bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization and potential antibacterial activity of green synthesis zinc-oxide nano particles using Physalis angulata linn leaves extract against Staphylococcus aureus
Authors: Kumala Yuliana Ratna , Fitriani Delvi , Adhuri Amyra Rahmi , Zahira Mayladiva Qaniya , Fadia Salma Larasati
Published: January 2025

Background: Staphylococcus aureus (S. aureus) is widely accepted as one of the etiology of dental caries. The development of nanoparticle-based drugs is necessary to enhance penetration to bacterial cells as well as reduce antimicrobial resistance. Green synthesis nanoparticles using plant compounds are proposed to support the metal structure with fewer toxicities. This study was aimed to evaluate the green synthesis of Zinc-Oxide Nano Particles (ZnONP) using Physalis angulata Linn (P. angulata L) leave extracts and antibacterial analysis against S. aureus.
Methods: Air-dried P. angulata L leaves simplicial were extracted using the maceration method in 70% ethanol solvent.  The green synthesis of ZnONP + P. angulata L was confirmed using sequential methods, namely Ultraviolet-Visible (UV-Vis) Spectroscopy, X-ray diffraction (XRD), Energy Dispersive X-ray (EDX), Field Emission Scanning Electron Microscope (FESEM) and Transmission Electron Microscope (TEM) to evaluate the nanoparticle formation, crystallinity phase, size, composition, surface morphology and crystal structure respectively.
Results: The UV-Vis analysis showed a peak of absorbance in the range of 350-400 nm. The EDS revealed Zn as a major metal composition. The XRD analysis confirmed the wurtzite crystal phase with a particle size of 96.38 nm. The FESEM imaging demonstrated mixed morphology of needle-like and nanoflake shapes of ZnONP. The TEM analysis also confirmed the size of nanoparticles as hexagonal crystal structures. The antibacterial test demonstrated the extract concentration of 25% as the minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC).
Conclusion: The ZnONP synthesis using 25% extract of P. angulata L showed a potential antibacterial toward S. aureus growth.
Correlation between hemoglobin levels and incidence of stunted children in Sorong Regency, Indonesia
Authors: Hardia Lukman , Akrom Akrom , Sulistyani Nanik
Published: January 2025

Introduction: Stunting cases in the Sorong of Regency are higher than the national stunting prevalence. Malnutrition is one of factor important reasons for stunting, malnutrition can cause anemia which is a condition where the rate of children's hemoglobin is below normal. Therefore, this study is to analyze the correlation between Hb levels and stunting incidence in Sorong Regency and to investigate sociodemographic factors associated with stunting causes.
Methods: This study is an observational analytic with a cross-sectional design. The sample size for this study consisted of 60 children who met the inclusion and exclusion criteria. The sample was further divided into two groups: 40 stunted children and 20 non-stunted children who comprised the control group. Measurement of hemoglobin levels using tool hematology analyzer carried out in the Laboratory Hospital Clinic Dr. J. P. Wanane Sorong of Regency. Analysis univariate use a distribution of the variables studied which include characteristics of respondents and families, meanwhile Pearson correlation analysis was used to analyze the correlation between hemoglobin status with the stunting status.
Results: Based on the results of the bivariate test, the value of r = -0.308 with a significance value of p = 0.017 (< 0.05) which means that the more children who experience stunting, the fewer children will have normal Hb levels. Children with normal Hb levels have a 5.4 times chance of not experiencing stunting when compared to children who have anemia.
Conclusion: There is a significant relationship (p=0.017) between the incidence of stunting and Hb levels in children in Sorong Regency, where stunted children are 5.4 times more likely to experience anemia compared to normal children who do not experience stunting.
Unemployment worst sleep quality in the elderly at the outpatient clinic of Dr. Soetomo Hospital Surabaya and Airlangga University Hospital Surabaya
Authors: Hamdan Muhammad , Rahmarini Edfina , Islamiyah Wardah Rahmatul
Published: January 2025

Background:  Impaired sleep quality often occurs in the elderly. Most of the elderly are retired or not working. Unemployment makes the elderly get more sleep during the day. So, the elderly have difficulty sleeping at night. This will cause sleep quality disorders in the elderly. The aim of this study was to determine the relationship between unemployment and sleep quality in the elderly.
Methods: This study is a cross-sectional study conducted at the multicenter at the outpatient polyclinic of RSUD Dr. Soetomo and the outpatient polyclinic at the Airlangga University Hospital, Surabaya. Each subject who entered this study will fill out the identity questionnaire to measure unemployment and the PSQI questionnaire to measure sleep quality. This study was approved by the ethics committee of Dr. Soetomo Surabaya Hospital and Airlangga University Surabaya Hospital from Dr. Sutomo Hospital number 0249/KEPK/VIII/2021 and from  Universitas Airlangga Hospital number 170/KEP/2021.
Results: We collected data from 345 subjects treated at the outpatient polyclinic of Dr. Soetomo Hospital Surabaya and Airlangga University Hospital Surabaya. It was found that  236(68.4%) subjects were in the unemployment category;109 (31.6%)subjects were still working; 86(24.9%) subjects were in the impaired sleep quality;  259(75.1%) subjects were in good sleep quality. Based on this research, unemployment is statistically significant for the worst sleep quality p 0.020 OR 2.046 CI 95 % (1.147-3.640).
Conclusion: Unemployment influences sleep quality in the elderly at the outpatient polyclinic of RSUD Dr. Soetomo and Airlangga University Hospital Surabaya.
In-vivo and in-silico immunomodulator activity of Caesalpinia sappan L. wood ethanol extract in Rattus norvegicus infected by E. coli
Authors: Rohmah Martina Kurnia , Anwari Farida , Nurdianto Arif Rahman , Rahayu Dwi Anggorowati , Taniasari Nungky , Susanti Elda
Published: January 2025

Introduction: Immunomodulators from natural compounds have a good potential in curing infectious diseases including Escherichia coli (E. coli) infection in the gastrointestinal and urinary tract. In Indonesia, Sappan wood (Caesalpinia sappan L.) is known as a traditional herbal drink that can be used to increase immunity. Caesalpinia sappan L. has a specific red natural pigment called brazilin. This study aimed to determine the immunomodulatory activity of Caesalpinia sappan L. in Rattus norvegicus infected with E. coli.
Method: This study was a true experimental with a post-test-only control design (in vivo) that used Rattus norvegicus infected by E. coli (10-9-CFU/ ml). This study consisted of normal control (non-infected group), negative control (placebo), positive control (immune booster), and 96% Ethanol Extract of Sappan Wood (SWEE) 25, 50, 100, and 200 mg/kg BW. The treatment was given for 7 days after E. coli infection. In silico study, we used brazilin as a ligand and pro-inflammatory cytokine (TNFα and IL-1β) as the target. It was conducted using a molecular docking web server (Docking Server).
Results: In vivo study showed that Caesalpinia sappan L. decreased C-reactive protein (CRP) levels and increased phagocytic index. SWEE 100 and 200 mg/kg BW was significantly different from the negative control (p<0.05) but not the positive control (p>0.05). SWEE 100 and 200 mg/kg BW increased phagocytic index by 2.82 and 4.62 folds. The molecular docking showed that brazilin binds to TNF-α, and IL-1β with total energy binding respectively -5.05 and -3.14 kcal/mol. The estimation inhibition constant (Ki) of brazilin into TNF-α and IL-1β respectively 199.52 and 4.99 µM.
Conclusion:  Caesalpinia sappan L. has immunomodulatory activity through CRP level suppression and phagocytosis induction, especially at 100 and 200 mg/kg BW. Brazilin as a specific pigment of Caesalpinia sappan L also has been proven to inhibit pro-inflammatory cytokine TNF-α and IL-1β.
The effect of enteral glutamine supplementation on T lymphocyte increase in a rat (Rattus norvegicus) model with thermal contact burns
Authors: Zakanito Marelno , Perdanakusuma David Sontani , Saputro Iswinarno Doso
Published: January 2025

Background: The common causes of death from burns are sepsis, infection, and multiorgan failure. Optimal immune cell function is crucial to prevent this condition. In this regard, T lymphocytes play a key role in the immune response to burns. Glutamine, an immunonutrition, serves as a main energy source for immune cells such as lymphocytes, macrophages, and fibroblasts. This study was conducted to understand the difference in T lymphocyte concentration in the tissue of contact thermal burns in control mice compared to mice given enteral glutamine.
Methods: This study was an experimental study using a post-test randomized control design. Male mice were divided into 5 groups, each consisting of 5 mice. Contact thermal burns were created by placing a heated steel rod on the dorsal area of their heads for 4 seconds. Group I did not receive glutamine and was observed 1 hour after the burn. Groups II and III also did not receive glutamine but were observed on day 5 and day 10. Groups IV and V were given glutamine and observed on the same days. Subsequently, the T lymphocyte count was determined through microscopic examination.
Results: Based on the analysis, there was no significant difference in the weight of the mice in all groups (p=0.130). In the control group, the T lymphocyte counts significantly varied between day 1, day 5, and day 10 (p=0.000), with no significant difference between day 5 and day 10 (p=0.410). Similar results were found in the glutamine group (p=0.000) but with no significant difference between day 5 and day 10 (p=0.158). The mean T lymphocyte count was significantly higher in the glutamine group on day 5 (p=0.007) and day 10 (p=0.006) compared to the control group.
Conclusion: Enteral glutamine administration increases the number of T lymphocytes in damaged tissue due to thermal contact burns in mice.
Enhancing colorectal cancer treatment efficacy: A comprehensive investigation into the synergistic potential of Phyllanthus niruri Linn and capecitabine in targeting cancer stem cells
Authors: Adrianto Albertus Ari , Riwanto Ignatius , Sadhana Udadi , Paramita Dewi Kartikawati , Setyawan Henry , Tjandra Kevin Christian , Adiningsih Dwi , Pravitha Clarissa Aulia , Mahati Endang
Published: January 2025

Introduction: Colorectal cancer (CRC) prevalence is rising globally with significant mortality rates. Cancer stem cells (CRC-SC) resist chemotherapy, marked by CD133 and CD44. Immune system involvement and immunosuppression in chronic inflammation impact CRC progression. CD18 and CD8 are crucial in T cell migration and activation. Capecitabine is a common chemotherapy for CRC. Phyllantus niruri Linn exhibits immunomodulatory effects, inducing apoptosis and inhibiting proliferation in colon cancer cell lines. The study aims to assess the effectiveness and safety of  combination therapy, correlating outcomes with key biomarkers CD133 and CD8-18, associated with CRC-SCs and T cell proliferation, respectively. Such insights may pave the way for more targeted and effective colorectal cancer treatments, offering hope for improved patient outcomes. Methods: This research was conducted for 4 months using a true experimental research method with a post-test-only control group design. This study used 57 Sprague-Dawley rats which were divided into 5 groups: positive control, negative control, and intervention with Phyllanthus niruri Linn, Xelloda, and combination of  Phyllanthus niruri Linn and Xelloda. All groups were subjected to three general procedures: pre-surgery, surgery, and post-surgery.
Results: The findings demonstrated that Phyllanthus niruri Linn had significant activating CTL markes (CD8 and CD-18) compared to the control group (p<0.05). The combination of Phyllanthus niruri Linn and Capecitabine also significantly reduced the stem cell biomarkers (CD133) compared to cancer groups (P<0.05).
Conclusion: The combination of Phyllanthus niruri L extract and Xeloda is proven able to increase the apoptosis of colorectal cancer stem cells.
Comparing drug-resistant pulmonary tuberculosis treatment with and without type 2 diabetes mellitus
Authors: Fachri Muhammad , Hatta Mochammad , Zafira Fauziah , Akaputra Risky , Wikanningtyas Tri Ariguntar
Published: January 2025

Background: Pulmonary TB and type 2 DM are interdependent medical-epidemiological challenges with high global impact. Pulmonary TB cannot improve in patients with uncontrolled diabetes. Pulmonary TB in patients with type 2 DM presents distinct characteristics, making it crucial to diagnose and treat to understand the effects of TB and oral antidiabetic drugs. The purpose of this study was to compare the duration of treatment for drug-resistant pulmonary TB in the presence and absence of type 2 DM.
Methods: This study used a cross-sectional design and single-population proportion method. The participants were enrolled using a consecutive sampling technique. The comparison focused on patients with drug-resistant TB with and without type 2 DM. Initially, 80 patients were recruited; however, after applying the inclusion and exclusion criteria, 22 patients remained.
Results: Among the 80 patients, 44 had drug-resistant pulmonary TB with type 2 DM, and 36 patients did not have type 2 DM. The male-to-female ratios ranged from 53 (66.3%) to 27 (33.8%). GeneXpert results in both groups indicated rifampicin resistance. Regarding treatment duration, 13 patients with drug-resistant pulmonary TB and type 2 DM who completed treatment mostly recovered between the 18th and 24th months, whereas nine patients with drug-resistant pulmonary TB without type 2 DM who completed treatment recovered between the 6th to 24th month (Mann‒Whitney test, P = 0.000).
Conclusion: The treatment period for patients with drug-resistant pulmonary tuberculosis with type 2 DM was much longer than that for patients with drug-resistant pulmonary tuberculosis without type 2 DM.
Mapping neurorestoration research, trends, and niche topics: bibliometric analysis
Authors: Saleh Arman Yurisaldi , Yogi Saputra Dwi Arwandi , Yulianti Retno
Published: January 2025

Introduction: This research aims to map trends and niche topics in the field of neurorestoration using bibliometric analysis. Neurorestoration, a field aiming to restore nerve function after injury or disease, uses various strategies like cell therapy, gene therapy, and brain-computer interfaces. Despite its potential, it requires further research. This study uses Scopus, the world's largest abstract and citation database, to conduct bibliometric studies on neurorestoration. Using data from Scopus, the study identifies emerging topics, important journals, and leading countries in the field, offering valuable insights for future research.
Methods: This research data was obtained from Scopus and analyzed using the Biblioshiny and Vosviewer applications. This method allows us to identify the most relevant authors, affiliations, documents by region or country, document subjects, and high document contributions.
Results: The findings of this study demonstrate the utilization of network visualization, overlay visualization, and density visualization techniques to examine the data. We succeeded in identifying the most relevant authors, affiliations, and documents with high contributions in the field of neurorestoration. We also managed to map documents by region, country, and subject..
Conclusions: A niche theme in the field of neurorestoration is nerve stimulation and delaying cognitive decline. This research provides valuable insight into trends and niche topics in the field of neurorestoration that may assist other researchers in planning and conducting their research.
Prognostic value of ACEF score, modified Gensini score, and troponin T levels on Major Adverse Cardiovascular Events (MACE) in STEMI patients undergoing Primary Percutaneous Coronary Intervention (PPCI)
Authors: Rosmaningtyas Christina Ayu Ariani , Rampengan Starry Homenta , Joseph Victor Florencia Ferdinand , Lolombulan Julius Hendrik
Published: January 2025

Background: Even though the recent management of STEMI is increasingly more advanced, major cardiovascular events (MACE) still become the main cause of mortality and morbidity in those patients. Risk stratification using both clinical scoring and angiography needs to be carried out to predict the occurrence of MACE in these patients. This study aims to assess the prognostic value of ACEF score, Modified Gensini score, and Troponin T levels in predicting MACE in STEMI patients undergoing primary percutaneous coronary intervention (PPCI).
Methods: This is an observational study employing a hospital-based cohort design. Data collection was carried out retrospectively on STEMI patients undergoing PPCI at Prof. Dr. R. D. Kandou General Hospital Manado between January 1st, 2019, and December 31st, 2022. The relationship between ACEF score, Modified Gensini score, and Troponin T level was analyzed using bivariate analysis and ROC curves.
Results: Of the total 216 research subjects, 84.25% of the patients were male with an average age of 60 years. The relationship between the ACEF score and the Modified Gensini score with MACE was analyzed using logistic regression. There was a weak positive correlation between the ACEF score and MACE [r = 0.353; P < 0.001] and a weak positive correlation between the Modified Gensini score and MACE [r = 0.218; P = 0.002]. Based on analysis using the Chi-square test, there was a significant relationship between troponin T levels and MACE (X2 = 8.335; P = 0.007). However, ACEF score, Modified Gensini score, and Troponin T levels were not significantly associated with MACE after multivariate analysis. The predictive value of the ACEF score was significantly higher than the Modified Gensini score.
Conclusion: There was a significant relationship between ACEF score, troponin T levels, and MACE in STEMI patients undergoing PPCI. However, there was no significant relationship between the Modified Gensini score and MACE in STEMI patients undergoing PPCI.
Comparison of the effect of low-intensity resistance training with blood flow restriction and moderate-intensity resistance training on balance functions in elderly women
Authors: Aprilya Asih , Nugraheni Nuniek , Utami Ditaruni Asrina , Melaniani Soenarnatalina
Published: January 2025

Background: The ageing leads to a loss of strength and mobility, which increases the risk of falls. It can be counteracted with resistance training. Low-intensity resistance training with blood flow restriction (LI-BFR) can be an alternative to increase strength and muscle size at the same level as high-intensity resistance training (HI-RT) for the population who does not tolerate high loads due to lower mechanical stress. This study aims to compare the effect of LI-BFR and moderate-intensity resistance training (MI-RT) on balance functions in elderly women.
Methods: This study is a true experimental research with pre and post-test randomized control group design located at Dr. Soetomo Hospital Surabaya that starting from June 2023The study sample was elderly women who met the study criteria. A total of 26 people were randomly divided into two groups. The moderate group received moderate-intensity resistance training (MI-RT) ≥40-60%1RM, BFR group received low-intensity resistance training with BFR (LI-BFR) 20-30%1RM, restriction pressure 50mmhg or 40%AOP. Duration intervention for 6 weeks. This study assessed static balance using the One Leg Stance test (OLS) and dynamic balance using the Time Up and Go test (TUG).
Results: There was a significant in MI-RT, score of OLS p<0.000 and TUG p<0.000. LI-BFR, significant in score of OLS p<0.001 and TUG p<0.000. The difference in OLS and TUG between groups was not significantly different (delta OLS p=0.6, delta TUG p=0.3). There were two mild adverse events in the MI-RT. Meanwhile, there were no adverse events in the LI-BFR.
Conclusion: Low-intensity resistance training with BFR for 6 weeks can improve static and dynamic balance function in elderly women as well as MI-RT. Low-intensity resistance training with BFR is safe, comfortable and beneficial, so it can be an alternative resistance training in older people.
Urine kidney injury molecule-1 and lactic acid as early predictors of acute kidney injury: a literature review
Authors: Juwono Kashi Ameta Resijiadi , Airlangga Prananda Surya , Semedi Bambang Pujo , Kriswidyatomo Prihatma , Waloejo Christrijogo Sumartono , Santoso Kohar Hari , Utomo Budi
Published: January 2025

The occurrence of acute kidney injury is frequently observed in critically ill patients and can lead to significant morbidity and mortality. It is crucial to identify AKI early on and intervene promptly for better patient outcomes. However, commonly used biomarkers like serum creatinine and urine output have certain limitations when detecting AKI at its initial stages. Urine biomarkers, such as Kidney Injury Molecule (KIM)-1, have shown promise in the early detection of AKI in critically ill patients. KIM-1 is released by damaged kidney cells, and its levels increase within 6 to 12 hours after AKI onset, before any changes are observed in serum creatinine or urine output. Research suggests that urine KIM-1 provides both sensitivity and specificity for diagnosing AKI, and it may also hold predictive value for evaluating the severity of AKI. Additionally, lactic acid has emerged as another potential biomarker for early detection of AKI in critically ill patients. According to certain studies, lactic acid is a byproduct of anaerobic metabolism and has been associated with AKI. Moreover, lactic acid is an established marker for perfusion status and clinical outcomes among critically ill individuals. Urine kidney injury molecule-1 and lactic acid have emerged as potential biomarkers for the early detection of acute kidney injury in critically ill patients. However, further research is necessary to determine precise cut-off values, evaluate treatment efficacy, and devise efficient diagnostic tests. The utilization of these biomarkers holds promising prospects for enhancing AKI management and optimizing patient outcomes, highlighting their importance within critical care settings.
Comparison of cortisol levels in subarachnoid block anesthesia patients with and without immersive virtual reality: a study protocol
Authors: Zaki Mokhammad Dzulfikar , Airlangga Prananda Surya , Sumartono Chritrijogo , Putri Herdiani Sulistyo , Fitriani Mariza , Wirabuana Belindo
Published: January 2025

Background: Most patients undergoing surgery using spinal anesthesia experience significant anxiety before the procedure. There were around 65-80% of patients before surgery experienced moderate to severe anxiety. Preoperative anxiety can affect patient well-being and trigger a physiological stress response that has many negative impacts.. Therefore, this study protocol aims to evaluate salivary and plasma cortisol levels comparison between subarachnoid block anesthesia patients with and without immersive virtual reality (IVR).
Methods: This study protocol uses a randomized controlled trial (RCT) design at the Operating Theatre of Universitas Airlangga Hospital in Surabaya, Indonesia. A control group that does not wear a virtual reality headset during the procedure and an intervention group that receives an immersive virtual reality experience during the subarachnoid block will be randomly assigned to each group of patients.
Discussion: Nonpharmacologic therapy has gained interest as a way to help patients awaiting surgery manage their stress responses and reduce their anxiety. One therapy that is gaining traction is the use of IVR technology. Patients can be introduced to a simulated operating room through virtual reality and get a first look at the surgical setting. This enables the patient to get used to circumstances in the operation setting. It may dawn on patients that their imagined anxieties are unfounded. Management of anxiety-related conditions and diseases with virtual reality is similar to exposure treatment in terms of effectiveness.
Conclusion: The type of anesthesia may also have an impact on changes in perioperative cortisol levels and overall anxiety related to surgical procedures. Nevertheless, it is yet unknown if patients receiving subarachnoid block anesthesia with or without IVR have different cortisol levels that need to be evaluated.
Delirium and thrombosis induced by community-acquired pneumonia in elderly and its effect on mortality: A review
Authors: Purnami Ni Ketut Rai , Kuswardhani RA Tuty , Bakta I Made , Niryana I Wayan , Manuaba Ida Bagus Putra , Manuaba Ida Bagus Amertha Putra , Sindhughosa Dwijo Anargha , Arsani Ni Luh Kadek Alit
Published: January 2025

Elderly patients who experience acute infectious diseases such as community-acquired pneumonia, they often do not show typical symptoms, until eventually the patient falls into a severe and life-threatening condition. If it is not recognized early, diagnosis will be late or even undiagnosed, so that treatment cannot be given quickly, lead to poor patient outcomes, prolonged hospitalization, and even death. One of the atypical symptoms is delirium which is often found as a cause of elderly patients being brought to the hospital by their families. The occurrence of delirium in various literature is suspected to be associated with severe infections, and it is even suggested to be a reference for providing more aggressive treatment because it is considered to be one of the clinical parameters for poor outcomes. Likewise, infection can trigger thrombosis and will worsen the patient's prognosis. In response to this, it is very important for clinicians to understand the pathogenesis of delirium and thrombosis in elderly patients with pneumonia, so they can diagnose the disease more quickly, provide the best treatment, and improve prognosis.
Advanced ultrasonography techniques for thyroid gland changes in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy in comparison with normal subjects
Authors: Asih Made Widhi , Antari Luh Putu Laksmi , Martono Budi , Nike Felicia , Ratnasari Putri Ayu
Published: January 2025

Introduction: Radiation therapy to the neck in Nasopharyngeal Carcinoma (NPC) patients could disrupt thyroid function, causing further damage to the thyroid parenchyma and fibrosis. Ultrasonography techniques could detect volume reduction, decreased echogenicity and increased shear-wave elastography. This paper aims to use advanced ultrasonography techniques to measure echogenicity index, color-pixel percentage (CPP), shear-wave elastography (SWE) and volume of the thyroid glands in NPC patients after Intensity-Modulated Radiation Therapy (IMRT) in comparison with normal subjects with an analytical observational study. 
Methods: The patients were selected consecutively from medical records of NPC patients who underwent IMRT using Linear Accelerator (LINAC) in Prof. dr. IGNG Ngoerah Hospital Denpasar between February to July 2023. Thyroid gland ultrasonography was then carried out for the patients at least six months after they completed radiation therapy. Patients were matched with healthy control 1:1. Patients with thyroid surgery, clinically or ultrasound-diagnosed thyroid abnormality, and incomplete medical record data were excluded. We performed an independent T-test and Mann-Whitney U statistical analysis with a confidence interval (CI) of 95%.
Results: The total research subjects were 56 people, consisting of 28 for each case and control group. The median age of subjects in the case group was 51 (33-64) years, while 36 (30-51) years were in the control group. There were also more males in the case group than in the control group (75% vs 42.9%). Independent t-tests were done on normally distributed data in echogenicity index and CPP while we used Mann-Whitney U tests for the remaining variables. Results showed that CPP and SWE from the case group are significantly higher than those of the control group. 
Conclusion: Advanced ultrasonography techniques may detect several components of morphological changes in NPC patients undergoing IMRT. The technique may become the predictor for occult hypothyroidism to improve the quality of life of the patients.
Seven years of intracranial aneurysm: study of epidemiology and outcome
Authors: Fauzi Asra Al , Suroto Nur Setiawan , Ranuh I Gusti Made Aswin Rahmadi , Meizikri Rizki , Wisnawa I Wayan Weda
Published: January 2025

Background: Intracranial aneurysms (IAs) are a common vascular malformation of the central nervous system, with varying mortality rates following aneurysmal subarachnoid hemorrhage (aSAH). In Indonesia, a notably high mortality rate is observed compared to other Southeast Asian countries, highlighting the need for epidemiological data and treatment outcome studies.
Methods: This retrospective study analyzes data from 2016 to 2023, including 132 cases of microsurgical clipping and 104 endovascular treatments for IAs. Demographics, aneurysm locations, presenting Glasgow Coma Scale (GCS) scores, and modified Rankin Scale (mRS) outcomes are evaluated.
Results: Most cases involved ruptured aneurysms in both treatment groups, with comparable mean GCS and mRS scores. A correlation between presenting GCS and mRS outcomes was observed in both groups. Age and comorbidities did not significantly affect outcomes. WFNS scores showed a trend toward worse outcomes in higher-grade cases. Limited epidemiological data on IAs in Indonesia necessitates further research. Treatment choice depends on multiple factors, including age, aneurysm size, and location. The study's even distribution between clipping and endovascular treatment suggests the importance of individualized decision-making. Aneurysms in our institution are commonly located at Acomm, ICA, and MCA. Outcomes are influenced by comorbidities and presenting GCS, while WFNS scores demonstrate a trend toward worse outcomes in higher grades. Individualized treatment decisions are crucial, considering patient-specific factors.
Conclusion: Most intracranial aneurysms are located at AcommA, ICA, and MCA. The outcome of patients with intracranial aneurysms correlates with age, the presence of comorbidity, and the presenting GCS.
Differences between serum transforming growth factor beta 1 (TGF-β1) levels in heart failure with reduced ejection fraction patients with and without type 2 diabetes mellitus
Authors: Lestari Anak Agung Wiradewi , Gacchanti Anak Agung Istri Rani Gacchanti , Subawa Anak Agung Ngurah , Mahartini Ni Nyoman , Herawati Sianny , Mulyantari Ni Kadek , Suastika Luh Oliva Saraswati , Putra I Wayan Gede Artawan Eka , Wangunharjo Tania , Prabawa I Putu Yuda
Published: January 2025

Background: Heart failure with reduced ejection fraction (HFrEF) is a clinical syndrome that results in a decreased cardiac output and/or increased intracardiac pressure with left ventricular ejection fraction (LVEF) <40%. Type 2 diabetes mellitus (T2DM) is often linked to a comorbidity of heart failure, but the differences in tissue damage between patients with and without T2DM have not been extensively studied. One of the markers that can be used for evaluating the tissue damage is TGF-β1. This study aims to assess the differences between serum TGF-β1 levels in HFrEF patients with and without T2DM.
Methods: This study is an analytical observational research with a cross-sectional study design, conducted at Prof. dr. I.G.N.G Ngoerah General Hospital. The study subjects were HFrEF patients aged ≥18 years old treated at a cardiology outpatient clinic, and divided into 2 groups, with and without T2DM. The TGF-β1 level was tested from blood samples using the ELISA method. Subject’s characteristics and differences in TGF-β1 levels were analyzed using the SPSS software, with a p-value <0.05 is considered significant.
Results: This study included 78 subjects, consisting of 42 subjects with T2DM and 36 subjects without T2DM. The mean level of TGF-β1 in HFrEF patients with T2DM was 428.57 pg/mL, while in patients without T2DM, it was 730.71 pg/mL. The difference in TGF-β1 level was 302.14 pg/mL (p <0.05).
Conclusion: Serum TGF-β1 level in HFrEF patients without T2DM was higher and significantly different compared to patients with T2DM.
Laparoscopic pancreatoduodenectomy: our clinical experience in a tertiary hospital in Indonesia
Authors: Fuadi Ahmad Fathi , Prabowo Erik
Published: January 2025

Background: Pancreatoduodenectomy (PD) is one of the most complex abdominal surgery procedures. Laparoscopic PD (LPD) has spread rapidly over the last decade due to the new development of laparoscopic devices and a better understanding of anatomy. The LPD offers reduced blood loss, less postoperative pain, shorter hospital stays, and minimal operative scars compared to Open PD (OPD). However, the LPD has a steep learning curve. In this article, we reported our cases of LPD in our hospital in Indonesia. We hope this report will support the development of advanced laparoscopic surgery in Indonesia.
Methods: We took data from medical records of patients who underwent LPD from 2017 to 2023. We collect demographic information, surgery duration, intraoperative blood loss, pathologic report, pancreatic fistula, and postoperative length of stay (LOS). We divided the data into two groups and compared our data before and after forming the team for LPD surgery. The ethical approval was obtained from the hospital review board.
Results: We analyzed 22 LPDs from 2017-2023. There were 12 LPDs performed in 2019-2020 by non-team setting and 10 LPDs performed in 2022-2023 by the team. Fourteen patients were males, and eight were females, with the mean age being 50 years. There was an improvement in intraoperative blood loss and duration of surgery after we formed the team. There were three postoperative pancreatic fistulas (POPF) and three mortalities. The mean postoperative LOS was 20 days from seven and 10 days from nine cases before and after team formation.
Conclusion: The high-volume center and the team protocol help surgeons effectively overcome the steep learning curve of LPD.
Contribution of SIRS and sepsis on the outcomes of patients with burn injuries in Dr. Soetomo Teaching Hospital
Authors: Perkasa-Hendropriyono Alexander Akbar Wiratama , Saputro Iswinarno Doso , Dianti Yuanita Safitri
Published: January 2025

Introduction: Sepsis can be defined as a systemic inflammatory response syndrome (SIRS) accompanied by a suspected or documented infection. One of the things that is often the concern of health workers in the management of burns is the presence of infections and permanent sepsis, as these are the leading causes of morbidity and mortality in patients with burns. This study aims to assess burn injuries patients with SIRS and SIRs accompanied by sepsis in one of the hospitals in Indonesia by identifying their mortality rates, length of hospitalization, potential risk factors in the patient's body, organ complications and the percentage of patients affected by SIRS accompanying sepsis to know the contribution of SIRs and SEPSIS to the outcome.
Methods: The research design used is retrospective, with data sources derived from secondary data. In its implementation, the study uses the total sampling method, where all data of burn patients treated at Burn Center Dr. Soetomo Teaching Hospital Surabaya from 2020-2023 are included as samples. Research data will be processed and analyzed using SPSS by Mann Whitney and the Chi-Square test. All findings from this analysis will be presented in table form for interpretation and analysis.
Results:  The average rating in cases where SIRS occurred, the LOS was more prolonged than in cases where SIRS did not occur. SIRS has an effect on LOS. There was a significant difference in LOS between cases where sepsis and sepsis did not occur.
Conclusion: Our results show a significant relationship between SIRS and the occurrence of sepsis, TBSA, and the occurrence of SIRS and sepsis, SIRS and sepsis on outcome (LOS and mortality). Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus hemolytic are the germs most commonly found in culture cultures.
A comprehensive and coordinated family support increasing the quality of life for cervical cancer patient after chemotherapy: a cohort study
Authors: Abuere Elsa Stellamary Ariesany , Arifuddin Sharvianty , Qadar Sriwijaya , Sunarmo Isharyah Surjandari Kambaliretno
Published: January 2025

Backgroundː Cervical cancer causes physical and psychological symptoms that can reduce the quality of life. Chemotherapy as a treatment modality for cervical cancer can cause side effects. However, there is an improvement in symptoms associated with successful treatment, which can also affect the quality of life. This study aims to determine the relationship between social support and the quality of life of people with cervical cancer before and after chemotherapy.
Methodsː Prospective observational study with a cohort design in cervical cancer patients above stage IIB before receiving chemotherapy and after chemotherapy. Quality of life data was collected using the Indonesian version of the WHO-QLQ-Cx24, and the validated Family Support questionnaire was filled out. Data were analyzed using the Wilcoxon test.
Resultsː Collected 120 cervical cancer patients above stage IIB, most of whom were less than 50 years old, had more than 9 years of education, did not work, were multiparous, had a normal BMI, and had their first sexual contact more than 5 years. Family support was significantly increased before and after chemotherapy (p < 0.05). There was a significant improvement in patient quality of life-based on the EORTC QLQ-Cx24 score before and after chemotherapy (p < 0.05).
Conclusionsː Good social support improves the quality of life for cervical cancer patients after chemotherapy. The social support feature that is significantly related to increasing the quality of life of cervical cancer patients after chemotherapy is overall support, which means comprehensive and coordinated social support.
Correlation of Modic type endplate to Oswestry Disability Index (ODI) and lumbopelvic angle parameters in Low Back Pain (LBP) patient cause of lumbar spondylosis
Authors: Situmorang Erika Tiurma Uli , Nelwan Dario Agustino , Arif Besse Arfiana , Hamid Firdaus , Biakto Karya Triko , Muis Mirna
Published: January 2025

Background: Endplate defects, such as Modic-type endplates, are linked to lumbar spondylosis and low back pain (LBP). Evaluating lumbar vertebrae sagittal alignment and using the Oswestry Disability Index (ODI) score is essential for assessing lumbar degenerative diseases. Assessing lumbopelvic parameters is crucial for evaluating sagittal alignment, which predicts the development of Modic-type endplates and related defects. This study aims to determine Modic-type endplates using magnetic resonance imaging (MRI) and explore their correlation with ODI scores and lumbopelvic angle parameters using weight-bearing images in patients with lumbar spondylosis.
Methods: This observational analytic study with a cross-sectional design was conducted from October 2023 until the required number of samples was achieved. Participants were patients with low back pain who underwent lumbosacral MRI examinations and lumbosacral weight-bearing imaging at our center. Statistical analyses were conducted using SPSS version 26.0. P-value £0.05 was considered statistically significant.
Results: A total of 41 subjects with lumbar spondylosis were included in this study. There was no correlation between the Modic endplate type and lumbar lordosis angle, pelvic incidence, or sacral slope. However, a statistically significant correlation was found with pelvic tilt angle, indicating that a lower angle corresponds to a higher Modic type (p < 0.05). There was no correlation between the Modic type endplate and the ODI score or between the ODI score and any lumbopelvic parameters (p > 0.05).
Conclusion: Modic endplate types correlate with pelvic tilt angle in these patients. This study did not find a significant correlation of modic type with ODI score and lumbopelvic parameters.
Association of Laminin subunit gamma-2 (LAMC2) gene expression with hepatic metastasis in colorectal cancer patient: An observational study
Authors: Hak Opi Zianul , Lukman Kiki , Rudiman Reno , Sulthana Bambang Am Am Setya , Sribudiani Yunia , Nugraha Prapanca
Published: January 2025

Link of Video Abstract: https://youtu.be/niQyXOLjEnk
 
Background: Laminin subunit gamma-2 (LAMC2) is a novel biomarker in the tumorigenesis of colorectal cancer and has been associated with metastasis and prognosis of the disease. This study investigates the potential association between LAMC2 gene expression and hepatic metastasis, aiming to evaluate its potential as a reliable predictor of metastasis in colorectal cancer patients.
Methods: This is an observational analysis of data from patients with colorectal cancer, collected between January and April 2024 at the Centre for Genetic Studies, Faculty of Medicine, Universitas Padjadjaran, Bandung City, West Java, Indonesia. Tumor tissues were obtained via biopsy or surgical resection. The LAMC2 expression was measured through quantitative real-time PCR (qt-PCR). ANOVA and T-test analyses were done to assess the mean difference in LAMC2 expression levels in colorectal cancer patients with and without hepatic metastasis.
Results: The expression of LAMC2 did not show any significant differences between sex, anatomical pathology, tumor location, stage, and metastases. But there were significant differences between early onset and late onset (P = 0.029); patients with late onset showed a higher mean of LAMC2 expression.
Conclusion: Our investigation revealed no association between the expression levels of LAMC2 and the occurrence of hepatic metastasis in colorectal cancer. Nevertheless, it is anticipated that future studies employing larger sample sizes will provide more comprehensive insights. Moreover, the exploration of LAMC2 as a potential target for anticancer therapy warrants further consideration and development in subsequent research endeavors.
Versatile low-cost ophthalmic wet lab device to improve diagnostic and surgical eye training
Authors: Mardianto Umar , Victor Andi Arus , Yusuf Prasandhya Astagiri , Juniantito Vetnizah , Kekalih Aria , Rahayu Tri , Bustamam Alhadi , Edwar Lukman
Published: January 2025

Introduction: Cataracts and glaucoma are the leading causes of worldwide blindness, accounting for more than 50% of blindness cases. Blindness from this condition could be treated before severe vision loss occurs. Cataract and glaucoma surgery can be performed to achieve better conditions. Training conducted by ophthalmologists for eye examinations and surgeries is carried out in wet laboratories. So, tools are needed to help facilitate training for eye examinations and surgeries, one of which is an eye holder made of affordable materials with an easy manufacturing method.
Methods: The eye holder of experimental animals is designed in 3D with a funnel shape that resembles an orbital eye socket. The author made a 3D printing design to optimize the use of this device in wet lab activities.
Results: Experimental animal eye holders could potentially be used for 1.) Ultrasound Biometry, 2.) Handheld Keratometry, 3.) Tonometry, and 4.) Training in ophthalmological surgical techniques. These activities can be performed stable on the animal’s eyes inside the holder in flat and inclined positions.
Conclusion: This versatile experimental animal eye holder has great potential for use in wet lab activities in conducting diagnostic and surgical training by veterinary students specializing in ophthalmology, general practitioners training to become ophthalmology specialists, and optometry students.
Effects of asymmetry in Kondo channels on thermoelectric efficiency
Authors: Nguyen T. K. T. , Cao T. B. , Chu T. A. , Nguyen T. L. H. , Nguyen H. Q. , Kiselev M. N.
Published: January 2025

We revisit an asymmetric two-channel charge Kondo model, which has been studied in the [Phys. Rev. B  82 (2010) 113306]. A nano-device modelling two-channel Kondo physics is a large metallic quantum dot which is embedded into a two-dimensional electron gas (2DEG) and connected strongly to two electrodes through two almost transparent single-mode quantum point contacts. The 2DEG is in the integer quantum Hall regime [Z. Iftikhar et al., Nature (London) 526 (2015) 233]. The reflection amplitudes at the quantum point contacts are asymmetric. We find that the thermopower and the figure of merit are decreased but the Kondo resonance width and Lorenz number in the vicinity of the Coulomb peak are lifted due to the effects of asymmetry in Kondo channels. We propose the method to improve the thermoelectric efficiency of the device.
Implementation of atmospheric proton spectrum in GEANT4 simulations for space applications
Authors: Topuz Ahmet Ilker
Published: January 2025

A major part of cosmic rays consists of the primary protons, and this portion plays a crucial role in the space applications such as shielding of spacecrafts. In this study, the proton flux values measured at the top of the atmosphere through the BESS-TeV spectrometer in 2004 are introduced into the GEANT4 simulations by using a probability grid that generates the corresponding discrete kinetic energies with a certain discrete probability. The introduced scheme is tested over a set of the shielding materials such as aluminum, polypropylene, Kevlar, polyethylene, and water by computing the total absorbed dose, which is the measure of the cumulative energy deposited in the investigated target volumes by protons per unit mass in Gy. It is shown that the present recipe provides the opportunity to use the discrete energy values together with the experimental flux values, thereby demonstrating a beneficial capability in the GEANT4 simulations for diverse space applications.
WhatsApp integration by business studies teachers to promote collaboration among learners
Authors: Gcabashe Nduduzo Brian
Published: January 2025

The pervasiveness of various social media platforms and its use among young people have strengthened collaborative learning across different contexts. With this study I explored the integration of WhatsApp by business studies teachers to promote collaboration among learners. This qualitative study is located within an interpretive paradigm and framed on social constructivism theory. Six business studies teachers were purposively selected from 6 secondary schools located in Mkhanyakude district in the KwaZulu-Natal province, South Africa. Data were collected through individual semi-structured interviews. Thematic analysis was employed to analyse the data. I found that WhatsApp is important in promoting collaborative learning among learners and that integrating WhatsApp in business studies instructional practices facilitates networking among learners. However, it appeared that collaboration among learners was mainly restricted to online and afterschool hours. I therefore recommend that business studies teachers ensure that the same level of collaboration among learners on WhatsApp also occurs in business studies classrooms. This may be achieved by incorporating educational material used during WhatsApp-based instruction in their lessons for learners to see the value of virtual and physical collaborating with their peers.