Narra J最新文献

Previous studies have associated tumor size with metastasis and prognosis in lung carcinoma; however, a precise cut-off for predicting distant metastasis in lung adenocarcinoma remains unclear. The aim of this study was to determine the cut-off point for predicting distant metastasis in lung adenocarcinoma. A cross-sectional study was conducted at Dr. Moewardi Hospital, Surakarta, Indonesia, from January 2022 to September 2023. Total sampling was employed, involving patients over 18 years old with a confirmed diagnosis of lung adenocarcinoma based on lung computed tomography (CT) scan findings, who had not yet received chemotherapy and had confirmed metastasis outside the lung. The study's dependent variable was the incidence of distant metastasis, while the independent variable was lung adenocarcinoma size. Two experienced thoracic radiologists measured lung adenocarcinoma size by assessing the longest axis using chest multi-slice computed tomography (MSCT) in the lung window setting. Receiver operating characteristic (ROC) curve analysis determined the optimal tumor size cut-off for predicting distant metastasis. Of 956 thoracic cancer patients, 108 were diagnosed with lung adenocarcinoma. After applying the inclusion and exclusion criteria, 89 patients were eligible. In the present study, tumor size predicted 68.1% of distant metastasis cases, with a cut-off point of 7.25 cm, yielding a sensitivity of 61.9% and a specificity of 61.5%. Tumors >7.25 cm had a 2.60-fold higher risk of distant metastasis compared to smaller tumors, with larger tumors more likely to spread to various sites. In conclusion, lung adenocarcinomas larger than 7.25 cm have a 2.60-fold increased risk of distant metastasis, making tumor size a crucial predictive factor. The study provides valuable insights for radiologists and can improve diagnosis accuracy and treatment planning by emphasizing tumor size as a key factor in managing lung adenocarcinoma.

In pharmaceutical care, patients' perceptions of drug information provided by pharmacists are vital for assessing pharmaceutical services at community health centers (in Indonesian known as Puskesmas). The aim of this study was to determine the alignment between patients' expectations and experiences of drug information services by pharmacists at Puskesmas in Indonesia. This multicenter cross-sectional study utilized a validated questionnaire among outpatient patients aged 18 years and above across all 47 Puskesmas in Makassar, Indonesia. A total of 622 respondents were interviewed between September to December 2023. Significant gaps were observed between patients' expectations and experiences regarding all the drug information aspects such as quantity (median: 4 vs 3, p<0.001), drug effects (median: 4 vs 3, p<0.001), dosage form (median: 3 vs 3, p<0.001), proper administration (median: 4 vs 4, p<0.001), side effects (median: 4 vs 2, p<0.001), storage (median: 3 vs 2, p<0.001), drug-drug interactions (median: 4 vs 2, p<0.001), drug-food interactions (median: 4 vs 2, p<0.001), handling missed dose (median: 3 vs 2, p<0.001), managing accidental overdoses (median: 4 vs 2, p<0.001), history of drug use (median: 3 vs 2, p<0.001), co-medications (median: 3 vs 2, p<0.001), and previous drug allergies (median: 3 vs 2, p<0.001). Sociodemographic factors influencing patients' need for drug information services encompass age, sex, educational attainment, comorbidities, family size, number of visits, monthly income, and occupation. The quality of drug information services at Puskesmas in Indonesia still requires optimization and customization to meet the specific needs of patients, taking into account their sociodemographic characteristics.

Silver nanoparticles (AgNPs) synthesized from plant extracts have gained attention for their potential applications in biomedicine. Calotropis gigantea has been utilized to synthesize AgNPs, called AgNPs-LCg, and exhibit antibacterial activities against both Gram-positive and Gram-negative bacteria as well as antifungal. However, further enhancement of their antimicrobial properties is needed. The aim of this study was to synthesize AgNPs-LCg and to enhance their antimicrobial and antifungal activities through a hybrid green synthesis reaction using patchouli oil (PO), as well as to characterize the synthesized AgNPs-LCg. Optimization was conducted using the response surface method (RSM) with a central composite design (CCD). AgNPs-LCg were synthesized under optimal conditions and hybridized with different forms of PO-crude, distillation wastewater (hydrolate), and heavy and light fractions-resulting in PO-AgNPs-LCg, PH-AgNPs-LCg, LP-AgNPs-LCg, and HP-AgNPs-LCg, respectively. The samples were then tested for their antibacterial (both Gram-positive and Gram-negative bacteria) and antifungal activities. Our data indicated that all samples, including those with distillation wastewater, had enhanced antimicrobial activity. HP-AgNPs-LCg, however, had the highest efficacy; therefore, only HP-AgNPs-LCg proceeded to the characterization stage for comparison with AgNPs-LCg. UV-Vis spectrophotometry indicated surface plasmon resonance (SPR) peaks at 400 nm for AgNPs-LCg and 360 nm for HP-AgNPs-LCg. The Fourier-transform infrared spectroscopy (FTIR) analysis confirmed the presence of O-H, N-H, and C-H groups in C. gigantea extract and AgNP samples. The smallest AgNPs-LCg were 56 nm, indicating successful RSM optimization. Scanning electron microscopy (SEM) analysis revealed spherical AgNPs-LCg and primarily cubic HP-AgNPs-LCg, with energy-dispersive X-ray spectroscopy (EDX) confirming silver's predominance. This study demonstrated that PO in any form significantly enhances the antimicrobial properties of AgNPs-LCg. The findings pave the way for the exploration of enhanced and environmentally sustainable antimicrobial agents, capitalizing on the natural resources found in Aceh Province, Indonesia.

Drug repurposing is a promising approach to identify new pharmacological indications for drugs that have already been established. However, there is still a limitation in the availability of a high-throughput in vivo preclinical system that is suitable for screening and investigating new pharmacological indications. The aim of this study was to introduce the application of Drosophila larvae as an in vivo platform to screen drug candidates with anti-aging and immunomodulatory activities. To determine whether Drosophila larvae can be utilized for assessing anti-aging and immunomodulatory activities, phenotypical and molecular assays were conducted using wildtype and mutant lines of Drosophila. The utilization of mutant lines (PGRP-LBΔ and Psh[1];;ModSP[KO]) mimics the autoinflammatory and immunodeficient conditions in humans, thereby enabling a thorough investigation of the effects of various compounds. The phenotypical assay was carried out using survival and locomotor observation in Drosophila larvae and adult flies. Meanwhile, the molecular assay was conducted using the RT-qPCR method. In vivo survival analysis revealed that caffeine was relatively safe for Drosophila larvae and exhibited the ability to extend Drosophila lifespan compared to the untreated controls, suggesting its anti-aging properties. Further analysis using the RT-qPCR method demonstrated that caffeine treatment induced transcriptional changes in the Drosophila larvae, particularly in the downstream of NF-κB and JAK-STAT pathways, two distinct immune-related pathways homologue to humans. In addition, caffeine enhanced the survival of Drosophila autoinflammatory model, further implying its immunosuppressive activity. Nevertheless, this compound had minimal to no effect on the survival of Staphylococcus aureus-infected wildtype and immunodeficient Drosophila, refuting its antibacterial and immunostimulant activities. Overall, our results suggest that the anti-aging and immunosuppressive activities of caffeine observed in Drosophila larvae align with those reported in mammalian model systems, emphasizing the suitability of Drosophila larvae as a model organism in drug repurposing endeavors, particularly for the screening of newly discovered chemical entities to assess their immunomodulatory activities before proceedings to investigations in mammalian animal models.

Enteropathy is a gastrointestinal disorder characterized by inflammation in the small intestine and one of the causes of enteropathy is the side effects of certain drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs). The mechanism of NSAIDs, such as indomethacin, could inhibit prostaglandin synthesis, leading to a decrease in mucus production and small intestine integrity. To test the effects of a drug, it is necessary to undergo preclinical testing using animal models. Commonly used animal models such as mice and rats have several drawbacks including high cost, ethical issues, and long lifespan. Therefore, alternatives such as using invertebrate animals like Drosophila melanogaster as a more economical in vivo platform with genetic similarity to mammals and devoid of ethical concerns are needed. The aim of this study was to evaluate Drosophila melanogaster as an in vivo model organism in testing the side effects of pharmaceuticals that cause enteropathy. In this study, flies aged 3-5 days were starved and then placed into treatment vials comprising untreated control and indomethacin-treated (3.75 mM, 7.5 mM, and 15 mM). Survival analysis was conducted during the treatment period, followed by a Smurf assay test after seven days of treatment. Subsequently, the expression of pro-inflammatory cytokine-related genes (drs and totA), mitochondria stability-related genes (tom40), and endogenous antioxidant-related genes (sod1, sod2, and cat) was performed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Our data indicated that indomethacin did not impact lifespan or cause intestinal damage. However, we observed increased expression of pro-inflammatory cytokine-related genes, including drs, and a twofold increase in totA gene expression. Furthermore, there was a significant upregulation of mitochondrial stability gene tom40, endogenous antioxidant genes sod1 and cat, and a threefold increase in sod2 at 15 mM indomethacin. Although no phenotypical changes in gut integrity were detected, the increased expression of pro-inflammatory cytokine genes suggests the occurrence of inflammation in the indomethacin-treated flies.

There is a notable gap in understanding how different living arrangements influence the psychosocial and emotional well-being of Syrian refugee children and adolescents. Moreover, limited literature exists on the comparison between in-camp and out-of-camp living situations. The aim of this study was to compare the psychosocial and emotional status between camp and non-camp Syrian refugee children and adolescents living in Jordan. A nationwide school survey was conducted in Jordan from December 2022 to April 2023 and targeted children (8-11 years) and adolescents (12-18 years), encompassing Jordanians, Syrians, and Palestinians, both in camps (camp refugees) and urban areas (urban refugees). In this paper, the analysis was limited to Syrian refugees. A total of 1,420 children and 1,249 adolescents were included. Children in camps had higher rates of hyperactivity (12.7% vs 8.3%) and total difficulties (19.3% vs 13.9%) compared to urban dwellers. However, they had lower rates of bedtime problems (12.8% vs 17.0%) and problematic internet use (19.9% vs 34.8%). Camp adolescents had higher rates of separation anxiety disorder (44.0% vs 37.8%) and conduct problems (22.2% vs 15.0%), but lower rates of poor physical functioning (43.3% vs 52.3%) compared to urban adolescents. Adjusted analysis showed lower odds of generalized anxiety disorder (OR=0.59), problematic internet use (OR=0.39), and bedtime problems (OR=0.67) for camp children. However, they had higher odds of emotional symptoms (OR=1.47), hyperactivity (OR=2.08), and overall difficulties (OR=1.50). Camp adolescents had higher odds of overall difficulties (OR=1.49) but lower odds of poor physical functioning (OR=0.67) compared to urban adolescents. In conclusion, children in refugee camps had lower rates of problematic internet use and bedtime issues but higher rates of hyperactivity and overall difficulties than urban children. Similarly, camp adolescents faced more total difficulties but reported better physical functioning than their urban peers. The complex interplay between living conditions and well-being underscores the need for tailored mental health interventions for displaced populations.

In vivo studies on the hazards of deep-fried foods were commonly done by feeding used-or heated-cooking oil to rats. The aim of this study was to determine the effect of feeding tempe deep-fried in palm, olive, and coconut oils and the used frying oil on the blood biochemical profile of laboratory rats. An in vivo randomized control group study with pre-test and post-test was conducted. This study included healthy male Sprague-Dawley rats aged 2-3 months and weighing 100-200 grams. After acclimatization, the rats were randomly assigned to seven groups, which were: (1) regular diet (control diet); (2) diet of tempe deep-fried in 5× used palm oil (Tempe-in-used-Po); (3) diet of tempe deep-fried in 5× used coconut oil (Tempe-in-used-Co); (4) diet of tempe deep-fried in 5× used olive oil (Tempe-in-used-Oo); (5) diet of 5× used palm oil (Used-Po); (6) diet of 5× used coconut oil (Used-Co); and (7) diet of 5× used olive oil (Used-Oo). Each rat received 15 grams of a treatment diet daily and blood samples were collected after four weeks for a complete blood count and serum biochemistry analysis. The results showed that the final body weight and the weight gain of Tempe-in-used-Po, Tempe-in-used-Co, Tempe-in-used-Oo group, and Used-Po groups increased significantly compared to the control, Used-Co, and Used-Oo groups. However, there was a significant increase in serum tumor necrosis factor-alpha (TNF-α) in the Used-Co and Used-Oo groups (p<0.05), suggesting the used oil's detrimental effect. The Used-Co and Used-Oo were the only two groups whose creatinine increased significantly (p<0.05). Subsequently, only the Used-Oo group had a significantly increased malondialdehyde (MDA) level compared to all groups (p<0.05). These results prove that the effect of feeding fried food differs from used oils. Feeding used oil did not reflect the consumption of fried foods as part of the whole diet and generally resulted in more harmful effects. This is the first study to report an in vivo rat feeding study of deep-fried tempe and the used oil as part of the diet.

Since its public release on November 30, 2022, ChatGPT has shown promising potential in diverse healthcare applications despite ethical challenges, privacy issues, and possible biases. The aim of this study was to identify and assess the most influential publications in the field of ChatGPT utility in healthcare using bibliometric analysis. The study employed an advanced search on three databases, Scopus, Web of Science, and Google Scholar, to identify ChatGPT-related records in healthcare education, research, and practice between November 27 and 30, 2023. The ranking was based on the retrieved citation count in each database. The additional alternative metrics that were evaluated included (1) Semantic Scholar highly influential citations, (2) PlumX captures, (3) PlumX mentions, (4) PlumX social media and (5) Altmetric Attention Scores (AASs). A total of 22 unique records published in 17 different scientific journals from 14 different publishers were identified in the three databases. Only two publications were in the top 10 list across the three databases. Variable publication types were identified, with the most common being editorial/commentary publications (n=8/22, 36.4%). Nine of the 22 records had corresponding authors affiliated with institutions in the United States (40.9%). The range of citation count varied per database, with the highest range identified in Google Scholar (1019-121), followed by Scopus (242-88), and Web of Science (171-23). Google Scholar citations were correlated significantly with the following metrics: Semantic Scholar highly influential citations (Spearman's correlation coefficient ρ=0.840, p<0.001), PlumX captures (ρ=0.831, p<0.001), PlumX mentions (ρ=0.609, p=0.004), and AASs (ρ=0.542, p=0.009). In conclusion, despite several acknowledged limitations, this study showed the evolving landscape of ChatGPT utility in healthcare. There is an urgent need for collaborative initiatives by all stakeholders involved to establish guidelines for ethical, transparent, and responsible use of ChatGPT in healthcare. The study revealed the correlation between citations and alternative metrics, highlighting its usefulness as a supplement to gauge the impact of publications, even in a rapidly growing research field.

Due to the persisting development of SARS-CoV-2 variants, studies on the kinetics, duration, and function of antibodies are essential for vaccine development and long-term immunity prediction. This longitudinal study examined post-vaccination antibody responses in people after receiving CoronaVac or ChAdOx1 vaccines with or without a history of SARS-CoV-2 infection. Conducted in Indonesia between August 2021 and May 2023, this study involved 121 participants divided into two groups based on the received vaccine types and monitored for 18 months post-second dose vaccination by assessing the binding antibody (BAb) level and neutralizing antibody (NAb) inhibition rate at six time points. The study also documented the participants' age, gender, and body mass index (BMI). Before the first dose vaccination, 85 (70.2%) participants were reactive BAb (defined by BAb level ≥50 AU/mL) indicating a history of infection. In the CoronaVac group, only 53.1% were reactive BAb. However, 100% of participants were positive NAb (defined by NAb inhibition rate ≥30%), which indicates a past history of infection with low initial or rapidly decreasing BAb levels. In the ChAdOx1 group, 81.9% of participants were reactive, while only 54.2% were positive NAb, suggesting a recent infection with a high BAb level but a relatively low NAb inhibition rate. During the 18 months post-second dose vaccination, the BAb levels fluctuated. However, 100% of participants were positive NAb. No significant difference in antibody response was documented among participants with or without infection history. Also, no significant impact was presented by the factors of sex, age, and BMI. The findings highlight the crucial of the vaccine in public health and how vaccination strategies could be optimized effectively during and after the post-pandemic.

Children who are at risk of involvement in violence need assistance from multisector agencies such as social services, law enforcement, health, and education. The aim of this study was to understand the perceptions and experiences of parents, teachers, and service providers (i.e., counselors, psychologists, paralegals, and social workers) on collaborative support for children at risk of violence in Banda Aceh, Indonesia. Twenty-four structured interviews were conducted with ten parents whose children were victims of sexual or physical abuse or were involved in substance abuse and theft and have received support from the Integrated Service Center for the Empowerment of Women and Children in Banda Aceh, Indonesia; ten service providers; and four teachers who either worked with the concerned children or knew them. Using a thematic analysis approach, the data was systematically coded and analyzed to identify important themes. Most parents who sought help or support from governmental agencies were referred by other service providers or recommended by relatives or friends. Parents hesitated to discuss their children's problems with the teachers, worrying about stigma, particularly for sexual abuse victims. The school's lack of collaboration with external agencies was consistent with the teacher's claim that they seldom work with other agencies outside of school, resulting in a siloed system of care. It can be concluded that the biggest barrier to communication and coordination among parents, teachers, and service providers is the parents' and service providers' lack of willingness and confidence to work with teachers. Clear policies are needed to establish a cross-institutional linkage structure that promotes shared responsibilities.