Childhood acute lymphoblastic leukemia: Four years evaluation of protocols 2013 and 2016 in a single center in Indonesia, a lower-middle-income country.

Background: The prognosis of childhood acute lymphoblastic leukemia (ALL) in Indonesia, a lower-middle-income country (LMIC), is lower than in high income countries (HICs). The Indonesian ALL2013 protocol resulted in too many toxic deaths (21%) and abandonments (11%). Therefore, we drafted an adapted protocol, ALL2016.

Impact of universal health coverage on childhood cancer outcomes in Indonesia.

Background: Starting from 2014, the Indonesian government has implemented Universal Health Coverage (UHC) with the aim to make healthcare services accessible and affordable to all Indonesian citizens. A major reason for childhood cancer treatment failure in low- and middle-income countries, particularly among families with low socioeconomic status (SES), is abandonment of expensive cancer treatment. Our study compared childhood cancer treatment outcomes of the overall, low, and high SES population before and after introduction of UHC at a large Indonesian academic hospital.

Aberrantly expressed Bruton's tyrosine kinase preferentially drives metastatic and stem cell-like phenotypes in neuroblastoma cells.

Purpose: Neuroblastoma, a common childhood tumor, remains one of the most elusive diseases to treat. To date, high-risk neuroblastoma is associated with low survival rates. To address this, novel and more effective therapeutic strategies must continue to be explored.

Effect of different feeding management on the respiratory methane emission and feces-derived methane yield of goat.

Objective: This study aimed to evaluate the respiratory methane emission and ultimate methane yield ( ) of goat feces that fed roughage consisted of and ) and fed roughage and concentrate with different protein source in the ration (fish meal and soybean meal).

Materials And Methods: Fifteen Kacang bucks were allocated to the control group (T0): goats were fed roughage only, T1: goats were fed roughage and concentrate with fish meal as protein sources, and T2: goats were fed roughage and concentrate and the protein source in the ration was soybean meal.

Results: The protein content of feces from T0 was significantly lower ( < 0.

Implementation of Medication Safety Practice in Childhood Acute Lymphoblastic Leukemia Treatment.

Objective: Medical Safety Practice (MSP) is a safe procedure in medication process. It is important to investigate the use of MSP among childhood cancer patients because pediatric oncology is a high-risk area for potentially harmful adverse events. The purpose of this study is to determine the effects of the implementation of MSP in chemotherapy on the incidence of medication errors in childhood ALL patient at Dr.

HealthCare Providers' and Parents' Perspectives on Complementary Alternative Medicine in Children with Cancer in Indonesia.

Background: Complementary alternative medicine (CAM) use in children with cancer is widespread. Health care providers (HCP) need to acknowledge and address this need. This study explored and compared perspectives on CAM of HCP and parents of young patients with cancer in Indonesia.

Modifying effect of XmnI, BCL11A, and HBS1L-MYB on clinical appearances: A study on β-thalassemia and hemoglobin E/β-thalassemia patients in Indonesia.

Objective/background: Thalassemia is a monogenic hematologic disease that has the highest prevalence globally. In addition, there is complexity of the genetic background associated with a variety of phenotypes presented among patients. Genetic heterogeneity related to fetal hemoglobin (HbF) production has been reported as an influencing phenotypic factor of β-thalassemia (β-thal).

The effect of mixed-enzyme addition in anaerobic digestion on methane yield of dairy cattle manure.

This study investigates the effect of applying a mixture of enzymes (ME) to dairy cattle manure (DCM) as substrate in anaerobic digestion (AD). The aims of this study were to evaluate different methods of ME application to DCM at different temperatures and to investigate the effect of adding ME during the pre-treatment of the solid fractions of dairy cattle manure (SFDCM). The results showed that there was no positive effect of direct ME addition to substrate at either mesophilic (35 degrees C) or thermophilic (50 degrees C) process temperatures, but there was a significant 4.

Effects of high-temperature isochoric pre-treatment on the methane yields of cattle, pig and chicken manure.

Cattle manure, dewatered pig manure and chicken manure were pre-treated in a high-temperature reactor under isochoric conditions for 15 min at temperatures between 100 and 225 degrees C with 25 degrees C intervals to study the effect on their methane yield. After 27 days of batch incubation, cattle manure showed a significant improvement in its biochemical methane potential (BMP) of 13% at 175 degrees C and 21% at 200 degrees C. Pig manure showed improvements at temperatures of 125 degrees C and above, with a maximum 29% increase in yield at 200 degrees C.

Randomized double blind trial of ciprofloxacin prophylaxis during induction treatment in childhood acute lymphoblastic leukemia in the WK-ALL protocol in Indonesia.

Objectives: Toxic death is a big problem in the treatment of childhood acute lymphoblastic leukemia (ALL), especially in low-income countries. Studies of ciprofloxacin as single agent prophylaxis vary widely in success rate. We conducted a double-blind, randomized study to test the effects of ciprofloxacin monotherapy as prophylaxis for sepsis and death in induction treatment of the Indonesian childhood ALL protocol.

L-asparaginase: long-term results of a randomized trial of the effect of additional 3 doses during consolidation treatment in the Indonesian WK-ALL-2000 protocol.

We conducted a randomized trial to compare the influence of 3 additional doses of L-asparaginase on clinical outcome of newly diagnosed childhood acute lymphoblastic leukemia (ALL). Patients were treated using Indonesian WK-ALL-2000 protocol between 1999 and 2005 and randomized to receive (3A arm, n=61) or not to receive (0A arm, n=56) an additional 3 weekly doses of 6000 IU/m(2)/dose of Escherichia coli L-asparaginase during consolidation treatment on top of 2 doses (standard-risk patients) or 5 doses (high-risk patients). Events after remission included relapse (37.

Chemical composition and methane yield of reed canary grass as influenced by harvesting time and harvest frequency.

This study examined the influence of harvest time on biomass yield, dry matter partitioning, biochemical composition and biological methane potential of reed canary grass harvested twice a month in one-cut (OC) management. The regrowth of biomass harvested in summer was also harvested in autumn as a two-cut management with (TC-F) or without (TC-U) fertilization after summer harvest. The specific methane yields decreased significantly with crop maturity that ranged from 384 to 315 and from 412 to 283 NL (normal litre) (kgVS)(-1) for leaf and stem, respectively.

Anaerobic digestion of acidified slurry fractions derived from different solid-liquid separation methods.

Batch assays investigating the ultimate methane yields (B(0)) of acidified slurry fractions produced with different solid-liquid slurry separation techniques were done. The result showed that the anaerobic digestion (AD) process was inhibited when raw and liquid fractions of sow, pig and dairy cow acidified slurry are digested, but AD treating solid fractions (SF) acidified slurry showed no sulphide inhibition. The B(0) of SF acidified sow slurry increased significantly with increasing screen size in the screw press.

Myeloid Antigen Expression in Childhood Acute Lymphoblastic Leukemia and Its Relevance for Clinical Outcome in Indonesian ALL-2006 Protocol.

The frequency of acute lymphoblastic leukemia (ALL) patients expressing myeloid antigens on their ALL cells varies between 5 and 36% in several different studies. The clinical relevance of myeloid antigen expression in childhood ALL is controversial. In Indonesian patients, no data were present.

Process performance of anaerobic co-digestion of raw and acidified pig slurry.

The effect of incorporating different ratios of acidified pig slurry on methane yield was evaluated in two scales of anaerobic digesters: Thermophilic (50 °C) pilot scale digester (120 l), operating with an average hydraulic retention time of 20 days and thermophilic (52 °C) full-scale digesters (10 and 30 m(3)), operating with an average hydraulic retention time of 30 days. In the lab-scale digester, different inclusion levels of acidified slurry (0-60%) were tested each 15 days, to determine the maximum ratio of acidified to non-acidified slurry causing inhibition and to find process state indicators helping to prevent process failure. In the full-scale digesters, the level of inclusion of the acidified slurry was chosen from the ratio causing methane inhibition in the pilot scale experiment and was carried on in a long-term process of 100 days.

Early Response to Dexamethasone as Prognostic Factor: Result from Indonesian Childhood WK-ALL Protocol in Yogyakarta.

Early response to treatment has been shown to be an important prognostic factor of childhood acute lymphoblastic leukemia (ALL) patients in Western studies. We studied this factor in the setting of a low-income province in 165 patients treated on Indonesian WK-ALL-2000 protocol between 1999 and 2006. Poor early response, defined as a peripheral lymphoblasts count of ≥1000/μL after 7 days of oral dexamethasone plus one intrathecal methotrexate (MTX), occurred in 19.

Thermophilic anaerobic co-digestion of separated solids from acidified dairy cow manure.

This study examined the potential for partly substituting dairy cow manure (DCM) with solids from solid to liquid separation of acidified dairy cow manure (SFDCM) during thermophilic anaerobic digestion. Three different substituting levels with a maximum of 30% substitution were tested. All digesters substituting DCM with SFDCM showed a stable biogas production with low volatile fatty acid concentrations after a short transition period.

NIR monitoring of ammonia in anaerobic digesters using a diffuse reflectance probe.

The feasibility of using a diffuse reflectance probe attached to a near infrared spectrometer to monitor the total ammonia nitrogen (TAN) content in an anaerobic digester run on cattle manure was investigated; as a previous study has indicated that this probe can be easily attached to an anaerobic digester. Multivariate modelling techniques such as partial least squares regression and interval partial least squares methods were used to build models. Various data pre-treatments were applied to improve the models.

Incidence of childhood leukemia in Yogyakarta, Indonesia, 1998-2009.

Background: In most developing countries, incidence data for childhood cancers are less reliable, because very few population-based registries exist. The aim of this study was to present the epidemiology of childhood leukemia in the Dr. Sardjito Hospital (DSH) region, which catchment area extends beyond the boundaries of the Yogyakarta Special Province (YSP).

Yogyakarta Pediatric Cancer Registry: an international collaborative project of University Gadjah Mada, University of Saskatchewan, and the Saskatchewan Cancer Agency.

Introduction: In July 2001, a 'twinning' project was undertaken between University Gadjah Mada, Indonesia, and the Saskatchewan Cancer Agency, Canada to create a computerised Pediatric Cancer Registry at Sardjito Hospital, Yogyakarta city.

Objectives: To analyse information from the Yogyakarta Pediatric Cancer Registry (YPCR) in order to i) determine the prevalence of pediatric cancers in Yogyakarta Special Region and, ii) compare the demographics of pediatric malignancies in the Special Region (population: 3.3 million), with those of the Saskatchewan Cancer Registry in the province of Saskatchewan (population: 1 million).

Generalized epilepsy with febrile seizures plus (GEFS+) spectrum: clinical manifestations and SCN1A mutations in Indonesian patients.

Generalized epilepsy with febrile seizures plus (GEFS+) is a childhood genetic epilepsy syndrome. GEFS+ includes a wide spectrum of clinical manifestations, and SCN1A mutations have frequently been reported among the GEFS+-related gene abnormalities. In this study, to clarify the distributions of the clinical subtypes, we analyzed 34 families with GEFS+ in Indonesia using the hospital records of the patients and questionnaires for the family members.

Chemotherapy-related side effects in childhood acute lymphoblastic leukemia in Indonesia: parental perceptions.

Noncompliance with prescribed medication has been associated with increased chance of relapse and poor outcome. Side effects may be an important cause of noncompliance. Fifty-one parents of children with acute lymphoblastic leukemia in a tertiary care hospital in Indonesia were interviewed about their perception of side effects and their impact on treatment noncompliance and daily activities.

Comparing childhood leukaemia treatment before and after the introduction of a parental education programme in Indonesia.

Setting: Previously, treatment and the results of treatment for childhood acute lymphoblastic leukaemia (ALL) in Indonesia differed significantly between poor and prosperous patients. Poor patients received less individual attention from oncologists and access to parental education and donated chemotherapy was lacking.

Intervention: A structured parental education programme for both poor and prosperous parents was introduced in January 2004 to improve access to parental education and donated chemotherapy.

Novel SCN1A mutations in Indonesian patients with severe myoclonic epilepsy in infancy.

Background: Severe myoclonic epilepsy in infancy (SMEI) and borderline SMEI (SMEB) are caused by a mutation in SCN1A, which encodes a voltage-gated sodium channel alpha1-subunit protein. Although many mutations in SCN1A have been associated with clinical features of SMEI or SMEB from different ethnic groups, there have been no such reports from the South-East Asian populations so far.

Methods: Patients 1 and 2 were Indonesian children diagnosed as having SMEI and SMEB based on their clinical features.

Parental experiences of childhood leukemia treatment in indonesia.

In our study, we examined socioeconomic, treatment-related, and psychologic experiences of parents during the acute lymphoblastic leukemia treatment of their children in an academic hospital in Indonesia. Children were treated with the WK-ALL-2000 protocol and received donated chemotherapy. From November 2004 to April 2006, 51 parents were interviewed by psychologists using semi-structured questionnaires.