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Most S. aureus infections are multidrug resistant. S. aureus infections often occur with prolonged conditions, causing increased treatment costs and mortality rates. There is a need to understand the antibiotic susceptibility pattern to S. aureus in mothers and infants because the burden of S. aureus infection in infants is high. This study aims to determine the prevalence of nasal carriers of S. aureus in lactating mothers and their infants and their antibiotic susceptibility patterns. This cross-sectional study involved 59 pairs of breastfeeding mothers and infants aged 0 to 6 months. The research was conducted in the work area of the South Tangerang City Health Office. We take a nasal swab of the mother and the baby. We used Vitek-2 to determine antibiotic resistance against S. aureus. Overall, we found 22/59 (37%) S. aureus in infants’ noses, 18% of whom were MRSA. In mothers, we found 18/59 (30%) S. aureus isolates and 17% were MRSA. The majority of S. aureus isolates from infants were sensitive to cefoxitin (82%), gentamicin (86%), ciprofloxacin (91%), levofloxacin (95%), moxifloxacin (91%), vancomycin (100%), clindamycin (82%), erythromycin (86%), nitrofurantoin (100%), linezolid (100%) and tetracycline (77%). The majority of S. aureus isolates from mothers are sensitive to cefoxitin (83%), gentamicin (94%), ciprofloxacin (89%), levofloxacin (89%), moxifloxacin (89%), vancomycin (100%), clindamycin (89%), erythromycin (89%), nitrofurantoin (100%), linezolid (100%) and tetracycline (83%). MRSA monitoring of mothers and babies in the community needs to be done to prevent and control the spread.

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Multiple myeloma is a neoplastic proliferation of immunoglobulin-producing plasma cells with clinical features resulting from infiltration of plasma cells into bones and other organs. Multiple myeloma manifesting as an apical lung mass is less common and very few cases have been reported. We report the case of a 50-year-old female who presented with an apical lung mass which happened to be multiple myeloma arising from the upper ribs into the lung. At the time of diagnosis, patient had axillary lymph node metastasis with extensive bony involvement. This case report and literature review provides insight to a rare but significant presentation of multiple myeloma and highlights the need to consider multiple myeloma as a possible differential for Pancoast tumor in the appropriate clinical setting as this could potentially affect management options and patient outcome.

The inhibition of acetylcholinesterase (AChE), the key enzyme in the breakdown of acetylcholine, is presently the most common pharmacological approach available for Alzheimer’s disease (AD). Despite research on the molecular bases of AD, potent therapeutic agent against its expansion is still needed. In searching for natural cholinesterase inhibitors, the present study was focused on the isolation of three new norditerpenoid alkaloids, uncinatine B-D together with known virescenine from Delphinium uncinatum. Chemical structures for all the isolated norditerpenoids (1–4) were established using latest spectroscopic techniques. The isolated undescribed compounds along with known virescenine were testified for their acetylcholinesterase inhibitory activity supported by docking analyses. Molecular docking simulation showed that the isolated compounds (1–4) were observed to adhered in the active site of AChE with docking scores − 13.5322 (1), −11.8173 (2), −12.4240 (3) and − 8.9352 (4) respectively. Overall results demonstrated that these natural norditerpenoids compounds were found as selective inhibitors of AChE. This is the first report regarding the use of bioactive ingredients of Delphinium uncinatum in testing against Alzheimer's disease.

The conventional chemical methods of nanoparticles synthesis have been effectively replaced by nanoparticle synthesis mediated by plants. The current study describes the environmental friendly synthesis of chromium oxide nanoparticles (Cr2O3 NPs) using Erythrophleum guineense plant extract. The synthesis of Cr2O3 NPs was validated by UV/VIS spectroscopy, Energy Dispersive X-Ray (EDX), Scanning Electron Microscopy (SEM), and X-ray diffraction (XRD) studies. The appearance of the Sharpe peak at 460 nm in the UV/Vis spectrum and the colour change caused by surface plasma resonance confirmed the formation of Cr2O3 NPs. The EDX spectrum of Cr2O3 nanoparticles revealed the presence of carbon, oxygen, and chromium, while SEM analysis revealed an irregular round morphology (with a size below 400 nm). In addition, XRD studies suggested their crystalline nature by the characteristic peaks at 34° and 36° and 42° (2Ɵ), respectively. The green synthesized Cr2O3 NPs showed promise as in-vitro cholinesterase inhibitor at tested concentrations (62.5–1,000 μg/ml), with IC50 values of 120 and 100 μg/ml against Acetylcholinesterase (AChE) and Butyrylcholinesterase (BChE), respectively. The results suggested that the green synthesized Cr2O3 NPs could be used in the future to stop enzyme from working and for other biological activities.

Coronary reactive hyperemia (CRH) protects the heart against ischemia. Adenosine A2AAR-deficient (A2AAR-/-) mice have increased expression of soluble epoxide hydrolase (sEH); the enzyme responsible for breaking down the cardioprotective epoxyeicosatrienoic acids (EETs) to dihydroxyeicosatrienoic acids (DHETs). sEH-inhibition enhances CRH, increases EETs, and modulates oxylipin profiles. We investigated the changes of oxylipins and their impact on CRH in A2AAR-/- and wild type (WT) mice. We hypothesized that the attenuated CRH in A2AAR-/- mice is mediated by changes in oxylipin profiles, and that it can be reversed by either sEH- or ω-hydroxylases-inhibition. Compared to WT mice, A2AAR-/- mice had attenuated CRH and changed oxylipin profiles, which were consistent between plasma and heart perfusate samples, including decreased EET/DHET ratios, and increased hydroxyeicosatetraenoic acids (HETEs). Plasma oxylipns in A2AAR-/- mice indicated an increased proinflammatory state including increased ω-terminal HETEs, decreased epoxyoctadecaenoic/dihydroxyoctadecaenoic acids (EpOMEs/DiHOMEs) ratios, increased 9-hydroxyoctadecadienoic acid, and increased prostanoids. Inhibition of either sEH or ω-hydroxylases reversed the reduced CRH in A2AAR-/- mice. In WT and sEH-/- mice, blocking A2AAR decreased CRH. These data demonstrate that A2AAR-deletion was associated with changes in oxylipin profiles, which may contribute to the attenuated CRH. Also, inhibition of sEH and ω-hydroxylases reversed the reduction in CRH.

Arachidonic acid is metabolized to epoxyeicosatrienoic acids (EETs) by cytochrome (CYP) P450 epoxygenases, and to ω-terminal hydroxyeicosatetraenoic acids (HETEs) by ω-hydroxylases. EETs and HETEs often have opposite biologic effects; EETs are vasodilatory and protect against ischemia/reperfusion injury, while ω-terminal HETEs are vasoconstrictive and cause vascular dysfunction. Other oxylipins, such as epoxyoctadecaenoic acids (EpOMEs), hydroxyoctadecadienoic acids (HODEs), and prostanoids also have varied vascular effects. Post-ischemic vasodilation in the heart, known as coronary reactive hyperemia (CRH), protects against potential damage to the heart muscle caused by ischemia. The relationship among CRH response to ischemia, in mice with altered levels of CYP2J epoxygenases has not yet been investigated. Therefore, we evaluated the effect of endothelial overexpression of the human cytochrome P450 epoxygenase CYP2J2 in mice (Tie2-CYP2J2 Tr) on oxylipin profiles and CRH. Additionally, we evaluated the effect of pharmacologic inhibition of CYP-epoxygenases and inhibition of ω-hydroxylases on CRH. We hypothesized that CRH would be enhanced in isolated mouse hearts with vascular endothelial overexpression of human CYP2J2 through modulation of oxylipin profiles. Similarly, we expected that inhibition of CYP-epoxygenases would reduce CRH, whereas inhibition of ω-hydroxylases would enhance CRH. Compared to WT mice, Tie2-CYP2J2 Tr mice had enhanced CRH, including repayment volume, repayment duration, and repayment/debt ratio (P < 0.05). Similarly, inhibition of ω-hydroxylases increased repayment volume and repayment duration, in Tie2-CYP2J2 Tr compared to WT mice (P < 0.05). Endothelial overexpression of CYP2J2 significantly changed oxylipin profiles, including increased EETs (P < 0.05), increased EpOMEs (P < 0.05), and decreased 8-iso-PGF2α (P < 0.05). Inhibition of CYP epoxygenases with MS-PPOH attenuated CRH (P < 0.05). Ischemia caused a decrease in mid-chain HETEs (5-, 11-, 12-, 15-HETEs P < 0.05) and HODEs (P < 0.05). These data demonstrate that vascular endothelial overexpression of CYP2J2, through changing the oxylipin profiles, enhances CRH. Inhibition of CYP epoxygenases decreases CRH, whereas inhibition of ω-hydroxylases enhances CRH.

The increasing survival rate after discharge from the intensive care unit (ICU) has revealed long-term impairments in the cognitive, psychiatric, and physical domains among survivors. However, clinicians often fail to recognize this post-ICU syndrome (PICS) and its debilitating effects on family members (PICS-F). This study describes two cases of PICS to illustrate the different impairments that may occur in ICU survivors. The PICS risk factors for each domain and the interactions among risk factors are also described. In terms of diagnostic evaluation, limited evidence-based or validated tools are available to assist with screening for PICS. Clinicians should be aware to monitor for its symptoms on the basis of cognitive, psychiatric, and physical domains. The Montreal Cognitive Assessment is recommended to screen for cognition, as it has a high sensitivity and can evaluate executive function. Mood disorders should also be screened. For mobile patients, a 6-minute walk test should be performed. PICS can be prevented by applying the ABCDEF bundle ABCDEF bundle in ICU described in this paper. Finally, the family members of patients in the ICU should be involved in patient care and a tactful communication approach is required to reduce the risk of PICS-F.

The Sadranan tradition is a tradition that has existed for a long time since ancient times, especially in the Kecandran area. The results show the Sadranan is held once a year, usually in mid-November and June. All from various backgrounds follow this Sadranan tradition. This tradition is carried out after the month of Shuro. The purpose of Sadranan is; first, this tradition is gratitude to Allah SWT for pleasure, and the second is as a form of respect for ancestors. Third, strengthen a sense of solidarity between citizens. Fourth, preserving the traditional inter and indigenous cultures of the area. Some benefits felt by the community are that people feel closer to Allah SWT.

This study examines whether spirituality has an effect on fraud prevention with internal control as an intervening variable. This research is an associative descriptive research. The population used was all employees of the Most District Offices of Kediri Regency using the quota sampling technique determined by the researcher as many as 91 respondents. In this study using the PLS analysis method through the SEM approach and supported by SmartPLS 3.0 software. The results of the study show that Spirituality has a significant effect on internal control and fraud prevention. Furthermore, spirituality has a significant effect on fraud prevention with internal control as an intervening variable. [ABSTRACT FROM AUTHOR]

Coronary reactive hyperemia (CRH) is a physiological response to ischemic insult that prevents the potential harm associated with an interruption of blood supply. The relationship between the pharmacologic inhibition of soluble epoxide hydrolase (sEH) and CRH response to a brief ischemia is not known. sEH is involved in the main catabolic pathway of epoxyeicosatrienoic acids (EETs), which are converted into dihydroxyeicosatrienoic acids (DHETs). EETs protect against ischemia/reperfusion injury and have numerous beneficial physiological effects. We hypothesized that inhibition of sEH by t-AUCB enhances CRH in isolated mouse hearts through changing the oxylipin profiles, including an increase in EETs/DHETs ratio. Compared to controls, t-AUCB-treated mice had increased CRH, including repayment volume (RV), repayment duration, and repayment/debt ratio (p < 0.05). Treatment with t-AUCB significantly changed oxylipin profiles, including an increase in EET/DHET ratio, increase in EpOME/DiHOME ratio, increase in the levels of HODEs, decrease in the levels of mid-chain HETEs, and decrease in prostanoids (p < 0.05). Treatment with MS-PPOH (CYP epoxygenase inhibitor) reduced CRH, including RV (p < 0.05). Involvement of PPARγ in the modulation of CRH was demonstrated using a PPARγ-antagonist (T0070907) and a PPARγ-agonist (rosiglitazone). T0070907 reduced CRH (p < 0.05), whereas rosiglitazone enhanced CRH (p < 0.05) in isolated mouse hearts compared to the non-treated. These data demonstrate that sEH inhibition enhances, whereas CYP epoxygenases-inhibition attenuates CRH, PPARγ mediate CRH downstream of the CYP epoxygenases-EET pathway, and the changes in oxylipin profiles associated with sEH-inhibition collectively contributed to the enhanced CRH.

Most S. aureus infections are multidrug resistant. S. aureus infections often occur with prolonged conditions, causing increased treatment costs and mortality rates. There is a need to understand the antibiotic susceptibility pattern to S. aureus in mothers and infants because the burden of S. aureus infection in infants is high. This study aims to determine the prevalence of nasal carriers of S. aureus in lactating mothers and their infants and their antibiotic susceptibility patterns. This cross-sectional study involved 59 pairs of breastfeeding mothers and infants aged 0 to 6 months. The research was conducted in the work area of the South Tangerang City Health Office. We take a nasal swab of the mother and the baby. We used Vitek-2 to determine antibiotic resistance against S. aureus. Overall, we found 22/59 (37%) S. aureus in infants' noses, 18% of whom were MRSA. In mothers, we found 18/59 (30%) S. aureus isolates and 17% were MRSA. The majority of S. aureus isolates from infants were sensitive to cefoxitin (82%), gentamicin (86%), ciprofloxacin (91%), levofloxacin (95%), moxifloxacin (91%), vancomycin (100%), clindamycin (82%), erythromycin (86%), nitrofurantoin (100%), linezolid (100%) and tetracycline (77%). The majority of S. aureus isolates from mothers are sensitive to cefoxitin (83%), gentamicin (94%), ciprofloxacin (89%), levofloxacin (89%), moxifloxacin (89%), vancomycin (100%), clindamycin (89%), erythromycin (89%), nitrofurantoin (100%), linezolid (100%) and tetracycline (83%). MRSA monitoring of mothers and babies in the community needs to be done to prevent and control the spread. [ABSTRACT FROM AUTHOR]

This study reports the isolation of three new C20 diterpenoid alkaloids, Chitralinine A–C (1–3) from the aerial parts of Delphinium chitralense. Their structures were established on the basis of latest spectral techniques and single crystal X-rays crystallographic studies of chitralinine A described basic skeleton of these compounds. All the isolated Compounds (1–3) showed strong, competitive type inhibition against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) in comparison to standard allanzanthane and galanthamine however, chitralinine-C remained the most potent with IC50 value of 11.64 ± 0.08 μM against AChE, and 24.31 ± 0.33 μM against BChE, respectively. The molecular docking reflected a binding free energy of −16.400 K Cal-mol−1 for chitralinine-C, having strong interactions with active site residues, TYR334, ASP72, SER122, and SER200. The overall findings suggest that these new diterpenoid alkaloids could serve as lead drugs against dementia-related diseases including Alzheimer’s disease.

Alzheimer’s disease is an emerging health disorder associated with cognitive decline and memory loss. In this study, six curcumin analogs (1a–1f) were synthesized and screened for in vitro cholinesterase inhibitory potential. On the basis of promising results, they were further investigated for in vivo analysis using elevated plus maze (EPM), Y-maze, and novel object recognition (NOR) behavioral models. The binding mode of the synthesized compounds with the active sites of cholinesterases, and the involvement of the cholinergic system in brain hippocampus was determined. The synthesized curcumin analog 1d (p < 0.001, n = 6), and 1c (p < 0.01, n = 6) showed promising results by decreasing retention time in EPM, significantly increasing % SAP in Y-maze, while significantly (p < 0.001) enhancing the % discrimination index (DI) and the time exploring the novel objects in NORT mice behavioral models. A molecular docking study using MOE software was used for validation of the inhibition of cholinesterase(s). It has been indicated from the current research work that the synthesized curcumin analogs enhanced memory functions in mice models and could be used as valuable therapeutic molecules against neurodegenerative disorders. To determine their exact mechanism of action, further studies are suggested.

This paper demonstrates the design of augmented reality (AR) in-car driving simulator system architecture and its experimental design. AR in-car driving simulator is developed in order to explore its effect towards subjects' simulator sickness when operating the driving simulator. Sensory conflict theory postulates that simulator sickness is a condition where an information between vestibular input system and visual that provides orientation and movement information is misaligned. Simulator sickness is a well-known issue entangled with simulator and various past research revealed that some of the methods to avoid simulator sickness are by taking prescribed medicine, shortening the length of drives and adjusting light of driving simulation environment. Augmented reality allows a combination between real world views with computer-generated object and runs in a real-time performance. By using AR, it is possible to create an outdoor driving simulator that allows a real world view with a mixture of case study that been replicate by computer. Affording similar driving experience to driving a normal car, AR is believed to be an alternative solution to simulator sickness. Therefore, the AR driving simulator would be employed in experimental study to measure its effect on simulator sickness towards subjects.