A Case of Traumatic Distal End Radius Fracture With a Hemorrhagic Volar Wrist Ganglion Cyst.

Wrist ganglion cysts are the most common benign soft tissue swelling in the hand and wrist. They may arise from flexor and extensor tendon sheaths, interphalangeal joints, wrist joints, and even the neural tissues around the hand and wrist. Some volar wrist ganglion cysts arise from the radiocarpal joint and scaphotrapezial joint. It is uncommonly encountered as an incidental finding during the fixation of a distal radius fracture. In our case, a volar wrist hemorrhagic ganglion cyst was incidentally found during the fixation of the fracture. Prior to the injury, the patient had no complaints of swelling over her right wrist. The cyst was removed using microscopic magnification.

The Relationship Between Bullying and Risk of Suicide Among Adolescents During the COVID-19 Pandemic in Indonesia.

Objectives: Although adolescents appear less vulnerable to coronavirus disease (COVID-19), the side effects of this pandemic can still be devastating. Bullying and suicidality are significant global issues with detrimental effects on young people, particularly during school closure. This study aimed to identify the relationship between bullying and suicide risk among adolescents in Indonesia during the COVID- 19 pandemic. Methods: A cross-sectional study was conducted on adolescents aged 14-18 years in May 2020 in Bandung, Indonesia, using a webbased closed survey. The Adolescent Peer Relations Instrument and the Suicide Behavior Questionnaire-Revised were used to measure bullying and risk of suicide. Multinomial logistic regression analysis was performed. Results: This study included 268 participants in 2020 and 175 participants in 2019. In 2020, the prevalence of perpetrators and victims of bullying combined was 74.6%. Meanwhile, in 2019, the prevalence of perpetrators and victims of bullying combined was 82.9%. Risk of suicide increased from 26.1% in 2019 (before the COVID-19 pandemic) to 36.5% in 2020 (during the first wave of the COVID-19 pandemic). The risk of perpetrators and suicide victims was higher than that of perpetrators and victims alone (odds ratio [OR]=4.0, 95% confidence interval [CI]=1.5-6.6 vs. OR=1.3, 95% CI=1.0-2.9 and OR=1.6, 95% CI=1.1-2.8, respectively). Conclusion: Bullying can enhance the likelihood of suicide among adolescents in Indonesia, and the risk was highest for the combination of victims and perpetrators. It is very important to provide early risk prediction for youths with bullying behavior and improve the knowledge and understanding of families and schools regarding the negative effects of bullying behavior.

Mechanistic basis for potassium efflux-driven activation of the human NLRP1 inflammasome.

Nigericin, an ionophore derived from Streptomyces hygroscopicus, is arguably the most commonly used tool compound to study the NLRP3 inflammasome. Recent findings, however, showed that nigericin also activates the NLRP1 inflammasome in human keratinocytes. In this study, we resolve the mechanistic basis of nigericin-driven NLRP1 inflammasome activation. In multiple nonhematopoietic cell types, nigericin rapidly and specifically inhibits the elongation stage of the ribosome cycle by depleting cytosolic potassium ions. This activates the ribotoxic stress response (RSR) sensor kinase ZAKα, p38, and JNK, as well as the hyperphosphorylation of the NLRP1 linker domain. As a result, nigericin-induced pyroptosis in human keratinocytes is blocked by extracellular potassium supplementation, ZAKα knockout, or pharmacologic inhibitors of ZAKα and p38 kinase activities. By surveying a panel of ionophores, we show that electroneutrality of ion movement is essential to activate ZAKα-driven RSR and a greater extent of K+ depletion is necessary to activate ZAKα-NLRP1 than NLRP3. These findings resolve the mechanism by which nigericin activates NLRP1 in nonhematopoietic cell types and demonstrate an unexpected connection between RSR, perturbations of potassium ion flux, and innate immunity.

Taxing sugar sweetened beverages in Indonesia: Projections of demand change and fiscal revenue.

The global trend of diets high in sugar sweetened beverages (SSB) is associated with a high risk of obesity and non-communicable diseases (NCDs). To reduce SSB consumption on a population level, SSB taxes have become a popular policy solution. In Indonesia, although the prevalence of obesity has doubled in the past decade (11.7% in 2010 to 21.8% in 2018), SSB taxes have not yet been implemented. Utilizing the 2021 Indonesian household socioeconomic survey (SUSENAS), this study estimated price elasticities and projected the plausible effects of implementing an SSB tax on consumers' demand for SSBs and the associated government revenue using the Quadratic Almost Ideal Demand System (QUAIDS) model. Five SSB groups were studied: 1) manufactured liquid milk; 2) sweetened condense milk; 3) instant coffee; 4) tea drinks and fizzy drinks with CO2; 5) fruit juices, "health" drinks, and energy drinks. The overall results showed that the non-milk SSB groups were price elastic. Probing deeper into the substitutions for SSB across categories, we found both substitutionary and complementary effects. Our analysis revealed that increasing SSB prices by 20% would reduce the demand for SSBs on average by 17.5% (14.3%-18.6% for each SSB group) and generate additional state revenue up to IDR 3,628.3 billion per year (approximately US$ 238.5 million or 0.2% of total tax revenue in 2022). Considering the health and economic impacts of high consumption of SSBs, this study provides empirical evidence that imposing taxes on SSBs could be an effective measure to reduce public consumption and to generate tax revenue for financing health programs that address obesity and NCDs in Indonesia.

Diphtheria toxin activates ribotoxic stress and NLRP1 inflammasome-driven pyroptosis.

The ZAKα-driven ribotoxic stress response (RSR) is activated by ribosome stalling and/or collisions. Recent work demonstrates that RSR also plays a role in innate immunity by activating the human NLRP1 inflammasome. Here, we report that ZAKα and NLRP1 sense bacterial exotoxins that target ribosome elongation factors. One such toxin, diphtheria toxin (DT), the causative agent for human diphtheria, triggers RSR-dependent inflammasome activation in primary human keratinocytes. This process requires iron-mediated DT production in the bacteria, as well as diphthamide synthesis and ZAKα/p38-driven NLRP1 phosphorylation in host cells. NLRP1 deletion abrogates IL-1ß and IL-18 secretion by DT-intoxicated keratinocytes, while ZAKα deletion or inhibition additionally limits both pyroptotic and inflammasome-independent non-pyroptotic cell death. Consequently, pharmacologic inhibition of ZAKα is more effective than caspase-1 inhibition at protecting the epidermal barrier in a 3D skin model of cutaneous diphtheria. In summary, these findings implicate ZAKα-driven RSR and the NLRP1 inflammasome in antibacterial immunity and might explain certain aspects of diphtheria pathogenesis.

Personalized federated learning for heterogeneous data: A distributed edge clustering approach.

Federated learning (FL) is a distributed machine learning technique that allows multiple devices (e.g., smartphones and IoT devices) to collaborate in the training of a shared model with each device preserving the privacy of its local data. However, the highly heterogeneous distribution of data among clients in FL can result in poor convergence. In addressing this issue, the concept of personalized federated learning (PFL) has emerged. PFL aims to tackle the effects of non-independent and identically distributed data and statistical heterogeneity and to achieve personalized models with rapid model convergence. One approach is clustering-based PFL, which utilizes group-level client relationships to achieve personalization. However, this method still relies on a centralized approach, whereby the server coordinates all processes. To address these shortcomings, this study introduces a blockchain-enabled distributed edge cluster for PFL (BPFL) that combines the benefits of blockchain and edge computing. Blockchain technology can be used to enhance client privacy and security by recording transactions on immutable distributed ledger networks, thereby improving client selection and clustering. The edge computing system offers reliable storage and computation such that computational processing is locally performed in the edge infrastructure to be closer to clients. Thus, the real-time services and low-latency communication of PFL are improved. However, further work is required to develop a representative dataset for the examination of related types of attacks and defenses for a robust BPFL protocol.

Hygiene and Health Coaching for Community Readiness to Perform the Hajj during an Ongoing COVID-19 Pandemic.

In March 2020, WHO declared Coronavirus Disease 2019 (COVID-19) as a global pandemic, which had a major impact on all mass gatherings (MG), including the Hajj. This has an impact for the government, as the party organizing the pilgrimage can make more mature preparations for a more optimal implementation of the pilgrimage. This study aimed to evaluate hygiene and health coaching for community readiness to perform the Hajj during an ongoing COVID-19 pandemic in Indonesia. We used a mixed qualitative and quantitative method, in which the quantitative component used an analytic cross-sectional design with a questionnaire given to 2425 pilgrims, while the qualitative component was carried out through Focus Group Discussion. During the pandemic, all hygiene and health coaching, including guidance, was carried out in three types of distance learning, called "online", "offline (face-to-face)", and "combination". This study shows that face-to-face health coaching is low (50.5%), while online coaching is high (70.0%). The total fraction of pilgrims who participated in blended coaching sessions was 55.1%, and the highest frequency of coaching was under four times (38.7%). However, in its implementation, there is still no integration between programs. There is quite a lot of health information given to pilgrims, but the material still varies between regions. Information on guidelines for preventing and transmitting COVID-19 for officers and pilgrims has not been fully socialized. There exists an urgent need to establish messages that are clear, meaningful, empathetic, consistent, and in context in order to achieve health improvement of pilgrims.

A national-scale land cover reference dataset from local crowdsourcing initiatives in Indonesia.

Here we present a geographically diverse, temporally consistent, and nationally relevant land cover (LC) reference dataset collected by visual interpretation of very high spatial resolution imagery, in a national-scale crowdsourcing campaign (targeting seven generic LC classes) and a series of expert workshops (targeting seventeen detailed LC classes) in Indonesia. The interpreters were citizen scientists (crowd/non-experts) and local LC visual interpretation experts from different regions in the country. We provide the raw LC reference dataset, as well as a quality-filtered dataset, along with the quality assessment indicators. We envisage that the dataset will be relevant for: (1) the LC mapping community (researchers and practitioners), i.e., as reference data for training machine learning algorithms and map accuracy assessment (with appropriate quality-filters applied), and (2) the citizen science community, i.e., as a sizable empirical dataset to investigate the potential and limitations of contributions from the crowd/non-experts, demonstrated for LC mapping in Indonesia for the first time to our knowledge, within the context of complementing traditional data collection by expert interpreters.

ZAKα-driven ribotoxic stress response activates the human NLRP1 inflammasome.

Human NLRP1 (NACHT, LRR, and PYD domain-containing protein 1) is an innate immune sensor predominantly expressed in the skin and airway epithelium. Here, we report that human NLRP1 senses the ultraviolet B (UVB)- and toxin-induced ribotoxic stress response (RSR). Biochemically, RSR leads to the direct hyperphosphorylation of a human-specific disordered linker region of NLRP1 (NLRP1DR) by MAP3K20/ZAKα kinase and its downstream effector, p38. Mutating a single ZAKα phosphorylation site in NLRP1DR abrogates UVB- and ribotoxin-driven pyroptosis in human keratinocytes. Moreover, fusing NLRP1DR to CARD8, which is insensitive to RSR by itself, creates a minimal inflammasome sensor for UVB and ribotoxins. These results provide insight into UVB sensing by human skin keratinocytes, identify several ribotoxins as NLRP1 agonists, and establish inflammasome-driven pyroptosis as an integral component of the RSR.

Elder abuse and hospitalization in rural Malaysia.

Our study aims to describe and determine factors associated with hospitalization among victims of elder abuse and neglect (EAN) in rural Malaysia. A cross sectional study based on the baseline data of the Malaysian Elder Mistreatment Project (MAESTRO) collected from November 2013 until July 2014 involving 1927 older adults in Kuala Pilah, Negeri Sembilan was conducted. EAN was determined using the modified Conflict Tactics Scale (CTS) and hospitalization rates were determined based on self-report. The prevalence of overall EAN was 8.1% (95%CI 6.9-9.3). Among male respondents, 9.5% revealed history of abuse and among female respondents, 7.2% reported experiencing EAN. The annual hospitalization rates per 100 persons within the past one year among EAN victims and non-victims were 18 per 100 persons (SD = 46.1) and 15 per 100 persons (SD = 64.1) respectively. Among respondents with history of EAN, 16.0% (n = 21) had been hospitalized in the past 12 months while among respondents with no EAN experience, 10.2% (n = 153) were hospitalized. Multivariable analyses using Poisson regression did not show any significant association between EAN and hospitalization. This could be due to the complex interactions between medical and social circumstances that play a role in hospital admissions, factors affecting the health care system, and access to health care among EAN victims.

Detrimental Effects of IFN-γ on an Epidermolysis Bullosa Simplex Cell Model and Protection by a Humanized Anti-IFN-γ Monoclonal Antibody.

Epidermolysis bullosa is a group of severe skin blistering disorders, which currently have no cure. The pathology of epidermolysis bullosa is recognized as having an inflammatory component, but the role of inflammation in different epidermolysis bullosa disorders is unclear. Epidermolysis bullosa simplex (EBS) is primarily caused by sequence variants in keratin genes; its most severe form, EBS generalized severe, is characterized by aggregates of keratin proteins, and cell models of EBS generalized severe show constitutively elevated stress. IFN-γ is a major mediator of inflammation, and we show that the addition of IFN-γ alone to disease model keratinocytes promotes keratin aggregation, decreases cell-cell junctions, delays wound closure, and reduces cell proliferation. IFN-γ exposure weakens the intercellular cohesion of monolayers on mechanical stress, with IFN-γ-treated EBS monolayers more fragmented than IFN-γ-treated wild-type monolayers. A humanized monoclonal antibody to IFN-γ neutralized the detrimental effects on keratinocytes, restoring cell proliferation, increasing cell-cell adhesion, accelerating wound closure in the presence of IFN-γ, and reducing IFN-γ-mediated keratin aggregation in EBS cells. These suggest that treatment with IFN-γ blocking antibodies may constitute a promising new therapeutic strategy for patients with EBS and may also have ameliorating effects on other inflammatory skin diseases.

Analysis relationship of fatness in venerable people at Johan Pahlawan Health Center, West Aceh District.

OBJECTIVE: To find out the relationship of energy intake, carbohydrate intake, protein intake, fat intake, and physical activity with the incidents of fatness in venerable. METHODS: Quantitative approach with cross-sectional design was applied and analyzed using chi square. Subjects in this research were venerable people aged 45-59 years old, who have the inclusion criteria were 88 people using Nutri survey technique through questionnaire. RESULT: The result showed a significant relationship between protein intake, fat, and activity of physic among fatness cases on venerable with p-value=0.023 (OR=0.164), p-value=0.028 (OR=1.529) and p-value=0.016 (OR=1.474). On the other hand, the research found not a significant relationship between energy intake and carbohydrate intake with the incidents of fatness in venerable with p-value =0.308 (OR=1.474) and p-value=1.000 (OR=1.450). CONCLUSION: Excessive protein intake and fat intake with light activity can be a risk factor for fatness, especially in the venerable. It is suggested to venerable people to keep their daily food intake and do physical activity to reduce the risk of fatness.

A cell-based drug discovery assay identifies inhibition of cell stress responses as a new approach to treatment of epidermolysis bullosa simplex.

In the skin fragility disorder epidermolysis bullosa simplex (EBS), mutations in keratin 14 (K14, also known as KRT14) or keratin 5 (K5, also known as KRT5) lead to keratinocyte rupture and skin blistering. Severe forms of EBS are associated with cytoplasmic protein aggregates, with elevated kinase activation of ERK1 and ERK2 (ERK1/2; also known as MAPK3 and MAPK1, respectively), suggesting intrinsic stress caused by misfolded keratin protein. Human keratinocyte EBS reporter cells stably expressing GFP-tagged EBS-mimetic mutant K14 were used to optimize a semi-automated system to quantify the effects of test compounds on keratin aggregates. Screening of a protein kinase inhibitor library identified several candidates that reduced aggregates and impacted on epidermal growth factor receptor (EGFR) signalling. EGF ligand exposure induced keratin aggregates in EBS reporter keratinocytes, which was reversible by EGFR inhibition. EBS keratinocytes treated with a known EGFR inhibitor, afatinib, were driven out of activation and towards quiescence with minimal cell death. Aggregate reduction was accompanied by denser keratin filament networks with enhanced intercellular cohesion and resilience, which when extrapolated to a whole tissue context would predict reduced epidermal fragility in EBS patients. This assay system provides a powerful tool for discovery and development of new pathway intervention therapeutic avenues for EBS.

The superiority of high-power short-duration radiofrequency catheter ablation strategy for atrial fibrillation treatment: A systematic review and meta-analysis study.

BACKGROUND: Radiofrequency catheter ablation (RFCA) using the high-power short duration (HPSD) results in better ablation lesion formation in the swine model. This systematic review and meta-analysis purposed to investigate the safety and efficacy profile between HPSD and low-power long-duration (LPLD) ablation strategies to treat atrial fibrillation (AF) patients. METHODS: We completed the literature review after identifying the relevant articles comparing HPSD and LPLD ablation methods for AF recorded in ClinicalTrials.com, CENTRAL, PubMed, and ScienceDirect until February 2021. The overall effects were calculated using pooled risk ratio (RR) and mean difference (MD) for categorical and continuous data, respectively. We also estimated the 95% confidence interval (CI). RESULTS: The HPSD strategy took shorter procedure time (MD = -33.75 min; 95% CI = -44.54 to -22.97; P < .01), fluoroscopy time (MD = -5.73 min; 95% CI = -8.77 to -2.70; P < .001), and ablation time (MD = -17.71; 95% CI = -21.02 to -14.41) than LPLD strategy. The HPSD RFCA was correlated with lower risk of esophageal thermal injury (RR = 0.75; 95% CI = 0.59 to 0.94; P = .02). The HPSD method resulted in higher first-pass pulmonary vein isolation (PVI) (RR = 1.36; 95% CI = 1.13 to 1.64; P < .01), lower PV reconnection (RR = 0.47; 95% CI = 0.34 to 0.64; P < .01), and lower recurrent AF (RR = 0.72; 95% CI = 0.54 to 0.96; P = .02) than LPLD strategy. CONCLUSION: HPSD RFCA was superior to the conventional LPLD RFCA in terms of safety and efficacy in treating AF patients.

Decentralized Trusted Data Sharing Management on Internet of Vehicle Edge Computing (IoVEC) Networks Using Consortium Blockchain.

The emergence of the Internet of Vehicles (IoV) aims to facilitate the next generation of intelligent transportation system (ITS) applications by combining smart vehicles and the internet to improve traffic safety and efficiency. On the other hand, mobile edge computing (MEC) technology provides enormous storage resources with powerful computing on the edge networks. Hence, the idea of IoV edge computing (IoVEC) networks has grown to be an assuring paradigm with various opportunities to advance massive data storage, data sharing, and computing processing close to vehicles. However, the participant's vehicle may be unwilling to share their data since the data-sharing system still relies on a centralized server approach with the potential risk of data leakage and privacy security. In addition, vehicles have difficulty evaluating the credibility of the messages they received because of untrusted environments. To address these challenges, we propose consortium blockchain and smart contracts to accomplish a decentralized trusted data sharing management system in IoVEC. This system allows vehicles to validate the credibility of messages from their neighboring by generating a reputation rating. Moreover, the incentive mechanism is utilized to trigger the vehicles to store and share their data honestly; thus, they will obtain certain rewards from the system. Simulation results substantially display an efficient network performance along with forming an appropriate incentive model to reach a decentralized trusted data sharing management of IoVEC networks.

Analysis relationship of fatness in venerable people at Johan Pahlawan Health Center, West Aceh District

Objective: To find out the relationship of energy intake, carbohydrate intake, protein intake, fat intake, and physical activity with the incidents of fatness in venerable. Methods: Quantitative approach with cross-sectional design was applied and analyzed using chi square. Subjects in this research were venerable people aged 45–59 years old, who have the inclusion criteria were 88 people using Nutri survey technique through questionnaire. Result: The result showed a significant relationship between protein intake, fat, and activity of physic among fatness cases on venerable with p-value = 0.023 (OR = 0.164), p-value = 0.028 (OR = 1.529) and p-value = 0.016 (OR = 1.474). On the other hand, the research found not a significant relationship between energy intake and carbohydrate intake with the incidents of fatness in venerable with p-value = 0.308 (OR = 1.474) and p-value = 1.000 (OR = 1.450). Conclusion: Excessive protein intake and fat intake with light activity can be a risk factor for fatness, especially in the venerable. It is suggested to venerable people to keep their daily food intake and do physical activity to reduce the risk of fatness. (AU)

A rare cystic lymphoplasmacyte-rich meningioma: A case report and review of the literature.

BACKGROUND: Meningiomas are common central nervous system neoplasms, accounts for 30% of all primary intracranial neoplasms; the occurrence of meningiomas with cystic lesions is an exceptionally rare. Lymphoplasmacyte-rich meningioma (LPRM) is a rare pathological entity belong to the World Health Organization Grade I meningiomas. LPRM is characterized by abundant lymphoplasmacytic infiltrates which over-shadow the underlying meningothelial component. CASE DESCRIPTION: A 42-year-old male was admitted to our hospital with a chronic headache for about 3 weeks prior to admission. His symptoms worsen, and subsequently, he experienced left extremities weakness about 1 week before admission. His brain magnetic resonance imaging revealed an irregular and heterogeneously enhancing solid lesion with intratumoral cystic changes at the temporal lobe. A gross total resection was performed; pathological examination revealed a cystic LPRM. CONCLUSION: This rare variant of meningioma is a benign tumor entity featured with massive inflammatory cell infiltration and often less proportion of meningothelial elements. Surgical resection remains the treatment of choice. This is the first report regarding cystic LPRM from Indonesia; we also summarized relevant literature upto-date, May 2020, reported LPRM cases.