bluuebunny/crossref_metadata_2025 huggingface dataset:
Consumer Behavior in Food Delivery Applications: A Systematic Literature Review and Future Research Agenda
Authors: Liu Xin , Ng Siew Imm , Basha Norazlyn Kamal , Cheah Jun-Hwa
Published: May 2024

Over the past few years, there has been notable interest among consumers in food delivery applications. Consequently, understanding consumer behavior within this context has become crucial for practitioners seeking to execute effective marketing strategies. While academic studies in this field are gaining traction, there remains a lack of a comprehensive overview. Existing literature on the subject is often fragmented and inconsistent, hindering a thorough comprehension of consumer behavioral patterns in food delivery applications. Thus, this study aims to address this gap by conducting a systematic literature review to organize and synthesize current knowledge on consumer behavior in such applications, elucidating how consumers interact within these platforms. We analyzed 587 journal articles extracted from primary databases (Scopus and Web of Science), ultimately reviewing 112 articles spanning from 2014 to August 2023. Furthermore, we developed a conceptual framework to fully grasp the variables influencing consumer behavior, showcasing frequently reported factors in food delivery application literature. This research also identifies nine directions for further exploration, including regional and country comparisons, methodological approaches, theoretical perspectives, demographic analyses, independent variables, moderating effects, affective and cognitive evaluations, outcome responses, and drone-based food delivery application perspectives. This review is expected to offer valuable insights for both researchers and practitioners.
Two solutions for Dirichlet double phase problems with variable exponents
Authors: Amoroso Eleonora , Bonanno Gabriele , D’Aguì Giuseppina , Winkert Patrick
Published: May 2024

This paper is devoted to the study of a double phase problem with variable exponents and Dirichlet boundary condition. Based on an abstract critical point theorem, we establish existence results under very general assumptions on the nonlinear term, such as a subcritical growth and a superlinear condition. In particular, we prove the existence of two bounded weak solutions with opposite energy sign and we state some special cases in which they turn out to be nonnegative.
Entwicklungen im Qualitätsmanagement und in der Indikatorik: Eine Folgeuntersuchung zum Einsatz von Webanalyse in überregionalen Informationsinfrastrukturen
Authors: Fahrer Sigrid , Rittberger Marc
Published: May 2024

Webanalyse ist zentral für das Verständnis und die Optimierung von Webnutzung. Diese Methode wird auch in den Informationsinfrastrukturen der Leibniz-Gemeinschaft eingesetzt, wie eine 2016 erschiene Studie zeigt. Diese Studie wurde nun wiederholt, um die Entwicklungsschritte im Bereich der Webanalyse nachzuzeichnen. Die zentralen Ergebnisse der Folgestudie werden in diesem Beitrag vorgestellt und vor dem Hintergrund von Qualitätsmanagement und wissenschaftlicher Leistungsmessung diskutiert.
Post hoc subgroup analysis of Asian children with paediatric GHD from the global phase 3 efficacy and safety study of once-weekly somatrogon vs. once-daily somatropin
Authors: Gomez Roy , Khadilkar Vaman , Shembalkar Jayashri , Chu Der-Ming , Ko Cheol Woo , Wajnrajch Michael P. , Wang Ronnie
Published: May 2024

Objectives

Somatrogon is a long-acting recombinant human growth hormone used to treat patients with paediatric growth hormone deficiency (pGHD). This global phase 3 study compared the efficacy and safety of once-weekly somatrogon with once-daily somatropin in children with GHD.

Methods

Prepubertal patients were randomized 1:1 to once-weekly somatrogon (0.66 mg/kg/week) or once-daily somatropin (0.24 mg/kg/week) for 12 months. The primary endpoint was height velocity (HV) at month 12; secondary endpoints included HV at month 6 and change in height standard deviation score (SDS) at months 6 and 12 and insulin-like growth factor 1 (IGF-1) SDS.

Results

This post hoc subgroup analysis focused specifically on Asian children (somatrogon: n=24 and mean age=7.76 years; somatropin: n=21 and mean age=8.10 years) across eight countries. Mean HV at month 12 was 10.95 cm/year (somatrogon) and 9.58 cm/year (somatropin); the treatment difference of 1.38 cm/year favoured somatrogon. The lower bound of the two-sided 95 % CI of the treatment difference (somatrogon–somatropin) was −0.20, similar to the overall study population (−0.24). Compared with the somatropin group, the somatrogon group had numerically higher HV at month 6 (8.31 vs. 11.23 cm/year); a similar trend was observed for height SDS and IGF-1 SDS at months 6 and 12. Safety and tolerability were similar between treatment groups; adverse events occurred in 83 % of somatrogon-treated children and 76 % of somatropin-treated children.

Conclusions

This subgroup analysis demonstrated that somatrogon efficacy and safety in Asian children were consistent with the overall study population, where once-weekly somatrogon was non-inferior to once-daily somatropin.

Clinicaltrials.gov: NCT02968004.
Neuroanatomical Substrates of Circuit-Specific Cholinergic Modulation across the Primate Anterior Cingulate Cortex
Authors: Tsolias Alexandra , Zhou Yuxin , Mojica Chromewell A. , Sakharkar Mitali , Tsolias Marianna Z. , Moore Tara L. , Rosene Douglas L. , Medalla Maria
Published: May 2024

Acetylcholine is a robust neuromodulator of the limbic system and a critical regulator of arousal and emotions. The anterior cingulate cortex (ACC) and the amygdala (AMY) are key limbic structures that are both densely innervated by cholinergic afferents and interact with each other for emotional regulation. The ACC is composed of functionally distinct dorsal (A24), rostral (A32), and ventral (A25) areas that differ in their connections with the AMY. The structural substrates of cholinergic modulation of distinct ACC microcircuits and outputs to AMY are thought to depend on the laminar and subcellular localization of cholinergic receptors. The present study examines the distribution of muscarinic acetylcholine receptors, m1 and m2, on distinct excitatory and inhibitory neurons and on AMY-targeting projection neurons within ACC areas, via immunohistochemistry and injections of neural tracers into the basolateral AMY in adult rhesus monkeys of both sexes. We found that laminar densities of m1+ and m2+ expressing excitatory and inhibitory neurons depended on area and cell type. Among the ACC areas, ventral subgenual ACC A25 exhibited greater m2+ localization on presynaptic inhibitory axon terminals and greater density of m1+ and m2+ expressing AMY-targeting (tracer+) pyramidal neurons. These patterns suggest robust cholinergic disinhibition and potentiation of amygdalar outputs from the limbic ventral ACC, which may be linked to the hyperexcitability of this subgenual ACC area in depression. These findings reveal the anatomical substrate of diverse cholinergic modulation of specific ACC microcircuits and amygdalar outputs that mediate cognitiveemotional integration and dysfunctions underlying stress and affective disorders.
Enhancing ESL Education with AI: Innovations in Teaching Methods and Au-thentic Materials
Authors: Ali Yolchiyeva Khanim , Mammadova Minavvar , Geyis Aghayeva Javahir , Mehdiyeva Gunel Bayramova
Published: May 2024

This article explores the integration of Artificial Intelligence (AI) in English as a Sec-ond Language (ESL) education, focusing on innovative teaching methods and authen-tic materials. AI-powered gamification is discussed, highlighting the use of AI tools like ChatGPT to enhance the gamification of key terms and concepts in ESL educa-tion. The interactive and enjoyable nature of gamified learning, combined with AI-driven content curation, deepens student understanding, critical thinking skills, and retention. By personalizing the learning experience, AI tools cater to individual stu-dent needs, allowing for flexibility in difficulty and fostering a love for the subject. Reflection and self-assessment play a crucial role in solidifying knowledge and pro-moting deeper learning. The article also discusses the importance of authentic materials in ESL education, emphasizing the use of AI-driven content curation to select and organize relevant and meaningful language content. AI-powered tools can analyze vast amounts of data, un-derstand patterns, and make accurate predictions, enhancing the user experience and delivering content that is most relevant and valuable to each individual student. The integration of AI in ESL education offers numerous benefits, including increased engagement, improved retention and application of key terms and concepts, personal-ized learning experiences, and enhanced critical thinking skills. By embracing AI-powered gamification and content curation, educators can create dynamic, interactive, and engaging learning experiences that foster a love for language learning and pro-mote deeper understanding.
Hysterectomy via vNOTES approach. A case report
Authors: Torre Julio Palau
Published: May 2024

Background: vNOTES (Vaginal Natural Orifices Transluminal Endoscopic Surgery), performed for the first time in 2010, is an emerging surgical technique that eliminates surgical trauma to the abdominal wall, through the use of natural orifices. Here we describe a case where this approach was used with excellent results. Due to the lack of reports using vNOTES surgery in Mexico, we present a case where this approach was achieved with excellent results. Objective: To report a case of hysterectomy using the vNOTES approach. Clinical case: A 60-year-old female, asymptomatic, referred for definitive procedure due to cervical intraepithelial neoplasia, after not accepting conservative management. A hysterectomy was performed using the vNOTES approach, lasting 100 minutes, with no eventualities or postoperative complications. She was discharged 24 hours after surgery, hemodynamically stable and asymptomatic, and without late complications. Conclusion: A hysterectomy was performed using the VNOTES approach successfully and without complications, with an adequate post-surgical evolution. Current evidence shows that the vNOTES approach to hysterectomy is an effective and safe surgery, which also combines the advantages of the vaginal approach with the laparoscopic approach.
Effect of acupressure on bowel function recovery after cesarean section: a randomized controlled trial
Authors: Prueksaritanond MD Nisa , Kunnitikorn MD Sasiwimol , Insin MD, MSc Putsarat
Published: May 2024

Aim: This randomized controlled clinical trial aims to evaluate the effect of acupressure on recovery of bowel function after cesarean section (CS). Methods: Forty-eight pregnant women who underwent CS at Rajavithi Hospital between December 1, 2020, and June 30, 2021, were recruited and randomly assigned into two groups: 24 participants in the study group and 24 participants in the control group. The study group received two acupressure sessions: one three hours after CS and another three hours after the initial session. The acupoint used was Zusanli (located on the stomach meridian, ST-36), and each acupressure session lasted 10 minutes. In contrast, participants in the control group followed the standard feeding protocol without receiving acupressure. The primary endpoint measured was the time to the first flatus. Secondary endpoints included the time to the first bowel sound, first defecation, the severity of nausea/vomiting, length of hospital stays, and adverse events related to acupressure, including soreness, bruising, and discomfort. Results: Participants in the acupressure group had a significantly shorter time to the first flatus, first bowel sound, first defecation, and experienced milder nausea/vomiting compared to those in the control group. However, no statistically significant difference in the length of hospital stays and no adverse events related to acupressure were observed. Conclusions: Acupressure, a non-invasive, feasible, and safe approach, has demonstrated its effectiveness in promoting faster recovery of bowel function in women undergoing CS. Therefore, we recommended it as an adjunct postoperative care method to reduce the incidence of postoperative ileus after CS. Trial registration: Clinical trial registration number: NCT04620850
Obstetric outcome after ultrasound guided transvaginal radiofrequency ablation of uterine myomas
Authors: Angel Santalla-Hernández , Sebastián Manzanares , Mariña Naveiro-Fuentes , Setefilla López-Criado María , Jorge Fernández-Parra
Published: May 2024

Purpose: The objective is to report the obstetric outcome of 8 pregnancies with uterine fibroids who conceived after RFA. Methods: A study was conducted on 115 women with symptomatic uterine fibroids undergoing transvaginal RFA using a bipolar radiofrequency generator and an internally cooled electrode. Data on pregnancies and outcomes were collected. Results: After the procedure, eight pregnancies occurred. Fibroid volume reduction exceeded 50% in half of the patients, with an average reduction rate of 43%. Six resulted in live births, with a cesarean section rate of 2/3, one in an ectopic pregnancy, and one in a miscarriage. Pregnancy complications were limited, and all newborns showed normal development. Conclusion: Minimally invasive ultrasound-guided RFA is effective in shrinking the myomas and may not carry an obstetric risk. Although the number of reported cases is low, no obstetric complications specifically associated with transvaginal radiofrequency ablation of uterine fibroids have been observed.
Random Mutagenesis of Lipomyces maratuensis InaCC Y720 Using Commercial UV Lamp To Increase Lipid Production
Authors: Lestari Agis Dwi , Kanti Atit , Ilmi Miftahul
Published: May 2024

AbstractOleaginous yeasts are capable of accumulating high lipid concentration up to 20% of dry cell weight. High lipid content, a shorter life cycle, and similar a fatty acid composition to vegetable oils makes oleaginous yeast a potential lipid producer. Lipomyces maratuensis InaCC Y720 is a novel species isolated from Maratua Island, East Kalimantan, which has been reported as a potential yeast lipid producer. However, lipid productivity of the yeast is needed to be increased to make it suitable for an industrial scale. The aim of this study is to obtain potential mutant strains for the biodiesel industry. Random mutagenesis was applied by using commercial UV-C lamp on the strain which resulting in an 80% death rate after three hours irradiation. Subsequent treatment was carried out using cerulenin as a selection agent for mutans, yielding six mutant strains. Among these strains, mutant 1 produced the highest lipid production, with a lipid concentration of 0.072 g/L and a lipid percentage of 8.603%.  Nevertheless, when compared to the wild type, the lipid productivity of mutant 1 is low. Based on these results, the mutagenesis approach using commercial lamp UV-C has not obtained the expected mutants, so it is recommended to use different methods for future study.AbstrakKhamir oleaginous memiliki kemampuan dapat mengakumulasi lipid hingga 20% dari berat kering selnya. Tingginya kadar lipid yang diproduksi, siklus hidup yang pendek serta komposisi lipid yang mirip dengan minyak tumbuhan dapat menjadikan khamir sebagai alternatif penghasil lipid. Lipomyces maratuensis InaCC Y720 merupakan spesies baru yang diisolasi dari Pulau Maratua, Kalimantan Timur yang dilaporkan sebagai khamir penghasil lipid potensial. Namun, produktivitas lipid khamir tersebut perlu ditingkatkan agar sesuai untuk skala industri. Tujuan dalam studi ini adalah mendapatkan strain mutan yang potensial untuk industri biodiesel. Metode mutagenesis secara acak dilakukan dengan menggunakan lampu UV-C komersial pada strain yang menghasilkan tingkat kematian 80% selama tiga jam penyinaran. Setelah itu, dilakukan perlakuan lebih lanjut dengan penggunaan serulenin sebagai agen seleksi mutan. Proses seleksi menghasilkan enam strain mutan. Di antara keenam strain mutan, mutan 1 menghasilkan jumlah lipid tertinggi dengan berat lipid 0,072 g/L dengan persentase lipid yaitu 8,603%. Namun, dibandingkan dengan wild type, produktivitas lipid mutan 1 lebih rendah. Berdasarkan hasil ini, mutagenesis menggunakan lampu UV-C komersial belum mendapatkan mutan yang diharapkan sehingga disarankan penggunaan metode yang berbeda untuk penelitian selanjutnya.
Prescribing Patterns of Nonrecommended Medications for Children With Acute COVID-19
Authors: Burns Julianne E. , Dahlen Alex , Bio Laura L. , Chamberlain Lisa J. , Bassett Hannah K. , Ramaraj Raksha , Schwenk Hayden T. , Teufel Ronald J. , Schroeder Alan R.
Published: May 2024

OBJECTIVE

Repurposed medications for acute coronavirus disease 2019 (COVID-19) continued to be prescribed after results from rigorous studies and national guidelines discouraged use. We aimed to describe prescribing rates of nonrecommended medications for acute COVID-19 in children, associations with demographic factors, and provider type and specialty.

METHODS

In this retrospective cohort of children <18 years in a large United States all-payer claims database, we identified prescriptions within 2 weeks of an acute COVID-19 diagnosis. We calculated prescription rate, performed multivariable logistic regression to identify risk factors, and described prescriber type and specialty during nonrecommended periods defined by national guidelines.

RESULTS

We identified 3 082 626 COVID-19 diagnoses in 2 949 118 children between March 7, 2020 and December 31, 2022. Hydroxychloroquine (HCQ) and ivermectin were prescribed in 0.03% and 0.14% of COVID-19 cases, respectively, during nonrecommended periods (after September 12, 2020 for HCQ and February 5, 2021 for ivermectin) with considerable variation by state. Prescription rates were 4 times the national average in Arkansas (HCQ) and Oklahoma (ivermectin). Older age, nonpublic insurance, and emergency department or urgent care visit were associated with increased risk of either prescription. Additionally, residence in nonurban and low-income areas was associated with ivermectin prescription. General practitioners had the highest rates of prescribing.

CONCLUSIONS

Although nonrecommended medication prescription rates were low, the overall COVID-19 burden translated into high numbers of ineffective and potentially harmful prescriptions. Understanding overuse patterns can help mitigate downstream consequences of misinformation. Reaching providers and parents with clear evidence-based recommendations is crucial to children’s health.
Influence of Sporophyte Emergence on Phytochemical Constituents and Antimicrobial Activity of Hyophila Involuta (Pottiaceae) – A Bryophyte Species
Authors: Isa M. O. , Makinde A. M. , Akinpelu B. A.
Published: May 2024

Hyophila involuta (Hook) Jaeg., a sample collected from a natural population in the Biological Garden, Obafemi Awolowo University, Nigeria, was sorted into non-sporophytic and sporophytic gametophytes. This was with a view to investigating the possible influence of sporophyte emergence on the bioactive constituents and the antimicrobial potentials of the moss plant. Aqueous extracts of each of the non-sporophytic and the sporophytic gametophyte samples were prepared, and each was subjected to qualitative and quantitative phytochemical screening, gas chromatography-mass spectrometry (GC-MS) analyses, and antimicrobial potentials tests on selected bacteria and fungi following standard procedures. The results showed both extracts testing positive for alkaloids, cardiac glycosides, saponins, and steroids. Quantitatively, alkaloids and cardiac glycosides concentrations were higher in the non-sporophytic than in the sporophytic gametophytes. Nevertheless, the saponins content was higher in sporophytic gametophytes. GC-MS analyses revealed 40 and 46 bioactive compounds in the non-sporophytic and the sporophytic gametophyte samples respectively. The most prominent compound was 1, 13-tetradecadiene (13.62%) in the non-sporophytic gametophyte but cycloheptasiloxane tetradecamethyl- (13.78%) in the sporophytic game-tophyte. Furthermore, the sporophytic gametophyte extract inhibited the growth of Escherichia coli, Pseudomonas aeruginosa, and Candida pseudotropicalis while the non-sporophytic gametophyte extract only inhibited the growth of P. aeruginosa at a minimum inhibitory concentration of 40 mg/mL except for C. pseudotropicalis (20 mg/mL). This study, therefore, provided insight for investigating the medicinal values of bryophytes and concluded that the emergence of sporophytes on gametophytes of a bryophyte species can vary significantly the synthesis of its biologically active compounds and its antimicrobial activity.
The relationship of psychosocial problems to the severity of psoriasis vulgaris
Authors: Flora Marlita Lubis  , Riana Miranda Sinaga
Published: May 2024

Background: Psoriasis is a skin disease belonging to the group of erythrosquamous dermatoses, chronic recurrent. Most psoriasis patients will experience psychological problems related to physical appearance and causing the patient's withdrawal from the social environment and also has a negative impact on work and career problems of patients, which will eventually cause stress in patients. The design of this study was a cross sectional study with the independent variable being psychosocial problems and the dependent variable being the severity of psoriasis.
Methods: The design of this study was a cross sectional study with the independent variable being psychosocial problems and the dependent variable being the severity of psoriasis. The design of this study was a cross sectional study with the independent variable being psychosocial problems and the dependent variable being the severity of psoriasis. We took the sample with consecutive sampling who appropriate with inclusion and exclusion criteria. Data were analyzed by ANOVA test with the p-value <0.001 was declared significant.
Results: The distribution of psoriasis vulgaris is more in males (16/30 patients, 53.3%). Psoriasis vulgaris mainly occurs in the age group of 41-50 (8/30 patients, 26.7%). The highest occupation distribution is not working (11/30 patients, 37%). The distribution of psoriasis vulgaris who did not experience anxiety and depression was 73.3%. The distribution of family history is 24 people 80% there is no family history. The most distribution of the severity of psoriasis vulgaris was mild, 73.3%.
Conclusion: There was no relationship between psychosocial factors and the severity of psoriasis (p=0.551).
Utilizing Trans-Oral Robotic Surgery (TORS) in head and neck malignancy – is it practical in oropharyngeal squamous cell carcinoma (OPSCC)? A case report
Authors: Fakhruzzaman Mohd Sharin , Khalid Ahmad Kusyairi , Abd Halim Haizlene , Yunus Mohammad Razif
Published: May 2024

Introduction: Oropharyngeal squamous cell carcinoma (OPSCC) is often managed by multimodal methods, including open surgical resection and reconstruction in advanced cases. Trans-oral Robotic Surgery (TORS) was introduced to minimize and avoid complications caused by the open surgery method and chemo-radiation therapy in treating oropharyngeal squamous cell carcinoma (OPSCC). In Malaysia, TORS is still a new, rare, and limited surgical technique practiced in our healthcare system.
Case Presentation: We present a case of the base of tongue lesion which presented with chronic globus sensation for four months associated with chronic dysphagia and cough. Endoscopy examination revealed a lobulated mass situated at the left side base of the tongue. Contrast Enhanced Computed Tomography (CECT) of the neck revealed an enhancing lesion at the same site. There were multiple subcentimeter cervical lymph nodes bilaterally from level II to level V. The patient underwent a TORS procedure using the da Vinci Surgery System for incisional biopsy. By using TORS, we were able to obtain a good tumor sample including the margins for the biopsy. Histopathology examination (HPE) of the sample reported moderate to poorly differentiated squamous cell carcinoma. Based on the HPE and CECT results, the patient was diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) with a clinical stage of T3N2cMx.
Conclusion: Management strategies for patients with OPSCC continue to evolve to minimize the morbidities and complications of treatments. Minimally invasive surgical techniques such as TORS offer impressive functional and oncologic outcomes particularly for patients (therapeutic function) compared to the traditional method of treatments.
Association between Ascaris lumbricoides infection and undernutrition in children: a systematic review and meta-analysis
Authors: Djohan Putra Brillian , AmeliaAmelia Prasetyadi  , Marcela Wirjanata  , Nicolas Daniel Widjanarko  , Antoninus Hengky  , Ellen Wijaya  , Yunisa Astiarani
Published: May 2024

Introduction: Ascariasis is the most common soil-transmitted helminths (STH) infection in children, with prevalence ranging from 6 to 60%, especially in an endemic region in Indonesia such as East Nusa Tenggara, Sumatera, and other remote areas. Ascariasis effects toward undernutrition were still unclear because there were differences between studies. This study aimed to investigate the association between Ascariasis and undernutrition in children.
Methods: Six authors reviewed and analyzed eligible studies from PubMed and MEDLINE, Google Scholar, ProQuest, EBSCO-Host, and Springer Link, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) guidelines with Reference manager was used, and the data analyzed using Revman 5.4. Newcastle-Ottawa Scale adapted for cross-sectional studies was used to examine the publication bias.
Results: This review included 15 studies and 12 studies used for meta-analyses. Pooled data indicates that Ascariasis is significantly associated with stunting (OR = 2.22, 95% CI = 1.31;3.77, p = 0.003) and underweight (OR = 1.27, 95% CI = 1.01;1.60, p = 0.04), meanwhile not significantly associated with wasted (OR = 1.11, 95% CI = 0.87;1.40, p = 0.40) of children aged 0-19 years.
Conclusion: Ascariasis increases the risk of stunting and underweight among other parameters of undernutrition. Therefore, early screening, diagnosis, and intervention must be taken to prevent stunting and underweight in children.
Comparison of conventional and electronic cigarette on formaldehyde in blood and alveolus histopathology in vivo
Authors: Surya Sinaga Immanuel  , Djuartina Tena , Iskandar Rahardjo Budianto  , Maria Dara Novi Handayani
Published: May 2024

Background: An e-cigarette is a cigarette that does not contain tobacco. The most toxic compounds in conventional cigarette smoke and e-cigarette vapors are carbonyls, such as formaldehyde which induce lung tissue damage. This study aims to compare the effect of exposure and the difference in duration of exposure to conventional cigarettes and electronic cigarettes on blood formaldehyde levels and alveoli histopathological features in Sprague dawley rats.
Method: This research is an experimental study with 30 white Sprague dawley rats, male, aged 10-12 weeks, and with body weights of 150-250 grams. Rats will be necropsied after intervention for two weeks and four weeks. Blood samples will be examined for formaldehyde levels, and lung tissue will be assessed for alveolar damage. The results were analyzed by one-way ANOVA statistical for blood formaldehyde levels and Mann Whitney for the degree of histopathological damage to the alveoli.
Result: There was no significant difference in blood formaldehyde levels between groups (p>0.05). There was an increasing trend in the intervention group compared to the control and in the fourth-week group compared to the second-week group. There was a significant difference in the degree of alveolar damage in the intervention group compared to the control (p<0.05). There was no significant difference between exposure for 2 and 4 weeks (p>0.05). Between rats given conventional cigarettes and e-cigarettes, there was no significant difference in the degree of alveolar damage at weeks 2 and 4 (p>0.05)
Conclusion: Exposure to conventional cigarette smoke or electronic cigarette vapor has a significant effect on alveoli histopathological features
Post-chemotherapy response of paclitaxel and carboplatin regimens in advanced stage cervical cancer types of histopathology squamous cell carcinoma and adenocarcinoma
Authors: Sukoco Yohanes Adhitya Prakasa , Meitria Syahadatina Noor  , Ferry Armanza  , Hariadi Yuseran  , Renny Aditya
Published: May 2024

Background: Cervical cancer incidence in South Borneo was placed 10th in Indonesia. South Borneo Department of Health revealed 1,930 patients diagnosed with cervical cancer in 2019. The main therapy for advanced cervical cancer was radiotherapy, chemotherapy, and combination. This study aims to demonstrate that paclitaxel plus carboplatin regimens have a better post-chemotherapy response in patients with advanced cervical cancer squamous cell carcinoma than adenocarcinoma.
Methods: This study used an analytical observational method with a cross-sectional approach. The sample size was taken during the period during which this study was conducted from January 2015 to December 2020 and was taken by total sampling and divided into 2 groups consisting of patients with advanced cervical cancer, squamous cell carcinoma, and adenocarcinoma histological types. Data were analyzed using SPSS version 21.0 for Windows.    
Results: A total of 202 individuals made up the study's sample, including 54 (26.8%) adenocarcinomas, 148 (73.2%) patients with advanced cervical cancer, and patients with various histological kinds of squamous cell carcinoma. About 107 (52.9%) patients provided complete responses, whereas up to 95 (47.1%) patients provided incomplete responses.
Conclusion: Squamous cell carcinoma, the histological type of cervical cancer, responds to treatment better than adenocarcinoma.
Plasma marker ACTH, cortisol, and beta-endorphins profile on pregnant women as targeted marker of approach for antenatal depression
Authors: Satrya Wijaya I Putu , Wihastuti Titin Andri , Wiyasa I Wayan Arsana , Muhammad Chair Effendi
Published: May 2024

Background: Antenatal depression is a frequent mental disorder with much less attention, and most women remain undiagnosed. Altered hypothalamic-pituitary-adrenal (HPA)-axis function mediates maternal depressive symptoms and has been widely reported. The present research aimed to determine the plasma marker HPA-axis including Adrenocorticotropic hormone (ACTH), cortisol, and beta-endorphin, as a suitable representation of mental health in pregnancy by evaluating the psychometric properties.
Methods: Therefore, we examined a case-control study of 216 Bontang pregnant women. Psychological measures were conducted during the 27th week of pregnancy, including the Patient Health Questionnaire-9 (PHQ-9) assessment and Depression Anxiety Stress Scale (DASS). Blood samples were collected for plasma ACTH, Cortisol, and beta-endorphins assay as a marker of the HPA axis profile. Data were analyzed Stata for Mac version 14 (StataCorp, USA).
Results: our finding showed that DASS scores correlated with PHQ-9 (r=0.79), ACTH (r=0.22), and beta-endorphin (r=54). PHQ-9 score significantly related to ACTH (r=0.27), cortisol (r=0.36) and beta-endorphin (r=0.71). Women with the highest DASS score and PHQ-9 depression scores at 27 weeks of pregnancy had significantly lower baby birth weight (P=0.000) than those women whose stress improved to or normal state. Plasma ACTH, cortisol, and beta-endorphin concentrations were significantly higher in pregnant women with antenatal depression compared to normal pregnancy (p<0.01). All effects remain without controlling unwanted pregnancy.
Conclusion: Our study demonstrates a role for circulating ACTH in regulating maternal cortisol secretion and a significant correlation between the HPA-axis profile and antenatal depression at 27 weeks of pregnancy.
Challenge in prominent grade IV hemorrhoid management: a case report
Authors: Budiono Bernardus Parish , Susilaningsih Neni , Prasetyo Sigit Adi , Chionardes Melissa Angela , Riwanto Ignatius
Published: May 2024

Background: Management of grades 1 and 2 of internal hemorrhoids is non-operative by advising the patients to have a high-fiber diet and take phlebotropic agents such as MPFF (Micronised Purified Flavonoid Fraction). Rubber band ligation is the alternative in case of failure office-like procedure sclerotherapy. Management of grade 3 and 4 internal hemorrhoids is operative management. The gold standard of hemorrhoid surgery is the Morgan Milligan method, an excisional surgery, since this method results in a low recurrence rate.
Case presentation: We presented a twenty-six-year-old male patient who came to St Elizabeth Hospital, Semarang, with a chief complaint painful lump in the anal canal for the past 7 days. For about 3 years, he got chronic spontaneously reducible anal pile and bleed, and since 2 months, the pile has enlarged and only can be reduced manually. Since 7 days ago, nonreducible anal lump (prolapse). He was several times treated medically by General Practitioner. The patient was in good condition on physical examination but looked painful with VAS: 7. The anal region looked like a big prolapsing anal canal skin and mucosa with a dentate line in between. The lump looked hyperemic, with edema and some thrombus.
Conclusion: Management of big grade IV internal hemorrhoids is challenging. Combination Morgan Milligan for a big pile and HAL-RAR for the rest of the pile gives a good result. The administration of MPPF one gram three times daily, pre and post-operatively, reduce the edema, post-operative pain and risk of bleeding, which is clinically significant.
Brain-derived neurotrophic factor (BDNF) and the capute scales in offspring of mothers with normal and deficient vitamin D levels
Authors: Dewantiningrum Julian , Hartanto Fitri , Mexitalia Maria , Soejoenoes Ariawan , Ediati Annastasia , Hadisaputro Suharyo , Pudjonarko Dwi
Published: May 2024

Background: Vitamin D deficiency during pregnancy is associated with a child's neurocognitive development. During the COVID-19 pandemic, the Capute Scales have become ineffective because requiring face-to-face interaction to examine children's neurocognitive development. Brain-Derived Neurotrophic Factor (BDNF) is an alternative method to determine children's neurocognitive development through blood sampling. This study aims to evaluate the relationships between BDNF and the Capute Scales in the offspring of mothers with vitamin D levels.
Methods: A diagnostic study from 14 community health centers in Semarang City, Central Java, Indonesia, was conducted. The study was performed from August 2017 until August 2018 and included vitamin D level records at 20–24 weeks of normal gestation in 2017 from all single births at these community health centers. The cases were divided into two groups: 30 children born to mothers with normal vitamin D levels (25(OH)D > 20 ng/mL) and 30 children born to mothers with vitamin D deficiency (25(OH)D < 20 ng/ml). This study aimed to assess the relationship between BDNF levels and the Capute Scales of children aged 2 years and to determine the cut-off value based on each group's examination of BDNF levels.
Results: The mean age of pregnant women whose vitamin D levels were checked was 29.32 years. The cut-off value of BDNF among the two groups was 7968 pg/mL. Of the 55 samples that met the Capute Scales criteria, 44 had a BDNF value less than the cut-off value, and 11 samples had a BDNF value more than the cut-off value. Meanwhile, of the five samples that met the Capute Scales criteria and were suspected of mental retardation, three had a BDNF value less than the cut-off value, and two had a BDNF value more than the cut-off value. The sensitivity, specificity, positive, and negative predictive values were 80%, 60%, 0.93, and 0.15, respectively.
Conclusions: BDNF levels can be an alternative neurocognitive examination in children born to mothers with normal and deficient vitamin D levels. BDNF is a growth factor that plays an important role in neurons' differentiation, growth, and survival in the postnatal phase.
Open reduction intramedullary rod with synthetic bone graft for the treatment of radius ulna pseudoarthrosis with neurofibromatosis type 1: a case report
Authors: Saleh Muhammad Ruksa , Torredes Reggie Anday , Musa Richa Resmiati
Published: May 2024

Background: Pseudoarthrosis is a false joint that occurs in cases of non-union and is commonly associated with neurofibromatosis. Treatment of refracture and non-union remains a challenge, and many methods have been attempted with varying results.
Case Presentation: A 7-year-old, left-handed male sought consult at the Philippine Orthopedic Center (POC) last February 2016 with a complaint of left forearm deformity. This patient was diagnosed with neurofibromatosis type 1 with pseudoarthrosis of the radius and ulna. The pseudoarthrosis was treated with an application of an intramedullary rod and synthetic bone graft. Union and a full range of motion of the forearm were achieved at 1.5 years post-op.
Conclusion: Pseudoarthrosis is a rare case of non-union that occurs spontaneously or after a minor trauma, most commonly associated with Neurofibromatosis Type 1. Since the condition is so rare, many methods have been attempted with varying results. Successful treatment of most atrophic non-union is achieved by optimizing the mechanical and biological environment of the pseudoarthrosis site.
Number of e-cadherin and VEGF in WiDr cell line post-induced by extract ethanol Annona muricata leaf
Authors: Yoni Astuti  , Agus Suharto  , Sabtanti Harimurti  , Helmi Hana Prinanda  , Wahyu Joko Priambodo
Published: May 2024

Introduction: Soursop leaves have benefits including anticancer, antifungal, and antibacterial. Soursop   leaves are proven to contain various phytochemicals, namely alkaloids (ALKs), essential oils and acetogenins. Annonaceous acetogenins compounds soursop cytotoxic effect on cancer cells.  One of the reasons for the malignancy of cancer cells is their ability to move to other tissues. Migration ability was related with the expression of e-cadherin, in cancer cells the expression of e-cadherin was low. Malignancy is also related to the amount of VEGF, in the type of tumor VEGF expression increases. Therefore, the aim of this study was to measure the amount of e-cadherin and VEGF of the WiDr colon cancer cell model after being induced by soursop leaf  ethanol extract.
Methods: Ethanol extract of soursop leaves is obtained by maceration.   The measurement of the amount of e-cadherin used the elisa kit e-cadherin while the amount of    VEGF was used by the elisa kit VEGF. The amount of e-cadherin and VEGF measurement used was an elisa reader at a wavelength of 560 NM.
Results: The results showed there were significant differences between various doses of extract ethanol Annona muricata to the number of e-cadherin. There were significant differences between various doses of Extract ethanol Annona muricata to the number of VEGF.
Conclusions: Ethanol extract Annona muricata leaf showed the anti migration and anti angiogenesis effect on WiDr cell line.
Understanding of home care and interest level of nursing students working as home care nurses
Authors: Nur Chayati  , Riska Adellia
Published: May 2024

Introduction: Comprehension materials in the learning curriculum allow students to think critically about nursing care while practicing in-home care. It also can foster an interest in working as a home care nurse but not all nurses students want to be home care nurses as hope. The purpose of this study is to analyze the relationship of understanding about home care with the interest level of nursing students to be home care nurses.
Methods: This study is a quantitative correlational method with a cross-sectional approach. Data were examined in the univariate and bivariate analysis with Pearson correlation. Sixty participants were recruited by using a stratified random sampling technique.
Results: This study showed that respondents have a good understanding of home care, as many as 51 respondents (85%). Also, most of the respondents are interested in working as a home care nurse, as many as 25 respondents (41.7%). The results obtained a  p-value 0.000 (p<0.05) (r=0.633). This study showed that the level of understanding of nursing students is good, and the interest in working students as home care nurses is high. It can be concluded that the understanding of home care influences the work interests of nursing students to work as home care nurses.
Conclusion: The theory and concept of home care as one of the working areas of nurses should be delivered to nursing students since they are in the academic stage, and clinical exposure to home care during the nurse profession will enhance them to involve more caring people in the home care setting.
Islamic nursing care implementation: patients’ perception
Authors: Sari Novita Kurnia , Asriani Aspia Dwi
Published: May 2024

Introduction: Since Islam is the dominant religion in the country, it is evident that Muslims make up most of the patients at Islamic hospitals. By incorporating Islamic values, Islamic hospitals should get Islamic nursing care. How patients perceive a hospital can be used to gauge its effectiveness. One of the reasons Islamic nursing should be practised is due to patient requests. This study aimed to understand how patients perceive Islamic nursing care.
Methods: Descriptive quantitative study was used with adult inpatient ward patients. Eighty-four subjects in this study met specific requirements and used accidental sampling. A valid and reliable Likert scale and a questionnaire with 26 questions made up the study instrument. Frequency distribution-based data analysis.
Results: Patients perceived good in three components, including doing care only with same-sex patients (88.1%), assisting prayer (66.7%) and doing Islamic communication (66.7%). At the same time, the poor perceived is to assess the spiritual aspect and help with prayer.
Conclusion: Based on the findings of this study, nurses can better attend to patients' spiritual needs to ensure that they receive Islamic nursing care.
An evaluation of the relationship between the occurrence of chronic kidney disease and the use of NSAIDs
Authors: Kamri Andi Maulana , Zullies Ikawati  , Rosnani Hashim  , Fita Rahmawati
Published: May 2024

Background: Non-steroidal Anti-Inflammatory Drugs (NSAIDs) are painkillers that Indonesians widely use. Many people use it because it is easy to get and low price. Although, the public does not pay attention to safety in its use. This study aims to determine the relationship and the level of causality between the use of NSAIDs and chronic kidney disease (CKD) events.
Methods: An observational case-control with retrospective retrieval was adopted, and the risk factors between the use of NSAIDs and CKD events were analyzed. Meanwhile, the study was conducted in Makassar city hospital with consecutive sampling from January 2017 until January 2018.
Results: The results showed that 118 patients from a total of 350 used NSAIDs, while 35 of the 175 with CKD had a history of NSAIDs. Furthermore, the data on the use of NSAIDs in these patients was 40% meloxicam and 10% mefenamic acid, and the result of the Chi-square analysis showed a p-value <0.001 and an OR of 0.277. Additionally, the possible incidence of CKD in men and women is 48.55% and 70.72%, respectively, with a history of using NSAIDs for over 3 months. It was further shown that  2 of 118 patients had side effects from CKD due to the long-term use of NSAIDs.
Conclusion: Conclusively, there is no relationship between CKD incidence and the use of NSAIDs in the community. However, some CKD side effects are related to NSAIDs, which implies that NSAIDs do not result in CKD.
Evidence of Dioxin as Endocrine Disrupting Chemicals in the Development of Endometriosis: A Narrative Review
Authors: Meidyana Shafira
Published: May 2024

Endometriosis is one of the most frequent abnormalities in women with infertility. Endocrine disruptors, such as dioxin, are considered to affect the development of endometriosis. Various studies have been done to find an association between dioxin and endometriosis, but the results are conflicting. Hence, this study aims to systematically review existing epidemiological studies on exposure to dioxin and the development of endometriosis.
Jatropha multifida L stem sap gel versus Aloe vera gel to post-gingivectomy healing process
Authors: Listari Khusnul Munika , Az-Zahra Tsarwah , Hasanah Amalia , Agistasari Yessy
Published: May 2024

Introduction: Gingivectomy is cutting the gingiva during a gingival enlargement condition that causes an open wound in the gingiva. Jatropha multifida L gel contains active ingredients of alkaloids, flavonoids, saponins and tannins, which are thought to accelerate the wound healing process, but its use in dentistry is limited. The objective of this research is to determine the effectiveness of the application of Jatropha multifida L stem sap gel in the wound healing process post-gingivectomy in Wistar rats (Rattus novergicus) compare with Aloe vera gel (Aloe Barbadensis Miller) by using parameters the number of fibroblasts, blood vessels and the density of collagen fibers
Methods: Rats were divided into 4 groups, namely group K (Aloe vera gel), P1 (Jatropha multifida L stem sap gel 2,5%), P2 (Jatropha multifida L stem sap gel 5%) and P3 (Jatropha multifida L stem sap gel 10%). Each group was given the gel twice a day in the wound area; then the wound was observed microscopically by Haematoxylin Eosin staining to count the number of fibroblasts and blood vessels also Masson Trichrome staining to observe the density of collagen fibers on day 3 and 7.
Results: The data obtained were statistically analyzed using the One Way Anova, Dunnet and Kruskal-Wallis test. One Way Anova test shows there is a significant difference (p<0.05) in the number of fibroblasts, and the Dunnet test shows there is a significant difference (p<0.05) in the number of fibroblasts in Jatropha multifida L stem sap gel group 2.5% and 5 % on day 3. One Way Anova test shows no significant difference (p>0.05) in the number of blood vessels. The Kruskal-Wallis test shows no significant difference (p>0.05) in collagen fiber density.
Conclusion:  Jatropha multifida L Stem Sap gel has the same potential as Aloe vera gel in accelerating wound healing after gingivectomy in Wistar rats.
Bilateral keratoconus hydrops in a patient with Down Syndrome: a case report
Authors: Idrus Elfa Ali , Mustaram Arief Akhdestira , Fajriansyah Angga , Muslima Patriotika
Published: May 2024

Background: Keratoconus has been reported in as many as 8% to 36% of people with Down syndrome. Corneal hydrops, a complication of advanced keratoconus, is characterized by the sudden onset of severe stromal and epithelial edema resulting from descemet membrane rupture. According to previous studies, acute corneal hydrops occurs in between 0.2% and 2.8% of keratoconus patients, while the incidence of corneal hydrops in Down syndrome patients with keratoconus is unclear. This study aims to evaluate the bilateral keratoconus hydrops in a patient with Down Syndrome.
Case Presentation: We reported a case of bilateral corneal hydrops in a Down syndrome patient aged 28. Upon arrival, his bilateral visual acuity was fixed to follow the object. Slit-lamp examination revealed bilateral corneal edema and apical corneal scarring, and grade 4 plus keratoconus were seen on the Scheimpflug camera system. The patient receives medical treatment to lessen the patient's symptoms while they wait for a cornea donor to do a transplant.
Conclusion: Patients with Down syndrome could experience bilateral corneal hydrops. Strong symptom communication, quick referral, and good cooperation during eye examinations are needed for early detection of this eye condition.