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This research investigated the best economically viable power source with the least environmental impact and socially acceptable for the maize crop. Maize is one of the key economic crops in Pakistan. Solar-, electric-, and diesel-powered drip irrigation systems (DIS) were considered for comparative study. We selected 45 sites of maize crop to collect the data, with an area of 1–3 ha, from three divisions. For economic viability, the benefit:cost ratio, life cycle cost, and payback period were calculated, and CO2 emissions were calculated to assess the environmental impact. The SPSS model was used for one-way ANOVA followed by post hoc and chi-squared tests to check the significance level between all power sources. It was found that the B-C of electric power, solar, and diesel drip irrigation systems was 1.65, 1.52, and 1.44, respectively. Solar, diesel, and electricity power DIS have CO2 emissions of 0.02, 0.730, and 1.106 tons/ha, respectively. The research concludes that solar power and electric power are the best sources for the environment and economically, respectively. It is recommended that solar power DIS be subsidized, which will help to lower CO2 emissions and reduce the electricity shortfall in Pakistan. [ABSTRACT FROM AUTHOR]

Contribution of mechanical inputs in farming is considered in terms of farm mechanization. Farm mechanization has helped in increasing the cultivated area and yield of major crops like wheat, rice and maize to 0.4%, 10.4% and 27.3%, respectively, by bringing barren land under cultivation. To study the present status of farm mechanization in all the districts of Punjab using GIS, data of farm machines, sowing area and wheat crop production was collected from Census Organizations for 1994-95 to 2004-05. Graduated color maps and multivariate maps were used to analyze the spatial variation in farm mechanization in thirty four districts of Punjab upto year 2004. To analyze the combined effect of most common farm machines (tractors, disc plows, cultivators, tubewells and threshers) on cultivated area of wheat and its production, multivariate maps help by considering the sum attribute of these farm machines. According to maps generated; Central, Southern and Eastern Punjab have greater area under cultivation as compared to Northern Punjab except Attock and Mianwali and there is a great need of recommended farm machines which may help to increase the wheat production for the same area under cultivation. [ABSTRACT FROM AUTHOR]

Energy is a crucial factor and a capital of a country's resources leading indicator. World's energy focus is shifting towards alternate renewable, cheap and environment-friendly resources that can provide long-term sustainability for survival. Due to the fossil fuels depletion and their ever-growing cost, the need to shift focus towards renewable energy resources has increased a lot. To overcome the above-said problems, there is a need to look for a feasible and robust solution for thermal applications in remote areas. Biomass gasification proved to be one of the most efficient and clean waste-to-energy conversion processes in contrast to direct combustion of agricultural waste. Other than controlled burning of biomass, it can be subjected for different purposes like a thermal, synthesis of ethanol, engine running, and for fuel cell applications. An excessive amount of impurities like char, ash, tar, and particulate matter are making these syngas non-feasible for thermal or engine applications. To overcome the above-stated problem, a downdraft gasifier with cyclone separator and hybrid biomass filter was fabricated using locally available materials in the workshop of the Dept. of Farm Machinery and Power at the University of Agriculture, Faisalabad. Uniform distribution of 2.54-5.08 cm2 sizes of feedstock was used for gasification. Air was used as a gasifying agent. The reactor capacity was 0.19 m3. The values of performance parameters for wood waste and corncobs were recorded as fuel consumption rate (0.002195, 0.002323) kg-s-1, the volume of gas produced (24.56, 26.33) m3, operating time (5480, 5164) s, cleaning unit efficiency (81.79, 79.9) % and gas yield (2.04, 2.19) m³-kg-1. [ABSTRACT FROM AUTHOR]

Socio-economic activities along the Citarum River basin in Indonesia can induce ecological disturbances in the structure of the benthic macroinvertebrate community. This research aims to (1) identify the environmental factors responsible (2) describe the ecological disturbances using biological measurements; (3) and to develop local biocriteria using a multi-metric conceptual approach. An inventory of benthic macroinvertebrates was carried out at eight stations over a sampling period of 3 months, along with water quality monitoring. The results confirm the change in the structure of benthic macroinvertebrate communities, explained by seven environmental parameters: dissolved oxygen (DO), ambient habitat quality, turbidity, nutrient enrichment, conductivity, temperature, and embeddedness percentage. The changes were then assessed using six biological measurements. Only four have been shown to be capable as alternatives to existing biocriteria. Their implementation enabled the development of local biocriteria compatible with the multimetric concept known as the cumulative biotic index (CBI). [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI)-based technologies are actively used for purposes of cyber defense. With the passage of time and with decreasing complexity in implementing AI-based solutions, the usage of AI-based technologies for offensive purposes has begun to appear in the world. These attacks vary from tampering with medical images using adversarial machine learning for false identification of cancer to the generation of adversarial traffic signals for influencing the safety of autonomous vehicles. In this research, we investigated recent cyberattacks that utilize AI-based techniques and identified various mitigation strategies that are helpful in handling such attacks. Further, we identified existing methods and techniques that are used in executing AI-based cyberattacks and what probable future scenarios will be plausible to control such attacks by identifying existing trends in AI-based cyberattacks. [ABSTRACT FROM AUTHOR]

Objective: The assessment of quality of life has significant impact in device therapy. This research was aimed to translate and evaluate the validity and reliability of the Indonesian version of the AQUAREL questionnaire. Results: We evaluated 32 patients during the cross-cultural adaptation stage and 20 patients during validity and reliability evaluation stages. Indonesian version of AQUAREL showed positive correlation between 6-min walking test and dyspnea domain (r = 0.228; p = 0.048), and showed negative correlation between NT pro-BNP and chest discomfort (r = − 0.231; p = 0.043) and dyspnea domain (r = − 0.268; p = 0.020). The total AQUAREL also showed positive moderate correlation toward total SF-36 (r = 0.543; p = 0.000). The internal consistency was good (Cronbach α = 0.728) and the repeatability between day 1 and day 8 was good, with moderate positive correlation (r = 0.581; p = 0.007). [ABSTRACT FROM AUTHOR]

Abstract: Tillage systems affect soil properties, crop growth and nutrient uptake under various agro-ecological conditions. The uptake of water and nutrients are largely dependent on the root systems of wheat (Triticum aestivum L.) and rice (Oryza sativa L.). The application of manure has direct influence on the nutrient uptake by the crop plants. A 2year field experiment was conducted to evaluate the impact of tillage and farm manure on root growth by measuring the root length density on a sandy clay loam (Typic calciargid soil). Three tillage systems were used; (i) minimum tillage (MT), (ii) deep tillage (DT) and (iii) conventional tillage (CT). Three farm manure levels were used; (i) FM0 (only chemical fertilizers), (ii) FM15 (farm manure at 15Mgha−1) and (iii) FM30 (farm manure at 30Mgha−1). The incorporation of farm manure into soil markedly improved the root length density (RLD) of both wheat and rice crops. For wheat, the application of FM30 increased RLD by 16% and 9% in cases of deep tillage and minimum tillage, respectively. For rice, the increase in RLD at the same farm manure rate (FM30) was 13% and 17%, during first and second year, respectively. Averaged across tillage, the trend of RLD for both wheat and rice was DT>CT>MT. The incorporation of FM has increased the uptake of N, P and K significantly (P <0.05), thereby increasing the agronomic parameters. The manure may be used to ameliorate the deleterious effects of tillage for sustainable crop yield. [Copyright &y& Elsevier]

The Asia-Pacific Evaluation of Cardiovascular Therapies (ASPECT) collaboration was established to inform on percutaneous coronary intervention (PCI) in the Asia-Pacific Region. Our aims were to (i) determine the operational requirements to assemble an international individual patient dataset and validate the processes of governance, data quality and data security, and subsequently (ii) describe the characteristics and outcomes for ST-elevation myocardial infarction (STEMI) patients undergoing PCI in the ASPECT registry. Seven (7) ASPECT members were approached to provide a harmonised anonymised dataset from their local registry. Patient characteristics were summarised and associations between the characteristics and in-hospital outcomes for STEMI patients were analysed. Six (6) participating sites (86%) provided governance approvals for the collation of individual anonymised patient data from 2015 to 2017. Five (5) sites (83%) provided >90% of agreed data elements and 68% of the collated elements had <10% missingness. From the registry (n=12,620), 84% were male. The mean age was 59.2±12.3 years. The Malaysian cohort had a high prevalence of previous myocardial infarction (34%), almost twice that of any other sites (p<0.001). Adverse in-hospital outcomes were the lowest in Hong Kong whilst in-hospital mortality varied from 2.7% in Vietnam to 7.9% in Singapore. Governance approvals for the collation of individual patient anonymised data was achieved with a high level of data alignment. Secure data transfer process and repository were established. Patient characteristics and presentation varied significantly across the Asia-Pacific region with this likely to be a major predictor of variations in the clinical outcomes observed across the region. [ABSTRACT FROM AUTHOR]

Extreme events of precipitation can be guessed from best-fit probability distribution which is found through frequency analysis. The choice of best-fit probability distribution from several available distributions is a major problem. The goal of this research was the estimation of daily maximum precipitation using best-fitted probability distribution for observed data of 50 stations of the source region of Indus River from 1961 to 2015. Nine commonly used probability distributions were applied and methods of moments were used to find the parameters of applied distributions. Three goodness-of-fit tests were employed and the best-fitted probability model was selected whose sum of values from these goodness-of-fit tests was minimum. Generalized extreme value was selected as the best-fitted probability distribution on 54% of the rainfall stations, followed by log–Pearson type 3 (14% of the stations), Gamma (12% of the stations), Weibull type 3 (12% of the stations), Weibull (4% of the stations), log–normal (2% of the stations), and extreme value type 1 (2% of the stations). Then, using the best-fitted probability model at each of the rainfall station, daily maximum rainfall was estimated against different return periods. The models to minimize the threats of flooding and damages can be developed using the results of this study. [ABSTRACT FROM AUTHOR]

Beta thalassemia major (TM) is a common hereditary disease in Indonesia. Iron overload due to regular transfusion may induce myocardial iron deposition leading to electrophysiological dysfunction and functional disorders of the heart. Ventricular arrhythmia is one of the most common causes of sudden cardiac death in thalassemia patients. This cross-sectional study of 62 TM patients aged 10–32 years in Cipto Mangunkusumo General Hospital was done to assess their electrophysiological properties and heart rate variability, including 24- hour Holter monitoring, signal averaged electrocardiogram (SAECG) for detection of ventricular late potential (VLP), and determination of heart rate variability (HRV). We also assessed their 12-lead ECG parameters, such as P wave, QRS complex, QT/ QTc interval, QRS dispersion, and QT/ QTc dispersion. Iron overload was defined by T2-star magnetic resonance (MR-T2*) values of less than 20 ms or ferritin level greater than 2500 ng/mL. Subjects were grouped accordingly. There were significant differences of QTc dispersion (p = 0.026) and deceleration capacity (p = 0.007) between MR-T2* groups. Multivariate analysis showed an inverse correlation between QTc dispersion and MR-T2* values. There was a proportional correlation between heart rate deceleration capacity in the low MR-T2* group (p = 0.058) and the high ferritin group (p = 0.007). No VLPs were detectable in any patients. In conclusion, prolonged QTc dispersion and decreased heart rate deceleration capacity were significantly correlated with greater odds of iron overload among patients with Thalassemia major. [ABSTRACT FROM AUTHOR]

A light weight zone disc tiller drill was redesigned and developed employing Solid works and AutoCAD software's. For field performance evaluation of the machine, the experimental trials were conducted at Post Graduate Research Station, University of Agriculture, Faisalabad, Pakistan. An area of 2.5 ha (6.12 acres) was divided into two halves; one-half of the area was used for the conventional method of maize planting and the second half was used for maize planting by redeveloped zone disc tiller drill. It was observed that under the conventional method, extensive field preparation operations were performed, whereas no field preparation had been done for planting maize with a zone disc tiller drill. After harvesting the paddy crop, the zone disc tiller drill was passed through the standing stubble field and planted the maize seed in one pass. Crop planting results with zone disc tiller drill and conventional method under three levels of irrigation and three levels of fertilizer levels were compared for their impact on the crop parameters including emergence rate index, root length, root shoot ratio, shoot length, root fresh weight, root dry weight, shoot fresh weight, and shoot dry weight. All the data were statistically analyzed and found that the emergence rate index by using a zone disc tiller drill was 1.43 times greater than that under conventional maize planting. The emergence rate index at irrigation level I3 (after 4 days) was 1.23 times greater than that at I2 (after 6 days) and 1.40 times greater than that at I1 (after 8 days). The value of the emergence rate index at fertilizer level F3 (148.2 kg ha-1) was 1.61 times greater than that at F2 (123.3 kg ha-1) and 3.32 times greater than that at F1 (98.8 kg ha-1). Plant shoot dry weight by using a zone disc tiller drill was 1.68 times greater than that observed under the conventional maize planting method. It was concluded from the cost analysis that the cost of sowing maize with a zone disc tiller drill on an area of one hectare was less as compared to the conventional method (tillage + sowing). The proposed study showed that the newly designed machine could sow maize seed in rice stubble field within an acceptable cost, saves time, improve soil physical parameters, and crop parameters for better production of maize. [ABSTRACT FROM AUTHOR]

Textile dyes especially azo dyes are the prime pollutants in wastewater due to the presence of complex azo bond (-N=N-). Many conventional methods such as physicochemical, mechanical and biochemical were employed recently for removal of these organic pollutants. These methods have not been proved to be so efficient. Photocatalysis, a latest physio-chemical methods is employed currently. Present work investigated the synthesis of a Carbon Nano Tubes (CNT's) doped ZnO/Fe2O3 catalyst by microwave-assisted sol-gel method. Removal efficiency of the synthesized catalyst was observed through removal of two azo dyes direct orange-26 and acid red-151 for different concentrations. The prepared ternary nano-hybrid was characterized by X-ray diffractometry (XRD), scanning electron microscopy (SEM) and Energy Dispersive Spectroscopy (EDS). The average crystalline size of the catalyst was calculated as 8.47nm by using data from XRD analysis. SEM images revealed the formation of nano-flakes of catalyst. And results of EDS investigation publicized that the distribution of all the atoms of Zn, Fe, O and C is homogeneous throughout the catalyst. Percentage removal by synthesized catalyst for direct orange-26 and acid red-151 was determined as 58.8% and 72.7% respectively without adding oxidant. After adding oxidant the percentage removal increases to 70.6% for direct orange-26 and 85.2% for acid red-151. The effect of pH, time and oxidant dose were optimized by developing relationships between these variables using central composite design (CCD) in response surface methodology (RSM). The results of RSM analysis show prepared catalyst performs best in acidic conditions at pH of 3 and irradiation time of 2.7 hours for acid red-151 and at pH of 5 and irradiation time of 3.8 hours for direct orange-26. [ABSTRACT FROM AUTHOR]

The rapid increase in population growth due to industrialization and urbanization has resulted in air quality deterioration in Pakistan. Consequently, a considerable increase has been seen in the types of sources of air pollutants. However, the air quality of the country has deteriorated in the absence of management capabilities against air quality. Evidence from numerous governmental organizations and international bodies has specified that the environment, health, and quality of life are at high risk due to air pollution. Although the government of Pakistan established the Pakistan Clean Air Program, along with continuous monitoring stations to manage the quality of ambient air, air quality values have not yet been achieved. The present investigations were made in the city of Faisalabad in selected locations. Sampling of a 24 h average was done for selected sites. The air quality parameters such as NO2, SO2, COx, O2, noise level, and suspended particulate matter (SPM) were measured at two locations, i.e., Khurrianwala and Liaqatabad in the Faisalabad District. The measured values of air quality parameters were compared with national environmental quality standards (NEQS). Air pollutants such as SPM, SO2, and noise levels were found to be significantly higher than the 24-h standards of NEQS, which poses harmful effects on the quality of air and health, whereas the O2 concentration was found to be lower than the normal values, and NO2 and COx values were normal. The SO2, CO2, noise level, SPM, and O2 values ranged from 418–652 and 423–661 µg/m3, 3.03–3.44 and 3.08–3.51 mg/m3, 68–73 and 69–75 dB, 555–667 and 581–682 µg/m3, and 19.5–20 and 19.5–20.3 % for summer and winter season, respectively, as compared to standard values (150 µg/m3, 10 mg/m3, 65 dB, 550 µg/m3 and 21%). After the complete analysis of the selected locations, it was concluded that the ambient air quality of this area is severely degraded due to industrial as well as other commercial activities. These significant variations in air quality parameters suggest that there is a need to check the air quality regularly to take appropriate measures for reducing ambient air pollutants, especially in industrial areas as well as commercial areas. [ABSTRACT FROM AUTHOR]

Background and Objectives : Preeclampsia has been linked to an inflammatory response that may be brought on by endothelial cell dysfunction. This paper investigates the pathomechanism of syncytiotrophoblast basement membrane (STBM) damage and Placental Protein 13 (PP13) release, which may have a role in systemic endothelial dysfunction in preeclampsia. Materials and Methods : This comparative cross-sectional study involves 54 preeclampsia patients (27 early-onset preeclampsia and 27 late-onset preeclampsia) and 27 pregnant women with normal blood pressure. An enzyme-linked immunosorbent assay was performed to evaluate maternal blood levels of PP13. Following birth, a portion of the placenta was collected for transmission electron microscope (TEM) and immunohistochemical (IHC) analysis. The data were analyzed using STATA version 15. Results : PP13 expression in the placental syncytiotrophoblast was significantly lower in the early-onset preeclampsia, compared to late-onset preeclampsia and normotensive pregnancy, group ( p < 0.001). In contrast, serum PP13 levels were found to be the highest in the early-onset preeclampsia group, although no significant difference were found in mean maternal serum levels of PP13 between the three groups. The decreased PP13 expression in placental syncytiotrophoblast can be attributed to the greater extent of damage in the STBM in early-onset preeclampsia that leads to the release of a larger amount of PP13 into maternal circulation. The hypothesis aligns with the TEM analysis results. Preeclamptic pregnancies showed placental syncytiotrophoblast aponeurosis, whereas normotensive pregnancies did not. Placental lesions and STBM shedding were found to be more pronounced in early-onset preeclampsia compared to late-onset preeclampsia. Conclusions : PP13 and STBM damage may play a role in systemic endothelial dysfunction in preeclampsia.

Background: Atherosclerosis is a progressive disease characterized by the build-up of lipids and connective tissue in the large arteries. Some patients experience chronic total occlusion (CTO). Inflammation plays a key role in the development and complications of atherosclerosis. Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation associated with the development of acute coronary syndrome (ACS). We aimed to assess the relationship between NLR and CTO in ACS patients with ST elevated myocardial infarction (STEMI) in Indonesia., Methods: This cross-sectional study was performed with secondary data obtained from patient medical records at Cipto Mangunkusumo National Central Hospital, Jakarta. Inclusion criteria were patients with ACS and STEMI who underwent coronary angiography in 2015-2018., Results: A total of 98 patients were enrolled in the analysis. Most subjects with CTO were male, elderly (> 60), smoking, had no history of diabetes mellitus (DM) or hypertension, no family history of coronary heart disease (CHD), but had a history of ACS and had never consumed statin or antiplatelet medications. Bivariate logistic regression analysis revealed that male gender (PR = 1.820; 95%CI 0.871-3.805; p = 0.025) and smoking (PR = 1.781; 95%CI 1.028-3.086; p = 0.004) were significantly correlated with CTO. Receiver operator characteristic (ROC) curve revealed that higher NLR (≥ 6.42) could predict a CTO diagnosis with positive predictive value (PPV) of 91%. Multivariate analysis revealed that NLR was correlated with an 11.2-fold increase in occurrence of CTO (95%CI 3.250-38.303; p < 0.001). Additionally, smoking was correlated with a 7-fold increase in CTO (95% CI 1.791-30.508; p = 0.006)., Conclusion: NLR value of ≥ 6.42 is potentially useful as a marker of CTO in STEMI patients. In addition, smoking increases the risk of CTO in ACS/STEMI patients., (© 2023. The Author(s).)

Background: More than 60% of patients with atrial fibrillation (AF) have a significant health-related quality of life (HRQoL) impairment. HRQoL, a patient-reported outcome (PRO), has become an important endpoint to assess treatment success in AF patients. The Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire is an AF-specific HRQoL tool shown to be feasible, reliable, and valid, with translations in various languages. Since this questionnaire has never been translated or validated in Indonesian, we aimed to determine the validity and reliability of the Indonesian version of the AFEQT questionnaire for AF patients., Results: This cross-sectional, observational study was conducted in the Integrated Cardiovascular Service Polyclinic, Cipto Mangunkusumo Hospital, Indonesia, from December 2021 to March 2022. A total of 30 participants were recruited for cross-cultural adaptation process, which consisted of translation and adaptation process, and a total of 102 participants were consecutively recruited to participate in the validation process, which consisted of validity test (construct validity) and reliability tests (internal consistency and test-retest). The retest was conducted within a 1-2-week interval after the baseline assessment, by analyzing the intraclass correlation coefficient (ICC). The construct validity was determined by multitrait scaling analysis, and the convergent and divergent validity was compared to SF-36 domains. Multitrait scaling analysis revealed that all items in the Indonesian version of the AFEQT questionnaire had a strong negative correlation towards their respective domains (r -0.639--0.960). For convergent and divergent validity, AFEQT domains had weak to strong positive correlations to all SF-36 domains (r 0.338-0.693). This questionnaire also had acceptable internal consistency (Cronbach's α for overall score: 0.947; Domains: Symptoms: 0.818, Daily Activities: 0.943, Treatment Concern: 0.894, and Treatment Satisfaction: 0.865), as well as moderate-to-good test-retest reliability (0.521-0.828)., Conclusions: The Indonesian version of the AFEQT questionnaire has good validity and reliability for assessing quality of life of atrial fibrillation patients in Indonesia., (© 2023. The Author(s).)

Cardiotoxicity associated with chemotherapy, also known as Cancer Therapy-Related Cardiac Dysfunction (CTRCD), affects 10% of patients undergoing chemotherapy and is the most undesirable side effect of chemotherapy. Over time, it is anticipated that there would be an increase in the number of cancer patients receiving treatments that could harm their cardiovascular systems. Physicians should choose whether to continue, halt, delay, or reduce the dose of chemotherapeutic drugs to reduce the impact of cardiotoxicity. Cardiotoxicity screening and diagnosis need a variety of methods, primarily echocardiography to evaluate Left Ventricular Ejection Fraction (LVEF) and Global Longitudinal Strain (GLS). Depending on the clinical state, these procedures may be carried out prior to, during, or following chemotherapy. It's critical to reduce cardiovascular risk factors and offer advice on leading a healthy lifestyle before giving cancer patients medicines. There are a lot of cancer treatment facilities all around the world that don't have evidence-based perspective cardiotoxicity scores to stratify the risk of cardiovascular problems caused by cancer therapy. Additionally, comorbid conditions like diabetes and hypertension are frequently present in cancer patients, which can have a significant impact on clinical outcomes and cancer treatment. Therefore, this article aims to discuss assessment methods, clinical practice guidance, and prevention of CTRCD.

Competing Interests: The authors declare no conflict of interest.

Background: In the atrial fibrillation (AF) population, worsened quality of life (QOL) has been reported even before complications occur. Symptom-based questionnaires can be used to evaluate AF treatment. The Atrial Fibrillation Severity Scale (AFSS) was first developed in Canada in English, which is not the main language in Indonesia. This study aims to test the reliability and validity of the Indonesian version of the Atrial Fibrillation Severity Scale (AFSS)., Methods: Translation of the AFSS from English to Indonesian was done using forward and backward translation. The final version was then validated with the Short Form-36 (SF-36) questionnaire, and a test-retest reliability study was done in a 7-14-day interval., Results: An Indonesian version of AFSS was achieved and deemed acceptable by a panel of researchers. This version is reliable and valid, with Cronbach's α of 0.819, Intraclass Correlation Coefficient (ICC) ranging from 0.803 to 0.975, and total score correlation ranging from 0.333 to 0.895. Pearson's analysis of AFSS and SF-36 revealed that the total AF burden domain was poorly correlated with role limitations due to emotional problems (r:0.427; p < 0.01) and pain (r:0.495; p < 0.01). The symptom severity domain was poorly correlated with physical functioning (r:-0.335; p < 0.01), role limitations due to emotional problems (r:0.499; p < 0.01), pain (r:0.458; p < 0.01), and total SF-36 score (r:-0.361; p < 0.01). Total AFSS score was moderately correlated with role limitations due to emotional problems (r:0.516; p < 0.01) and pain (r:0.538; p < 0.01). The total AFSS score was poorly correlated with the European Heart Rhythm Association (EHRA) score (r:0.315; p < 0.01)., Conclusion: The Indonesian version of AFSS has good internal and external validity with good reliability., (© 2023. The Author(s).)

Multiple sclerosis (MS) is a neurological condition characterized by severe structural brain damage and by functional reorganization of the main brain networks that try to limit the clinical consequences of structural burden. Resting-state (RS) functional connectivity (FC) abnormalities found in this condition were shown to be variable across different MS phases, according to the severity of clinical manifestations. The article describes a system exploiting machine learning on RS FC matrices to discriminate different MS phenotypes and to identify relevant functional connections for MS stage characterization. To this end, the system exploits some mathematical properties of covariance-based RS FC representation, which can be described by a Riemannian manifold. The classification performance of the proposed framework was significantly above the chance level for all MS phenotypes. Moreover, the proposed system was successful in identifying relevant RS FC alterations contributing to an accurate phenotype classification., (© 2023 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)

Background: The Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) was developed in Sweden using English which may pose cultural and language barriers for Indonesian patients. As such, we aimed to translate the original ASTA into Indonesian, then assess its validity and reliability., Methods: Translation of the ASTA from English to Indonesian was done using forward and backward translation. The final version was then validated with the Short Form-36 (SF-36) questionnaire. Test-retest reliability study was done in a 7-14-day interval., Results: The Indonesian version of ASTA was deemed acceptable by a panel of researchers with Cronbach's α of 0.816 and Intraclass Correlation Coefficient (ICC) ranging from 0.856-0.983. In a comparison to the SF-36, the medication utilization domain was poorly correlated with role limitations due to physical health (r:0.384; p<0.01) and pain (r:-0.317; p<0.05). The arrhythmia-specific symptoms domain was poorly correlated with role limitations due to emotional problems (r:0.271; p<0.05). In addition, the health-related quality of life (HRQOL) domain was poorly correlated with role limitations due to physical health (r:0.359; p<0.01) and emotional problems (r:0.348; p<0.01), also total SF-36 score (r:-0.367; p<0.01). The ASTA total score was poorly correlated with role limitations due to physical health (r:0.37; p<0.01), and emotional problems (r:0.376; p<0.01), also total SF-36 score (r:-0.331; p<0.01)., Conclusion: The Indonesian version of ASTA has good internal and external validity as well as good reliability. Both the physical and mental domains of ASTA are correlated with role limitations due to emotional problems and SF-36 total score.

The use of IoT devices has increased rapidly in recent times. While the development of new devices is moving quickly, and as prices are being forced down, the costs of developing such devices also needs to be reduced. IoT devices are now trusted with more critical tasks, and it is important that they behave as intended and that the information they process is protected. It is not always the IoT device itself that is the target of a cyber attack, but rather, it can be a tool for another attack. Home consumers, in particular, expect these devices to be easy to use and set up. However, to reduce costs, complexity, and time, security measures are often cut down. To increase awareness and knowledge in IoT security, education, awareness, demonstrations, and training are necessary. Small changes may result in significant security benefits. With increased awareness and knowledge among developers, manufacturers, and users, they can make choices that can improve security. To increase knowledge and awareness in IoT security, a proposed solution is a training ground for IoT security, an IoT cyber range. Cyber ranges have received more attention lately, but not as much in the IoT field, at least not what is publicly available. As the diversity in IoT devices is large with different vendors, architectures, and components and peripherals, it is difficult to find one solution that fits all IoT devices. To some extent, IoT devices can be emulated, but it is not feasible to create emulators for all types of devices. To cover all needs, it is necessary to combine digital emulation with real hardware. A cyber range with this combination is called a hybrid cyber range. This work surveys the requirements for a hybrid IoT cyber range and proposes a design and implementation of a range that fulfills those requirements.

Background: Cardiac arrhythmias are significantly associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. Microvolt T-wave alternans (TWA) can be automatically quantified and has been recognized as a representation of repolarization heterogeneity and linked to arrhythmogenesis in various cardiovascular diseases. This study aimed to explore the correlation between microvolt TWA and COVID-19 pathology., Methods: Patients suspected of COVID-19 in Mohammad Hoesin General Hospital were consecutively evaluated using Alivecor ® Kardiamobile 6L™ portable electrocardiogram (ECG) device. Severe COVID-19 patients or those who are unable to cooperate in active ECG self-recording were excluded from the study. TWA was detected and its amplitude was quantified using the novel enhanced adaptive match filter (EAMF) method., Results: A total of 175 patients, 114 COVID-19 patients (polymerase chain reaction (PCR)-positive group), and 61 non-COVID-19 patients (PCR-negative group) were enrolled in the study. PCR-positive group was subdivided according to the severity of COVID-19 pathology into mild and moderate severity subgroups. Baseline TWA levels were similar between both groups during admission (42.47 ± 26.52 µV vs. 44.72 ± 38.21 µV), but higher TWA levels were observed during discharge in the PCR-positive compared to the PCR-negative group (53.45 ± 34.42 µV vs. 25.15 ± 17.64 µV, P = 0.03). The correlation between PCR-positive result in COVID-19 and TWA value was significant, after adjustment of other confounding variables (R 2 = 0.081, P = 0.030). There was no significant difference in TWA levels between mild and moderate severity subgroups in patients with COVID-19, both during admission (44.29 ± 27.14 µV vs. 36.75 ± 24.46 µV, P = 0.34) and discharge (49.47 ± 33.62 µV vs. 61.09 ± 35.99 µV, P = 0.33)., Conclusions: Higher TWA values can be observed on follow-up ECG obtained during discharge in the PCR-positive COVID-19 patients., Competing Interests: The authors declare no conflict of interest., (Copyright 2023, Tondas et al.)

Internet of Things (IoT) devices are becoming a part of our daily life; from health monitors to critical infrastructure, they are used everywhere. This makes them ideal targets for malicious actors to exploit for nefarious purposes. Recent attacks like the Mirai botnet are just examples in which default credentials were used to exploit thousands of devices. This raises major concerns about IoT device security. In this work, we aimed to investigate security of IoT devices through performing automatic penetration test on IoT devices. A penetration test is a way of detecting security problems, but manually testing billions of IoT devices is infeasible. This work has therefore examined autonomous penetration testing on IoT devices. In recent studies, automated attack execution models were developed for modeling automated attacks in cyber ranges. We have (1) investigated how such models can be applied for performing autonomous IoT penetration testing. Furthermore, we have (2) investigated if some well known and severe Wi-Fi related vulnerabilities still exist in IoT devices. Through a case study, we have shown that the such models can be used to model and design autonomous penetration testing agents for IoT devices. In addition, we have demonstrated that well-known vulnerabilities are present in deployed and currently sold products used in IoT devices, and that they can be both autonomously revealed through our developed system.

Dengue has been a perennial public health problem in Medan city, North Sumatera, despite the widespread implementation of dengue control. Understanding the spatial and temporal pattern of dengue is critical for effective implementation of dengue control strategies. This study aimed to characterize the epidemiology and spatio-temporal patterns of dengue in Medan City, Indonesia. Data on dengue incidence were obtained from January 2016 to December 2019. Kulldorff's space-time scan statistic was used to identify dengue clusters. The Getis-Ord Gi* and Anselin Local Moran's I statistics were used for further characterisation of dengue hotspots and cold spots. Results: A total of 5556 cases were reported from 151 villages across 21 districts in Medan City. Annual incidence in villages varied from zero to 439.32 per 100,000 inhabitants. According to Kulldorf's space-time scan statistic, the most likely cluster was located in 27 villages in the south-west of Medan between January 2016 and February 2017, with a relative risk (RR) of 2.47. Getis-Ord Gi * and LISA statistics also identified these villages as hotpot areas. Significant space-time dengue clusters were identified during the study period. These clusters could be prioritized for resource allocation for more efficient prevention and control of dengue.

Background: chronic kidney disease (CKD) increases the severity and risk of mortality in acute coronary syndrome (ACS) patients. The role of β2-M as a filtration and inflammation marker and FGF23 as a CKD-MBD process marker might be significant in the pathophysiology in ACS with CKD patients. This study aims to determine the association of β2-M and FGF23 with major adverse cardiac event (MACE) in ACS patients with CKD., Methods: we used cross sectional and retrospective cohort analysis for MACE. We collected ACS patients with CKD consecutively from January until October 2018 at Dr. Cipto Mangunkusumo General Hospital. Data were analyzed using logistic regression and Cox's Proportional Hazard Regression., Results: a total of 117 patients were selected according to the study criteria. In bivariate analysis, β2-M, FGF23, and stage of CKD had significant association with MACE (p = 0.014, p = 0.026, p = 0.014, respectively). In multivariate analysis, β2-M - but not FGF 23- was significantly associated with MACE (adjusted HR 2.16; CI95% 1.15-4.05; p = 0.017)., Conclusion: β2-M was significantly associated with MACE, while FGF23 was not so. This finding supports the role of inflammation in cardiovascular outcomes in ACS with CKD patient through acute on chronic effect.

Background: Prevalence of atrial fibrillation (AF) in patients with congenital heart disease (CHD) is on the rise. Anti-arrhythmic drugs are usually the first line of treatment in CHD, however, it is often ineffective and poorly tolerated. We aimed to perform a systematic review to assess the efficacy and safety of catheter ablation for AF in CHD., Methods: We performed a comprehensive search on catheter ablation for atrial fibrillation in congenital heart disease up until July 2019 through several electronic databases., Results: Ablation of AF in patients with CHD had a modest 12 months AF freedom ranging from 32.8% to 63%, which can be increased by subsequent/repeat ablation. The complexity of CHD appears to have a significant effect on a study but not in others. Catheter ablation in ASD and persistent left superior vena cava had a high success rate. Overall, catheter ablation is safe whichever the type of CHD is., Conclusion: Catheter ablation for AF in CHD had modest efficacy that can be increased by subsequent/repeat ablation and it also has an excellent safety profile. Ablation in complex CHD could also have similar efficacy, however, it is preferably done by experts in a high volume tertiary center., (Copyright © 2019 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.)

Aim: to evaluate the results of transcatheter closure of atrial septal defect (ASD) in adolescents and adult., Methods: a case series of patients undergoing transcatheter closure of ASD in RS Cipto Mangunkusumo, Jakarta during 2002 -2013. Transesophageal echocardiography, hemodynamic study, and angiography were performed before the procedure. Oxygen test was done if PA pressure was more than 2/3 of aortic pressure, followed by an occlusion test if no response observed to determine whether the device could be released., Results: we enrolled 54 patients, of whom 26% were adolescents and 3% were males. Median body weight was 49 (26-75) kg and ASD size was 21 (9.4-39.6) mm. The procedure was done under general anesthesia in 26% of patients. Oxygen test was applied in 11% patients and occlusion test in 2% of patient. Transcatheter closure of ASD was successful in all patients using common technique (31%), right pulmonary vein-assisted (65%), left pulmonary assisted (2%), and cutting long sheath (2%). There was neither residual ASD nor complications observed. Mean fluoroscopy and procedure time were 29 (SD 18) and 109 (SD 36) minutes, respectively. Median hospital stay was 1 (1-3) day., Conclusion: transcatheter closure of ASD in adolescents and adults is safe and effective.

Aim: To investigate the acute results (parameters at implant and clinical parameters) of permanent pacemaker implantation at our institution., Methods: Twenty five patients undergoing pacemaker implantation were included in this study. Subjects underwent medical history and functional class was assessed using New York Heart Association (NYHA) classification. All technical parameters (pacing threshold, sensing, and pacing impedance) and clinical parameters (complication and procedure time) were measured during and post implant., Results: Majority (80%) of patients were in NYHA functional class II. The commonest indication for pacemaker implant was the complete heart block (56%). The most frequent pacemaker type was single chamber (80%) with the commonest pacing mode of VVIR (72%). Average optimal parameters achieved were pacing threshold of 0.5 volt, sensing of 12.6 mV, and impedance of 829 Ohm. Average procedure time was 1.6 hour. Major complication (pocket infection) was noted in only one patient., Conclusion: It is confirmed from this study that permanent pacemaker implantation could be carried out safely and effectively with low complication rate in a general hospital. Optimal pacing parameters could be achieved in the acute phase. Most patients still could not afford appropriate pacing devices due to limited financial support. Government insurance coverage for the poor should be encouraged to cover more people.