IJEPA: Gray Area for Health Policy and International Nurse Migration

Indonesia is recognized as a nurse exporting country, with policies that encourage nursing professionals to emigrate abroad. This includes the country's adoption of international principles attempting to protect Indonesian nurses that emigrate as well as the country's own participation in a bilateral trade and investment agreement, known as the Indonesia�Japan Economic Partnership Agreement that facilitates Indonesian nurse migration to Japan. Despite the potential trade and employment benefits from sending nurses abroad under the Indonesia�Japan Economic Partnership Agreement, Indonesia itself is suffering from a crisis in nursing capacity and ensuring adequate healthcare access for its own populations. This represents a distinct challenge for Indonesia in appropriately balancing domestic health workforce needs, employment, and training opportunities for Indonesian nurses, and the need to acknowledge the rights of nurses to freely migrate abroad. Hence, this article reviews the complex operational and ethical issues associated with Indonesian health worker migration under the Indonesia�Japan Economic Partnership Agreement. It also introduces a policy proposal to improve performance of the Indonesia�Japan Economic Partnership Agreement and better align it with international principles focused on equitable health worker migration

An Efficient Management System for Wireless Sensor Networks

Wireless sensor networks have garnered considerable attention recently. Networks typically have many sensor nodes, and are used in commercial, medical, scientific, and military applications for sensing and monitoring the physical world. Many researchers have attempted to improve wireless sensor network management efficiency. A Simple Network Management Protocol (SNMP)-based sensor network management system was developed that is a convenient and effective way for managers to monitor and control sensor network operations. This paper proposes a novel WSNManagement system that can show the connections stated of relationships among sensor nodes and can be used for monitoring, collecting, and analyzing information obtained by wireless sensor networks. The proposed network management system uses collected information for system configuration. The function of performance analysis facilitates convenient management of sensors. Experimental results show that the proposed method enhances the alive rate of an overall sensor node system, reduces the packet lost rate by roughly 5%, and reduces delay time by roughly 0.2 seconds. Performance analysis demonstrates that the proposed system is effective for wireless sensor network management

Fascia tissue engineering with human adipose-derived stem cells in a murine model: Implications for pelvic floor reconstruction

Background/PurposeMesh-augmented vaginal surgery for treatment of pelvic organ prolapse (POP) does not meet patients' needs. This study aims to test the hypothesis that fascia tissue engineering using adipose-derived stem cells (ADSCs) might be a potential therapeutic strategy for reconstructing the pelvic floor.MethodsHuman ADSCs were isolated, differentiated, and characterized in vitro. Both ADSCs and fibroblastic-differentiated ADSCs were used to fabricate tissue-engineered fascia equivalents, which were then transplanted under the back skin of experimental nude mice.ResultsADSCs prepared in our laboratory were characterized as a group of mesenchymal stem cells. In vitro fibroblastic differentiation of ADSCs showed significantly increased gene expression of cellular collagen type I and elastin (p < 0.05) concomitantly with morphological changes. By contrast, ADSCs cultured in control medium did not demonstrate these changes. Both of the engrafted fascia equivalents could be traced up to 12 weeks after transplantation in the subsequent animal study. Furthermore, the histological outcomes differed with a thin (111.0 ± 19.8 μm) lamellar connective tissue or a thick (414.3 ± 114.9 μm) adhesive fibrous tissue formation between the transplantation of ADSCs and fibroblastic-differentiated ADSCs, respectively. Nonetheless, the implantation of a scaffold without cell seeding (the control group) resulted in a thin (102.0 ± 17.1 μm) fibrotic band and tissue contracture.ConclusionOur results suggest the ADSC-seeded implant is better than the implant alone in enhancing tissue regeneration after transplantation. ADSCs with or without fibroblastic differentiation might have a potential but different role in fascia tissue engineering to repair POP in the future

The Role of Nucleus Accumbens Core/Shell in Sleep-Wake Regulation and their Involvement in Modafinil-Induced Arousal

Background: We have previously shown that modafinil promotes wakefulness via dopamine receptor D1 and D2 receptors; however, the locus where dopamine acts has not been identified. We proposed that the nucleus accumbens (NAc) that receives the ventral tegmental area dopamine inputs play an important role not only in reward and addiction but also in sleep-wake cycle and in mediating modafinil-induced arousal. Methodology/Principal Findings: In the present study, we further explored the role of NAc in sleep-wake cycle and sleep homeostasis by ablating the NAc core and shell, respectively, and examined arousal response following modafinil administration. We found that discrete NAc core and shell lesions produced 26.5% and 17.4% increase in total wakefulness per day, respectively, with sleep fragmentation and a reduced sleep rebound after a 6-hr sleep deprivation compared to control. Finally, NAc core but not shell lesions eliminated arousal effects of modafinil. Conclusions/Significance: These results indicate that the NAc regulates sleep-wake behavior and mediates arousal effects of the midbrain dopamine system and stimulant modafinil

Combination of capecitabine and ludartin inhibits colon cancer growth in mice

Purpose: To investigate the efficacy of capecitabine and ludartin in the treatment of colon cancer in mice.Methods: Mice model of colon cancer was used in this study. Quantitative real-time polymerase chain reaction (Qrt-PCR) was used to quantify the expression of vascular endothelial growth factor (VEGF) mRNA. Micro-vessel density was assessed using immunohistochemical analysis.Results: When administered separately, capecitabine and ludartin treatments significantly suppressed tumor growth in the mice model of colon cancer for 4 weeks, compared to control group. Coadministration of capecitabine and ludartin significantly inhibited tumor growth for 6 weeks (p &lt; 0.05). Symptoms of colon cancer such as weight loss, skin discoloration and leukopenia were observed in untreated control group. However, these symptoms were completely absent in the group treated with combination of capecitabine and ludartin. The combined treatment also prevented colon cancer-induced increase in white blood cell (WBC) count, and increased median survival time of colon cancer mice from 38 to 55 days. Expression of VEGF in combination (capecitabine + ludartin) treatment group was significantly lower than in the control, i.e., untreated group (p ˂ 0.05). The combination treatment group also had significantly lower micro-vessel density in the tumor tissues, compared to the  ntreated control mice (p &lt; 0.05).Conclusion: These results show that a combination treatment of capecitabine and ludartin effectively inhibits colon tumor growth and angiogenesis in mice via a mechanism involving suppression of VEGF expression. Thus, capecitabine and ludartin combination is a potentially  uitable treatment for colon cancer.Keywords: Colon cancer, Mice, Ludartin, Leukopenia, VEGF expression, Angiogenesi

Clinical significance of circulating tumor cells in predicating the outcomes of patients with colorectal cancer

Background: Relapse and metastasis of patients with Colorectal Cancer (CRC) is the major obstacle to the long-term life of patients. Its mechanisms remain defined. Methods: A total of&nbsp;48&nbsp;CRC patients were enrolled and 68&nbsp;samples were obtained from the peripheral blood of patients before or after treatments in this study. Twenty non-cancer patients were also detected as a negative control. Circulating Tumor Cells (CTCs), including Epithelial CTCs (eCTCs), Mesenchymal (MCTCs), and epithelial/mesenchymal mixed phenotypes (mixed CTCs), were identified by CanPatrolTM CTC enrichment and RNA in situ hybridization. The relationship between CTCs number and Progression-Free Survival (PFS) or Overall Survival (OS) was evaluated. Results: Thirty-four of&nbsp;48&nbsp;patients (70.8%) were found to have positive CTCs. Total CTCs and MCTCs in the post-treatment had a significant correlation PFS and OS. When total CTCs or MCTCs in&nbsp;5&nbsp;mL blood of patients were more than&nbsp;6&nbsp;CTCs or 5&nbsp;MCTCs, PFS of the patients was significantly shorter (p &lt; 0.05) than that in patients with less than&nbsp;6&nbsp;CTCs&nbsp;or&nbsp;5&nbsp;MCTCs. The patients with&nbsp;&gt; 5&nbsp;CTCs count changes were found to exhibit poor PFS and OS rates (p &lt; 0.05). Conclusion: Total CTCs and MCTCs number detection in patients with colorectal cancer was very useful biomarker for predicting the prognosis of patients. Higher CTCs or MCTCs had poorer PFS and OS rates

Exosomes: Novel Biomarkers for Clinical Diagnosis

Exosomes are 30–120 nm endocytic membrane-derived vesicles that participate in cell-to-cell communication and protein and RNA delivery. Exosomes harbor a variety of proteins, nucleic acids, and lipids and are present in many and perhaps all bodily fluids. A significant body of literature has demonstrated that molecular constituents of exosomes, especially exosomal proteins and microRNAs (miRNAs), hold great promise as novel biomarkers for clinical diagnosis. In this minireview, we summarize recent advances in the research of exosomal biomarkers and their potential application in clinical diagnostics. We also provide a brief overview of the formation, function, and isolation of exosomes