Narra J (Journal)
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Exploring the antidiabetic potential of Sulawesi ethnomedicines: A study of Cordia myxa and Syzygium malaccense in a Drosophila model of hyperglycemia
Get PDFThe escalating prevalence of diabetes represents a critical challenge to global health and quality of life. Indonesia, particularly the Sulawesi region, is home to a diverse array of endemic plants with potential as sources of novel antidiabetic compounds. However, traditional preclinical models for evaluating these candidates are limited by high costs and lengthy timelines. The aim of this study was to explore the antidiabetic potential of Cordia myxa and Syzygium malaccense extracts using Drosophila melanogaster as a novel, cost-effective and efficient in vivo model. Hyperglycemia was induced in D. melanogaster larvae through a high-sugar diet, and the plant extracts were incorporated into the larval diets at concentrations ranging from 0.3125% to 2.5%. Phenotypic parameters, including body size, body weight, crawling activity, and hemolymph glucose levels, were evaluated, and the expression of metabolism-related genes (dilp2, dilp5, and srl) was analyzed using RT-qPCR. This study found that C. myxa and S. malaccense extracts improved crawling activity and body size in hyperglycemic larvae. Notably, C. myxa extract significantly reduced hemolymph glucose levels (p<0.01), increased body weight (p<0.01), and upregulated the expression of metabolic genes such as dilp2 (p<0.001), dilp5 (p<0.001), and srl (p<0.0001). In contrast, S. malaccense extract showed less pronounced effects, highlighting the efficacy of C. myxa extract in alleviating hyperglycemia and restoring metabolic homeostasis. The study highlights that C. myxa extract demonstrated promising antidiabetic properties in the Drosophila model, underscoring the utility of this model for early-stage antidiabetic drug screening and supporting further preclinical investigation into the therapeutic potential of C. myxa for managing hyperglycemia
Seroepidemiological investigation of SARS-CoV-2 infection and risk factors in Indonesia before mass COVID-19 vaccination
Get PDFAt the onset of the coronavirus disease 2019 (COVID-19) pandemic in Indonesia, surveillance focused on finding and treating symptomatic cases. However, emerging evidence indicated that asymptomatic and pre-symptomatic individuals significantly contributed to viral transmission. This highlights the need for comprehensive surveillance to understand better the actual spread of SARS-CoV-2. Therefore, the aim of this study was to determine the seroprevalence of SARS-CoV-2 antibodies in the general population across Indonesia and identify risk factors associated with infection at the beginning of the pandemic. A cross-sectional survey was conducted across 17 provinces, 69 districts/cities, and 1,020 villages in Indonesia from December 22, 2020, to February 15, 2021. A multistage random sampling technique was employed. Serological testing using enzyme-linked immunosorbent assay (ELISA) was performed to detect anti-SARS-CoV-2. Complex sample analysis, adjusted for weights, was utilized to estimate the national seroprevalence and a generalized linear model with a binomial distribution was applied to identify risk factors. A total of 10,161 individuals were included in the final analysis, with the national seroprevalence being 14.8% (95% confidence interval (CI): 14.2–18.5). The prevalence was higher in females (16.8%; 95%CI: 12.5–22.3), individuals aged 46–59 years (18.6%; 95%CI: 14.2–24.0), and in urban areas (20.1%; 95%CI: 15.0–26.2). The highest prevalence was observed in North Maluku (35.6%; 95%CI: 29.3–42.5). Notably, 54.2% of seropositive individuals were asymptomatic, while 7.5% reported hypertension as a comorbidity. Factors associated with higher seroprevalence were being married (adjusted prevalence ratio (aPR): 1.47; 95%CI: 1.02–2.12), widow (aPR: 1.74, 95%CI: 1.01–3.00), and close contact with confirmed cases (aPR: 2.04; 95%CI: 1.52–2.73). This study revealed a COVID-19 prevalence significantly higher than official estimate in Indonesia, underscoring the need for improved surveillance system to more accurately track disease spread and to inform timely public health responses in the future
Factors associated with mental health disorders in undergraduate students: A meta-analysis
Get PDFMental health disorders are a significant issue, yet there is currently no consistent data regarding the factors that may contribute to their occurrence. The aim of this study was to identify the factors that may influence the occurrence of mental health disorders in the undergraduate student population. This meta-analysis, registered in PROSPERO, was conducted as of September 5, 2024. The systematic searches were conducted on three databases (Scopus, Embase, and PubMed). Data on factors related to the occurrence of mental health disorders in undergraduate students were collected to calculate pooled point estimates using the Mantel-Haenszel test. Out of 6,837 articles, 16 articles were included in the analysis. Our findings revealed that female students had a higher chance of experiencing mental health disorders compared to male students (OR: 1.43; 95%CI: 1.14–1.80; p-Egger of 0.1041; p-Heterogeneity of <0.0001; p=0.0020). The chance of having mental health disorders was also higher among single students compared to those in relationships (OR: 1.20; 95%CI: 1.02–1.43; p-Egger of 0.0535; p-Heterogeneity of 0.1130; p=0.0180). This study did not find any associations between age group, family income, smoking, living arrangements, years of study, or regularity of physical activity with the occurrence of mental health disorders. These findings could serve as a basis for improving policies aimed at reducing the rates of mental health disorders in undergraduate students
Predicting the risks of stroke, cardiovascular disease, and peripheral vascular disease among people with type 2 diabetes with artificial intelligence models: A systematic review and meta-analysis
Get PDFMacrovascular complications, including stroke, cardiovascular disease (CVD), and peripheral vascular disease (PVD), significantly contribute to morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the performance of artificial intelligence (AI) models in predicting these complications, emphasizing applicability in diverse healthcare settings. Following PRISMA guidelines, a systematic search of six databases was conducted, yielding 46 eligible studies with 184 AI models. Predictive performance was assessed using the area under the receiver operating characteristic curve (AUROC). Subgroup analyses examined model performance by outcome type, predictor data (lab-only, non-lab, mixed), and algorithm type. Heterogeneity was evaluated using I2 statistics, and sensitivity analyses addressed outliers and study biases. The pooled AUROC for all AI models was 0.753 (95%CI: 0.740–0.766; I2=99.99%). Models predicting PVD achieved the highest AUROC (0.794), followed by cerebrovascular diseases (0.770) and CVD (0.741). Gradient-boosting algorithms outperformed others (AUROC: 0.789). Models with lab-only predictors had superior performance (AUROC: 0.837) compared to mixed (0.759) and non-lab predictors (0.714). External validations reported reduced AUROC (0.725), underscoring limitations in generalizability. AI models show moderate predictive accuracy for T2DM macrovascular complications, with laboratory-based predictors being key to performance. However, the limited external validation and reliance on high-resource data restrict implementation in low-resource settings. Future efforts should focus on non-lab predictors, external validation, and context-appropriate AI solutions to enhance global applicability
Exploring the hypoglycemic potential of fresh, semangit, and bosok tempe: A comparative metabolite profile
Get PDFTempe, a traditional Indonesian fermented soybean product made with Rhizopus spp., is classified based on fermentation duration into fresh (two days), semangit (five days), and bosok (seven days) varieties, fermented at room temperature (28–30°C). Longer fermentation is believed to enhance its antidiabetic properties. The aim of this study was to compare the metabolite profiles and hypoglycemic activities of fresh, semangit, and bosok tempe made from germinated and non-germinated soybeans. Diabetic rat models were used to assess the effects of these tempe types on body weight, blood glucose levels, serum insulin, pancreatic β-cell count, and glycogen content in liver and muscle tissues. Metabolomic profiling was conducted using gas chromatography-mass spectrometry (GC-MS), followed by principal component analysis (PCA) to assess the influence of fermentation stage and germination. Fresh tempe, especially from germinated soybeans, had the highest moisture content. Fermentation duration significantly influenced color, texture, and pH, with bosok tempe showing the most notable changes. Tempe and gliclazide significantly reduced blood glucose in diabetic rats in vivo, with semangit and bosok tempe restoring levels close to normal. However, weight loss was not reversed. Bosok non-germinated tempe induced the highest insulin levels among tempe treatments and improved β-cell count and density to levels comparable with gliclazide. Glycogen stores in the liver and muscle were significantly restored by tempe, with bosok non-germinated tempe showing the greatest effect. GC-MS profiling identified 154 metabolites, of which 63 were annotated. Fermentation and germination shifted the metabolite profile, with bosok non-germinated tempe showing the highest diversity, including amino acids, sugars, and amines. PCA separated samples by fermentation stage, highlighting metabolite accumulation with prolonged fermentation. The findings revealed that bosok tempe from non-germinated soybeans had the highest abundance of bioactive metabolites, including isoflavones, which likely contributed to its superior antioxidant and hypoglycemic potential compared to other tempe types
Chinese generative AI models (DeepSeek and Qwen) rival ChatGPT-4 in ophthalmology queries with excellent performance in Arabic and English
Get PDFThe rapid evolution of generative artificial intelligence (genAI) has ushered in a new era of digital medical consultations, with patients turning to AI-driven tools for guidance. The emergence of Chinese-developed genAI models such as DeepSeek-R1 and Qwen-2.5 presented a challenge to the dominance of OpenAI’s ChatGPT. The aim of this study was to benchmark the performance of Chinese genAI models against ChatGPT-4o and to assess disparities in performance across English and Arabic. Following the METRICS checklist for genAI evaluation, Qwen-2.5, DeepSeek-R1, and ChatGPT-4o were assessed for completeness, accuracy, and relevance using the CLEAR tool in common patient ophthalmology queries. In English, Qwen-2.5 demonstrated the highest overall performance (CLEAR score: 4.43±0.28), outperforming both DeepSeek-R1 (4.31±0.43) and ChatGPT-4o (4.14±0.41), with p=0.002. A similar hierarchy emerged in Arabic, with Qwen-2.5 again leading (4.40±0.29), followed by DeepSeek-R1 (4.20±0.49) and ChatGPT-4o (4.14±0.41), with p=0.007. Each tested genAI model exhibited near-identical performance across the two languages, with ChatGPT-4o demonstrating the most balanced linguistic capabilities (p=0.957), while Qwen-2.5 and DeepSeek-R1 showed a marginal superiority for English. An in-depth examination of genAI performance across key CLEAR components revealed that Qwen-2.5 consistently excelled in content completeness, factual accuracy, and relevance in both English and Arabic, setting a new benchmark for genAI in medical inquiries. Despite minor linguistic disparities, all three models exhibited robust multilingual capabilities, challenging the long-held assumption that genAI is inherently biased toward English. These findings highlight the evolving nature of AI-driven medical assistance, with Chinese genAI models being able to rival or even surpass ChatGPT-4o in ophthalmology-related queries
Role of adult attachment and spiritual attachment on meaning in life among religious minorities in Thailand: Insights for mental health promotion
Get PDFAttachment theory suggests that secure relationships are foundational to meaning in life, but less is known about the role of spiritual attachment, especially among religious minorities. This study examined whether attachment to God mediates the relationship between insecure human attachment and the presence of meaning in life among Thai Protestant Christians. A cross-sectional survey was conducted with Thai Protestant Christians, assessing insecure human attachment (avoidant and anxious), attachment to God, and the presence of meaning in life using validated self-report measures. Mediation analysis was used to test the indirect effect of insecure attachment on meaning via attachment to God. The results showed that attachment to God fully mediated the negative relationship between insecure human attachment and the presence of meaning in life. Participants with higher insecure attachment reported lower meaning in life, but those with a secure attachment to God did not display this deficit. Attachment to God serves as a central psychological resource, a positive figure for humans, and enhances meaning in life, particularly in the minority context of Thai Protestant Christians. These findings highlight the importance of spiritual interventions for individuals experiencing relational or social marginalization
Neutrophil-to-lymphocyte ratio and stenosis severity in ischemic stroke: Digital subtraction angiography evaluation and implications for inflammation-based risk stratification in the Indonesian population
Get PDFNeutrophil-to-lymphocyte ratio (NLR), an accessible biomarker derived from routine blood counts, has been associated with stroke severity and outcomes. However, its association with angiographically confirmed stenosis has not been fully established. The aim of this study was to investigate the correlation and association between the NLR and the severity of intracranial arterial stenosis assessed by digital subtraction angiography (DSA). An observational analytic study with a cross-sectional design was conducted. Patients with acute ischemic stroke who underwent DSA were included using a total sampling method. Eligible patients were aged >18 years, had ischemic stroke onset <14 days, and had no prior thrombolysis, endovascular treatment, or surgery for cerebral stenosis. Those with infection, hematological disorders, malignancy, or immunosuppression were excluded. NLR was calculated from complete blood count results at admission, while stenosis severity was quantified using the Warfarin–Aspirin Symptomatic Intracranial Disease (WASID) method. A total of 44 ischemic stroke patients who underwent DSA were included. Pearson correlation test revealed a strong positive correlation between NLR and the severity of intracranial arterial stenosis (r=0.671; p<0.001). In subgroup analysis, NLR showed a strong positive correlation with stenosis severity in the cerebral arteries (r=0.707; p<0.001), but not in the carotid arteries (r=0.434; p=0.182). One-way ANOVA revealed significant differences in NLR across stenosis severity groups (p<0.0001), with higher NLR in moderate and severe stenosis compared with mild stenosis (p=0.017 and p=0.0003, respectively). These findings suggest that NLR reflects the inflammatory burden contributing to vascular narrowing and may serve as a simple and widely available biomarker for identifying ischemic stroke patients with a higher burden of intracranial arterial stenosis, particularly in settings where access to advanced imaging is limited
Salt intake- related knowledge, attitudes, and practices among Jordanian adults
Get PDFHigh salt consumption is a worldwide public health problem, and its magnitude varies considerably among different communities. This study aimed to assess Jordanian adults’ knowledge, attitudes, and practices related to salt intake and to examine how these domains differed between genders. A quantitative cross-sectional survey was conducted using a multi-stage sampling technique to select a representative sample from the population of Amman, Jordan. Data were collected through a structured, validated questionnaire administered by trained interviewers between November and December 2021. The findings indicate that the majority of participants (70.8%) did not know the maximum recommended daily salt intake and reported not reading food labels when purchasing food. Almost half of the participants (48.2%) reported always adding salt while cooking, and 14.6% reported always adding table salt after cooking. The most commonly reported practices to reduce salt intake included using spices other than salt while cooking (67.2%) and avoiding or reducing the consumption of salt-rich foods. Significant gender differences were observed in knowledge, attitudes, and practices (KAP) toward salt intake. Females demonstrated greater awareness of recommended salt intake and associated health risks, and were more likely to engage in practices aimed at reducing salt consumption, such as avoiding high-salt foods and using alternatives in cooking. In contrast, males were more likely to report misconceptions, limited use of food labels, and higher engagement in unhealthy practices such as daily smoking and lower awareness of low-salt alternatives. In conclusion, this study showed that Jordanian adults have relatively limited knowledge about salt intake, and their practices regarding salt consumption are inappropriate. Therefore, there is a need to adopt long-term strategies to reduce salt intake among the Jordanian population and mitigate its negative impacts on community health
Occupational risk factors related to musculoskeletal disorders among Praewa silk weavers in the Northeast region, Thailand
Get PDFPraewa silk weavers are subject to numerous occupational risk factors that contribute to musculoskeletal disorders (MSDs), primarily due to inadequate occupational safety measures, limited access to health services, and substandard working conditions. The aim of this study was to assess the prevalence rate and determinants of MSDs among Praewa silk weavers. A cross-sectional study employing a convenience sampling method was conducted, involving 198 Praewa silk weavers from four provinces in the Northeast region of Thailand. Data collection was facilitated through a two-part research tool. The first part included a questionnaire assessment using demographic information, workplace conditions, and self-reported MSDs. The second part involved an ergonomic risk assessment using rapid upper limb assessment (RULA) and hand activity level (HAL). Descriptive statistics and multiple logistic regression analyses were conducted to determine the prevalence and associated factors of MSDs among participants. The findings revealed that the prevalence rates of MSDs in the past 7 days and 12 months were 68.68% and 96.46%, respectively. The highest prevalence rates of MSDs (over 60.00%) were observed in the wrists, fingers, and neck, with similar trends reported in both the past 7 days and 12 months. Key factors associated with MSDs over the past 12 months included low hand strength test results (adjusted odds ratio (AOR)=2.09; 95%CI: 0.44–11.05), quite low hand strength test results (AOR=2.49; 95%CI: 0.29–21.15), weaving experience of 21–30 years (AOR=1.07; 95%CI: 0.20–5.64), age between 31–40 years (AOR=2.63; 95%CI: 0.49–13.91), age above 41 years (AOR=1.13; 95%CI: 1.08–1.19), RULA level 4 (AOR=3.62; 95%CI: 0.66–19.96), and HAL score exceeding 0.78 (AOR=0.63; 95%CI: 0.80–0.98) were significantly associated with MSDs during the past 12 months. This study highlights the high prevalence of MSDs among Praewa silk weavers, attributed to occupational risk factors such as low hand strength, high hand activity level, extensive weaving experience, and poor working posture. The weaving process itself is a significant contributor to these disorders. In conclusion, ergonomics interventions aimed at preventing MSDs, including postural training, injury prevention programs, and re-designed pull-cloth devices, are recommended to mitigate these risks