloid subsets. Then, the relationship between the cellular levels and progression-free survival (PFS) or overall survival (OS) was statistically analyzed.Results We found that high levels of several myeloid subsets expressing molecules that have been targeted in drug discovery but not yet approved for clinical use were significantly associated with shorter PFS/OS as compared with low levels: PDL1+ and CTLA4+ myeloid subsets within tumors at baseline, PDL1+, B7H3+ and CD115+ myeloid subsets in peripheral blood at baseline, and LAG3+, CD155+ and CD115+ myeloid subsets in peripheral blood at post-treatment.Conclusions This study revealed that these myeloid subsets are significant risk factors in nivolumab therapy for advanced GC. Targeting them may be useful as diagnostic biomarkers to predict potential anti-PD1 therapeutic efficacy, and also as therapeutic targets for accelerating the development of new drugs to improve clinical outcomes in immunotherapy for GC.

Beiji nairovirus (BJNV), in the family Nairoviridae, the order Bunyavirales, was recently reported as a causative agent of an emerging tick-borne zoonotic infection in China. This study investigated the prevalence of BJNV in ticks in Japan. Screening of over 2,000 ticks from multiple regions revealed a widespread distribution of BJNV and BJNV-related viruses in Japan, particularly in the northern island, and in other high altitude areas with exclusive occurrence of Ixodes ticks. Phylogenetic analysis identified three distinct groups of nairoviruses in ticks in Japan: BJNV, Yichun nairovirus (YCNV) and a newly identified Mikuni nairovirus (MKNV). BJNV and YCNV variants identified in ticks in Japan exhibited high nucleotide sequence identities to those in China and Russia with evidence of non-monophyletic evolution among BJNVs, suggesting multiple cross-border transmission events of BJNV between the Eurasian continent and Japan. Whole genome sequencing of BJNV and MKNV revealed a unique GA-rich region in the S segment, the significance of which remains to be determined. In conclusion, the present study has shown a wide distribution and diversity of BJNV-related nairoviruses in Ixodes ticks in Japan and has identified unique genomic structures. The findings demonstrate the significance of BJNV as well as related viruses in Japan and highlight the necessity of monitoring emerging nairovirus infections and their potential risks to public health.

Purpose – Science learning often struggles to boost student engagement and understanding. Educational games offer an innovative approach, but they often overlook local cultural contexts, reducing their relevance for students. This study examines the views of science educators on the use of Edu Game Adventure based on Minangkabau culture in science learning. Method – This study uses a mixed-method approach with questionnaires distributed to 50 science teachers and lecturers in West Sumatra. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative analysis focused on open-ended responses. The purposive sampling ensures diverse perspectives on the integration of local cultures in science learning, providing a deeper understanding of practitioners' views across different educational levels and experiences. Findings – The results indicate that most practitioners view the integration of Minangkabau culture in educational games positively. 80% believe it boosts student interest in science, 75% say it promotes cultural diversity and local values, 65% feel it encourages active involvement, and 70% think it broadens perspectives on cultural diversity. These findings suggest that integrating Minangkabau culture enhances student engagement and understanding, providing valuable insights for designing culturally relevant learning tools. Research Implications – The study's results offer practical guidance for curriculum developers and educators to integrate local culture into engaging, meaningful learning designs, highlighting the importance of culturally relevant content to enhance teaching effectiveness.

Background: Parry-Romberg Syndrome (PRS), characterized by progressive hemifacial atrophy, presents unique challenges in oral health management due to its rare nature and varied clinical manifestations. While cutaneous and craniofacial features are well-documented, gingival involvement is less commonly recognized. Case Presentation: We present a case of gingival manifestation of PRS in a 26-year-old female, emphasizing the progressive nature of the condition and its impact on oral health. Clinical examination revealed significant gingival recession on the affected side, leading to tooth sensitivity and compromised periodontal health. Diagnosis: The diagnosis of PRS was established based on characteristic facial asymmetry, radiographic findings, and absence of systemic involvement. Gingival recession was confirmed through periodontal assessment. Management: Management strategies included symptomatic relief with desensitizing toothpaste, preservation of periodontal health through oral hygiene instructions and periodontal therapy, and supportive care tailored to the patient's needs. Multidisciplinary collaboration was essential to optimize patient care and address the complex clinical manifestations of PRS. Outcome: While complete resolution of gingival recession was not achieved due to the progressive nature of PRS, symptomatic relief and preservation of periodontal health were achieved through comprehensive management strategies. Long-term follow-up is essential to monitor disease progression and adjust treatment as needed. Conclusion: Gingival involvement in PRS underscores the importance of a multidisciplinary approach to oral health management. Recognition of gingival manifestations and implementation of individualized treatment plans are crucial for optimizing oral health outcomes and enhancing the quality of life for affected individuals. Update Dent. Coll. j: 2024; 14(2): 27-30

IntroductionThe Mishima Islands in Kagoshima Prefecture, Japan, are remote islands designated as medically underserved. Supporting the people living in such remote islands requires a multifaceted examination of the livelihoods of the residents, including their health, work, and living environment.MethodsStudents from the faculties of nursing, veterinary science, agriculture, and engineering participated in a 3-day virtual fieldwork session held synchronously from the campus of Kagoshima University and on a remote island in the Mishima Mura island group in Kagoshima Prefecture, Japan. Coursework and post-course surveys were analyzed to determine student engagement and learning. In particular, the analysis considered learning in relation to interprofessional learning and community-based learning.Results and discussionStudents expressed being able to conduct fieldwork online, collaborate with students from multiple faculties and graduate schools, and apply their expertise. These outcomes were reflected in the five-point Likert scale evaluation responses, highlighting a sense of accomplishment and satisfaction. Virtual fieldwork can contribute to student learning by introducing new concepts and allowing them to consider development issues in remote areas from multiple perspectives.

Depression and anxiety represent significant global health concerns, with a particularly high prevalence observed in economically disadvantaged developing countries. The availability of reliable and culturally relevant assessment instruments is crucial for the effective diagnosis and intervention of mental health issues, particularly among adolescents. The objective of this study was to adapt the Depression Anxiety Stress Scales for Youth (DASS-Y) into an Indonesian version (IDASS-Y) and to evaluate its psychometric properties among Indonesian adolescents. A multicenter cross-sectional study was conducted in West Sumatra Province and Yogyakarta Province, Indonesia. The study entailed a cross-cultural adaptation of the DASS-Y into the IDASS-Y through a five-step process and a psychometric evaluation. The study sample consisted of 255 adolescents between the ages of 16 and 18, recruited from two public senior high schools. The psychometric assessment comprised content validity testing, construct validity testing through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and reliability testing. The IDASS-Y has demonstrated robust psychometric properties. The content validity was found to be high, with an overall S-CVI/Ave of 0.95. The EFA demonstrated a consistent three-factor structure corresponding to depression, anxiety, and stress, with no alterations to the item dimensions. The CFA results yielded a good model fit, as indicated by the following values: χ2/df ratio = 2.553; RMSEA = 0.022; CFI = 1.000; SRMR = 0.083. The internal consistency of the scale was satisfactory, with Cronbach's alpha coefficients of 0.897 for depression, 0.893 for anxiety, and 0.884 for stress, and an overall alpha of 0.948. Additionally, McDonald's omega coefficients were notably high, at 0.897 for depression, 0.894 for anxiety, and 0.874 for stress, with an overall omega of 0.949. The Indonesian version of the Depression Anxiety Stress Scales for Youth (IDASS-Y) is a valid and reliable instrument for assessing depression, anxiety, and stress among Indonesian adolescents. It retains the original conceptual framework of the DASS-Y and demonstrates strong psychometric properties, making it suitable for both research and clinical use.