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Indonesia experiences frequent flooding, with data from the National Disaster Management Agency (BNPB) revealing that floods account for 41% of all natural disasters (1,441 incidents) recorded in 2021. These floods cause significant property damage and casualties. To address this challenge, we have developed a prototype flood early warning system. This system utilizes ultrasonic sensors for real-time water level detection. Sensor data is transmitted to designated personnel through a website interface. Additionally, the system leverages a Telegram bot to deliver flood early warnings directly to the community residing in flood-prone areas. The sensor data comparison test yielded an error rate of only 0.6175% with an average difference of 1 cm, demonstrating the system's accuracy and functionality. Furthermore, a notification test conducted ten times achieved 100% accuracy. The Telegram bot successfully sent text message alerts (alert 1, alert 2, alert 3) with an average delivery time of 4.07 seconds. This prototype offers a promising solution for flood mitigation. By providing real-time water level data and issuing timely alerts via a user-friendly Telegram bot, the system empowers communities to prepare for potential flooding and minimize associated risks.

Real-world studies of pyruvate kinase (PK) deficiency and estimates of mortality are lacking. This retrospective observational study aimed to identify patients with PK deficiency and compare their overall survival (OS) to that of a matched cohort without PK deficiency. Patients with ≥1 diagnosis code related to PK deficiency were selected from the US Veterans Health Administration (VHA) database (01/1995–07/2019); patients with a physician-documented diagnosis were included (PK deficiency cohort; index: date of first diagnosis code related to PK deficiency). Patients in the PK deficiency cohort were matched 1:5 to patients from the general VHA population (non-PK deficiency cohort; index: random visit date during match’s index year). OS from index was compared between the two cohorts. Eighteen patients in the PK deficiency cohort were matched to 90 individuals in the non-PK deficiency cohort (both cohorts: mean age 57 years, 94% males; median follow-up 6.0 and 8.0 years, respectively). At follow-up, patients in the non-PK deficiency cohort had significantly longer OS than the PK deficiency cohort (median OS: 17.1 vs. 10.9 years; hazard ratio: 2.3; p = 0.0306). During their first-year post-index, 75% and 40% of the PK deficiency cohort had laboratory-confirmed anemia and iron overload, respectively. Among patients who died, cause of death was highly heterogeneous. These results highlight the increased risk of mortality and substantial clinical burden among patients with PK deficiency. While the intrinsic characteristics of the VHA database may limit the generalizability of the results, this is the first real-world study to characterize mortality in patients with PK deficiency.

Bahan cetak alginat kedokteran gigi dapat menjadi media penularan infeksi dan mudah mengalami perubahan dimensi. Metode disinfeksi alternatif perlu dilakukan dengan mencampurkan bahan alam kayu manis (Cinnamomum burmannii) yang memiliki manfaat anti fungi dan anti bakteri serta bersifat desinfektan sebagai pelarut bahan cetak alginat tanpa mempengaruhi dimensi. Tujuan penelitian untuk mengetahui pengaruh ekstrak kayu manis (Cinnamomum burmannii) sebagai pelarut bahan cetak alginat terhadap perubahan dimensi dan mengetahui pengaruh peningkatan konsentrasi ekstrak kayu manis (Cinnamomum burmannii) sebagai pelarut bahan cetak alginat terhadap perubahan dimensi. Desain penelitian posttest-only control group design dengan cara mengukur selisih volume akhir dengan volume awal menggunakan jangka sorong ketelitian 0,01 mm. Kelompok perlakuan larutan ekstrak kayu manis dibagi menjadi 5 konsentrasi yaitu kontrol, 5%, 10%, 20%, dan 40%. Hasil penelitian dengan uji One-Way ANOVA menunjukkan nilai p=0,066 (p0,05) yang berarti tidak terdapat pengaruh ekstrak kayu manis sebagai pelarut bahan cetak alginat terhadap perubahan dimensi. Simpulan penelitian bahwa ekstrak kayu manis (Cinnamomum burmannii) sebagai pelarut bahan cetak alginat tidak berpengaruh terhadap perubahan dimensi. Peningkatan konsentrasi ekstrak kayu manis (Cinnamomum burmannii) hingga 40% sebagai pelarut bahan cetak alginat juga tidak berpengaruh terhadap perubahan dimensi.

Remotely sensed data and habitat model approach were employed to evaluate the present of oceanographic aspect in the Bigeye tuna's potential fishing zone (PFZ) at a profundity of 155 m. Vessel monitoring system was employed to acquire the angling vessels for Bigeye tuna from January through December, 2015-2016. Daily data of sub-surface temperature (Sub_ST), sub-surface chlorophyll-a (Sub_SC), and sub-surface salinity (Sub_SS) were downloaded from INDESO Project website. Vessel monitoring system and environmental data were employed for maximum entropy (maxent) model development. The model predictive achievement was then estimated applying the area under the curve (AUC) value. Maxent model results (AUC>0.745) exhibited its probable to understand the Bigeye tuna's spatial dispersion on the specific sub-surface. In addition, the results also showed Sub_ST (43,1%) was the most affective aspect in the Bigeye tuna dispersion, pursued by Sub_SC (35,2%) and Sub_SS (21,6%).

The partner of this Community Partnership Program (PKM) service are Potronayan Ibtidaiyah Muhammadiyah (MIM) 1. The main problems raised in this activity are two, namely schools have not been able to implement e-report cards or known as digital report cards (ARD) applications and the problem is not yet the optimal role of the school health business (UKS), especially the school dental health business (UKGS). The purpose of this activity is to improve the supporting facilities for implementing e-report cards and increase the knowledge of teachers and students to support UKS and UKGS. The method of implementing the activity is the application of computer infrastructure to support the application of e-report cards and the implementation of training and application of Android applications to increase knowledge about maintaining oral health and UKS. The results obtained from this activity are partners already have a computer infrastructure that is in accordance with the needs for the application of e-report cards and teachers and students have received training and Android applications to improve knowledge of dental and mouth maintenance. Evaluation results show that the Android application that is applied is able to make learning about oral health more enjoyable when compared to just using printed material.

Abstract Introduction Japan has one of the highest prevalence rate of chronic hepatitis C (CHC) in the industrialized world. However, the burden of CHC treatment is poorly understood. Thus, the healthcare resource utilization and costs of treated versus untreated patients, and patients with early versus delayed treatment initiation, were assessed in Japan. Methods Adult patients with ≥ 2 CHC diagnoses were identified from the Medical Data Vision hospital claims database (1 April 2008–31 May 2016). The presence or absence of antiviral treatment claims was used to form the treated and untreated cohorts, respectively. Among treated patients, the presence of a cirrhosis-related diagnosis was used as an indicator of delayed treatment. The index date was defined as the date of the first antiviral claim for treated patients and randomized to any date with a medical visit for untreated patients. Annualized total healthcare costs and costs associated with hepatic manifestations (HMs) or extrahepatic manifestations (EHMs) were evaluated from the index date to the last observed medical visit. Results Of 100,125 patients with CHC, 12,984 were treated (early: 8104, delayed: 4880) and 87,141 were untreated. After adjusting for covariates, untreated patients had ¥613,034 ($5456 USD; ¥1 = $0.0089) higher annual medical costs compared with treated patients (P

Abstrak Artikel ini menggambarkan tentang nilai sosial keaagamaan dalam tradisi Aia Kubah. Tradisi Aia Kubah sebelumnya merupakan bentuk dari tradisi ziarah secara syariat Islam, namun dalam pekembangannya tradisi ini mengalami perubahan dalam pelaksaanaanya, yaitu adanya tradisi Aia Kubah, tradisi ini dilakukan dengan cara menggunakan Aia Kubah untuk memenuhi setiap permintaan para peziarah yang ada di makam para syekh. Desain penelitian yang digunakan adalah kualitatif. Pengumpulan data dilakukan dengan cara observasi terlibat (observasi partisipasi), wawancara mendalam, dan dokumentasi. Berdasarkan penelitian ini, peneliti menyimpulkan bahwa tradisi Aia Kubah ini merupakan bentuk penghormatan dan penghargaan terhadap syekh-syekh yang telah meninggal dunia, adanya nilai-nilai yang dianggap keramat dari air makam merupakan bentuk kepercayaan masyarakat di Lubuak Landua terhadap sesuatu yang gaib, tradisi yang bernilai dan bermanfaat bagi masyarakat di Luabuak Landua, maka masyarakat mempertahankannya.

Introduction : Different minimally invasive surgical approaches to the orbit allow individualized bone resection to reduce proptosis and decompress the optic nerve in patients with Graves' orbitopathy (GO). This study aims to compare piezosurgery to an oscillating saw used to resect bone from the lateral orbital wall. Methods : In a retrospective study, we analyzed balanced orbital decompressions performed on 174 patients (318 cases) with GO. An oscillating saw was used in 165 cases (saw group) and piezosurgery in 153 cases (piezo group). Peri- and postoperative complications, reduction of proptosis, new onset of diplopia and improvement of visual acuity in cases of pre-operative optic nerve compression were analyzed. Results : We observed no significant differences in the surgical outcome between the two groups. Proptosis reduction was 4.6 mm in the saw group ( p < 0.01) and 5.3 mm in the piezo group ( p < 0.01). Intraoperative handling of the piezosurgery device was judged superior to the oscillating saw, due to soft tissue conservation and favourable cutting properties. Duration of the surgery did not differ between the groups. No serious adverse events were recorded in both groups. Conclusion : The application of piezosurgery in orbital decompression is more suitable than an oscillation saw due to superior cutting properties such as less damage to surrounding soft tissue or a thinner cutting grove.

Purpose: To systematically review the safety and efficacy of transarterial drug-eluting beads, irinotecan (DEBIRI) for the treatment of pretreated patients with unresectable colorectal liver metastases (CRLM)., Methods: A systematic search of the current literature was conducted to extract publications reporting on the use of DEBIRI for CRLM. Data on the safety and efficacy was extracted and tabulated. Weighted average values (WAV) were calculated for each variable to provide a single value representing the pooled safety and efficacy data., Results: 13 studies (15 treatment arms) were evaluated, comprising a total of 850 patients. There were 6 prospective phase I/II trials, 5 retrospective trials and 2 randomized control trials. All papers involved patients previously treated with systemic chemotherapy. The weighted average all-grade toxicity rate was 35.2% (range; 6-100%). The high-grade WAV toxicity rate was 10.1% (range; 0-32%). Weighted average response rates were 56.2% and 51.1% according to RECIST (Response Evaluation Criteria in Solid Tumors) and modified RECIST/EASL (European Association for the Study of the Liver) response criteria respectively. The weighted average progression-free survival and overall survival were 8.1 months and 16.8 months, respectively., Conclusion: Transarterial DEBIRI is safe and effective in the treatment of unresectable CRLM to the liver. Further studies are warranted to better define its role in the treatment algorithm of this patient subset., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: Whether the origin of severe hearing loss in Refsum's syndrome is caused by cochlear impairment or retrocochlear degeneration remains unclear. This case report aims to investigate hearing performance before and after cochlear implantation to shed light on this question. Also, identification of new mutations causing Refsum's syndrome would be helpful in generating additional means of diagnosis., Methods: A family of 4 individuals was subjected to genetic testing. Two siblings (56 and 61 years old) suffered from severe hearing and vision loss and received bilateral cochlear implants. Genetic analysis, audiological outcome, and clinical examinations were performed., Results: One new mutation in the PHYH gene (c.768del63bp) causing Refsum's disease was found. Preoperative distortion product otoacoustic emissions (DPAOEs) were absent. Postoperative speech perception in Freiburger speech test was 100% for bisyllabic words and 85% (patient No. 1) and 65% (patient No. 2), respectively, for monosyllabic words. Five years after implantation, speech perception remained stable for bisyllabic words but showed decreasing capabilities for monosyllabic words., Discussion: A new mutation causing Refsum's disease is presented. Cochlear implantation in case of severe hearing loss leads to an improvement in speech perception and should be recommended for patients with Refsum's disease, especially when the hearing loss is combined with a severe loss of vision. Decrease of speech perception in the long-term follow-up could indicate an additional retrocochlear degeneration.

Background: The basal-like breast cancer (BLBC) subtype is characterized by positive staining for basal mammary epithelial cytokeratin markers, lack of hormone receptor and HER2 expression, and poor prognosis with currently no approved molecularly-targeted therapies. The oncogenic signaling pathways driving basal-like tumorigenesis are not fully elucidated., Methods: One hundred sixteen unselected breast tumors were subjected to integrated analysis of phosphoinositide 3-kinase (PI3K) pathway related molecular aberrations by immunohistochemistry, mutation analysis, and gene expression profiling. Incidence and relationships between molecular biomarkers were characterized. Findings for select biomarkers were validated in an independent series. Synergistic cell killing in vitro and in vivo tumor therapy was investigated in breast cancer cell lines and mouse xenograft models, respectively., Results: Sixty-four % of cases had an oncogenic alteration to PIK3CA, PTEN, or INPP4B; when including upstream kinases HER2 and EGFR, 75 % of cases had one or more aberration including 97 % of estrogen receptor (ER)-negative tumors. PTEN-loss was significantly associated to stathmin and EGFR overexpression, positivity for the BLBC markers cytokeratin 5/14, and the BLBC molecular subtype by gene expression profiling, informing a potential therapeutic combination targeting these pathways in BLBC. Combination treatment of BLBC cell lines with the EGFR-inhibitor gefitinib plus the PI3K pathway inhibitor LY294002 was synergistic, and correspondingly, in an in vivo BLBC xenograft mouse model, gefitinib plus PI3K-inhibitor PWT-458 was more effective than either monotherapy and caused tumor regression., Conclusions: Our study emphasizes the importance of PI3K/PTEN pathway activity in ER-negative and basal-like breast cancer and supports the future clinical evaluation of combining EGFR and PI3K pathway inhibitors for the treatment of BLBC.

Esophageal leiomyomas are rare benign tumors that can be treated successfully with limited surgical resection. It is occasionally important to distinguish leiomyomas from more aggressive submucosal esophageal tumors, most notably gastrointestinal stromal tumors (GISTs). GISTs have a worse prognosis, particularly when they are large (>10 cm). Increased uptake of (18)F-fluorodeoxyglucose on positron emission tomography (PET) scans is common in GISTs, potentially allowing PET scanning to differentiate between GIST and benign esophageal tumors. Three patients presented with large (>10 cm) esophageal masses of ranging PET avidity [maximum standardized uptake value (SUVmax) of 1.3-10.1]. All were treated surgically and histologically confirmed to be esophageal leiomyomas. Unfortunately, the wide range of PET uptake precludes PET scanning from differentiating large leiomyomas from more aggressive lesions.

Unsustained enzyme inhibition is a barrier to targeted therapy for cancer. Here, resistance to a class I PI3K inhibitor in a model of metastatic breast cancer driven by PI3K and MYC was associated with feedback activation of tyrosine kinase receptors (RTKs), AKT, mTOR, and MYC. Inhibitors of bromodomain and extra terminal domain (BET) proteins also failed to affect tumor growth. Interestingly, BET inhibitors lowered PI3K signaling and dissociated BRD4 from chromatin at regulatory regions of insulin receptor and EGFR family RTKs to reduce their expression. Combined PI3K and BET inhibition induced cell death, tumor regression, and clamped inhibition of PI3K signaling in a broad range of tumor cell lines to provide a strategy to overcome resistance to kinase inhibitor therapy., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Phosphatase and tensin homolog on chromosome ten (PTEN) is a tumor suppressor and an antagonist of the phosphoinositide-3 kinase (PI3K) pathway. We identified a 576-amino acid translational variant of PTEN, termed PTEN-Long, that arises from an alternative translation start site 519 base pairs upstream of the ATG initiation sequence, adding 173 N-terminal amino acids to the normal PTEN open reading frame. PTEN-Long is a membrane-permeable lipid phosphatase that is secreted from cells and can enter other cells. As an exogenous agent, PTEN-Long antagonized PI3K signaling and induced tumor cell death in vitro and in vivo. By providing a means to restore a functional tumor-suppressor protein to tumor cells, PTEN-Long may have therapeutic uses.