Motorcycle seats undeniably provides good comfort to motorcyclists but there are some that offers less affirmation on ushering comfort, whilst some even results in harm to users, resulting in back pains, neck, shoulders, and other parts of the body over prolonged riding periods. This research aims to investigate the discomforts faced by motorcyclist and the best seat concept based on an ergonomic design, fit for the masses through a subjective evaluation. A study that includes a survey was conducted to study the subjective assessment against the motorcycle seat comfort. The study is divided into two parts, where in part 1, the anthropometric data were collected from a total of 100 respondents, representing 88 males and 12 females. Mean from the anthropometric data was used for two new seat redesigns, designated Seat A and Seat B. For part 2, sets of questionnaire were distributed to 130 respondents to measure their perception of seat design A and design B. Based on the results produced, 86.2% respondents suffered discomforts while riding a motorcycle. Most suffered discomforts at particular body areas: lower back, buttock and shoulder, while no discomfort reported around leg, feet and thigh. Results also proved that current seat designs needed an improvement with a majority of respondents opting an added backrest and to increase surface around buttock area. Based on the evaluation of designs, Seat B was selected as a better option as compared to seat A in terms of comfort usage.

Aims: In recent studies, xylanase is the valuable enzyme in paper industry, and the demand of this enzyme is increasing. The finding out of the new xylanases with good properties and applicable for paper industries from Indonesian biodiversity is still required. In this study, we isolated, cloned, and expressed the gene encoding alkalophilic xylanase gene from Indonesia indigenous Bacillus halodurans CM1 in Escherichia coli, and applied the recombinant xylanase in deinking process. Methodology and results: The open reading frame of the gene consist of 1191 bp, with nucleotide identity 99% with that of B. halodurans C-125 has been obtained by using PCR. The gene was submitted into GenBank with accession number KU759320. The gene was then subcloned and expressed in E.coli using pET 21d(+) vector, and we found that only extracellular that have significant activity. The gene product had optimum activity at 65 °C and pH 9. After purification using Ni-NTA, the single band was obtained, and the molecular mass was about 45 kDa based on SDS/PAGE analyses. The recombinant xylanase had been applied in deinking process of old news paper at laboratory scale of a paper industry. This recombinant xylanase application showed better brightness and whiteness, as well as higher brightness and whiteness gain of of product compared to the commercial one when using the same raw material. Conclusion, significance and impact of study The study is the first example of the cloning of industrially important enzyme (xylanase) from B. halodurans CM1 and showed potential application of the recombinant enzyme in deinking process of waste paper.

Objective:To evaluate the anti-inflammatory activity of oolong tea ethanol extract (OTEE) and epigallocatechin gallate (EGCG) on lipopolysaccharide-induced murine macrophage cell line (RAW 264.7).Methods:A cytotoxic assay using MTS tetrazolium was conducted to find a nontoxic level of OTEE and EGCG toward RAW 264.7 cells.Interleukins (IL-6,IL-1β),tumor necrosis factor-tα (TNF-α),and cyclooxigenase-2 (COX-2) levels were measured by ELISA,and nitric oxide (NO) levels measured by a nitrate/nitrite colorirnetric assay to determine the inhibition activity of OTEE and EGCG.Results:Lipopolysaccharide induction increases NO,COX-2,IL-6,IL-1β,and TNF-α levels compared with the untreated cell (negative control).The positive control,lipopolysaccharide-induced RAW 264.7 without treatments showed the highest level of all pro-inflammatory cytokines and modulators tested in this study.The positive control was used as standard to obtain OTEE and EGCG inhibition activity toward NO,COX-2,IL-6,IL-1 β,and TNF-α.OTEE had a higher inhibition activity toward NO,COX-2,IL-6,and IL-1 β than EGCG;the reverse was seen for TNF-α.However,both OTEE and EGCG suppressed production of NO,COX-2,IL-6,IL-1β,and TNF-α.Conclusions:OTEE and EGCG have the potential for use as anti-inflammatory drugs,which is shown by their ability to reduce the production of NO,COX-2,IL-6,IL-1β,and TNF-α in active macrophages.

Background: Osteogenesis imperfecta (OI) is a rare disease with an estimated incidence of between 1/25,000 and 1/10,000 globally. The main treatment for OI is the administration of bisphosphonate drugs. Research on clinical, radiographic, and biochemical markers to monitor patients with OI treated with zoledronate can be challenging in countries in which patients have limited national health insurance. We aimed to examine patients with OI treated in Indonesia with a minimum follow-up period of 2 years. Methods: An observational study was conducted of all patients with OI treated with zoledronate between 2021 and 2023 at a tertiary hospital in Indonesia. We evaluated the paediatric quality of life (PedsQL), bone mineral density (BMD), and alkaline phosphatase (ALP) level before and after zoledronate treatment. To monitor safety, serum creatinine and calcium levels were also measured. Results: Eleven boys (55%) and nine girls (45%), with an average age of 6.9 years (range, 4–17 years), were included. After 2 years of zoledronate treatment, the total PedsQL score increased from 66.7 to 76.9 (P=0.0001) and the mean lumbar and total body BMD increased from 0.467 and 0.501 to 0.599 g/cm2, and 0.626 g/cm2 (P=0.001), respectively. The ALP level decreased from 310.6 to 186.4 mg/mL (P=0.0001). Neither serum creatinine (P=0.586) nor calcium (P=0.53) levels changed from the pre-treatment to 2 years post-treatment time points. Conclusions Zoledronate was safe and effective for the treatment of OI. There were significant improvements in the quality of life and BMD in patients with OI. The ALP level decreased, but serum creatinine and calcium levels were not affected by zoledronate.

Background: Osteogenesis imperfecta (OI) is a rare disease with an estimated incidence of between 1/25,000 and 1/10,000 globally. The main treatment for OI is the administration of bisphosphonate drugs. Research on clinical, radiographic, and biochemical markers to monitor patients with OI treated with zoledronate can be challenging in countries in which patients have limited national health insurance. We aimed to examine patients with OI treated in Indonesia with a minimum follow-up period of 2 years. Methods: An observational study was conducted of all patients with OI treated with zoledronate between 2021 and 2023 at a tertiary hospital in Indonesia. We evaluated the paediatric quality of life (PedsQL), bone mineral density (BMD), and alkaline phosphatase (ALP) level before and after zoledronate treatment. To monitor safety, serum creatinine and calcium levels were also measured. Results: Eleven boys (55%) and nine girls (45%), with an average age of 6.9 years (range, 4–17 years), were included. After 2 years of zoledronate treatment, the total PedsQL score increased from 66.7 to 76.9 (P=0.0001) and the mean lumbar and total body BMD increased from 0.467 and 0.501 to 0.599 g/cm2, and 0.626 g/cm2 (P=0.001), respectively. The ALP level decreased from 310.6 to 186.4 mg/mL (P=0.0001). Neither serum creatinine (P=0.586) nor calcium (P=0.53) levels changed from the pre-treatment to 2 years post-treatment time points. Conclusions Zoledronate was safe and effective for the treatment of OI. There were significant improvements in the quality of life and BMD in patients with OI. The ALP level decreased, but serum creatinine and calcium levels were not affected by zoledronate.

Background: Osteogenesis imperfecta (OI) is a rare disease with an estimated incidence of between 1/25,000 and 1/10,000 globally. The main treatment for OI is the administration of bisphosphonate drugs. Research on clinical, radiographic, and biochemical markers to monitor patients with OI treated with zoledronate can be challenging in countries in which patients have limited national health insurance. We aimed to examine patients with OI treated in Indonesia with a minimum follow-up period of 2 years. Methods: An observational study was conducted of all patients with OI treated with zoledronate between 2021 and 2023 at a tertiary hospital in Indonesia. We evaluated the paediatric quality of life (PedsQL), bone mineral density (BMD), and alkaline phosphatase (ALP) level before and after zoledronate treatment. To monitor safety, serum creatinine and calcium levels were also measured. Results: Eleven boys (55%) and nine girls (45%), with an average age of 6.9 years (range, 4–17 years), were included. After 2 years of zoledronate treatment, the total PedsQL score increased from 66.7 to 76.9 (P=0.0001) and the mean lumbar and total body BMD increased from 0.467 and 0.501 to 0.599 g/cm2, and 0.626 g/cm2 (P=0.001), respectively. The ALP level decreased from 310.6 to 186.4 mg/mL (P=0.0001). Neither serum creatinine (P=0.586) nor calcium (P=0.53) levels changed from the pre-treatment to 2 years post-treatment time points. Conclusions Zoledronate was safe and effective for the treatment of OI. There were significant improvements in the quality of life and BMD in patients with OI. The ALP level decreased, but serum creatinine and calcium levels were not affected by zoledronate.

Introduction: Stunting is known to be a major public health problem among Indonesian children. We aimed to examine the association between dietary diversity and vitamin D intake with stunting in children aged 6-23 months. Methods: This case-control study was conducted in Bantul District, Yogyakarta Special Region, Indonesia. A total of 79 subjects aged 6-23 months were selected for each case and control group based on their stunting status. We assessed potential explanatory variables at the child, parental, household, and community levels. Results: Factors which were significantly associated with stunting included young children aged 1823 months (adjusted OR = 3.84; 95% CI: 1.17-12.26), birth length ≥48 cm (adjusted OR = 0.36; 95% CI: 0.16-0.83), inadequate intake of vitamin D (adjusted OR = 5.18; 95% CI: 1.03-26.02), and diversified diet (adjusted OR = 0.17; 95% CI: 0.03-0.92). Other variables such as household economic status, living residency, history of exclusive breastfeeding, and infectious diseases, as well as intakes of energy and protein were not significantly related to stunting. Conclusion: Minimum dietary diversity, vitamin D intake from complementary foods, and birth length were associated with stunting status among children. Therefore, it is crucial to focus on stunting prevention programmes in the first two years of life, or even since the preconception period.

Objectives: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment. Methods: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years. Results: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72). Conclusions Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

ABSTRACT Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.
Malocclusion, Angle Class II

In Malaysia, chronic respiratory disease including COPD is responsible for 7% of the total Disability-Adjusted Life Years (DALYs). Sleep disturbance in COPD patients is often underestimated and overlooked clinically. Respiratory symptoms caused by COPD often leads to poor sleep quality and insomnia. Poor sleep quality contributes to frequent episodes of exacerbation which directly increases mortality risk. This study aims to determine health-related quality of life and sleep quality among COPD patients and their associations with severity. In this cross-sectional study, 102 COPD patients classified according to Global Initiative for Chronic Obstructive Lung Disease were evaluated. EQ5D and Pittsburgh Sleep Quality Index (PSQI) questionnaires were used to assess health-related quality of life and sleep quality respectively. Results showed the severity of COPD is significantly associated (p<0.05) with all 5 dimensions of EQ5D among COPD patients in Kuala Lumpur. In this study, 71 patients (69.9%) were reported to be poor sleepers (PSQI>5) with a mean g l o b a l score of 6.93 ± 4.072. Sleep quality was also found to be significantly associated (p <0.05) with COPD severity, in which patients with lower severity showed better sleep quality. In this study, COPD severity was found to be significantly associated with health-related quality of life. As the disease severity progresses, both quality of life and sleep quality worsens gradually. Findings from this study highlight the importance to consider the quality of life and sleep quality as part of the management plan for COPD patients.