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Endometriosis is a chronic gynecological condition defined by the ectopic presence of endometrial-like tissue outside the uterine cavity, often resulting in debilitating symptoms and significant impacts on quality of life. While the exact etiology of endometriosis remains elusive, emerging evidence suggests that diet and nutrition may play a crucial role in its pathogenesis and management. This comprehensive review explores the complex interplay between various food substances and endometriosis, summarizing the latest research findings on both risk-enhancing and protective nutritional factors. Notably, consumption of alcohol, red and processed meats, foods high in saturated and trans fats, and excessive caffeine has been correlated with increased systemic inflammation and hormonal dysregulation-key mechanisms implicated in endometriosis pathogenesis. In contrast, nutrients such as antioxidants, B-complex vitamins, vitamin D, calcium, polyunsaturated fatty acids (PUFAs, particularly omega-3 and omega-6), and dietary fiber have shown promise in exerting anti-inflammatory and protective effects against endometriosis. The review emphasizes the importance of promoting a balanced and nutritious diet rich in anti-inflammatory and antioxidant-rich food while limiting the intake of pro-inflammatory substances for individuals with endometriosis. In addition to dietary interventions, lifestyle modifications, including regular physical activity, stress management, and optimizing sleep hygiene, are highlighted as integral components of comprehensive treatment plans for endometriosis patients. Further research is required to clarify the precise mechanisms underlying the relationship between diet and endometriosis and to establish evidence-based dietary recommendations personalized for patients with endometriosis.

IntroductionThalassaemia is an inherited blood disorder, for which definitive treatments remain largely inaccessible. The recommended approach to reduce the disease burden is by prevention through screening. Currently, the implementation of thalassaemia preventive measures is poorly regulated in Indonesia. Thalassaemia prevention and education are best targeted to the youth, but information on their awareness towards thalassaemia is limited. This study aims to investigate the knowledge, attitude and practice (KAP) towards thalassaemia among Indonesian youth.MethodsThis observational study took place between January and May 2021. An online questionnaire was disseminated to Indonesian youth aged 15–24. Eligible respondents included carriers, unaffected individuals and individuals with unknown carrier status. The questionnaire comprised 28 questions to assess KAP. A cut-off of 75% was used to categorise participant’s KAP into poor or negative and good or positive. Descriptive statistics, χ2 test, logistic regression and Pearson correlation were performed for data analysis.ResultsA total of 906 responses were gathered, and 878 were analysed. Most respondents had poor knowledge (62.1%), positive attitude (83.3%) and poor practice (54.4%) towards thalassaemia. The results implied that respondents had limited understanding regarding the types of thalassaemia and the difference between asymptomatic carriers and individuals without the thalassaemia trait. Many (82.6%) believed they were not carrying thalassaemia trait despite the fact that most (95.7%) never got tested. Age, education, gender, residence and family income were key factors that correlated with or predicted the youth’s KAP towards thalassaemia. Older respondents and women were more likely to have good KAP.ConclusionThalassaemia screening targeted to the youth is urgently needed, and future interventions must consider sociodemographic factors that may affect how they perceive the disease. Social media appeals to the youth as an important source of information, but school, parents and health professionals should also be involved in delivering education about thalassaemia.

Background: The coronavirus disease 2019 (COVID-19) pandemic has been found to negatively affect medical students’ wellbeing. This finding may be related to how medical education is being conducted at present, with online learning replacing face-to-face teaching in many countries. This cross-sectional study aims to assess how the online learning environment is connected to medical students’ wellbeing. Methods: A self-administered online questionnaire was distributed to undergraduate medical students at Universitas Indonesia. The study was conducted from September 2020 to February 2021. The questionnaire included a modified version of the Online Learning Environment Scale (OLES) and the Positive Emotion, Engagement, Relationships, Meaning and Accomplishment (PERMA) profiler. The OLES was used to evaluate students’ perceptions of the online learning environment, whereas the PERMA Profiler was used to evaluate students’ wellbeing. We validated the questionnaire before distribution. The content validity index was 1.0, with internal consistency coefficients of 0.87 and 0.89, respectively. Regression analyses were performed to evaluate the relationship between OLES and PERMA scores. Results: The questionnaire was completed by 274 undergraduate medical students. Students reported moderate to high degrees of positive perception towards online learning, high levels of positive emotions and moderate levels of negative emotions. Statistically significant differences were found across groups based on students’ gender, year of study and academic programme. Almost all aspects of the online learning environment were significantly predictive of students’ wellbeing, with personal relevance and evaluation and assessment being the two most important predictors (R2 = 0.201; P < 0.001). Conclusion: Medical students generally enjoyed online learning, although some challenges were presented. The online learning environment was positively associated with students’ wellbeing; however, some students expressed negative emotions including loneliness, anxiety, anger and sadness.

COVID-19 cases have been increasing among young people as they are often considered to have low compliance with COVID-19 preventive measures. Given that challenge, there have been limited studies exploring this issue. Through a nationwide online survey, we assessed knowledge, attitudes, and practice toward COVID-19 among Indonesian youth and potential interventions to improve their behavior. We found that Indonesian youth had good knowledge of COVID-19, but their practices remained poor. Noncompliance was more frequent in males, students in Islamic high schools, those residing outside the Java-Bali islands, and students living in a lower income household. Significant barriers included lack of regulation, difficulties in avoiding crowds, and soap shortage. Their exposure to and trust in the internet was very high. These findings highlight that youth compliance with COVID-19 preventive measures should be improved by reducing barriers, collaborating actively with young people, and encouraging effective campaigns together with social media influencers.

Glioblastoma multiforme (GBM) is the most malignant primary brain tumour and there is no definite cure. It has been suggested that there are significant interactions among mesenchymal stem cells (MSCs), their released factors and tumour cells that ultimately determine GBM's growth pattern. This study aims to analyse the expression of molecules involved in GBM cell apoptotic pathways following treatment with the MSC secretome. A conditioned medium of umbilical cord-derived MSCs (UCMSC-CM) was generated by culturing the cells on serum-free αMEM for 24 h. Following this, human GBM T98G cells were treated with UCMSC-CM for 24 h. Quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) was then performed to measure the mRNA expression of survivin, caspase-9, TNF-related apoptosis-inducing ligand (TRAIL), DR4 and DcR1. mRNA expression of caspase-9 in CM-treated T98G cells increased 1.6-fold ( = 0.017), whereas mRNA expression of survivin increased 3.5-fold ( = 0.002). On the other hand, TRAIL protein expression was upregulated (1.2-fold), whereas mRNA expression was downregulated (0.4-fold), in CM-treated cells. Moreover, there was an increase in the mRNA expression of both DR4 (3.5-fold) and DcR1 (1,368.5-fold) in CM-treated cells. The UCMSC-CM was able to regulate the expression of molecules involved in GBM cell apoptotic pathways. However, the expression of anti-apoptotic molecules was more upregulated than that of pro-apoptotic molecules.

[...]TRAIL protein expression was upregulated (1.2-fold), whereas mRNA expression was downregulated (0.4-fold), in CM-treated cells. [...]there was an increase in the mRNA expression of both DR4 (3.5-fold) and DcRi (1,368.5-fold) in CM-treated cells. MSCs can be genetically engineered to deliver antitumorigenic molecules into specific tumour sites in vivo (5). Because tumour development is largely orchestrated by inflammation, MSCs exhibit upregulation of various chemokine receptors (CCR1, CXCR5 and CCR2) and adhesion molecules (ALCAM, P-selectin and integrins) to facilitate extensive tropism towards specific tumour sites (5). [...]the crosstalk between MSCs and cancer cells raises doubt regarding the clinical validity of MSCs as a potential treatment approach for GBM and other types of cancer (7). By investigating caspase-9, survivin, TRAIL, TRAIL agonistic receptor DR4 and TRAIL antagonistic receptor DcR1 expression in GBM cells after treatment with UCMSC-CM, the regulation of GBM cell apoptosis by UCMSC-CM can be elaborated. [...]this study aimed to measure the gene expression of caspase-9, survivin, TRAIL and its receptor to understand how UCMSC-CM affects apoptotic pathways in GBM cells.

Importance The monoclonal antibody combination of casirivimab and imdevimab reduced viral load, hospitalization, or death when administered as a 1200-mg or greater intravenous (IV) dose in a phase 3 COVID-19 outpatient study. Subcutaneous (SC) and/or lower IV doses should increase accessibility and/or drug supplies for patients. Objective To assess the virologic efficacy of casirivimab and imdevimab across different IV and SC doses compared with placebo. Design, Setting, and Participants This phase 2, randomized, double-blind, placebo-controlled, parallel-group, dose-ranging study included outpatients with SARS-CoV-2 infection at 47 sites across the United States. Participants could be symptomatic or asymptomatic; symptomatic patients with risk factors for severe COVID-19 were excluded. Data were collected from December 15, 2020, to March 4, 2021. Interventions Patients were randomized to a single IV dose (523 patients) of casirivimab and imdevimab at 300, 600, 1200, or 2400 mg or placebo; or a single SC dose (292 patients) of casirivimab and imdevimab at 600 or 1200 mg or placebo. Main Outcomes and Measures The primary end point was the time-weighted average daily change from baseline (TWACB) in viral load from day 1 (baseline) through day 7 in patients seronegative for SARS-CoV-2 at baseline. Results Among 815 randomized participants, 507 (282 randomized to IV treatment, 148 randomized to SC treatment, and 77 randomized to placebo) were seronegative at baseline and included in the primary efficacy analysis. Participants randomized to IV had a mean (SD) age of 34.6 (9.6) years (160 [44.6%] men; 14 [3.9%] Black; 121 [33.7%] Hispanic or Latino; 309 [86.1%] White); those randomized to SC had a mean age of 34.1 (10.0) years (102 [45.3%] men; 75 [34.7%] Hispanic or Latino; 6 [2.7%] Black; 190 [84.4%] White). All casirivimab and imdevimab treatments showed significant virologic reduction through day 7. Least-squares mean differences in TWACB viral load for casirivimab and imdevimab vs placebo ranged from –0.56 (95% CI; –0.89 to –0.24) log10copies/mL for the 1200-mg IV dose to –0.71 (95% CI, –1.05 to –0.38) log10copies/mL for the 2400-mg IV dose. There were no adverse safety signals or dose-related safety findings, grade 2 or greater infusion-related or hypersensitivity reactions, grade 3 or greater injection-site reactions, or fatalities. Two serious adverse events not related to COVID-19 or the study drug were reported. Conclusions and Relevance In this randomized clinical trial including outpatients with asymptomatic and low-risk symptomatic SARS-CoV-2, all IV and SC doses of casirivimab and imdevimab comparably reduced viral load. Trial Registration ClinicalTrials.gov Identifier:NCT04666441