[Objective] To evaluate the feasibility of a novel outpatient infusion model for blinatumomab in two acute lymphoblastic leukemia (ALL) patients, aiming to address challenges of poor treatment tolerance, high healthcare costs, and compromised quality of life, thereby providing clinical insights for broader adoption of this approach. [Methods] Two post-allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients undergoing blinatumomab maintenance therapy were selected to evaluate the efficacy of the outpatient infusion model. Patient selection criteria, nursing protocols, standardized workflows, and advancements in infusion practices were systematically analyzed combined with a review of global developments in this field. [Results] Both patients completed outpatient blinatumomab infusion without severe adverse events, demonstrating preliminary feasibility and safety of this model. The novel approach enhanced treatment convenience, reduced hospitalization costs, and improved quality of life. [Conclusion] Despite the limited sample size, this pilot study highlights the potential of outpatient blinatumomab administration as a viable alternative to traditional inpatient regimens.

OBJECTIVE To explore the mechanism of Zadi-5 pill in improving myocardial ischemia-reperfusion injury （MIRI）. METHODS The targets and pathways of potential effects of Zadi-5 pill improving MIRI were screened based on the network pharmacology. Seventy-two rats were randomly divided into model group， sham operation group， Danshen group [Compound danshen dripping pills 80 mg/（kg·d）] and Zadi-5 pill high-dose， medium-dose and low-dose groups [1.6， 0.8， 0.4 g/（kg·d）]， with 12 rats in each group. The rats in each group were given corresponding drugs intragastrically， once a day， for 14 consecutive days. After the last administration， MIRI model was established by ligating the anterior descending branch of left coronary artery in rats， while rats in the sham operation group were threaded without ligation. The contents of creatine kinase （CK）， lactate dehydrogenase （LDH）， aspartate transaminase （AST）， cardiac troponin T （CTn-T）， apoptotic rate of cardiomyocyte， phosphatidylinositol 3-kinase （PI3K）， protein kinase B （Akt）， B-cell lymphoma-2 （Bcl-2）， Bcl-2 related X protein （Bax） and caspase-3 in myocardial tissue were detected in each group after modeling； the morphological changes of myocardial tissue were observed. RESULTS A total of 177 active ingredients and 220 targets of Zadi-5 pill were obtained， including 51 targets involved in improving myocardial ischemia； the core target of Zadi-5 pill improving MIRI was AKT1， including PI3K-Akt， endoplasmic reticulum and hypoxia-inducible factor-1. Compared with model group， the contents of CK， LDH， AST and CTn-T， the apoptotic rate of cardiomyocyte as well as the protein expressions of caspase-3 and Bax were significantly decreased in Danshen group and Zadi-5 pill high-dose group （P＜0.05 or P＜0.01）， while the protein expressions of PI3K， Akt and Bcl-2 in myocardial tissue were significantly increased （P＜0.05 or P＜0.01）， respectively； the myocardial histopathological changes were significantly improved. The above indicators were improved to varying degrees in Zadi-5 pill low-dose and medium-dose groups， too. CONCLUSIONS Zadi-5 pill may inhibit apoptosis by activating the PI3K-Akt signaling pathway， thus playing a role in improving MIRI.

Objectives: The use of technology has rapidly increased in the past century. Artificial intelligence (AI) and information technology (IT) are now applied in healthcare and medical education. The purpose of this study was to assess the readiness of Indonesian teaching staff and pediatric residents for AI integration into the curriculum. Methods: An anonymous online survey was distributed among teaching staff and pediatric residents from 15 national universities. The questionnaire consisted of two sections: demographic information and questions regarding the use of IT and AI in child health education. Responses were collected using a 5-point Likert scale: strongly disagree, disagree, neutral, agree, and highly agree. Results: A total of 728 pediatric residents and 196 teaching staff from 15 national universities participated in the survey. Over half of the respondents were familiar with the terms IT and AI. The majority agreed that IT and AI have simplified the process of learning theories and skills. All participants were in favor of sharing data to facilitate the development of AI and expressed readiness to incorporate IT and AI into their teaching tools. Conclusions The findings of our study indicate that pediatric residents and teaching staff are ready to implement AI in medical education.

Introduction: Dengue Fever (DF) is a disease spread by Aedes spp. caused by dengue virus infection. The study aimed to identify the density of Aedes spp eggs and larvas stages and the characteristics of their habitat in dengue-endemic areas in Ternate City in September-December 2021. Methods: the research was conducted in four dengue-endemic villages in Ternate City, namely Sangaji, Maliaro, Bastiong Karance, and Bastiong Talangame village. In 80 households, egg density was determined by placing 2 ovitraps in each house, one inside and one outside the house. After a week, the filter paper which is a medium mosquito to lay their eggs in the ovitrap was collected, and the ovitrap index value was calculated. The value of the House Index (HI), Container Index (CI), and Breuteu Index (BI) was used to calculate the larval density. The type and materials of the containers were used to assess the parameters of the larval environment. Results: The ovitrap index value in the four villages was categorized as moderate level 3 (27.50% -36.25%). The highest larval density was found in Sangaji Village (HI = 81%), while the lowest was in Bastion Talangame Village (HI = 70%). The highest CI and BI values were found in Bastiong Karance Village (CI=51.5% and BI=190%), and the lowest was in Maliaro Village (CI=37.5% and BI=128%). Density figures in all endemic villages have a high larval density with a value of 8. Conclusion: There was no significant difference (p>0.05) between the types and the materials of containers in each village in Dengue endemic areas. The high density of the egg and larval stage and the information characteristic of habitat Aedes spp. could be considered as basic information for dengue vector control in Ternate City.

Melanoma is the most aggressive cutaneous tumor. Neuropilin and tolloid-like 2 (NETO2) is closely related to tumorigenesis. However, the functional significance of NETO2 in melanoma progression remains unclear. Herein, we found that NETO2 expression was augmented in melanoma clinical tissues and associated with poor prognosis in melanoma patients. Disrupting NETO2 expression markedly inhibited melanoma proliferation, malignant growth, migration, and invasion by downregulating the levels of calcium ions (Ca²⁺) and the expression of key genes involved in the calcium signaling pathway. By contrast, NETO2 overexpression had the opposite effects. Importantly, pharmacological inhibition of CaMKII/CREB activity with the CaMKII inhibitor KN93 suppressed NETO2-induced proliferation and melanoma metastasis. Overall, this study uncovered the crucial role of NETO2-mediated regulation in melanoma progression, indicating that targeting NETO2 may effectively improve melanoma treatment.
Humans ; Calcium-Calmodulin-Dependent Protein Kinase Type 2/metabolism* ; Cell Line, Tumor ; Cell Proliferation ; Melanoma/genetics* ; Membrane Proteins/genetics* ; Phosphorylation ; Signal Transduction

Background: Factor VIII (FVIII) inhibitor diagnosis and surveillance in Indonesia are challenging owing to geographic conditions and the lack of laboratory facilities nationwide for inhibitor assays. This study aimed to determine the prevalence of FVIII inhibitors in children diagnosed with hemophilia A (HA) in Indonesia. Methods: A cross-sectional study was conducted in 12 hospitals in eight provinces of Indonesia between 2020 and 2021. Factor VIII inhibitor screening was performed in a central hemostasis laboratory for all children with HA (≤18 yr) who had received a minimum of 10 exposure days to clotting factor concentrates. The FVIII inhibitor titer was determined using the Bethesda assay. Results: Children (388) were enrolled in this study, including 219 (56.4%), 131 (33.8%), and 38 (9.4%) with severe, moderate, and mild HA, respectively. The prevalence of children who developed FVIII inhibitors was 37 out of 388 (9.6%). Factor VIII inhibitors were found in 25/219 (11.4%) severe, 11/131 (8.3%) moderate, and 1/38 (2.6%) children with mild HA. Thirteen children had low-titer inhibitors and 24 had high-titer inhibitors, with a median of 9.44 (1.48‒412.0) Bethesda Units. Among 13 children with low-titer inhibitors, eight underwent a confirmation test, of which five tested negative and were classified as transient. A significant difference in annual joint bleeding rate was found between patients with low and high inhibitor titers and those without inhibitors (P ＜0.001). Conclusion Factor VIII inhibitor prevalence in Indonesia was relatively low. However, the risk factors that may contribute to FVIII inhibitor development among Indonesian patients require further study.

Introduction: Dengue Fever (DF) is a disease spread by Aedes spp. caused by dengue virus infection. The study aimed to identify the density of egg and larval Aedes spp. stages and the characteristics of their habitat in dengue-endemic areas in Ternate City in September 2021. Methods: the research was conducted in four dengue-endemic villages in Ternate City, including Sangaji, Maliaro, Bastiong Karance, and Bastiong Talangame. In 80 households, egg density was determined utilizing ovitrap placement of up to two pieces per dwelling, one inside and one outside the house. After a week of ovitrap installation, the filter paper was collected, and the ovitrap index value was calculated. The value of the House Index (HI), Container Index (CI), and Breuteu Index (BI) was used to calculate the larval density. The type and materials of the containers were used to assess the parameters of the larval environment. Results: The ovitrap index value in the four sub-districts was categorized as moderate level 3 (27.50% -36.25%). The highest larval density was found in Sangaji Village (HI = 81%), while the lowest was in Bastion Talangame Village (HI = 70%). The highest CI and BI values were found in Bastiong Karance Village (CI=51.5% and BI=190%), and the lowest was in Maliaro Village (CI=37.5% and BI=128%). Density figures in all endemic villages have a high larval density with a value of 8. Conclusion: There was no significant difference (p>0.05) between the types and the materials of containers in each village in DF endemic areas. The high density of the egg and larval stage and the information characteristic of habitat Aedes spp. Could be considered the basis of information dengue vector prevention and control in Ternate City.

Introduction: Breast cancer is a significant health problem that affects patients and their family members. Family members are often key to supporting the patient. However, there is an inadequate understanding of the role of female breast cancer patients’ family members in Malaysia. This study aimed to explore the roles of family members of female breast cancer patients from symptom appraisal until the patient treatment commences. Methods: Snowball sampling was applied and 14 participants were recruited through the nomination of the female breast cancer patients. The participants took part in in-depth, face-to-face, and audio-recorded one-time interviews. All of the interviews were subsequently transcribed verbatim and analysed using narrative analysis. Results: Five themes were identified with regard to the roles of family members: 1) confirming breast changes; 2) managing personal emotions; 3) seeking the information; 4) seeking alternative forms of treatment; and 5) advocating for conventional treatment. Conclusion: This study discovered that family members play an important role in the journey of women with breast cancer from the time an abnormality is discovered to the time the patient receives treatment. During this time, many of them suppressed their emotions in order to focus on the women suffering from breast cancer. Healthcare professionals working with breast cancer should recognise and support the key role of family members in supporting women to get treatment. It is important to take a proactive approach in recognising the early signs of stress for family members and, when appropriate, offering them additional sources of support.

We conducted a hospital based study to collect data on the clinical characteristics of neuropathic pain (NP) patients in neurology outpatients in 13 big cities in Indonesia. We aimed to identify the clinical characteristics of NP among patients with the symptoms of pain. A simple questionnaire was conducted to explore the clinical symptoms and signs. Participants who reported of NP symptom was 1,779 (21.8%) among 8,160 patients. The higher prevalence of NP was reported in 41-60 years old (n= 1,030; 57.9%). It was more prevalent in male (n=1,104; 62.1%). The group of patients with low educational level has higher prevalence of pain with NP (n=1,177; 66.1%). There are five main clinical symptoms of NP patients, pinprick sensation (n=589; 33.1%), electric shock like sensation (n=542, 30.5%), burning (n=407, 22.9%), paresthesia (n=401; 22.5%) and hyperalgesia (n=351, 19.7%). In this study, NP was mostly associated with low back pain (n=509, 28,6%), carpal tunnel syndrome (n=343; 19.3%), frozen shoulder syndrome (n=191, 10.7%), diabetic neuropathy (n=170, 9.6%) and brachialgia (n=108, 6.1%). The most frequent modality to treat NP symptoms were adjuvant analgesics, antidepressants or anticonvulsants (n=1,199; 67.4%), non-steroidal anti-inflammatory drugs (n=1,177, 66.2%), non-opioids analgesics (n=606; 34.1%), non-pharmacological treatment (n=366; 20.6%) and opioid treatments (n=100, 5.6%).

We conducted a hospital based study to collect data on the clinical characteristics of neuropathic pain (NP) patients in neurology outpatients in 13 big cities in Indonesia. We aimed to identify the clinical characteristics of NP among patients with the symptoms of pain. A simple questionnaire was conducted to explore the clinical symptoms and signs. Participants who reported of NP symptom was 1,779 (21.8%) among 8,160 patients. The higher prevalence of NP was reported in 41-60 years old (n= 1,030; 57.9%). It was more prevalent in male (n=1,104; 62.1%). The group of patients with low educational level has higher prevalence of pain with NP (n=1,177; 66.1%). There are five main clinical symptoms of NP patients, pinprick sensation (n=589; 33.1%), electric shock like sensation (n=542, 30.5%), burning (n=407, 22.9%), paresthesia (n=401; 22.5%) and hyperalgesia (n=351, 19.7%). In this study, NP was mostly associated with low back pain (n=509, 28,6%), carpal tunnel syndrome (n=343; 19.3%), frozen shoulder syndrome (n=191, 10.7%), diabetic neuropathy (n=170, 9.6%) and brachialgia (n=108, 6.1%). The most frequent modality to treat NP symptoms were adjuvant analgesics, antidepressants or anticonvulsants (n=1,199; 67.4%), non-steroidal anti-inflammatory drugs (n=1,177, 66.2%), non-opioids analgesics (n=606; 34.1%), non-pharmacological treatment (n=366; 20.6%) and opioid treatments (n=100, 5.6%).
Neuralgia