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Shed a New Light on the Role of Probiotics: A Case Report on the Patient with Ulcerative Colitis and Non- Hodgkin’s Lymphoma (Perspektif Baru tentang Peran Probiotik: Laporan Kasus pada Pasien dengan Kolitis Ulseratif dan Limfoma Non-Hodgkin)
No full textLatar Belakang: Kolitis Ulseratif (UC) merupakan penyakit radang usus kronis (IBD) yang menyebabkan peradangan dan
ulserasi pada lapisan dalam kolon dan rektum. UC meningkatkan risiko komplikasi serius, seperti kanker kolorektal dan limfoma.
Limfoma Non-Hodgkin (NHL) adalah kelompok kanker pada sistem limfatik yang dapat muncul sebagai komplikasi UC, terutama
pada pasien yang menerima terapi imunosupresif.
Presentasi Kasus: Seorang pasien laki-laki berusia 44 tahun datang dengan keluhan perdarahan gastrointestinal kronis sejak
Januari 2022. Awalnya bersifat intermiten, frekuensi perdarahan meningkat dalam dua bulan berikutnya menjadi 10–14 kali per hari
sehingga sangat mengganggu aktivitas sehari-hari. Pemeriksaan kolonoskopi dan histopatologi menegakkan diagnosis UC dan NHL.
Pasien menjalani delapan siklus kemoterapi dengan tambahan suplementasi probiotik multistrain sebagai adjuvan dengan dosis 2 × 15
mL per hari selama 14 hari di antara siklus kemoterapi ke-6 dan ke-7, serta 2 × 15 mL per hari selama 21 hari di antara siklus ke-7 dan
ke-8. Sebelum suplementasi probiotik, pasien mengalami efek samping kemoterapi yang memerlukan pengobatan suportif. Namun,
setelah pemberian probiotik, efek samping menjadi lebih ringan dan tidak lagi memerlukan resep tambahan. Efek samping yang
dilaporkan, termasuk malaise, mual, dan gangguan gastrointestinal, mereda lebih cepat dibandingkan periode sebelum suplementasi.
Kesimpulan: Kombinasi kemoterapi dengan suplementasi probiotik multistrain berpotensi menghambat progresi keganasan.
Probiotik dapat memberikan manfaat terapeutik dengan meningkatkan apoptosis sel kanker sekaligus menurunkan peradangan pada
U
Perbandingan Efektivitas dan Biaya Terapi Guillain-Barré Syndrome: Literature Review
No full textGuillain-Barré syndrome (GBS) merupakan penyakit langka yang menyebabkan kelemahan pada anggota
gerak. Prevalensi kejadian GBS di dunia 1–2 per 100.000 orang. Tujuan terapi GBS adalah mengatasi
gejala, mempercepat penyembuhan, mengobati komplikasi, dan memperbaiki prognosis. Terapi yang
dapat diberikan pada pasien GBS adalah terapi suportif dan imunoterapi. Pemilihan terapi pada pasien
mempertimbangkan beberapa faktor, seperti biaya yang mahal serta ketersediaan obat. Di Indonesia,
imunoterapi hanya dapat dilakukan di rumah sakit tertentu dengan biaya yang mahal. Di Eropa biaya
yang dibutuhkan untuk terapi GBS adalah EUR 15.060, sedangkan di India biaya yang dibutuhkan
untuk terapi intravenous immunoglobulin (IVIg) dengan dosis 1.530 gram adalah INR 195.000 dan
terapi plasma exchange (PE) adalah INR 89.921. Tujuan penelitian ini digunakan untuk mengetahui
pilihan terapi yang tepat untuk pasien GBS sesuai dengan kebutuhan pasien. Metode yang digunakan
adalah literature review dengan pencarian sumber artikel dari situs Pubmed ataupun Google Scholar
berupa original artikel, systematic review-meta analysis, atau penelitian randomized control trial (RCT)
yang tersedia full text selama rentang 10 tahun terakhir di situs Pubmed dan Google Scholar dengan
menggunakan dengan kata kunci “Guillain-Barré syndrome”, “Guillain-Barré syndrome and therapy”,
dan “cost-effectiveness therapy Guillain-Barré syndrome”. Berdasarkan hasil pencarian, ditemukan 7
artikel yang menunjukkan bahwa terapi PE dan IVIg efektif untuk mengatasi GBS dan 6 artikel yang
berkaitan dengan biaya terapi GBS. Dari segi biaya terapi PE lebih murah dibandingkan IVIg
Product bundling and substitution recommendation system: Facilitating marketing improvement strategy of retail business
No full textA retail store is a place where a variety of everyday items are sold. Supermarkets need to use
different tactics to sell their products and attract consumers. According to an interview with an
employee of Supermarket X, one strategy supermarkets use is to bundle products. This involves
combining two or more products into one package and selling them at a discounted price.
Supermarkets sometimes need help choosing the products to bundle and finding similar
products due to limited stock. Based on the problem description, it can be inferred that the
supermarket system will utilize the Apriori algorithm for creating product bundling and the
Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method to
showcase similar products and predict if any products are running low on stock. The system's
performance has been evaluated through trials and validation at the supermarket. The findings
showed that they were able to determine which products may be included in the package with
the use of this product packaging automation system. The results were promising, indicating
that choosing replacement products can aid in lowering the inventory of goods that are not
doing well
Catalytic versatility of lipoxygenase from Microcystis aeruginosa
No full textLipoxygenases (LOXs) catalyze the regio- and enantioselective addition of molecular oxygen to polyunsaturated fatty acids (PUFAs), yielding fatty acid hydroperoxides (FAHPs) with significant industrial relevance. Bacterial LOXs are of particular interest due to their broad substrate range and distinct regio- and enantioselectivity profiles. In the current study, we characterized the biochemical properties and product scope of a newly identified LOX from the cyanobacterium Microcystis aeruginosa (Ma-LOX). Our results demonstrate that Ma-LOX exhibits a strong preference for linoleic acid (LA) and α-linolenic acid (ALA), catalyzing regioselective dioxygen insertion predominantly at the ω-5 position for these substrates. Notably, this regioselectivity diminishes with longer-chain PUFAs. Ma-LOX shows opposite enantioselectivity with respect to eukaryotic LOXs, producing 13(R)-hydroperoxy-9Z,11E-octadecadienoic acid (13R-HPODE) from LA with an enantiomeric excess (ee) of 79.3 ± 8.8 % (n = 3). Structural prediction and molecular docking simulations suggest that the observed regioselectivities of Ma-LOX are influenced by oxygen insertion via two distinct pathways: a putative oxygen access channel and the entrance of a relatively shallow substrate-binding pocket, distinguishing Ma-LOX from other LOXs. Additionally, we identified that this shallow binding pocket facilitates Ma-LOX’s double dioxygenation activity toward ALA, resulting in the formation of dihydroperoxides. Beyond FAHPs and dihydroperoxides, Ma-LOX catalyzes the synthesis of epoxy alcohols and ketones, suggesting the enzyme possesses an unusual but highly relevant hydroperoxide isomerase (HPI) activity. These results offer important insights into the catalytic mechanism and functional versatility of Ma-LOX, underscoring its potential for a broad range of biotechnological applications
Analysis of Antibiotic Use in Outpatient Pneumonia Patients at X Blitar Health Center using the Gyssens Method and the Defined Daily Dose (DDD)
No full textPneumonia is one of the respiratory infections that is still a public health problem and requires appropriate antibiotic therapy. However, irrational use of antibiotics has the potential to increase resistance and worsen patient clinical outcomes. This study aims to analyze antibiotic use in outpatient pneumonia patients at the X Blitar Health Center using the Defined Daily Dose (DDD) and Gyssens methods. This study employed a cross-sectional approach, utilizing secondary data from 109 medical records and prescriptions for pneumonia patients (ICD-10 codes J12-J18) from February 2024 to May 2025. Quantitative analysis was conducted using the DDD/1,000 patients per day method, while qualitative analysis of prescriptions was performed using the Gyssens method. The results showed that Amoxicillin (J01CA04) was the most widely used antibiotic, namely 232.42 DDD/1,000 patients per day, followed by Cefadroxil (87.04 DDD/1,000 patients per day), Ciprofoxacin (18.35 DDD/1,000 patients per day), and Azithromycin (15.29 DDD/1,000 patients per day). Gyssens’ analysis revealed that most prescriptions fell into category IIA (33.94%), category IVA (29.36%), and category V (27.52%). Inaccurate dosage and suboptimal antibiotic selection were the leading causes of irrational antibiotic use. Additionally, 30 pneumonia patients were identified who did not receive antibiotics despite having clinical indications for them. The results of this study emphasize the need for rationalization training in therapy, prescription audits, and strengthening the implementation of clinical guidelines in primary care facilities
The Essence of Trancendent Accountability Based on Tri Hita Karana in Desa Adat Penglipuran
Full text linkAccountability plays a crucial role and is applied in almost all types of organizations, whether profit-oriented or social organizations. However, the application of accountability in organizations that combine social, financial, and cultural aspects, such as Desa Adat Penglipuran, demonstrates different needs and focuses. This study highlights the unique concept of accountability in Desa Adat Penglipuran, which is expected to be replicated by other village organizations, particularly in Indonesia, thereby contributing both practically and theoretically. Using a qualitative approach and data collection methods, including interviews, observations, and document analysis, this study reveals that accountability in Desa Adat Penglipuran is understood by the community as a form of devotion and service to ancestors and God, in line with the characteristics of transcendent accountability. Local wisdom, such as Tri Hita Karana and Tri Mandala, plays a role in raising awareness among the community about the importance of balancing spiritual and financial factors in preserving village traditions. The construction of the transcendent accountability concept based on Tri Hita Karana creates more holistic understanding of transcendent accountability, which is capable of balancing financial and non-financial factors
The potential of circulating free DNA of methylated IGFBP as a biomarker for type 2 Diabetes Mellitus: A Comprehensive review
No full textT2DM detection methods are commonly used in teens and adults but are generally unsuitable to unborn fetuses in the context of non-invasive prenatal testing (NIPT). Biophysical and biochemical tests for fetuses are often invasive, carry risks, and have low sensitivity and specificity, with no direct method available to diagnose T2DM in utero. In contrast, cell-free DNA (efDNA) is known have high sensitivity (93-98%) and specificity (94-100%) for cancer detection and fetal genetic disorders (trisomy 21, 8, and 13) making it applicable for fetal epigenetic and genetic analysis, including T2DM early detection. However, no study has explored its use for this purpose. Our review focuses on the potential of IGFBP methylation levels in efDNA as biomarkers for NIPT of T2DM. Placental global hypomethylation in GDSM may predict T2DM during the prenatal period, and a similar pattern potentially be detected in cfDNA. Targeted genes reliable for NIPT, such as IGFBPs are needed because their significant role in T2DM and GDM. Among these, IGFBP-1 and IGFBP-2 have shown potential as predictive genes, exhibiting hypermethylation in placental tissue from GDM cases. This hypermethylation reduces their expression and the formation of the IGF-1-IGFBP complex, leading to increased levels of free IGF-1, which is associated with T2DM in the fetus. Hypermethylation regions have longer fragment sizes in cfDNA, thus in T2DM cases, hypermethylation of IGFBP-1 and IGFBP-2 from fetus results in longer efDNA fragments. Therefore, analyzing the methylation levels and fragment sizes of IGFBP-1 or IGFBP-2 cDNA could be a promising biomarker for iden- tifying fetal T2DM risk non-invazively
Achieving Speaking Proficiency For Professionals: Segmental And Suprasegmental Challenges
Full text linkIndonesian professionals face significant challenges in achieving English-speaking proficiency due to
phonological hurdles encompassing segmental and suprasegmental aspects. Difficulties with consonant sounds
(/θ/ and /v/), vowel quality, stress patterns, and intonation impede effective communication, impacting clarity,
comprehension, and professionalism. Initial observation shows that there has been an increase of awareness of
professionals to improve their speaking proficiency for professional purposes. Yet, the baseline reveals
insufficient proficiency of their speaking. This study examines common segmental and suprasegmental errors
that prevent professionals from better speaking proficiency. For the purpose, this descriptive qualitative study
involves 235 professionals as participants. A set of questionnaires and records of their speaking voice are used
as source of data. For robust analysis, error analysis is also applied for phonological issue encountered by the
participants. Results show that difficulty with /v/ sound, misplacement of word stress, intonation errors,
difficulty with /θ/ sound and vowel reduction are still a struggle for them to achieve the expected speaking
proficiency.
Keywords
Pengaruh Kompetensi, Pengembangan Karir, Budaya Organisasi Dan Pelatihan Terhadap Kinerja Karyawan
Full text linkA modern company requires employee performance that is able to achieve targets so that company goals are met. Employees as human resources in the company are expected to be able to contribute and add value.This study was conducted with the objectives of this research are (1) able to prove whether competence has a positive influence on employee performance, (2) able to prove whether career development has a positive influence on employee performance, (3) able to prove whether organizational culture has a positive influence on performance employees, (4) able to prove whether training has a positive influence on employee performance, (5) able to prove whether simultaneously competency, career development, organizational culture and training have a positive influence on employee performance. This research is classified as basic research because this research aims to test, identify, explain, modify and develop theories from previous research. Based on its objectives, this research is included in the category of causal research which is descriptive explanatory in nature and explains the influence of the independent variable on the dependent variable. This research is a quantitative type with primary data sources from research subjects, namely employees with a minimum work period of 1 year through distributing questionnaires. The sampling used is saturated/census sampling where all members of the population are used as samples. The total population is 152 people. The questionnaire uses a Likert scale measurement type with five scales consisting of strongly disagree, disagree, quite agree, agree, strongly agree with a value range of 1 to 5. Data analysis uses multiple linear regression analysis techniques using JASP 0.18.3 software. From the research results, it is partially proven that the competency and organizational culture variables have a positive and significant effect on employee performance. Meanwhile, the career development variable has a negative and significant effect on employee performance. The training variable has a negative and insignificant effect on employee performance. This research also proves that simultaneously competency, career development, organizational culture and training have a positive and significant effect on employee performance. The results of this research can be used as a basis for management to determine the company's strategic direction in the medium or long term into the future