Padjadjaran University

Conservation and restoration of cultural heritage and protection of abandoned buildings is possible using new technologies in order to create a knowledge base to maintain the original condition of buildings as long as possible. This paper presents the digital geometric survey, combining photogrammetry and photogrammetry with drone for the documentation of a building located in the Riviera Romagnola. The fundamental task to survey historic buildings, in order to document their geometric and morphological features with very high accuracy, becomes an important incentive for the use of innovative hybrid approach. The building case study is the Woodpecker nightclub built in 1966 and abandoned in 1970 due to a fire that devastated the structure.

BACKGROUND: We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015. METHODS: We estimated the incidence and hospital admission rate of RSV-associated ALRI (RSV-ALRI) in children younger than 5 years stratified by age and World Bank income regions from a systematic review of studies published between Jan 1, 1995, and Dec 31, 2016, and unpublished data from 76 high quality population-based studies. We estimated the RSV-ALRI incidence for 132 developing countries using a risk factor-based model and 2015 population estimates. We estimated the in-hospital RSV-ALRI mortality by combining in-hospital case fatality ratios with hospital admission estimates from hospital-based (published and unpublished) studies. We also estimated overall RSV-ALRI mortality by identifying studies reporting monthly data for ALRI mortality in the community and RSV activity. FINDINGS: We estimated that globally in 2015, 33·1 million (uncertainty range [UR] 21·6-50·3) episodes of RSV-ALRI, resulted in about 3·2 million (2·7-3·8) hospital admissions, and 59 600 (48 000-74 500) in-hospital deaths in children younger than 5 years. In children younger than 6 months, 1·4 million (UR 1·2-1·7) hospital admissions, and 27 300 (UR 20 700-36 200) in-hospital deaths were due to RSV-ALRI. We also estimated that the overall RSV-ALRI mortality could be as high as 118 200 (UR 94 600-149 400). Incidence and mortality varied substantially from year to year in any given population. INTERPRETATION: Globally, RSV is a common cause of childhood ALRI and a major cause of hospital admissions in young children, resulting in a substantial burden on health-care services. About 45% of hospital admissions and in-hospital deaths due to RSV-ALRI occur in children younger than 6 months. An effective maternal RSV vaccine or monoclonal antibody could have a substantial effect on disease burden in this age group. FUNDING: The Bill & Melinda Gates Foundation.

INTRODUCTION: Type 2 Diabetes (T2D) is a major health problem worldwide. This metabolic disease is indicated by high blood glucose levels due to insufficient insulin production by the pancreas. An inflammatory response occurs as a result of the immune response to high blood glucose levels as well as the presence of inflammatory mediators produced by adipocytes and macrophages in fat tissue. This low and chronic inflammation damages the pancreatic beta cells and leads to insufficient insulin production, which results in hyperglycemia. Hyperglycemia in diabetes is thought to cause dysfunction of the immune response, which fails to control the spread of invading pathogens in diabetic subjects. Therefore, diabetic subjects are known to more susceptible to infections. The increased prevalence of T2D will increase the incidence of infectious diseases and related comorbidities. OBJECTIVE: This review provides an overview of the immunological aspect of T2D and the possible mechanisms that result in increased infections in diabetics. CONCLUSION: A better understanding of how immune dysfunctions occur during hyperglycemia can lead to novel treatments and preventions for infectious diseases and T2D comorbidities, thus improving the outcome of infectious disease treatment in T2D patients.

BACKGROUND: The Direct Repeat locus of the Mycobacterium tuberculosis complex (MTC) is a member of the CRISPR (Clustered regularly interspaced short palindromic repeats) sequences family. Spoligotyping is the widely used PCR-based reverse-hybridization blotting technique that assays the genetic diversity of this locus and is useful both for clinical laboratory, molecular epidemiology, evolutionary and population genetics. It is easy, robust, cheap, and produces highly diverse portable numerical results, as the result of the combination of (1) Unique Events Polymorphism (UEP) (2) Insertion-Sequence-mediated genetic recombination. Genetic convergence, although rare, was also previously demonstrated. Three previous international spoligotype databases had partly revealed the global and local geographical structures of MTC bacilli populations, however, there was a need for the release of a new, more representative and extended, international spoligotyping database. RESULTS: The fourth international spoligotyping database, SpolDB4, describes 1939 shared-types (STs) representative of a total of 39,295 strains from 122 countries, which are tentatively classified into 62 clades/lineages using a mixed expert-based and bioinformatical approach. The SpolDB4 update adds 26 new potentially phylogeographically-specific MTC genotype families. It provides a clearer picture of the current MTC genomes diversity as well as on the relationships between the genetic attributes investigated (spoligotypes) and the infra-species classification and evolutionary history of the species. Indeed, an independent Naïve-Bayes mixture-model analysis has validated main of the previous supervised SpolDB3 classification results, confirming the usefulness of both supervised and unsupervised models as an approach to understand MTC population structure. Updated results on the epidemiological status of spoligotypes, as well as genetic prevalence maps on six main lineages are also shown. Our results suggests the existence of fine geographical genetic clines within MTC populations, that could mirror the passed and present Homo sapiens sapiens demographical and mycobacterial co-evolutionary history whose structure could be further reconstructed and modelled, thereby providing a large-scale conceptual framework of the global TB Epidemiologic Network. CONCLUSION: Our results broaden the knowledge of the global phylogeography of the MTC complex. SpolDB4 should be a very useful tool to better define the identity of a given MTC clinical isolate, and to better analyze the links between its current spreading and previous evolutionary history. The building and mining of extended MTC polymorphic genetic databases is in progress.

Background: Patients critically ill with coronavirus disease-2019 (COVID-19) feature hyperinflammation, and the associated biomarkers may be beneficial for risk stratification. We aimed to investigate the association between several biomarkers, including serum C-reactive protein (CRP), procalcitonin (PCT), D-dimer, and serum ferritin, and COVID-19 severity. Methods: We performed a comprehensive systematic literature search through electronic databases. The outcome of interest for this study was the composite poor outcome, which comprises mortality, acute respiratory distress syndrome, need for care in an intensive care unit, and severe COVID-19. Results: A total of 5350 patients were pooled from 25 studies. Elevated CRP was associated with an increased composite poor outcome [risk ratio (RR) 1.84 (1.45, 2.33), p < 0.001; I 2 : 96%] and its severe COVID-19 (RR 1.41; I 2 : 93%) subgroup. A CRP ⩾10 mg/L has a 51% sensitivity, 88% specificity, likelihood ratio (LR) + of 4.1, LR- of 0.5, and an area under curve (AUC) of 0.84. An elevated PCT was associated with an increased composite poor outcome [RR 3.92 (2.42, 6.35), p < 0.001; I 2 : 85%] and its mortality (RR 6.26; I 2 : 96%) and severe COVID-19 (RR 3.93; I 2 : 63%) subgroups. A PCT ⩾0.5 ng/ml has an 88% sensitivity, 68% specificity, LR+ of 2.7, LR- of 0.2, and an AUC of 0.88. An elevated D-dimer was associated with an increased composite poor outcome [RR 2.93 (2.14, 4.01), p < 0.001; I 2 : 77%], including its mortality (RR 4.15; I 2 : 83%) and severe COVID-19 (RR 2.42; I 2 : 58%) subgroups. A D-dimer >0.5 mg/L has a 58% sensitivity, 69% specificity, LR+ of 1.8, LR- of 0.6, and an AUC of 0.69. Patients with a composite poor outcome had a higher serum ferritin with a standardized mean difference of 0.90 (0.64, 1.15), p < 0.0001; I 2 : 76%. Conclusion: This meta-analysis showed that an elevated serum CRP, PCT, D-dimer, and ferritin were associated with a poor outcome in COVID-19. The reviews of this paper are available via the supplemental material section.

Recently, multifunctional drug delivery systems (DDSs) have been designed to provide a comprehensive approach with multiple functionalities, including diagnostic imaging, targeted drug delivery, and controlled drug release. Chitosan-based drug nanoparticles (CSNPs) systems are employed as diagnostic imaging and delivering the drug to particular targeted sites in a regulated manner. Drug release is an important factor in ensuring high reproducibility, stability, quality control of CSNPs, and scientific-based for developing CSNPs. Several factors influence drug release from CSNPs, including composition, composition ratio, ingredient interactions, and preparation methods. Early, CSNPs were used for improving drug solubility, stability, pharmacokinetics, and pharmacotherapeutics properties. Chitosan has been developed toward a multifunctional drug delivery system by exploring positively charged properties and modifiable functional groups. Various modifications to the polymer backbone, charge, or functional groups will undoubtedly affect the drug release from CSNPs. The drug release from CSNPs has a significant influence on its therapeutic actions. Our review's objective was to summarize and discuss the relationship between the modification in CSNPs as multifunctional delivery systems and drug release properties and kinetics of the drug release model. Kinetic models help describe the release rate, leading to increased efficiency, accuracy, the safety of the dose, optimizing the drug delivery device's design, evaluating the drug release rate, and improvement of patient compatibility. In conclusion, almost all CSNPs showed bi-phasic release, initial burst release drug in a particular time followed controlled manner release in achieving the expected release, stimuli external can be applied. CSNPs are a promising technique for multifunctional drug delivery systems.

Quantitative research is a research approach that represents the understanding of positivism, while qualitative research is an approach that represents a familiar naturalistic research (phenomenology). Research with quantitative and qualitative approach by some may not be mixed , but knowledge is considered wrong by researchers who noticed that each research approach has a weakness, and therefore deemed necessary to do a combination, for each approach complement each other. The reason for the selection of both research approaches is that both types of research are mutually reinforcing and complementing each other so that research results will be achieved not only an objective, structured and measurable but it will be achieved also in-depth research results and factual. Penelitian kuantitatif merupakan pendekatan penelitian yang mewakili paham positivisme, sementara itu penelitian kualitatif merupakan pendekatan penelitian yang mewakili paham naturalistik (fenomenologis). Penelitian dengan pendekatan kuantitatif dan kualitatif oleh sebagian kalangan tidak boleh dicampuradukan, namun pemahaman ini dianggap keliru oleh para peneliti yang melihat bahwa masing-masing pendekatan penelitian mempunyai kelemahan, dan oleh karenanya dianggap perlu untuk melakukan kombinasi, agar masing-masing pendekatan saling melengkapi. Alasan pemilihan kedua pendekatan penelitian tersebut adalah bahwa kedua jenis penelitian tersebut saling memperkuat dan saling melengkapi sehingga akan dicapai hasil penelitian yang tidak hanya obyektif, terstruktur dan terukur namun akan dicapai juga hasil penelitian yang mendalam dan faktual

Leung and colleagues have revealed a five-dimensional structure of social axioms across individuals from five cultural groups. The present research was designed to reveal the culture level factor structure of social axioms and its correlates across 41 nations. An ecological factor analysis on the 60 items of the Social Axioms Survey extracted two factors: Dynamic Externality correlates with value measures tapping collectivism, hierarchy, and conservatism and with national indices indicative of lower social development. Societal Cynicism is less strongly and broadly correlated with previous values measures or other national indices and seems to define a novel cultural syndrome. Its national correlates suggest that it taps the cognitive component of a cultural constellation labeled maleficence, a cultural syndrome associated with a general mistrust of social systems and other people. Discussion focused on the meaning of these national level factors of beliefs and on their relationships with individual level factors of belief derived from the same data set.

Perilaku hidup bersih dan sehat di lingkungan sekolah merupakan sekumpulan perilaku yang dipraktikan oleh peserta didik, guru, dan masyarakat lingkungan sekolah sebagai hasil pembelajaran. Permasalahan yang muncul di sekolah menengah pertama negeri menunjukan siswa/siswi tidak melakukan PHBS seperti jarang melakukan cuci tangan dengan air mengalir dan sabun, jarang menggunakan jamban sehat, jarang membuang sampah pada tempatnya sehingga terjadi beberapa kasus kejadian penyakit dseperti diare, cacingan, typoid, dan maag. Penelitian ini bertujuan untuk mengidentifikasi gambaran PHBS pada siswa/siswi di sekolah menengah pertama negeri. Penelitian ini menggunakan desain penelitian deskriptif kuantitatif. Populasi pada penelitian ini adalah siswa/siswi di SMPN 3 dan SMPN 4 di Wilayah Kerja Puskesmas Guntur Garut yang berjumlah 1458. Teknik pengambilan sempel menggunakan stratified random sampling sehingga didapatkan 317 orang. Penelitian ini menggunakan intrumen kuesioner PHBS di sekolah. Data dianalisis secara univariat dengan menggunakan nilai mean dan disajikan dalam distribusi frekuensi. Hasil penelitian menunjukan bahwa setengah dari responden yaitu sebanyak 160 (50,5%) siswa/siswi sudah berperilaku baik dalam berperilaku hidup bersih dan sehat, dan hampir setengah responden yaitu sebanyak 157 (49,5%) siswa/siswi masih berperilaku buruk dalam berperilaku hidup bersih dan sehat. PHBS pada siswa/siswi ini harus lebih ditingkatkan lagi dengan cara pemberdayaan UKS bekerjasama dengan perawat yang ada di puskesmas terdekat dengan melakukan penyuluhan tentang PHBS.Clean and healthy life behaviour in school environment is an accumulation of behaviours which are practiced by students, teachers, and community as a result of learning. Problems which arose in junior high school showed that students did not do clean and healthy life behaviour such as rarely washing their hands with running water and soap, rarely using healthy toilets, rarely throwing garbage in the right places so that there were several cases of diseases such as diarrhea, intestinal worms, typoid, and peptic ulcer.This research aimed to identify the description of clean and healthy life behaviour in SMPN 3 and SMPN 4 Garut in the area of Guntur Community Health Centre. The research method used descriptive quantitative. The population in this research was students of SMPN 3 and SMPN 4 Garut, with the total of 1458. The sampling technique used stratified random sampling so that 317 people were obtained. This research used the clean and healthy life behaviour questionnaire instrument in schools. Data were analyzed univariately using mean values and presented in a frequency distribution. The results showed half of the respondents were 160 (50.5%) of students had behaved well in behaving clean and healthy, and almost half the respondents were 157 (49.5%) students still behaved poorly in the behavior of clean and healthy. PHBS for these students must be further improved by empowering School Health Unit in collaboration with the nurses at the nearest community health centre by conducting education about clean and healthy life behaviour.

Kebiasaan siswa berperilaku hidup bersih dan sehat (PHBS) di sekolah sangat penting dilaksanakan. PHBS sekolah merupakan sekumpulan perilaku yang dilakukan siswa untuk terwujudnya sekolah sehat. Pengetahuan dan sikap merupakan hal yang sangat penting sebagai faktor predisposisi pelaksanaan PHBS, selain faktor penunjang dan pendukung yang sudah tersedia di sekolah. Penelitian ini bertujuan mengidentifikasi gambaran pengetahuan, sikap dan perilaku PHBS siswa sekolah dasar. Rancangan penelitian menggunakan metode deskriptif kuantitatif, variabel pengetahuan dan sikap diambil secara crossectional, sedangkan untuk variabel perilaku diambil secara retrospective. Responden penelitian ini siswa kelas V dan VI. Teknik pengambilan sampel menggunakan total sampling yaitu 87 responden. Instrumen yang digunakan berupa kuesioner yang telah dilakukan uji validitas dan reliabilitas. Analisis data dilakukan univariat dan disajikan dalam bentuk tabel frekuensi dan presentase. Hasil penelitian menunjukan bahwa sebagian besar siswa memiliki pengetahuan baik dan sebagian kecil siswa pengetahuannya cukup. Sebagian besar siswa memiliki sikap negatif dan hampir setengahnya memiliki sikap positif. Kemudian hampir seluruh siswa berperilaku kurang baik dan sebagian kecil berperilaku baik. Rendahnya perilaku PHBS tersebut dimungkinkan karena pembinaan yang kurang maksimal dan program usaha kesehatan sekolah (UKS) yang tidak berjalan dengan baik. Upaya meningkatkan PHBS pada siswa SD perlu dilakukan pembinaan secara berkala dengan meningkatkan program UKS melalui penyuluhan, motivasi dalam pelaksanaan PHBS di sekolah. Kata Kunci : Anak Sekolah, Pengetahuan, PHBS Sekolah, Sikap

BACKGROUND: A 9-month regimen of isoniazid can prevent active tuberculosis in persons with latent tuberculosis infection. However, the regimen has been associated with poor adherence rates and with toxic effects. METHODS: In an open-label trial conducted in nine countries, we randomly assigned adults with latent tuberculosis infection to receive treatment with a 4-month regimen of rifampin or a 9-month regimen of isoniazid for the prevention of confirmed active tuberculosis within 28 months after randomization. Noninferiority and potential superiority were assessed. Secondary outcomes included clinically diagnosed active tuberculosis, adverse events of grades 3 to 5, and completion of the treatment regimen. Outcomes were adjudicated by independent review panels. RESULTS: Among the 3443 patients in the rifampin group, confirmed active tuberculosis developed in 4 and clinically diagnosed active tuberculosis developed in 4 during 7732 person-years of follow-up, as compared with 4 and 5 patients, respectively, among 3416 patients in the isoniazid group during 7652 person-years of follow-up. The rate differences (rifampin minus isoniazid) were less than 0.01 cases per 100 person-years (95% confidence interval [CI], -0.14 to 0.16) for confirmed active tuberculosis and less than 0.01 cases per 100 person-years (95% CI, -0.23 to 0.22) for confirmed or clinically diagnosed tuberculosis. The upper boundaries of the 95% confidence interval for the rate differences of the confirmed cases and for the confirmed or clinically diagnosed cases of tuberculosis were less than the prespecified noninferiority margin of 0.75 percentage points in cumulative incidence; the rifampin regimen was not superior to the isoniazid regimen. The difference in the treatment-completion rates was 15.1 percentage points (95% CI, 12.7 to 17.4). The rate differences for adverse events of grade 3 to 5 occurring within 146 days (120% of the 4-month planned duration of the rifampin regimen) were -1.1 percentage points (95% CI, -1.9 to -0.4) for all events and -1.2 percentage points (95% CI, -1.7 to -0.7) for hepatotoxic events. CONCLUSIONS: The 4-month regimen of rifampin was not inferior to the 9-month regimen of isoniazid for the prevention of active tuberculosis and was associated with a higher rate of treatment completion and better safety. (Funded by the Canadian Institutes of Health Research and the Australian National Health and Medical Research Council; ClinicalTrials.gov number, NCT00931736 .).

BACKGROUND: Diabetes mellitus (DM) is a known risk factor for tuberculosis (TB), and with the increasing prevalence of type 2 DM in less developed regions, many patients with TB will have concomitant DM. Presently, little is known about the effect of DM on the clinical presentation and treatment outcome of TB. METHODS: In an urban setting in Indonesia, 737 patients with pulmonary TB were screened for DM and were followed up prospectively during TB treatment. Clinical characteristics and outcome were compared between patients with TB who had DM and patients with TB who did not have DM. RESULTS: DM was diagnosed in 14.8% of patients with TB and was associated with older age and a greater body weight. On presentation, diabetic patients with TB had more symptoms but had no evidence of more-severe TB. After 2 months, results of sputum microscopic examination was more often positive in diabetic patients (18.1% vs. 10.0%). After 6 months, 22.2% of cultured sputum specimens from diabetic patients were positive for Mycobacterium tuberculosis (adjusted odds ratio, 7.65; P=.004). CONCLUSION: DM seems to have a negative effect on the outcome of TB treatment. The underlying mechanisms for the different response to treatment in diabetic patients with TB must be explored. Screening for DM and subsequent glycemic control may improve the outcome of TB treatment.

TiO2 exists naturally in three crystalline forms: Anatase, rutile, brookite, and TiO2 (B). These polymorphs exhibit different properties and consequently different photocatalytic performances. This paper aims to clarify the differences between titanium dioxide polymorphs, and the differences in homophase, biphase, and triphase properties in various photocatalytic applications. However, homophase TiO2 has various disadvantages such as high recombination rates and low adsorption capacity. Meanwhile, TiO2 heterophase can effectively stimulate electron transfer from one phase to another causing superior photocatalytic performance. Various studies have reported the biphase of polymorph TiO2 such as anatase/rutile, anatase/brookite, rutile/brookite, and anatase/TiO2 (B). In addition, this paper also presents the triphase of the TiO2 polymorph. This review is mainly focused on information regarding the heterophase of the TiO2 polymorph, fabrication of heterophase synthesis, and its application as a photocatalyst.

Objective: To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia. Methods: We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest. Results: A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), p < 0.001; I 2 , 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), p < 0.001; I 2 , 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), p < 0.001; I 2 31%), ARDS (RR 1.64 (1.11, 2.43), p = 0.01; I 2 ,0%, p = 0.35), ICU care (RR 2.11 (1.34, 3.33), p = 0.001; I 2 18%, p = 0.30), and disease progression (RR 3.01 (1.51, 5.99), p = 0.002; I 2 0%, p = 0.55). Meta-regression analysis showed that gender ( p = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79). Conclusion: Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

Flank instability and sector collapses, which pose major threats, are common on volcanic islands. On 22 Dec 2018, a sector collapse event occurred at Anak Krakatau volcano in the Sunda Strait, triggering a deadly tsunami. Here we use multiparametric ground-based and space-borne data to show that prior to its collapse, the volcano exhibited an elevated state of activity, including precursory thermal anomalies, an increase in the island's surface area, and a gradual seaward motion of its southwestern flank on a dipping décollement. Two minutes after a small earthquake, seismic signals characterize the collapse of the volcano's flank at 13:55 UTC. This sector collapse decapitated the cone-shaped edifice and triggered a tsunami that caused 430 fatalities. We discuss the nature of the precursor processes underpinning the collapse that culminated in a complex hazard cascade with important implications for the early detection of potential flank instability at other volcanoes.

Era globalisasi ini teknologi semakin maju, tidak dapat dipungkiri hadirnya internet semakin dibutuhkan dalam kehidupan sehari-hari, baik dalam kegiatan sosialisasi, pendidikan, bisnis, dsb. Tidak dapat dipungkiri bahwa media sosial mempunyai pengaruh yang besar dalam kehidupan seseorang. Seseorang yang awalnya kecil bisa menjadi besar dengan media sosial, atau sebaliknya. Bagi masyarakat khususnya kalangan remaja, media sosial sudah menjadi candu yang membuat penggunanya tiada hari tanpa membuka media sosial.Padahal dalam masa perkembangannya, di sekolah remaja berusaha mencari identitasnya dengan bergaul bersama teman sebayanya. Penelitian ini bertujuan untuk mengetahui pengaruh media sosial Menjelaskan mengenai apa saja pengaruh media sosial bagi remaja dimasa perkembangannya kemudian untuk mengetahui apa saja pengaruh terhadap perilaku remaja yang disebabkan oleh media sosial saat ini.Dalam penelitian ini, peneliti menggunakan metode penelitian kualitatif karena ingin mendalami suatu fakta, gejala dan peristiwa pengaruh media sosial terhadap perilaku remaja di lapangan sebagaimana adanya dalam konteks ruang dan waktu serta situasi lingkungan remaja secara alami. Peneliti menginginkan hasil penelitian berupa rincian data yang lebih kompleks tentang fenomena yang sulit diungkapkan oleh metode kuantitatif dan tidak memerlukan pengolahan data secara statistika. Hasil dari penelitian kualitatif yang dibutuhkan peneliti adalah berupa informasi yang mendalam mengenai pengaruh media sosial bagi remaja itu sendiri.

Bullying adalah tindakan penggunaan kekuasaan untuk menyakiti seseorang atau sekelompok orang baik secara verbal, fisik, maupun psikologis sehingga korban merasa tertekan, trauma, dan tak berdaya (Sejiwa, 2008). Remaja yang menjadi korban bullying lebih berisiko mengalami berbagai masalah kesehatan, baik secara fisik maupun mental. Adapun masalah yang lebih mungkin diderita anak-anak yang menjadi korban bullying, antara lain munculnya berbagai masalah mental seperti depresi, kegelisahan dan masalah tidur yang mungkin akan terbawa hingga dewasa, keluhan kesehatan fisik, seperti sakit kepala, sakit perut dan ketegangan otot, rasa tidak aman saat berada di lingkungan sekolah, dan penurunan semangat belajar dan prestasi akademis. Dalam kasus yang cukup langka, anak-anak korban bullying mungkin akan menunjukkan sifat kekerasan. Seperti yang dialami seorang remaja 15 tahun di Denpasar, Bali, yang tega membunuh temannya sendiri karena dendamnya kepada korban. Pelaku mengaku kerap menjadi target bullying korban sejak kelas satu SMP.Artikel ini bertujuan untuk mengetahui faktor-faktor penyebab terjadinya bullying oleh remaja, peran-peran dalam tindakan bullying, dan jenis-jenis bullying. Sumber data tulisan ini dilakukan dengan metode studi dokumentasi. Dalam artikel ini didapatkan hasil bahwa faktor-faktor yang mempengaruhi terjadinya bullying bisa datang dari individu, keluarga, kelompok bermain, hingga lingkungan komunitas pelaku. Tindakan ini sangat berhubungan dengan dunia pekerjaan sosial, yang dalam kasus ini dituntut untuk menjadi konselor bagi pelaku bullying.

This study examines tourist loyalty in creative tourism comprising of experience quality, perceived value, satisfaction, and motivation as its antecedents and assesses the mediation role of motivation in the development of tourist loyalty. The data was collected from four creative tourism attractions in Bandung, Indonesia. Self-administrated questionnaires were distributed to tourists after they experienced the attraction. In total, 369 useful questionnaires were collected with the hypotheses developed examined using Partial Least Square method. This study discloses that experience quality, perceived value, tourist satisfaction, and tourist motivation are key factors that determine tourist loyalty towards a creative attraction. Likewise, this study highlights that the influence of tourist loyalty determinants (on tourist loyalty), is partly mediated by tourist motivation. Lastly, this study discloses that among the loyalty determinants, experience quality has the biggest effect on tourist loyalty. These results offer a better understanding for both scholars and practitioners of creative attraction businesses on how to develop their clients’ loyalty.

Sampai saat ini budaya patriarki masih langgeng berkembang di tatanan masyarakat Indonesia. Budaya ini dapat ditemukan dalam berbagai aspek dan ruang lingkup, seperti ekonomi, pendidikan, politik, hingga hukum sekalipun. Akibatnya, muncul berbagai masalah sosial yang membelenggu kebebasan perempuan dan melanggar hak-hak yang seharusnya dimiliki oleh perempuan. Meskipun Indonesia adalah negara hukum, namun kenyataannya payung hukum sendiri belum mampu mengakomodasi berbagai permasalahan sosial tersebut. Penyebabnya masih klasik, karena ranah perempuan masih dianggap terlalu domestik. Sehingga penegakan hukum pun masih cukup lemah dan tidak adil gender. Oleh karena itu, peran pekerja sosial sangat dibutuhkan pada situasi ini agar penyelesaian masalah bisa cepat dilakukan. Artikel ini menggunakan metode penelitian kualitatif dan mengumpulkan data melalui studi pustaka, yaitu buku dan jurnal. Hasilnya menunjukkan keterkaitan antara budaya patriarki dan berbagai permasalahan sosial serta realitas sosial yang terjadi di masyarakat Indonesia.