METHODS: In this prospective cohort study, 268 healthcare professionals and medical students in Malaysia were followed up for 24 weeks following homologous (messenger ribonucleic acid [mRNA]-mRNA [mR-mR], viral vector-viral vector [VV-VV], inactivated virus-inactivated virus [IV-IV]) and heterologous (inactivated virus-mRNA [IV-mR], viral vector-mRNA [VV-mR]) booster vaccines. Of them, 190 recipients underwent a longitudinal immunogenicity study. Anti-spike (anti-S) immunoglobulin G (IgG) and anti-receptor-binding domain (anti-RBD) responses were assessed by the ADVIA Centaur severe acute respiratory syndrome coronavirus 2 chemiluminescent immunoassay followed by a surrogate virus neutralization test using the Omicron variant across all boosters.
RESULTS: Compared to homologous boosters, heterologous regimens, particularly the IV-mR booster, elicited significantly higher and sustained anti-S IgG and anti-RBD antibody (P < 0.0001) responses. Over 24 weeks, the heterologous IV-mR booster group had 100% seropositivity for anti-S IgG and anti-RBD antibodies; conversely, in the homologous (IV-IV) booster group, the seropositivity of anti-S IgG and anti-RBD antibodies decreased to 15.63% and 18.75%, respectively. Omicron virus-neutralizing was observed to be as high as 95.92% (IV-mR) and 83.87% (VV-mR) at week 24 after the heterologous booster, while virus neutralization was found to be as low as 9.38% in the IV-IV homologous booster. Age, gender, and ethnicity were not found to be confounding factors for antibody kinetics following a booster vaccine.
CONCLUSION: In conclusion, heterologous booster vaccines induced a superior prolonged humoral immune response against coronavirus disease 2019 infection.
MATERIALS AND METHODS: A 23-item validated questionnaire including closed and open questions pertaining to the teaching of posterior composites was emailed to faculty members of all 38 dental schools in Indonesia. Responses were compiled on Excel and analyzed.
RESULTS: The questionnaire response rate was 84%. All schools instructed placement of occlusal, and two, and three-surface occluso-proximal composite restorations in premolar and molar teeth. Nine dental schools (n = 9; 28%) taught posterior composites first, whereas 13 schools (n = 13; 41%) taught the use of dental amalgam first. Most dental schools (n = 26; 81.25%) taught removal of residual caries, prior to placement of restorations. Most schools (n = 10; 31%) taught rubber dam before the placement of composites. Students were taught use of clear matrix, sectional metal matrix systems (n = 24; 75%), or use a circumferential metal system such as Tofflemire (n = 20; 62%). Most institutions reported teaching Solventum composites (n = 25; 78%). Twenty-eight dental schools (88%) taught the use of water cooling while finishing.
CONCLUSION: Instruction in posterior composite restorations is well-established and growing in Indonesian dental schools. Differences in the teaching between dental schools in Indonesia and the teaching in dental schools in other countries and regions of the world should be the subject of review. It is anticipated that the teaching and limited use of dental amalgam by students in Indonesian dental schools will continue to be phased down.
CLINICAL SIGNIFICANCE: Aligning Indonesian dental curricula with global trends in posterior resin composite instruction ensures that future practitioners master modern, minimally invasive restorative techniques. Standardized instructional frameworks are necessary to maximize material selection, improve technique-sensitive placement, and provide high-quality, tooth-preserving direct restorations as dental amalgam is gradually phased down.
METHODS: We randomly assigned adults with IgA nephropathy to receive subcutaneous sibeprenlimab (at a dose of 400 mg) or placebo every 4 weeks. The key secondary end point was the annualized slope of the eGFR over 24 months. Other secondary end points included the change in eGFR from baseline to 24 months, a composite kidney end point of kidney-function decline or kidney failure, and pharmacodynamic and safety end points.
RESULTS: A total of 510 patients underwent randomization - 259 to receive sibeprenlimab and 251 to receive placebo. The annualized eGFR slope over 24 months was 0.3 ml per minute per 1.73 m2 of body-surface area per year (95% confidence interval [CI], -0.4 to 0.9) with sibeprenlimab and -4.2 ml per minute per 1.73 m2 per year (95% CI, -4.9 to -3.6) with placebo (between-group difference, 4.5 ml per minute per 1.73 m2 per year; 95% CI, 3.6 to 5.4; P<0.001). The least-squares mean treatment difference for the change in eGFR from baseline to 24 months was 9.2 ml per minute per 1.73 m2 (95% CI, 7.1 to 11.4; P<0.001). A composite kidney end-point event occurred in 1 patient (0.4%) in the sibeprenlimab group and in 28 patients (11.2%) in the placebo group (adjusted difference, -10.8 percentage points; hazard ratio, 0.029; 95% CI, 0.004 to 0.214; P<0.001). Adverse events occurred in 235 patients (90.7%) in the sibeprenlimab group and 226 patients (90.0%) in the placebo group; serious adverse events occurred in 21 patients (8.1%) and 32 patients (12.7%), respectively; and serious infections in 5 patients (1.9%) and 10 patients (4.0%). No deaths were reported.
CONCLUSIONS: Among patients with IgA nephropathy, treatment with sibeprenlimab stabilized the eGFR slope over 24 months, a finding consistent with a reduced risk of kidney-function decline. (Funded by Otsuka Pharmaceutical Development and Commercialization; VISIONARY ClinicalTrials.gov number, NCT05248646.).
OBJECTIVE: To develop and validate a bilingual questionnaire (MyACE) assessing perceived usefulness (PU), perceived ease of use (PEOU), satisfaction, and functionality of MyUBAT among adult users.
METHODS: This cross-sectional study developed a questionnaire integrating constructs from Technology Acceptance Model, Mobile App Rating Scale and System Usability Scale. Two rounds of content validation involving eight experts were conducted using the Item-level Content Validity Index (I-CVI). The bilingual (English and Malay) version underwent face validation with 10 adults from the general public via the Item-level Face Validity Index (I-FVI). A pilot study recruited end-users (N = 30) via convenience sampling at outpatient pharmacy units to evaluate internal consistency using Cronbach's alpha and Corrected Item-Total Correlation (CITC).
KEY FINDINGS: MyACE (20 items) showed strong content validity (I-CVI: 0.88-1.00; S-CVI/Ave: 0.96) and excellent face validity (I-FVI ≥ 0.83 for 19/20 items; S-FVI/Ave: 0.99; S-FVI/UA: 0.90). Pilot testing confirmed excellent overall reliability (α = 0.91), with strong domain-specific reliability for Functionality (α = 0.90) and Satisfaction (α = 0.80). Although PU (α = 0.55) and PEOU (α = 0.62) showed lower reliability, all items were retained after considering overall reliability and CITC results.
CONCLUSION: The MyACE questionnaire demonstrated good validity and excellent reliability, supporting its use as a bilingual instrument to evaluate user perceptions of the MyUBAT mobile application and providing a foundation for future large-scale validation.
OBJECTIVE: The aim of this study is to develop, validate, and field-evaluate SmartGlove BISINDO, an AI-assisted wearable sign language-to-speech system that embeds large language model (LLM)-powered NLG into a BISINDO translation pipeline for the first time.
METHODS: This study followed the design science research (DSR) framework, covering phases 1 through 5 (problem identification, solution objectives, prototype design and development, demonstration, and evaluation). Data were collected from 12 purposively selected informants (6 domain experts and 6 deaf education companions/teachers) across 3 Indonesian cities (Malang, Surabaya, and Makassar), using a needs-analysis questionnaire and an expert validation sheet, and analyzed through statistical triangulation of agreement percentage, content validity ratio (CVR), and Aiken V. The validated prototype was field-tested in Makassar and Malang with 15 participants with communication disorders and 4 observers or companions; it was evaluated by a disability expert in Surabaya.
RESULTS: The needs analysis yielded a grand mean of 4.77 (SD 0.51) across 4 clusters, with 89% mean agreement, indicating very high priority for all identified needs. The prototype's 5-layer architecture integrates wearable sensors, on-device gesture classification, and LLM-based NLG. Expert validation showed an overall Aiken V of 0.94, with all 14 items exceeding the 0.75 validity cutoff and with 11/14 items (79%) rated highly valid (V>0.90). The grand mean CVR was 0.76 (SD 0.16), exceeding the Lawshe minimum threshold of 0.56 (P