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Objective : To determine the correlation between body mass index, age, parity, gestational weight gain and low birth weight at Atma Jaya Hospital in 2016-2019. Methods : This was a cross-sectional study of 111 sample medical records of pregnant women who gave birth at Atma Jaya Hospital in 2016-2019 and met the inclusion and exclusion criteria. Data management was performed using the Chi-square test and multivariate logistic regression test. Results: Most of the mothers were in the group with normal BMI (60.4%), the G1 age group (21-29 years old) (45.9%), the low multiparity group (parity 1-3 times) (57.7%). The analysis showed that there was a significant relationship between parity group grand multipara (p=0.028; OR=5.206; 95% CI=1.195-22.686) with the incidence of LBW. There was no significant relationship between BMI group lean (p=0.303; OR=1.646; 95% CI=0.638-4.246), group normal (p=0.532), group fat (p=0.440; OR=1.957; 95% CI=0.357-10.737), maternal age group G1 (p=0.141), group G2 (p=0.587; OR=1.327; 95% CI=0.478-3.687), group G3 (p=0.111; OR=0.262; 95% CI=0.050-1.360), parity group nulliparity (p=0.494; OR=0.669; 95% CI=0.212-2.117), group low multiparity (p=0.051), and gestational weight gain group low (p=0.955; OR=1.028; 95% CI=0.396-2.667), group normal (p=0.986), group high (p=0.897; OR=0.917; 95% CI=0.245-3.424) with the incidence of LBW. Conclusion : There is a significant relationship between parity with the incidence of low birth weight. There is no relationship between body mass index, age, and gestational weight gain with the incidence of low birth weight. Keywords: age, BMI, gestational weight gain, LBW, parity. Abstrak Tujuan: Mengetahui apakah terdapat hubungan antara indeks massa tubuh, usia, paritas, dan pertambahan berat badan ibu hamil terhadap kejadian berat bayi rendah di Rumah Sakit Atma Jaya tahun 2016-2019. Metode: Penelitian ini merupakan penelitian analitik potong lintang dengan menggunakan rekam medis sebanyak 111 sampel ibu hamil yang melangsungkan persalinan di RS Atma Jaya pada tahun 2016-2019 dan memenuhi kriteria inklusi dan eksklusi. Pengelolaan data dilakukan dengan menggunakan uji Chi-square dan uji regresi logistik multivariat. Hasil : Didapatkan sebagian besar ibu berada pada kelompok dengan indeks massa tubuh normal (60,4%), kelompok usia G1 (21-29 tahun) (45,9%), kelompok paritas low multiparity (paritas 1-3 kali) (57,7%), dan kelompok pertambahan berat badan normal (47,7%). Hasil analisis menunjukkan terdapat hubungan antara paritas kelompok grand multipara (p=0,028; OR=5,206; 95% CI=1,195-22,686) terhadap kejadian BBLR. Tidak terdapat hubungan signifikan antara indeks massa tubuh kelompok kurus (p=0,303; OR=1,646; 95% CI=0,638-4,246), kelompok normal (p=0,532), kelompok gemuk (p=0, 440; OR=1, 957; 95% CI=0, 357-10.737), usia ibu hamil kelompok G1 (p=0,141), kelompok G2 (p=0,587; OR=1,327; 95% CI=0,478-3,687), usia kelompok G3 (p=0,111; OR=0,262; 95% CI=0, 050-1,360), paritas kelompok nulliparity (p=0,494; OR=0,669; 95% CI=0,212-2,117), kelompok low multiparity (p=0.051), pertambahan berat badan ibu hamil kelompok kurang (p=0.955; OR=1.028; 95% CI=0.396-2.667), kelompok sesuai (p=0.986), dan kelompok lebih (p=0.897; OR=0.917; 95% CI=0.245-3.424) dengan kejadian BBLR. Kesimpulan : Terdapat hubungan yang signifikan antara paritas dengan kejadian berat bayi lahir rendah. Tidak terdapat hubungan antara indeks massa tubuh, usia, dan pertambahan berat badan ibu hamil dengan kejadian berat bayi lahir rendah. Kata kunci: BBLR, IMT, paritas, pertambahan berat badan, usia.

Diabetes mellitus is characterized by high blood glucose levels known as hyperglycemia. In addition, diabetes is associated with decreased Superoxide Dismutase and increased Malondialdehyde levels. Alternative treatments for diabetes mellitus may involve the use of natural ingredients. This study aimed to evaluate the effect of Ginger (Zingiber officinale), Cinnamon (Cinnamomum verum), Cloves (Syzygium aromaticum), and their combination on blood glucose, superoxide dismutase (SOD) and malondialdehyde (MDA)levels in a rat model of diabetes mellitus. Diabetes was induced in the rats by a single intraperitoneal dose of streptozotocin (55 mg/kg BW). The diabetic rats were divided into five groups; DM which served as the control (Diabetic rats without treatment), A1 (Diabetic rats treated with Zingiber officinale extract), A2 (Diabetic rats treated with Cinnamomum verum extract), A3 (Diabetic rats treated with Syzygium aromaticum extract), and A4 (Diabetic rats treated with a combination of the three spices). The treatments were orally administered once daily for 14 days. On day 15, all the rats were euthanized, and blood samples were collected. The blood samples were analyzed for the concentrations of glucose, superoxide dismutase (SOD), and malondialdehyde (MDA). The results showed that the administration of A3 significantly reduced blood glucose level, the administration of A1 and A4 significantly reduced MDA level compared to the control. Therefore, these spices have the potential to be used as an alternative medicine for the treatment of diabetes mellitus. [ABSTRACT FROM AUTHOR]

Abstract Background Diabetes mellitus, particularly Type 2 diabetes (T2D), represents a significant global health challenge, with its prevalence steadily rising over the past few decades. This study was conducted with the aim of estimating the economic burden of T2D in Iran. Methods This study employed a prevalence-based approach to estimate the economic burden of T2D and its attributable complications in adults above 20 years old in Iran for 2022. Both direct medical costs and indirect costs were considered in our analysis. Direct medical costs included inpatient and outpatient costs attributable to T2D and its complications, while indirect costs encompassed absenteeism, presenteeism, inability to work, and premature mortality costs due to the disease. Results The findings showed that a total of 5,702,547 people, equivalent to 14.2% of Iranian adults, had T2D. The estimated total direct medical cost of T2D and its attributable complications in Iran in 2022 was 1,879.2 million US dollars (US$-PPP 6,676.9 million). Chronic kidney disease accounted for the largest proportion, followed by ischemic heart disease (IHD), and T2D itself. The total economic burden of T2D and its attributable complications in Iran in 2022, was estimated to be $2,905.7 million US dollars (US$-PPP 10,324.2 million). The direct medical cost constituted the majority of the economic burden (64.7%), while the inability to work due to these health conditions also contributes significantly (28.6%). Absenteeism (2.9%), presenteeism (1.7%), and premature mortality (2.2%) make up smaller proportions of the overall economic impact of T2D and its complications in Iran during that year. Conclusion Our study highlights the significant and diverse economic impact of T2D and its complications in Iran. This burden encompasses not only healthcare-related expenses but also negative impacts on society and productivity, as well as the occurrence of early death. To successfully address this burden, a comprehensive strategy is needed, which includes programs to prevent diabetes, better access to healthcare services, and increased social support for individuals with this long-term condition.

Abstract Background Diabetes is a significant risk factor for sarcopenia, a muscle dystrophy affecting older individuals. Sarcopenia management typically involves resistance exercise and oral supplements. Given the limitations of resistance training for many elderly individuals, oral supplements play a crucial role in treatment. This study is a protocol for evaluating the efficacy of the Sarcomeal® supplement, a mixture of whey protein, creatine, branch-chained amino acids (BCAAs), glutamine, and hydroxyl-methyl-butyrate (HMB) in diabetic people who also have sarcopenia. Methods and analysis This study is a randomized clinical trial, in which sixty diabetic sarcopenia patients who meet the inclusion criteria will be randomly assigned to the control or the intervention group with a 1:1 allocation. The intervention group will receive one Sarcomeal® supplement sachet plus 1000 IU of vitamin D daily and both groups will be recommended to consume protein-rich food, be educated about the disease, and perform light exercises for 12 weeks. Anthropometric measurements, body composition analysis, muscle strength assessments, and blood tests will be conducted at the trial's start and end. Discussion It is hypothesized that the Sarcomeal® supplement plus vitamin D may be beneficial for the management of diabetic sarcopenia by reducing inflammation, oxidative stress, and glucose metabolism. The outcome of this trial will provide a basis for prescribing sarcomeal to patients with diabetic sarcopenia. Ethics and dissemination This protocol is registered at the Iranian Registry of Clinical Trials (IRCT20230831059311N1) and also is approved by the ethics committee of Tehran University of Medical Sciences (September 2023, IR.TUMS.EMRI.REC.1402.071). Trial registration Iranian Registry of Clinical Trials (ID: IRCT20230831059311N1)

Background: This article introduces SC-Phi2, a fine-tuned StarCraft II small language model. Small language models, like Phi2, Gemma, and DistilBERT, are streamlined versions of large language models (LLMs) with fewer parameters that require less computational power and memory to run. Method: To teach Microsoft’s Phi2 model about StarCraft, we create a new SC2 text dataset with information about StarCraft races, roles, and actions and use it to fine-tune Phi-2 with self-supervised learning. We pair this language model with a Vision Transformer (ViT) from the pre-trained BLIP-2 (Bootstrapping Language Image Pre-training) model, fine-tuning it on the StarCraft replay dataset, MSC. This enables us to construct dynamic prompts that include visual game state information. Results: Unlike the large models used in StarCraft LLMs such as GPT-3.5, Phi2 is trained primarily on textbook data and contains little inherent knowledge of StarCraft II beyond what is provided by our training process. By using LoRA (Low-rank Adaptation) and quantization, our model can be trained on a single GPU. We demonstrate that our model performs well at build order prediction, an important StarCraft macromanagement task. Conclusions: Our research on the usage of small models is a step towards reducing the carbon footprint of AI agents.

Perkembangan perumahan berpagar di wilayah metropolitan Jabodetabek terlihat dari tingginya permintaan atas hal tersebut. Namun, perumahan berpagar mencerminkan bentuk segregasi spasial yang berkontribusi terhadap segregasi sosial yang makin meluas. Tren ini bertentangan dengan tujuan pembangunan perumahan, yaitu menciptakan komunitas yang kohesif. Tujuan studi ini untuk mengidentifikasi faktor-faktor yang mempengaruhi preferensi pemilihan perumahan berpagar. Terdapat tiga tipe perumahan berpagar di wilayah Jabodetabek: single-gated community, clustered gated community, dan private city. Pengumpulan data menggunakan metode survei kuesioner dengan menggunakan Skala Likert dengan sampel 100 responden. Teknik analisis menggunakan Regresi Linier Berganda. Responden berasal dari tiga kategori perumahan berpagar. Hasil penelitian menunjukkan bahwa variabel lokasi dan aksesibilitas, kontrol keamanan di tingkat cluster, dan fisik rumah berpengaruh signifikan pada preferensi penghuni pada tiga tipe komunitas berpagar di wilayah ini. Berdasarkan preferensi responden, tipe private cities adalah yang paling tinggi. Dalam mengurangi segregasi sosial melalui pembangunan tipe ini perlu dipertimbangkan penyediaan diversifikasi tipe rumah dan penyediaan fasilitas dan ruang komunal yang lebih luas agar menarik penduduk dari berbagai latar belakang.

Abstract Background Effective communication is a key element of medical care; it can foster a warm interpersonal relationship, facilitate the exchange of information, and enable shared decision-making. In the context of obstetric care, it is associated with a range of positive clinical and social outcomes for mother and baby. Extant communication frameworks and respectful maternity care (RMC) guidelines emphasize the importance of effective communication during intrapartum care. Yet, studies conducted in Indian public health settings suggest that there are gaps in the implementation of RMC guidelines. Methods As part of a larger study on disrespect and abuse in Indian public hospitals, we studied the nature of communication in the intrapartum context and the extent to which it is respectful. The study is based on interviews with 29 providers across different levels of public health facilities. Interviews were translated, transcribed, and thematically coded. We examined codes related to communication to understand what kinds of communication occur during intrapartum care and the role played by knowledge and power hierarchies. We then considered their implications for RMC. Results We identified four types of communication that occurred in the context of intrapartum care: (a) compassionate, to comfort and support the laboring woman, (b) factual, to obtain or provide information or updates, (c) prescriptive, to obtain consent and cooperation from the woman and her family members, and (d) defensive, to protect against accusations of poor care. Knowledge and power hierarchies operated differently in each type of communication, with prescriptive and defensive communication more likely to be disrespectful than others. Conclusions Our findings suggest that successful implementation of RMC guidelines requires greater attention to knowledge and power hierarchies, and an understanding of the ways in which they operate in a clinical setting. Integrating this understanding into guidelines, medical education, training programmes, and interventions will facilitate effective and respectful communication during maternity care.

Abstract Objective Sarcopenia is linked to escalating health costs, heightened risk of physical disability, diminished quality of life and an increased demand for care services. This study aimed to assess the economic impact of sarcopenia-related disability in Iran. A prevalence-based economic burden study was conducted utilizing the Population Attributable Risk (PAR) method, based on 2022 price index. Prevalence data for sarcopenia, categorized by gender and disease severity, were extracted from recent comprehensive studies. The relative risk of sarcopenia disability was determined from the most robust available evidence. Subsequently, direct medical costs, direct non-medical costs, and indirect costs for each individual with sarcopenia were computed and adjusted to 2022 values to estimate disability costs. Results Taking into account the prevalence of sarcopenia and the Iranian population across various age groups, 2,192,168 adults aged ≥ 60 years with sarcopenia in Iran were included. The total PAR of sarcopenia for men and women was estimated at 49% and 28%, respectively. The cumulative direct medical costs, direct non-medical costs, and indirect costs amounted to $215.1 million, $7.76 million, and $34.1 million, respectively. Additionally, the average total economic burden of sarcopenia-related disability in Iranian population aged ≥ 60 years was estimated at $257.1 million.

The study examines the selective adoption of the school-autonomy-with-accountability (SAWA) reform at upper secondary school level in Iceland. It draws on a review of policy documents (acts, amendments to acts, regulations) and interviews with 17 individuals, including four former ministers of education that served over the period 1995-2017. The authors identify three distinct reform waves: a general public management reform (NPM) implemented across all sectors (1991 – 1995), the school autonomy reform (1995-2009), and the school-autonomy-with-soft-accountability reform (2009-2015). The sequence explains why opening up to the private sector during NPM required all line ministries to come up with clearly defined tasks and expected outcomes and why the third wave was an attempt to (minimally) reregulate the sector. The proliferation of standardized testing, a feature of SAWA in many other countries, did not occur in Iceland. Strikingly, the argument for autonomy was from the onset linked to diversity, that is, enabling upper secondary schools to respond to students’ diverse needs and interests and thereby reduce student drop. The study attempts to demonstrate the importance of the temporal dimension of policy transfer such as, for example, the timing, tempo, sequence and duration of adopted policies.

Objective: Schizophrenia which is a chronic disabling burdensome psychotic disorder has been treated with different antipsychotic medications. Some studies have reported a possible correlation between deficiency in minerals, nutrients and vitamins — mainly group B vitamins — and the development of schizophrenia. In the present study, we aimed to examine the effect of the B vitamin group as an adjuvant treatment to antipsychotics in individuals with chronic schizophrenia. Method: In a randomized, double-blind clinical trial study, involving two groups of 25 patients with chronic schizophrenia, we compared the effects of a 12-week adjuvant treatment with a combination of B vitamins — B1 (15mg), B2 (15mg), B6 (10mg), B12 (10µg) and nicotinamide (50 mg) — with a placebo. The impact on negative, positive and cognitive symptoms of schizophrenia was assessed for both groups before the intervention (T0) and at 4, 8 and 12 weeks after the intervention (T1, T2, and T3, respectively). Results: Following the treatment, negative symptoms scores decreased in the treatment group at 12 weeks following the beginning of the treatment (F (4, 45) = 464.7, P < 0.0001). Although a trend toward improvement in positive symptoms and cognitive scores was seen, these changes were not significant. Conclusion: Our results suggest that selecting the group B vitamins as an adjuvant treatment to the antipsychotics may have beneficial effects on improving negative symptoms of patients with chronic schizophrenia.

Over recent decades, nanomedicine has played an important role in the enhancement of therapeutic outcomes compared to those of conventional therapy. At the same time, nanoparticle drug delivery systems offer a significant reduction in side effects of treatments by lowering the off-target biodistribution of the active pharmaceutical ingredients. Cancer nanomedicine represents the most extensively studied nanotechnology application in the field of pharmaceutics and pharmacology since the first nanodrug for cancer treatment, liposomal doxorubicin (Doxil®), has been approved by the FDA. The advancement of cancer nanomedicine and its enormous technological success also included various other target diseases, including hepatic fibrosis. This confirms the versatility of nanomedicine for improving therapeutic activity. In this review, we summarize recent updates of nanomedicine platforms for improving therapeutic efficacy regarding liver fibrosis. We first emphasize the challenges of conventional drugs for penetrating the biological barriers of the liver. After that, we highlight design principles of nanocarriers for achieving improved drug delivery of antifibrosis drugs through passive and active targeting strategies.

The present study employs the Delphi method to devise a consensus-based protocol for utilizing integrated acupuncture in treating medial tibial stress syndrome (MTSS). Twenty acupuncture experts contributed opinions across six key themes, including diagnosis, acupuncture points, additional Traditional Oriental Medicine modalities, treatment rationale, treatment duration/frequency, and integration of yoga/naturopathic therapies. Consensus, defined as a 70% agreement or higher, was reached on all themes, reflecting a collective acknowledgment of the necessity for a holistic approach to MTSS management. The final protocol includes six diagnostic criteria, six acupuncture points, one additional modality, two Traditional Oriental Medicine therapies, four treatment rationales, and six yoga/naturopathic therapies. The present comprehensive protocol offers valuable guidance for healthcare professionals seeking an integrated approach to MTSS management.

Abstract Aim Manipulation of the intestinal microbiome and supplying vitamin D can attenuate psychiatric symptoms in schizophrenic patients. The current study tried to evaluate the effects of probiotic/vitamin D supplementation on the cognitive function and disease severity of schizophrenic patients. Methods In the present study, 70 patients (aged 18–65) with schizophrenia were recruited. Participants were randomly allocated to the placebo (n = 35) and intervention (probiotic supplements+400 IU vitamin D, n = 35) groups. Severity of disease and cognitive function (primary outcomes) were evaluated by Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MoCA) tests, respectively. Moreover, lipid profile, body mass index (BMI), gastrointestinal (GI) problems, serum C‐reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated as secondary outcomes. Results A total of 69 patients completed the study. The MoCA score was increased by 1.96 units in the probiotic‐containing supplement group compared to the placebo (p = 0.004). Also, the percentage of subjects with MoCA score ≥ 26 rose significantly in the intervention group (p = 0.031). Moreover, TC (p = 0.011), FBS (p = 0.009), and CRP (p

Background The aim of this study was to investigate the association of osteosarcopenia with frailty and poor health conditions among older Iranian adults. Methods This cross-sectional study analyzed data from the Bushehr Elderly Health Program. Osteosarcopenia was defined as the presence of osteopenia/osteoporosis and sarcopenia, while the Fried criteria were used to assess frailty. We assessed the history of falls and health-related quality of life (HRQoL), including physical and mental component summaries (PCS and MCS, respectively), history of fractures, activities of daily living (ADL), and instrumental activities of daily living (IADL), as indicators of poor health conditions. Results This study included a total of 2,371 older adults. The prevalence rates of osteosarcopenia-only, frailty-only, and osteosarcopenia with frailty were 17.4%, 3%, and 4.8%, respectively. The prevalence of a history of falls, poor ADL, and poor IADL was significantly higher in the frailty-only and osteosarcopenia with frailty groups. Osteosarcopenia with frailty was significantly associated with a history of falls (adjusted odds ratio [adjOR]=1.94; 95% confidence interval [CI], 1.20–3.15), poor ADL (adjOR=2.85; 95% CI, 1.81–4.50), and poor IADL (adjOR=5.09; 95% CI, 2.85–9.11). However, the frailty-only group also showed an association with falls and poor ADL and IADL. Only osteosarcopenia was associated with an increased OR for fracture. Frailty had the greatest effect on the MCS and PCS scores, whereas osteosarcopenia with frailty had a moderate impact. Conclusion Osteosarcopenia with frailty significantly increased the odds of falls, poor ADL, poor IADL, and lower HRQoL compared with the robust group. Combined osteosarcopenia and frailty were not associated with poor health. These findings indicate the importance of diagnosing osteosarcopenia and frailty as separate entities to provide appropriate interventions and treatment.

Yezo virus (YEZV) is an emerging tick-borne virus that causes acute febrile illness. It has been continuously reported in patients and ticks in Japan and China since its first identification in Hokkaido, Japan. While serological tests have demonstrated that YEZV infections are prevalent in wild animals, such as raccoons (Procyon lotor), the determinants of infection in wild animals remain largely unknown. We examined the prevalence of YEZV in invasive raccoons, native tanukis (raccoon dogs, Nyctereutes procyonoides albus), and ticks in six study areas in Hokkaido between 2018 and 2023 to identify ecological factors underlying YEZV infection in wild animals. YEZV RNA fragments were detected in 0.22% of the 1,857 questing ticks. Anti-YEZV antibodies were detected in 32 of the 514 (6.2%) raccoon serum samples and in 5 of the 40 (12.5%) tanuki serum samples. Notably, the seroprevalence in raccoons varied significantly in one of the study areas over the years, that is, 0.0%, 60.0%, and 28.6% in 2021, 2022, and 2023, respectively, implying the temporary emergence of YEZV microfoci. By analyzing the tick load and YEZV seropositivity in raccoons in a field-based setting, we found a positive correlation between adult Ixodes ovatus load and YEZV-antibody positivity, highlighting the importance of I. ovatus in YEZV infection in wild animals. We also explored the environmental and host factors influencing YEZV seropositivity in raccoons and tanukis and found that landscape factors, such as the size of forest area around the trap site, were crucial for YEZV seropositivity in these animals. The significant variables for YEZV seropositivity in raccoons were partially different from those affecting tick infestation intensity in raccoons. The present results extend our understanding of tick-borne virus circulation in the field, emphasizing the unique ecology of the emerging YEZV.

Revealing interactions between ticks and wild animals is vital for gaining insights into the dynamics of tick-borne pathogens in the natural environment. We aimed to elucidate the factors that determine tick infestation in wild animals by investigating ticks on invasive raccoons (Procyon lotor) in Hokkaido, Japan. We first examined the composition, intensity, and seasonal variation of ticks infesting raccoons in six study areas in Hokkaido from March 2022 to August 2023. In one study area, ticks infesting tanukis (raccoon dog, Nyctereutes procyonoides albus) were collected in May to July in both 2022 and 2023, and questing ticks were collected from the vegetation by flagging every other week in the same period. Next, we screened 17 environmental and host variables to determine factors that affect the number of ticks infesting raccoons using generalized linear (mixed) models. From 245 raccoons, we identified a total of 3,917 ticks belonging to eight species of two genera: the most prominent species were Ixodes ovatus (52.9 %), followed by Haemaphysalis megaspinosa (14.4 %), Ixodes tanuki (10.6 %), and Ixodes persulcatus (9.5 %). Ixodes ovatus was also predominant among questing ticks and ticks infesting tanukis. Although I. tanuki was frequently collected from raccoons and tanukis, it was rarely collected in the field. The variables that significantly affected the infestation on raccoons differed by genus, species and developmental stage of the tick. For instance, the infestation of adult I. ovatus was significantly affected by four variables: night-time temperature during nine days before capturing the raccoon, the size of forest area around the capture site, sex of the raccoon, and sampling season. The first two variables were also responsible for the infestation on raccoons of almost all species and stages of ticks. Our study revealed that the number and composition of ticks infesting raccoons can be affected not only by landscape of their habitats but also by weather conditions in several days before capturing.

The paper presents the research, development, and some of the major implementations to date of the web-based platform for intelligent cultural content management CultIS. It is an innovative environment providing descriptive cataloging, subject indexing, intelligent data retrieval, curation and collection development aimed at meeting the functional needs associated with the growing expectations of users of cultural institutions such as libraries, museums and other providers of cultural and historical heritage. Based on the implementations of CultIS for different purposes and contexts, not only its effectiveness, stability and reliability are tested, but the results also serve for its constant development and improvement.

Early laboratory confirmation is important for the accurate diagnosis and treatment of patient infected by leptospirosis. However, Microscopic agglutination test (MAT) as the gold standard for detection of human leptospirosis has many limitation and only available in reference laboratories. Therefore, many studies suggested LipL32 protein as a good candidate for development of leptospirosis detection kit because it is highly conserved and produced only in pathogenic Leptospira species. In this study, we aim to investigate the performance of our in-house ELISA using recombinant LipL32 to detect leptospirosis in Indonesia. Fourteen human sera were used in this study and the infection status were determine using MAT. The result showed that nine of eleven MAT positive sera were successfully recognized by LipL32 ELISA. The antibody binding to LipL32 was also confirm by immunoblot. There was one of three MAT negative sera has high OD above 0.5 in ELISA, but it showed negative reaction in immunoblot result. Overall, this study demonstrated that recombinant LipL32 protein can recognized antibody from human leptospirosis and can be used as a universal antigen to detect infection by any serovars of pathogenic leptospira.

Abstract As the population ages, the global burden of cardiometabolic disorders will increase. This study aimed to investigate the prevalence of cardiometabolic disorders (diabetes, hypertension, and hyperlipidemia) in elderly and to evaluate the effects of various variables including age, sex, education, marital status, smoking, income, physical activity, dementia and depressed mood on untreated cardiometabolic disorders. This was a cross sectional study conducted in Bushehr Elderly Health Program. A total 2381 participants were included. Medical data were collected by trained interviewers. The mean age of the study participants was 69.34 years. Proportions of diabetes, hypertension, hyperlipidemia and hypercholesterolemia were 43.25%, 75.71%, 64.74% and 35.31% respectively. Untreated diabetes prevalence was higher for males (OR = 1.60, 95%CI = 1.20–2.15), older adults (OR = 1.02, 95%CI = 1.00–1.05), and pre-frail status (OR = 0.69, 95%CI = 0.52–0.92). Males (OR = 2.16, 95%CI = 1.64–2.84) and current smokers (OR = 1.42, 95%CI = 1.05–1.93), in contrast to married participants (OR = 0.25, 95%CI = 0.08–0.78), people with higher education levels (OR = 0.51, 95%CI = 0.29–0.89) and dementia (OR = 0.78, 95%CI = 0.61–1.00) were more likely to have untreated HTN. Untreated dyslipidemia is more common in smokers (OR = 1.78, 95%CI = 1.19–2.66) and males (OR = 1.66, 95%CI = 1.21–2.27), while untreated hypercholesteremia is more common in males (OR = 3.20, 95%CI = 1.53–6.69) and is reported lower in people with dementia (OR = 0.53, 95%CI = 0.28–1.01).

Abstract Background Social media is widely used by medical students, including for learning purposes since it facilitates their involvement in the communities of inquiry where they can share, express, and engage in the development of knowledge. Navigating the use of social media requires self-regulated learning (SRL) skills. Hence, studies on the relationships between social media use and SRL skills are necessary. Aim This study aims to investigate the relationships between social media use and students’ SRL skills. Methods A cross-sectional study was conducted using two validated questionnaires: the Social Networking Sites for Medical Education questionnaire (SNSME, 19 items) and the Motivated Strategies for Learning Questionnaire (MSLQ, 81 items). Cross-cultural adaptation and exploratory factor analysis (EFA) were also completed for the SNSME questionnaire, followed by descriptive and bivariate analysis. Results and discussion The SNSME questionnaire is valid for use in the current setting and consists of three subscales: (1) attitudes towards the use of social media for learning and knowledge development, (2) the use of social media for information sharing and interaction, and (3) the use of social media for knowledge development and research. Among 1,122 respondents, male students presented lower scores than female students in the total score of social media for learning (80 vs. 82, p 0.007), and public medical students showed higher scores in terms of attitudes towards the use of social media for learning and knowledge development compared to private medical students (83 vs. 81, p 0.007). The differences in SRL scores for different education stages and among students from public and private medical schools were statistically significant (426 vs. 418, p 0.003, and 436 vs. 418, p

Abstract Background Type 2 diabetes mellitus (T2DM) is the most prevalent form of Diabetes Mellitus (DM), with social and economic determinants significantly influencing its prevalence. This study aimed to analyze the socioeconomic inequalities associated with T2DM in Iran. Methods Data from an observational survey in Iran, titled “Diabetes Care (DiaCare),” were utilized for this study. Socioeconomic inequalities were assessed through variables including Hemoglobin A1C (HbA1c), Fasting Blood Glucose (FBG), and Triple target (HbA1c, blood pressure, LDL-C), using concentration indices (CIs) and a multivariate logistic regression analysis. Individual socioeconomic status (SES) was determined by calculating an asset index using principle component analysis (PCA) based on their properties. Data analysis was conducted using STATA software version 14. Results A total of 13,321 participants were included in the study. The CIs were significantly positive for controlled HbA1c (0.0324) and triple target (0.1067), while for controlled FBG, it was 0.0125, although not significant. Among females, the CIs were significantly positive for controlled HbA1c (0.0745), FBG (0.0367), and triple target (0.209). Additionally, in the 45–55 and 65–75 age groups, the CIs were significantly positive for controlled HbA1c (0.0607) and FBG (0.0708), respectively. This index was significant for controlled Triple target in the 35–45 (0.376) and 65–75 (0.124) age groups. The CI for controlled FBG was significant in rural dwellers (-0.044) while the concentration of controlled triple target was significant in urban dwellers (0.0967). Controlled HbA1c showed significant concentration in both urban (0.0306) and rural (-0.0576) dwellers. Furthermore, the CIs were significant for controlled HbA1c in regions with medium prevalence (0.0534) and FBG in regions with low prevalence (-0.0277). This index was significantly positive for controlled triple target in regions with high prevalence (0.124). Conclusions Diabetes care is more concentrated among individuals with higher SES. Policymakers should consider this to mitigate the inequality and alleviate the burden of T2DM.

Objectives: On 11 March 2020, the World Health Organization (WHO) announced the detection of a new virus epidemic in Wuhan, China. Many studies have shown that the SARS-CoV-2 virus can cause mental disorders, such as anxiety, depression, and bipolar disorder. Here, we presented a case without a history of psychiatric illness. After contracting COVID-19 Case Presentation: A 40-year-old woman was hospitalized for ten days and then discharged. However, on the fourth day following her discharge, the patient exhibited talkative, energetic, and distractible behavior. She believed herself to be God’s daughter with the ability to cure COVID-19, leading to abnormal behaviors and necessitating readmission. Treatment was started with haloperidol 5 mg, sodium valproate 500 g, and clonazepam 2 mg. By the 17th day, the patient’s mania rating scale score had decreased. Discussion: This case report underscores the significance of viral diseases as triggering and exacerbating factors in bipolar disorder. It also emphasizes the importance of considering viral infections as potential causes of psychiatric symptoms in individuals with COVID-19.

Flavonoids are naturally occurring plant molecules. Fisetin belongs to a class of flavonoids; it is a bioactive polyphenolic flavanol molecule found in fruits and vegetables with potential pharmacological activities. This study was designed to validate a simple method for estimating and evaluating fisetin in the strawberry extract by spectrophotometry. Methodology: Isolation of fisetin from the methanolic extract of Fragaria ananassa with chloroform by liquid-liquid extraction technique. The wet granulation method was formulated for making the tablet by incorporating pure fisetin as a biomarker. Spectrophotometric detection was carried out at an absorption maximum of 362 nm using methanol as solvent. The method was validated by linearity, accuracy, and precision studies. In the validation study, fisetin obeyed Beer-Lambert's law in the concentration range of 1 to 8 µg/mL, and it was found to be linear with a correlation coefficient of 0.99, and the regression equation was found to be Y= 0.10x -0.04. Found the percentage relative standard deviation among all the responses was less than 2%, indicating the method's precision. The percentage recovery of fisetin was found to be in the range of 96.61 to 101.63%. The present study was statistically confirmed. Therefore, the proposed approach can accurately measure the active marker compound in the crude drug (fisetin). The analysis allows the optimization of a precise method for determining the fisetin in the fruit of Fragaria ananassa, which can be used to support the quality assessment of this herbal material.

This paper will focus on illustrating through qualitative personal narratives the lived realities of three South Asian Indian women in academia across the continuum of their experiences personally, professionally, and as academics within the field of Marriage and Family Therapy (MFT). The authors will speak to their South Asian identity, their acculturation experiences as Asian Indian women in the US professional and academic context, their different generational experiences in immigration journeys, their different academic and clinical journeys, and other contextual variables such as age, solidarity with other South Asian women in academia, peer mentorship experiences, and finding their own voices and empowerment through connections with other women with similar experiences. In addition to the lack of formal academic mentorship, the authors will describe how they as South Asian Indian women have grappled with the challenges of systemic gender and racial biases that undermined their development as academics and hindered their progress toward gender and racial equality in academic and clinical settings. The authors will situate their personal narratives within the frameworks of feminist solidarity and social justice through describing their mentorship experiences, as mentors and mentees, and how they still were able to establish their professional identities as professional, academic, South Asian women of color.

IntroductionChronic depression and anxiety can be a risk factor for coronary aArtery bypass grafting (CABG) and is an emerging factor after coronary artery disease when the patient is admitted to the hospital and after surgery. We aimed to assess the effect of Escitalopram in treating mild to moderate depressive disorder and improving the quality of life in patients undergoing CABG.MethodsIn this randomized clinical trial, 50 patients undergoing CABG referred to Tehran Heart Hospital from January 2021 to May 2021 and were suffering from mild to moderate depression were randomly assigned to one of the two groups of Escitalopram or placebo. The level of depression was assessed based on Beck’s depression inventory and the quality-of-life status and its domains were assessed based on the SF-36 questionnaire in 2 groups. Measurements were obtained at baseline and at four and eight weeks after treatment. Chi-square, Fisher’s exact, paired, and Wilcoxon tests or ANOVA were used as appropriate.ResultsThere was no significant difference between the level of depression between the two study groups at baseline (P=0.312). There was no significant difference between the quality of life and its domains in the two study groups at baseline (P=0.607). However, the most important effect of Escitalopram was reducing depression scores in the intervention group at weeks 4 and 8 after treatment compared to the placebo group (P0.05).ConclusionEscitalopram was effective in treating mild to moderate depressive disorder and improving quality of life in patients undergoing CABG.Clinical trial registrationhttps://irct.behdasht.gov.ir/, identifier IRCT20140126016374N2.

Objective: Manic and mixed episodes of bipolar disorder are important episodes of this disorder. The aim of the current study was to assess serum vitamin D (SVD) levels in patients with mania and mixed bipolar disorder, compared to healthy subjects. Method: The current cross-sectional study was conducted on 75 subjects, including healthy subjects (n = 25), patients with acute-phase mania (n = 25), and patients with mixed bipolar disorder (n = 25). The SVD levels were measured in all of the enrolled subjects. The Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Clinical Global Impression- Severity (CGI-S) were used to assess disease activity in patient groups. Data analysis was performed using SPSS version 18. For statistical analysis, analysis of variance (ANOVA), independent-sample t test, Pearson correlation, and Chi-square tests were utilized. P-values < 0.05 were considered statistically significant. Results: The results showed that the mean of SVD was significantly lower in mania and mixed bipolar patients compared to healthy subjects (P < 0.05). In addition, the number of subjects with SVD ≥ 20 ng/ml was higher in the healthy group compared to the patient groups (P < 0.05). Also, SVD was negatively correlated with the CGI-S (r = -0.311; P = 0.028), YMRS (r = -0.464; P = 0.001), and HDRS (r = -0.393; P = 0.005) in the total patient subjects. Conclusion: Prevalence of low SVD was considerably high in mania and mixed bipolar patients compared to healthy subjects. Additionally, meaningful negative correlations were found between SVD and disease activity-related variables including the HDRS, YMRS, and CGI-S.

Abstract Background Urinary tract cancers including bladder, kidney, ureter, and pelvis are a common malignancy worldwide with high mortality ratio. Aimed to investigate the prevalence of these cancers, we conducted this study. Methods In this study, all the information related to ICD10 codes, gender, age and province of residence of individuals were obtained from the data of Iran’s cancer registry by the Ministry of Health, Medicine and Medical Education and demographic evidence for each sub-country from the reports of Statistics Center of Iran (SCI). Also, the data of two Iranian national survey studies CASPIAN-III, IV, and V (information related to the care and prevention of non-communicable diseases (NCD) in childhood and adolescence) and STEPs (including information on NCD in adults over 18 years old) were used. The data was analyzed using Poisson regression with mixed effects to estimate the incidence of cancers. Results Bladder and kidney neoplasm are the most common cancers of the urinary system in Iran. The prevalence of bladder cancer has increased from 5.82 to 11.50 per 100,000 individuals. The increasing trend is growing faster in men compared with women. The incidence of kidney neoplasm has increased over the years (2.03 in 2005 vs. 7.02 in 2020 per 100,000). Having a higher incidence ratio compared with bladder cancer, kidney cancer is responsible for 35.06% of all urinary cancers in 2020 compared with 23.71% in 2005. Both neoplasms of the ureter and renal pelvis were recorded rarely and with lower incidence in both sexes during this period. Conclusion Considering the increasing trend in the incidence of urinary neoplasms in Iran during these years, the advantage of focusing on the risk of urinary cancers is highlighted. Therefore, investigating the prevalence and incidence of urinary cancers to plan and manage these cancers will result in prevention and reduction of the disease burden on the Iranian society. Future studies in this field can help in the prevention and well-timed diagnosis of these cancers.

Abstract Background Metabolic syndrome (MetS) known as a risk factor for cardiovascular diseases (CVDs) has developed into a major source of health issue, especially for the elderly. In the present study, we investigated the association between continuous MetS (cMetS) score and its components with electrocardiographic (ECG) abnormalities in the community-dwelling older adults. Methods This cross-sectional study is derived from the second phase of BEH cohort study which is conducted on individuals aged over 60 years old. Standard 12-lead ECGs were recorded and coded by qualified physicians and continuous values of metabolic syndrome risk scores (cMetS) were measured. Data regarding socio-demographic, medical history, and lifestyle variables were collected by trained interviewers. The multinomial regression analysis was used to investigate the relationship between cMetS and its components with ECG abnormalities in the included participants. Results 2426 individuals (mean age ± standard deviation: 69.30 ± 6.33 years) were included in the final analysis. Overall, 22.5% of the participants showed ECG abnormalities. Among these, 8.0% (n = 139) of participants had minor and 14.6% (n = 354) had major ECG abnormalities. In the final models, cMetS (OR = 1.04), mean arterial pressure (MAP((OR = 1.01), and higher fasting blood glucose (FBG) (OR = 1.01) increased the risk of ECG abnormalities (p

Objectives: This cross-sectional study, conducted as part of the Bushehr Elderly Health program stage II in Bushehr, Iran, aimed to evaluate health-related quality of life (HR-QoL) in individuals aged ≥ 60 with osteosarcopenia, a condition characterized by the co-occurrence of osteopenia/osteoporosis and sarcopenia. Given the increasing elderly population worldwide, understanding the HR-QoL of this demographic is crucial, with osteosarcopenia being a significant factor. Methods: The study enrolled 2369 participants aged ≥ 60 and collected demographic and anthropometric data. Various questionnaires, including the Short Form 12, Patient Health Questionnaire-9, Activities of Daily Living, and Instrumental Activities of Daily Living, were administered. Comparisons were made between individuals with and without osteosarcopenia. Regression models were employed to identify variables associated with HR-QoL in those with osteosarcopenia. Results: Key findings revealed that 22.5% of participants had osteosarcopenia. Significantly different HR-QoL measures were observed between the 2 groups, especially in physical functioning and physical component summary scores. Male gender, advanced age, and chronic illnesses were linked to lower physical and mental HR-QoL scores among those with osteosarcopenia. In female participants, a history of fractures and physical disability were associated with reduced quality of life. Conclusions: This study underscores the negative impact of osteosarcopenia on HR-QoL, particularly in male participants, with a focus on physical aspects. It also highlights age and chronic disease as contributing factors to diminished HR-QoL in individuals with osteosarcopenia. These findings emphasize the importance of addressing osteosarcopenia in the elderly population to improve their overall well-being.

Without good financial planning, it will not be easy to achieve all of one's financial goals in the future. The purpose of this community service is to teach students how to manage finances so that they can understand personal financial planning and be wise in managing their finances. This activity is aimed at students of the Faculty of Business, Economics, and Accountancy Universiti Malaysia Sabah and students of the Faculty of Economics and Management Universiti Kebangsaan Malaysia. Knowledge of financial planning will be taught by a lecturer and a speaker from Finansialku as a digital financial application to introduce how to use the application for financial planning. The result of this event is that students need to have sufficient and good financial literacy in order to be able to prepare their financial condition for the future.

The asymmetrical competence model continues to undermine the model of risk-related standard of competence. While some theorists equivocate two senses of competence, those of competence to complete a task and competence in completing a task, this process fails to address issues such as objective evaluation, benevolent intervention and individual autonomy.