Pelita Harapan University

Objectives This systematic review aimed to consolidate existing MRI findings in PMD cases, establish optimal imaging indications, and explore their clinical value. Methods The protocol for this review was registered in PROSPERO (CRD42024592190). Searches were performed in MEDLINE, Cochrane Library, PubMed, ScienceDirect, and Google Scholar on December 1, 2024. Eligible studies included those with clinically diagnosed PMD and MRI findings. Data on patient characteristics, MRI sequences, thrombus stage, and study quality were extracted and assessed using the Joanna Briggs Institute checklist for case reports. Results From 710 records, four studies were included, encompassing four patients with PMD. The median age of the four patients is 35.5 years old (25-53), and two are from Turkey. MRI findings highlighted variable thrombus stages (one acute, two subacute, and one chronic) and heterogeneous imaging protocols. Only one study explicitly mentioned MRI indications. MRI provided detailed assessments of penile anatomy and thrombus characteristics but lacked consistency in usage, timing, and sequence protocols. No studies received a good quality rating; two were rated poor, and one was fair. Conclusion MRI's role in PMD diagnosis is limited, with its utility primarily in complex or atypical cases. Standardized MRI indications and sequence protocols are warranted to optimize its clinical application. More extensive studies are needed to validate its diagnostic and therapeutic impact. Advances in knowledge MRI is primarily utilized for complex cases of PMD; however, more systematic documentation of its indications could guide clinicians in determining when MRI is appropriate for PMD patients. Keywords: Penile Mondor's disease, Magnetic resonance imaging, thrombophlebitis, diagnostic imaging, systematic review

Background Predicting nontraumatic spontaneous intracerebral hemorrhage (SICH) patient prognosis has been commonly practiced, particularly when providing informed consent and considering surgical treatment. Biomarkers might provide more real-time evaluation of SICH patients’ condition than clinical prognostic scoring systems. This study aimed to evaluate the reliability of blood biomarkers in predicting prognosis in SICH patients by systematic review and meta-analysis. Methods Studies that evaluated the association of blood biomarker(s) with mortality and/or functional outcome in SICH patients up to October 11, 2024, were identified through PubMed, Google Scholars, Scopus databases, and reference lists. Studies that satisfied the inclusion criteria were included in the meta-analyses. Good functional outcome was defined by patient’s Glasgow Outcome Scale (GOS) ≥ 4 or modified Rankin scale mRS ≤ 2. Blood biomarkers were classified into the following categories: angiogenic factors, growth factors, inflammatory biomarkers, coagulation parameters, blood counts, and others. Individual meta-analysis was performed for every evaluation endpoint:7 days, 30 days, 3 months, 6 months, and 1 year. Meta-analyses were performed using Random Effect Mean-Difference with a 95% Confidence Interval for continuous data and visualized as forest plots in RevMan version 5.3 software. Cochrane Tool to Assess Risk of Bias in Cohort Studies was used to assess potential risk of bias of the included studies. GRADE Profiler was used to assess quality of evidence. Results Seventy-seven studies fulfilled the inclusion criteria. Surviving SICH patients have significantly lower C-reactive protein (CRP), D-dimer, copeptin, S100β, white blood cell (WBC), monocyte, and glucose than non-surviving patients. SICH patients with good functional outcome have lower D-dimer, Interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), WBC count, neutrophil count, monocyte count, copeptin and significantly higher lymphocyte counts and calcium levels. Out of all blood biomarkers that were evaluated, only S100β and copeptin had very high effect size and high certainty of evidence. Conclusion It is interesting to notice that many blood biomarkers significantly associated with SICH patients’ outcomes are related to inflammatory responses. This suggests that modulation of inflammation might be essential to improve SICH patients’ prognosis. We confidently concluded that S100β and copeptin are the most reliable blood biomarkers that can be used as prognosticators in SICH patients. On other biomarkers, in addition to heterogeneities and inconsistencies, several factors might affect the conclusions of current meta-analysis; thus, future studies to increase the certainties of evidence and effect size on other biomarkers are crucial.

The hotel industry, recognizing the critical need to understand the dynamics between job demands, job resources, service-oriented job crafting and employee well-being, investigates this interplay utilizing the Job-Demands-Resources (JD-R) theory as its framework. The study employed a quantitative method, specifically a cross-sectional survey, with a sample comprising 259 hotel managers from five-star hotels in Jakarta, Indonesia, selected through purposive sampling. The analysis employed partial least squares structural equation modeling (PLS-SEM) to examine the relationship between variables. This study revealed that both job demands and job resources positively influence service-oriented job crafting and employee well-being, with service-oriented job crafting mediating the relationships between job demands and resources on employee well-being, highlighting the pivotal role of job resources. This study holds significant implications for management to support job resources, manage job demands and create programs to enhance service-oriented job crafting, and it provides insights for the government to facilitate professional certification in the hotel industry. By targeting employees in five-star Jakarta hotels, this study sets a precedent for future research in other Indonesian cities to explore additional mediators like work engagement or servant leadership, potentially improving strategies for enhancing employee well-being in the hotel sector.

Background Overweight and obesity are growing public health concerns globally for which innovative prevention and care delivery efforts are required. We recently developed a web-based training program to improve the quality of health professionals’ weight management counseling of adolescents in Indonesia. Having previously confirmed its acceptability, this study aimed to measure the effectiveness of the program through a randomized controlled trial. Methods We recruited 64 primary healthcare professionals from 17 provinces across Indonesia who were randomized to participate in a 4-week online training program (intervention group [IG, n = 32] or a waitlist control group [CG, n = 32]). Using active learning approaches, the training program focused on adolescent development, psychosocial assessment, motivational interviewing (MI), and parent engagement. Participants in each arm were asked to record two counseling sessions with adolescents. These were objectively rated by trained psychologists using a validated tool, and also by qualitative assessment of counseling quality. In both groups, the first recorded counseling session occurred before the training. The second recording took place after the training for IG participants, but not for CG participants. Results IG participants demonstrated significant improvements in their knowledge and counseling skills (p<0.001, t-test). This included improvements in introductory remarks, quality of psychosocial assessment, and MI skills. There was no change in the extent of parental involvement. The MI training successfully oriented the counseling sessions towards a more collaborative and participatory conversation for supporting behavioral change. Conclusion This novel online training program improved the knowledge and counseling skills of Indonesian primary healthcare professionals. Greater emphasis on engaging parents and more guidance on conducting telehealth counseling may improve parental involvement in future iterations.

Background: Several studies have shown that tranexamic acid (TXA), an anti-fibrinolytic agent, may reduce hematoma expansion (HE) in intracerebral hemorrhage (ICH), but its therapeutic time window is unclear. We analyzed the efficacy and safety of TXA based on its time of administration after hemorrhage onset. Methods: We searched PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs) published up to July 27, 2024 comparing TXA with placebo in ICH. We excluded trials that used TXA for longer than 3 days which causes delayed vasospasm, increasing the risk of cerebral ischemia. The primary outcomes were HE, 24-hour hemorrhagic volume change, 90-day mortality and poor functional outcome. We grouped the trials into 2 hours, 8 hours or 24 hours of TXA administration after hemorrhage onset. We pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) using Rstudio. Heterogeneity was examined with the I2 test. Results: We included 12 studies with 3,567 patients. Most of the studies used 1 g TXA in patients with Glasgow Coma Scale score ranging from 13-15. TXA reduced HE risk (OR 0.85; 95% CI 0.73 to 0.98; p= 0.03; I2= 0%). This reduction was observed in studies that administered TXA within 8 hours of ICH onset (OR 0.82; 95% CI 0.70 to 0.97; p= 0.02; I2= 0%). TXA slightly reduced 24-hour hemorrhagic volume (MD -1.30 mL; 95% CI -2.51; -0.09; p= 0.04; I2= 47%). This reduction was mainly seen in patients who were administered TXA within 8 hours of hemorrhage onset (MD -1.86 mL; 95% CI -3.15 to -0.58; p< 0.01; I2= 35%). There were no significant differences in poor functional outcome (OR 0.87; 95% CI 0.67 to 1.15; p= 0.34; I2= 24%), 90-day mortality (OR 1.00; 95% CI 0.84 to 1.19; p= 0.96; I2= 0%), major thromboembolic events (OR 1.22; 95% CI 0.82 to 1.82; p= 0.33; I2= 0%), neurosurgical intervention (OR 0.94; 95% CI 0.61-1.45; p= 0.78; I2= 0%) or length of hospital stay (MD -0.49 days; 95% CI -3.27 to 2.29; p= 0.73; I2= 0%). Conclusion: TXA reduced the risk of HE and slightly reduced 24-hour hemorrhagic volume in patients with ICH within 8 hours. Larger RCTs stratifying administration timing are required to establish these findings.

Background The Monkeypox Virus (MPOX) has caused a surge in viral infections, leading to the WHO recognizing it as a public health emergency of international concern. MPOX infection shares clinical similarities with smallpox but can cause complications like myocarditis, anorectal pain, ocular lesions, kidney damage, or soft tissue superinfection. The study aims to understand the characteristics of myocarditis, fixed drug eruption, and dry eye syndrome in Monkeypox patients. Methods This review was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), and the Cochrane Handbook for Systematic Reviews of Interventions. The data was obtained from Scopus and international journal databases by conducting combined keyword searches restricted to English-language publications. Result The study examined 25 cases of Monkeypox, primarily involving males aged 32.9 years and experiencing chest pain. The prognosis was generally good, with no reported death. Risk factors for infection include sexual activity, STD diagnosis, sexual encounters, and workplace exposure to orthopoxviruses. Most cases were male and involved chest pain. Myocarditis, an inflammation in the myocardium, can cause dilated cardiomyopathy, acute arrhythmia, and heart failure. The pathophysiology of myocarditis in Monkeypox patients is not yet determined due to rarity of cases. Conclusion MPOX infection presents unique complications like myocarditis, necessitating research for vaccines, antiviral drugs, and infection prevention measures. Early screening for chest pain and investigating MPXV infection's pathogenesis and clinical features are crucial for differential diagnosis during outbreaks. This systematic review can determine MPOX infection outcomes and prepare appropriate treatment for patients with complications.

Background and Study Aims: Spine surgeries are one of the most widely accepted method of surgery in orthopaedics. However, one of the most common complications of spine surgeries is surgical site infection (SSI), that associated with various post operative morbidities. The use of antibiotics impregnated bone cement (AIBC) is common in orthopaedics surgeries. Therefore, we aim to provide comprehensive review of AIBC use in spine surgeries. Methods: Data was gathered from PubMed, Europe PMC, and ScienceDirect using keywords associated with AIBC and spine surgeries. We included all publications associated with AIBC and spine surgeries. Studies without full paper, non-English publications, review articles, and animal or cadaveric studies are excluded. The quality of each included studies assessed using Newcastle Ottawa Scale (NOS) and Joana Briggs Institute (JBI) Critical Appraisal for case reports, case series, and quasi experimental studies. Results: 15 studies with total of 322 patients using AIBC in spine surgery were included. 10 of 15 studies reported 100% infection-free event with AIBC administration with or without given systemic antibiotics. Two studies did not report 100% infection free event due to MRSA infections and technical causes. 3 studies reported the use of AIBC without disclosing outcomes. Various types of bacteria ranging from MSSA to MRSA have been discovered, with PMMA and vancomycin being the most frequently used AIBC. Conclusion: Antibiotics impregnated bone cement can be used to prevent post-operative infections due to its high effectiveness, easy administration, and no side effects have ever been reported. Further studies are needed to determine the most appropriate antibiotics, dose, and type of cement.

Purpose: The external ureteral catheter (EUC) and double-J stent (DJ-stent) are frequently used for drainage in tubeless percutaneous nephrolithotomy (PCNL). This study aims to compare the outcomes and effectiveness of these two methods. Materials and Methods: We conducted a detailed literature search using relevant key words on Google Scholar, Europe PMC, Medline, and Scopus databases. Continuous variables were combined using mean difference (MD), while binary variables were analysed using risk ratio (RR) with 95% confidence intervals through random-effects models. Results: Our analysis included nine studies. The results showed that EUC was associated with a significantly lower incidence of stent-related symptoms [RR 0.32 (95% CI 0.19 - 0.54), p < 0.0001, I² = 24%] compared to the DJ-stent. There were no significant differences between EUC and DJ-stent in terms of postoperative fever (p = 0.92), urine leakage (p = 0.21), perinephric collection (p = 0.85), haemoglobin drop (p = 0.06), transfusion rate (p = 0.27), VAS score (p = 0.67), analgesic requirements (p = 0.59), stone-free rate (p = 0.14), duration of surgery (p = 0.10), and duration of hospitalization (p = 0.50). Conclusion: The EUC demonstrated fewer stent-related symptoms than the DJ-stent in tubeless PCNL, while both methods showed comparable safety and efficacy. The choice between EUC and DJ-stent should consider patient preferences and surgeon expertise. Further randomized controlled trials (RCTs) with larger sample sizes are needed to affirm these results. Keywords: Kidney Calculi; Nephrolithotomy; Percutaneous; Urinary Catheters

Purpose of Review The use of stem cell therapy is a rapidly evolving and progressing frontier of science that has been used to treat illnesses such as malignancies, immunodeficiencies, and metabolic syndromes. This review aims to give an overview of the use of stem cell therapy in the treatment of pain caused by diabetic neuropathy, osteoarthritis, and other spinal cord pathologies. Recent Findings Pain is defined as a generalized or localized feeling of distress related to a physical or emotional stimulus and can be caused by a multitude of pathologies. The field of pain management has explored many strategies such as gene therapies, neuromodulation, platelet-rich plasma, and numerous pharmacotherapies. The approach to the delivery of these strategies has varied, with the method of stem cell therapy delivery being the focus of this present investigation. In addition, we combined several different studies to analyze the effects of stem cell therapies and improvement in pain scores quantified by the visual analog scale (VAS). The overall results showed a mean difference of -2.58, suggesting that the stem cell treatment group had a lower VAS score at 6 months compared to the control group. Summary The use of different types of stem cells, such as pluripotent and mesenchymal stem cells, play a critical role in the care of cases suffering from pain. Effective delivery methods are evolving and can transform treatment options in the future, for which large cohort studies are warranted.

Background Magnetic resonance imaging (MRI), together with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), has been the mainstay of diagnostic imaging for neonatal ischemic stroke. This systematic review will describe the current research progress on DWI and ADC in neonatal ischemic stroke. Methods The protocol for this study is available in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024543678). The studied population was all neonates (≤ 28 days old) who suffered from ischemic stroke and DWI or ADC was analyzed. The inclusion criteria were articles of any cross-sectional, case-control, cohort, or randomized controlled trial that were published in any language. To evaluate the risk of bias, we employed the Newcastle Ottawa Scale (NOS). Results 17 studies were included in the systematic review, and only 4 (23.5%) had a good rating. There are 373 neonates with a gestational age ranging from 35 1/7 weeks old to 43 weeks old. Most neonates undergo MRI scans when they are < 10 days old and most studies come from the United States of America (USA) (n = 6) and the Netherlands (n = 3). The middle cerebral artery (MCA) is the most commonly affected vascular territory with 197 neonates (52.8%). Ten studies assess the utility of DWI and ADC in neonatal stroke, while the others incorporated DWI and ADC into a prediction modeling score to predict a disease entity or the prognosis. Infarctions faded on DWI within a week; by 14 days, increased diffusion and visible lesions appeared on T2-weighted images. Conclusion Early use of DWI and ADC has been recommended for early detection of neonatal ischemic stroke. However, the progression of both of these sequences has been slow, with DWI and ADC being incorporated into prediction modeling tools.

The demonization of seed oils “campaign” has become stronger over the decades. Despite the dietary guidelines provided by nutritional experts recommending the limiting of saturated fat intake and its replacement with unsaturated fat–rich food sources, some health experts ignore the dietary guidelines and the available human research evidence, suggesting the opposite. As contrarians, these individuals could easily shift public opinion so that dietary behavior moves away from intake of unsaturated fat-rich food sources (including seed oils) toward saturated fats, which is very concerning. Excess saturated fat intake has been known for its association with increased cholesterol serum levels in the bloodstream, which increase atherosclerotic cardiovascular disease risks. Furthermore, high saturated fat intake may potentially induce insulin resistance and non-alcoholic fatty liver disease, based on human isocaloric feeding studies. Hence, this current review aimed to assess and highlight the available human research evidence, and if appropriate, to counteract any misconceptions and misinformation about seed oils.

One of the ways to advance toward a more regenerative construction industry is by developing a biodegradable, waste-based alternative building material. Building upon the previous research on dry-stacking interlocking modular blocks made of three kinds of organic waste (cotton, coffee chaff, and sawdust+mycelium), this study focuses on designing Mycelium-Based Composite (MBC) B-Blocks. By developing this reusable and adaptable MBC block design, this study addresses the current trend of using MBC solely as a temporary building material. The primary objectives are to refine the B-Blocks module design, improve the proportion to increase configuration possibilities for wall components, and explore different approaches for wall installations using these blocks. The research was conducted with students from the Innovative Digital Technology elective class in the Architecture Department at Universitas Pelita Harapan (UPH). The methodology involved exploring digital tectonics through parametric associative modeling, creating a mock-up model using parametric associative modeling and digital fabrication machinery, and producing 1:1 prototypes of the modules in collaboration with MYCL-Mycotech Lab.

The absence of suitable intervention significantly increases the likelihood of type 2 diabetes mellitus (T2DM) development in people with prediabetes. Recent statistical findings indicate that the gut microbiome might influences the development of insulin resistance. The objective of our study was to assess the efficacy and safety of probiotic supplementation in individuals diagnosed with prediabetes. A thorough search was carried out on the Cochrane Library, Medline, Scopus, and ClinicalTrials.gov databases until September 12th, 2024, using a mix of pertinent keywords. This review incorporates randomized clinical trials (RCTs) concerning the effect of probiotics for prediabetes. We used random-effect models to examine the mean difference (MD). A total of eight RCTs were incorporated. The results of our meta-analysis indicated that probiotics supplementation was associated with higher reduction in hemoglobin A1c (HbA1c) (MD -0.07% (95% CI -0.11, -0.03), p = 0.0005, I² = 0%) among individuals with prediabetes when compared to placebo. Other indicators such as total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and body mass index (BMI) did not differ significantly between probiotics and placebo. No significant difference was observed in the occurrence of adverse events (AEs) between the two groups. This study indicates the efficacy and safety of probiotics supplementation to improve the glycemic parameters in patients with prediabetes.

Background and Aims Despite its superior blood–gas partition coefficient compared to sevoflurane, use of desflurane in neurosurgery is limited due to concerns about cerebral vasodilation and potential adverse haemodynamic effects. This study aims to systematically evaluate the comparative efficacy and safety of desflurane and sevoflurane in neurosurgical procedures. Methods A search was performed in the Cochrane Library, Scopus, Europe PMC and Medline databases for articles published until 5 November 2024 using a combination of pertinent keywords. This review includes randomised controlled trials (RCTs) that analyse the comparison between desflurane and sevoflurane in neurosurgery. The risk of bias from each RCT was assessed using the Risk of Bias version 2 tool from Cochrane Collaboration. We utilised random-effects models to evaluate the mean difference (MD) and odds ratio (OR) for the outcomes presented. Results Fourteen trials, encompassing 904 patients, were included in the analysis. Our analysis revealed significantly faster recovery profiles with desflurane, including reduced emergence time [MD -2.26; 95% confidence interval (CI): -2.99, -1.52, P < 0.00001, I ² = 71%], extubation time (MD -3.02; 95% CI: -3.89, -2.15, P < 0.00001, I ² = 79%) and overall recovery time (MD -3.26; 95% CI: -5.01, -1.51, P = 0.0003, I ² = 83%), compared to sevoflurane. Desflurane was associated with better postoperative cognitive function, as evidenced by higher short orientation memory concentration test scores – a measure of attention and memory – at 15 min (MD: 2.26; 95% CI: 0.13, 4.39, P = 0.04, I ² = 91%) and 60 min (MD: 0.29; 95% CI: 0.09, 0.50, P = 0.005, I ² = 0%) after extubation. We did not find any significant difference in the intra- and/or postoperative events, such as emergence agitation, nausea and vomiting, shivering, hypertension, hypotension, tachycardia, bradycardia, pain and convulsions, between the two groups of intervention. Conclusion This study suggests that desflurane anaesthesia offers faster recovery with a similar safety profile to sevoflurane for neurosurgery.

Purpose: Parental satisfaction is essential for evaluating pediatric care quality and influences healthcare practices and performance. Pediatric patients frequently experience anxiety, affecting their and their parents' satisfaction. Nurses play a key role in reducing anxiety and improving care interactions. Meeting parents' expectations shapes long-term outcomes and impacts the hospital's reputation. While instruments such as the Child ZAP (Zufriedenheit in der Arztpraxis) provide comprehensive measures of satisfaction, their use in Indonesia has not been explored. This study aimed to validate the Child ZAP and offer insights to improve pediatric care quality in Indonesia. Methods: A cross-sectional study was conducted with 139 mothers whose children were older than 5 years and received treatment at private hospitals. Structured questionnaires were analyzed using partial least squared-structural equation modeling in SmartPLS 4, and a disjoint two-stage method was used to test dimensionality. Results: All hypotheses were significant (p<.05), demonstrating strong support. All Child ZAP dimensions, treated as lower-order constructs, effectively measured parents' satisfaction as a higher-order construct. Overall parental satisfaction significantly influenced behavioral intention and mediated its relationship with Child ZAP. The mother's and the child's age served as moderating factors. The research model exhibited strong predictive power, underscoring pediatric nurses' pivotal role in improving communication among parents, physicians, and children to ensure quality care. Conclusion: The Child ZAP instrument effectively evaluates parental satisfaction by examining how children interact and communicate with medical staff. It assesses doctors' engagement with children and their communication skills, highlighting nurses' essential role in providing family-centered pediatric care.