Narra J最新文献

Malnutrition among school-aged children in urban-industrial settings presents a dual burden of undernutrition and overnutrition. The aim of this study was to examine factors influencing the nutritional status of elementary school children in Batam, Indonesia. A case-control study was conducted in Batam, focusing on children aged 6-12 years, with malnourished cases (undernutrition and overnutrition) and well-nourished controls, along with their mothers. Respondents were selected through stratified random sampling from public elementary schools. Inclusion criteria encompassed children enrolled in these schools, while exclusion criteria involved children with chronic health conditions. Data were collected via structured interviews utilizing validated questionnaires, anthropometric assessments (weight-for-age and height-for-age), and parent-reported socioeconomic, behavioral and family characteristics. Statistical analysis involved binary logistic regression to identify significant risk factors associated with malnutrition. A total of 188 children, including 94 malnourished cases (40 undernutrition and 54 overnutrition) and 94 well-nourished controls. The findings revealed significant differences between cases and controls in socioeconomic factors (pocket money (p = 0.027), family income (p = 0.042)), behavioral factors (sedentary activity (p = 0.019), dietary habits (p = 0.037)) and family factors (maternal BMI, p = 0.011; maternal nutritional knowledge, p = 0.004; parenting style, p = 0.035). Dominant risk factors for malnutrition (undernutrition or overnutrition) included poor dietary habits (adjusted odds ratio (aOR): 0.451; 95%CI: 0.225-0.901; p = 0.024), maternal obesity class II (aOR: 0.126; 95%CI: 0.030-0.535; p = 0.005), and low maternal nutritional knowledge (aOR: 0.294; 95%CI: 0.124-0.696; p = 0.005). Targeted family-centered interventions focusing on dietary practices and maternal education are therefore recommended to address this issue.

Ground-glass opacities (GGOs) are hazy opacities on chest computed tomography (CT) scans that can indicate various lung diseases, including early COVID-19, pneumonia, and lung cancer. Artificial intelligence (AI) is a promising tool for analyzing medical images, such as chest CT scans. The aim of this study was to evaluate AI models' performance in detecting GGO nodules using metrics like accuracy, sensitivity, specificity, F1 score, area under the curve (AUC) and precision. We designed a search strategy to include reports focusing on deep learning algorithms applied to high-resolution CT scans. The search was performed on PubMed, Google Scholar, Scopus, and ScienceDirect to identify studies published between 2016 and 2024. Quality appraisal of included studies was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, assessing the risk of bias and applicability concerns across four domains. Two reviewers independently screened studies reporting the diagnostic ability of AI-assisted CT scans in early GGO detection, where the review results were synthesized qualitatively. Out of 5,247 initially identified records, we found 18 studies matching the inclusion criteria of this study. Among evaluated models, DenseNet achieved the highest accuracy of 99.48%, though its sensitivity and specificity were not reported. WOANet showed an accuracy of 98.78%, with a sensitivity of 98.37% and high specificity of 99.19%, excelling particularly in specificity without compromising sensitivity. In conclusion, AI models can potentially detect GGO on chest CT scans. Future research should focus on developing hybrid models that integrate various AI approaches to improve clinical applicability.

High recurrence rate and the necessity for repeated surgical interventions contribute to the chronicity and treatment-resistant nature of chronic rhinosinusitis with nasal polyps (CRSwNP). Thymoquinone, known for its protective effects on epithelial integrity, has not been previously explored in CRSwNP. The aim of this study was to investigate the therapeutic potential of thymoquinone to restore epithelial integrity by assessing p63 transcription factor and claudin protein expressions, as well as periostin mRNA expression in an animal model. An in vivo study using post-test-only control group design was conducted in which male Wistar rats were randomly assigned to three groups, each consisting of 10 animals: healthy group, CRSwNP group, and thymoquinone-treated group for three weeks. Immunohistochemistry was used to analyze the p63 and claudin protein expressions, while periostin mRNA expression was quantified using quantitative reverse transcription polymerase chain reaction (qRT-PCR). This study found that thymoquinone significantly reduced p63 transcription factor expression compared to the untreated CRSwNP group (p = 0.009). Claudin protein expression was significantly higher in thymoquinone-treated group compared to CRSwNP group (p = 0.007), indicating improved epithelial barrier function. Periostin mRNA expression showed no significant difference between healthy and thymoquinone-treated groups (p = 0.564), but a significant decrease was observed in CRSwNP group compared to thymoquinone-treated group (p = 0.000) and between the healthy and CRSwNP groups (p = 0.002), suggesting attenuation of tissue remodeling and inflammation. In conclusion, thymoquinone could enhance sinonasal epithelial barrier integrity in CRSwNP by downregulating p63 transcription factor, upregulating claudin protein expression, and reducing periostin mRNA expression. These findings emphasize the potential of thymoquinone as a therapeutic agent to mitigate inflammation and tissue remodeling in CRSwNP, warranting further investigation as a novel treatment option.

Anemia and stunting are major public health concerns in low- and middle-income countries, including Indonesia, with significant impacts on child development, morbidity, and mortality. The aim of this study was to assess the effect of improved sanitation on the co-occurrence of anemia and stunting (CAS) in Indonesian children using pooled data from the Indonesian Family Life Survey (IFLS) across three waves, from IFLS 3 in 2000, IFLS 4 in 2007, and IFLS 5 in 2014. The sample included 839 children aged 1-5 years with complete anthropometric and hemoglobin data, measured in 2000 as the baseline cohort and followed across subsequent waves. The main independent variable was improved sanitation, and other covariates included maternal and child characteristics, parental factors, and socio-economic status. Multinomial logistic regression was used to assess the impact of sanitation over time. The prevalence of CAS was 30.75% in 2000, 6.08% in 2007, and 4.29% in 2014. Stunting-only prevalence increased from 16.21% in 2000 to 27.41% in 2007 but decreased to 19.31% in 2014. Anemia-only prevalence decreased from 31.23% in 2000 to 10.25% in 2007 and slightly rose to 16.92% in 2014. The analysis found that children with unimproved sanitation were at significantly higher risk of CAS (crude relative risk ratio (RRR): 2.49; 95% confidence interval (CI): 1.92-3.23), which decreased after adjusting for confounding factors (adjusted RRR: 1.55; 95%CI: 1.12-2.14). Similarly, the risk for anemia was higher in children with unimproved sanitation (adjusted RRR: 1. 43; 95%CI: 1.07-1.90). However, the risk for stunting was not statistically significant after adjustment. This study underscores the importance of improved sanitation in reducing anemia and stunting but also highlights the need to address other factors, such as nutrition, maternal health, and socioeconomic inequalities, through comprehensive public health policies.

Testicular torsion, a critical urological emergency caused by twisting of the spermatic cord, poses a risk of ischemia, particularly in children who often struggle to pinpoint symptoms onset. Delay in managing testicular torsion can lead to the need for orchiectomy. The aim of this study was to assess the association between hematologic parameters-mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP)-and testicular salvage in cases of testicular torsion. Four databases (PubMed, Embase (Ovid), Science Direct, and Scopus) were systematically searched for eligible studies published up to November 4, 2024. The primary outcome was testicular salvage. Sensitivity analysis was performed using leave- one-out plot. Subgroup analysis was performed based on age, country, region, duration to orchiopexy and duration to orchiectomy. Heterogeneity was examined using I ² statistics, and a random-effect model was applied. Out of 363 studies identified, nine observational studies involving 796 patients were included, with 338 (42.3%) in orchiopexy group. The meta-analysis indicated that MPV value was significantly elevated in orchiectomy group (mean difference (MD): -0.4; 95% confidence interval (95%CI): -0.62-(-0.18); p < 0.01), with higher MPV levels associated with an increased likelihood of orchiectomy (odds ratio (OR): 2.12; 95%CI: 1.35-3.33; p < 0.01). NLR, PLR, and CRP showed no significant association with testicular salvage, as demonstrated by pooled MD and OR analyses (p > 0.05). No significant differences were observed after sensitivity and subgroup analysis (p > 0.05). These findings suggest that elevated MPV levels are associated with non- salvageable testis, requiring orchiectomy highlighting its potential utility in clinical evaluation for testicular torsion.

Understanding the molecular mechanisms underlying skeletal muscle adaptation to different training regimens is essential for advancing muscle health and performance interventions. The aim of this study was to investigate molecular and genetic adaptations in the resting skeletal muscle of sedentary individuals compared to strength- and endurance-trained athletes using bioinformatics and in vitro validation. Differentially expressed genes (DEG) analysis of the GSE9405 dataset was conducted. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed, followed by protein-protein interaction (PPI) network analysis and receiver operating characteristic (ROC) analysis. To validate the bioinformatics findings, the expression of two identified genes was assessed using real-time polymerase chain reaction (PCR) in professional athletes and age-matched non-athletes. Analysis of RNA expression profiles from the GSE9405 dataset identified 426 DEGs, with 165 upregulated and 261 downregulated in trained individuals. Enrichment analysis highlighted pathways related to metabolic efficiency, mitochondrial function, and muscle remodeling, all crucial for athletic performance. PRKACA and CALM3 were identified as key upregulated genes in trained individuals with central roles in these pathways. The area under the curve (AUC) values for CALM3 and PRKACA were 0.8558 and 0.8846, respectively, for differentiating the two groups. Validation in human samples confirmed that CALM3 expression was significantly higher in athletes (p = 0.00i), suggesting its critical role in muscle adaptation. However, PRKACA expression differences between the groups were not statistically significant (p = 0.32i). These findings provide insights into gene-level responses to long-term training, offering a basis for targeted interventions to enhance muscle health and athletic performance.

Glochidion philippicum has been suggested to exhibit considerable pharmacological potential, yet its chemical composition and bioactivity remain inadequately explored. The aim of this study was to investigate the chemical fingerprint and antioxidant properties of G. philippicum leaf extracts using Fourier-transform infrared spectroscopy (FTIR) with chemometric analyses, and in vitro and in vivo evaluations. Four extraction methods (maceration, reflux, ultrasound-assisted extraction (UAE), and microwave-assisted extraction (MAE)) were optimized with water, 70% ethanol, ethyl acetate, and n-hexane as solvents. FTIR profiles were analyzed with principal component analysis (PCA), hierarchical cluster analysis, and orthogonal partial least squares discriminant analysis. An in vitro study assessing the free radical scavenging capacity was conducted using the 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1- picrylhydrazyl (DPPH), and ferric-reducing antioxidant power (FRAP) methods, while in vivo evaluations were conducted using Drosophila melanogaster to measure antioxidant enzyme activity and expression of endogenous antioxidant-related genes. FTIR profiles identified functional groups contributing to antioxidant activity. In vitro assays using ABTS and FRAP methods revealed that extracts obtained with 70% ethanol and water exhibited the highest antioxidant activity, attributed to key functional groups such as C = C (aromatic), O-H (acidic), N = O (nitro), and C-O (ester). In vivo studies showed that ethanol-based MAE extracts (MAEEO) significantly improved the survival of autoinflammatory PGRP-LB^A mutant larvae exposed to heat-killed Escherichia coli. Real-time quantitative PCR analysis indicated this effect was dependent on endogenous antioxidant gene activation. The study highlights that G. philippicum leaf extracts as a natural source of bioactive compounds with exogenous antioxidant properties, offering potential for therapeutic applications.

Obesity-related diastolic dysfunction is an emerging contributor to heart failure and cardiovascular mortality. However, effective and accessible diagnostic tools are still limited. Current methods for assessing diastolic dysfunction are often invasive or technologically demanding, making them impractical for routine clinical use and community settings. The aim of this study was to develop a novel, non-invasive scoring system designed to predict diastolic dysfunction in obese adults, addressing this diagnostic gap. This community-based, prospective cross-sectional study was conducted in Jakarta, Indonesia, from March to November 2021, and included 82 participants aged 18 to 60 years, all with a body mass index (BMI) ≥25 kg/m². Patients with acute or critical illnesses, valvular heart diseases, or acute confusional states were excluded. Each participant underwent blood tests, polysomnography, and echocardiography. Of the study population, 80.5% were diagnosed with obstructive sleep apnea (OSA), and 12.2% exhibited diastolic dysfunction, all within the OSA group. The novel scoring system integrates four predictors: oxygen desaturation index (ODI) ≥39 (score 1; prevalence ratio: 4-31 (95% confidence interval (CI): 1.58-11.75)), HbAiC ≥5.95% (score 2; prevalence ratio: 6.32 (95%CI: 2.84-14.06)), pulmonary artery wedge pressure (PAWP) ≥10 mmHg (score 1; prevalence ratio: 5.95 (95%CI: 2.30-15.39)), and global longitudinal strain (GLS) ≥-16.95% (score 1; prevalence ratio: 4.32 (95%CI: 1.87-9.99)). A score of ≥2 predicted diastolic dysfunction with 90% sensitivity, with positive predictive value and negative predictive value of 40.91% and 98.33%, respectively. In conclusion, the diastolic dysfunction score is a simple and practical tool for the early detection of diastolic dysfunction in obese individuals without cardiovascular symptoms.

A comprehensive approach to managing frailty is required due to the increasing number of elderly. Physical frailty, associated with inflammatory processes and a loss of muscle mass, can significantly impair health status. The aim of this study was to determine the effect of Moringa oleifera Lam. leaf extract on frailty in geriatric mice model. An experimental study was conducted using a post-test-only control group design using Mus musculus Balb/C mice aged eight weeks. The animals were divided into five groups: negative control group received intraperitoneal injections of normal saline (0.5 cc/day) for eight weeks, positive control group received D-galactose (150 mg/kg body weight (BW)/day) only, and three treatment groups treated with 150 mg/kg of D-galactose intraperitoneally for eight weeks followed by 100 mg/kg BW, 200 mg/kg BW, and 400 mg/kg BW of M. oleifera leaf extract orally for five weeks. At the end of the study, the blood levels of malondialdehyde (MDA), transforming growth factor-beta (TGF-β) and caspase-3, as well as caspase-3 expression in skeletal muscle, skeletal muscle mass fibrosis, and physical endurance were measured. The results showed that a dose of 400 mg/kg/day of M. oleifera leaf extract had the most significant effect on lowering MDA, TGF-β, and caspase-3 expression in skeletal muscle tissue, skeletal muscle fibrosis, and improved physical endurance compared to other groups (p < 0.001). This study highlights that M. oleifera leaf extract reduced frailty in geriatric mice model-induced using D-galactose by reducing inflammaging factors, thereby improving physical endurance.

Caregivers of children with cancer frequently endure considerable psychological distress. The challenging nature of caregiving, combined with the emotional burden of witnessing a child's illness and treatment, can impact the quality of life and lead to the development of post-traumatic stress disorder (PTSD) in these caregivers. The aim of this study was to assess the prevalence of PTSD among caregivers of pediatric cancer patients and to identify the risk factors contributing to its development. Additionally, it examined the stress burden on caregivers and its impact on their quality of life. A cross-sectional comparative study was conducted over six months at the outpatient pediatric oncology clinics in Ain Shams University Hospital and the National Cancer Institute, Cairo, Egypt. The Post-Traumatic Stress Disorder Checklist for DSM-5, Zarit Burden Interview, and PCASEE quality of life were utilized to assess the PTSD symptoms, perceived burden, and quality of life, respectively. A total of 60 caregivers of children with cancer and 60 caregivers of children without cancer were included. Among the caregivers of children with cancer, 91.3% (n = 55) exhibited post-traumatic stress symptoms, with 31.3% (n = 19) meeting the diagnostic criteria for PTSD, compared to 0% of caregivers of children without cancer. Caregivers of children with cancer had significantly higher stress burden and lower quality of life scores compared to caregivers of children without cancer (48.66 ± 9.95 vs 13.25 ± 5.64; p = 0.001 and 51.8 ± 15.2 vs 72.2 ± 14.3; p < 0.001, respectively). Young age (p = 0.033), being a mother (p = 0.003), and taking care of those with tumor relapse (p = 0.012) were identified as significant factors associated with PTSD development among caregivers of cancer patients. Moreover, caregivers of children with cancer experienced significantly higher stress burden levels and reduced quality of life compared to those caring for children without cancer (p = 0.001), further increasing their risk of developing PTSD. These findings highlight the critical need for targeted psychological support and interventions to improve the well-being of these caregivers.