Subclinical Hypothyroidism Post-Bariatric Surgery: A Reversible Case of Iodine Deficiency Without Autoimmune Thyroid Disease

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Subclinical hypothyroidism is a common finding in clinical practice, often prompting initiation of levothyroxine therapy. However, not all cases of elevated thyroid-stimulating hormone (TSH) reflect permanent thyroid dysfunction. This report discusses a 39-year-old woman with a history of Roux-en-Y gastric bypass surgery who presented with elevated TSH in the absence of thyroid autoantibodies or classic hypothyroid symptoms. Laboratory and clinical findings suggested iodine deficiency as the underlying cause. Her TSH normalized following potassium iodide supplementation. This case underscores the need for a nuanced approach to managing elevated TSH, particularly in post-bariatric surgery patients where iodine deficiency may be the etiology of subclinical hypothyroidism.

The Development of Ethnomathematics-Based Learning Devices of Sulur Godong Batik Using Digital Manipulatives on Geometry Transformation to Improve Students Creative Thinking Abilities

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The research conducted aims to create learning devices that can be declared valid, practical, and effective, especially on the subject of Geometric Transformation. The development of this learning device is carried out with the aim of improving students’ creative thinking skills. This research is a type of research and development with the 4-D Thiagarajan development model. The stages of 4-D Thiagarajan include define, design, develop, and disseminate. Data collection is carried out using observation, test, and questionnaire techniques. The results of the Ethnomathematics-based development research using digital manipulatives are classified into valid, practical, and effective. The level of validity can be seen from the validity value of each teaching module of 3.78, LKPD of 3.87, and test of 3.92 which are included in the valid category. The practicality value is obtained from the results of observations of the implementation of learning devices and the results of observations of student activities of 92.25% and 93.08%, respectively. The effectiveness value is seen from the learning outcome data obtained 83.0% completed classically with the category of very creative and creative thinking and the student response questionnaire has a positive value of 88.2%. Suggestions for teachers are expected to use learning devices more often because they can train students’ creative thinking skills and can be used as a guideline in a more varied and innovative learning process. Not only that, other researchers can reach wider research subjects and different materials in the development of further learning devices.

Modeling Volatility Asymmetry in Government-Owned Stocks: Evidence from Value at Risk Estimation in Indonesia

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This study evaluates the comparative effectiveness of four volatility models—EWMA, GARCH(1,1), EGARCH, and TGARCH—in estimating daily Value at Risk (VaR) for a portfolio of Indonesian state-owned enterprise (SOE) stocks over the period 2019–2024. Motivated by the rapid growth of retail investor participation and increasing exposure to market risk in Indonesia’s emerging capital market, the research addresses a critical gap in empirical risk modeling for government-owned equities. A key contribution of this study lies in the integration of asymmetric GARCH-family models with Student-t innovations into a VaR estimation framework, tailored specifically to SOE stocks—an approach seldom explored in the Southeast Asian context. The analysis uses daily return data from ten liquid, sectorally diverse SOEs. Volatility is estimated via parametric methods, assuming a normal distribution for EWMA and Student-t distributions for GARCH-type models. Model accuracy is evaluated through in-sample and out-of-sample backtesting, employing MAE, RMSE, and the Kupiec and Christoffersen tests. The findings indicate that GARCH(1,1) performs most reliably at the 95% confidence level, while TGARCH demonstrates superior performance at the 99% level, particularly in capturing downside risk. EGARCH tends to produce conservative estimates, whereas EWMA underestimates tail risk. The results support a dual-model strategy for operational monitoring and capital risk management.

Analysis of Patient Safety Culture among Healthcare Workers at Community Health Centers in Bandar Lampung, Indonesia

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This study aims to analyze the culture of patient safety among healthcare workers at Way Halim II Inpatient community health center, Satelit Inpatient community health center, and Pasar Ambon community health center in Bandar Lampung, Indonesia, in 2025. This cross-sectional survey used quantitative data that were collected through questionnaires distributed to all 200 healthcare workers using total sampling and analyzed with SPSS software. The research looks at 12 aspects of patient safety culture, such as how openly information is shared, how feedback and communication about mistakes happen, how often safety incidents are reported, how handoffs and transitions are managed, the support from management, responses that don’t punish mistakes, learning within the organization, views on patient safety, staffing levels, actions to promote safety, cooperation between different units, and cooperation within the same unit. The findings indicate that, overall, patient safety culture in the three community health centers is relatively good, particularly in staff support, cross-unit collaboration, and leadership openness. However, challenges remain, especially regarding low reporting rates for non-severe incidents, suboptimal non-punitive environments, and uneven information completeness during handoffs. Promoting inclusive leadership, strengthening teamwork, and fostering open communication are critical for enhancing patient safety practices. This study provides recommendations for policy development, capacity building, and future research directions to foster a sustainable, safety-oriented organizational culture in primary healthcare settings.

Pineal Body Tumour, A Very Rare but Often Misdiagnosed in Our Clinics and Literature Review

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This publication aims to review and remind Medical Practitioners of a very rare and often misdiagnosed case of a central nervous system tumour, pineal body tumour. A 4-year old boy child referred from a peripheral hospital in a neighbouring town on account of not responding to several treatments. Mother booked for antenatal care by 3rd month of the pregnancy. She adhered to her treatments and kept to her appointments throughout the care. Mother had a hitch-free labour and delivery. Immediate neonatal and postnatal life was good up to the onset of the present illness. Pineal body tumour is a very rare and often misdiagnosed malignancy because of its several mimicries, which demands a very high index of suspicion and extensive clinical assessment to diagnose. Presently there is daft information on this rare brain tumour, and so this publication.

Evaluation of Complete Systematic Land Registration Policy in Gorontalo City

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This study aims to evaluate the Complete Systematic Land Registration (PTSL) policy in Gorontalo City using six main dimensions of policy evaluation: effectiveness, efficiency, adequacy, equity, responsiveness, and accuracy. The study adopts a qualitative approach with a descriptive-analytical design. Data were collected through in-depth interviews with relevant stakeholders, field observations, and a review of policy documents and PTSL implementation reports. The data analysis technique used was the interactive model by Miles and Huberman, which includes data reduction, data presentation, and conclusion drawing. The findings reveal that the PTSL policy has achieved a high level of effectiveness, with 87.4% of the 67,229 land parcels already certified. The implementation cost is considered efficient, averaging IDR 250,000 per certificate, with a completion time of one to two months. The program is also considered adequate in terms of regional coverage and accessibility, although challenges remain in documenting inherited land and reaching marginalized communities. In terms of equity, the implementation of PTSL has yet to show affirmative attention toward vulnerable groups such as the poor and female-headed households, although geographic distribution has been relatively even. The responsiveness of the implementation is fairly good, with quick handling of complaints and the existence of direct reporting mechanisms at the sub-district level. The policy is also considered accurate as it aligns with both national and local regulations and can adapt to the cultural values of the community, such as respect for burial land and the involvement of traditional leaders. The participation of local stakeholders significantly supports the successful implementation of this program.

Capital Buffer and Bank Risk-Taking: Evidence of Non-Linearity from Commercial Bank in Indonesia

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Banks function as financial intermediaries and are inherently exposed to risk. Capital, particularly capital buffer, is one of the tools used to absorb such risks. Therefore, this study aims to examine the relationship between capital buffer and bank risk-taking levels, specifically focusing on the non-linear relationship among commercial banks in Indonesia. The data consists of annual data from Indonesian commercial banks from 2013–2023, excluding foreign bank branches and digital banks, with a sample size of 81 banks representing a total market share of 94%. The method employed is quantile regression. The result of the study shows that there is a non-linear and U-Shaped relationship between capital buffer and bank risk-taking among commercial banks in Indonesia.

Selecting the Best Alternatives of Virtual Hotel Operator Using SMART Analysis: A Case of CBS Hotel

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This study investigates the strategic decision faced by CBS Hotel in 2024, following the decline in revenue in 2024, despite stable occupancy rates. The decline was not caused by reduced demand, but rather by centralized pricing policies, and internal competition from an increasing number of properties managed by the same Virtual Hotel Operator (VHO). The purpose of the research is to analyze the root causes of the performance decline and evaluate whether the CBS Hotel should renew its partnership with RedDoorz or switch to OYO or Zuzu. The research employs a two-stage methodology, the first stage is a root cause analysis, which is conducted using the Ishikawa Diagram and Porter Five Forces Analysis to explore environmental, operational, and market-based pressures. Second, a structured decision-making framework is applied using Value Focused Thinking (VFT) and SMART (Simple Multi Attributes Rating Technique) method to assess three alternative VHO options. Six criteria are generated, which consist of: pricing autonomy, commission scheme, operational support, average room rate, occupancy, and contract flexibility. Findings indicate that RedDoorz scores highest across the criteria. Making it a more strategically aligned option. However, the study also recommends that CBS Hotel leverage its high-performing status to negotiate better terms, particularly in rate control and area exclusivity. This study demonstrates the value of combining root cause identification with multi-criteria decision-making analysis to guide hotel budget segments or industries to optimize the 3rd party partnership with the VHO business model company in a highly competitive urban market.

Transparent Model of Village Financial Governance: A Review of Public Service Administration

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This article discusses a transparent model in village financial governance in Limboto Barat District, Gorontalo Regency, with a focus on the application of the principle of transparency in the management of village funds. Although Law Number 14 of 2008 concerning Public Information Disclosure has encouraged accountability and transparency, the level of information disclosure in Gorontalo Province is still low. This study uses a qualitative-exploratory approach to analyze transparency indicators, such as document accessibility and clarity of information. The results show that access to information related to budget use is still limited, and community participation in supervision is not optimal. This article recommends increasing the commitment of the village government and increasing access to information through the use of digital technology to increase transparency. In addition, it is necessary to build a supervision system that involves the community as active supervisors, in order to increase the efficiency and accountability of village financial management and public trust in the village government.

The Relationship between the Levels of Perspiration (Sweating) on Confidence Level and Productivity of Students Who Live in Bangkok

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Sweating is a physiological mechanism whose function is to cool the body down, but nowadays, it may seem problematic in socializing and working settings, mainly due to stains, odor, and other discomforting sensations that can affect confidence and productivity. This study aims to determine how sweating can impact confidence and productivity levels for students in Bangkok. Based on a comprehensive literature review by 2 experts, an online survey was distributed to students (school, college, university) across Bangkok; the respondents were asked to answer 3 sets of questions about their perspectives on sweat. 345 students (173 male, 162 female, and 10 others) comprised the sample group for this study to observe the correlation between the 2 variables by implementing statistics software. As a result, we discovered a highly significant correlation between sweat levels and productivity with a p-value of 0.010. Our data also show a correlation between gender and confidence; between confidence and age, and between productivity and confidence. However, there was no significant correlation between sweat and confidence.