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Dysphagia in extremely elderly patients represents a significant clinical challenge because it is frequently associated with frailty, malnutrition, and an increased risk of aspiration. Multifactorial etiologies and atypical clinical manifestations may complicate diagnosis and delay appropriate management. This study aimed to describe the diagnostic evaluation and clinical findings of dysphagia in an extremely elderly patient through a case report supported by a scoping review. A 105-year-old woman with chronic progressive dysphagia underwent comprehensive assessment, including physical examination, upper gastrointestinal endoscopy, histopathological evaluation, and chest radiography. Relevant literature on dysphagia in geriatric populations was reviewed to provide contextual understanding of diagnostic challenges and underlying etiologies. The evaluation revealed chronic active gastritis and a hamartomatous polyp in the gastroesophageal region without evidence of malignancy. Comprehensive assessment successfully excluded malignant and acute obstructive causes, emphasizing the complexity of dysphagia diagnosis in extremely elderly individuals with frailty and aspiration risk. These findings underscore the importance of endoscopic and histopathological examinations in distinguishing benign from malignant etiologies and support early recognition of multifactorial non-malignant causes to optimize clinical management and reduce the risk of adverse outcomes in this vulnerable population

The global energy crisis and climate change are driving the development of biodiesel as a renewable energy source. Graphite as an additive shows significant potential in improving the efficiency and reducing emissions of biodiesel. This study maps graphite-biodiesel research in Southeast Asia using a meta analysis of systematic reviews of 68 publications from Scopus, Web of Science, and ScienceDirect from 2015-2024. The results show that Malaysia leads in publication contributions (32%), followed by Thailand (28%) and Indonesia (18%). The optimal graphite concentration of 50 ppm increases brake thermal efficiency by 8.3% and reduces CO (15.7%), HC (12.4%), and smoke (18.9%) emissions, although there is an increase in NOx (6.8%). Palm oil methyl ester dominated the research (56%). Indonesia has strategic opportunities with abundant feedstock and graphite deposits, but faces challenges in research infrastructure, limited international collaboration, and the absence of an integrated national roadmap. Infrastructure investment, human resource strengthening, and industry academia collaboration are needed to accelerate national biodiesel research.