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Suicidal ideation and suicidal behaviour among university students are associated with multiple psychological factors, yet evidence from Indonesia remains limited, particularly studies examining emotion regulation difficulties, psychological well-being, and life satisfaction simultaneously. This study aimed to examine the associations of emotion regulation difficulties, psychological well-being, and life satisfaction with suicidal ideation and suicidal behaviour among university students in Indonesia. This cross-sectional study was conducted from June to September 2024 among 420 university students from three state universities in Central Java and East Java, Indonesia. Participants were recruited using convenience sampling. Suicidal ideation and suicidal behaviour were assessed using the Beck Scale for Suicidal Ideation and the Suicidal Behaviors Questionnaire-Revised. Emotion regulation difficulties, psychological well-being, and life satisfaction were measured using the Difficulties in Emotion Regulation Scale-16, Ryff's Psychological Well-Being Scale, and the Satisfaction with Life Scale, respectively. Binary logistic regression analyses were performed using psychological total scores as continuous variables. The adjusted models controlled for age, sex, education level, GPA score, GPA satisfaction, parental socioeconomic status, place of residence, perceived family harmony, past physical medical history, and past mental health problem history. Among the participants, 180 students (42.9%) were identified as having suicidal ideation, and 87 students (20.7%) were identified as being at risk of suicidal behaviour. In the adjusted continuous-variable models, higher emotion regulation difficulty scores were associated with higher odds of suicidal ideation (AOR = 1.07, 95% CI: 1.04-1.10) and suicidal behaviour (AOR = 1.04, 95% CI: 1.01-1.08). Higher life satisfaction scores were associated with lower odds of suicidal ideation (AOR = 0.93, 95% CI: 0.88-0.98) and suicidal behaviour (AOR = 0.93, 95% CI: 0.87-1.00). Higher psychological well-being scores were associated with lower odds of suicidal behaviour (AOR = 0.95, 95% CI: 0.92-0.99), but were not significantly associated with suicidal ideation after adjustment. Greater emotion regulation difficulties and lower life satisfaction were associated with both suicidal ideation and suicidal behaviour, whereas lower psychological well-being was associated only with suicidal behaviour after adjustment. These findings suggest the importance of assessing multiple psychological factors in campus-based suicide prevention strategies and support the integration of mental health promotion into higher education policies in Indonesia.

BackgroundMen who have sex with men (MSM) living with HIV in Indonesia experience intersecting stigma affecting psychosocial wellbeing and healthcare engagement. Existing peer support models often lack cultural and spiritual relevance.AimThis study aimed to develop a culturally informed peer support model based on the experiences of MSM living with HIV and key stakeholders.MethodsA qualitative study was conducted in Central Java, Indonesia, using in-depth interviews, a focus group discussion, and field observations. Data were analysed using reflexive thematic analysis.ResultsThree themes emerged: stigma and internalised stigma, barriers to healthcare access, and the need for holistic peer support integrating psychosocial, spiritual, and cultural aspects. These informed a culturally grounded peer support model integrating the Information-Motivation-Behavioural Skills framework with the Javanese philosophy of Sangkan Paraning Dumadi.ConclusionThis model may support HIV care engagement and improve the relevance of peer support interventions among MSM living with HIV.

Reducing stunting remains a pressing global challenge, particularly in low and middle-income countries (LMICs), where nutrition insecurity and limited access to health services persist. With its large-scale national social assistance and health programmes, Indonesia offers valuable insights into implementing integrated strategies for stunting prevention. This study examines the substantive elements of food and social assistance interventions as well as the contextual and structural factors that influence their implementation. It also assesses how multisectoral collaboration contributes to the implementation process of nutrition-specific efforts aimed at reducing stunting. We conducted a qualitative case study in two districts of West Java Province, representing contrasting urban and rural contexts. Data were collected through 78 in-depth interviews with policymakers, implementers and primary beneficiaries. The policy implementation framework developed by Edward was used as a guide for the thematic analysis. We identified key factors influencing programme delivery, including communication, resource availability, commitment of implementers and bureaucratic structure. Urban settings demonstrated better outreach, service utilisation and intersectoral coordination while rural areas faced logistical and administrative barriers. Innovative local practices, such as digital health monitoring and women's farmer groups helped bridge implementation gaps. However, structural constraints, such as inflexible eligibility criteria, poor data integration and fiscal dependency on the central government, limited the programme's reach. Indonesia's experience demonstrates that effective stunting reduction requires national policy frameworks and locally adapted, multisectoral approaches that address system-level barriers. The practical lessons from this study can empower LMICs aiming to scale up integrated nutrition, health and social protection programmes, equipping them with the necessary knowledge and insights.

Bats, the second most diverse mammalian Order, have great ecological and economical importance. Globally, a large proportion of bat species are threatened and the trade in bats, either dead or alive, imperils several species, and may pose health risk for those people handling them. In southwestern Indonesia, bats are sold at wildlife markets for traditional Asian medicines, especially as a treatment for asthma. After purchase, bats are slaughtered at the market location where they were sold. Between 2012 and 2025 we conducted 362 surveys in 34 animal markets on the islands of Sumatra, Java, Bali and Lombok, and counted live bats offered for sale. We recorded 2245 Pteropus bats and 1080 Cynopterus bats during 249 (68%) of the surveys, and most markets displayed between 5 and 10 bats with a maximum of 50 bats at any given time. More bats were displayed on weekends than on weekdays, and over the 14 years covered by our survey trade was stable. There was no observed seasonality in the number of bats for sale. Average asking prices were US$22.25 ± 1.15 for Pteropus bats and US$12.75 ± 4.19 for Cynopterus bats. Cities with lower purchasing power per capita offered more bats per million people than their more affluent counterparts. Indonesia is the largest Muslim country globally by population, and bats are considered haram (unfit for consumption). Consequently, we observed more bats in cities with larger Christian populations. We found no evidence that the harvest or collecting of bats in Indonesia is sustainable, but sufficient support that it is not. Given the illegality of the trade in live bats in Indonesia, as there are no legal harvest quotas for the species we observed in trade, we urge local and national authorities to more effectively enforce existing regulations concerning the sale of wildlife in the animal markets.

Recent studies suggest that heat exposure may benefit cardiovascular health, but in overweight and obese older adults, the chronic effects of heat therapy on artery function are still uncertain. We aimed to compare the effects of 12 weeks (3×/week, 40 min) of aerobic exercise (EXE) to hot water immersion (HWI) and an inactive control group (CON), on vascular function. Thirty-one inactive older adults (58 ± 7years; 30.1 ± 3.8 kg/m2) were randomly assigned into three groups: EXE (cycle ergometry, n = 11), HWI (40°C, n = 11) or an inactive CON group (n = 9). Resting blood pressure (BP), pulse wave velocity (PWV; Sphygmocor), and flow-mediated dilation (FMD%) and glyceryl trinitrate-induced dilation (GTN%) in the brachial and femoral arteries (Doppler ultrasound) were assessed at baseline and after 12 weeks. The groups were matched for age, BMI and clinical parameters. For brachial FMD%, an interaction effect (P = 0.014) was observed, with post hoc analysis indicating that the increases observed in the EXE and HWI groups did not differ significantly, whereas the EXE group increased significantly more than CON. For femoral FMD%, an interaction effect (P = 0.047) indicated that the EXE group increased more than CON, with no difference between HWI and CON. Brachial and femoral GTN%, resting BP and PWV showed no main or interaction effect. These data suggest that 12 weeks of moderate aerobic exercise induces brachial and femoral artery endothelial function benefits relative to an inactive control group of older individuals with overweight and obesity, that brachial responses increased in response to both EXE and HWI, and the changes induced by exercise and hot water immersion did not statistically differ.

Japanese waters represent the northern distributional limit of the western Pacific distribution of the oceanic manta ray (Mobula birostris), yet movement ecology in this region remains poorly understood. We report movements of the first satellite-tagged individual in Japan. High-resolution depth-time series data documented repeated dives to 300 m and a maximum depth of 1082 m, with deeper use occurring predominantly at night. The individual undertook repeated long-distance movements between the Kerama Islands and Miyako Islands, including multiple transits across the Okinawa-Miyako Submarine Plateau and associated bathymetric features. Although based on a single tracked individual, these observations provide the first high-resolution movement data of M. birostris in Japanese waters and highlight key hypotheses regarding habitat use and connectivity for future investigation.

The teaching and learning of academic essays faced difficulties in in-person classes. Challenges in academic essay instruction were exacerbated in online learning environments during COVID-19. Yet some institutions arranged sophisticated platforms to share instructional materials for imparting English language education online. The focal university was one such progressive institution. Like other courses, English language education was delivered through 'Arwa', an online platform developed by the university to support teaching and learning during the pandemic. The phenomenological study aimed to understand how instructional materials designed for an English foundation course contributed to first-year undergraduates' experiences of learning persuasive essay writing. Data were collected primarily through semi-structured interviews and supplemented by an open-ended questionnaire administered to the same eight participants. Phenomenological thematic analysis was applied to interpret the data. The findings reveal how participants experienced the instructional design and materials as supporting their engagement with outlining, drafting, editing, and revising persuasive essays. Participants also described collaborative writing and rubric-guided peer feedback as meaningful learning experiences that supported their engagement with persuasive essay writing. From a phenomenological perspective, the study contributes to understanding how learners make sense of persuasive essay writing through structured online instruction, collaborative writing, and rubric-guided peer feedback. Pedagogically, the findings highlight the value of sequenced instructional materials, collaborative writing, and guided peer interaction in supporting students' engagement with persuasive writing in online and blended learning environments.

Winter chilling has long been considered the primary driver of bud dormancy release in woody perennials. However, the cellular mechanisms underlying dormancy transitions remain poorly understood. This study aimed to investigate the relationship between dormancy depth, cell cycle activity, and cellular ultrastructure in grapevine buds across the dormancy cycle. Bud dormancy progression in single node explants of Vitis vinifera cv. Cabernet Sauvignon was monitored from early autumn dormancy to the end of winter. Dormancy depth was quantified as the time to 50% bud burst under forcing conditions. Cell cycle status was assessed using quantitative flow cytometry, while the cellular ultrastructure of the shoot apical meristem was examined by transmission electron microscopy. Dormancy depth declined dramatically from over 280 days in early autumn to ca 50 days in late autumn, despite negligible chilling exposure during this period. Following chilling exposure in winter, the depth of dormancy declined to ca 20 days. Strikingly, flow cytometry revealed that the majority of cells remained arrested in the G1 phase of mitosis throughout this period, regardless of dormancy depth, supported by ultrastructural analysis of the shoot apical meristem. Starch grains were abundant in both deeply dormant pre-winter buds (no chilling) and winter buds (with chilling), indicating that starch dynamics may be regulated independently of both dormancy status and chilling exposure. These findings demonstrate temporal uncoupling of dormancy release from cell cycle reactivation, challenging assumptions that dormancy release is directly linked to both chilling and cell cycle activation. Our results establish that in grapevine, the transition to growth competence occurs independently of detectable cell division and can precede significant winter chilling accumulation. This work provides new insights into the cellular basis of dormancy regulation in woody perennials and establishes a methodological framework for dissecting this relationship in other species.

Hydrogen is a promising clean energy vector with a pivotal role toward a sustainable and renewable energy future. The latest advancement in hydrogen evolution reaction is mainly governed through photocatalysis, thermocatalytic steam reforming, and electrocatalysis. Yet the reliance on noble metal catalysts, particularly platinum, remains a key challenge due to their high cost and scarcity. Recent advancements in material science and nanotechnology introduce non-noble metal-based nanocatalysts (transition metal phosphides, sulfides, carbides, and nitrides), offering advantages of earth abundance, cost-effectiveness, and tunable properties. This review explores the current progress and future prospects of non-noble metal-based nanocatalysts for hydrogen production. Advanced characterization tools, such as ultrafast pump-probe spectroscopy and scanning electrochemical microscopy, provide unprecedented insights into charge carrier dynamics and active site distributions, linking nanoscale structures to catalytic performance. Beyond electrocatalysis, the integration of photocatalytic and thermocatalytic systems with renewable feedstocks is highlighted as a pathway for broader sustainability goals. By addressing challenges in catalyst design, synthesis, and characterization, this work underscores the potential of non-noble metal-based nanocatalysts to rival noble metals, paving the way for transformative advancements in hydrogen production and energy technologies. This comprehensive analysis aims to bridge knowledge gaps and inspire innovative strategies for a sustainable clean hydrogen economy.

This paper proposes the dual functional microwave sensor with high gain array antenna using loaded U-resonator and asymmetric T-junction. The microwave sensor is designed to operate at fr = 2.11 GHz while the array antenna operates at fr = 2.84 GHz which is integrated using asymmetric T-junction based on microstrip line. The performance of the sensor is observed based on the frequency shift of S21 for solid material characterization with a permittivity range of 1-9.8 while for the antenna is observed based on the parameters S11, bandwidth, gain and radiation pattern. From the measurement results, the antenna and sensor have high performance and have independent characteristics with high isolation of ≤ -40 dB to work concurrently. Moreover, the antenna has performance of S11 ≤ -10 dB, Fractional Bandwidth (FBW) 2.11% and gain of 6.03 dBi at fr = 2.84 GHz. The sensors operating at fr = 2.11 GHz has a performance of ∆F of 0.4 GHz, FDR of 0.061 GHz / ∆εr, normalized sensitivity (NS) of 2.21% and accuracy of 99.38%. Therefore, this work can be recommended for application in industries such as material quality control, pharmaceuticals and biomedical as a solution for real-time measurement processes integrated with wireless communications.

We report a rare case of congenital cystic adenomatoid malformation (CCAM) diagnosed antenatally based on USG and postnatally based on babygram, CT scan, and chest x-ray. We follow up the baby up to 1 year of age. This study is a retrospective case report describing the clinical presentation, diagnosis, and management of a single patient. The patient is an outpatient clinic with a diagnosis of G2P1A0, gestational age 38-39 weeks with breech presentation, not in labor, and the fetus is suspected for CCAM. The patient was planned for termination with cesarean delivery. The patient was first diagnosed with CCAM based on antenatal USG examination: A cystic mass in the thorax region of the fetus measuring 1.5 cm was found. The baby was then born by CS in consideration of breech presentation. At birth, the baby had a good APGAR score of 7-8-9. The baby underwent a babygram at 2 days old, which showed a CPAM type III result; CT scan at 16 days old showed infected CPAM type I/CCAM. The baby has been observed for 1 year of life, and no signs of respiratory distress were found. The latest chest x-ray at 1 year of age showed left superior pulmonary cyst. CCAM can be diagnosed perinatally by ultrasound examination. Management of CCAM depends on the size of the lesion and whether significant respiratory distress is present in the newborn. In our case, the CCAM was established prenatally and postnatally; no signs of respiratory symptoms were found within 1 year of age.

This study explored bioethanol production from Taberau lignocellulosic biomass through fungal delignification, enzymatic hydrolysis, and fermentation using MIL-100(Fe)-immobilized yeast. The fungal pre-treatment with Coriolopsis caperata enhanced laccase activity, reaching a maximum of 520 U/L at 12 days, and significantly reduced lignin content from 20.87% to 10.92%. This reduction improved cellulose accessibility and increased the availability of fermentable sugars during hydrolysis. Enzymatic hydrolysis results showed that fungal-treated biomass produced higher reducing sugar concentrations compared to untreated and control samples, indicating effective lignin removal. Fermentation was conducted under various conditions, with optimal ethanol production achieved at a yeast dosage of 2% (w/v) and a fermentation time of 4 days, resulting in an ethanol concentration of 11.57 g/L. Characterization using FTIR, XRD, and SEM confirmed successful immobilization of yeast on MIL-100(Fe) without structural degradation. The immobilized system demonstrated improved stability and reusability compared to free yeast. The obtained ethanol concentration is within the typical range for SHF-based lignocellulosic bioethanol production. The integration of fungal pre-treatment with MOF-based immobilization provides a promising and sustainable strategy, with potential for further improvement through process optimization and alternative fermentation approaches.

Indonesia's new capital, Nusantara, is generating urban expansion that extends beyond administrative boundaries, yet its cross-boundary land-use dynamics remain insufficiently understood. This study develops a contextualized predictive-preventive framework of land use change (LUC) indicators for future urbanization assessment in the Nusantara agglomeration through a review-based conceptual synthesis. Drawing on recent LUC studies, published empirical evidence, and the Nusantara Development Masterplan, the study identifies 46 predictive indicators representing internal urban growth conditions and six preventive indicators capturing regional ecological capacity and spatial inequality. Predictive indicators explain land-conversion suitability and growth pressure, whereas preventive indicators function as safeguards that regulate or moderate expansion in environmentally fragile or unequal areas. The framework links internal urban drivers with regional socio-ecological constraints, extending LUC assessment beyond administrative borders. It provides a conceptual foundation for future scenario modeling, comparative research, and sustainable land management in new city development contexts.

Orocraniofacial (OCF) trauma includes injuries to the oral cavity, cranial structures, and facial skeleton caused by road traffic accidents, interpersonal violence, falls, and other high-energy events. Dental injuries are an often underreported component of OCF trauma despite their important forensic value in victim identification, documentation of violence, and determination of cause of death. This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines. Five electronic databases (PubMed, Scopus, Web of Science, ProQuest, and Cochrane Library) were searched from inception to March 2026 without language restrictions. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and Risk of Bias 2 (RoB-2) tools. A random-effects meta-analysis was applied, and heterogeneity was quantified using the I² statistic. Out of 1,860 records, 18 studies involving 46,247 participants across 12 countries met the inclusion criteria. The pooled prevalence of dental injuries in OCF trauma was 24.3% (95% CI: 19.8-29.1%), with substantial heterogeneity (I² = 81.2%). Crown fractures were the most common injury type (OR 2.09; 95% CI: 1.74-2.51). Interpersonal violence showed the strongest association (OR 2.61; 95% CI: 1.98-3.44). Male gender (OR 1.58) and individuals under 18 years (OR 1.45) were consistently associated risk factors. Maxillary anterior teeth accounted for 82.7% of injuries. In conclusion, dental injuries are significantly associated with OCF trauma and hold substantial forensic importance. Routine dental examination should be integrated into trauma assessment and forensic investigations, with future research focusing on standardized classification systems and multicenter prospective studies.

Despite remarkable achievements in infectious disease control, more than 20 major pathogens responsible for significant global morbidity and mortality remain without licensed, effective vaccines. This so-called 'vaccine gap' disproportionately burdens low- and middle-income countries (LMICs), exacerbating health inequities and threatening global pandemic preparedness. This review comprehensively examines scientific and technological advances that are actively bridging the vaccine gap, with emphasis on novel platform technologies, immunological innovations, and translational strategies. We conducted a systematic narrative review of literature published between 2015 and 2024, encompassing peer-reviewed articles, WHO reports, clinical trial registries, and regulatory agency databases. Six transformative technology clusters were identified: (1) mRNA and self-amplifying RNA (saRNA) platforms enabling rapid antigen production; (2) viral-vectored vaccines with improved immune breadth; (3) structure-guided antigen design using cryo-electron microscopy and artificial intelligence (AI)-driven protein engineering; (4) broadly neutralising monoclonal antibodies as surrogate vaccine benchmarks; (5) mucosal and inhalable delivery systems targeting tissue-resident immunity; and (6) combination adjuvant systems amplifying magnitude and durability of protective responses. Clinical translation is exemplified by candidates against HIV-1, tuberculosis (TB), respiratory syncytial virus (RSV) in infants, and Plasmodium falciparum malaria. Convergence of AI-assisted rational antigen design, next-generation mRNA platforms, and innovative adjuvant-delivery pairings represents a paradigm shift toward vaccinatable diseases previously considered intractable. Equitable access frameworks and regulatory harmonisation across LMICs remain critical unresolved challenges.

The likelihood of developing concurrent infections, such as bacterial vaginosis (BV) and sexually transmitted syphilis, tends to increase. Delayed diagnosis of maternal syphilis may allow progression to secondary syphilis and substantially increase the risk of vertical transmission. We report a neglected case of syphilis during pregnancy presenting as condyloma lata with concurrent bacterial vaginosis that subsequently resulted in congenital syphilis. A 17-year-old married woman, gravida 1 para 0 abortus 0 (G1P0A0), at 34-35 weeks of gestation, presented with progressively enlarging vulvar warty lesions for three weeks and malodorous vaginal discharge for one month. Physical examination demonstrated multiple confluent yellowish-white plaques involving both labia majora and the vaginal introitus, consistent with condyloma lata. Serological screening showed reactive TPHA and VDRL with non-reactive HIV and HBsAg. She was diagnosed with secondary syphilis presenting as condyloma lata, bacterial vaginosis, urinary tract infection, and premature uterine contractions. Treatment consisted of intramuscular benzathine penicillin G (2.4 million units) and oral metronidazole (2 g). Because labor progressed with extensive vulvovaginal lesions, an emergency cesarean section was performed. The newborn had reactive TPHA and VDRL and was diagnosed with congenital syphilis despite the absence of overt clinical manifestations. This case highlights that delayed antenatal syphilis screening and late maternal treatment may allow progression to secondary syphilis with condyloma lata and increase the risk of congenital syphilis. Early screening and timely treatment are essential to prevent vertical transmission.

Bruck syndrome type 2 (BRKS2) is a rare disorder marked by congenital joint contractures and bone fragility, caused by variants in PLOD2, which encodes lysyl hydroxylase 2 essential for collagen stability. We report the first genetically confirmed BRKS2 cases from Indonesia and Ukraine, both showing fractures, skeletal deformities, and contractures. The Indonesian patient had compound heterozygous variants, while the Ukrainian patient had a homozygous missense variant, expanding the phenotypic and geographic spectrum of the disorder.

Adolescents with intellectual disabilities are at increased risk of experiencing and displaying inappropriate sexual behaviours, while parents in culturally sensitive settings often lack adequate guidance for managing them. This study examined how Indonesian parents recognise and manage inappropriate sexual behaviours among adolescents with intellectual disabilities within culturally embedded contexts. A qualitative descriptive design with a case-study orientation was employed. Semi-structured interviews were conducted with 10 mothers of adolescents with intellectual disabilities in Indonesia between October and December 2024. Data were analysed using reflexive thematic analysis to examine emotional responses, behavioural management strategies, and parents' support needs. Parents reported diverse inappropriate sexual behaviours occurring during daily routines and described difficulty distinguishing normative from problematic actions. Emotional reactions included shame, panic, fear of judgment, and anxiety about exploitation, shaped by cultural and religious expectations of modesty. Parents resorted to reactive strategies such as correction, supervision, environmental control, and consistent reinforcement, but lacked structured guidance and culturally appropriate resources. They expressed strong needs for hands-on training, clear behavioural criteria, visual teaching tools, and coordinated support between families and schools. The findings highlight the emotional and cultural complexity of parental responses to inappropriate sexual behaviours and underscore the need for culturally grounded, family-centred interventions. Strengthening parental capacity through tailored training and collaborative frameworks is essential to improving behavioural management and safeguarding adolescents with intellectual disabilities.

Infective endocarditis (IE) complicated by aortic root abscess, fistulation and multivalve involvement is rare but carries high mortality. Fistulation from the left ventricular outflow tract (LVOT) to the right atrium (RA) represents an exceptionally uncommon sequela due to extensive perivalvular tissue destruction. Early surgical intervention remains crucial, but postoperative outcomes vary widely depending on host factors, organism control and the feasibility of durable reconstruction. We report two cases of severe aortic valve endocarditis with aortic root abscess and acquired LVOT-RA fistula. The first patient had native-valve Streptococcus mitis endocarditis and underwent aortic and tricuspid valve replacement with double CardioCel patch repair of the fistula. He recovered after transient renal and hepatic dysfunction and completed six weeks of intravenous ceftriaxone. The second patient had prosthetic aortic valve endocarditis with aortomitral curtain destruction, pseudoaneurysm, severe malnutrition, and tricuspid involvement. He underwent redo sternotomy, aortomitral curtain reconstruction, double patch fistula repair, and triple bioprosthetic valve replacement. Although the initial repair was technically satisfactory, he later developed severe mitral paravalvular regurgitation with recurrent Staphylococcus haemolyticus bacteremia and died after deterioration with sepsis and multiorgan dysfunction. These cases illustrate the range of outcomes after complex endocarditis surgery. Patch-based reconstruction may be appropriate when radical debridement leaves sufficient tissue for secure prosthetic seating, whereas extensive prosthetic infection, malnutrition, recurrent bacteremia, and tissue friability increase the risk of late mechanical failure.