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Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an obligate intracellular bacterium that affects the skin, peripheral nerves, upper respiratory mucosa, and eyes. Type 2 diabetes mellitus (T2DM) is a comorbidity that can worsen the course of leprosy. The female patient, Mrs. D, aged 55 years came to the emergency room of Cut Meutia Hospital with the main complaint of red bumps accompanied by pain on the face, hands, chest, and back since 3 days ago and additional complaints such as fever, joint pain, and numbness and loss of feeling in the legs, weakness, frequent thirst, and frequent urination. Dermatologic status is obtained in the facial region in the form of erythema nodules with firm boundaries with numular size, multiple. Laboratory examination showed anemia and leukocytosis. The therapy given was MDT MB package, ferrous sulfate 1x325 mg and PRC transfusion 3 kolf. Complaints arose acutely after the patient resumed taking MDT (multidrug therapy) leprosy drugs which had previously been stopped for more than 3 months. Based on the time of onset of symptoms, history of leprosy treatment, and the manifestation of systemic inflammatory lesions with signs of neurotropism, it can be suspected that the patient is experiencing a type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL).

This study aims to analyze the in silico profile of the compound orientin derived from the water hyacinth plant (Eichhornia crassipes) as a potential antioxidant candidate. Orientin was selected based on its chemical structure data registered in PubChem, which provides complete information regarding molecular identity, physicochemical properties, and 2D and 3D structural representations. The prediction of biological activity was conducted using PASS Online, which indicated that orientin possesses a promising likelihood of exhibiting antioxidant activity according to relevant probability values. Furthermore, the safety assessment of the compound was carried out through ProTox-II to identify potential toxicity, including toxicity class, possible hepatotoxic effects, and other predicted safety parameters. To determine its pharmacokinetic profile, pkCSM was employed to predict ADMET characteristics such as absorption, distribution, metabolism, excretion, and additional toxicity risks. The results of these analyses show that orientin demonstrates favorable potential as an antioxidant candidate, supported by predicted pharmacological properties and relatively low toxicity levels according to in silico evaluations. Therefore, orientin has promising potential for further development in subsequent in vitro and in vivo studies.

The development of multimedia-based interactive games requires a system capable of effectively managing game logic, character behavior, and the integration of visual and animation elements. This study aims to implement GDScript in the development of a 2D RPG game using the Godot Engine. The research method was carried out through the design of scene and node structures, the implementation of game logic using GDScript, and the application of Finite State Machine (FSM) to regulate enemy behavior. GDScript is used to control character movement, animation systems, and interactions between players and objects in the game. The implementation of FSM allows enemies to have dynamic behavior through state settings such as idle and wander. Functional testing results show that the game system can run according to the design and is capable of producing responsive interactions. In addition, the use of modular architecture in the Godot Engine facilitates system development and maintenance. Based on the research results, the Godot Engine and GDScript are considered effective for developing multimedia-based interactive games.

Generalized pustular psoriasis (GPP) is a severe inflammatory form of psoriasis characterized by widespread sterile pustular eruptions. Pro-inflammatory mediators released during chronic inflammation may contribute to comorbidities, including type 2 diabetes mellitus (T2DM). A 65-year-old woman presented with pustular eruptions over almost the entire body for seven days, accompanied by burning sensation and pruritus. Some pustules coalesced forming “lakes of pus,” while others appeared as erythematous plaques with coarse white scales. The patient had a history of T2DM. Based on clinical findings, the patient was diagnosed with GPP. She was hospitalized for seven days and followed up weekly until week 10. Inflammatory mediators such as Th-1, TNF-α, IL-6, IL-7, IL-8, IL-17, and IL-23 in psoriasis may inhibit insulin receptor signaling and glucose uptake, leading to insulin resistance and increased blood glucose levels. The duration of treatment until remission in psoriasis patients with T2DM tends to be longer than in non-diabetic patients. In patients with comorbidities, low-dose methotrexate (5–7.5 mg/week) was administered. The coexistence of GPP and T2DM may lead to more severe exacerbations, prolonged treatment duration, and reduced quality of life, posing challenges in management.

Type 2 diabetes mellitus (T2DM) requires comprehensive management beyond pharmacological therapy, including sustainable lifestyle-based interventions. Yoga asana, as a form of mind–body intervention, integrates physical postures, breathing techniques, and relaxation practices that may influence metabolic and psychosocial pathways relevant to T2DM. This article aimed to synthesize evidence regarding the physiological mechanisms, clinical effectiveness, and healthcare implementation context of yoga asana in T2DM management, as well as to discuss the role of physicians in integrating this complementary therapy, including within health tourism settings. A narrative literature review was conducted using scientific databases, focusing on publications addressing yoga asana, mind–body interventions, T2DM, and clinical integration. The findings indicate that yoga asana is associated with improved glycemic control, including reductions in fasting blood glucose, postprandial glucose, and HbA1c, alongside modulation of stress-related physiological parameters and psychological well-being. Beyond clinical outcomes, yoga asana shows potential for community-based and health tourism contexts as part of chronic disease lifestyle management. Physicians play a central role in clinical assessment, patient education, coordination with complementary therapy providers, and ongoing monitoring to ensure safe, evidence-based integration. Although current evidence suggests consistent beneficial trends, methodological heterogeneity highlights the need for more standardized and mechanistic research.  

The increasing volume and complexity of data have made traditional 2D visualization methods insufficient for effectively exploring and understanding high-dimensional datasets. Immersive Virtual Reality (VR) presents a promising solution by providing an interactive 3D environment that enhances spatial understanding, task efficiency, and user satisfaction. This research aims to evaluate the user experience (UX) and interaction design quality of immersive VR interfaces for 3D data visualization in complex environments. The study employs a mixed-methods approach, combining usability testing, UX questionnaires, and task-based performance analysis. Participants interacted with VR prototypes designed to visualize complex data and were assessed on their ability to manipulate and explore the data efficiently. The findings show that immersive VR interfaces significantly improve spatial comprehension, reduce cognitive load, and increase task performance efficiency compared to traditional 2D systems. Additionally, user satisfaction was notably high, with participants appreciating the intuitive and engaging interaction methods. The study concludes that immersive VR can provide substantial benefits in real-world data visualization applications, particularly in domains requiring the exploration of complex and high-dimensional data. However, further research is needed to optimize VR interfaces and address challenges such as motion sickness and interaction complexity.

Diabetes mellitus (DM) is a global health problem characterized by increased blood glucose levels. Type 2 diabetes mellitus (T2DM) accounts for 90-95% of all diabetes cases and is characterized by insulin resistance. Persistent hyperglycemia in patients with T2DM increases the risk of various complications, including renal dysfunction. Therefore, monitoring HbA1c levels is important for assessing long-term glycemic control and preventing complications, one of which is impaired kidney function that can be detected through increased blood creatinine levels. To analyze the relationship between HbA1c levels and blood creatinine levels in type 2 diabetes mellitus patients at RSUD ODSK North Sulawesi Province. This study used an observational analytic design with a cross-sectional approach. This study was retrospective using secondary data in the form of medical record data for the period February 2024-August 2025. This study used a total sampling method with 71 patients who met the inclusion criteria. The findings showed that the majority of patients had HbA1c levels >6,5%, while most blood creatinine levels were within the normal range. Based on the results of the Spearman-Rank correlation test, a significance value of 0.040 (p-value <0.05) was obtained. There is a significant relationship between HbA1c levels and blood creatinine levels, with a negative correlation strength in patients with type 2 diabetes mellitus at RSUD ODSK North Sulawesi Province.

This study investigates the levels of asprosin and irisin in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN), and evaluates their relationships with insulin resistance, glycemic control, and renal function. Additionally, it explores their diagnostic performance as potential non-invasive biomarkers for the early detection of DN using ROC curve analysis. A controlled prospective study was conducted involving 130 participants, categorized into healthy controls, T2DM patients, and T2DM with DN. Serum asprosin, irisin, and insulin levels were measured using ELISA, while biochemical and renal parameters such as fasting blood glucose, HbA1c, creatinine, urea, and eGFR were assessed using standard spectrophotometric techniques. ROC analysis was employed to assess the diagnostic accuracy of asprosin and irisin. Asprosin levels were significantly elevated, while irisin levels were markedly reduced in DN patients compared to T2DM and control groups (p < 0.001). Moreover, DN patients exhibited higher levels of fasting glucose, HbA1c, HOMA-IR, creatinine, and urea, with lower eGFR, indicating substantial renal dysfunction. ROC analysis revealed that asprosin had an AUC of 0.910 (95% CI: 0.839–0.981), with 90.0% sensitivity and 88.9% specificity at a cutoff value of 11.27 ng/mL. Irisin showed an AUC of 0.886 (95% CI: 0.812–0.960), with 95.0% sensitivity and 71.1% specificity at a 158.25 ng/mL cutoff. Asprosin and irisin are strongly associated with insulin resistance and renal impairment in patients with T2DM and DN. Their high diagnostic performance supports their utility as promising non-invasive biomarkers for the early detection and monitoring of diabetic nephropathy progression.

Type 2 Diabetes Mellitus (T2DM) is a global health problem with continuously increasing prevalence, covering the majority of diabetes cases worldwide. Persistent hyperglycemia in T2DM progressively damages the kidneys. Early assessment of kidney function, especially through the examination of urea levels and estimated glomerular filtration rate (eGFR) values, is important to predict CKD prognosis and guide therapeutic intervention. To discover the profile of urea levels and eGFR values in Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province. This study is a descriptive quantitative observational study with a cross-sectional design, conducted retrospectively using secondary data from the medical records of Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province during the period February 2024–August 2025 who met the inclusion criteria. From a total sample of 658 Type 2 Diabetes Mellitus patients, the majority of patients had high urea levels (53.3%). Based on sex, the proportion of high urea levels in males (57.2%) was higher compared to females (50.5%). Meanwhile, the distribution of eGFR values showed that the G1 category was the most frequent (23.9%). However, the majority of other patients (75.1%) were already in categories G2 to G5, which indicates a decrease in kidney function. This decrease in kidney function was slightly more detected in male patients (76.1%) compared to female patients (74.4%). Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province, have high urea levels and the majority have decreased eGFR values.

Psoriasis is a chronic inflammatory skin disease characterized by keratinocyte hyperproliferation, inflammation, and neoangiogenesis, largely driven by dominant T helper 1 (Th1) and T helper 17 (Th17) immune responses. Psoriasis is associated with metabolic, psychological, cardiovascular, and arthritic comorbidities. Vitamin D plays an important role in the management of psoriasis. Calcitriol (1,25(OH)₂D₃), regulates keratinocyte proliferation, differentiation, and apoptosis. Vitamin D supports the formation of the cornified envelope as well as epidermal lipid and ceramide production, also acts synergistically with the epidermal calcium gradient to maintain barrier function. In addition to its epidermal effects, vitamin D exerts immunomodulatory actions by enhancing regulatory T cells and anti-inflammatory cytokines (interleukin (IL)-10, IL-4, transforming growth factor-beta (TGF-β)), while suppressing Th1/Th17 activity and production of pro-inflammatory cytokines (IL-2, IL-17, tumor necrosis factor-alpha (TNF-α)). These mechanisms highlight its potential role in psoriasis therapy. Topical vitamin D₃ analogues are effective for mild to moderate disease due to the high expression of vitamin D receptors in psoriatic keratinocytes. Oral supplementation has also been explored for its systemic immunomodulatory effects, although findings remain inconsistent.  

The calculation of work volume and construction costs is a fundamental aspect of project management, as errors in the estimation process can directly affect the preparation of the project budget. Many projects still use conventional methods for estimation, which are based on 2D working drawings with the assistance of Microsoft Excel, as seen in the Sungai Raya Religious Court Building project. This method is considered prone to calculation errors and less efficient due to the considerable amount of time required. With the advancement of technology, Building Information Modeling (BIM) has emerged, enabling automatic and integrated calculation of work volumes and construction costs through a three-dimensional digital model. This study aims to examine the implementation of BIM in the Sungai Raya Religious Court Building project and to compare the results of work volume and construction cost calculations between the BIM method using Autodesk Revit and the conventional method based on the project’s Bill of Quantity (BoQ). The research method was conducted by modeling the structural elements of the building, including pile caps, tie beams, columns, beams, floor slabs, and reinforcements. The results of work volume and construction cost calculations obtained from Autodesk Revit were then compared with the project’s BoQ as the conventional method. Based on the analysis, an average difference of 6.3% in work volume and 5.6% in construction cost was found, with the Autodesk Revit calculations showing slightly lower values compared to the project’s BoQ.

The rapid advancement of technology has made it easier for the public to access online loans (pinjol), but it has also increased the risk of misuse by illegal entities. The Financial Services Authority (OJK) recorded that from 2018 to 2022, it shut down 4,265 illegal online lending platforms. However, many cases continue to emerge due to the ease of creating applications and the use of overseas servers. Teachers are among the most affected victims due to low salaries and high living costs. The impacts of illegal online loans are highly detrimental, including the leakage of personal data, threats, intimidation, and excessively high interest rates. Education is crucial to prevent new victims. Isometric motion graphics are chosen as a medium because of their advantages in delivering information through engaging, clear, and easily understood visual and audio elements that are sustainable for audiences.

Abstract. This study originates from the low awareness among early childhood learners regarding the importance of consuming nutritious and minimally processed Real Food. The purpose of this design project is to create an engaging educational medium in the form of a 2D animation titled “Kebun Imajinasi: Teman Realfoodku” to introduce the concept of Real Food to five-year-old children. A mixed-method approach (qualitative and quantitative) was applied through observation, interviews, and questionnaires involving children, parents, and professional animators. The collected data served as the foundation for designing characters, storylines, illustration styles, colors, and audio suitable for young audiences. The results show that 2D animation featuring bright visuals, playful characters, and educational narration effectively increases children’s interest and understanding of healthy food. The implication of this study highlights the potential of animation as an effective visual communication tool to promote nutritional education and healthy lifestyle habits from an early age.

The rapid advancement of digital technology has significantly influenced students’ learning behavior while gradually reducing their interest in local cultural education, including the study of the Javanese script. This phenomenon is evident at SDIP Haji Muhammad Subandi, where most students still struggle to recognize, read, and understand Javanese characters due to the limited use of engaging and interactive learning media. To address this issue, a 2D educational game was developed as an innovative, contextual, and enjoyable learning medium that integrates cultural elements into an interactive digital learning experience. The design and development process employed the Multimedia Development Life Cycle (MDLC) method, which consists of six stages: concept, design, material collecting, assembly, testing, and distribution. The game was built using Unity software to produce dynamic visuals, responsive controls, and supporting audio elements that enhance the immersive quality of gameplay. The educational game enables students to learn Javanese script through interactive play activities, including letter recognition, pronunciation practice, and quiz-based challenges. Each component was designed to strengthen cognitive understanding while increasing students’ intrinsic motivation to learn. Expert validation results indicated that the game met the “highly feasible” criteria as a learning medium, while user testing showed notable improvements in motivation, engagement, and learning enjoyment. Overall, this educational game not only enhances learning effectiveness but also contributes to the preservation and revitalization of the Javanese script as part of Indonesia’s cultural heritage in the digital era. Therefore, this game-based learning approach serves as an adaptive and culturally grounded educational innovation for primary-level students

Animated films are not only a medium of entertainment but also an effective tool for delivering moral, social, and educational values through innovative storytelling and engaging visual styles. In Indonesia, although many animated films are broadcast on national television, only a limited number originate from domestic creators. This condition highlights the need to strengthen local creative content that reflects Indonesia’s cultural and environmental identity. The present design project aims to develop an alternative television program in the form of a 2D animated film that emphasizes the preservation of Mentilin, an endemic animal of Bangka Island, while simultaneously serving as an educational medium for the local community. The research and design process employed a qualitative approach, focusing on data collection through observation, interviews, and literature review to identify effective strategies for socialization and education. The animation production of Mentilin, The Tiny Tarsier was carried out in three main stages: pre-production, including concept development and storyboarding; production, involving character design, background creation, and animation; and post-production, which covered editing, sound design, and final rendering. The preliminary evaluation indicated that the animation successfully captured local cultural elements and delivered messages about environmental awareness in an engaging manner. This design is expected not only to provide a creative educational platform for the community but also to contribute to the broader efforts of environmental preservation and the development of Indonesia’s animation industry. Furthermore, the program has the potential to be expanded as a replicable model for other regions in promoting endemic species conservation through creative media.

Type 2 Diabetes Mellitus (T2DM) is a chronic condition that requires optimal adherence to pharmacological treatment to prevent disease progression and complications. This study aims to analyze the level of adherence to anti-diabetic medication among T2DM patients and to explore the association between the experience of medication side effects and adherence levels. A descriptive-analytic cross-sectional design was employed, involving 97 T2DM patients in Bandung Regency and Bandung City, Indonesia. Data were collected through structured questionnaires and analyzed using descriptive statistics and the Chi-Square test. The results revealed that 53.6% of respondents exhibited low medication adherence. The majority reported having diabetes-related complications (88.7%) and experiencing medication side effects (57.7%). A significant positive association was found between medication side effects and adherence level (p = 0.039), indicating that patients who experienced side effects tended to be more adherent. Demographic factors such as place of residence, gender, and age showed no significant association with adherence. The findings suggest that side effects may hinder adherence; however, awareness of the body’s response to medication, including side effects, may also serve as a motivator for adherence.

When producing a perfect product, design process namely 2D modeling and 3D drawing, are closely related. The purpose of this study is to design a 3D model of a gun mastering machine product as a fan drive using CAD applications. The method of this study is decision data on API production (analytical product inspection). Measurement of sterling machine degradation using CPK (deviation) received results of -0.97, -0.22, 0.86, 0.11, 0.11 between zero and what indicates this specification. On average, the results of the stirling fluid fluorescent agent measurement are red numbers indicating that the survey dimensions are absent, especially from the basic dimensions of point 4, with samples 2, 3, and 5 exceeding the specified tolerance limits.

Type 2 diabetes mellitus (T2DM), hypertension, anemia, nephrotic syndrome, and urinary tract infection (UTI) are interrelated clinical conditions frequently encountered in patients with chronic kidney disease (CKD). This case report presents a 33-year-old woman who was admitted with complaints of generalized weakness, accompanied by headache, generalized edema, and pruritus. Laboratory findings revealed hyperglycemia (>300 mg/dL), elevated blood pressure (210/120 mmHg), increased urea and creatinine levels, 2+ proteinuria, and microcytic hypochromic anemia (hemoglobin ranging from 7.9 to 9.9 g/dL). Urinalysis showed leukocyturia, hyaline casts, and bacteriuria. The patient was diagnosed with uncontrolled T2DM, hypertensive urgency, microcytic hypochromic anemia, nephrotic syndrome, and UTI. Management included basal-bolus insulin regimen, combined antihypertensive therapy, packed red cell transfusions, and supportive treatments. Throughout the hospitalization, improvements were observed in hemoglobin levels and blood pressure, although subjective symptoms such as fatigue and headache remained fluctuating. This case highlights the importance of comprehensive and multidisciplinary management in patients with complex multisystem chronic conditions to prevent complications and improve clinical outcomes.

The coastal area of Manado City, particularly the estuary of the Bailang River in Bunaken District, frequently experiences inundation due to the complex interaction between river discharge and tidal fluctuations. This study aims to analyze the spatial distribution and extent of flooding resulting from the combination of river discharge and tides, as well as to evaluate mitigation strategies based on numerical modeling results. A two-dimensional hydrodynamic model was developed using MIKE 21 Flow Model FM HD, utilizing topographic and bathymetric data from DEMNAS and BATNAS, along with 2023 river discharge and tidal data. Simulations were conducted for existing conditions, minimum discharge with maximum tide, and maximum discharge with maximum tide. The results show that tidal influence significantly contributes to the increase in flood extent and duration, especially when high river discharge coincides with peak tidal conditions. The most affected areas are Kelurahan Molas and Tumumpa, located along the riverbanks and near the fish auction port, with inundation covering up to 4.973 hectares and water depths exceeding 0.5 meters. Recommended mitigation strategies include river normalization and the implementation of a real-time hydrodynamic early warning system. This study supports flood risk management and coastal spatial planning, serving as a technical reference for local government policy-making.

Background: In 2021, there were 19.5 million diagnosed cases of Type 2 Diabetes Mellitus (T2DM) in Indonesia. In Riau Province, T2DM ranked fifth among the most common conditions treated at community health centers in 2022. Obesity, a major risk factor for T2DM, had a national adult prevalence of 21.8% (Riskesdas 2018) and 24.1% in Riau. At Puskesmas Karya Wanita, 483 new T2DM cases were recorded in 2024, with 434 patients having a BMI ≥ 25 kg/m². The productive age group is particularly at risk for obesity and T2DM, yet screening remains suboptimal. Therefore, research on the relationship between obesity and T2DM at this primary healthcare facility is essential.Objective: To determine the association between obesity and the incidence of T2DM among individuals of productive age at Puskesmas Rawat Inap Karya Wanita, Pekanbaru.Methods: This was a quantitative analytic observational study with a cross-sectional design. The sample included productive age outpatients at the general clinic of Puskesmas Karya Wanita, selected using quota sampling. Data were analyzed using univariate, bivariate (Chi-square test), and Odds Ratio analyses.Results: A significant association was found between obesity and T2DM (p = 0.0029), with an Odds Ratio of 4.517.Conclusion: There is a significant relationship between obesity and T2DM in the productive age group. Individuals with obesity are 4.517 times more likely to develop T2DM compared to those without obesity.