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Makhfudli Makhfudli,1 Abdulloh Machin,2 Abd Nasir,1,3 Andri Setiya Wahyudi,1 Susilo Harianto,1,3 Rindayati Rindayati,1,3 Hafna Ilmy Muhalla,1,3 Emuliana Sulpat,1,3 Fanni Okviasanti,1,3 Joko Susanto,1,3 Ilkafah Ilkafah,3 Yanis Kartini4 1Faculty of Nursing, Airlangga University, Surabaya, Indonesia; 2Faculty of Medicine, Airlangga University, Surabaya, Indonesia; 3Faculty of Vocational, Airlangga University, Surabaya, Indonesia; 4Department of Nursing, and Midwifery Faculty, Universitas Nahdlatul Ulama Surabaya, East Java, IndonesiaCorrespondence: Makhfudli Makhfudli, Tel +62 081332544455, Email makhfudli@fkp.unair.ac.idIntroduction: Being treated in isolation rooms for people infected with COVID-19, creates various perceptions of uncertainty, especially when strict “health protocols” are applied. This study aims to determine the understanding patients with COVID in the intensive care unit from the perspective of care.Materials and Methods: The research design used phenomenological qualitative with in-depth interviews. Purposive sampling was used with interpretive phenomenological analysis. Participants were 25 patients who had been exposed to COVID-19, consisting of 10 men and 15 women.Results: This study resulted in the theme of the perception of COVID-19 sufferers while undergoing treatment in isolation rooms, with four themes, namely, 1) mental attacks, 2) feel like fighting alone, 3) expecting Concern, 4) positive attitude.Conclusion: This analysis shows that various perceptions of uncertainty that are felt while being treated in the isolation room due to suffering from COVID-19 disease can be anticipated by increasing the awareness of nurses to be closer to patients through caring-based nursing practices by emphasizing meaningful interpersonal relationships.Keywords: perception, COVID-19, nursing, isolation room, caring

Characteristics of unemployment vary, so this study analyzes whether the effect of growth on unemployment differs between youth and adults. This study uses secondary data covering the growth, unemployment, and wages of several age groups. The research period lasts from 1991 to 2021. This study uses regression analysis based on Okun's Law. The regression model is realized in the equation with an unemployment rate as the dependent variable, growth as the independent variable, and wages as a covariate. The results show that growth has no impact on youth unemployment. However, growth has a negative effect on adult unemployment. Higher growth leads to lower adult unemployment. That is, for adult unemployed, the result is in line with Okun's law. However, the results do not support Okun's law for youth unemployment. Furthermore, the wage rate negatively affects youth unemployment, but the wage rate does not affect adult unemployment. Furthermore, the change in government from the New Order to the Reform Order impacts youth and adult unemployment.

Background: The HIV infection affects the immune system by decreasing CD4/CD8 ratios. Previous studies reported that the use of nutrient supplements in HIV patients was quite high. Propolis is one of nutrient supplements that are reported to be beneficial in the immune system but evidences of its clinical benefits are limited. The aimed of this study was to reveal the advantageous outcome of propolis supplementation in patients on antiretroviral regimen therapy. Methods: The research was conducted in a double blind randomized controlled trial, pre and post-test control group including the treatment group (antiretroviral regimen + propolis) and the control group (antiretroviral regimen + placebo). CD4/CD8 ratio was checked at baseline and 6 months after the trial, as well as their safety profile, any side effect was documented and treated properly. Results: Forty-three subjects managed to reach the end of the study, consisting of 19 subjects in the treatment group and 21 subjects in the control group. Duviral-Neviral is the most widely used ARV regimen (51.2%). After 6 months of treatment, there was an increase in the mean CD4/CD8 ratio in the propolis group, but it was not statistically significant (p = 0.22). Interestingly, the delta CD4/CD8 ratio between propolis and placebo was significantly different (0.06 vs -0.01; p = 0.02). Conclusion: There were non-life-threatening side effects that occur in the propolis group subjects which improve after supplementation was stopped. To conclude, the effect of propolis supplementation on increasing CD4/CD8 ratio in HIV patients who had received antiretroviral regimen therapy did not reach statistical significance. [ABSTRACT FROM AUTHOR]

Amniotic Mesenchymal Stem Cells Metabolite Products (AMSC-MP) contain growth factors that benefit human health. This study aims to evaluate the use of transfersomal serum (Trans) with hyaluronic acid (HA) addition to deliver large molecules of AMSC-MP for skin regeneration. Trans is composed of L-α-phosphatidylcholine and surfactants, i.e., sodium cholate (SC) or stearylamine (SA), at the weight ratio of 85:15, prepared by the thin film method with or without HA addition. The results showed that HA addition increased the particle size of Trans-SA and Trans-SC, from 261.9 ± 1.9 and 105.3 ± 0.9 nm respectively, to 317.7 ± 9.1 and 144.3 ± 0.8 nm for Trans-SA-HA and Trans-SC-HA. In contrast, no significant changes in the zeta potential occurred. The relative deformability indexes of Trans-SA, Trans-SA-HA, Trans-SC, and Trans-SC-HA compared to liposome were 0.43 ± 0.09, 0.46 ± 0.09, 1.58 ± 0.17, and 1.40 ± 0.17 respectively. The addition of HA successfully increases the in vivo skin hydration, collagen density, and number of fibroblast cells, reflecting the capacity for skin regeneration in UV-induced aged mice. Furthermore, no erythema or skin rash was observed at the 24-hour post-topical application sites. AMSC-MP transfersomal serum with HA addition successfully enhanced skin regeneration and proved safe during the in vivo study using UV aging-induced mice models, thereby enabling its potential use as skin-aging therapy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: There is an increasing availability of digital technologies for teaching and learning of human anatomy. Studies have shown that such applications allow for better spatial awareness than traditional methods. These digital human anatomy platforms offer users myriad features, such as the ability to manipulate 3D models, conduct prosection, investigate anatomical regions through virtual reality, or perform knowledge tests on themselves. This study examined what faculty members' value when using digital human anatomy platforms for teaching and what students value when using these platforms for learning., Methods: Six anatomy faculty members and 21 students were selected to participate in this study. After using the three digital anatomy platforms for at least 1 week, a survey was conducted to record their feedback in 4 categories: usability, interactive features, level of detail, and learning support. Respondents' Qualitative feedback within each category was also analyzed to strengthen the study's findings., Results: The study's findings showed that faculty members and students have different priorities when evaluating digital anatomy platforms. Faculty members valued platforms that provided better accuracy and detailed anatomical structures, while students prioritized usability above the rest of the features., Conclusion: Given that faculty and students have different preferences when selecting digital anatomy platforms, this article proposed that educators maximize the specific affordances offered by the technology by having a clear pedagogy and strategy on how the technology will be incorporated into the curriculum to help students achieve the desired learning outcomes., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Objectives: To study the relationship between anxiety and the spiritual wellbeing of hypertensive elderly patients during the corona virus disease-2019 pandemic., Method: The cross-sectional, correlational, analytical study was conducted from March to May 2022 in Lamongan Regency, East Java, Indonesia, after approval from the Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia, and comprised elderly hypertensive subjects aged >45 years who had good cognitive skills. Data was collected using the Geriatric Anxiety Scale and the Spiritual Wellbeing Scale. Anxiety was the independent variable, while spiritual wellbeing was the dependent variable. Data was analysed using univariate and bivariate analyses., Results: Of the 200 subjects, 107(53.5%) were females and 93(46.5%) were males. Overall, 97(48.5%) were aged 45-49 years, 81(40.5%) had completed primary school, 96(48%) were farmers, 121(60.5%) had moderate anxiety and 80(40%) had moderate spiritual wellbeing. There was a significant relationship between anxiety and spiritual wellbeing (p<0.05). Age, education and occupation of the subjects had significant association with both anxiety and spiritual wellbeing (p<0.05)., Conclusions: The coronavirus disease-2019 led to decreased anxiety and increased spiritual wellbeing among the hypertensive elderly.

Transfersome has been developed to enhance dermal delivery of amniotic mesenchymal stem cell metabolite products (AMSC-MP). AMSC-MP contains many growth factors for managing skin aging, thus improving the quality of an adjusted life year. This study aims to determine the effect of surfactant types acting as the edge activator on transfersome-loading AMSC-MP. Transfersome was prepared by thin-layer hydration method and composed of l-α-phosphatidylcholine as a phospholipid and three types of surfactants, namely; cationic (stearylamine), anionic (sodium cholate), and nonionic surfactant (Tween 80) at a weight ratio of 85:15, respectively. Transfersomes were evaluated for physical characteristics, penetration, effectiveness, and safety. The results showed that sodium cholate, an anionic surfactant, produced the smallest transfersome particle size, i.e., 144.2 ± 3.2 nm, among all formulas. Trans-SA containing stearylamine had a positive charge of 41.53 ± 6.03 mV compared to Trans-SC and Trans-TW, whose respective charges were -56.9 ± 0.55 mV and -41.73 ± 0.86 mV. The small particle size and low negative value of zeta potential enabled high dermal penetration by transfersomes containing AMSC-MP, while the positive charge of stearylamine hindered its penetration of deeper skin layers. Trans-SC and Trans-TW produced higher collagen density values at 77.11 ± of 4.15% and 70.05 ± of 6.95%, than that of Trans-SA. All the AMSC-MP transfersomes were relatively safe with 0.5-1.0 macrophage cell numbers invaded the dermis per field of view. In conclusion, sodium cholate, an anionic surfactant, demonstrated considerable capacity as the edge activator of transfersome-loading AMSC-MP for skin anti-aging therapy.

We introduce a strategy to optimize the photoswitching behavior of rhodamines for (d)STORM super-resolution microscopy. By replacing the benzene ring in the rhodamine core with a permanently charged 1,3-disubstituted imidazolium, the resultant dyes are markedly sensitized toward photoswitching, and exhibit outstanding (d)STORM performance with fast on-off switching, long-lasting blinking, and bright single-molecule emission. We thus attain excellent (d)STORM images under green excitation that are on par with the "ideal" red-excited dyes, including for difficult structures such as the mammalian actin cytoskeleton, and demonstrate high-quality two-color three-dimensional (d)STORM., (© 2021 Wiley-VCH GmbH.)

Coenzyme Q10 (CoQ10) is a naturally produced organic molecule which acts as an antioxidant agent, including in skin anti-ageing, and plays a major role in the social determinants of health. However, its level in the body will decrease during ageing. Therefore, an external supplement is required to repair damaged skin, especially the skin dermis layer. This study aims to evaluate the use of a protransfersomal emulgel to improve the skin delivery and stability of CoQ10 which demonstrates low water solubility, poor permeability and instability. CoQ10 was initially dissolved in oleic acid at a weight ratio of 1:56. Protransfersome was then loaded with CoQ10 (Protransf-CoQ10) and prepared using a composition of L-α-Phosphatidylcholine and Tween 80 at a molar ratio of 85:15. The Protransf-CoQ10 was dispersed in an emulgel base consisting of Tween 80 and Span 80 to produce Protransf-CoQ10 emulgel. The in vivo studies of anti-aging activity and irritability were further evaluated by applying daily 200 mg of emulgels twice a day to a 4 cm 2 section on the back of a UV-ray aging-induced male Balb/c mouse 20 min before irradiation. The results showed that Protransf-CoQ10 could transform into transfersomal vesicles with particle sizes of approximately 201.5 ± 6.1 nm and a zeta potential of - 11.26 ± 5.14 mV. The dispersion of Protransf-CoQ10 into emulgel base resulted in stable Protransf-CoQ10 Emulgel during 28 days of observation at low temperatures. Moreover, the in vivo study revealed that Protransf-CoQ10 Emulgel successfully increases the collagen density and number of fibroblast cells in UV radiation skin-aged induced-mice which reflects its potential for repairing the skin ageing process. In addition, the 24-h topical application of Protransf-CoQ10 Emulgel showed that no erythema or skin rash was observed during the study. In conclusion, loading CoQ10 into protransfersomal Emulgel successfully enhanced the stability and anti-ageing efficacy enabling its potential use as anti-ageing cosmetics., (© 2022. The Author(s).)

Background and Objectives: Data suggest that genetic factors are associated with BMI. The fat mass and obesity- associated (FTO) gene modulates adipogenesis through alternative splicing and m6A demethylation. Individuals with FTO rs9939609 gene polymorphism have a preference for energy-dense foods. This study investigates the relationship between FTO rs9939609 and obesity and preference for dietary fat intake among selected Indonesian adults., Methods and Study Design: A total of 40 non-obese and 40 obese participants aged 19-59 living in Jakarta were recruited. Body composition measurements included body weight, height, BMI, waist circumference, and body fat mass. Dietary intake was assessed using a semiquantitative food frequency questionnaire and food recall over 2 × 24-h periods. Genetic variation was determined using amplification-refractory mutation system polymerase chain reaction., Results: The genotype distribution of the FTO gene (rs9939609) was at Hardy- Weinberg equilibrium (p=1) with minor allele frequency=0.19. Individuals with AT/AA genotypes had 3.72 times higher risk of obesity (p=0.009) and 5.98 times higher dietary fat intake (p=0.02) than those with TT genotype. Obese participants with the AT/AA genotypes had 1.40 times higher dietary fat intake than those with the TT genotype (p=0.016)., Conclusions: These findings suggest that Indonesian adults with AT/AA genotypes of the FTO rs9939609 have higher obesity risks and preferences for high dietary fat intake than those with TT genotype.

Background & Aims: The appearance of hepatic foci in pancreas has been well-documented in animal experiments and in patients with pancreatic cancer. We previously demonstrated that transdifferentiation of pancreatic exocrine cells to hepatocytes required members of the CCAAT enhancer binding protein family. Although the molecular basis of hepatic transdifferentiation is understood, the early cellular events remain to be defined., Methods: Dexamethasone and oncostatin M were used to induce transdifferentiation of primary cultures of mouse acinar cells and exocrine cell lines into hepatocytes. Fluorescent-activated cell sorting was used to identify intermediate cell types and side-population characteristics. Cre-loxP-based lineage tracing was used to investigate whether acinar cells contribute directly to hepatocytes via intermediates that express adenosine triphosphate-binding cassette subfamily G member 2 (ABCG2)., Results: Lineage tracing studies showed that hepatocytes were derived directly from pancreatic cells via ABCG2-expressing intermediates. Exposure of cells to insulin increased Akt phosphorylation, ABCG2 expression, and hepatic transdifferentiation. Inhibition of the phosphoinositide 3-kinase pathway, through addition of LY294002 or overexpression of a dominant-negative form of Akt, was sufficient to prevent transdifferentiation. When ABCG2-expressing cells were incubated with glucagon-like-peptide 1 or epidermal growth factor, the intermediate cells could differentiate into insulin-producing beta-like cells., Conclusions: The phosphoinositide 3-kinase pathway is important in the transdifferentiation of acinar cells to hepatocytes and those hepatocytes arise from acinar cells via ABCG2-expressing intermediates. Furthermore, ABCG2-expressing cells are multipotent and able to differentiate into hepatocytes and insulin-producing beta cells., (Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Background: Under appropriate culture conditions, undifferentiated embryonic stem (ES) cells can undergo multiple self-renewal cycles without loss of pluripotency suggesting they must be equipped with specific defense mechanisms to ensure sufficient genetic stability during self-renewal expansion. The ATP binding cassette transporter ABCG2 is expressed in a wide variety of somatic and embryonic stem cells. However, whether it plays an important role in stem cell maintenance remains to be defined., Methodology/principal Findings: Here we provide evidence to show that an increase in the level of ABCG2 was observed accompanied by ES colony expansion and then were followed by decreases in the level of protoporphyrin IX (PPIX) indicating that ABCG2 plays a role in maintaining porphyrin homoeostasis. RNA-interference mediated inhibition of ABCG2 as well as functional blockage of ABCG2 transporter with fumitremorgin C (FTC), a specific and potent inhibitor of ABCG2, not only elevated the cellular level of PPIX, but also arrest the cell cycle and reduced expression of the pluripotent gene Nanog. Overexpression of ABCG2 in ES cells was able to counteract the increase of endogenous PPIX induced by treatment with 5-Aminolevulinic acid suggesting ABCG2 played a direct role in removal of PPIX from ES cells. We also found that excess PPIX in ES cells led to elevated levels of reactive oxygen species which in turn triggered DNA damage signals as indicated by increased levels of gammaH2AX and phosphorylated p53. The increased level of p53 reduced Nanog expression because RNA- interference mediated inhibition of p53 was able to prevent the downregulation of Nanog induced by FTC treatment., Conclusions/significance: The present work demonstrated that ABCG2 protects ES cells from PPIX accumulation during colony expansion, and that p53 and gammaH2AX acts as a downstream checkpoint of ABCG2-dependent defense machinery in order to maintain the self-renewal of ES cells.

Objective: To investigate the effect of 3 months iron supplementation on physical growth among anemic school children given daily and weekly and to know the response based on hemoglobin level., Subject: One hundred forty-four children were measured for height, weight and hemoglobin level. Ninety seven children were anemic (67.36%) with Hb level < 12 g/dl and forty seven children were non anemic. anemic children were divided into 2 subgroups and randomly assigned to either daily and weekly Fe treatment for 12 weeks. The non anemic group were treated with weekly iron supplementation, which was accepted by the parents., Outcome Measures: Children's height, weight, and hemoglobin of T1 and T2 food recall method was used to know calorie, protein, vitamin C and iron intake in both daily and weekly subgroups. Three days food recall was performed in the second and third months by a nutritionist., Result: After iron supplementation, the hemoglobin level in both group increased significantly. The average change of hemoglobin between the 2 groups gave no significant difference. W/A and H/A after iron supplementation showed significantly increased in both groups. The average change of W/A and H/A between the 2 groups gave no significant difference., Conclusion: Daily and weekly iron supplementation showed no significant difference in increasing of hemoglobin level and physical growth. Further research must be done with appropriate sample size and well design.