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Insulin resistance is one of the metabolic complications of COVID-19. Our previous study showed a 22% median increase in homeostasis model assessment-estimated insulin resistance (HOMA-IR) in obese individuals at 12 months post-infection compared to acute infection. This study aimed to investigate the association between various subsets of IFN-γ-expressing SARS-CoV-2-specific CD4 +  and CD8  +  T cells and insulin resistance in convalescent COVID-19 patients over a one-year post-infection follow-up period. A nested case control study of 47 COVID-19 patients was followed for 12 months post-infection and categorized into three groups based on obesity and changes in HOMA-IR at one year: non-obese without increased HOMA-IR (NO), obese without increased HOMA-IR (O), and obese with increased HOMA-IR (O-IR). Increased HOMA-IR was defined as a HOMA-IR ratio (12-month to 1-month convalescence phase) > 1.21. To study antigen-specific responses, peripheral blood mononuclear cells (PBMC)s were isolated and incubated with SARS-CoV-2 peptide antigens for 24 h. Intracellular IFN-γ expression, as well as exhaustion and senescence markers, in various CD4 + and CD8 + T cell subsets were measured by flow cytometry. The abundance of IFN-γ-expressing SARS-CoV-2-specific CD4 + T cells was lower in the O-IR group compared to individuals without increased HOMA-IR during the 9th to 12th months of follow-up ( p  < 0.05). Conversely, the O-IR group exhibited a mild but significantly higher IFN-γ-expressing CD8 + T cells from the 3rd to the 9th month of the convalescence phase ( p  < 0.05). A reduced proportion of functional (PD-1 − CD57 − ) SARS-CoV-2-specific T cells was observed in O-IR group. Furthermore, the reduced proportion of functional SARS-CoV-2-specific CD4⁺ T cells observed within 12 months of convalescence were have significant weak negative correlation with HOMA-IR ratio as well as HOMA-IR value. Our study demonstrates that obese individuals with increased HOMA-IR exhibited a reduced proportion of IFN-γ–expressing functional SARS-CoV-2-specific CD4⁺ T cells one year after COVID-19. This reduction, along with the decreased frequencies of both functional CD4⁺ within 12 months of convalescence, suggests a potential association between impaired SARS-CoV-2-specific T cell function and the development of insulin resistance following COVID-19. These findings warrant further investigation.

Indonesia has implemented a programmatic transition of nevirapine to a dolutegravir-based antiretroviral therapy for stable people living with HIV (PLWH). This study aimed to identify changes in quality of life (QoL) after six months of this transition and evaluate the correlation of weight, sleep quality, depression, and estimated glomerular filtration rate (eGFR) changes to QoL. Our cohort prospective study involved 145 participants who underwent transition from nevirapine to dolutegravir-based regimen. QoL was assessed using the Indonesian version of the EQ-5D-3 L questionnaire. Of the 145 participants, 57.2% were male, with a median age of 43 (40–46.5) years, and 99.3% had undetectable viruses. We found a significant improvement in EQ VAS score (median 90 (IQR 80–99) vs. median 90 (IQR 85–100), p = < 0.001). There was, however, a significant number of participants who had worsening pain/discomfort ( p  = 0.036). We found no correlation between changes in weight, sleep quality, depression, and eGFR with QoL. Our study shows a promising improvement in QoL as a result of transitioning from nevirapine to dolutegravir-based regimen despite an increase in reported pain.

Background Pilot errors and preconditions are major concerns that affected by multiple factors physiologically, psychologically and psychosocially. This study aimed to analyse the correlation between the internal and external risk factors, and pilot preconditions in Indonesia. Methods A cross-sectional study design with purposive sampling, directed to male pilots who had flight duty in the past seven days, underwent medical examination at the Aviation Medical Center, Jakarta, August 12–16, 2024. The data were collected through a self-report questionnaire, Trail Making Test A and B, laboratory tests (plasma lipid, fasting blood glucose), and physical measurements (height, weight, waist circumference, and blood pressure). The independent variables divided into internal factors (Age, Burnout, Metabolic Syndrome parameters); and external factors (Flight Time, Duty Time, Unscheduled Flight Duty, Number of Sectors, Sleep Duration). The dependent variables were pilot preconditions based on the Human Factor Analysis and Classification System (HFACS). Results A total of 122 participants participated and 28.7% had an Unscheduled Flight Duty in the last 30 days. Significant correlations were found between Adverse Mental State and HDL-Cholesterol (95%CI=1.52–5.80), Adverse Physiological State and Burnout [Personal (95%CI=0.005–0,04), Work-Related (95%CI=0.009–0.042)], Physical Mental Limitation and Fasting Blood Glucose (95%CI=(-0.479)–(-0.071)), Number of Sectors (95%CI=0.022–3.001). For Personal Readiness (PR), significant correlation was found between PR-Psychological Demand and Flight-Time One Year (95%CI=(0.000–0.001), Sleep Duration (95%CI=(-0.137)–(-0.013)), Waist Circumference (95%CI=(-0.014)–(-0.002)), PR-Social Support and Sleep Duration (95%IK=0.018–0.207), Client-Related Burnout (95%IK=(-0.011)–(-0.002)). Conclusions The internal factors that correlated with pilot preconditions in Indonesia were Waist Circumference, HDL-Cholesterol, Fasting Blood Glucose, Personal Burnout, Work, and Client-related burnout. External factors that correlated with pilot preconditions were the Number of Sectors, Flight-Time One Year and Sleep duration. These findings emphasize the need to address physical and mental health aspects of pilots to enhance aviation safety.

Background: Obesity and central obesity have become serious public health problems in developing countries such as Indonesia. Although 10 years have passed since the largest national health survey was conducted in 2007, no further analysis and publication concerning obesity and central obesity in Indonesia have been conducted based on the survey. The aim of this study is to determine the prevalence of obesity and central obesity, and its association with sociodemographic characteristics and comorbidities in Indonesia.Methods: A cross-sectional study was conducted based on the National Basic Health Survey 2007 using total sampling method from 33 provinces. Obesity is defined as body mass index ≥25 according to the Asia-Pacific standard for obesity. Central obesity is defined as waist circumference >90 cm for men and > 80 cm for women according to the Asia-Pacific standard for central obesity.Results: The prevalence of obesity and central obesity in the Indonesian adult population are 23.1% and 28%, respectively. Both rates are higher in females than in males. Obesity and central obesity are associated with the risk of diabetes and hypertension.Conclusion: Prevalence of obesity and central obesity is high in the Indonesian adult population. Interventional programs are important to promote awareness of obesity and healthy lifestyle changes in the community.

This study investigates the influence of the independent board of commissioners and audit committee on earnings management to achieve earning targets in Indonesian banking. The research sample was drawn from 33 banks listed on the Indonesia Stock Exchange from 2012 to 2022 to evaluate the time frame of the study and its relevance to current banking trends in Indonesia, as well as to examine the data sources used and their reliability. The data analysis method used in this study is a dummy variable regression model. The findings reveal significant insights into the motivations behind earnings management practices. Specifically, this study finds that managers engage in earnings management to meet profit targets, thereby signaling strong performance to stakeholders and potentially securing bonuses. Notably, the influence of corporate governance structures varies: while the independent board of commissioners demonstrates no significant effect on earnings management (p = –0.01), the audit committee plays a pivotal role, significantly influencing earnings management practices (p = –0.017). Moreover, the analysis uncovers that company size has a significant impact on earnings management (p = 0.002), while return on assets (ROA) does not. This study provides empirical evidence demonstrating the efficacy of audit committees in curbing managerial incentives for earnings management to meet targets. Furthermore, by quantifying the influence of corporate governance mechanisms and firm characteristics on earnings management, this study sheds light on key dynamics in the Indonesian banking industry.

Graves’ disease (GD) has a high recurrence rate despite various and adequate treatment. Numerous studies have been performed to identify the predictor of disease recurrence. This report aims to investigate the role of thyroid stimulating hormone (TSH) level as a thyrotropin in predicting the recurrence of Graves’ disease within 1 to 2 years following antithyroid drug (ATD) withdrawal. Literature searching was conducted on PubMed, Scopus, Cochrane, Proquest, EBSCO in August 2019 and Google Scholar in October 2020. The study criteria include the study that evaluates TSH level 4 weeks following ATD withdrawal, with subjects ≥18 years old who are retrospectively or prospectively followed up after 1 to 2 years following ATD withdrawal. Four eligible studies were selected based on inclusion/exclusion criteria, all of which measured TSH level at 4 weeks following ATD withdrawal. All studies had 1 to 2 years follow up. One study was an RCT, two studies were done in prospective cohort and another in retrospective cohort. All studies had comparable validity and applicability. Three out of four studies suggested that low TSH level measured 4 weeks following treatment withdrawal was associated with higher risk of disease recurrence. In conclusion, low TSH level obtained 4 weeks after ATD withdrawal was associated with higher rate of recurrence rate in GD.

This study examines the impact of corporate governance on the probability of financial statement fraud and evaluates the moderating role of financial distress in this relationship. This issue remains highly relevant given the persistence of fraudulent financial practices despite evolving governance regulations. The analysis is conducted on a sample of 330 non-financial companies listed on the Indonesia Stock Exchange from 2021 to 2022. Using purposive sampling and secondary data, the study measures financial statement fraud with the F-score, corporate governance through institutional ownership, ineffective monitoring, regulatory compliance, and financial distress using the Zmijewski model. The study applies moderated regression analysis across three models. The results from Model 1 show that corporate governance has a significant negative effect on the likelihood of financial statement fraud (β = –0.085; p < 0.05). Model 2 finds that financial distress alone has a significant positive effect (β = 0.315; p < 0.05). Model 3 confirms a significant moderation effect, where financial distress strengthens the relationship between governance and fraud (interaction β = 0.353; p < 0.05). These findings indicate that while effective governance can reduce fraudulent financial reporting, this effect is influenced by a company’s financial state. Therefore, robust governance structures are vital, particularly in times of financial hardship. Future studies should consider external institutional mechanisms to further understand these dynamics.

Thyroid carcinoma rarely metastasizes to the orbit. Approximately only 2%-7% of orbital metastatic lesion were found originally from thyroid carcinoma. We present three cases to increase the awareness of orbital metastases as the initial manifestation of thyroid carcinoma. Three female patients aged 28-65 years old presented with initial complaint of orbital mass. Further examination discovered an asymptomatic lump on every patient's neck. However, one patient was unaware of her lump. Examination revealed that all lesions were metastases from papillary thyroid carcinoma. These cases conclude several similarities. First, prominent unilateral proptosis, orbital mass in the superior quadrant, limited eyeball movement, and orbital bone destruction were found in every patient. Second, all the orbital computed tomography scan showed extraconal solid masses involving adjacent structures and expanding intra-cranially or intrasinusly. These findings should raise one's suspicion of a metastatic lesion primarily caused by thyroid carcinoma. Despite the rarity of orbital metastases, thyroid carcinoma must be considered as a potential primary tumor in patients with initial presentation of orbital mass. Thorough physical examination is important to determine the origin of metastases.

This study aims to examine the impact of isomorphic pressures (coercive, normative, and mimetic) on the adoption of eXtensible Business Reporting Language (XBRL), with the economic level as a moderator. We employ a meta-analysis approach to synthesize 138 outcomes from articles published between 2010 and 2024. The findings indicate that isomorphic pressures, particularly mimetic pressures, affect XBRL adoption. The economic level of a country has a moderating influence, and developed countries are more susceptible to normative demands. This study expands institutional theory by revealing the varied effects of isomorphic pressures on technology adoption in different economic contexts and introducing a nuanced theoretical framework of understanding technological adoption. The findings offer practical insights for policymakers to design institutional settings that include regulatory mandates, financial incentives, and technical support, and for business leaders regarding the execution of successful strategies.

Abstract Background Pilot errors and preconditions are major concerns that affected by multiple factors physiologically, psychologically and psychosocially. This study aimed to analyse the correlation between the internal and external risk factors, and pilot preconditions in Indonesia. Methods A cross-sectional study design with purposive sampling, directed to male pilots who had flight duty in the past seven days, underwent medical examination at the Aviation Medical Center, Jakarta, August 12–16, 2024. The data were collected through a self-report questionnaire, Trail Making Test A and B, laboratory tests (plasma lipid, fasting blood glucose), and physical measurements (height, weight, waist circumference, and blood pressure). The independent variables divided into internal factors (Age, Burnout, Metabolic Syndrome parameters); and external factors (Flight Time, Duty Time, Unscheduled Flight Duty, Number of Sectors, Sleep Duration). The dependent variables were pilot preconditions based on the Human Factor Analysis and Classification System (HFACS). Results A total of 122 participants participated and 28.7% had an Unscheduled Flight Duty in the last 30 days. Significant correlations were found between Adverse Mental State and HDL-Cholesterol (95%CI=1.52–5.80), Adverse Physiological State and Burnout [Personal (95%CI=0.005–0,04), Work-Related (95%CI=0.009–0.042)], Physical Mental Limitation and Fasting Blood Glucose (95%CI=(-0.479)–(-0.071)), Number of Sectors (95%CI=0.022–3.001). For Personal Readiness (PR), significant correlation was found between PR-Psychological Demand and Flight-Time One Year (95%CI=(0.000–0.001), Sleep Duration (95%CI=(-0.137)–(-0.013)), Waist Circumference (95%CI=(-0.014)–(-0.002)), PR-Social Support and Sleep Duration (95%IK=0.018–0.207), Client-Related Burnout (95%IK=(-0.011)–(-0.002)). Conclusions The internal factors that correlated with pilot preconditions in Indonesia were Waist Circumference, HDL-Cholesterol, Fasting Blood Glucose, Personal Burnout, Work, and Client-related burnout. External factors that correlated with pilot preconditions were the Number of Sectors, Flight-Time One Year and Sleep duration. These findings emphasize the need to address physical and mental health aspects of pilots to enhance aviation safety.