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.

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

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-α (TNF-α), and cyclooxigenase-2 (COX-2) levels were measured by ELISA, and nitric oxide (NO) levels measured by a nitrate/nitrite colorimetric 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-1β, and TNF-α. OTEE had a higher inhibition activity toward NO, COX-2, IL-6, and IL-1β 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.

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.

Background: Regarding the long-term safety issues with the use of inhaled corticosteroids (ICS) and the clinical predominance of dual bronchodilators in enhancing treatment outcomes in chronic obstructive pulmonary disease (COPD), ICS is no longer a “preferred therapy” according to the Global Initiative for Chronic Obstructive Lung Disease except on top of a dual bronchodilator. This has necessitated a change in the current therapy for many COPD patients. Objective: To determine a standardised algorithm to reassess and personalise the treatment COPD patients based on the available evidence. Methods: A consensus statement was agreed upon by a panel of pulmonologists in from 11 institutes in Malaysia whose members formed this consensus group. Results: According to the consensus, which was unanimously adopted, all COPD patients who are currently receiving an ICS-based treatment should be reassessed based on the presence of co-existence of asthma or high eosinophil counts and frequency of moderate or severe exacerbations in the previous 12 months. When that the patients meet any of the aforementioned criteria, then the patient can continue taking ICS-based therapy. However, if the patients do not meet the criteria, then the treatment of patients need to be personalised based on whether the patient is currently receiving long-acting beta-agonists (LABA)/ICS or triple therapy. Conclusion: A flowchart of the consensus providing a guidance to Malaysian clinicians was elucidated based on evidences and international guidelines that identifies the right patients who should receive inhaled corticosteroids and enable to switch non ICS based therapies in patients less likely to benefit from such treatments.

Trypanosoma brucei parasites are flagellated kinetoplastid protozoan which is responsible for Human African Trypanosomiasis (HAT). Current chemotherapy drugs have a number of side effects and drug resistance has emerged as a major issue in current treatment. Active bisindole alkaloid compound ochrolifuanine was previously isolated from the leaves of Dyera costulata. In vitro antitrypanosomal activity of ochrolifuanine against Trypanosoma brucei brucei strain BS221 showed strong activity with an IC50 value of 0.05 ± 0.01 µg/ml. We compared the effect of ochrolifuanine and reference compound staurosporine in T. b. brucei apoptosis. The apoptosis-inducing activity of ochrolifuanine was evaluated using TUNEL assay and cell cycle analysis. Trypanosoma brucei brucei was shown to undergo apoptotic cells death as demonstrated by the appearance of several conical hallmarks of apoptosis. Ochrolifuanine was found to induce apoptosis in parasites in a dose- and time-dependent manner. The cell cycle study revealed 0.025 and 0.05 µg/ml of ochrolifuanine arrested the growth of T. b. brucei at two different growth phases (G0/G1 and in S phases). While at concentration 0.10 µg/ml arrested at the G2/M phase. In conclusion, the results indicate that ochrolifuanine displayed an antitrypanosomal effect on T. b. brucei by inducing apoptosis cell death and causing the arrest of parasite cells at different growth phases. The results suggested that ochrolifuanine may be a promising lead compound for the development of new chemotherapies for African trypanosomiasis.