Penghambat Kanal Kalsium sebagai Kontrol Glukosa Darah pada Insulinoma: Sebuah Laporan Kasus

Insulinoma is a rare neuroendocrine tumor of the pancreas arising from β-cells, leading to excessive insulin secretion and resultant hypoglycaemia. Surgical resection is the first-line treatment for insulinoma, but when surgery is not feasible, medical therapy is an important option. Calcium channel blockers (CCBs) such as verapamil can inhibit insulin release from β-cells and have been proposed as an adjunct therapy to help control blood glucose levels in insulinoma. We report a 43-year-old man who presented to the emergency department with decreased consciousness due to hypoglycaemia. His capillary blood glucose at home was 35 mg/dL, about 8 hours after his last meal. He had a history of recurring hypoglycaemic episodes in the past month, with recorded blood glucose ranging from 26–100 mg/dL during a prior hospitalization. On examination, he was hemodynamically stable but had mild epigastric tenderness. Laboratory tests confirmed hyperinsulinemic hypoglycaemia (plasma glucose 58 mg/dL with concurrent serum insulin 47 µIU/mL and C-peptide 13.1 ng/mL), consistent with insulinoma. Abdominal imaging revealed a heterogeneous pancreatic mass suspected as an insulinoma. Initial management included a continuous infusion of 10% dextrose (500 mL/24h) with IV boluses of 40% dextrose as needed for blood glucose \u3c70 mg/dL. Despite this, the patient experienced recurrent hypoglycaemia, so octreotide 50 µg three times daily was added. Octreotide alone did not fully stabilize his blood glucose levels. On the 6th day of hospitalization, oral verapamil 80 mg once daily was initiated – chosen both to treat the patient’s concurrent hypertension and for its potential to suppress insulin release. Following the addition of verapamil, the patient’s blood glucose levels improved and remained above 100 mg/dL with markedly reduced hypoglycemic episodes. The patient subsequently underwent a debulking surgery of the pancreatic tumor. This case highlights the importance of controlling blood glucose in insulinoma patients and demonstrates that the addition of verapamil can stabilize blood glucose when used alongside standard medical therapy (such as octreotide). Verapamil may serve as a useful adjunct in the management of insulinoma-related hypoglycemia, especially in patients awaiting surgery or those who are not surgical candidates

Public Health Entrepreneurship in Indonesia: What is Next?

Public health has been demanded to search for ways to improve well-being by tackling societal and ecological factors that influence health through cooperative strategies and partnerships across various fields. More interdisciplinary, interprofessional, and action-oriented approaches toward sustainable public health programs are recommended to be made. Therefore, public health entrepreneurship is an indispensable approach to creating new interventions that address future public health problems. The Indonesian Ministry of Health conceptualized five public health entrepreneurship skills as standard competence for public health personnel. In addition, the Association of Indonesian Public Health Higher Education Institutions has identified several study materials and learning outcomes for undergraduate public health personnel. To enrich the currently available approaches, a similar concept of entrepreneurship training, including three course areas: systems of laws and regulations, advertising and public outreach, and financial oversight, consumer insights, and assessment, is presented. The Public Health Entrepreneurship and Intrapreneurship Framework is also presented in this study. Researchers, government, private sectors, experienced entrepreneurs and intrapreneurs, and other stakeholders should collaborate to formulate the best entrepreneurship curriculum for Indonesia. This curriculum can initially be piloted, evaluated, and finally adopted by public health educational institutions in the country

THE IMPACT OF COST LEADERSHIP ON FINANCIAL DISTRESS MEDIATED ENVIRONMENTAL, SOCIAL, AND GOVERNANCE

Background: This study investigates the mediating role of environmental, social, and governance (ESG) performance in the relationship between cost leadership and financial distress among companies in Indonesia. Methods: Using path analysis, the research analyzed a sample of 43 firms listed on the Indonesia Stock Exchange from 2018 to 2022. Findings: The findings indicate that cost leadership positively affected ESG; however, no direct relationship was observed between cost leadership or ESG and financial distress. The mediation analysis reveals that ESG acted as a mediator, linking cost leadership to a reduced risk of financial distress. Conclusion: These results highlight the importance of integrating cost leadership with ESG practices to strengthen corporate financial resilience. Novelty/Originality of this article: The study has offered valuable insights for companies and stakeholders looking to improve sustainability practices that could mitigate the risk of financial distress

Effect of Niobium Dopant on ZnO Thin Films Prepared via the Sol–gel Spin Coating Method

Thin films of zinc oxide (ZnO) and niobium (Nb)-doped ZnO were deposited on a glass substrate using the sol–gel spin coating method. Diethanolamine, isopropyl alcohol, and zinc acetate served as the stabilizers, solvent, and starting ma-terial, respectively. Niobium pentachloride was employed as the dopant source. Energy-dispersive X-ray analysis con-firmed Nb incorporation. Field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), and ultravio-let–visible spectroscopy (UV–Vis) analyses characterized the morphology, structure, and optics of the films, respective-ly. Both films, comprising nanoparticles, were visible in FESEM. Nb doping reduced the particle size from 44.2 nm to 35.8 nm. The XRD peaks at 31.23°, 33.48°, and 35.7° indicate the (100), (002), and (101) orientations, respectively. Nb-doped ZnO exhibited enhanced visible-range transmission in UV–Vis analysis. However, UV spectrum transmission significantly decreased. Nb doping reduced the optical bandgap of ZnO from 3.30 eV to 3.27 eV

Determinants of Adolescent Resilience Levels in Surabaya City, East Java Province, Indonesia

Assessing adolescent resilience may provide valuable insights into adult resilience. This study aimed to analyze the relationship between determinants and adolescent resilience in Surabaya City. The participants of this cross-sectional study were 277 adolescents aged 12–19 years who were in senior high school. The outcome was the resilience levels. This study\u27s findings indicated relationships between resilience levels and stress experience (p-value = 0.01), access to mental health information (p-value = 0.00), life satisfaction (p-value = 0.00), family harmony (p-value = 0.03), presence of adults to share (p-value = 0.04), feeling safe at home, school, and community (p-value = 0.00), perception of ideal body image (p-value = 0.03), and suicidal urges (p-value = 0.00). The multivariate analysis showed that a variable related to resilience was satisfaction with life (p-value = 0.04, 95% CI 1.07–24.22). Adolescents dissatisfied with their lives had a 5.09-fold greater risk of developing into established categories of resilience. Therefore, intervention efforts are necessary to increase adolescents’ resilience levels

Evaluation of Dentistry Students\u27 Perceptions and Attitudes Towards Artificial Intelligence in Kazakhstan

Objective: Artificial intelligence’s (AI) potential to analyze medical data and improve patient outcomes is driving its rapid integration into healthcare systems. This study addresses the knowledge gap regarding Kazakhstani dental students’ attitudes toward AI in dentistry. Methods: A survey with 213 participants assessed dental students’ views on AI in dentistry at two Kazakhstani universities. A self-administered questionnaire (22 items) via Google Forms was used to gather data on demographics, baseline knowledge (information sources, understanding of AI principles, and familiarity with dental AI applications), and attitudes/perceptions. Frequency analyses and chi-square tests (p \u3c 0.05) explored the responses. Results: The survey included 213 dental students (mean age: 21.79 ± 1.82 years). Two-thirds of participants reported basic knowledge of AI principles; however, the rate of dental AI application awareness was lower (40.9%). Friends and family (65.7%) were the primary sources of information, followed by lectures (14.1%) and social media (13.6%). The year of study and sex did not significantly impact AI knowledge or attitudes (p \u3e 0.05). Conclusion: This study in Kazakhstan reveals dental students’ limited awareness of dental AI applications despite possessing basic AI knowledge. This study recommends taking AI-related dental courses and participating in AI workshops to equip students for the future of dentistry and empower them to contribute to and potentially lead Kazakh-specific dental AI advancements

Microstructural and Elemental Characterization of Hydrated Carbonated Hydroxyapatite as Pulp Capping Agent: An in vitro Study

Understanding the microstructural and elemental composition of pulp capping materials is crucial for predicting their biocompatibility and effectiveness in promoting pulp healing. Objectives: This study aimed to characterize the microstructural and elemental properties of carbonated hydroxyapatite as a dental pulp-capping material. Methods: Carbonated hydroxyapatite was synthesized using the precipitation method. MTA and Apacal ART were obtained from commercial sources. The materials were prepared into disk-shaped specimens, hydrated in deionized water at 37°C for 14 days, and analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Results: SEM images revealed that MTA exhibited smooth, plate-like crystalline structures surrounded by a rougher matrix. Apacal ART showed smooth, spherical particles. carbonated hydroxyapatite displayed small, spherical, and irregularly shaped particles. EDX analysis indicated carbonated hydroxyapatite had the highest calcium content, followed by MTA and Apacal ART. Conclusion: Carbonated hydroxyapatite demonstrated favorable microstructural and elemental properties for use as a pulp capping agent. Its high calcium content and specific microstructural features suggest it could be a viable alternative to traditional materials like MTA and Apacal ART. Further clinical studies are needed to validate these findings and assess the in vivo efficacy of carbonated hydroxyapatite

Duty Bearer-Right Holder in Law Number 4 Year 2024 on Maternal and Child Welfare in The First Thousand Days of Life Phase

Law No. 4 Year 2024 on Maternal and Child Welfare in the First Thousand Days of Life has been promulgated by the government of the Republic of Indonesia. The regulation guarantees the implementation and fulfilment of the needs of mothers and children in order to improve the quality of human resources. This article aims to map the duty-bearers-rights holders in the draft law on maternal and child welfare in the first thousand days of life. Analysing the position of maternal mothers is the main focus of this research, as maternal mothers are the main subjects in the draft law on maternal and child welfare in the first thousand days of life. Articles were analysed by context review from secondary data sources of Law No. 4 of 2024 on Maternal and Child Welfare in the First Thousand Days of Life and publication documents with the keywords ‘duty bearers’, ‘rights holders’, ‘maternal welfare’ and ‘maternal and child health’. The results show that most maternal mothers have a dual status as rights holders as well as duty bearers in their duties and responsibilities as pregnant women and newborns in Law No. 4 of 2024 on Maternal and Child Welfare in the First Thousand Days of Life

The Influence of Environmental Knowledge on Pro-Environmental Lifestyles of UI Vocational Students Domiciled in the Jabodetabek Area

The environmental crisis demands the younger generation, especially students, to play an active role in implementing an environmentally friendly lifestyle. This study aims to determine the influence of environmental knowledge on the pro-environmental lifestyle of students in the Jabodetabek area. Using a quantitative survey method on 100 students, the data was analyzed through simple linear regression. The results showed that environmental knowledge significantly influenced pro-environmental lifestyle (p \u3c 0.05), while family support and access to environmentally friendly facilities also played important roles. These findings support the importance of environmental education at the college level to shape sustainable behavior

ARAH BARU POLITIK KEWARGAAN ETNIS TIONGHOA DI INDONESIA (STUDI KASUS JAKARTA & MANADO)

The new direction of ethnic Chinese citizenship politics in Indonesia is marked by a communal revival in non-governmental organizations, media and schools. The past of ethnic Chinese in Indonesia is indeed full of crises, but the future of Chinese citizens in Indonesia really depends on the policies of each ruling regime towards their group. The new direction of ethnic Chinese citizenship politics in Indonesia must be understood as a process of psychological rehabilitation for sentiment and antipathy towards China in the past. The interpretation of social reality and the social movements they carry out on a local scale should be appreciated and appreciated rationally and sympathetically. The government\u27s efforts to create democratic change require much greater effort. Perhaps with the development of democratization in Indonesia, residents of Chinese descent, especially in Jakarta and Manado, will feel that there is security stability, economic growth and equal access to work so that social justice for all is truly achieved to the maximum. Thus, the central government needs to encourage the involvement of Chinese citizens in the world of local government politics at both the executive and legislative levels so that they can find the best way to deal with ethnic and religious tensions in our democratic political system