Puff of Smoke’ In A Young Brain: A Classic Imaging Sign of Moyamoya Disease – Case Report

/in /by

Moyamoya disease is a rare and progressive cerebrovascular disorder marked by the occlusion or blockage of the distal internal carotid arteries and their main branches. In response, the brain develops a network of fragile collateral vessels, which appear as a “puff of smoke” on angiographic imaging—a characteristic feature that inspired the disease’s name. The condition primarily affects children and young adults, often presenting with transient ischemic attacks, strokes, seizures, or cerebral haemorrhage. Although the underlying mechanisms are not fully understood, genetic factors, particularly mutations in the RNF213 gene, have been closely associated with disease susceptibility, The major susceptibility gene for moyamoya disease in people investigation into the mechanisms of disease and potential treatment targets. The Arg4810Lys variant of the gene is most strongly associated with moyamoya disease, but the penetrance is lower than 1%, suggesting a synergistic relationship with additional environmental and genetic risk factors. A 11-year-old female patient presented with the complaints of sudden onset of left upper limb and lower limb transient weakness associated with bowel incontinence patient has  a past medical history of seizures since 10 months with multiple seizure episodes Diagnostic evaluation typically involves magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography, the latter of which remains the gold standard. Treatment strategies are primarily surgical, with revascularization procedures—either direct, indirect, or combined approaches—aimed at improving cerebral blood flow and reducing the risk of ischemic events . Based on laboratory investigations and radiological reports case was diagnosed as MOYAMOYA DISEASE preoperative and anaesthesia clearance patient was taken up for STA-MCA bypass (Superficial Temporal Artery to Middle Cerebral Artery Bypass) associated  treatment with perivascular sympathectomy and superior cervical ganglionectomy may be useful but more investigation needs to be carried out into the pathogenesis of the disease before more definitive therapy is realized.

This review outlines the latest developments in the understanding, diagnosis, and management of Moyamoya disease, with attention to its genetic background and surgical outcomes.

Legal Certainty in the Management and Supervision of Donations for Humanitarian Purposes in Indonesia

/in /by

The rapid progress of information technology has greatly enhanced public fundraising via donation-based crowdfunding platforms that use social media and digital channels. This innovation expands public access and fosters community involvement in social initiatives, yet it functions within a framework of legal ambiguity due to the lack of specific regulations governing the mechanisms, oversight, and accountability of online donation activities in Indonesia. This study seeks to examine the operational procedures of donation-based crowdfunding in Indonesia, identify regulatory deficiencies, and provide legislative remedies to enhance protection for contributors, platform operators, and recipients. This study utilizes a qualitative normative research technique, using legislative and conceptual methods, to analyze existing legislation and various instances of purported donation fund misappropriation. Research reveals that existing regulations, including Law No. 9 of 1961, Government Regulation No. 29 of 1980, and Minister of Social Affairs Regulation No. 8 of 2021, inadequately address the contemporary realities and risks of the digital donation landscape, leading to transparency deficiencies, opportunities for fraud, and diminished legal accountability. This thesis asserts that legislative change, enhanced supervisory mechanisms, and extensive legal literacy initiatives are essential to guarantee that donation-based crowdfunding functions in a reliable, responsible, and sustainable way within Indonesian society.

Generator of Electric Current without rotating according to the New Axioms and Laws

/in /by

The Theory of new Axioms and Laws contains 2 new Axioms and 8 Laws and it is by the same author. The classical axiom (Maxuell 1864) states that one closed vortex has constant velocity and it explains the Classical Field Theory. In contrast, the first new   Axiom1 asserts that an open vortex has always a changing speed and it explains the new Theory of Open vortices.  The Law1 describes that   the electron is generated by a self -decelerating  transverse open vortex in direction  from out to in that is like open input. It generates inward (in2D) in its Gravity center a perpendicular self-accelerating longitudinal vortex upward (in 3D). Because generating transverse vortex is strongly self-decelerating the electron becomes to eccentric toroid. The Geometric center of body moves from to a new Gravity   center that is in second quadrant. Thus the distance between these centers forms a Vector of Eccentricity. The Vector of Eccentricity lies on    diameter of this toroid. Along this diameter on side of Gravity center, the distance between the transverse windings is minimal, and on the opposite side of diameter – the distance is maximal. Pulsating in time the electron emits a larger electric wave from place of   the maximum distance, but a smaller one -from the side with minimum distance, Therefore, the resultant Electric wave moves in direction of towards the maximal distance that coincides open input of the electron.

If pulsating electrons are phased with their open inputs towards one and the same end of a Conductor then their predominant radiation towards that end. It cause the movement of Electric wave to the this end. Thus the Electric wave flows inside to this end and Electric current – on surface of Conductor to its opposite  end.

The author proposes  the Induction to be achieved without  movement of the Conductor or the Magnetic field. The scientists can implant on the surface of Conductor a dense nano-grid emitting impulse Magnetic field. The pulsating lines of force of the Magnetic field hit the pulsating electrons and thus electrons rotate. The rotating continues until most of the electrons in the conductor order and phased their perpendicular vectors parallel and unidirectional to the external magnetic lines. Thus open inputs most likely point towards one and the same end of the Conductor.

Therefore the phenomenon Induction of Electric current is connected with phasing of the electrons along the 3 axes. The existence of the phenomena Induction are direct evidence of exactly this structure of the electron according Theory of new Axioms and Laws. Ecxactly  the inner structure of the electron is the reason  it   to react  the outer impact of   the lines of  external Magnetic field  in this kind. Therefore electron reacts like a particle or cell possessing some internal sensitivity and external reflex.

The Development of RBL-STEAM Learning Design to Improve Climate Change Literacy Through the Construction of Energy-Efficient Houses in Sixth Grade of Elementary School Students

/in /by

Climate change literacy is essential for preparing future generations to understand environmental challenges and take an active role in mitigation and adaptation efforts. This study aims to enhance students’ climate change literacy through the development of Research-Based Learning (RBL) integrated with the STEAM approach, which combines Science, Technology, Engineering, Arts, and Mathematics. Students were engaged in the construction of energy-efficient house projects that incorporated simple electrical circuits, allowing them to apply scientific concepts in a meaningful context. The study employed a research and development methodology using the 4D model, which consists of the stages Define, Design, Develop, and Disseminate. The developed learning materials included lesson plans, student worksheets (LKPD), and a climate change literacy test. A sequential exploratory mixed-methods design was implemented, beginning with qualitative data collection and analysis, followed by quantitative data collection and analysis. The study was conducted at SDN Banjarwungu 2 as the experimental group and SDN Gempolklutuk as the control group. The findings indicate that the RBL-STEAM learning materials are valid, practical, and effective in improving students’ understanding of the causes, impacts, and potential solutions to climate change. The study concludes that integrating RBL-STEAM with project-based learning activities can significantly enhance climate change literacy in primary education.

Chemical synthesis and applications of Gold nanoparticles

/in /by

The range of scientific and technical uses for nanoparticles makes it evident how important nanotechnology is in today’s world. Gold nanoparticles are among the many metal nanoparticles that can be produced using a variety of methods. This review article emphasizes the fundamental methods of chemical synthesis for gold nanoparticles, exploring their production processes and diverse applications. The data for the research was gathered through a review of existing literature. The Brust-Schiffrin method is a significant approach for synthesizing gold nanoparticles (AuNPs). In this technique, two reaction pathways are employed to achieve an efficient surface reaction during the formation and growth process. AuCl4− is transferred from the aqueous phase to toluene and subsequently reduced by sodium borhydrate (NaBH4) in the presence of dodecanethiol. The adaptable surface chemistry of AuNPs enables them to be coated with small molecules, polymers, and biological recognition molecules, thus expanding their scope of use. The size of AuNPs can be regulated during synthesis and functionalization with various chemical groups. They have the ability to accumulate in tumor cells, exhibit optical scattering, and serve as probes for microscopic studies of harmful cells. Additionally, AuNPs are employed in cancer therapy and diagnosis. Furthermore, they hold significant promise in catalysis, as their surfaces facilitate interactions between reactants and the catalytically active sites on gold nanoparticles.

Assessment of the Management of Museum Storage Units at The National Museum of Tanzania: Reality and Challenges

/in /by

Museum storage units are crucial in protecting and preserving the museum’s precious collections in the most effective and efficient way. A well planned and organized storage system not only increases the level of preservation but also helps in organizing the collections it hosts (NPS Museum Handbook, 2012).  However, many museums across the globe are faced with challenges of improper and ineffective storage units hence risking the safety and security of museum objects.  As such, the museums’ essential roles and functions including research, exhibitions, conservation, acquisition and education are hampered. Based on in-house research, this paper explores the reality of collections’ storage units and systems at the national Museum of Tanzania (NMT) which has been in existence since 1940.  During data collection, methods including Museum Storage Survey Method (MSSM) and Desktop Works Method (DWM) were applied to collect information for the study.

The Influence of Patient Satisfaction and Brand Image on Patient Loyalty with Patient Trust as a Mediator at Anna Medika Hospital

/in /by

In the era of digitalization and globalization, service quality has become one of the most critical aspects of a healthcare institution’s success, such as a hospital. High patient satisfaction significantly influences repeat visit frequency when patients require further treatment. Moreover, if patients experience positive outcomes after receiving care at a hospital, it becomes their primary choice for future medical needs due to the trust and loyalty built toward the healthcare provider. This study aims to analyze the influence of patient satisfaction and brand image on patient loyalty, with patient trust as a mediating variable at Anna Medika Hospital.

This quantitative research employs Partial Least Squares Structural Equation Modeling (PLS-SEM) with a sample of 120 inpatients. Data were collected through questionnaires and analyzed using SmartPLS 4.0.

The results show that patient satisfaction and brand image significantly affect patient trust (β = 0.465 and β = 0.404, respectively). Patient trust mediates the effect of satisfaction on loyalty (β = 0.274; *p* < 0.05) but is not a significant mediator between brand image and loyalty (*p* = 0.077).

Patient trust plays a crucial role in transforming satisfaction into loyalty, while brand image directly influences loyalty without mediation by trust.

Therapeutic Promise of Natural Antioxidants in Redox Regulation

/in /by

Phytochemical research has attracted the attention of researchers in the field of biomedical and biotechnological research and explored a new era of drug discovery. Focus of these studies is to minimize or overcome the side effects of synthetic drugs.  It aims to find out the equivalent natural molecules that can replace the drugs having harmful side effects on human health.

Advances in the organic and analytical chemistry during last century offered new vision towards the phytochemical research. Investigations of various molecules through different biochemical and biophysical methods can easily reveals the structural and functional properties of the compounds and have opened the new avenues in natural drug discovery. These new techniques are more competent to isolate, characterize and analyze the active principles from these medicinal plants and other natural resources. Thus, the phytochemical research has proved to have a pivotal role in drug discovery.

The Influence of Governance and Job Satisfaction on the Performance of Husada Hospital Mediated by Employee Loyalty

/in /by

Background: Hospital performance is vital for sustaining quality healthcare services. At Husada Hospital, fluctuations in inpatient numbers and workforce trends from 2019 to 2024 underscore the need to understand how governance and job satisfaction influence performance. Employee loyalty may play a key mediating role, yet this relationship remains underexplored.

Objective: This study aims to analyze the effects of governance and job satisfaction on hospital performance, and to assess the mediating role of employee loyalty in these relationships.

Methods: This quantitative study was conducted at Husada Hospital, Jakarta, from June 9–13, 2025, involving 160 employees selected through proportionate stratified random sampling. Data were collected using Likert-scale questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS) via SMARTPLS to assess direct and mediated relationships among governance, job satisfaction, employee loyalty, and hospital performance.

Results: PLS-SEM analysis showed that governance and job satisfaction significantly influenced employee loyalty (R² = 0.580) and hospital performance (R² = 0.413). Employee loyalty had the strongest direct effect on performance (β = 0.642) and significantly mediated the effects of both governance and job satisfaction, highlighting its key role in improving hospital outcomes.

Conclusion: Governance and job satisfaction significantly influence employee loyalty, which plays a key role in enhancing hospital performance. Job satisfaction had the strongest effect on loyalty, while loyalty emerged as the most dominant predictor of performance. Loyalty also mediated the effects of governance and job satisfaction on performance, confirming its central role in linking internal organizational factors to hospital outcomes.

Assessing Consumer Perceptions and Intentions Toward Plant-Based Meat: Scale Development and Exploration

/in /by

This paper introduces a comprehensive multidimensional scale designed to assess consumer perceptions and intentions regarding plant-based meat (PBM) products. In light of the global shift toward sustainable food choices, this study addresses the need for a holistic instrument to gauge various facets of PBM adoption. The scale comprises five core dimensions: (1) Perceived Benefits of PBM, encompassing health, environmental, and ethical considerations; (2) Perceived Barriers to PBM, encompassing concerns related to taste, protein content, texture, price, and sustainability; (3) Consumer Attitudes Toward PBM, reflecting sensory experiences and perceived similarity to traditional meat; (4) Awareness of PBM, assessing knowledge of PBM existence and prior consumption; and (5) Purchasing Intentions of PBM, measuring intentions based on factors such as taste, health benefits, sustainability, price, labeling, and positioning.

The exploratory factor analysis (EFA) findings indicate that the multidimensional scale effectively captures the intricate nature of consumer perceptions regarding PBM. Notably, consumer attitudes toward PBM are influenced by sensory experiences and perceived product similarity to traditional meat. Additionally, perceived benefits, including health, environmental sustainability, and ethical considerations, significantly influence consumer attitudes and purchasing intentions. Conversely, perceived barriers, encompassing concerns about taste, protein content, and price, may present obstacles to PBM adoption. The scale’s dimensions offer practical implications for marketers, policymakers, and scholars. Marketers can tailor their product positioning to emphasize factors such as taste, health benefits, and sustainability. Policymakers can design effective public health campaigns and policies to promote sustainable and healthier dietary choices. Scholars can utilize the scale to conduct in-depth research on PBM adoption, enabling cross-cultural comparisons, longitudinal studies, and intervention assessments.