Narra J最新文献

{"title":"KOMPAK: Translation, cross-cultural adaptation, and validation of an instrument for assessing interprofessional collaboration between pharmacists and physicians in Indonesia.","authors":"Irnawati H Amin, Muhammad N Massi, Elly Wahyudin, Muhammad A Bahar, Veni Hadju, Eva Niamuzisilawati, Makiyatul Munawwaroh, Ikrimah N Utami, Akhmad Ardiansyah, Sylmina D Alkaff, Bustanul Arifin","doi":"10.52225/narra.v5i1.1309","DOIUrl":"https://doi.org/10.52225/narra.v5i1.1309","url":null,"abstract":"<p><p>Interprofessional collaboration is crucial for addressing the complexity of health problems, requiring contributions from various professions to enhance healthcare quality, improve patient satisfaction, and achieve better clinical outcomes. The aim of this study was to develop and validate the physicians and pharmacists collaborative practice instrument, known as KOMPAK (<i>Kolaborasi Medis Persepsi Apoteker dan Dokter</i>/Medical Collaboration: Perceptions of Pharmacists and Physicians) for use in Indonesia. A cross-sectional study was conducted across the western, central, and eastern rigors of Indonesia, targeting physicians and pharmacists. The study included translation (forward and backward), cross-cultural adaptation (with 30 participants), and validation using confirmatory factor analysis (CFA) among 315 physicians and 315 pharmacists. The present study found no significant changes emerged during the translation and adaptation phases. In the validation phase, the CFA results for the physician instrument indicated a Comparative Fit Index (CFI) of 0.94 (>0.92), Tucker-Lewis Index (TLI) of 0.93 (>0.92), Root Mean Squared Error of Approximation (RMSEA) of 0.055 (<0.07), Standardized Root Mean Residual (SRMR) of 0.07 (<0.08), and Cronbach's Alpha reliability of 0.88. The pharmacist instrument yielded similar results with a CFI of 0.94 (>0.92), TLI of 0.93 (>0.92), RMSEA of 0.06 (<0.07), SRMR of 0.05 (<0.08), and Cronbach's Alpha reliability of 0.83. The final instrument consists of 24 items. In conclusion, the KOMPAK instrument demonstrated validity and reliability, supporting its use for measuring interprofessional collaboration between physicians and pharmacists in Indonesia.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1309"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research trends in microRNA profiling as a biomarker for lung adenocarcinoma via liquid biopsy: A bibliometric analysis.","authors":"Aprilia I Kartika, Muchamad Dafip, Nastiti Wijayanti, Didik S Heriyanto, Sofia M Haryana, Kartika W Taroeno-Hariadi","doi":"10.52225/narra.v5i1.1372","DOIUrl":"https://doi.org/10.52225/narra.v5i1.1372","url":null,"abstract":"<p><p>Research related to the development of diagnostic biomarkers in lung adenocarcinoma in various countries is important. Research on microRNA as a biomarker in lung adenocarcinoma varies depending on the population, specimen, and technology used for profiling and validation. The aim of this study was to map and analyze bibliometric data of publications related to the topic of microRNA as a candidate biomarker in lung adenocarcinoma and to determine any potential research gaps. A total of 8,506 articles were collected from Crossref, Google Scholar, Semantic Scholar, PubMed, and Scopus databases using Harzing's Publish or Perish platform. A systematic search was conducted using four keywords: \"profiling,\" \"validating,\" \"microRNA,\" and \"lung adenocarcinoma,\" and synonyms of these keywords based on the MeSH on NCBI. The data extraction process followed the chart from PRISMA-P. The article's elimination was conducted using Mendeley Desktop and then was analyzed based on the authors' keywords using VOSviewer and Biblioshiny. A bibliometric analysis of 692 relevant articles identified four primary research clusters: (1) microRNA (19 keywords), which highlights its potential as a biomarker for early detection and diagnosis; (2) lung adenocarcinoma (18 keywords), reflecting advancements in lung cancer research; (3) liquid biopsy (19 keywords), emphasizing the growing interest in non-invasive diagnostic methods; and (4) bioinformatics (nine keywords), underscoring the role of computational approaches in transcriptomic analysis. As a primary topic, microRNAs have become a focal point of research for diagnosing lung cancer across various stages and as biomarkers for cancer cell proliferation, invasion, migration, and metastasis. Numerous studies have demonstrated the successful application of microRNAs in lung cancer diagnosis in the last decade, although the reported types of microRNAs are inconsistent. Therefore, further research on this topic should be continuously conducted, particularly to validate the types of microRNAs and the types of environments that influence them.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1372"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network analysis of the relationship between self-management, self-efficacy, and quality of life among diabetes mellitus patients.","authors":"Minh H Le, Tran Np Dao, Ngoc D Le, Van D Tran","doi":"10.52225/narra.v5i1.2029","DOIUrl":"https://doi.org/10.52225/narra.v5i1.2029","url":null,"abstract":"<p><p>Diabetes mellitus (DM) requires constant self-management and self-efficiency, which affects the quality of life among patients. It is important to understand the complex interplay between these factors to improve the results of treatment. The aim of this study was to explore the relationship between self-management, self-efficacy, and quality of life among diabetes mellitus patients. A cross-sectional study of 363 diabetes patients from three public hospitals in Cao Lanh City, Vietnam, was conducted. Self-management, self-efficacy, and quality of life were assessed using the 35-item Diabetes Self-Management Instrument (DSMI), the 6-item Self-Efficacy for Managing Chronic Disease Scale (SECD6), and the 5-item European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L), respectively. Network analysis was performed to visually describe the relationship between self-management (which includes five domains of self-integration, self-regulation, interaction with health professionals and other significant people, self-monitoring, and medication adherence), self-efficacy, and quality of life. The network analysis showed that self-monitoring had the highest centrality. Two subscales of self-management, adherence and self-integration, were directly and positively correlated with quality of life, while the interaction was directly and negatively correlated with quality of life. Self-efficacy was positively correlated with self-regulation and self-monitoring, while it was negatively correlated with adherence. A direct positive correlation was also found between self-efficacy and quality of life. In conclusion, these findings highlight the pivotal role of self-management and self-efficacy in enhancing quality of life. Future studies should focus on patient education interventions to enhance adherence and self-efficacy, ultimately improving the quality of life in people with diabetes.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e2029"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projecting the impact of a national strategy to accelerate stunting prevention in East Nusa Tenggara, Indonesia, using the Lives Saved Tool.","authors":"Helen Andriani, Miftahul Arsyi, Alphyyanto E Sutrisno, Alexander Waits, Nurul D Rahmawati","doi":"10.52225/narra.v5i1.1462","DOIUrl":"https://doi.org/10.52225/narra.v5i1.1462","url":null,"abstract":"<p><p>Stunting remains a critical public health issue in East Nusa Tenggara (ENT), Indonesia, with prevalence rates among the highest in the country despite national efforts to reduce its occurrence. The aim of this study was to project the impact of the 2018-2024 National Strategy to Accelerate Stunting Prevention on children under five years old in ENT, using the Lives Saved Tool. A cross-sectional approach was employed, integrating data from various sources, including the 2020 Census of Indonesia, the Global Data Lab-Area Database, the Central Bureau of Statistics Republic Indonesia, the National Socioeconomic Survey, the 2017 Indonesia Demographic and Health Survey, the 2018 Basic Health Research, and the 2021 Indonesia Nutrition Status Survey. The analysis considered three scenarios: (1) a baseline scenario reflecting ENT's 2017 coverage, maintained through 2028; (2) a scenario assuming Indonesia achieves the Health Plan Action Stunting targets; and (3) a projection of stunting rates based on ENT-specific coverage. Under scenarios 1 and 2, the prevalence of stunting was projected to decrease from 40.04% in 2018 to 39.82% and 39.78%, respectively, by 2028, with scenario 3 reflecting a similar trend. The findings revealed a sharp increase in the number of stunting cases averted among children under five years old between 2017 and 2021, followed by a more gradual decline, culminating in the 2028 projections: 2,249 children (scenario 2), 2,130 children (scenario 3), and 1,966 children (scenario 1). Breastfeeding promotion emerged as the most impactful intervention, accounting for over half of the total stunting cases averted under both Indonesia-wide and ENT-specific coverage scenarios. This was followed by interventions such as multiple micronutrient supplementation and vitamin A supplementation. The study highlights that reducing the prevalence of stunting among children requires a comprehensive prioritization of intervention strategies. The implementation of breastfeeding promotion, combined with appropriate complementary feeding practices, is expected to contribute significantly to achieving the sustainable development goal targets.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1462"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative predictive value of APACHE-II, SAPS-II and GRACE scores for mortality in acute coronary syndrome (ACS) patients: Evidence from Indonesia intensive cardiovascular care unit registry.","authors":"Indra Prasetya, Dennis I Hakim, Setyasih Anjarwani, Hendry P Bagaswoto, Akhtar F Muzakkir, Faisal Habib, Tri Astiawati, Hendy Wirawan, Yose R Ilhami, Dewi U Djafar, Safir Sungkar, Siska S Danny, Dafsah A Juzar","doi":"10.52225/narra.v5i1.1911","DOIUrl":"10.52225/narra.v5i1.1911","url":null,"abstract":"<p><p>The Global Registry of Acute Coronary Events (GRACE) score is acknowledged for its ability to predict in-hospital mortality among patients with acute coronary syndrome (ACS). However, intensive care physicians often employ general prognostic scores such as Acute Physiologic and Chronic Health Evaluation II (APACHE-II) and Simplified Acute Physiology Score II (SAPS-II) to predict the mortality of ACS patients. However, their predictive values are not well-determined in predicting mortality in ACS treated in the cardiovascular care unit (CVCU). The aim of this study was to evaluate the performance of APACHE-II and SAPS-II scores in comparison with GRACE scores in predicting the CVCU mortality and in-hospital mortality of ACS patients admitted to CVCU. A multicenter retrospective cohort study was conducted using data from a registry of patients admitted to 10 hospitals in Indonesia between August 2021 and July 2023. This study evaluated the APACHE-II, SAPS-II, and GRACE scores for patients with ACS upon admission to CVCU. The area under the curve (AUC) of the receiver operating characteristic (ROC) was utilized to assess the discriminative ability for predicting mortality. Among the 12,950 admitted patients, 9,040 were diagnosed with ACS, and 6,490 patients were included in the final analysis. All three scoring systems had relatively good discriminative ability to predict CVCU mortality with APACHE-II having better results (AUC: 0.771; sensitivity: 63.9%; specificity: 78.7%) compared to GRACE (AUC: 0.726; sensitivity: 61.7%; specificity: 73.2%) and SAPS-II (AUC: 0.655; sensitivity: 38.9%; specificity: 85.2%). To predict in-hospital mortality, APACHE-II had better results (AUC: 815; sensitivity: 68.7%; specificity: 80.4%) compared to GRACE (AUC: 0.769; sensitivity: 64.6%; specificity: 77.5%) and SAPS-II (AUC: 0.683; sensitivity: 41.8%; specificity: 86.2%). APACHE-II had the best single risk factor for CVCU mortality (odds ratio (OR): 1.198; 95% confidence interval (CI): 1.181-1.214) and in-hospital mortality (OR: 1.259; 95%CI: 1.240-1.279). In conclusion, APACHE-II, SAPS-II, and GRACE scores moderately predict CVCU and in-hospital mortalities, with the APACHE-II score exhibiting the highest predictive capability in ACS patients admitted to CVCU.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1911"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese generative AI models (DeepSeek and Qwen) rival ChatGPT-4 in ophthalmology queries with excellent performance in Arabic and English.","authors":"Malik Sallam, Israa M Alasfoor, Shahad W Khalid, Rand I Al-Mulla, Amwaj Al-Farajat, Maad M Mijwil, Reem Zahrawi, Mohammed Sallam, Jan Egger, Ahmad S Al-Adwan","doi":"10.52225/narra.v5i1.2371","DOIUrl":"10.52225/narra.v5i1.2371","url":null,"abstract":"<p><p>The rapid evolution of generative artificial intelligence (genAI) has ushered in a new era of digital medical consultations, with patients turning to AI-driven tools for guidance. The emergence of Chinese-developed genAI models such as DeepSeek-R1 and Qwen-2.5 presented a challenge to the dominance of OpenAI's ChatGPT. The aim of this study was to benchmark the performance of Chinese genAI models against ChatGPT-40 and to assess disparities in performance across English and Arabic. Following the METRICS checklist for genAI evaluation, Qwen-2.5, DeepSeek-R1, and ChatGPT-40 were assessed for completeness, accuracy, and relevance using the CLEAR tool in common patient ophthalmology queries. In English, Qwen-2.5 demonstrated the highest overall performance (CLEAR score: 4.43 ± 0.28), outperforming both DeepSeek-R1 (4.3 ± 0.43) and ChatGPT-40 (4.14 ± 0.41), with <i>p</i> = 0.002. A similar hierarchy emerged in Arabic, with Qwen-2.5 again leading (4.40 ± 0.29), followed by DeepSeek-R1 (4.20 ± 0.49) and ChatGPT-40 (4.14 ± 0.41), with <i>p</i> = 0.007. Each tested genAI model exhibited near-identical performance across the two languages, with ChatGPT-40 demonstrating the most balanced linguistic capabilities (<i>p</i> = 0.957), while Qwen-2.5 and DeepSeek-R1 showed a marginal superiority for English. An in-depth examination of genAI performance across key CLEAR components revealed that Qwen-2.5 consistently excelled in content completeness, factual accuracy, and relevance in both English and Arabic, setting a new benchmark for genAI in medical inquiries. Despite minor linguistic disparities, all three models exhibited robust multilingual capabilities, challenging the long-held assumption that genAI is inherently biased toward English. These findings highlight the evolving nature of AI-driven medical assistance, with Chinese genAI models being able to rival or even surpass ChatGPT-40 in ophthalmology-related queries.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e2371"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance for a booster dose of COVID-19 vaccine in Indonesia: A follow-up study.","authors":"Harapan Harapan, Imelda Maelani, Samsul Anwar, Kamaluddin Latief, Sania A Mellinia, Cut M Nanda, Firzan Nainu, Aura Nirwana, Rahmad Aksa, Sarifuddin Sarifuddin, Yesi Astri, Raisha Fathima, Widhy Y Nalapraya, Ikram Ikram, Suci Mutiara, Aigia Syahraini, Mudatsir Mudatsir","doi":"10.52225/narra.v5i1.803","DOIUrl":"https://doi.org/10.52225/narra.v5i1.803","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) vaccination program in Indonesia has been implemented as a key strategy to mitigate the spread of the virus within communities. The success of this program depends on public acceptance of COVID-19 vaccines, including booster doses. The aim of this study was to assess the acceptance of the COVID-19 booster dose in Indonesia and to identify factors influencing individuals' acceptance. A cross-sectional study was conducted across 34 provinces in Indonesia in June 2023. Logistic regression analysis was used to identify the factors associated with booster dose uptake. The findings revealed that 88.8% (2,049/2,308) of respondents were willing to receive a booster dose if provided free of charge by the Indonesian government. However, acceptance decreased to 61.7% when respondents were informed of a 20% likelihood of side effects, even with a reported 95% vaccine efficacy. Adjusted logistic regression analysis identified ten significant factors associated with booster dose acceptance: sex, age, religion, history of previous COVID-19 infection, type of primary vaccine received, belief in vaccine-related conspiracy theories, trust in traditional medicine conspiracies, confidence in natural immunity, perceived vaccine efficacy, and perceived vaccine effectiveness. These findings suggest that acceptance of COVID-19 booster doses in Indonesia is influenced by intrinsic and extrinsic factors, including limited knowledge of booster dose benefits and concerns about potential side effects. To enhance public acceptance, targeted health campaigns and educational initiatives should be intensified, emphasizing the safety, efficacy, and importance of booster vaccinations in controlling the COVID-19 pandemic.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e803"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring adolescent girls' involvement in decision-making processes regarding child marriage: A systematic review.","authors":"Sri Wahyuningsih, Sri Widati, Nunik Puspitasari, Lutfi A Salim, Mohammad W Azkiya","doi":"10.52225/narra.v5i1.1656","DOIUrl":"10.52225/narra.v5i1.1656","url":null,"abstract":"<p><p>Child marriage often involves adolescents aged 10-19 years and poses significant health risks and challenges to gender equality. The aim of this systematic review was to examine the involvement of adolescent girls in decision-making processes regarding child marriage and identify influencing factors. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this review covered studies published between January 2014 and July 2024. The databases searched included ScienceDirect, Springer Link, PubMed, and Taylor & Francis, using terms related to adolescent girls, decision-making, and child marriage. Inclusion criteria targeted studies involving girls aged 10-19, with methods including qualitative, quantitative, longitudinal, and mixed- method, published in English. Data extraction and quality assessment followed the standards of the Joanna Briggs Institute. Of 6,967 articles, 29 met the inclusion criteria, spanning 26 countries across three continents, with 51.7% being qualitative studies. Economic pressure was identified as the primary driver of child marriage, with significant parental and community influences restricting the girls' decision-making autonomy. Parents, especially fathers, often force girls into marriage to reduce economic burdens and enhance family honor. Some adolescent girls initiate marriage to escape adverse home conditions or societal stigma. Education and strong family support emerged as protective factors, while entrenched social norms perpetuated early marriages. Comprehensive approaches including educational improvement, economic support, and social norm transformation are essential. Addressing child marriage requires multidimensional strategies, encompassing enhanced educational opportunities, economic support, and changing entrenched social norms. Future research should focus on interventions that boost adolescent girls' life skills and decision-making autonomy to delay marriage and enable informed choices.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1656"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining treatment paradigms: Early use of dapagliflozin and empagliflozin in acute heart failure - a systematic review and meta-analysis of randomized controlled trials.","authors":"Surya S Immanuel, Eric R Yonatan, Gabriel Tandecxi, Clifford P Anthony, Janice Z Chan, Andrew Ep Sunardi, Ira Posangi, Victor Bandana","doi":"10.52225/narra.v5i1.1833","DOIUrl":"10.52225/narra.v5i1.1833","url":null,"abstract":"<p><p>Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have proven to significantly reduce mortality and rehospitalization in heart failure with reduced ejection fraction (HFrEF). Supported by the 2023 European Society of Cardiology (ESC) guidelines and the safety, tolerability, and efficacy of rapid optimization of heart failure (STRONG-HF) trial, SGLT2i offer improved outcomes with a favorable safety profile, emphasizing their pivotal role in HFrEF management. The aim of this study was to evaluate early initiation with dapagliflozin and empagliflozin, focusing on their efficacy and safety in acute heart failure (AHF). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven databases for randomized controlled trials on SGLT2i in AHF (2019-2024). Outcomes included all-cause mortality, heart failure (HF)-related events, all-cause rehospitalization, length of hospital stay, diuretic response, serum electrolytes, and adverse events (AEs). The Cochrane Risk of Bias 2 tool was used. Data were analyzed using a random-effects model and presented as standardized mean differences and risk ratios with 95% confidence intervals. A subgroup analysis was conducted based on intervention. Nine studies encompassing 1,417 patients with a generally low risk of bias were included. Initiating SGLT2i within five days of admission significantly reduced in-hospital all-cause mortality risk by 42% and in-hospital worsening HF during rehospitalization by 39%. SGLT2i also significantly reduced serious AEs risk by 27%. No significant differences were found in other outcomes, including specific AEs (acute kidney injury, hepatic injury, symptomatic hypotension, hypoglycemia, urinary tract infections, and diabetic ketoacidosis). The analysis showed homogeneity, with no significant differences between SGLT2i. The study highlights that initiating SGLT2i within five days of admission significantly reduces all-cause mortality and worsening HF during rehospitalization, with a better safety profile than placebo.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1833"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the interplay between endometriosis and later-life cerebro-cardiovascular diseases: A systematic review, meta-analysis, and trial sequential analysis.","authors":"Winata I Gs, Surya S Immanuel, Leonardo Leonardo, Fransiskus X Rinaldi, Gabriel Tandecxi, Richard Wijaya","doi":"10.52225/narra.v5i1.1935","DOIUrl":"10.52225/narra.v5i1.1935","url":null,"abstract":"<p><p>Beyond gynecological issues, women with endometriosis have a significant risk of cardiac outcomes. Despite this evidence, the extent and mechanisms of the association remain unclear. The aim of this study was to evaluate the association between endometriosis and the incidence of cerebro-cardiovascular disorders. Using preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines, seven databases were searched as of October 14, 2024, for observational studies assessing the association between endometriosis and cerebro-cardiovascular disorders. The main outcome was major adverse cardiovascular and cerebrovascular event (MACCE) while the secondary outcomes included all-cause mortality, cerebrovascular accident (CVA), ischemic heart disease (IHD), myocardial infarction (MI), arrhythmia, and heart failure (HF). Bias was assessed with the risk of bias in non-randomized studies of exposures (ROBINS-E) tool. Odds ratios with 95% confidence interval (CI) were calculated using random-effects meta- analysis. Evidence certainty was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Robustness was assessed via sensitivity analyses and trial sequential analysis (TSA). Out of 3,141 studies, nine cohort studies encompassing 1,670,589 women (follow-up 7-28 years) were included. Endometriosis was associated with 24% higher odds of MACCE incidence (95%CI: 1.18-1.31, moderate certainty). In addition, having endometriosis increased the odds of CVA by 49% (95%CI: 1.20-1.85, high certainty), IHD by 64% (95%CI: 1.31-2.05, low certainty), MI by 53% (95%CI: 1.18-1.98, high certainty), arrhythmias by 24% (95%CI: 1.12-1.37, high certainty), and HF by 13% (95%CI: 1.03-1.25, high certainty). Endometriosis did not significantly associate with all-cause mortality. Sensitivity analyses and TSA reinforced all of these findings. In conclusion, endometriosis was significantly associated with increased odds of cerebro-cardiovascular disorders. Future research should clarify the underlying mechanisms and develop targeted prevention strategies.</p>","PeriodicalId":517416,"journal":{"name":"Narra J","volume":"5 1","pages":"e1935"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}