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Background: Indonesia faces a growing double burden of non-communicable diseases, particularly cancer. The latest data from the Global Cancer Observatory (Globocan) indicates over 408,661 new cases and 242,099 cancer-related deaths in 2022, with a projected 63% increase in the case burden between 2025 and 2040 without strategic intervention. Although a new legal framework through Health Law No. 17 of 2023 and the Minister of Health Decree (KMK) No. HK.01.07/MENKES/2180/2023 has mandated palliative care as an integral component of health services, its implementation still faces significant systemic barriers.

Policy and implications: This policy brief analyzes the disconnection between the policy mandate and on-the-ground reality, identifying critical gaps in accessibility, healthcare workforce capacity particularly among nursesand financing mechanisms through the National Health Insurance (JKN) program. The failure to effectively integrate palliative care not only causes unnecessary suffering for millions of patients but also burdens the health system with inefficient costs and suboptimal end-of-life care, reflected in the high "financial toxicity" experienced by patients.

Recommendations: We recommend a four-pillar strategy: (1) Formalize and standardize palliative services within the JKN benefits package with a clear financing model to address regulatory ambiguity; (2) Develop a national competency-based palliative education and training strategy for all health workers, with a focus on empowering nurses in primary care; (3) Implement a decentralized and tiered palliative care delivery model centered on Community Health Centers (Puskesmas) to ensure equitable access; and (4) Launch a national public education campaign to destigmatize palliative care and increase awareness.

Conclusion: The integration of palliative care is not merely an option but a strategic and ethical imperative for achieving Universal Health Coverage (UHC) in Indonesia. It is a cost-effective investment to improve patients' quality of life, support families, and ensure the sustainability of the national health system in facing future non-communicable disease challenges.

Background: As lung cancer treatment has progressed, there has been an increase in awareness of the short- and long-term adverse effects of targeted cancer therapies of tyrosine kinase inhibitors, particularly cardiovascular toxicities.

Methods: The current study assessed the potential drug-drug interactions using interaction checkers (IBM Micromedex and Drugs.com). Molecular docking was employed to further investigate the involvement of human ether-à-go-go-related gene (hERG) and pregnane X receptor (PXR) proteins to elucidate their potential interactions and their underlying mechanisms.

Results: A total of 74 pharmacokinetic and 105 pharmacodynamic interactions were detected between tyrosine kinase inhibitors and cardiovascular drugs, along with a report on the severity and level of documentation. A considerable fraction of molecular modelling outcomes concurred with information from drug-drug interaction checkers. The binding energies of tyrosine kinase inhibitors with hERG and PXR were high, indicating significant interactions. The cardiovascular drug class encompasses calcium channel blockers, antiarrhythmic medicines, and statins, which were observed to exhibit synergistic interactions. The identification of these potential drug-drug interactions involving CYP3A4, P-gp, and hERG proteins can be utilized in therapy optimization in clinical settings.

Conclusion: This study will aid clinicians in designing safe dosage regimens for patients with lung cancer. In cases where patients have multiple comorbidities, it is essential to study the clinical aspects to design efficient chemotherapy and manage adverse effects and toxicities.

Background: The Ichu River serves as the primary water source for urban consumption, agricultural irrigation, and several local industrial operations in the Huancavelica region; however, increasing anthropogenic pressures including untreated municipal wastewater, mining effluents, agricultural runoff, and expanding urbanization have significantly deteriorated its water quality. These combined stressors highlight the need for an integrated assessment to understand the extent of contamination and associated human health risks.

Methods: The investigation measured water quality and health-related risks by analyzing physicochemical parameters, heavy metals, and microbial pollutants at eight sampling points, site 1 (S1) through (S8).

Results: The research data showed that water quality worsened progressively from upstream to downstream locations such as turbidity, TDS, conductivity, and BOD levels increased. Oil pollution and oxygen depletion arose from a reduction in dissolved oxygen from 6.3 to 4.5 mg/L at the different sampling sites (S1 to S8). Heavy metals (As, Pb, Cd, and Cr) in the samples exceeded the standards established by the World Health Organization (WHO) established standards because of mining and industrial wastewater and local wastewater discharge. The presence of excessive Escherichia coli (E. coli) and total coliforms in microbial tests proved that the water was severely contaminated by fecal matter. Principal Component Analysis showed that heavy metals exist with microbial pollution and organic load as the main sources of water quality decline, and pollution indicators were found to establish powerful relationships with depleted oxygen levels.

Conclusion: The severe contamination risks found in this study justify immediate pollution control measures, wastewater treatment enforcement, and sustainable watershed management practices. Urgent action is necessary because vital parameters surpass the standards set by the WHO and (United States Environmental Protection Agency (USEPA) to avoid enduring environmental damage and health problems. This research demonstrates the value of continuing water quality assessments while enforcing policies and raising public awareness to improve the water quality of the Ichu River.

Background: Oral health is closely linked to well-being at work; however, evidence in hospital personnel remains limited.

Methods: Cross-sectional study in a Level II-1 hospital (n = 72). Oral-health-related quality of life (OHRQoL) was measured with OHIP-14 and perceived oral health (POH) with a modified HU-DBI. Bivariate associations were estimated with Spearman's ρ and 95% confidence intervals; domain-level relationships were examined with proportional-odds ordinal logistic regression (Nagelkerke's pseudo-R ²).

Results: OHRQoL was distributed as 38.9% Excellent, 26.4% Fair and 34.7% Poor; POH concentrated in the Low level (52.8%), followed by Excellent (29.2%) and Fair (18.1%). POH correlated positively with OHRQoL (ρ = 0.391; 95% CI 0.18-0.57; p = 0.001). Domain-level analyses showed the strongest links for psychological discomfort (ρ = 0.421; p < 0.001; pseudo-R ² = 0.111; p = 0.027) and physical disability (ρ = 0.319; p = 0.006; pseudo-R ² = 0.167; p = 0.004); social disability (ρ = 0.242; p = 0.040; pseudo-R ² = 0.124; p = 0.017) and handicap (ρ = 0.298; p = 0.011; pseudo-R ² = 0.131; p = 0.013) were smaller but significant, whereas functional limitation was non-significant (ρ = 0.096; p = 0.424; pseudo-R ² = 0.014; p = 0.6).

Conclusions: Better perceived oral health is significantly associated with higher oral-health-related quality of life among hospital staff. Consequently, targeted workplace strategies, including education for self-care, pain management, and functional support, could enhance oral well-being. Moreover, open instruments and pilot reliability outputs are available to ensure transparency and reproducibility.

Background: Artificial intelligence (AI) is rapidly reshaping various aspects of human life, including healthcare. In the Western world, AI is increasingly applied in education and clinical practice through algorithms designed to analyze health data, aid in prediction, and assist with disease diagnosis. However, developing countries like India face obstacles in adopting AI due to limited resources and socio-cultural factors.

Aim: This study seeks to assess and compare the knowledge, attitudes, and practices related to AI in dentistry among undergraduate and postgraduate students in South India.

Methodology: A descriptive cross-sectional online survey was conducted among dental students in South India. The survey included 21 validated, structured, close-ended questions addressing demographic details, self-assessment of knowledge, attitudes toward AI applications in dentistry, and self-perceived understanding of AI practice in the field.

Results: Of 208 respondents (81.8% response rate), 95.6% were familiar with the term AI. Postgraduates demonstrated significantly greater awareness of AI applications (90.9%) compared to undergraduates (25.8%). About 78.3% of undergraduates believed AI supports diagnosis and treatment planning, while 33.4% of undergraduates and 43.2% of postgraduates expressed concern that AI may replace dentists in the future. Most respondents acknowledged AI's role in oral radiology (UG: 79.1%; PG: 72.2%). Interest in future learning was high (UG: 82.5%; PG: 92.2%). Level of education was a significant predictor of knowledge (p<0.01), while male students showed more positive attitudes (p<0.01). First-year postgraduates reported better AI-related practices than other groups (p<0.01).

Conclusion: Although most dental students lacked sufficient knowledge regarding the use of AI in dentistry, they displayed positive and encouraging attitudes toward its application. A large proportion expressed willingness to learn AI technologies to apply them in clinical practice. It is therefore recommended that universities and government bodies work together to integrate AI related topics into the dental curriculum to strengthen dental education in India.

Background: The burden of visual impairment and avoidable blindness has been attributed to the shortage and poor distribution of adequately trained eye care personnel. In the district health system, primary health care (PHC) nurses are the first point of contact for eye care patients. To provide adequate eye care, the nurses in PHC clinics apply their knowledge on basic eye health to ensure best practices and management for patients that present at their clinics. Anecdotal evidence regarding the knowledge and practices of these PHC professionals is scarce. The purpose of this study was to evaluate PHC nurses' knowledge and practices on eye health.

Methods: A quantitative, cross-sectional study was conducted in a rural district of the Eastern Cape Province in South Africa. Stratified random sampling was used to select 28 from the 74 PHC clinics in the district. A researcher-administered questionnaire using a 5-point likert scale with options strongly disagree, disagree, neutral, agree and strongly agree, was developed, piloted and finalised for this study. The tool had four sections: demographic information, knowledge of eye health, practices on evaluating visual function and identification and management of presenting eye conditions. Data were collected, captured onto MSXcel, cleaned, coded and analysed descriptively, and for Chi-squared significance at 95%, using R statistical software.

Results: From 200 responses, 86.4% (n=172) were females of the African race. Most (93.5%, n=187) had never undergone formal training in eye care. Only 28% (n=56) correctly identified a mature cataract while 28% (n=56) correctly identified signs of glaucoma; the global leading causes of preventable blindness. A total of 94% (n=188) failed to accurately measure visual acuity on a patient.

Conclusions: PHC nurses showed poor knowledge and practices of common eye conditions. There is an urgent need for eye health training for PHC nurses, and the clear management protocols on eye care.

Background: Plectranthus amboinicus is an aromatic herb known for its medicinal properties and is increasingly explored for cosmetic applications. Its bioactive compounds possess antioxidant, antimicrobial, and anti-inflammatory properties, making it a promising candidate for multifunctional skincare formulations.

Methods: This study investigated the extraction of bioactive compounds from P. amboinicus leaves using microwave-assisted ethanol extraction. Two drying techniques-tray drying and freeze-drying-were compared to evaluate their impact on the extraction efficiency. The optimal extract (PF15), prepared using 15-minute microwave extraction and freeze-drying, was selected for further analysis. Bioactive content was assessed through quantification of caffeic acid, total phenolic content, and antioxidant activity via the DPPH assay. The antimicrobial activity of PF15 was tested against Staphylococcus aureus, Staphylococcus epidermidis, and Cutibacterium acnes. Anti-inflammatory potential of PF15 was evaluated in LPS-stimulated human THP-1 macrophages by measuring cytokine production.

Results: The PF15 extract yielded the highest levels of bioactive compounds and demonstrated strong antioxidant activity. It exhibited significant antimicrobial effects against all tested skin pathogens. In the anti-inflammatory assay, PF15 significantly decreased pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) while upregulating the anti-inflammatory cytokine IL-10. The extract was formulated into a topical cream, which underwent accelerated stability testing over six heat-cool cycles. The cream remained stable with no signs of phase separation, discoloration, odor change, or microbial contamination, and maintained a pH of 5.5.

Conclusions: The PF15 extract of P. amboinicus demonstrates potent antioxidant, antimicrobial, and anti-inflammatory properties. Its successful incorporation into a stable cream formulation supports its potential as a multifunctional active ingredient in skincare products. These findings highlight P. amboinicus as a valuable natural source for the development of cosmetic formulations targeting oxidative stress, microbial infection, and inflammation.

Streptomyces sp. BTA 1-131 was isolated from the marine sponge Melophlus sarasinorum collected in Indonesia. The crude extracts of this strain displayed antibacterial and cytotoxic activity, and therefore, to further investigate the bioactive potential of the strain, whole genome sequencing was performed in this study. The whole genome sequencing of Streptomyces sp. BTA 1-131 was conducted using both Illumina NextSeq and Oxford Nanopore platforms with a de novo hybrid assembly approach. The high-quality genome obtained is 10.23 Mbp with a GC content of 71.57%. It is organised into a single chromosomal contig, two linear plasmids, and one circular plasmid. Interestingly, a long-terminal inverted repeat (L-TIR) sequence of 1.5 Mbp has been confirmed in the strain genome. Phylogenomic analysis suggested that the strain BTA 1-131 likely represents a new species within the genus Streptomyces. To the best of our knowledge, the genome data described here would be the first report on the hybrid genome sequence of Streptomyces associated with the rarely reported sponge Melophlus sarasinorum from Indonesia, with a unique feature of L-TIR. The complete genome data generated here will provide compelling information for further analysis of the biosynthetic potential of the strain BTA 1-131 to produce new bioactive compounds.

Hyperspectral band selection has become a key focus in hyperspectral image processing as it reduces the spectral redundancy and computational overhead, thereby improving classification performance. However, optimal band selection remains challenging due to its combinatorial nature. Although numerous metaheuristic algorithms have been introduced in recent years to address this problem, achieving an effective balance between exploration and exploitation continues to pose a major challenge. This paper proposes a novel approach that combines a parameter-free binary Jaya algorithm with a mutation operator to enhance exploration and maintain solution diversity within the search space. We employ Opposition-based Learning (OBL) for population initialization and Quasi-Reflection reinitialization strategy to add diversity whenever fitness stagnation occurs. To simultaneously improve classification performance and band reduction we adopt weighted sum multi-objective fitness function that minimizes redundancy and enhances model generalization. Our proposed method is evaluated using three benchmark datasets, namely Indian Pines, Pavia University, and Salinas. Experimental results demonstrate that the pro-posed method outperforms recent metaheuristic-based band selection techniques. Its superior performance makes it well suited for various HSI applications.

Background: Recently, health professional education uses visual art observation to promote various observation-related technical skills. This article maps the studies on such interventions, scrutinizes what they measured as observational skills, and discusses their effectiveness.

Methods: Following the PRISMA Extension for Scoping Reviews, a scoping review was conducted. Publications from 2001 on were identified by searching four databases and by hand searching. The author screened each publication using the pre-designed eligibility criteria: participants were novice healthcare learners enrolled in visual art observation training; the study aimed to evaluate the effect of the intervention on technical skills related to observation; the skills were objectively measured. The author extracted relevant information from the included papers without additional inquiry into the study authors. The extracted information was illustrated in both a tabular and descriptive format.

Results: 3,157 publications were identified, of which 18 articles were included. Few studies had valid and reliable experiments. The relatively valid evidence is that the participants listed more elements or signs for artistic or medical images.

Conclusions: Sound evidence is lacking for all the technical skills intended to be fostered. Observation skills for artistic images have not been demonstrated to transfer to technical skills. Nor do the studies show that they promoted accurate diagnoses and reduced misdiagnoses. Additionally, the evidence on verbalizing skills is not isolated from the impact of discussions and is unclear regarding its transfer to actual communication. For the others, there are not enough valid studies on technical skills. This is true for studies that directly examine promoting accurate diagnosis or reducing misdiagnosis. Moreover, there may be promising alternatives to visual art observations for cultivating such technical skills, but no comparative studies were conducted.