Narra J最新文献

Stroke is a leading cause of mortality and disability-adjusted life years. Its incidence is rising across Asia, with ischemic stroke accounting for approximately 80% of total stroke cases in Thailand. Stroke often leads to long-term disabilities, including impairments in speech, communication, and cognitive function. The aim of this study was to investigate risk factors associated with newly diagnosed ischemic stroke. A matched case-control study was conducted, including 154 newly diagnosed ischemic stroke cases and 183 non-stroke controls, all with type 2 diabetes mellitus (T2DM). Data were collected between February and September 2022 (post-COVID-19 period) using a structured questionnaire covering socio-demographics, lifestyle factors, perceived social support, and self-care management (SCM). Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). The majority of participants were female (60.8%), Buddhist (92.9%), and agriculturists (66.5%), with a mean age of 58.9 (±9.9) years. Factors associated with ischemic stroke included male (aOR: 3.53; 95%CI: 1.73-7.21), Buddhism (aOR: 3.53, 95%CI: 1.11-11.25), sedentary occupation (aOR: 5.78; 95%CI: 2.61-12.81), and T2DM duration >10 years (aOR: 6.19, 95%CI: 3.55-10.80). Protective factors included age >60 years (aOR = 0.55, 95%CI: 0.31-98) and moderate SCM levels (aOR=0.45, 95%CI: 0.26-0.80). This study highlighted that prolonged T2DM and sedentary occupations significantly contributed to ischemic stroke risk. Targeted prevention strategies, including lifestyle modifications and enhanced diabetes self-care management, may help reduce the burden of ischemic stroke.

Cardiopulmonary bypass in tetralogy of Fallot (TOF) corrective surgery induces hyperinflammation by activating NLRP3, caspase-1, and interleukin-ιβ (IL-ιβ), subsequently triggering an interleukin-10 (IL-10) response. Despite its known metabolic and anti-inflammatory effects, the impact of the modified Atkins diet (MAD) in pediatric cardiac surgery remains unexplored, with no studies on its use in TOF patients undergoing open-heart surgery. The aim of this study was to assess the effect of MAD on the expression of NLRP3, caspase-1, IL-ιβ, and IL-10, in TOF patients undergoing open-heart surgery. A double-arm, randomized-controlled trial was conducted with 44 TOF patients. The treatment group (n = 22) received the MAD, a low-carbohydrate, high-fat regimen with unrestricted fat and protein intake for at least 14 days preoperatively, while the control group (n = 22) followed a standard diet without carbohydrate restriction. Blood plasma and infundibulum heart tissues were collected for analysis. Whole blood samples were collected using a winged infusion needle before the intervention, an Abbocath infusion needle after 14 days of intervention, and a syringe without a needle connected to an arterial line in patients undergoing open-heart surgery at 6, 24, and 48  hours post-surgical correction. Infundibulum heart tissues were collected during the open-heart surgery. This study demonstrated significant differences in NLRP3 protein expression (p = 0.015), caspase-1 protein expression (p = 0.001), and IL-10 levels between after intervention and 6-, 24-, and 48-hours post-surgery in the MAD group compared to the control group. In contrast, no significant differences in IL-10 levels were observed in the control group between after intervention and 48  hours post-surgery (p = 0.654). In conclusion, MAD may modulate perioperative inflammation in TOF patients undergoing open-heart surgery by downregulating NLRP3 and caspase-1 expression while sustaining IL-10 levels. Despite reduced NLRP3 and caspase-1 expression, unchanged IL-ιβ levels indicate alternative regulatory mechanisms.

Macrovascular complications, including stroke, cardiovascular disease (CVD), and peripheral vascular disease (PVD), significantly contribute to morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the performance of artificial intelligence (AI) models in predicting these complications, emphasizing applicability in diverse healthcare settings. Following PRISMA guidelines, a systematic search of six databases was conducted, yielding 46 eligible studies with 184 AI models. Predictive performance was assessed using the area under the receiver operating characteristic curve (AUROC). Subgroup analyses examined model performance by outcome type, predictor data (lab-only, non-lab, mixed), and algorithm type. Heterogeneity was evaluated using I ² statistics, and sensitivity analyses addressed outliers and study biases. The pooled AUROC for all AI models was 0.753 (95%CI: 0.740-0.766; I ² = 99-99%)· Models predicting PVD achieved the highest AUROC (0.794), followed by cerebrovascular diseases (0.770) and CVD (0.741). Gradient-boosting algorithms outperformed others (AUROC: 0.789). Models with lab-only predictors had superior performance (AUROC: 0.837) compared to mixed (0.759) and non-lab predictors (0.714). External validations reported reduced AUROC (0.725), underscoring limitations in generalizability. AI models show moderate predictive accuracy for T2DM macrovascular complications, with laboratory-based predictors being key to performance. However, the limited external validation and reliance on high-resource data restrict implementation in low-resource settings. Future efforts should focus on non-lab predictors, external validation, and context-appropriate AI solutions to enhance global applicability.

Stigma against people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) poses significant health threats and contributes to the uncontrolled transmission of HIV. Although tools for measuring stigma against PLWHA have been validated in Indonesia, a previous study was geographically limited and conducted with small sample sizes. The aim of this study was to perform cross-cultural adaptation and validate the psychometric properties of the 9-item Indonesian HIV/AIDS Stigma Scale (InHASS-9) in the Indonesian general population. Utilizing a cross-sectional design, the study recruited 1,302 participants from six major islands in Indonesia. The validity of the instrument was determined using recognized group validity and construct validity, while internal consistency was evaluated using Cronbach's alpha. During the adaptation phase, nine simple items were finalized for inclusion in the scale. The findings revealed that the InHASS-9 instrument exhibited strong internal consistency, with Cronbach's alpha coefficient of 0.83, indicating high reliability. In conclusion, the InHASS-9 instrument is a valid and reliable tool for assessing the extent of social stigma associated with PLWHA in Indonesia.

Calcium (Ca) deficiency is a primary contributor to osteoporosis, a condition characterized by low bone density and increased fracture risk. Fortifying widely consumed foods with calcium is one approach for addressing this insufficiency. Given the popularity of noodles, adding Ca to them offers a promising approach to enhancing Ca intake within communities. The aim of this study was to investigate the effects of Ca-fortified sweet potato noodles on osteoporosis prevention. This study used 4-month-old Sprague-Dawley rats. A completely randomized design was used with four treatment groups: CS (SHAM, control diet), CO (Sham, test diet), US (OVX, control diet), and UO (OVX, test diet). Both control and test diets, which included Ca-fortified sweet potato noodles, were administered to OVX (ovariectomy-induced osteoporosis model) and SHAM (control for surgical procedure) groups for two months. At the end of the experiments, serum Ca levels were collected and analyzed for Ca and alkaline phosphatase (ALP) levels and their bones were analyzed for physical properties and bone mineral density (BMD) using X-ray analysis. Data were analyzed using one-way analysis of variance (ANOVA) followed by Duncan as a post hoc test. The intervention of Ca-fortified sweet potato noodles for two months significantly increased serum Ca levels and reduced ALP levels compared to controls, both in SHAM (Ca: 38.03±0.877 mg/dL; ALP: 355±38.0 IU/L) and OVX (Ca: 36.18±2.810 mg/dL; ALP: 340±5.5 IU/L) groups. The test diet maintained the ratio of bone weight to bone volume and preserved the Ca content in the rats' bones. OVX rats consuming the test diet for two months exhibited significantly higher femur bone strength than OVX rats consuming the control diet (test: 6.50±0.300 kg; control: 4.83±0.289 kg). There was no significant difference in BMD between the SHAM and OVX groups on the test diet, indicating that the test diet can maintain bone BMD despite accelerated aging. These findings suggest that Ca-fortified sweet potato noodles can serve as a dietary Ca source, contributing to the prevention of osteoporosis by maintaining serum Ca levels, preserving bone Ca content, as well as maintaining bone density and strength.

Essential oils have gained interest in wound management, with prior studies exploring combinations of hemp seed oil (Cannabis sativa) and other oils. However, single-oil strategies may offer simpler formulation, reducing the risk of interactions while preserving therapeutic benefits. The aim of this study was to explore the effect of hemp seed oil on accelerating wound healing, focusing on wound size reduction, epithelialization, granulation tissue formation, and vascularization in murine models. An in vivo with a post-test-only control group was conducted using 36 male Mus musculus mice (3-4 months, 150-250 grams) which were divided into three groups: negative control (NC), positive control (PC, treated with chloramphenicol ointment twice daily), and treatment group (TG, treated with hemp seed oil 400,000 mg/mL twice daily). Mice were euthanized on day 3, 7, 14, and 21 for wound healing assessment, including macroscopic evaluation (visual observation, wound size, and wound healing rate) and microscopic evaluation (epithelialization, granulation tissue formation, and vascularization). The present study found that the TG group demonstrated smaller wound sizes on day 14 (p < 0.001) and day 21 (p < 0.001). This group also enhanced wound healing rates observed on day 14 (p < 0.001) and day 21 (p = 0.001) compared to PC and NC groups. Epithelialization was significantly higher in the TG group compared to PC and NC groups on day 14 (p = 0.007), while granulation tissue formation showed significant improvement on day 3 (p = 0.045), day 14 (p = 0.028), and day 21 (p = 0.003). Additionally, TG group showed significantly greater new blood vessel formation on day 21 (p = 0.001) compared to the PC and NC groups. In conclusion, hemp seed oil demonstrated significant potential in accelerating wound healing processes suggesting a superior effect compared to chloramphenicol ointment. Therefore, hemp seed oil may serve as a promising natural and cost-effective adjunct for wound management.

Several cellular markers have been identified as effective in detecting vascular remodeling recently. The reduced activity of bone morphogenetic protein receptor type-II (BMPR-II), commonly observed in Down syndrome, results in insufficient production of vascular endothelial cadherin (VE-cadherin). This, in turn, increases hypoxia-inducible factor-1α (HIF-1α) levels and leads to excessive production of caspase-3. The aim of this study was to compare the plasma levels of BMPR-II, VE-cadherin, HIF-1α, and caspase-3 between pediatric Down syndrome with and without congenital heart disease (CHD) and pulmonary hypertension (PH). This was to investigate the role of these biomarkers in the pathogenesis of PH associated or not associated with CHD. A cross-sectional study was conducted on Down syndrome children aged two months to five years at a tertiary hospital between January and December 2023. The children were classified into four groups: CHD with PH, CHD without PH, non-CHD with PH and normal heart. Plasma levels of BMPR-II, caspase-3, HIF-1α, and VE-cadherin were measured using ELISA and compared based on the presence or absence of CHD and PH using Kruskal-Wallis followed by post hoc Bonferroni tests. Elevated plasma HIF-1α levels were observed in all patients with PH, with significantly higher levels in those with CHD-PH. Elevated levels of caspase-3 were also observed among children with PH groups, with the highest levels observed in the non-CHD PH group. Plasma levels of BMPR-II and VE-cadherin were elevated in PH, with significantly higher levels in the non-CHD PH group compared to other groups.

The current standard treatment for ovarian cancer is a combination of cytoreductive surgery and platinum-based chemotherapy; however, many patients develop resistance, leading to a high recurrence rate. The aim of this study was to analyze the expression of PD-L1, CTR-1, VEGF, and p53 in epithelial ovarian cancer (EOC) patients, comparing those sensitive and resistant to platinum-based chemotherapy. A cross-sectional study was conducted among EOC patients who underwent surgery and platinum-based chemotherapy between 2020 and 2023 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, with evaluations performed six months post-chemotherapy. The expression of PD-L1, CTR-1, VEGF, and p53 were measured using immunohistochemistry (IHC) and compared between chemotherapy-sensitive and resistant patients. A total of 65 patients were included: 31 resistant and 34 sensitive cases. The results showed higher PD- L1 expression in the resistant group compared to the sensitive group (mean combined positive score (CPS) of 0.46 ± 0.29 vs 0.17 ± 0.09, p < 0.00i). The CTR-1 expression was lower in the resistant group (immunoreactive score 2.90 ± 1.30) compared to the sensitive group (immunoreactive score 6.82 ± 2.68) with p < 0.001. VEGF and p53 expression were also higher in the resistant group (6.68 ± 2.59 vs 2.76 ± 1.10 and 64.68 ± 13.54% vs 30.15 ± 13.06%, respectively) compared to the sensitive group, with both having p < 0.001. The study suggests that increased expression of PD-L1, VEGF, and p53 and decreased CTR-1 expression are associated with platinum-based chemotherapy resistance among EOC patients. Therefore, these biomarkers might have the potential for predicting treatment responses and understanding resistance mechanisms.

Laportea decumana (Roxb.) Wedd., known as itchy leaves, is traditionally used for pain relief due to its bioactive compounds. However, previous studies were limited by resource-intensive in vivo methods and a lack of mechanistic insights into cyclooxygenase (COX)-1 and COX-2 binding. The aim of this study was to identify compounds in the n-hexane and ethyl acetate extracts of L. decumana with potential as COX-1 and COX-2 inhibitors and to predict their binding affinity and stability within the binding pocket through molecular dynamics simulations. Leaves collected from Arso, Keerom Regency, Papua, Indonesia, were dried, sieved into simplicia, and macerated with n-hexane to obtain a n-hexane extract. The residual simplicia was further macerated with ethyl acetate to produce an ethyl acetate extract. N-hexane extract compounds were analyzed by gas chromatography- mass spectrometry (GC-MS), and ethyl acetate extract compounds by liquid chromatography-mass spectrometry (LC-MS). Identified chemicals were used in in silico evaluations targeting COX-1 and COX-2. This study identified ten compounds with high performance in docking analysis, which were further evaluated by molecular dynamics. The n-hexane extract contained 31 compounds, while the ethyl acetate extract contained Among these, 4,8,12,16-tetramethylheptadecan-4-olide from the n-hexane extract demonstrated the strongest affinity for both COX-1 and COX-2, with binding free energies of -41.62 ± 1.03 kcal/mol and -33.05 ± 0.11 kcal/mol, respectively. Its interactions were comparable to those of native ligands, with superior binding free energy. In the ethyl acetate extract, pseudosantonim demonstrated the highest affinity for COX-1 (-24.4 ± 1.32 kcal/mol), while arteamisinine showed strong potential as a COX-2 inhibitor (-23.53 ± 0.30 kcal/mol). In conclusion, 4,8,12,16-tetramethylheptadecan-4-olide was the most potent COX-1 and COX-2 inhibitor, pseudosantonim was the most effective COX-1 inhibitor, and arteamisinine demonstrated COX-2 inhibitory potential. Further validation through in vitro or in vivo studies is recommended.

Sexual violence, including sexual intercourse, can occur in women experiencing vaginal discharge, particularly in cases of vaginal candidiasis. In candidiasis, the vaginal microbiome undergoes changes that could serve as a diagnostic indicator or as evidence of sexual activity. The aim of this study was to assess the effects of semen insemination on the vaginal microbiome profile of candidiasis rats and to determine its forensic investigations in cases of sexual violence. An experimental study was carried out using Wistar strain rats (Rattus norvegicus), consisting of four male rats (for spermatozoa donors) and twenty-four female rats. The female rats were divided into four groups: normal condition (control), normal condition post-semen insemination, candidiasis rats, and candidiasis rat post-semen insemination. Vaginal microbiome profiles were examined for each group, using alpha diversity (Chao 1, Shannon, Simpson, and Faith PD indices) and beta diversity (Bray Curtis, Jaccard, Unweighted Unifrac and Weighted Unifrac indices). Data were analyzed using the Kruskal-Wallis test for alpha diversity and the PERMANOVA test for beta diversity. There is no significant difference in alpha and beta diversity of the vaginal microbiome between groups of rats in normal conditions and those with candidiasis, both pre- and post-semen insemination (p>0.05). In candidiasis rats, the microbiome predominantly consisted of the Eukaryota kingdom, particularly Candida albicans. However, the study highlights that the presence of Eschericia-Shigella, Roseomonas, and Archaea in the vaginal microbiome post-semen insemination potentially serves as an indicator of sexual intercourse, which may provide evidence of sexual violence in forensic medicine.