Search

Background: Metastatic gastroenteropancreatic neuroendocrine neoplasms (GEPNEN) can cause ectopic Cushing’s syndrome (ECS). ECS is highly morbid and medical therapy is complex and can be ineffective. Patients unsuitable for bilateral adrenalectomy (BA) have dismal outcomes. Peptide receptor radionuclide therapy (PRRT) is a rational option for hormone and disease control in ECS caused by NEN with high somatostatin receptor (SSTR) expression. Aim: To describe the characteristics and outcomes of patients with ECS treated with PRRT. Methods: Single-centre, retrospective analysis of imaging, biochemistry and outcomes of seven consecutive patients with ECS caused by metastatic GEPNEN treated with PRRT from 2006 to 2023. Results: Patients were aged 17–75 (female n = 6). The primary site was the pancreas (5/7) and rectum (2/7). Six patients were on medical therapy for ECS at baseline (one had a previous BA). A median of 34.4 GBq of [177Lu]Lu-DOTA-octreotate was given. [90Y]Y-DOTA-octreotate (one patient) and [111In]In-octreotide (one patient) were also used. Five patients had radiosensitising chemotherapy. Five patients had a flare of ECS within 1 week of PRRT cycle 1 (PRRT-C1). Following PRRT-C1, 5/7 patients had complete biochemical resolution of ECS at 1.5–6 months (four ongoing; one recurred after 12 months and had elective BA at 18 months). Best metabolic response on [18F]F-FDG PET/CT: Four patients had a complete metabolic response (CMR), and one had a partial metabolic response. PFS was 3–208 months. Two patients progressed at the first follow-up. The longest ECS remission and CMR continues at >17 years. Conclusion: PRRT can be effective for ECS caused by metastatic SSTR-positive GEPNEN and should be considered in its treatment algorithm.

Biogas, an alternative energy source derived from organic materials, particularly POME, is produced through anaerobic digestion. The utilization of an UASB-HCPB fermenter has successfully yielded biogas with elevated methane content. However, the produced biogas still contained a moderate amount of CO2, necessitating further purification to make the biogas suitable for engine fuel applications. The presence of CO2 must be mitigated through an absorption method. The amount of CO₂ removed from biogas required an absorption system designed to utilize environmentally friendly solvents that can operate effectively at low pressures. The absorption design is important in designing absorber columns, particularly packed column types. It requires careful consideration of flow rates and absorbent concentrations to ensure optimal performance and suitability for industrial applications. This study aims to elaborate the design, fabrication, and performance of a packed absorption column for CO2 removal utilizing K2CO3 as a solvent with MSG as a promoter. K2CO3 promoted with MSG represents an eco-friendly solvent with potential for biogas purification applications. The novelty of this study highlights a gap in integrating biogas production and purification design, wherein biogas generated from anaerobic digestion of POME undergoes purification via an absorption system. Experimental parameters included absorbent flow rates of 1, 1.5, and 2 L/min; a biogas flow rate of 20 L/min; promoter concentrations of 1, 3, and 5 %; temperatures of 35, 45, and 55 °C; and a contact time of 5 min. Results indicated that optimal CO2 removal (47.38±1.58 %) was achieved with an absorbent flow rate of 2 L/min and MSG concentration of 5 %. Based on the calibration results, the distilled water, air, and CO2 flowmeters have regression values (R²) of 0.9947, 1.0000, and 0.9253, respectively. The highest CO2 removal was 94.44 % on CO2 flow rate of 5 L/min, air flow rate of 20 L/min and absorbent flowrate of 1.8 L/min. Maximum CO2 loading (0.0081 mol CO2/mol K2CO3) was obtained at an absorbent flow rate of 1 L/min and MSG concentration of 5 %. Temperature effects revealed optimal CO2 removal (63.32±0.42 %) at 55 °C, while peak CO2 loading (0.00987 mol CO2/mol K2CO3) occurred at 45 °C. At 55 °C, the final biogas composition achieved was 94.18 % CH4, 5.81 % CO2, and 0.01 % H2S. These results indicate an increase in the effectiveness of CO2 removal and high-purity biogas products. However, future research of synergistic study is needed on the regeneration capability of monosodium glutamate-activated K2CO3 for long-term CO2 absorption. Futhermore, development of the absorption column design is also needed by considering the operating pressure. It is expected that this initial study on integrated biogas production and purification can be further developed and applied to the palm oil industry to support the implementation of sustainable zero waste technology.

The retail industry has complex and demanding work dynamics. In this context, a deep understanding of the factors that influence employee performance is highly relevant to managing retail companies. This study examines the interrelationships among work intensification, high-performance work systems (HPWS), emotional exhaustion, employee creativity, and employee performance within the retail industry. This study used a survey approach with a quantitative methodology; data were gathered through questionnaire distribution to 235 retail employees across Jakarta, Indonesia, utilizing non-probability convenience sampling. Analysis was conducted using partial least squares-structural equation modeling (PLS-SEM) via the SmartPLS version 3.3.3 tool. Results revealed that work intensification significantly and positively influences HPWS and emotional exhaustion (p < 0.05). While HPWS exhibited no significant impact on employee creativity, emotional exhaustion had a significant and negative effect (p > 0.05). Furthermore, employee creativity demonstrated a significant positive effect on employee performance (p < 0.05). It was a significant mediator between emotional exhaustion and employee performance, though not between HPWS and employee performance (p < 0.05). The study underscores the intricate dynamics within the retail work environment, highlighting the intertwined roles of HPWS, emotional exhaustion, and employee creativity. Practical implications emphasize the necessity for effective management strategies to navigate work intensification and emotional exhaustion, ultimately enhancing employee performance. Notably, this paper offers a comprehensive analysis of factors shaping employee performance in the retail sector, emphasizing the pivotal significance of HPWS, emotional exhaustion, and employee creativity as interconnected components.

Pectin-based films incorporating carbonate hydroxyapatite (CHA) as a cinnamaldehyde carrier present a novel approach to oral drug delivery, addressing the limitations of pectin's hydrophilicity while leveraging CHA's porosity and adsorption capabilities to enhance controlled release properties. This study investigated CHA incorporation at various concentrations (0 %, 1 %, 3 %, 5 %, 7 % w/w). CHA addition increased film thickness (0.054–0.079 mm) and tensile strength (0.0081–0.0153 MPa), while reducing elongation (11.833 %–7.20 %) and swelling (231 %–192 %). FTIR and SEM analyses confirmed successful drug incorporation and structural modifications. Drug release kinetics demonstrated slower release profiles and lower diffusivity coefficients (De: 1.107 × 10−6 to 5.15 × 10−7 cm2/s) in pectin-CHA films, thus underscoring CHA's potential for enhancing controlled drug delivery. Cost analysis estimates promising financial viability, with a total production cost of 12,967 IDR/L yielding a profit of 17,525 IDR/L and a net profit of 4558 IDR/L, indicating strong potential for scale-up. This innovative approach not only addresses the challenges of sustainable and efficient oral drug delivery systems but also offers potential in structurally superior delivery system with targeted and sustained drug release capabilities.

Some researcher missed the role of hooks in their bamboo reinforcement. Consequently, the bamboo reinforcement and concrete used to have slip and failure to composited, this make the concrete and bamboo working independently to sustain the given loading and the bond failure become the main issue than the beam failure. This research studied about the role of the pivot hooks that capable to enhance the loading capacity higher than the beams without the pivot hooks. Experimental test performed in order to identify the effect of the pivot hooks presence which added to the flexural reinforcement which made by bamboo materials to avoid the bond slip failure that mostly occur in the bamboo reinforced concrete beams. The experimental test which verified by the numerical analysis by FEA NX commercial software proof that the pivot hooks are able to increase the loading capacity of a concrete beam 33% - 40% higher than the bamboo reinforcement without the pivot hooks. Architectural façade and budget efficiency caused the bamboo become unavoidable material in construction, by adding the structure modification such as the pivot hooks for the bamboo reinforcement, the failure can be reduced, then the entanglement of bamboo in construction become more functional.

Abstract The clinical application of Pharmacogenomics (PGx) has improved patient safety. However, comprehensive PGx testing has not been widely adopted in clinical practice, and significant opportunities exist to further optimize PGx in cancer care. This systematic review and meta‐analysis aim to evaluate the safety outcomes of reported PGx‐guided strategies (Analysis 1) and identify well‐studied emerging pharmacogenomic variants that predict severe toxicity and symptom burden (Analysis 2) in patients with cancer. We searched MEDLINE, EMBASE, CENTRAL, clinicaltrials.gov, and International Clinical Trials Registry Platform from inception to January 2023 for clinical trials or comparative studies evaluating PGx strategies or unconfirmed pharmacogenomic variants. The primary outcomes were severe adverse events (SAE; ≥ grade 3) or symptom burden with pain and vomiting as defined by trial protocols and assessed by trial investigators. We calculated pooled overall relative risk (RR) and 95% confidence interval (95%CI) using random effects models. PROSPERO, registration number CRD42023421277. Of 6811 records screened, six studies were included for Analysis 1, 55 studies for Analysis 2. Meta‐analysis 1 (five trials, 1892 participants) showed a lower absolute incidence of SAEs with PGx‐guided strategies compared to usual therapy, 16.1% versus 34.0% (RR = 0.72, 95%CI 0.57–0.91, p = 0.006, I2 = 34%). Meta‐analyses 2 identified nine medicine(class)‐variant pairs of interest across the TYMS, ABCB1, UGT1A1, HLA‐DRB1, and OPRM1 genes. Application of PGx significantly reduced rates of SAEs in patients with cancer. Emergent medicine‐variant pairs herald further research into the expansion and optimization of PGx to improve systemic anti‐cancer and supportive care medicine safety and efficacy.

Background: The decreasing prevalence of COVID-19 has highlighted the value of vaccinations. CoronaVac® vaccine was one of the most widely used vaccines in Indonesia, in other Southeast Asian countries, as well as in Latin America. However, to date the safety and side effect profiles of CoronaVac® vaccine among the Indonesian population have not been reported. Objective: In this study, the CoronaVac® safety profiles were determined in a community of a public health center in North Jakarta, Indonesia. Method: This is a descriptive cross-sectional questionnaire-based study on vaccine side effects as recorded in the yellow form (MESO). Patients (n = 300) who received CoronaVac® vaccinations between July and August 2021 were enrolled. SPSS was used to analyze the descriptive data. Results: Most respondents were women (72.7 %) between the ages of 17 and 21 years. A significantly (p = 0.009) positive correlation was established between the vaccine side effects (namely pain at the injection site) with the female gender. Other side effects such as fatigue (p = 0.034) and headache (p

Abstract This study explored the acceptability of a novel pharmacist‐led pharmacogenetics (PGx) screening program among patients with cancer and healthcare professionals (HCPs) taking part in a multicenter clinical trial of PGx testing (PACIFIC‐PGx ANZCTR:12621000251820). Medical oncologists, oncology pharmacists, and patients with cancer from across four sites (metropolitan/regional), took part in an observational, cross‐sectional survey. Participants were recruited from the multicenter trial. Two study‐specific surveys were developed to inform implementation strategies for scaled and sustainable translation into routine clinical care: one consisting of 21 questions targeting HCPs and one consisting of 17 questions targeting patients. Responses were collected from 24 HCPs and 288 patients. The 5‐to‐7‐day PGx results turnaround time was acceptable to HCP (100%) and patients (69%). Most HCPs (92%) indicated that it was appropriate for the PGx clinical pharmacist to provide results to patients. Patients reported equal preference for receiving PGx results from a doctor/pharmacist. Patients and HCPs highly rated the pharmacist‐led PGx service. HCPs were overall accepting of the program, with the majority (96%) willing to offer PGx testing to their patients beyond the trial. HCPs identified that lack of financial reimbursements (62%) and lack of infrastructure (38%) were the main reasons likely to prevent/slow the implementation of PGx screening program into routine clinical care. Survey data have shown overall acceptability from patients and HCPs participating in the PGx Program. Barriers to implementation of PGx testing in routine care have been identified, providing opportunity to develop targeted implementation strategies for scaled translation into routine practice.

Research Purposes. The aim of this study is to delve into several factors that can fortify the firm value of retail companies during a crisis period, such as operational efficiency, financing ability, and investment returns. Research Methods. The research employs a panel regression analysis technique on retail companies listed on the Indonesia Stock Exchange (IDX) from 2016 to 2021. Research Results and Findings. The study's findings reveal that operational efficiency and financing ability can affect firm value during a crisis, whereas investment returns do not. The results of this study can assist retail companies in formulating business strategies and provide insights for investors during the decision-making process for investments in the retail sector amid a crisis.

Paracetamol, a commonly used analgesic and antipyretic medication, is well-known for its ability to relieve pain and reduce temperature. However, there is a constant push to improve its therapeutic efficacy, especially towards increasing its oral bioavailability. The increase in bioavailability will lead to a better reception of the drugs by the body. This research aims to provide valuable insights into the molecular mechanisms underlying paracetamol’s mode of action and propose novel strategies for enhancing its therapeutic effectiveness. We investigated the notion of functional group alteration by molecular docking as a strategy to increase the efficacy of paracetamol in this work. Using modern computational approaches, it could be conducted through the examination of the structural characteristics and active regions of paracetamol and its target receptors. Additionally, molecular docking simulations were used to examine the binding interactions between paracetamol and its target receptors, offering insights into the essential functional groups required for ligand-receptor recognition. Tests of several molecular docking techniques and scoring functions allowed the researchers to find potential alterations that might improve its pharmacological characteristics. By integrating structural analysis, molecular docking studies, and computational screening, the uncovering of promising modifications that can significantly improve paracetamol’s efficacy was expected. Ultimately, this work may lead to the development of next-generation analgesics with superior pharmacological profiles, providing enhanced pain relief and fever reduction for patients.

Abstract Background Oesophageal and gastrooesophageal junction (GOJ) carcinoma frequently present with dysphagia and de novo metastatic disease. There is scope to improve treatment paradigms to both address symptoms and improve survival. One method is integrating immune checkpoint inhibition with novel treatment combinations. Methods PALEO is a single arm, phase II clinical trial in patients with previously untreated, oligometastatic or locoregionally advanced oesophageal or GOJ carcinoma and dysphagia. PALEO is sponsored by the Australasian Gastro-Intestinal Trials Group (AGITG). Participants receive 2 weeks of therapy with concurrent hypofractionated radiotherapy of 30Gy in 10 fractions to the primary tumour, weekly carboplatin AUC2, weekly paclitaxel 50 mg/m2 and durvalumab 1500 mg q4 weekly, followed by durvalumab monotherapy continuing at 1500 mg q4weekly until disease progression, unacceptable toxicity or 24 months of therapy. A single metastasis is treated with stereotactic radiotherapy of 24Gy in 3 fractions in week 7. The trial primary endpoint is the progression free survival rate at 6 months. Secondary endpoints include duration of dysphagia relief, nutritional status change, quality of life, response rate, toxicity, progression free survival and overall survival. The tertiary endpoint is prediction of outcome based on biomarkers identified from patient serial blood samples collected pre- and post-radiotherapy. Discussion This unique investigator-initiated clinical trial is designed to simultaneously address the clinically relevant problems of dysphagia and distant disease control. The overarching aims are to improve patient nutrition, quality of life and survival with low toxicity therapy. AGITG PALEO is a multidisciplinary collaboration and will add to the understanding of the relationship between radiotherapy and the anti-tumour immune response. Trial registration Australian and New Zealand Clinical Trials Registry: ACTRN12619001371189 , registered 8 October 2019.