Narra J最新文献

Green synthesis of nanoparticles has garnered significant attention for its sustainable and environmentally friendly approach. Despite extensive research on Artocarpus heterophyllus-derived nanoparticles using seeds, fruits, and rind, the therapeutic potential of its leaf extract remains largely unexplored, particularly in MCF-7 breast cancer cells. The aim of this study was to investigate the potential of aqueous leaf extract from A. heterophyllus as a reducing and capping agent to synthesize silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs), as well as to evaluate their anticancer efficacy. The nanoparticles were characterized using ultraviolet-visible spectroscopy, transmission electron microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and particle size analysis to confirm the formation. To evaluate anticancer potential, key oncogenes associated with cancer proliferation and survival were analyzed, including c-Myc, cyclin D1, human epidermal growth factor receptor-2 (HER-2), microRNA-622 (miR-622), and cyclooxygenase-2 (COX-2). The present study demonstrated that AgNPs and AuNPs synthesized from A. heterophyllus extract had distinct sizes and shapes, with AgNPs averaging approximately 12.75 nm and exhibiting a spherical morphology, while AuNPs averaged 109.26 nm and had a pentagonal shape. Furthermore, AuNPs had no anticancer activity. In contrast, AgNPs showed potent anticancer effects, with inhibitory concentration (IC₅₀₎ values of 124.626 and 54.981 µg/mL at 48 and 72 hours, respectively. The AgNPs treatment increased the proportion of cells in G2/M phase, indicating the induction of mitotic catastrophe leading to cell death. AgNPs downregulated the expression of several oncogenes associated with cancer cell proliferation and survival (cyclin D1, COX-2, HER-2, and miR622), but did not significantly reduce c-Myc expression. In conclusion, AgNPs derived from A. heterophyllus leaf extract have significant potential as a novel therapeutic agent in cancer treatment while preserving its biocompatibility, emphasizing the promise of sustainable and cost-effective synthesis of plant-based nanoparticles.

The increasing resistance of pathogenic microbes to antibiotics is a major public health concern, necessitating the discovery of effective antimicrobial compounds. The aim of this study was to assess the bioactive metabolites produced by Aspergillus fumigatus LBKURCC269 and Bacillus paramycoides LBKURCC218 under three fermentation conditions: monoculture of each microorganism and their co-culture. Metabolite analyses initiated with gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-high-resolution mass spectrometry (LC-HRMS) followed with molecular networking-Global Natural Products Social Molecular Networking (GNPS) and molecular docking. Antimicrobial activity of the extracts was then conducted. Metabolite analysis using GC-MS identified key antimicrobial compounds, including 2,6-bis(1,1-dimethylethyl)-4-methylphenol, pentadecanoic acid, cyclopropane pentanoic acid, and 3-piperidinol. LC-HRMS, combined with multivariate analysis and GNPS molecular networking, revealed additional antimicrobial compounds, including novel pyrazine derivatives induced in co-culture fermentation. Molecular docking analysis of 3-(propan-2-yl)-octahydropyrrolo[1,2-a]pyrazine-1,4-dione demonstrated its potential as an antimicrobial agent by inhibiting topoisomerase IV and cytochrome monooxygenase with binding affinity of -5.34 kcal/mol and -5.6 kcal/mol, respectively. The antimicrobial assays showed that the co-culture fermentation extract had the strongest activity, with inhibition zones of 20.33±0.59 mm (Escherichia coli), 14.33±0.59 mm (Staphylococcus aureus), and 25.67±0.59 mm (Candida albicans). This study highlights the advantages of co-culture fermentation in enhancing the discovery of antimicrobial compounds. The findings underscore the potential of this approach to simplify chemical isolation and accelerate the identification of novel antimicrobial agents for pharmaceutical development.

The laggard (lag) mutant mouse, which arises from a mutation in the Kif14 gene, begins to exhibit ataxia and impaired growth after the first postnatal week and subsequently dies prematurely around two weeks of age. In this mutant mouse, the layered architecture of the cerebellar cortex, cerebral cortex, dentate gyrus, and olfactory bulb is disrupted at the cellular level. The aim of this study was to identify the effect of Kif14 mutation on the development of the cerebellar cortex. Abnormalities in the cytoarchitectonics of the developing cerebellar cortex were assessed using hematoxylin-eosin (HE) staining and immunohistochemistry. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and bromodeoxyuridine (BrdU) assays were performed to identify apoptotic and proliferating cells. Macroscopic observation of the lag mutant cerebellum reveals a marked reduction in size compared to wild-type mice. HE staining displays a normal foliation and lamination pattern in the lag mutant cerebellum, but detailed analysis has shown morphological disorganization in the cytoarchitectonics of the cerebellar cortex. The mutant internal granular layer is poorly defined and contains significantly fewer granule cells. Meanwhile, Purkinje cells form multilayer arrangements instead of a monolayer arrangement, as observed in wild-type mice, with their dendritic arborization being severely underdeveloped. Some Purkinje cells exhibit multiple nuclei, suggesting that the Kif14 mutation disrupts normal cell division. These phenotypes are already recognized during early postnatal days, although no difference is determined before birth. TUNEL-positive cells are significantly more numerous in the mutant external granular layer, indicating that increased apoptotic cell death contributes to the diminished granule cell population in the lag mutant mouse. In conclusion, the lag mutant cerebellar cortex shows distinct structural abnormalities, suggesting that the Kif14-encoded protein exerts multifaceted roles in the development of the brain laminated structures as well as in myelin formation.

Stigma often accompanies people with multidrug-resistant tuberculosis (MDR-TB) and potentially affects their health-related quality of life (HRQoL). The aim of this study was to investigate the stigma faced by patients with MDR-TB, both from the patients' and community's perspective, and its relationship with HRQoL. Data was gathered at the provincial hospital in Makassar, South Sulawesi, Indonesia. The instrument employed in this research was the Indonesian version of the tuberculosis (TB) stigma instrument to assess MDR-TB stigma from the patient and community perspectives. The patient perspective represents how individuals with TB perceive and experience stigma, including the fear of disclosure, isolation, and guilt (feeling responsible for the burden on their family or their own risky behaviors). Meanwhile, the community perspective reflects how individuals with TB perceive societal attitudes towards them, such as social distancing, avoidance, and reluctance to interact. HRQoL was measured using the European quality of life-5 dimensions-5 level version (EQ-5D-5L) instrument. Notably, the evaluation of anxiety and depression is centered on the fifth dimension of the EQ-5D-5L instrument. A total of 210 patients with MDR-TB were included in the study, all of whom reported experiencing stigma. Most participants perceived stigma at a moderate level, with 76% from the patient perspective and 71% from the community perspective. The average EQ-5D-5L index score was 0.72 (95% confidence interval (95%CI): 0.68-0.76). Measurements from both perspectives show similar scores. There is a substantial negative association between the level of stigma and HRQoL, both from the patient's perspective (R ²=-0.33; F=102.52; p<0.001) and the community's (R ²=-0.32; F=96.76; p<0.001). The study highlights that the stigma of MDR-TB significantly affects the HRQoL from the patient and community perspective.

The high transmissibility and mortality rates of the COVID-19 pandemic pose significant challenges. Patients can deteriorate rapidly, making it crucial to identify laboratory biomarkers for high-risk individuals. The aim of this study was to evaluate the predictive value of various laboratory parameters, including C-reactive protein (CRP), D-dimer, ferritin, neutrophil-to-lymphocyte ratio (NLR), prothrombin time (PT), and procalcitonin (PCT), in predicting COVID-19 mortality. A retrospective cohort study was conducted at Sulianti Saroso Infectious Disease Hospital, where COVID-19 patients were categorized into survivors and non-survivors. The Mann-Whitney test was used to assess group differences, while receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of each biomarker, with Youden's index (J) determining optimal cut-off values. Kaplan-Meier analysis was used to compare median survival times, and Cox regression assessed hazard rates and the relationship between biomarkers and mortality. A total of 1,598 patients were analyzed, the majority of whom were admitted with oxygen saturation levels >95% and classified as having mild to moderate disease severity. Among them, 216 patients died, resulting in a mortality rate of 13.52%. Significant variations in mortality rates were observed along the survival functions for NLR, ferritin, D-dimer, CRP, and PCT (p<0.001). The survival curves for these biomarkers demonstrated distinct trends across tertiles over time. Among hematological markers, NLR was significantly associated with mortality (p<0.001), with a 1.5-2.2% increased risk per unit increase. Biochemical markers (complete blood count) proved to be more effective than hematological parameters (NLR, ferritin, PT, D-dimer, CRP, PCT) when evaluating individual prognostic performance. Bivariate analysis of CRP, D-dimer, ferritin, NLR, PT, and PCT between survivors and non-survivors showed significant differences. Notably, NLR and PCT were highly relevant for predicting disease prognosis and mortality, with sensitivity and specificity values exceeding 80%.

Helicobacter pylori infection drives heterogeneous gastric pathologies, yet genotype-phenotype correlations in diverse populations remain underexplored. The aim of this cross-sectional study was to investigate the associations between H. pylori virulence genotypes (sabA, hopQ, hom family) and histopathological severity in gastric mucosa among 113 Indonesian dyspepsia patients (mean age: 49.6 years; male predominance: 64.6%). Whole-genome sequencing characterized virulence genotypes, while histopathological grading system using the Updated Sydney System assessed inflammation, atrophy, and bacterial density in the antral and corporal gastric regions. Phylogenetic analysis elucidated strain relatedness. Key genotype frequencies included sabA "on" (40.6%, 43/106), hopQ type I (53.7%, 43/80), and homC ^L (82.4%, 75/91). Statistical analysis revealed sabA "on" status significantly associated with elevated antral bacterial density (odds ratio (OR) 2.70 and 95% confidence interval (95%CI) 1.10-6.60, p=0.027). The homC variants (homC ^L /homC ^S ) demonstrated robust associations with chronic inflammation severity (OR: 3.04; 95%CI: 0.99-9.36, p=0.046) and atrophy progression (OR: 4.78; 95%CI: 1.00-22.86, p=0.035), in contrast to the hopQ genotype, which showed no histopathological association. These findings indicated that sabA and homC as critical determinants of gastric microenvironment modulation, potentially through sabA-mediated colonization efficiency and homC ^L -babA synergistic interactions. While histological profiles predominantly indicated mild atrophy, widespread severe chronic inflammation signals latent progression risks.

Healthcare workers in developing countries, such as Indonesia, experience significant psychological stress due to heavy workloads, limited resources, and systemic inefficiencies, all of which negatively impact their psychological well-being (PWB). The aim of this study was to investigate the direct and indirect effects of quality of work life (QWL) on PWB, with meaningful work (MW) as a mediating variable. A cross-sectional survey was conducted with 285 healthcare professionals from various healthcare facilities, including specialists, general practitioners, and nurses. Data were collected using validated scales to assess QWL, MW, and PWB. Pearson correlation analysis was employed to examine relationships among variables, while mediation analysis tested direct and indirect effects. The results indicate that QWL positively influences PWB both directly (β=0.22, p<0.001) and indirectly through MW (β=0.13, p<0.001). Furthermore, MW was found to be a strong mediator (β=0.61, p<0.001), underscoring its critical role in enhancing purpose and resilience. Specialists reported the highest QWL and PWB, whereas nurses exhibited the lowest levels, highlighting occupational disparities. These findings suggest that enhancing the QWL and fostering MW can significantly improve healthcare professionals' PWB. Accordingly, organizations should prioritize strategies that promote MW and improve work-life conditions to support mental well-being and job satisfaction.

Genome-wide association studies (GWAS) have identified the single nucleotide polymorphism (SNP) rs11190870 near the ladybird homeobox 1 (LBX1) gene as being associated with the susceptibility and severity of adolescent idiopathic scoliosis (AIS). However, no such genetic studies have been conducted in the Indonesian population. The aim of this study was to investigate the genetic profile of AIS patients in the Acehnese population, with a focus on LBX1 rs11190870, and to assess its association with disease severity. A total of 30 female AIS patients were included. Genetic analysis was performed to determine the rs11190870 genotype in each subject. The association between rs11190870 and curve progression, measured by Cobb angle, was analyzed using the Mann-Whitney U test. The T allele was found to be more prevalent (73.3%), with the TC genotype being the most common (53.3%). A significant association was observed between LBX1 rs11190870 and curve progression, where patients with the TT genotype exhibited a larger Cobb angle compared to those with TC or CC genotypes (p=0.01). This is the first study to characterize the genetic profile of AIS and its association with curve severity in the Acehnese population. These findings suggest that LBX1 rs11190870 may act as a disease modifier in AIS. Further studies with larger sample sizes are warranted to confirm the role of LBX1 rs11190870 in AIS susceptibility and severity in the Indonesian population.

Preeclampsia and eclampsia remain significant contributors to maternal and perinatal mortality. Managing these conditions is particularly challenging in remote areas in many islands of Indonesia, where access to medical care is severely limited. The aim of this study was to analyze the pre-hospital anesthetic management of an eclampsia patient during maritime evacuation to a higher-level facility, highlighting the complexities of medical transport in resource-limited settings. A 38-year-old multiparous woman from a remote village on Pagerungan Island, Indonesia, at 37 weeks of gestation, presented with tonic-clonic seizures consistent with eclampsia. The absence of antenatal care necessitated urgent intervention. Upon presentation, the patient had a Glasgow Coma Scale (GCS) score of 5, tachycardia, and irregular breathing, requiring rapid-sequence intubation and magnesium sulfate administration. Given the geographic constraints, the patient was evacuated by sea under challenging conditions. Despite significant waves, a multidisciplinary team successfully performed an emergency cesarean section onboard, delivering a male infant who required neonatal resuscitation. Postoperatively, both mother and neonate were transferred to a higher-level facility. However, engine failure extended the journey to 18 hours, leading to depletion of oxygen and essential medications, necessitating critical decision-making. This case underscores the significant challenges of emergency eclampsia management in remote settings, particularly during maritime evacuation. Effective stabilization, anesthesia, monitoring, and timely transport are crucial. This case highlights the need for optimized evacuation protocols and increased healthcare resource allocation to enhance maternal and neonatal outcomes in maritime and other resource-limited settings.

Ureteral stents, commonly used in urology, can cause side effects affecting patient quality of life. However, studies on managing lower urinary tract symptoms showed inconsistencies due to the use of various alpha-blockers and antimuscarinic drugs. The aim of this study was to evaluate the effectiveness of combining tamsulosin and solifenacin therapy compared to tamsulosin and solifenacin monotherapy for treating stent-related symptoms. Randomized controlled trials assessing tamsulosin, solifenacin, or their combination for stent-related symptoms treatment were identified through a comprehensive search of four databases (PubMed, Scopus, Web of Science, and Cochrane) from January 2018 to December 2023. Ureteral stent symptom questionnaire (USSQ), international prostate symptom score (IPSS), visual analog scale (VAS), and quality of life (QoL) were pooled for meta-analysis. Eleven studies with a total of 1,627 patients were included in the quantitative analysis. Solifenacin significantly improved urinary symptoms (MD: 15.31; 95%CI: 0.36-30.26; p=0.040) and reduced the IPSS (MD: -2.52; 95%CI: -3.68--1.36; p<0.00001) compared to the control group. Tamsulosin reduced urinary symptoms on the USSQ (MD: 14.27; 95%CI: 8.68-19.86; p<0.00001), general health problems (MD: 4.53; 95%CI: 2.13-6.94; p=0.0002), and IPSS (MD: -0.95; 95%CI:-1.86--0.03; p<0.00001) compared to the control group. Solifenacin demonstrated a more significant reduction in the overall IPSS compared to tamsulosin (MD: -1.57; 95%CI: -2.85--0.29; p=0.020). The combination of solifenacin and tamsulosin resulted in a significantly superior reduction in IPSS compared to solifenacin monotherapies (MD: - 2.30; 95%CI: -3.23--1.37; p<0.00001) and tamsulosin monotherapy (MD: -3.17; 95%CI: -5.07--1.27; p=0.00001). No significant differences were found between tamsulosin and solifenacin in terms of QoL (MD: 0.12; 95%CI: -0.01-0.26; p=0.070) and VAS (MD: 0.25; 95%CI: -0.95-1.44; p=0.690). In conclusion, solifenacin was more effective than tamsulosin in reducing stent-related symptoms, and the combination of tamsulosin and solifenacin was superior to either monotherapy in alleviating stent-related symptoms.