Muflihatul Muniroh

Adiponectin is an adipokine involved in glucose and lipid metabolism and plays an important role in enhancing insulin sensitivity and suppressing inflammation. Higher circulating adiponectin levels are generally associated with improved metabolic regulation in individuals with type 2 diabetes mellitus (T2DM). The objective of this study is to evaluate the effect of Intermittent fasting (IF), Exercise (Ex), and combination (CO) on insulin resistance marker; to assess the effect of IF, Ex, and the combination on adiponectin level; To determine the most effective intervention. In conclusion, all interventions significantly improved insulin sensitivity and glucose homeostasis in diabetic rats, as indicated by improvements in glucose, insulin, and HOMA-IR levels. In addition, all interventions significantly increased adiponectin levels under diabetic conditions. Among the intervention groups, the combination of exercise and intermittent fasting demonstrated the greatest effectiveness

Mercury presents a significant environmental health hazard due to its ability to bioaccumulate in the food chain, posing risks through the consumption of contaminated fish. This systematic review aims to analyze and compare mercury levels in human populations, specifically focusing on the health risks associated with fish consumption in urban versus rural areas. The review followed PRISMA guidelines and included articles published between January 1, 2020 and March 15, 2025 from PubMed, Scopus, and ScienceDirect. A total of 768 articles were identified, and seven studies met the inclusion criteria. Data extraction was performed, and study quality was assessed using the JBI checklist and risk of bias assessment with ROBINS-E. Data were extracted and synthesized using RevMan 5.4 for the meta-analysis. The meta-analysis showed substantially higher mercury levels in rural populations (SMD 2.76; 95% CI: 2.63–2.89), largely influenced by dietary patterns, predominant fish species, and environmental contamination levels. Health effects associated with elevated mercury exposure included neurodevelopmental risks, elevated mercury levels in pregnant women, and increased vulnerability among populations with high reliance on freshwater fish. These findings highlight the need for targeted public health strategies to mitigate mercury exposure while maintaining the nutritional benefits of fish consumption.

The phosphatidylinositol 3-kinase (PI3K)–Protein kinase B (AKT)–mechanistic target of rapamycin (mTOR) signaling axis represents one of the most important oncogenic pathways in breast cancer and a major driver of therapeutic resistance, particularly in hormone receptor–positive, and triple-negative subtypes. Although PI3K and mTOR inhibitors such as alpelisib and everolimus have improved clinical outcomes in selected patients, their broader application is limited by toxicity and adaptive resistance mechanisms. Increasing attention has therefore been directed toward medicinal plant-derived phytochemicals as multi-target modulators of this pathway. This review summarizes current mechanistic evidence showing how selected phytochemicals—including flavonoids, polyphenols, and isothiocyanates—interfere with PI3K–AKT–mTOR signaling at multiple nodes, suppress compensatory survival pathways, and enhance the efficacy of endocrine therapy, chemotherapy, and targeted agents. Rather than acting as standalone therapies, these compounds are increasingly viewed as adjunctive modulators or lead scaffolds for anticancer drug development. This mini review uniquely integrates emerging evidence on phytochemical modulation of the PI3K–AKT–mTOR axis with mechanisms of therapeutic resistance and rational combination strategies with targeted therapies. It also highlights recent advances in nanoformulation technologies that may improve phytochemical bioavailability and facilitate clinical translation in precision breast cancer therapy.

Atherosclerosis is predominantly an inflammatory process that is the key pathophysiological cause of ischemic coronary heart disease (CHD). Some studies suggest that sorghum can reduce atherosclerotic parameters through many biological activities, such as antioxidant, anti-inflammation, and anti-thrombotic properties. The primary objective was to evaluate the effect of an enteral sorghum tempeh formula on the levels of Plasminogen Activator Inhibitor-1 (PAI-1) and Interleukin-6 (IL-6) in an atherosclerotic rat model. A total of 24 male rats were utilized, with the experiment structured into an 8-week atherogenic diet induction period, followed by a 4-week intervention phase. The rats were divided into four groups: a healthy control, an atherogenic control, and two treatment groups supplemented with the formula at 0.75g/200 g and 1.50g/200 g body weight (BW), respectively. IL-6 and PAI-1 levels were quantified using Enzyme-Linked Immunosorbent Assay (ELISA). The atherogenic diet successfully induced a significant elevation in both IL-6 and PAI-1 levels compared to the healthy control group (p=0.000), indicating a heightened inflammatory and thrombotic state in the atherosclerotic group. Conversely, the groups receiving the sorghum tempeh-based formula exhibited a significant reduction in both IL-6 and PAI-1 levels compared to the atherogenic control group (p=0.000), suggesting potent anti-inflammatory and antithrombotic properties of the sorghum tempeh.

Distance learning during the coronavirus disease (COVID-19) pandemic reduced social interactions and physical activities in elementary school students, which may have affected their mental health, self-esteem, and cognitive function. ACT workshops of the Creative Health Program (ACHP), a participatory mini-theatre that encourages agency in children, empower children to collaborate with others and express their thoughts about their community using their bodies. This study aims to analyze the effects of the ACHP on reaction time, working memory, self-esteem, and total mood disorder (TMD) among children in Indonesia. It was a quasi-experimental pre- and post-test control group design. Participants were 189 5th-grade elementary school students, which randomly allocated to control ( N = 111) and ACHP intervention ( N = 78) groups. The ACHP was a class lasting approximately 90 min in which children worked in groups to exchange opinions about their community, select a topic, develop a short-acting scene, and perform it in front of peers and adults. Reaction time, working memory, self-esteem, and TMD were examined in both groups pre- and post-intervention. The ACHP group showed significant improvements in all indicators, including reduced reaction time ( p < 0.001), improved working memory ( p < 0.01), self-esteem ( p < 0.001), and lowered TMD score ( p < 0.001). Compared with the control group, the ACHP group showed significant improvements in all indicators except reaction time. In conclusion, ACHP improved working memory, self-esteem, and TMD scores in elementary school children. A more comprehensive and continuous implementation of such creative group activities is recommended to compensate for lost active learning opportunities during the pandemic.

Genetic polymorphisms can modulate susceptibility to mercury (Hg) toxicity by altering metabolic and detoxification pathways. This review evaluated the association between genetic variants, Hg exposure, and obstetric outcomes. A systematic search of Scopus, PubMed and ScienceDirect through May 2025 identified 12 eligible studies (n = 4995), conducted in accordance with PRISMA guidelines, with methodological quality assessed using the Newcastle–Ottawa Scale. Meta-analysis was selectively performed only for genetically and methodologically comparable studies. The most frequently examined genes were GSTP1, GCLC, GCLM, GPX1, MT1A, ALAD, and APOE. Meta-analysis of GSTP1 rs1695, showed no statistically significant association between the Val105 allele and hair mercury concentrations (MD = −0.08 µg/g; 95% CI: −0.18 to 0.02; p = 0.13), although the direction of effect suggested a potential protective trend. Polymorphisms in other glutathione-related genes (GCLC, GCLM, and GPX1) were consistently associated with increased risks of small-for-gestational-age infants, preeclampsia, and impaired neurodevelopmental outcomes in offspring. In contrast, the APOE ε4 allele appeared to be associated with reduced fetal mercury burden, whereas polymorphisms in ALAD and MT1A were linked to higher mercury levels and adverse pregnancy-related outcomes. By integrating epidemiological evidence with mechanistic insights within a gene–environment interaction framework, this review helps to address important gaps in the existing literature. These findings underscore the importance of incorporating genetic susceptibility into Hg risk assessment and precision-based prenatal interventions.

Background: The consumption of tobacco is regarded as a contributing factor to several diseases. However, the impact of tobacco dust exposure (TDE) on tobacco workers has not been extensively investigated. Objective: This protocol introduces the design and implementation of the Tobacco Dust Cohort for Health Assessment and Risk Monitoring (T-CHARM) study, a prospective cohort study aimed at evaluating the health impacts of TDE. Methods: This prospective cohort study will recruit women working in tobacco processing who are nonsmokers and women who do not work for the tobacco industry and are nonsmokers living in a nearby area (unexposed group), with a total of 400 expected participants. The impact of TDE on health, including metabolic syndrome parameters; complete blood count; and cardiovascular, liver, renal, and lung function, will be evaluated in relation to urine cotinine levels. Air quality and chemical substances in the air and leaves will also be analyzed. The data will be subsequently analyzed using appropriate statistical tools. Results: A total of 120 respondents have participated as of August 2025. Another 80 respondents will be recruited, laboratory analysis is ongoing, and baseline results are expected by the end of 2025. Conclusions: The strength of the T-CHARM study’s approach is its detailed occupational and environmental factors and longitudinal health data from the corporate clinic or the district health center, as well as links to cancer and mortality registries and self-reported health. The current phase of the study focuses on baseline data collection for long-term follow-up. The cohort will be monitored for up to 20 years, depending on sustained funding. T-CHARM offers a robust framework for understanding the chronic health effects of occupational TDE. International Registered Report Identifier (IRRID): DERR1-10.2196/84231

The precise prevalence of pathogenic gene variants in high or moderate penetrance genes associated with hereditary cancer in Indonesia remains undetermined. Furthermore, the criteria for prioritizing individuals for genetic testing are not well-defined. This study examined gene variants in Indonesian familial cancer among both affected and unaffected individuals. A total of 159 participants from 55 families with a history of cancer, including affected (N = 61) and unaffected (N = 98) individuals, underwent genetic testing using germline DNA with the 113 multigene panel. Various cancer types were identified, including breast (N = 46), ovarian (N = 3), retinoblastoma (N = 3), colon (N = 2), uterine (N = 2), and other cancers (N = 1 each) such as lung, prostate, thyroid, bladder, and testicular seminoma. Pathogenic variants were identified in 10 (18.8%) of the 55 families, with 6 (60%) confirmed as hereditary cancer families. These variants were detected in 14 affected individuals, involving 8 distinct genes (BRCA1, BRCA2, MUTYH, PALB2, RAD51D, VHL, ERCC4, and RB1), and the prevalence was significantly higher in cases of early-onset (< 40 years) compared to late-onset cancer (53.8% vs. 14.6%, p < 0.01). These findings confirm that several pathogenic gene variants in familial cancer in Indonesia are inherited. This data is crucial for both affected and unaffected family members to facilitate appropriate management strategies.