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Background When the brain is deprived of oxygen and nutrients due to stenosis or arterial rupture, neurons in the affected area suffer irreversible damage and cellular death. MicroRNA has been shown to regulate target genes implicated in arterial hypertension, atherosclerosis, and diabetes mellitus, all of which influence the risk of ischemic stroke through inflammation, oxidative stress, cell proliferation, and apoptosis. The study aims to determine the changes in miRNA expression, namely miRNA-21, between acute ischemic stroke patients and controls and their relationship to proinflammatory cytokines, clinical severity, and outcome. Methods Serum samples from tertiary hospitals and controls were used to evaluate miRNA-21 expression as well as cytokines TNF-α, IL-10, ICAM-1, and CCL5 levels within 7 days of stroke onset. The 30-day clinical severity and outcome were assessed using the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS), respectively. Result A total of 64 acute ischemic stroke patients and 22 age-matched controls were recruited, with median ages of 56 and 55.5 years old, respectively. There were more male subjects than females (35 to 29). A statistically significant difference was observed in miRNA-21 expression between patients and controls ( p Conclusion Our study demonstrated increased miRNA-21 expression and proinflammatory cytokine expression in acute ischemic stroke patients relative to controls. However, this was not related to clinical severity or clinical outcomes.

Background Indonesia is one of the countries that is endemic to avian influenza virus subtype H9N2. This study aims to compare the molecular characteristics of avian influenza virus (AIV) subtype H9N2 from West Java. Methods Specific pathogen-free (SPF) embryonated chicken eggs were used to inoculate samples. RNA extraction and RT–qPCR confirmed the presence of H9 and N2 genes in the samples. RT–PCR was employed to amplify the H9N2-positive sample. Nucleotide sequences were obtained through Sanger sequencing and analyzed using MEGA 7. Homology comparison and phylogenetic tree analysis, utilizing the neighbor-joining tree method, assessed the recent isolate’s similarity to reference isolates from GenBank. Molecular docking analysis was performed on the HA1 protein of the recent isolate and the A/Layer/Indonesia/WestJava-04/2017 isolate, comparing their interactions with the sialic acids Neu5Ac2-3Gal and Neu5Ac2-6Gal. Results RT–qPCR confirmed the isolate samples as AIV subtype H9N2. The recent virus exhibited 11 amino acid residue differences compared to the A/Layer/Indonesia/WestJava-04/2017 isolate. Phylogenetically, the recent virus remains within the h9.4.2.5 subclade. Notably, at antigenic site II, the recent isolate featured an amino acid N at position 183, unlike A/Layer/Indonesia/WestJava-04/2017. Molecular docking analysis revealed a preference of HA1 from the 2017 virus for Neu5Ac2-3Gal, while the 2023 virus displayed a tendency to predominantly bind with Neu5Ac2-6Gal. Conclusion In summary, the recent isolate displayed multiple mutations and a strong affinity for Neu5Ac2-6Gal, commonly found in mammals.

Background Non-union fractures can be prevented with bone grafts, such as hydroxyapatite made from green mussel shells. Green mussel shells contain a high percentage of HA, making them a promising alternative for bone healing. This research aims to reveal the effectiveness of green mussel shell HA as a bone substitute material and to provide knowledge for further research. Methods This research was conducted for four months using a true experimental research method with a post-test-only control group design. This study used 36 New Zealand rabbits ( Oryctolagus cuniculus) which were divided into 9 groups: positive control, negative control, and intervention at weeks 2, 4 and 6 after the intervention. All groups were subjected to three general procedures: pre-surgery, surgery, and post-surgery. This study utilized histological evaluation and biochemical assessment, specifically measuring serum alkaline phosphatase (ALP) levels, to investigate the effects of hydroxyapatite (HA) from green mussel shells on bone healing in rabbits. Results The findings demonstrated that green mussel shell HA hashad efficacy in accelerating bone healing, better than HA bovine HA i.e. green mussel shell hydroxyapatite showed superior efficacy compared to bovine hydroxyapatite in accelerating and maximizing fracture healing, as compared to the 6-week negative control group and demonstrated a significant difference ( p < 0.05). Conclusions Green mussel hydroxyapatite is proven to be able to fasten and maximize the bone healing process as fast as bovine HA, and even has higher efficacy than bovine HA.

Background Indonesia is one of the countries that is endemic to avian influenza virus subtype H9N2. This study aims to compare the molecular characteristics of avian influenza virus (AIV) subtype H9N2 from West Java. Methods Specific pathogen-free (SPF) embryonated chicken eggs were used to inoculate samples. RNA extraction and RT–qPCR confirmed the presence of H9 and N2 genes in the samples. RT–PCR was employed to amplify the H9N2-positive sample. Nucleotide sequences were obtained through Sanger sequencing and analyzed using MEGA 7. Homology comparison and phylogenetic tree analysis, utilizing the neighbor-joining tree method, assessed the recent isolate’s similarity to reference isolates from GenBank. Molecular docking analysis was performed on the HA1 protein of the recent isolate and the A/Layer/Indonesia/WestJava-04/2017 isolate, comparing their interactions with the sialic acids Neu5Ac2-3Gal and Neu5Ac2-6Gal. Results RT–qPCR confirmed the isolate samples as AIV subtype H9N2. The recent virus exhibited 11 amino acid residue differences compared to the A/Layer/Indonesia/WestJava-04/2017 isolate. Phylogenetically, the recent virus remains within the h9.4.2.5 subclade. Notably, at antigenic site II, the recent isolate featured an amino acid N at position 183, unlike A/Layer/Indonesia/WestJava-04/2017. Molecular docking analysis revealed a preference of HA1 from the 2017 virus for Neu5Ac2-3Gal, while the 2023 virus displayed a tendency to predominantly bind with Neu5Ac2-6Gal. Conclusion In summary, the recent isolate displayed multiple mutations and a strong affinity for Neu5Ac2-6Gal, commonly found in mammals.

Background Non-union fractures can be prevented with bone grafts, such as hydroxyapatite made from green mussel shells. Green mussel shells contain a high percentage of HA, making them a promising alternative for bone healing. This research aims to reveal the effectiveness of green mussel shell HA as a bone substitute material and to provide knowledge for further research. Methods This research was conducted for four months using a true experimental research method with a post-test-only control group design. This study used 36 New Zealand rabbits (Oryctolagus cuniculus) which were divided into 9 groups: positive control, negative control, and intervention at weeks 2, 4 and 6 after the intervention. All groups were subjected to three general procedures: pre-surgery, surgery, and post-surgery. This study utilized histological evaluation and biochemical assessment, specifically measuring serum alkaline phosphatase (ALP) levels, to investigate the effects of hydroxyapatite (HA) from green mussel shells on bone healing in rabbits. Results The findings demonstrated that green mussel shell HA hashad efficacy in accelerating bone healing, better than HA bovine HA i.e. green mussel shell hydroxyapatite showed superior efficacy compared to bovine hydroxyapatite in accelerating and maximizing fracture healing, as compared to the 6-week negative control group and demonstrated a significant difference (p < 0.05). Conclusions Green mussel hydroxyapatite is proven to be able to fasten and maximize the bone healing process as fast as bovine HA, and even has higher efficacy than bovine HA.

Introduction Essential oil treatment has been explored as a potential alternative medicine, as these therapies can induce calming and sedative effects by acting on the neuro-limbic system and upregulating neurotransmitter synthesis. Objectives This paper aims to assess the impact of essential oil interventions on aggressive behavior in people with dementia. Methods The literature search was carried out through six databases. The outcomes of interest were the survival risk and post-treatment score of the Cohen-Mansfield Agitation Inventory (CMAI), Neuropsychiatric Inventory (NPI), and Quality of Life (QoL). Quality appraisal was done using RoB 2.0, while meta-analysis was done using RevMan 5.4. This systematic review has been registered to the PROSPERO database (CRD42023476844). Results We analyzed 11 included studies with 1,418 patients. RoB 2.0 analysis resulted in eight low-risk-of-bias and three high-risk-of-bias studies. This study suggests that essential oil interventions lead to statistically significant improvements in survival risk with moderate heterogeneity [OR = 0.63 (95% CI: 0.41, 0.98, p = 0.04; I 2 = 74%)]. This study also found a significant improvement in NPI scores following the use of essential oils [SMD = -2.97 (95% CI = -5.61, -0.32, p = 0.03; I 2 = 98%)], but no statistically significant improvements were found in CMAI scores [SMD = 0.17 (95% CI = 0.37, 0.71, p = 0.53; I 2 = 74%)]. The QoL assessment showed a trend favoring the control group after implementing essential oil treatments [SMD = 4.89 (95% CI = 1.51, 8.27, p = 0.005; I 2 = 98%)]. Conclusions Essential oil is a potential approach in alleviating the agitated behavior of dementia patients considering its survival risk and some parameters, such as NPI, CMAI, and QoL score. However, more studies regarding essential oils on these parameters should be done, especially studies with specific main ingredients of the essential oil.

Background High infection rates of COVID-19 in Indonesia require attention, especially transmission and prevention behaviors. One way to lower infection rates is the use of face masks. However, people’s adherence to its usage when in public is still low. This necessitates the exploration of predictors of the use of masks to increase community compliance. This study further aims to investigate the predictors of face mask use by applying the Health Belief Model, anxiety, stress, depression, and health motivation. Methods A total of 255 respondents from Jakarta, Bandung, Tangerang, and Banten filled out an online questionnaire. Furthermore, hierarchical multiple regression was used to detect predictors associated with face mask use. Results The results showed that the high perceived benefits and health motivation were higher in individuals who used a face mask when in public, while those who have high perceived barriers likely do not use masks. The respondent’s level of psychological distress, including depression, anxiety, and stress were not associated with face mask use. Conclusions These findings highlight the importance of personal appraisal regarding COVID-19 and its prevention behaviors. Comfortable mask design, and emphasizing the benefits of using masks in the community improve compliance.

Background High infection rates of COVID-19 in Indonesia require attention, especially transmission and prevention behaviors. One way to lower infection rates is the use of face masks. However, people’s adherence to its usage when in public is still low. This necessitates the exploration of predictors of the use of masks to increase community compliance. This study further aims to investigate the predictors of face mask use by applying the Health Belief Model, anxiety, stress, depression, and health motivation. Methods A total of 255 respondents from Jakarta, Bandung, Tangerang, and Banten filled out an online questionnaire. Furthermore, hierarchical multiple regression was used to detect predictors associated with face mask use. Results The results showed that the high perceived benefits and health motivation were higher in individuals who used a face mask when in public, while those who have high perceived barriers likely do not use masks. The respondent’s level of psychological distress, including depression, anxiety, and stress were not associated with face mask use. Conclusions These findings highlight the importance of personal appraisal regarding COVID-19 and its prevention behaviors. Comfortable mask design, and emphasizing the benefits of using masks in the community improve compliance.

Limb ischemia is a complication of peripheral artery disease (PAD)which can lead to amputation. Amputation occurs in approximately 3-4% of PAD patients. In Indonesia, post-amputation patients are only hospitalized for the acute phase and the post-amputation rehabilitation programs must be done as an outpatient. This could be a barrier to the continuity of rehabilitation programs. A solution is the application of home-based rehabilitation programs. A 57-year-old female was referred from the Cardiothoracic Surgery Outpatient Clinic post-amputation with bilateral below-knees and partial-hands amputation after being diagnosed with PAD. On initial examination, all her elbows, wrists, thumbs, hips, and knees showed weakness. The patient received neuromuscular electrical stimulations (NMES) as well as a home-based rehabilitation programs. On the second examination, after considering the data from the clinical finding and supporting examination, the patient received bilateral below-knee prostheses and bilateral functional partial-hand prostheses, created using 3D printing technology with polylactic acid material. After a few months, she was able to do most of her activities of daily living (ADLs) independently, work as a shopkeeper in her store, and feel more confident interacting with others. A comprehensive rehabilitation programs, patient adherence to exercise, and caregiver support are critical to improving functional capacity and the quality of life in a patient with bilateral below-knee and bilateral partial-hand amputation caused by PAD.

Background: Some Ebola vaccines have been developed and tested in phase III clinical trials. However, assessment of whether public have willingness to purchase or not, especially in unaffected areas, is lacking. The aim of this study was to determine willingness to pay (WTP) for a hypothetical Ebola vaccine in Indonesia. Methods: A cross-sectional study was conducted from 1 August to 30 December 2015 in five cities in Aceh province of Indonesia. Patients’ family members who visited outpatient departments were approached and interviewed about their sociodemographic characteristics, knowledge of Ebola, attitude towards vaccination practice and their WTP for a hypothetical Ebola vaccine. A multivariable linear regression model assessed the relationship between these explanatory variables and WTP. Results: During the study, 500 participants were approached and interviewed. There were 424 (84.8%) respondents who completed the interview and 74% (311/424) expressed their acceptance for an Ebola vaccine. There were 288 participants who were willing to pay for an Ebola vaccine (92.6% out of 311). The mean of WTP was US$2.08 (95% CI: 1.75-2.42). The final multivariable model indicated that young age, high educational attainment, working as a private employee, entrepreneur or civil servant (compared to farmers), being unmarried, and residing in a suburb (compared to a city) were associated with higher WTP. Conclusions: Although the proportion of the participants who would accept the Ebola vaccine was relatively high, the amount they were willing to pay for Ebola vaccine was very low. This finding would indicate the need of subsidies for Ebola vaccine in the country.

Background: A non-union fracture is one of the most common complications arising from an untreated fracture. Bone grafts are able to fasten bone healing which can prevent and cure non-union fractures. Therefore, alternative hydroxyapatite bone grafts from waste resources are needed to increase the availability of bone grafts in the healthcare system. A bone substitute, hydroxyapatite (HA), has the ability to prevent non-union fractures. Green mussel shell contains 95.69 percent HA, allowing for an annual production of 133.97–287.07 tons per ha of HA, and is a potent alternative material in the manufacture of HA. Methods: This research was conducted for four months using a true experimental research method with a post-test-only control group design. This study used 36 New Zealand rabbits ( Oryctolagus cuniculus) which were divided into 9 groups: positive control, negative control, and intervention at weeks 2, 4 and 6 after the intervention. All groups were subjected to three general procedures: pre-surgery, surgery, and post-surgery. Results: The findings demonstrated that green mussel shell HA has efficacy in accelerating bone healing, better than HA bovine, as compared to the 6-week negative control group and demonstrated a significant difference ( p < 0.05). Conclusions: Green mussel hydroxyapatite is proven to be able to fasten and maximize the bone healing process as fast as bovine HA, and even has higher efficacy than bovine HA.

Background: Salivary orosomucoid 1 (ORM1) is highly increased in hepatocellular carcinoma related to hepatitis B. Thus, this systematic review aimed to investigate the diagnostic and prognostic value of salivary orosomucoid 1 (ORM1) in patients with that mentioned disease. Methods: The sources included were original articles published from 2013 until 2023 (last date searched, January 2023) from 4 databases (ProQuest, Google Scholar, Springer, and ScienceDirect). The inclusion criteria were original research articles (observational cohort or diagnostic studies). Other article reviews, meta-analyses, non-comparative research, and in silico, in vitro and in vivo studies, technical reports, editor responses, conference abstracts, non-English, non-full-text, and irrelevant articles that were not related to either salivary ORM1, or hepatocellular carcinoma, hepatitis B, or kidney failure were excluded. Then, the ROBINS-I taken was used to assess bias. The result was constructed with PICOS criteria within the table created in the Google spreadsheet. This systematic review followed the PRISMA guidelines. Results: Five diagnostic studies with 533 samples conducted in China and Japan. Limited original studies with homogenous PICO were a limitation, but the evidence output of this study can still be well presented. Salivary ORM1 may be useful to detect early cancer diagnosis as rapidly increased levels of ORM1 can be observed in the early stages of HCC (four times higher than usual) and the biomarker has a sensitivity of 81.67% and a specificity of 77.5%. This biomarker can detect the prognosis of individuals with the disease with or without chemotherapy. It is because level of salivary ORM1 related to liver damage, the higher the level of ORM1, the more liver damage occurs which leads to a poorer prognosis. Conclusions: Salivary ORM1 is a potential early diagnostic biomarker of HCC related to hepatitis B and a biomarker of the disease prognosis. Registration: Open Science Framework (OSF) (March 16, 2023).

Background: Some Ebola vaccines have been developed and tested in phase III clinical trials. However, assessment of whether public have willingness to purchase or not, especially in unaffected areas, is lacking. The aim of this study was to determine willingness to pay (WTP) for a hypothetical Ebola vaccine in Indonesia. Methods: A cross-sectional study was conducted from 1 August to 30 December 2015 in five cities in Aceh province of Indonesia. Patients’ family members who visited outpatient departments were approached and interviewed about their sociodemographic characteristics, knowledge of Ebola, attitude towards vaccination practice and their WTP for a hypothetical Ebola vaccine. A multivariable linear regression model assessed the relationship between these explanatory variables and WTP. Results: During the study, 500 participants were approached and interviewed. There were 424 (84.8%) respondents who completed the interview and 74% (311/424) expressed their acceptance for an Ebola vaccine. There were 288 participants who were willing to pay for an Ebola vaccine (92.6% out of 311). The mean of WTP was US$2.08 (95% CI: 1.75-2.42). The final multivariable model indicated that young age, high educational attainment, working as a private employee, entrepreneur or civil servant (compared to farmers), being unmarried, and residing in a suburb (compared to a city) were associated with higher WTP. Conclusions: Although the proportion of the participants who would accept the Ebola vaccine was relatively high, the amount they were willing to pay for Ebola vaccine was very low. This finding would indicate the need of subsidies for Ebola vaccine in the country.

Mycoses or fungal infections are a general health problem that often occurs in healthy and immunocompromised people in the community. The development of resistant strains in Fungi and the incidence of azole antibiotic resistance in the Asia Pacific which reached 83% become a critical problem nowadays. To control fungal infections, substances and extracts isolated from natural resources, especially in the form of plants as the main sources of drug molecules today, are needed. Especially from Piperaceae, which have long been used in India, China, and Korea to treat human ailments in traditional medicine. The purpose of this review is to describe the antifungal mechanism action from Piper crocatum and its phytochemical profiling against lanosterol 14a demethylase CYP51. The methods used to search databases from Google Scholar to find the appropriate databases using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Flow Diagram as a clinical information retrieval method. From 1.150.000 results searched by database, there is 73 final results article to review. The review shows that P. crocatum contains flavonoids, tannins, terpenes, saponins, polyphenols, eugenol, alkaloids, quinones, chavibetol acetate, glycosides, triterpenoids or steroids, hydroxychavikol, phenolics, glucosides, isoprenoids, and non-protein amino acids. Its antifungal mechanisms in fungal cells occur due to ergosterol, especially lanosterol 14a demethylase (CYP51) inhibition, which is one of the main target sites for antifungal activity because it functions to maintain the integrity and function of cell membranes in Candida. P. crocatum has an antifungal activity through its phytochemical profiling against fungal by inhibiting the lanosterol 14a demethylase, make damaging cell membranes, fungal growth inhibition, and fungal cell lysis.

Incorporating eels and tempe can replace and complement the content of proteins, macronutrients, and micronutrients, which may be related to curative effects for malnutrition. In addition, converting the ingredients into a form of flour can increase their shelf life and nutrient concentration. Therefore, an in vivo approach was undertaken to explore further the nutritional status value of biomarkers in malnourished male rats ( Rattus norvegicus) after Eel and Tempe Composite (ETC) flour supplementation. Data was collected from blood samples (both plasma and serum) of rats in all groups, and the appropriate biomarkers were analyzed. The final data presented in this study is openly available and can be further analyzed using statistical means to determine the dose of ETC flour as the basis of clinical trials, which other researchers can reproduce. This data may also be valuable for those interested in using different analytical methods to research the same questions or even new preclinical studies focusing solely on nutritional status biomarker analysis methods, including clinical trial prospects.

Background: Salivary orosomucoid 1 (ORM1) is highly increased in hepatocellular carcinoma related to hepatitis B. Thus, this study aims to investigate the role of salivary ORM1 as an early diagnostic and prognostic biomarker of HCC related to hepatitis B. Methods: The sources included were original articles published from 2013 until 2023 (last date searched, January 2023) from ProQuest, Google Scholar, Springer, and ScienceDirect. The inclusion criteria were original research articles (observational cohort or diagnostic studies). Other article reviews, meta-analyses, non-comparative research, and in silico, in vitro and in vivo studies, technical reports, editor responses, conference abstracts, non-English, non-full-text, and irrelevant articles that were not related to either salivary ORM1, or hepatocellular carcinoma, hepatitis B, or kidney failure were excluded. Then, the ROBINS-I took was used to assess bias . The result was constructed with PICOS criteria within the table created in the google spreadsheet. This systematic review followed the PRISMA guidelines. Results: We included five diagnostic studies with 533 samples conducted in China and Japan. Even though limited original studies with homogenous PICO was a limitation, the evidence output of this study can still be well presented. Salivary ORM1 may be useful to detect early cancer diagnosis as rapidly increased levels of ORM1 can be observed in the early stages of HCC (four times higher than usual) and the biomarker has a sensitivity of 81.67% and a specificity of 77.5%. This biomarker is also able to detect the prognosis of individuals with the disease with or without chemotherapy because the higher the level of ORM1, the more liver damage occurs that leads to a poorer prognosis. Conclusions: Salivary ORM1 is a potential early diagnostic biomarker of HCC related to hepatitis B and a biomarker of the disease prognosis. Registration: Open Science Framework (OSF) (March 16, 2023).

Introduction: Grapsus albolineatus is thought to have a high concentration of carotenoid pigments. Although studies on male G. albolineatus have been conducted, no studies on pigment extraction from female G. albolineatus have been carried out. Carotenoids have a high ability to fight free radicals. Previous research has shown that carotenoids can fight free radicals that cause premature skin-aging. Aim: The purpose of this research was to find out what kinds of carotenoids are found in G. albolineatus and whether they can act as natural inhibitors of proteins that cause premature aging, such as glucogenase, elastase, and hyaluronidase enzymes. Methods: Carotenoids were extracted from G. albolineatus using column chromatography and high-performance liquid chromatography (HPLC); molecular docking and visualization were done with Autodock 4.2 and Discovery Studio/Biovia, respectively. Results: According to HPLC data, there are carotenoid pigments such as didehydroastaxanthin, tetrahydroastaxanthin, dihydroastaxanthin, diatoxanthin, astaxanthin, and adonixanthin. According to molecular docking experiments, pigment carotenoids from G. albolineatus are efficient inhibitors of protein elastase and hyaluronidase with binding energy range -7.58 kcal/mol - -9.03 kcal/mol and -6.16 kcal/mol - -7.71 kcal/mol, respectively. Conclusions: G. albolineatus carotenoids have the potential to be anti-aging since they are more effective as protein elastase and hyaluronidase inhibitors than their native inhibitors.

Mycoses or fungal infections are general health problem that often occurs in healthy and immunocompromised people in the community. The development of resistant strains in Fungi and the incidence of azole antibiotic resistance in the Asia Pacific which reached 83% become a critical problem nowadays. To control fungal infections, substances and extracts isolated from natural resources, especially in the form of plants as the main sources of drug molecules today, are needed. Especially from Piperaceae, which have long been used in India, China, and Korea to treat human ailments in traditional medicine. The purpose of this review is to describe the antifungal mechanism action from Piper crocatum and its phytochemical profiling against lanosterol 14a demethylase CYP51. The methods used to search databases from Google Scholar to find the appropriate databases using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Flow Diagram as a clinical information retrieval method. From 1.150.000 results searched by database, there is 73 final results article to review. The review shows that P. crocatum contains flavonoids, tannins, terpenes, saponins, polyphenols, eugenol, alkaloids, quinones, chavibetol acetate, glycosides, triterpenoids or steroids, hydroxychavikol, phenolics, glucosides, isoprenoids, and non-protein amino acids. Its antifungal mechanisms in fungal cells occur due to ergosterol especially lanosterol 14a demethylase (CYP51) inhibition, which is one of the main target sites for antifungal activity because it functions to maintain the integrity and function of cell membranes in Candida. P. crocatum has an antifungal activity through its phytochemical profiling against fungal by inhibiting the lanosterol 14a demethylase, make damaging cell membranes, fungal growth inhibition, and fungal cell lysis.

Background: High infection rates of COVID-19 in Indonesia require attention, especially transmission and prevention behaviors. One way to lower infection rates is the use of face masks. However, people’s adherence to its usage when in public is still low. This necessitates the exploration of predictors of the use of masks to increase community compliance. This study further aims to investigate the predictors of face mask use by applying the Health Belief Model, anxiety, stress, depression, and health motivation. Methods: A total of 255 respondents from Jakarta, Bandung, Tangerang, and Banten filled out an online questionnaire. Furthermore, hierarchical multiple regression was used to detect predictors associated with face mask use. Results: The results showed that the high perceived benefits and health motivation were higher in individuals who used a face mask when in public, while those who have high perceived barriers likely do not use masks. The respondent’s level of psychological distress, including depression, anxiety, and stress were not associated with face mask use. Conclusions: Therefore, these findings highlight the importance of personal appraisal regarding COVID-19 and its prevention behaviors. Comfortable mask design, and emphasizing the benefits of using masks in the community improve compliance.

Introduction: Epistaxis occurs in approximately 60% of the general population globally and herbal medicine for its treatment including Chromolaena odorata L. could be one of the alternatives. The aims of this study were: (a) to determine the putative compounds and the bioactivities of C. odorata leaf extract; and (b) to assess their hemostatic and angiogenesis properties in an animal epistaxis model. Methods: The putative compounds of C. odorata extract were determined using gas chromatography and mass spectroscopy (GC-MS) and the bioactivities were determined using the Molinspiration Cheminformatics 2018 software. The hemostatic and angiogenesis activities were assessed using an epistaxis model of male rabbits ( Oryctolagus cuniculus), on which three concentrations of C. odorata were tested. The gel was applied twice a day until 21 days. The hemostatic activity was evaluated by measuring the clotting time and the angiogenesis activity was evaluated by measuring the serum blood electrolyte, serum CD34 and CD68 levels and the histopathology of fibroblast and new blood vessels. Results: Eight putative compounds with activities that increased immune responses and angiogenesis by having antithrombotic, antioxidant and anti-inflammatory effects were identified. Those compounds had a range of bioactivity to G-protein coupled receptor ligand, ion channel modulator, kinase inhibitor, nuclear receptor ligand, protease inhibitor and enzyme inhibitor. Our data suggested that C. odorata extract had an effect on the levels of sodium, potassium and chloride. There was no significant difference in the mean levels of CD34 and CD68 among treatment and control groups, p=0.443 and p>0.050, respectively. The extract had no significant effect in inducing the growth of fibroblasts. Our data indicated that C. odorata extract induced angiogenesis significantly (p=0.018). Conclusions: The C. odorata extract gel consisted of the compounds that contribute in antithrombotic, antioxidant and anti-inflammatory activities and these compounds increased the angiogenesis during wound healing in the epistaxis model.

Mycoses or fungal infections are a general health problem that often occurs in healthy and immunocompromised people in the community. The development of resistant strains in Fungi and the incidence of azole antibiotic resistance in the Asia Pacific which reached 83% become a critical problem nowadays. To control fungal infections, substances and extracts isolated from natural resources, especially in the form of plants as the main sources of drug molecules today, are needed. Especially from Piperaceae, which have long been used in India, China, and Korea to treat human ailments in traditional medicine. The purpose of this review is to describe the antifungal mechanism action from Piper crocatum and its phytochemical profiling against lanosterol 14a demethylase CYP51. The methods used to search databases from Google Scholar to find the appropriate databases using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Flow Diagram as a clinical information retrieval method. From 1.150.000 results searched by database, there is 73 final results article to review. The review shows that P. crocatum contains flavonoids, tannins, terpenes, saponins, polyphenols, eugenol, alkaloids, quinones, chavibetol acetate, glycosides, triterpenoids or steroids, hydroxychavikol, phenolics, glucosides, isoprenoids, and non-protein amino acids. Its antifungal mechanisms in fungal cells occur due to ergosterol, especially lanosterol 14a demethylase (CYP51) inhibition, which is one of the main target sites for antifungal activity because it functions to maintain the integrity and function of cell membranes in Candida. P. crocatum has an antifungal activity through its phytochemical profiling against fungal by inhibiting the lanosterol 14a demethylase, make damaging cell membranes, fungal growth inhibition, and fungal cell lysis.

Background: High infection rates of COVID-19 in Indonesia require attention, especially transmission and prevention behaviors. One way to lower infection rates is the use of face masks. However, people's adherence to its usage when in public is still low. This necessitates the exploration of predictors of the use of masks to increase community compliance. This study further aims to investigate the predictors of face mask use by applying the Health Belief Model, anxiety, stress, depression, and health motivation. Methods: A total of 255 respondents from Jakarta, Bandung, Tangerang, and Banten filled out an online questionnaire. Furthermore, hierarchical multiple regression was used to detect predictors associated with face mask use. Results: The results showed that the high perceived benefits and health motivation were higher in individuals who used a face mask when in public, while those who have high perceived barriers likely do not use masks. The respondent's level of psychological distress, including depression, anxiety, and stress were not associated with face mask use. Conclusions: Therefore, these findings highlight the importance of personal appraisal regarding COVID-19 and its prevention behaviors. Comfortable mask design, and emphasizing the benefits of using masks in the community improve compliance.

Algae have shown numerous advantages as biofunctional and bioactive material sources. The development of biosynthetic or synthetic materials has enabled algal-derived macromolecules and their derivatives to be used in biomedical applications. This review examines and analyzes the most recent developments in the production of biomaterials from algal-derived macromolecules and their composites and their potential applications in bone and cardiovascular tissue engineering. Several macromolecules derived from algal polysaccharides, including sulfated polysaccharides, fucoidans, and fucans, have been developed for cartilage, intervertebral disc, bone, and skeletal muscle transplants because of their stable structures. Alginates, fucoidans, chitin, porphyrin, and other algal polysaccharide derivatives have been investigated for engineering blood vessels, heart valves, and even the liver. One advantage of algal-derived macromolecules and composites is their safe immunity properties. This review also highlights cutting-edge developments in applying algal-derived macromolecules with a broader biomedical scope to encourage in-depth research into their potential as biomaterial scaffolds in medical applications.

Introduction: Grapsus albolineatus is thought to have a high concentration of carotenoid pigments. Although studies on male G. albolineatus have been conducted, no studies on pigment extraction from female G. albolineatus have been carried out. Carotenoids have a high ability to fight free radicals. Previous research has shown that carotenoids can fight free radicals that cause premature skin-aging. The purpose of this research was to find out what kinds of carotenoids are found in G. albolineatus and whether they can act as natural inhibitors of proteins that cause premature aging, such as glucogenase, elastase, and hyaluronidase enzymes. Methods: Carotenoids were extracted from G. albolineatus using column chromatography and high-performance liquid chromatography (HPLC); molecular docking and visualization were done with Autodock 4.2 and Discovery Studio/Biovia, respectively. Results: According to HPLC data, there are carotenoid pigments such as didehydroastaxanthin, tetrahydroastaxanthin, dihydroastaxanthin, diatoxanthin, astaxanthin, and adonixanthin. According to molecular docking experiments, pigment carotenoids from G. albolineatus are efficient inhibitors of protein elastase and hyaluronidase. Conclusions: G. albolineatus carotenoids have the potential to be anti-aging since they are more effective as protein elastase and hyaluronidase inhibitors than their native inhibitors.

Mycoses or fungal infections are a general health problem that often occurs in healthy and immunocompromised people in the community. The development of resistant strains in Fungi and the incidence of azole antibiotic resistance in the Asia Pacific which reached 83% become a critical problem nowadays. To control fungal infections, substances and extracts isolated from natural resources, especially in the form of plants as the main sources of drug molecules today, are needed. Especially from Piperaceae, which have long been used in India, China, and Korea to treat human ailments in traditional medicine. The purpose of this review was to describe antifungal activity from Piper crocatum and its phytochemical profiling against lanosterol 14 alpha demethylase CYP51. The methods used search databases from Google Scholar to find the appropriate databases using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram as a clinical information retrieval method. From 1,150,000 results search by database, there were 73 selected articles to review. The review shows that P. crocatum contains flavonoids, tannins, terpenes, saponins, polyphenols, eugenol, alkaloids, quinones, chavibetol acetate, glycosides, triterpenoids or steroids, hydroxychavikol, phenolics, glucosides, isoprenoids, and non-protein amino acids. Its antifungal mechanisms in fungal cells occur due to ergosterol especially lanosterol 14 alpha demethylase CYP51 inhibition as a result of 5,6 desaturase (ERG3) downregulation. P. crocatum has an antifungal activity by its phytochemical profiling that act against fungi by inhibiting the fungal cytochrome P 450 pathway, make damaging cell membranes, fungal growth inhibition, morphological changes, and fungal cell lysis.

Background: Meningiomas are the second most common intracranial neoplasm, contributing to 30% of all intracranial tumors. Clinical examination, anatomical pathology testing, CT, and MRI are required to confirm the meningioma diagnosis. Surgery is the therapy of choice for meningiomas. Understanding factors affecting the outcome of meningioma surgery is critical to predicting the outcome of meningioma surgery. Methods: A retrospective analytic method was conducted in this study, which included meningioma patients who underwent surgery at Dr. Soetomo General Academic Hospital between January 2014 and December 2020. The study incorporated secondary data in the form of medical records. Data collection was followed by binomial logistic regression analysis using SPSS IBM 25. Results: A total of 440 samples of patients with meningiomas were obtained through medical records. Post-operative hematoma (2.5%), postoperative infection (3.0%), neurologic deterioration (3.9%), and 30-day mortality (2.3%) were the postoperative complications reported. Emergency surgery was found to be a significant predictor of postoperative hematoma (p=0.025; OR=4.539; 95% CI: 1.211-17.006), postoperative infection (p=0.015; OR=4.777; 95% CI: 1.362-16.751), neurologic deterioration (p=0.022; OR=5,151; 95% CI: 1,271-20,882), and 30-day mortality (p=0.002; OR=17,874; 95% CI: 2,933-108,915). Simpson Grade IV (p=0.016; OR=33,524; 95% CI: 1.905-590.056) was a significant predictive factor for postoperative hematomas. Post-operative hematoma was a significant predictive factor for neurologic deterioration (p=0.000; OR=235,807; 95% CI: 38,058-1461,069) and 30-day mortality (p=0.001; OR=40,047; 95% CI: 4,985-321,699). Conclusions: Post-operative complications following meningioma surgery may result in high morbidity and mortality. The predictive factors for meningioma surgery complications were identified in this study. Knowledge of these factors may aid in preventing or predicting meningioma surgery complications.

Background: High infection rates of COVID-19 in Indonesia require attention, especially transmission and prevention behaviors. One way to lower infection rates is the use of face masks. However, people's adherence to its usage when in public is still low. This necessitates the exploration of predictors of the use of masks to increase community compliance. This study further aims to investigate the predictors of face mask use by applying the Health Belief Model, anxiety, stress, depression, and health motivation. Methods: A total of 255 respondents from Jakarta, Bandung, Tangerang, and Banten filled out an online questionnaire. Furthermore, hierarchical multiple regression was used to detect predictors associated with face mask use. Results: The results showed that the high perceived benefits and health motivation were higher in individuals who used a face mask when in public, while those who have high perceived barriers likely do not use masks. The respondent's level of psychological distress, including depression, anxiety, and stress were not associated with face mask use. Conclusions: Therefore, these findings highlight the importance of personal appraisal regarding COVID-19 and its prevention behaviors. Comfortable mask design, and emphasizing the benefits of using masks in the community improve compliance.

Incorporating eels and tempe can replace and complement the content of proteins, macronutrients, and micronutrients, which may be related to curative effects for malnutrition. In addition, converting the ingredients into a form of flour can increase their shelf life and nutrient concentration. Therefore, an in vivo approach was undertaken to explore further the nutritional status value of biomarkers in malnourished male rats ( Rattus norvegicus) after Eel and Tempe Composite (ETC) flour supplementation. Data was collected from blood samples (both plasma and serum) of rats in all groups, and the appropriate biomarkers were analyzed. The final data presented in this study is openly available and can be further analyzed using statistical means to determine the dose of ETC flour as the basis of clinical trials, which other researchers can reproduce. This data may also be valuable for those interested in using different analytical methods to research the same questions or even new preclinical studies focusing solely on nutritional status biomarker analysis methods, including clinical trial prospects.

Background: Following the surge of coronavirus disease 2019 (COVID-19) cases in the epicenter of East Java Province, this study aimed to determine the clinical characteristics of patients with COVID-19 at one of the emergency field hospitals in Indonesia. Methods: This was a single-centered, retrospective descriptive study of 763 patients admitted to the COVID-19 Emergency Field Hospital of Bangkalan from July 5 2021 to September 30 2021. The demographic data, clinical signs and symptoms, pre-existing comorbidities, therapy, and clinical outcomes of the patients were analyzed using SPSS. Results: The clinical characteristics of patients with COVID-19 at the emergency hospital were varied. A total of 763 patients were included. The most common age was between 40 and 49 years (31.1%), a slight majority were women (51.5%), and most had travelled abroad in the last 14 days (99.1%). Of the 763 patients, 70.9% had no comorbidities. Half of the patients were asymptomatic (49.4%), 46% were mild cases, 4.1% were moderate, and 0.5% severe. The most common symptoms were productive cough (15.7%) and headache (15.3%). Supportive and comorbidity therapy were given which showed excellent clinical outcomes. Conclusions: This study presents the description of the clinical characteristics of COVID-19 patients during high surge cases of COVID-19 that are mostly dominated by Indonesian migrant workers in a field hospital. majority of COVID-19 patients were asymptomatic and therapy without antibiotics or antivirals showed positive outcomes in COVID-19 patients.

Background: This study aimed to determine the potential anti-aging effects of sea grapes and tempe (fermented soybeans) collagen particle size, by measuring the activities of anti-glycation, antioxidant, and tyrosinase inhibitors. Methods: Collagen was isolated from freeze-dried sea grapes and tempe powder and treated with different NaOH concentrations (0.10 M; 0.20 M; 0.30 M), and CH 3COOH 1 M solution, separately. The collagen particle size was adjusted by stirring at 1000 rpm for 5 and 10 hours. 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to measure the antioxidant activity, and L-tyrosine and L-DOPA (l-3,4-dihydroxyphenylalanine) was used as a marker of tyrosine inhibition. Results: The collagen treated with 0.10 M NaOH produced the highest collagen yield (11.65%), and the largest particle size (2455 nm). Additionally, this collagen, when treated for 5 hours, exhibited 24.70% antioxidant activity, 62.60% anti-glycation, 8.97% L-tyrosine, and 26.77% L-Dopa inhibition activities. Meanwhile, the collagen treated for 10 hours had a 9.98% antioxidant activity, 41.48% anti-glycation, 7.89% L-tyrosine, and 2.67% L-Dopa inhibition activity. Conclusion: Sea grapes and tempe collagen powder treated with 0.10 M NaOH and stirred for 5 hours, possess the best potential anti-aging properties as a functional food.

Background: Mesenchymal stem cells (MSCs) are known to have immunomodulatory, anti-inflammatory, anti-apoptotic, and angiogenesis effects that are useful for relieving inflammation, recovery, and protection of lung tissues in COVID-19 patients. Secretome, a secretory product of MSCs, has several advantages over MSCs. We conducted a study to investigate secretomes’ effectiveness and safety profile as a treatment for severe COVID-19. Methods: A double-blind, multicenter, randomized, placebo-controlled trial was conducted between February 2021 and July 2021 in three top COVID-19 referral hospitals in the Greater Jakarta area, Indonesia. Eligible subjects (n=40) were randomized in a 1:1 ratio to an intervention group (n=20) and a control group (n=20). The primary outcome of this study was the changes in inflammatory markers and the ratio of inflammatory to anti-inflammatory markers. The secondary outcomes of this study included clinical outcome, laboratory outcome, radiological outcome, RT-PCR result conversion, and safety profile of MSC secretome. Results: Our analysis showed that on the 14th day after placebo administration, IL-6 level in the control group was significantly increased [4.110 (2.403–12.820) at baseline to 13.320 (2.958–33.285) on the 14th day after intervention, p=0.017]. The IL-6/IL-10 ratio in the control group was significantly increased (p=0.036) on the 14th day after placebo administration. We also found that most of the subjects who received placebo had high levels of IL-6 and ferritin (p=0.043) on the seventh day after the intervention. However, we found no significant differences in inflammatory marker levels on the seventh day and 14th day after intervention between both groups. There was no adverse event reported. There were no significant differences in the laboratory outcome, radiology outcome, RT-PCR result conversion, and safety profiles between both groups. Conclusions: MSC secretome can control inflammation in patients with severe COVID-19 and has a good safety profile. MSC secretome is a promising treatment modality for severe COVID-19.

Background: In Indonesia, maternal health care services are widely available, aiming to improve health and survival among mothers. However, these services remain underutilised, and its determining factor was unknown. This study sought to identify determinant factors of maternal healthcare services utilisation among Indonesian mothers. Methods: This population-based cross-sectional study leveraged the 2017 Indonesia Demographic and Health Survey data. A total of 12,033 mothers aged from 15 to 49 years who had a live birth in the five years preceding the survey were included in the analysis. Multivariable logistic regressions were used to identify the determinant factors. Results: Approximately 93.44% of the mothers had adequate antenatal care, 83.73% had a delivery at the healthcare facility, and 71.46% received postnatal care. The mother’s age and household wealth index were the typical determinants of all maternal healthcare services. Determinants of antenatal care visits were husband’s occupational status, the number of children, and access to the healthcare facility. Next, factors that drive mothers’ delivery at the healthcare facility were the mother’s education level, husband’s educational level, and residential area. The use of postnatal care was determined by the mother’s occupational status, husband’s educational level, number of children, wealth index, access to the healthcare facility, and residential area. Conclusions: The utilisation of each maternal healthcare service was determined by various socio-structural and intermediary determinants, but the mother’s age and household wealth index were emerged as the typical determinants of all maternal healthcare services. Providing maternal healthcare services that are adjusted and tuned with these socio determinant factors may ensure that mothers can adequately utilise each service.

Background: This study aimed to determine the potential anti-aging effects of sea grapes and tempe (fermented soybeans) collagen particle size, by measuring the activities of anti-glycation, antioxidant, and tyrosinase inhibitors. Methods: Collagen was isolated from freeze-dried sea grapes and tempe powder and treated with different NaOH concentrations (0.10 M; 0.20 M; 0.30 M), and CH 3COOH 1 M solution, separately. The collagen particle size was adjusted by stirring at 1000 rpm for 5 and 10 hours. 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to measure the antioxidant activity, and L-tyrosine and L-DOPA (l-3,4-dihydroxyphenylalanine) was used as a marker of tyrosine inhibition. Results: The collagen treated with 0.10 M NaOH produced the highest collagen yield (11.65%), and the largest particle size (2455 nm). Additionally, this collagen, when treated for 5 hours, exhibited 24.70% antioxidant activity, 62.60% anti-glycation, 8.97% L-tyrosine, and 26.77% L-Dopa inhibition activities. Meanwhile, the collagen treated for 10 hours had a 9.98% antioxidant activity, 41.48% anti-glycation, 7.89% L-tyrosine, and 2.67% L-Dopa inhibition activity. Conclusion: Sea grapes and tempe collagen powder treated with 0.10 M NaOH and stirred for 5 hours, possess the best potential anti-aging properties as a functional food.

Background: Following the surge of coronavirus disease 2019 (COVID-19) cases in the epicenter of East Java Province, this study aimed to determine the clinical characteristics of patients with COVID-19 at one of the emergency field hospitals in Indonesia. Methods: This was a single-centered, retrospective descriptive study of 763 patients admitted to the COVID-19 Emergency Field Hospital of Bangkalan from July 5 2021 to September 30 2021. The demographic data, clinical signs and symptoms, pre-existing comorbidities, therapy, and clinical outcomes of the patients were analyzed using SPSS. Results: The clinical characteristics of patients with COVID-19 at the emergency hospital were varied. A total of 763 patients were included. The most common age was between 40 and 49 years (31.1%), a slight majority were women (51.5%), and most had travelled abroad in the last 14 days (99.1%). Of the 763 patients, 70.9% had no comorbidities. Half of the patients were asymptomatic (49.4%), 46% were mild cases, 4.1% were moderate, and 0.5% severe. The most common symptoms were productive cough (15.7%) and headache (15.3%). Supportive and comorbidity therapy were given which showed excellent clinical outcomes. Conclusions: The majority of COVID-19 patients were asymptomatic, female, middle aged and had recently been overseas. Therapy without antibiotics or antivirals showed positive outcomes in COVID-19 patients.

Background: Following the surge of coronavirus disease 2019 (COVID-19) cases in the epicenter of East Java Province, this study aimed to determine the clinical characteristics of patients with COVID-19 at one of the emergency field hospitals in Indonesia. Methods: This was a single-centered, retrospective descriptive study of 763 patients admitted to the COVID-19 Emergency Field Hospital of Bangkalan from July 5 2021 to September 30 2021. The demographic data, clinical signs and symptoms, pre-existing comorbidities, therapy, and clinical outcomes of the patients were analyzed using SPSS. Results: The clinical characteristics of patients with COVID-19 at the emergency hospital were varied. A total of 763 patients were included. The most common age was between 40 and 49 years (31.1%), a slight majority were women (51.5%), and most had travelled abroad in the last 14 days (99.1%). Of the 763 patients, 70.9% had no comorbidities. Half of the patients were asymptomatic (49.4%), 46% were mild cases, 4.1% were moderate, and 0.5% severe. The most common symptoms were productive cough (15.7%) and headache (15.3%). Supportive and comorbidity therapy were given which showed excellent clinical outcomes. Conclusions: This study presents the description of the clinical characteristics of COVID-19 patients during high surge cases of COVID-19 that are mostly dominated by Indonesian migrant workers in a field hospital. majority of COVID-19 patients were asymptomatic and therapy without antibiotics or antivirals showed positive outcomes in COVID-19 patients.

Background: Mesenchymal stem cells (MSCs) are known to have immunomodulatory, anti-inflammatory, anti-apoptotic, and angiogenesis effects that are useful for relieving inflammation, recovery, and protection of lung tissues in COVID-19 patients. Secretome, a secretory product of MSCs, has several advantages over MSCs. We conducted a study to investigate secretomes’ effectiveness and safety profile as a treatment for severe COVID-19. Methods: A double-blind, multicenter, randomized, placebo-controlled trial was conducted between February 2021 and July 2021 in three top COVID-19 referral hospitals in the Greater Jakarta area, Indonesia. Eligible subjects (n=40) were randomized in a 1:1 ratio to an intervention group (n=20) and a control group (n=20). The primary outcome of this study was the changes in inflammatory markers and the ratio of inflammatory to anti-inflammatory markers. The secondary outcomes of this study included clinical outcome, laboratory outcome, radiological outcome, RT-PCR result conversion, and safety profile of MSC secretome. Results: Our analysis showed that on the 14th day after placebo administration, IL-6 level in the control group was significantly increased [4.110 (2.403–12.820) at baseline to 13.320 (2.958–33.285) on the 14th day after intervention, p=0.017]. The IL-6/IL-10 ratio in the control group was significantly increased (p=0.036) on the 14th day after placebo administration. We also found that most of the subjects who received placebo had high levels of IL-6 and ferritin (p=0.043) on the seventh day after the intervention. However, we found no significant differences in inflammatory marker levels on the seventh day and 14th day after intervention between both groups. There was no adverse event reported. There were no significant differences in the laboratory outcome, radiology outcome, RT-PCR result conversion, and safety profiles between both groups. Conclusions: MSC secretome can control inflammation in patients with severe COVID-19 and has a good safety profile. MSC secretome is a promising treatment modality for severe COVID-19.

Background: This study aimed to determine the potential anti-aging effects of sea grapes and tempe (fermented soybeans) collagen particle size, by measuring the activities of anti-glycation, antioxidant, and tyrosinase inhibitors. Methods: Collagen was isolated from freeze-dried sea grapes and tempe powder and treated with different NaOH concentrations (0.10 M; 0.20 M; 0.30 M), and CH3COOH 1 M solution, separately. The collagen particle size was adjusted by stirring at 1000 rpm for 5 and 10 hours. 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to measure the antioxidant activity, and L-tyrosine and L-DOPA (l-3,4-dihydroxyphenylalanine) was used as a marker of tyrosine inhibition. Results: The collagen treated with 0.10 M NaOH produced the highest collagen yield (11.65%), and the largest particle size (2455 nm). Additionally, this collagen, when treated for 5 hours, exhibited 24.70% antioxidant activity, 62.60% anti-glycation, 8.97% L-tyrosine, and 26.77% L-Dopa inhibition activities. Meanwhile, the collagen treated for 10 hours had a 9.98% antioxidant activity, 41.48% anti-glycation, 7.89% L-tyrosine, and 2.67% L-Dopa inhibition activity. Conclusion: Sea grapes and tempe collagen powder treated with 0.10 M NaOH and stirred for 5 hours, possess the best potential anti-aging properties as a functional food.

Background: Mesenchymal stem cells (MSCs) are known to have immunomodulatory, anti-inflammatory, anti-apoptotic, and angiogenesis effects that are useful for relieving inflammation, recovery, and protection of lung tissues in COVID-19 patients. Secretome, a secretory product of MSCs, has several advantages over MSCs. We conducted a study to investigate secretomes’ effectiveness and safety profile as a treatment for severe COVID-19. Methods: A double-blind, multicenter, randomized, placebo-controlled trial was conducted between February 2021 and July 2021 in three top COVID-19 referral hospitals in the Greater Jakarta area, Indonesia. Eligible subjects (n=40) were randomized in a 1:1 ratio to an intervention group (n=20) and a control group (n=20). The primary outcome of this study was the changes in inflammatory markers and the ratio of inflammatory to anti-inflammatory markers. The secondary outcomes of this study included clinical outcome, laboratory outcome, radiological outcome, RT-PCR result conversion, and safety profile of MSC secretome. Results: Our analysis showed that on the 14th day after placebo administration, IL-6 level in the control group was significantly increased [4.110 (2.403–12.820) at baseline to 13.320 (2.958–33.285) on the 14th day after intervention, p=0.017]. The IL-6/IL-10 ratio in the control group was significantly increased (p=0.036) on the 14th day after placebo administration. We also found that most of the subjects who received placebo had high levels of IL-6 and ferritin (p=0.043) on the seventh day after the intervention. However, we found no significant differences in inflammatory marker levels on the seventh day and 14th day after intervention between both groups. There was no adverse event reported. There were no significant differences in the laboratory outcome, radiology outcome, RT-PCR result conversion, and safety profiles between both groups. Conclusions: MSC secretome can control inflammation in patients with severe COVID-19 and has a good safety profile. MSC secretome is a promising treatment modality for severe COVID-19.

Background: In Indonesia, maternal health care services are widely available, aiming to improve health and survival among mothers. However, these services remain underutilised, and its determining factor was unknown. This study sought to identify determinant factors of maternal healthcare services utilisation among Indonesian mothers. Methods: This population-based cross-sectional study leveraged the 2017 Indonesia Demographic and Health Survey data. A total of 12,033 mothers aged from 15 to 49 years who had a live birth in the five years preceding the survey were included in the analysis. Multivariable logistic regressions were used to identify the determinant factors. Results: Approximately 93.44% of the mothers had adequate antenatal care, 83.73% had a delivery at the healthcare facility, and 71.46% received postnatal care. The mother’s age and household wealth index were the typical determinants of all maternal healthcare services. Determinants of antenatal care visits were husband’s occupational status, the number of children, and access to the healthcare facility. Next, factors that drive mothers’ delivery at the healthcare facility were the mother’s education level, husband’s educational level, and residential area. The use of postnatal care was determined by the mother’s occupational status, husband’s educational level, number of children, wealth index, access to the healthcare facility, and residential area. Conclusions: The utilisation of each maternal healthcare service was determined by various socio-structural and intermediary determinants, but the mother’s age and household wealth index were emerged as the typical determinants of all maternal healthcare services. Providing maternal healthcare services that are adjusted and tuned with these socio determinant factors may ensure that mothers can adequately utilise each service.

Background: In Indonesia, maternal health care services are widely available, aiming to improve health and survival among mothers. However, these services remain underutilised, and its determining factor was unknown. This study sought to identify determinant factors of maternal healthcare services utilisation among Indonesian mothers. Methods: This population-based cross-sectional study leveraged the 2017 Indonesia Demographic and Health Survey data. A total of 12,033 mothers aged from 15 to 49 years who had a live birth in the five years preceding the survey were included in the analysis. Multivariable logistic regressions were used to identify the determinant factors. Results: Approximately 93.44% of the mothers had adequate antenatal care, 83.73% had a delivery at the healthcare facility, and 71.46% received postnatal care. The mother’s age and household wealth index were the typical determinants of all maternal healthcare services. Determinants of antenatal care visits were husband’s occupational status, the number of children, and access to the healthcare facility. Next, factors that drive mothers’ delivery at the healthcare facility were the mother’s education level, husband’s educational level, and residential area. The use of postnatal care was determined by the mother’s occupational status, husband’s educational level, number of children, wealth index, access to the healthcare facility, and residential area. Conclusions: Although there were differences in the determinant factors of three key maternal healthcare services, the mother’s age and household wealth index were the typical determinants of all maternal healthcare services utilisation. Providing a tailored programme aligned with these determinant factors may ensure that mothers can access and adequately utilise maternal healthcare services.

Background: Sea grapes or Caulerpa racemosa have a lot of phytochemical content, especially unsaturated fatty acids that are beneficial for health. This study aims to evaluate the effects of sea grapes extract on blood glucose levels, total cholesterol-, and Peroxisome proliferator-activated receptor-gamma coactivator (PGC)-1α in male Wistar rats, which were given per-oral (p.o.) cholesterol- and carbohydrates fat-enriched diets (CFED). Methods: Forty male Wistar albino rats weighing between 200 – 250 g were used for this study. Animals were randomly distributed into four groups of ten animals each. Group A served as control (received standard dry pellet diet). Rats in group B were fed on CFED for 4 weeks. Groups C and D were fed on CFED and were administered 150 and 450 mg/kg of sea grapes extract (p.o.), respectively. Results: Group C rats indicated a blood glucose reduction and an increase in PGC-1α serum, in comparison to group D (pConclusion: Sea grapes extract is proven to improve blood glucose, total cholesterol, and PGC-1α levels in rats fed with CFED.

Background: This study aimed to determine the potential anti-aging effects of sea grapes and tempe (Fermented soybeans) collagen particle size, by measuring the activities of anti-glycation, antioxidant and tyrosinase inhibitors. Methods: Collagen was isolated from sea grapes and tempe freeze dried powder and treated with different NaOH concentrations (0.10 M; 0.20 M; 0.30 M), and CH 3COOH 1 M solution, separately. The collagen particle size was adjusted by stirring at 1000 rpm for 5 and 10 hours. 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to measure the antioxidant activity, and L-tyrosine and L-DOPA (l-3,4-dihydroxyphenylalanine) were used as a marker of tyrosine inhibition. Results: The collagen treated with 0.10 M NaOH produced the highest collagen yield (11.65%), and largest particle size (2455 nm). Additionally, this collagen, when treated for 5 hours, exhibited 24.70% antioxidant activity, 62.60% anti-glycation, 8.97% L-tyrosine, and 26.77% L-Dopa inhibition activities. Meanwhile, the collagen treated for 10 hours had a 9.98% antioxidant activity, 41.48% anti-glycation, 7.89% L-tyrosine, and 2.67% L-Dopa inhibition activity. Conclusion: Sea grapes and tempe collagen powder treated with 0.10 M NaOH and stirred for 5 hours, as functional foods have anti-aging properties.

Background: Sea grapes or Caulerpa racemosa have a lot of phytochemical content, especially unsaturated fatty acids that are beneficial for health. This study aims to evaluate the effects of sea grapes extract on blood glucose levels, total cholesterol-, and Peroxisome proliferator-activated receptor-gamma coactivator (PGC)-1α in male Wistar rats, which were given per-oral (p.o.) cholesterol- and carbohydrates fat-enriched diets (CFED). Methods: Forty male Wistar albino rats weighing between 200 – 250 g were used for this study. Animals were randomly distributed into four groups of ten animals each. Group A served as control (received standard dry pellet diet). Rats in group B were fed on CFED for 4 weeks. Groups C and D were fed on CFED and were administered 150 and 450 mg/kg of sea grapes extract (p.o.), respectively. Results: Group C rats indicated a blood glucose reduction and an increase in PGC-1α serum, in comparison to group D (pConclusion: Sea grapes extract is proven to improve blood glucose, total cholesterol, and PGC-1α levels in rats fed with CFED.

Background: There are three methods for renal replacement therapy for end stage chronic kidney disease; dialysis, continuous ambulatory peritoneal dialysis, and renal transplantation which is the best because of the least morbidity rate, the best survival rates, the best quality of life, and the best improvement in activities of daily living. In the field, flow cytometry serves a well-established role in pre- and post-transplant crossmatching, and if it is combined with human leukocyte antigen (HLA) immunophenotyping based on DNA, it will produce a more sensitive prediction of the chronic graft rejection compared to complement-dependent cytotoxicity crossmatching and can eliminate irrelevant antibody (IgM). This is the first experience using this method in our hospital. The survival rate at one, five and ten years has been shown to be 99%, 97% and 96%, respectively; therefore, we wanted to find out the five year follow up of the patient. Case presentation: We evaluated a 20-year-old female with a history of pediatric renal transplantation five years previously due to end stage renal disease caused by bilateral parenchymatous renal disease. She had a history of hypertension since December 2014 and underwent hemodialysis for three months. The transplantation took place in March 2015. A kidney from her mother was transplanted to recipient using end-to-side anastomoses. After five years, the patient was routinely monitored at the urology clinic, with creatinine serum results between 1.5 and 2 mg/dL, urea and electrolyte serum levels within normal limits and she could resume normal life. Conclusions: Survival five years after the procedure showed a beneficial outcome of the method used.

Background: Some Ebola vaccines have been developed and tested in phase III clinical trials. However, assessment of whether public have willingness to purchase or not, especially in unaffected areas, is lacking. The aim of this study was to determine willingness to pay (WTP) for a hypothetical Ebola vaccine in Indonesia. Methods: A cross-sectional study was conducted from 1 August to 30 December 2015 in five cities in Aceh province of Indonesia. Patients’ family members who visited outpatient departments were approached and interviewed about their sociodemographic characteristics, knowledge of Ebola, attitude towards vaccination practice and their WTP for a hypothetical Ebola vaccine. A multivariable linear regression model assessed the relationship between these explanatory variables and WTP. Results: During the study, 500 participants were approached and interviewed. There were 424 (84.8%) respondents who completed the interview and 74% (311/424) expressed their acceptance for an Ebola vaccine. There were 288 participants who were willing to pay for an Ebola vaccine (92.6% out of 311). The mean of WTP was US$2.08 (95% CI: 1.75-2.42). The final multivariable model indicated that young age, high educational attainment, working as a private employee, entrepreneur or civil servant (compared to farmers), being unmarried, and residing in a suburb (compared to a city) were associated with higher WTP. Conclusions: Although the proportion of the participants who would accept the Ebola vaccine was relatively high, the amount they were willing to pay for Ebola vaccine was very low. This finding would indicate the need of subsidies for Ebola vaccine in the country.

Background: Some Ebola vaccines have been developed and tested in phase III clinical trials. However, assessment of whether public have willingness to purchase or not, especially in unaffected areas, is lacking. The aim of this study was to determine willingness to pay (WTP) for a hypothetical Ebola vaccine in Indonesia. Methods: A cross-sectional study was conducted from 1 August to 30 December 2015 in five cities in Aceh province of Indonesia. Patients’ family members who visited outpatient departments were approached and interviewed about their sociodemographic characteristics, knowledge of Ebola, attitude towards vaccination practice and their WTP for a hypothetical Ebola vaccine. A multivariable linear regression model assessed the relationship between these explanatory variables and WTP. Results: During the study, 500 participants were approached and interviewed. There were 424 (84.8%) respondents who completed the interview and 74% (311/424) expressed their acceptance for an Ebola vaccine. There were 288 participants who were willing to pay for an Ebola vaccine (92.6% out of 311). The mean of WTP was US$2.08 (95% CI: 1.75-2.42). The final multivariable model indicated that young age, high educational attainment, working as a private employee, entrepreneur or civil servant (compared to farmers), being unmarried, and residing in a suburb (compared to a city) were associated with higher WTP. Conclusions: Although the proportion of the participants who would accept the Ebola vaccine was relatively high, the amount they were willing to pay for Ebola vaccine was very low. This finding would indicate the need of subsidies for Ebola vaccine in the country.