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Objective: Over the past several decades, ethnobotany and ethnomedicine have been considered as a more appropriate interdisciplinary approach to drug discovery involving interdisciplinary collaboration. Several studies on ethnomedicine and ethnobotany worldwide have shown that diabetes mellitus has been recognised by the traditional healer as a pathological condition which can be treated with specific medicinal plants. The starting point in an ethno-directed search for anti-diabetic plants is the identification of plant species used by local healers for this purpose. This study aims to document medicinal plants used by local communities for the treatment of diabetes mellitus. Methods: This ethnographical study highlights the emic point of the local people to documents knowledge, belief, and practice of ubar kampung in Sunda Region. Results: The results of this study reveals 20 of most frequently used of medicinal, aromatic, and cosmetic plants by people in Sundanese community. The majority of plant species used for the treatment of diabetes mellitus belong to the families of Asteraceae (2 species), Lauraceae (2 species), and Liliaceae (2 species). Conclusion: Most of the medicinal plants reported in the research area are already publicly acknowledged for their medicinal properties, indicating that their pharmacological activities have been studied in different areas. Medicinal plants such Syzygium polyanthum, Moringa oleifera, Swietenia mahagoni, Allium sativum, and Cinnammomum burmanni have been widely used in several regions by various ethnic groups. Leaves are the most frequently used plant part. In general, infusion and decoction are the most common plant preparation methods in the research area.

A liquid chromatography–tandem mass spectrometry method was developed and validated to quantify the small-molecule inhibitors (SMIs) brigatinib, lorlatinib, pralsetinib and selpercatinib, which are used in patients with oncogenic-driven non-small cell lung cancer. Chromatographic separation was performed on a HyPURITY® C 18 analytical column with a gradient elution using ammonium acetate in water and in methanol, both acidified with formic acid 0,1%. Detection and quantification were performed using a triple quad mass spectrometer with an electrospray ionization interface. The assay was validated over a linear range of 50–2,500 ng/ml for brigatinib, 25–1,000 ng/ml for lorlatinib, 100–10,000 ng/ml for pralsetinib and 50–5,000 ng/ml for selpercatinib. All four SMIs were stable for at least 7 days under cool conditions (2–8°C), and at least 24 h at room temperature (15–25°C) in K2-EDTA plasma. Under freezing conditions (−20°C), all SMIs were stable for at least 30 days, except for the lowest quality control (QC LOW) of pralsetinib. The QC LOW of pralsetinib was stable for at least 7 days at −20°C. This method provides an efficient and simple way to quantify four SMIs with a single assay in clinical practice.

Contains fulltext : 202702.pdf (Publisher’s version ) (Open Access) In the past few decades, cardiac ultrasound has become a widely available, easy-to-use diagnostic tool in many scenarios in acute cardiac care. The introduction of microbubbles extended its diagnostic value. Not long thereafter, several investigators explored the therapeutic potential of contrast ultrasound on thrombus dissolution. Despite large improvements in therapeutic options, acute ST elevation myocardial infarction remains one of the main causes of mortality and morbidity in the western world. The therapeutic effect of contrast ultrasound on thrombus dissolution might prove to be a new, effective treatment strategy in this group of patients. With the recent publication of human studies scrutinising the therapeutic options of ultrasound and microbubbles in ST elevation myocardial infarction, we have entered a new stage in this area of research. This therapeutic effect is based on biochemical effects both at macrovascular and microvascular levels, of which the exact working mechanisms remain to be elucidated in full. This review will give an up-to-date summary of our current knowledge of the therapeutic effects of contrast ultrasound and its potential application in the field of ST elevation myocardial infarction, along with its future developments.

Objective Acute peripheral arterial occlusions can be treated by catheter directed thrombolysis (CDT). However, CDT is time consuming and accompanied by the risk of bleeding complications. The addition of contrast enhanced ultrasound and microbubbles could improve thrombus susceptibility to thrombolytic agents and potentially shorten treatment time with a lowered risk of bleeding complications. This article reports the outcomes of the safety and feasibility of this novel technique. Methods In this single arm phase II trial, 20 patients with acute lower limb ischaemia received CDT combined with an intravenous infusion of microbubbles and locally applied ultrasound during the first hour of standard intra-arterial thrombolytic therapy. The primary endpoint was safety, i.e., occurrence of serious adverse events (haemorrhagic complications and/or amputation) and death within one year. Secondary endpoints included angiographic and clinical success, thrombolysis duration, additional interventions, conversion, and quality of life. Results The study included 20 patients (16 men; median age 68.0 years; range, 50.0 – 83.0; and 40% native artery and 60% bypass graft). In all patients, the use of microbubble contrast enhanced sonothrombolysis could be applied successfully. There were no serious adverse events related to the experimental treatment. Duplex examination showed flow distal from the occlusion after 23.1 hours (range 3.1 – 46.5) with a median thrombolysis time of 47.5 hours (range 6.0 – 81.0). The short term ABI and pain scores significantly improved; however, no changes were observed before or after thrombolysis in the microcirculation. Overall mortality and amputation rates were both 2% within one year. The one year patency rate was 55%. Conclusion Treatment of patients with acute peripheral arterial occlusions with contrast enhanced sonothrombolysis is feasible and safe to perform in patients. Further research is necessary to investigate the superiority of this new treatment over standard treatment.

Background Standard therapy in acute peripheral arterial occlusion consists of intra-arterial catheter-guided thrombolysis. As microbubbles may be used as a carrier for fibrinolytic agents and targeted to adhere to the thrombus, we can theoretically deliver the thrombolytic medication locally following simple intravenous injection. In this intervention-controlled feasibility study, we compared intravenously administered targeted microbubbles incorporating urokinase and locally applied ultrasound, with intravenous urokinase and ultrasound alone. Methods In 9 pigs, a thrombus was created in the left external iliac artery, after which animals were assigned to either receive targeted microbubbles and urokinase (UK + tMB group) or urokinase alone (UK group). In both groups, ultrasound was applied at the site of the occlusion. Blood flow through the iliac artery and microcirculation of the affected limb were monitored and the animals were euthanized 1 hr after treatment. Autopsy was performed to determine the weight of the thrombus and to check for adverse effects. Results In the UK + tMB group (n = 5), median improvement in arterial blood flow was 5 mL/min (range 0–216). Improvement was seen in 3 of these 5 pigs at conclusion of the experiment. In the UK group (n = 4), median improvement in arterial blood flow was 0 mL/min (−10 to 18), with slight improvement in 1 of 4 pigs. Thrombus weight was significantly lower in the UK + tMB group (median 0.9383 g, range 0.885–1.2809) versus 1.5399 g (1.337–1.7628; P = 0.017). No adverse effects were seen. Conclusions Based on this experiment, minimally invasive thrombolysis using intravenously administered targeted microbubbles carrying urokinase combined with local application of ultrasound is feasible and might accelerate thrombolysis compared with treatment with urokinase and ultrasound alone.

The focus of LEAD Programme in research and training is on the implementation and development of applied ethnoscience, also known as neo-ethnoscience, in various policy-oriented disciplines, such as ethnomedicine, ethnobotany, ethno-ecology, ethno-communication, ethno-economics and ethno-education, based on the emic – insiders - point of view. It is a challenging idea that in Indonesia, where the national climate commitment under the Paris Agreement is largely depending on keeping the rainforests intact, indigenous communities could be the key to climate action. The complementarity of ethnoscience and science implies, that ethnoscience needs a specific ‘scientific’ research methodology to enable the scientific study of Indigenous Knowledge Systems from the local people’s emic perspective. It shows that ethno-education provides an important study of indigenous peoples' knowledge and practice of education of the young generation to maintain their cultural identity and strengthen their self-determination, and secure their social justice, while becoming modern citizens in Indonesia.

A new direction for the further improvement and implementation of the Integrated Community-Managed Development strategy is also shown in the concept of strategic management development (SMD) which seeks to encompass a science-based step-wise approach to adapt and focus institutions or organisations, to formulate, implement and evaluate the decision-making process in order to achieve future goals, particularly relevant for the functionalisation of indigenous institutions in coping with external policy and programme interventions. The strategic management process consists of different stages, i.e. strategy formulation, strategy implementation and strategy evaluation, which are important for the appropriate application of the objective of strategising indigenous institutions for poverty reduction and sustainable community development. The significance of the new direction for advancing the new model of Integrated Community-Managed Development (ICMD) is twofold. Firstly, it serves quality improvement in post-graduate education through the introduction of training in a SMD module in programmes of Integrated Microfinance Management and Integrated Community-Managed Development, in order to familiarise future community-based managers with the benefits of effective development of strategic management at the community level. Secondly, it increases the effectiveness of indigenous institutions in the promotion and factual participation of local stakeholders and participants in democratic decision-making processes.

The recent broadening of the conceptualisation of poverty which goes beyond the narrow financial definition of a mere lack of money to acquire food and shelter, includes several dimensions of limited access to health care, education, public support, employment and communication, and vulnerability to economic crises, violence and conflict, recently extended by moral and spiritual dimensions of humiliation, disempowerment and denial of human rights. Despite renewed approaches to pay more attention to the new Multidimensional Poverty Index (MPI), recent international strategies tend to remain incapable of engendering local peoples’ participation needed to realise poverty alleviation and sustainable development at the community level. A short review of the subsequent approaches, implemented over the past decades by major international organisations such as the World Bank with its financially-based ‘World Development Approach’ and the United Nations with its people-centered ‘Human Development Approach’ shows that both policies towards poverty reduction remain inadequate to reach the poor, particularly in the developing countries. This Chapter identifies the ‘Missing Link’ in the international poverty reduction policies, and elaborates on alternative approaches based on the advance in neo-ethnoscience thinking of Indigenous Knowledge Systems and Development (IKS&D). Embarking on the integration of global and local knowledge systems and institutions, an IKS-based Model for Integrated Community-Managed Development (ISCD) is introduced, which is based on such a broader, holistic assessment of poverty and poverty reduction with a view to achieve more realistic sustainable community development.

This Chapter embarks on the description of the growing interest since the 1960s in ethnoscience as an advancing discipline to observe and understand the emic view of non-Western peoples themselves on their universe and life, as opposed to the conventional, rather normative perspective of outsiders on ‘primitive’ cultures. Following the evolution of the discipline of ethnoscience as complementary to science, a number of sub-fields increased, accumulating a new body of knowledge, beliefs and practices. When a small group of scientists made a breakthrough in the 1980s by documenting the relevance of ethnoscience as the study of culture in terms of indigenous knowledge systems (IKS) for sustainable development—also known as neo-ethnoscience—a revolutionary shift took place in the paradigm of international development cooperation, away from a ‘top-down’ towards a ‘bottom-up’ approach. After the pioneering role of the LEAD Programme at Leiden University in this academic process since the late 1980s is highlighted, special attention is given to the so far largely ignored role of indigenous institutions in strategies of poverty reduction for sustainable development. The Chapter concludes with a preview of two alternative development approaches of integrated local and global knowledge systems in terms of Integrated Microfinance Management (IMM) and Integrated Sustainable Community Development (ISCD) as IKS-based contributions to the realisation of poverty reduction for the people of Indonesia and elsewhere around the globe.

This Chapter addresses a widely spread traditional institution in Indonesia known as Gotong Royong in which the active involvement of the indigenous communities has also contributed to the successful implementation of the ‘bottom-up’ approach of Integrated Community-Managed Development (ICMD). Since such local institutions are part of a wider system of indigenous knowledge, practices and beliefs based on the traditional cosmologies, they are crucial for the integration of global systems from outside and local systems from inside the communities. The active involvement of these indigenous institutions—so far largely ignored in development policies and programmes—have shown to enhance local participation in development-oriented intervening activities from outside. Embarking on the dual spirit of the communal service and mutual assistance of Gotong Royong, which has survived for many generations to provide a strong identity to Indonesia’s village culture, the Chapter also underscores that since independence it has become a pan-Indonesian institution providing a binding force among the various sub-cultures of Indonesia with important cultural and socio-political significance for the unity of the nation. Furthermore, the debate on communalism versus individualism is described in relation to the dimension of the collectivism of Gotong Royong. The Chapter concludes that the (re-)integration of these indigenous institutions into development policies and programmes can indeed contribute to increased local involvement and participation of all community members, and as such pertains to the realisation of poverty reduction and sustainable development throughout Indonesia.

In this Chapter, an advanced statistical Integrated Poverty Impact Analysis Model (IPIA) is presented for the evidence-based analysis of the impact of development policies and projects on indigenous communities, with special attention for the poor. The underlying Indigenous Knowledge Systems and Development (IKS&D)-oriented research provides the basis for an objective explanation and prediction of the consumption behaviour of goods and services among poverty groups of the target population under impacting conditions of outside interventions. Embarking on conventional, less objective, economic, environmental and social impact assessment methodologies, this integrated poverty impact analysis focuses on the development of a standardised and independent approach on impacts across disciplinary perspectives and sectoral interests, with special attention given to the emic dimension of development, indispensable for the implementation of integrated IMM and ICMD programmes. Following a review of the conventional impact assessment approaches, the objective of the IPIA model is presented as the development of an evidence-based analysis of impacts on the basis of the execution of a sequence of complementary research and advanced analytic methodologies focused on the micro-level of institutions, households and individuals in local communities. In this way, the Integrated Poverty Impact Analysis (IPIA) is aiming at the explanation and prediction of consumer behaviour of the poor expressed in their differential consumption patterns of goods and services, representing possible changes in their well-being in a comparison between retrospective and prospective—i.e. ex ante—studies of poverty groups under external impacts of policy planning and implementation in the community.

This Chapter describes the failure of the previous ‘top-down’ approaches to achieve effective poverty reduction in Indonesia, which forced the government in the late 1990s to empower rural communities in order to increase their participation. So, after the global financial crisis, during the era of President Gusdur and Vice-President Megawati, the problem of poverty was tackled by the introduction in 1998/1999 of several national programmes supported by the World Bank and implemented at the community level, including the Kecamatan Development Programme (PKK). It also documents, that later onwards, the Urban Poverty Programme (UPP) was implemented to alleviate poverty in the urban areas throughout the country. The idea of a ‘bottom-up’ approach, however, was not completely implemented as the involvement of the local people has remained rather disappointing. The description of the introduction of the dual PNPM Mandiri programme in 2007 documents the role of trained facilitators whose task is to coordinate and integrate local people and institutions in order to prepare the local initiatives and projects, based on the needs of the local people, varying from economic needs to infrastructure. The success of the PNPM Mandiri programme is well documented in the increase in employment, and access to basic health care and education. The Chapter concludes that although the various programmes had initially been planned to empower the community, it was found that without an adequate involvement of the local people to take their own decisions, the programme simply became an adjusted development approach ‘from the top’ with a justification ‘from the bottom’ where factors of failing leadership and elite capture at the local level have contributed to the decline in the achievement of the community-based development approach throughout the country.