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PROCESSING NYERE GODEBAG PLATES TO IMPROVE THE CREATIVE ECONOMY OF THE TANJUNGKERTA VILLAGE COMMUNITY
Get PDFBecause coconut trees are versatile plants, almost every part of them can be used, including the nutrient-dense fruit, the skin, which can be used as charcoal or a container, and the leaves, which can be used as a broom. This makes the study important. Despite its many benefits, coconut tree waste is often neglected by the community. A lot of coconut trees are left and not utilized. One of the utilizations that will be done is the creative craft of processing nyere godebag plates. The contribution of this research in terms of integration into the courses taught is integration for the development of teaching materials based on the results of research outputs. The method used in this research uses qualitative methods because interviews are conducted with local leaders and continued with the implementation of entrepreneurship socialization programs and training in the production/processing of nyere coconut leaves into nyere godebag plates
IMPROVING EMPLOYEE PERFORMANCE BY STRENGTHENING ORGANISATIONAL COMMITMENT AND WORK DISCIPLINE
Get PDFThis study aims to analyse the influence of organisational commitment and work discipline on employee performance at PT Pegadaian (Persero) in the city and regency of Cirebon. Employee performance is a key factor in achieving organisational goals, where commitment and work discipline play an important role in improving the effectiveness and productivity of the company. This study employs a quantitative approach using an associative method. Data was collected through the distribution of questionnaires to 71 employees as respondents using a saturated sampling technique. The research model was analysed using the Structural Equation Modelling (SEM) method based on Partial Least Square (PLS) version 4. Model evaluation was conducted through validity, reliability, and structural analysis tests using R-square values, F-tests, and t-tests. The results of the study indicate that both organisational commitment and work discipline have a positive and significant influence on employee performance. The R-square value of 0.184 indicates that 18.4% of employee performance variables can be explained by organisational commitment and work discipline variables, while the remainder is influenced by factors outside the research model. Therefore, companies need to enhance employee commitment and discipline through effective management strategies, such as training, development, and appropriate incentives to optimise productivity
UNVEILING THE EXPANDING CLINICAL HORIZONS OF BOTULINUM TOXIN ACROSS MEDICAL SPECIALITIES
Get PDFIntroduction: Originally identified for its potent neurotoxicity, botulinum toxin (BoNT) has been successfully repurposed into a highly versatile agent used across numerous medical specialities. Through targeted inhibition of acetylcholine release at neuromuscular synapses, BoNT induces localized, reversible muscle relaxation, effectively alleviating symptoms in a variety of neuromuscular and autonomic disorders.
Aim: This review aims to highlight the approved therapeutic uses of BoNT, its expanding applications, and the importance of proper technique and anatomical knowledge in maximizing efficacy and minimizing adverse events.
Materials and Methods: A comprehensive literature review was conducted to evaluate current therapeutic indications, mechanisms of action, safety profile, and emerging uses of BoNT.
Results: Approved therapeutic indications include dystonias, spasticity, chronic migraine, hyperhidrosis, bruxism, while growing evidence supports its emerging role in pain management, selected psychiatric disorders and certain cardiovascular conditions. In aesthetic medicine, BoNT remains primary non-surgical option for addressing dynamic facial lines and hyperfunctional musculature. The safty profile of BoNT remains favorable, however, the efficacy and safety of BoNT is strongly linked to appropriate dosing, product selection, formulation and precise injection technique, emphasizing the critical role of anatomical knowledge to maximize therapeutic benefit while minimizing adverse events.
Conclusion: Botulinum toxin has evolved from a potent neurotoxin to a valuable therapeutic agent across a broad range of medical disciplines. Its continued success depends on deep understanding of anatomy, product characteristics, and injection technique. Ongoing research into novel serotypes, delivery systems, and expanded indications will further solidify BoNT’s role as a cornerstone in both therapeutic and aesthetic practice
BASILIXIMAB AND ANTI-THYMOCYTE GLOBULIN AS AN INDUCTION OF IMMUNOSUPPRESSION IN RECIPIENTS OF VASCULARIZED ORGAN TRANSPLANTS
Get PDFIntroduction and Aim: The advancement of immunosuppressive therapy has significantly increased organ transplantations. Among immunosuppressive agents, basiliximab and anti-thymocyte globulin (ATG) are key in induction therapy. However, clear guidelines on when to use basiliximab alone, ATG alone, or their combination are lacking, posing clinical challenges. This study aims to review recent data on basiliximab and ATG use in induction therapy post-transplant.
Materials and Methods: A literature review was conducted using PubMed with keywords “basiliximab”, “ATG” and “immunosupression" including articles published up to September 2024, focusing on studies from the last two years. The review targeted information on their application in induction immunosuppression after vascularized organ transplantation, effects relative to organ type, and drug combinations.
Results: Basiliximab and ATG differ in efficacy and side effects. ATG is more effective in reducing acute rejection, especially in high-risk patients, but carries higher infection and hematologic risks. Basiliximab has a better safety profile, suitable for elderly or low-risk patients. Treatment should be individualized by age, immunological risk, and infection susceptibility. Steroid continuation after basiliximab induction improves outcomes, a benefit not clearly seen with ATG.
Conclusion: Induction therapy is advised for high-risk patients and certain transplants, mainly using ATG, Grafalon, or basiliximab. ATG may be a safe, effective alternative to basiliximab, which is preferred in older or comorbid patients. Limited data support ATG use in other transplants like pediatric heart transplants. Further multicenter trials and personalized therapy are needed
TELECARE FOR THE ELDERLY: EFFECTIVENESS OF REMOTE MONITORING OF VITAL SIGNS IN HOME SETTINGS
Get PDFIntroduction and Objective: The growing aging population and increased prevalence of chronic diseases necessitate innovative healthcare approaches. Telecare—particularly remote monitoring of vital signs—has emerged as a promising method to support older adults in home environments. This review aims to evaluate the effectiveness of remote monitoring systems in improving health outcomes, safety, and independence among elderly individuals.
Review Methods: A narrative review methodology was used to synthesize current evidence from peer-reviewed articles published between 2018 and 2024. Major databases such as PubMed, Scopus, and Google Scholar were searched using targeted keywords. Articles included focused on the use of remote vital sign monitoring technologies in home-based care for individuals aged 60 and above.
State of Knowledge: The findings suggest that telecare technologies, including wearable sensors and connected health platforms, contribute to earlier detection of clinical deterioration, reduction in hospital readmissions, and enhanced patient engagement. Furthermore, remote monitoring improves medication adherence and enables continuous communication between patients and healthcare providers. Despite technological and ethical challenges, user satisfaction and acceptance remain generally high when systems are tailored to older users' needs.
Conclusion: Telecare with remote vital sign monitoring holds significant potential to support aging in place while reducing healthcare burdens. Integrating these technologies into standard care models can enhance elderly care quality, improve health outcomes, and increase autonomy. Further interdisciplinary research is needed to optimize implementation strategies and address remaining barriers to scalability and equity
IMMUNOTHERAPY IN THE FIGHT AGAINST MELANOMA: CHALLENGES AND DEVELOPMENT PERSPECTIVES- A LITERATURE REVIEW
Get PDFMelanoma is a highly malignant skin cancer with a high propensity to metastasize and a very poor prognosis. Melanoma is considered a multifactorial disease resulting from the interaction between genetic susceptibility and environmental exposure. The rate of increase in incidence worldwide is much higher than any other cancer and comparable to an epidemic. Prompt diagnosis, detection and treatment are crucial in melanoma diagnosis. Traditional treatment methods, such as surgical removal of the tumor, sentinel node biopsy and chemotherapy, often show limited efficacy. Chemotherapy offers little benefit in prolonging survival, and in 15-20% of patients leads to recurrence and relapse. Advances in knowledge of the molecular mechanisms of melanoma development and the discovery of the role of immune molecules such as PD-1, PD-L1 and CTLA-4 have made modern immune therapies possible. The 2018 Nobel Prize recognized the discovery of these mechanisms, resulting in new drugs such as immune checkpoint inhibitors (ipilimumab, pembrolizumab, nivolumab). Modern immunotherapy in recent years has become the fourth (next to surgery, chemotherapy and radiotherapy) pillar of systemic treatment of melanoma. The purpose of this review is to summarize the available immune therapies for the treatment of melanoma.  
ANXIETY DISORDERS IN CORONARY ARTERY DISEASE PATIENTS: NARRATIVE REVIEW
Get PDFObjective: Psychiatric comorbidities, particularly anxiety and depressive disorders, are highly prevalent among patients with cardiovascular disease and represent significant contributors to adverse clinical outcomes and healthcare resource utilization. This investigation examined the association between evidence-based mental health interventions and subsequent healthcare utilization patterns in patients with heart failure (HF) and coronary artery disease.
Methods: We evaluated the impact of psychiatric treatment modalities, including pharmacological therapy and psychotherapeutic interventions, on hospital readmission rates and emergency department (ED) utilization among cardiovascular patients with comorbid anxiety or depressive disorders.
Key Findings: Mental health treatment demonstrated substantial protective effects against adverse healthcare utilization outcomes. Patients receiving combination therapy (both pharmacotherapy and psychotherapy) exhibited the most pronounced benefit, with a 75% reduction in hospital readmission risk and a 74% decrease in ED visits compared to untreated controls. Monotherapy approaches also yielded significant improvements: psychotherapy alone was associated with a 49% reduction in readmission risk and 53% decrease in ED utilization, while pharmacological intervention alone resulted in 58% and 49% risk reductions for readmissions and ED visits, respectively. These findings remained statistically significant across all treatment modalities examined.
Conclusions: The implementation of appropriate mental health interventions, whether through pharmacological management, psychotherapeutic approaches, or combined treatment strategies, represents a critical component in the comprehensive care of cardiovascular patients with psychiatric comorbidities. These data provide compelling evidence that addressing psychological comorbidities is not merely adjunctive but essential for optimizing clinical outcomes, reducing healthcare burden, and improving the overall prognosis of patients with HF and coronary disease. Integration of psychiatric care into standard cardiovascular management protocols should be considered a clinical imperative
THE IMPACT OF VITAMIN D3 LEVELS ON RECOVERY AND REHABILITATION FOLLOWING SURGICAL TREATMENT OF FEMORAL NECK FRACTURES: A NARRATIVE REVIEW
Get PDFIntroduction and purpose: Femoral neck fractures are a major source of morbidity and mortality among older adults, frequently leading to prolonged hospitalization, disability, and loss of independence. Vitamin D3 plays a central role in bone metabolism, muscle function, and immune modulation- all crucial for postoperative recovery. However, the clinical relevance of vitamin D3 status in patients undergoing surgery for femoral neck fractures remains incompletely understood. This narrative review aims to synthesize current evidence on the relationship between vitamin D3 levels and key outcomes including functional recovery, complication rates, and mortality in this population.
Material and method: A comprehensive literature search was conducted in PubMed and Embase using Boolean operators and relevant medical subject terms. Filters limited the search to full-text, English-language studies published between 2020 and 2025 involving human subjects. In Embase, only randomized controlled trials and systematic reviews were included. A total of 98 non-duplicate studies were screened; 34 were selected for full-text analysis and thematic synthesis.
Results: Most studies demonstrate a positive association between sufficient 25(OH)D levels and faster mobility recovery, improved functional scores (e.g., Harris Hip Score, Barthel Index), and better postoperative quality of life. Vitamin D3 deficiency is consistently linked to higher rates of infectious complications, delayed fracture healing, and increased fall risk. Several studies also associate low 25(OH)D levels with elevated short-term mortality. Supplementation strategies appear beneficial, although optimal dosing and timing remain under debate.
Conclusions: Vitamin D3 status is a potentially modifiable factor influencing outcomes after femoral neck fracture surgery. Routine screening and appropriate supplementation should be considered as part of multidisciplinary perioperative care. Further randomized trials are needed to define causal relationships and refine clinical protocols
EVOLVING CERVICAL CANCER SCREENING GUIDELINES AND HPV VACCINATION STATUS. A LITERATURE REVIEW
Get PDFBackground: Persistent infection with high-risk types of human papillomavirus is the primary cause of cervical cancer globally. Recent decades have witnessed significant advances in prevention, with the introduction of effective prophylactic HPV vaccines and highly sensitive molecular screening methods transforming how cervical cancer is detected and managed.
Aim of this review is to explore the impact of HPV vaccination programs on cervical cancer prevention strategies, focusing on how vaccination coverage influences the global shift from traditional cytology-based screening to HPV DNA testing in selected high-income countries.
Methodology: A comprehensive search was conducted across scientific databases, including PubMed, the Cochrane Library, and WHO reports, focusing on recent peer-reviewed studies.
Results: The diagnostic performance of cytology has declined in vaccinated populations due to fewer abnormal findings, prompting a shift toward primary HPV DNA testing. This method offers sensitivity rates exceeding 90% and supports longer screening intervals of five years or more. Countries like Australia, the Netherlands, Sweden, and the UK have adopted nationwide HPV-based screening, while Poland initiated pilot HPV testing programs in 2024.
However, several barriers persist, including disparities in vaccine distribution, the high cost of molecular diagnostics, and persistent public hesitancy toward vaccination.
Conclusions: Combining widespread HPV vaccination with HPV DNA-based screening offers the most promising strategy for reducing cervical cancer incidence and achieving the WHO's 2030 elimination targets. Those recommendations include expanding gender-neutral vaccination, supporting transitions to HPV testing in lagging regions, and incorporating innovations like self-sampling to improve outreach and screening participation
NUTRITIONAL AND LIFESTYLE DETERMINANTS IN THE PATHOGENESIS AND PROGRESSION OF AGE-RELATED MACULAR DEGENERATION
Get PDFAge-related macular degeneration (AMD) is a leading cause of irreversible vision loss among the elderly, with its global prevalence expected to rise substantially in the coming decades. Given its multifactorial pathogenesis—driven by oxidative stress, retinal pigment epithelium (RPE) dysfunction, and chronic inflammation—identifying modifiable nutritional and lifestyle risk factors has become a central focus in developing preventive strategies. This review article synthesizes current literature retrieved from PubMed and Google Scholar to examine the influence of dietary fatty acids, antioxidants, smoking, and alcohol consumption on the onset and progression of AMD. Key sources include large-scale observational cohorts and randomized controlled trials, notably AREDS and AREDS2. Long-chain omega-3 polyunsaturated fatty acids (PUFAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), primarily obtained from fish, show consistent protective effects against both early and late AMD. In contrast, excessive omega-6 intake and an unfavorable omega-6 to omega-3 ratio may promote retinal inflammation. Antioxidants and zinc significantly reduce the risk of disease progression, particularly in individuals with intermediate AMD. Lutein and zeaxanthin offer additional benefits. Smoking is one of the strongest modifiable risk factors, with persistent effects even after cessation. Moderate to heavy alcohol consumption correlates with early-stage AMD. Robust evidence supports the implementation of public health strategies focused on smoking cessation, reducing alcohol intake, and promoting nutrient-rich diets to lower AMD incidence and progression. Integrating nutritional counseling into routine ophthalmologic care represents a biologically plausible and cost-effective approach to preserving vision and improving long-term outcomes in at-risk populations