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Background Cardio-metabolic diseases are a major cause of death worldwide, including in Indonesia, where diabetes is one of the most critical diseases for the health system to manage. Methods We describe the characteristics, levels of control, health behavior, and diabetes-related complications of diabetes patients in Aceh, Indonesia. We use baseline data and blood testing from a randomized-controlled trial. We conducted semi-structured interviews with eight health providers from Posbindu and Prolanis programs that target diabetes and other non-communicable diseases (NCDs). We also conducted three focus group discussions with 24 diabetes patients about their experiences of living with diabetes and the existing support programs. Results The blood tests revealed average HbA1c levels indicative of poor glycemic control in 75.8 percent of patients and only 20.3 percent were free from any symptoms. Our qualitative findings suggest that patients are diagnosed after diabetes-related symptoms manifest, and that they find it hard to comply with treatment recommendations and lifestyle advice. The existing programs related to NCDs are not tailored to their needs. Conclusion We identify the need to improve diabetes screening to enable earlier treatment and achieve better control of the disease. Among diagnosed patients, there are widespread beliefs about diabetes medication and alternative forms of treatment that need to be addressed in a respectful dialogue between healthcare professionals and patients. Current diabetes screening, treatment and management programs should be revised to meet the needs of the affected population and to better respond to the increasing burden of this disease.

Indonesia is prone to natural hazards, which have continued to occur even during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study explored the response and strategy employed by Muhammadiyah, one of Indonesia's moderate Islamic organisations, in dealing with natural hazards during this pandemic. A qualitative descriptive method was used in this study, and the data collection procedure involved finding related literature, reports, and decrees. Online interviews were also conducted with the Muhammadiyah Disaster Management Center (MDMC) administration to strengthen the data. Subsequently, this study discovered that Muhammadiyah responded by aiding victims of natural hazards, which occurred in various regions in Indonesia during the COVID-19 pandemic. The strategies employed comprise Muhammadiyah COVID-19 Command Center (MCCC) to handle COVID-19, alongside essential recommendations to the MDMC network throughout Indonesia and the various arms of the government for dealing with natural hazards during the pandemic. Also, it showed commitment to handling these hazards by establishing a standard operating procedure for Muhammadiyah volunteers and represented Indonesia during a presentation at the World Health Organization.

Background: The present study aimed to determine the global prevalence of anosmia and dysgeusia in coronavirus disease 2019 (COVID-19) patients and to assess their association with severity and mortality of COVID-19. Moreover, this study aimed to discuss the possible pathobiological mechanisms of anosmia and dysgeusia in COVID-19. Methods: Available articles from PubMed, Scopus, Web of Science, and preprint databases (MedRxiv, BioRxiv, and Researchsquare) were searched on November 10th, 2020. Data on the characteristics of the study (anosmia, dysgeusia, and COVID-19) were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Newcastle-Ottawa scale was used to assess research quality. Moreover, the pooled prevalence of anosmia and dysgeusia were calculated, and the association between anosmia and dysgeusia in presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was assessed using the Z test. Results: Out of 32,142 COVID-19 patients from 107 studies, anosmia was reported in 12,038 patients with a prevalence of 38.2% (95% CI: 36.5%, 47.2%); whereas, dysgeusia was reported in 11,337 patients out of 30,901 COVID-19 patients from 101 studies, with prevalence of 36.6% (95% CI: 35.2%, 45.2%), worldwide. Furthermore, the prevalence of anosmia was 10.2-fold higher (OR: 10.21; 95% CI: 6.53, 15.96, p < 0.001) and that of dysgeusia was 8.6-fold higher (OR: 8.61; 95% CI: 5.26, 14.11, p < 0.001) in COVID-19 patients compared to those with other respiratory infections or COVID-19 like illness. To date, no study has assessed the association of anosmia and dysgeusia with severity and mortality of COVID-19. Conclusion: Anosmia and dysgeusia are prevalent in COVID-19 patients compared to those with the other non-COVID-19 respiratory infections. Several possible mechanisms have been hypothesized; however, future studies are warranted to elucidate the definitive mechanisms of anosmia and dysgeusia in COVID-19. Protocol registration: PROSPERO CRD42020223204.

Background Aceh, the westernmost province in Indonesia, was granted autonomous status, allowing the area to officially practice Sharia law, making the region religiously conservative. The province has the lowest measles vaccination rates in the country, with only 54% coverage. This study aims to quantify the contribution of concerns or structural barriers on non-vaccination. Methods In a 2022 cross-sectional population-based study, 899 parents reported religious vaccine concerns, concerns about side effects, and whether they encountered structural barriers. The degree to which religious concerns impact the first dose of measles-rubella (MR1) and pentavalent (Penta1) vaccination was quantified through population-attributable fractions (PAF). Results Among respondents, 62% reported their child had received MR1 and 63% Penta1. In total, 60% of parents expressed religious concerns about vaccination and 75% about vaccine side effects. The PAF for MR1 non-vaccination was 36% (95% CI: 21%, 52%) for religious concerns and 35% (95% CI: 16%, 51%) for concerns about side effects. For Penta1, the PAF was 42% (95% CI: 24%, 59%) for concerns about side effects and 28% (95% CI: 13%, 44%) for religious concerns. Structural barriers like stockouts, cost, or inconvenient clinic hours were less frequently cited and contributed minimally to non-vaccination. Conclusions While concerns can overlap, evidence suggests that religious concerns are distinct and influence vaccination rates more than structural barriers. Understanding barriers to vaccination is a precursor to developing tailored interventions, like encouraging religious leaders to act as a trusted source of vaccine guidelines or promoting the use of a halal vaccine, that can mitigate hesitancy.

Background Despite advancements in child immunization, inadequate immunization rates in low- and middle-income countries persist due to inadequate health infrastructure, challenges in vaccine supply and distribution, insufficient healthcare provider training, and low levels of community trust in vaccines. Aceh, a religiously conservative province in Indonesia, has low pediatric vaccination coverage and exemplifies the need for innovative vaccine delivery models. Evidence suggests interventions should target both logistical barriers (e.g., distance or clinic wait times) and societal factors, including misinformation, that contribute towards vaccine hesitancy. Methods The trial “TABRIE” will measure the impact of two strategies on children’s vaccination rates and parental attitudes towards vaccines in Banda Aceh and Aceh Besar, Indonesia, compared to current outreach strategies. The two strategies being tested are (a) an informational conference with religious leaders who work in specific clinics and (b) a mobile vaccine clinic staffed with community health workers conducting a variety of outreach events. We will execute a stepped wedge cluster randomized design with baseline measures and a cross-sectional sampling structure. Twelve districts ( Kecamatan ) will be randomized into one of the two strategies. In year 1, three districts from each strategy will implement the intervention, with the other three districts implementing the strategy in the second year. We will conduct cross-sectional surveys in September 2023 (baseline), September 2024 (year 1), and September 2025 (year 2). The primary outcome is the proportion of fully vaccinated children aged 1–5 years for bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis (DTP), polio, and measles. Secondary outcomes include the proportion of children aged 1–5 years with at least one dose of DTP and measles vaccines, the proportion of vaccine-hesitant parents, social norms surrounding vaccination, parental trust in community health workers to administer vaccines, the proportion of parents experiencing distance barriers to vaccination, the proportion of parents reporting that their religious leader encourages vaccination, and the proportion of parents receiving vaccination information from their religious leader. Discussion This study will conduct a stepped wedge cluster randomized trial to separately estimate the effects of religious conferences and mobile vaccine clinics on pediatric vaccination rates and parental attitudes towards vaccination. It will offer a novel paradigm in vaccination delivery by inserting vaccination from clinics into social spaces that provide alternative, community-centered policy solutions to vaccine hesitancy. Trial registration ClinicalTrials.gov NCT06160999. Registered on December 14, 2023.

With the advancement of technology and the growth of the internet and cyber, many negative factors, such as cyberattacks and cybercrime, are on the rise and hinder the internet's and technology's positive use. Cybercrime is one of the worst factors significantly increasing in Indonesia today. Cybercrime is a criminal act that is prohibited in every country on the planet. The instances of cybercrime have harmed Indonesian computer users. The present study evaluates the legal frameworks and articles designed to control cybercrime issues within the Indonesian public administration. This study utilized a qualitative descriptive approach, along with an empirical judicial technique and statute approach analysis method. Documents about articles and legal frameworks in Indonesia were analyzed for data collection. The types and patte+rns of Cybercrime in Indonesia are outlined in Articles 27 to 35 of Law No. 11/2008. Chapter XI of Act No. 11/2008 describes the forms and patterns of violation of confidentiality and privacy. Based on the findings and discussion of the legal framework and analysis, recommendations are made to promote preventive measures, increase accountability, and reduce the communication divide between the government and Cybercrime-authoritative agencies. Along with the research limitations discussed in the study, the study has numerous theoretical and practical implications.

The study utilizes the colorimetric method (involving 1,5-diphenylcarbazide and potassium thiocyanate as complexing agents), computer vision, and machine learning (ML) regression algorithms to determine the content of Cr (VI) and Fe (III) in water samples. To process digital images of water samples, the integration technique utilized a flatbed scanner known as the CanoScan LiDE 100, operating as a digital image capture device, and its performance was compared to that of conventional instruments. The study reveals that PolyReg and SVR-Poly are the most reliable ML regression algorithms for processing color space data (G and B of RGB, c* of CIELch, and b* of CIELab) of digital images of water samples that contain Cr (VI) and Fe (III). The mean absolute percentage error (MAPE) of the ML regression algorithms PolyReg and SVR-Poly for determining the content of Cr (VI) and Fe (III) is < 10% (with 8.48% error for Cr (VI) determination using PolyReg G of RGB and 6.78% error for Fe (III) determination using PolyReg B of RGB) in the estimation algorithm model. The Mean Absolute Percentage Error (MAPE) indicates that the prediction method is highly accurate. The Limit of Detection (LOD) value of the flatbed scanner colorimetric method integrated with PolyReg G of Red–Green–Blue (RGB) for Chromium (VI) and Blue of RGB for Iron (III) is approximately 0.02 mg/L. The Limit of Detection (LOD) for Chromium (VI) and Iron (III) is 0.0209 mg/L and 0.0257 mg/L, respectively. The limit of detection (LOD) values from this technique are superior to those obtained from certain UV–vis spectrometric and colorimetric methods. The low LOD values demonstrate that this technique is suitable for estimating the concentration of Cr (VI) and Fe (III) in water samples for quality assessment purposes, as these values are below the maximum concentration levels established by various regulations, including US-EPA, ASEAN, and EECCA. Graphical abstract

The coronavirus disease 2019 (COVID-19) pandemic is a major global threat. With no effective antiviral drugs, the repurposing of many currently available drugs has been considered. One such drug is ivermectin, an FDA-approved antiparasitic agent that has been shown to exhibit antiviral activity against a broad range of viruses. Recent studies have suggested that ivermectin inhibits the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus suggesting its potential for use against COVID-19. This review has summarized the evidence derived from docking and modeling analysis, in vitro and in vivo studies, and results from new investigational drug protocols, as well as clinical trials, if available, which will be effective in supporting the prospective use of ivermectin as an alternative treatment for COVID-19.

This study aimed to investigate the concentrations of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) in vitreous and serum samples, analyze the ratio, and compare among proliferative diabetic retinopathy (PDR) subgroups. This study included 17 eyes of patients with PDR, identified as the PDR group which was divided into three subgroups (vitreous hemorrhage [VH], VH with fibrotic tissues, and tractional retinal detachment), and five control eyes (nucleus and intraocular lens drop). Vitreous and serum samples were obtained on the same day. The VEGF-A and PDGF-AB concentrations were calculated by enzyme-linked immunosorbent assay. The VEGF-A and PDGF-AB concentrations in vitreous samples were significantly higher in the PDR group (630.72 ± 342.81 pg/mL) compared with those in the control group (153.58 ± 145.85 pg/mL); however, they were not detected in serum samples. The vitreous/serum ratio of the VEGF-A concentration in the PDR group (2.1 ± 1.8) was significantly higher compared with that in the control group (0.31 ± 0.33). The VEGF-A concentrations in vitreous samples were highest in the VH group and lowest in the VH with fibrotic tissue subgroup (mean difference 536.16 pg/mL). The vitreous VEGF-A/PDGF-AB concentration ratios were also significantly different among the PDR subgroups. High concentrations of VEGF and PDGF in vitreous samples of PDR eyes indicate its local related activity in PDR pathology. There is a possibility of PDGF involvement in the pathogenesis of PDR. The VEGF/PDGF concentration ratios possibly play a significant role in the formation of fibrotic tissue in PDR.

Purpose: This research aims to identify risk indicators of delays in critical scheduling activities of a railway station construction project from the service provider's perspective. It aims to help prepare and respond to potential delays, ensuring project success and boosting economic growth and national connectivity in Indonesia. Design/methodology/approach: A literature study was conducted to identify variable risk information on project delays in a railway station project. Expert validation was done using Delphi methods or structured interviews. Focus group discussion (FGD) was used to identify the most dominant risks in each critical scheduling activity. The study revealed 51 risk variables influencing project delays, with 22 dominant risks identified in a case study project. FGD surveys were conducted on each critical activity, and data from five experts was evaluated using descriptive techniques and elimination techniques to determine the most influential risk. The results were that there were 9 critical activities and 6 most dominant risks. Findings: The study reveals that delays in completing the railway station project are primarily due to issues with issuing permits, which is the most significant risk factor for the three critical activities. Other risks include working on the active track, adjusting train operation patterns, dependencies between phases and work packages, long decision- making processes by the project owner, and complicated construction authorization procedures. Research limitations/implications: Further comprehensive investigation is required to ascertain the impact of project risk assessment on the expenses and caliber of additional railway projects, in addition to projects with broader scopes like other transportation construction projects. Originality/value: This study analyzes and identifies the most dominant risks to critical activities of railway station projects, and investigates their impact on project completion time optimization.