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All Journal Scientia Psychiatrica Sriwijaya Journal of Forensic and Medicolegal Sriwijaya Journal of Obstetrics and Gynecology
Taryudi Suharyana
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health

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Assessing the Effectiveness of Telemedicine for Cervical Cancer Screening in Remote Areas of Indonesia Kristianti, Silvia; Reza Andrianto; Sonya Syarifah; Taryudi Suharyana
Sriwijaya Journal of Obstetrics and Gynecology Vol. 2 No. 1 (2024): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i2.86

Abstract

Introduction: Cervical cancer remains a significant public health issue in Indonesia, particularly in remote areas with limited access to healthcare facilities. Telemedicine offers a potential solution to overcome geographical barriers and improve cervical cancer screening rates. This study aimed to assess the effectiveness of a telemedicine-based cervical cancer screening program in remote areas of Indonesia. Methods: A cross-sectional study was conducted in five remote villages in Indonesia. Women aged 30-49 years were invited to participate in cervical cancer screening using a telemedicine platform. The program involved self-sampling for human papillomavirus (HPV) DNA testing, followed by teleconsultation with healthcare providers for result interpretation and referral for further management if required. The primary outcome was the participation rate in the telemedicine-based screening program. Secondary outcomes included the positivity rate for high-risk HPV, the rate of referral for colposcopy, and participant satisfaction with the program. Results: A total of 500 women were invited to participate in the study, of whom 380 (76%) completed the screening process. The high-risk HPV positivity rate was 12%, and 46 women (12.1%) were referred for colposcopy. Participant satisfaction with the telemedicine program was high, with 92% of women reporting that they were satisfied with the convenience and accessibility of the service. Conclusion: Telemedicine-based cervical cancer screening is a feasible and effective strategy for reaching women in remote areas of Indonesia. The program achieved a high participation rate and enabled timely referral for further management. This approach has the potential to improve cervical cancer screening coverage and reduce mortality rates in underserved populations.
White-Matter Hyperintensities and Cognitive Decline in Late-Life Depression: A Longitudinal Neuroimaging Study in Medan, Indonesia Taryudi Suharyana; Jason Willmare; Despian Januandri; Brenda Jaleel; Wisnu Wardhana Putra
Scientia Psychiatrica Vol. 6 No. 3 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.185

Abstract

Introduction: Late-life depression (LLD) is often associated with cognitive impairment and structural brain changes, particularly white-matter hyperintensities (WMH). This longitudinal study investigated the relationship between WMH burden, cognitive decline, and depressive symptoms in a cohort of older adults with LLD in Medan, Indonesia. Methods: A prospective, longitudinal study was conducted with 120 participants aged 60 years and older. Participants underwent baseline and 3-year follow-up assessments, including structural MRI, neuropsychological testing, and depression severity. Statistical analyses included mixed-effects models to examine longitudinal changes and correlations. Results: At baseline, the LLD group exhibited significantly higher WMH volume compared to controls (p < 0.001). Over the 3-year follow-up, the LLD group showed a significantly greater increase in WMH volume (average increase of 0.4 Fazekas points) compared to controls (average increase of 0.1 Fazekas points, p < 0.001). Greater WMH burden at baseline was associated with worse performance on all cognitive domains in both groups (p < 0.05). In the LLD group, the increase in WMH volume was significantly correlated with a decline in global cognition (r = -0.45, p < 0.001), executive function (r = -0.38, p = 0.003), and processing speed (r = -0.41, p = 0.001). Changes in depression severity were also correlated with WMH progression (r = 0.32, p = 0.012). Conclusion: This study provides evidence that WMH burden is significantly increased in LLD and that WMH progression contributes to cognitive decline and may exacerbate depressive symptoms over time. These findings highlight the importance of assessing and potentially targeting WMH in the management of LLD.
Decoding Deception: Advanced fMRI and Machine Learning Techniques for Detecting Malingered Psychiatric Symptoms in Forensic Evaluations in Indonesia Taufiq Indera Jayadi; Taryudi Suharyana; Vita Amanda; Brenda Jaleel
Sriwijaya Journal of Forensic and Medicolegal Vol. 2 No. 2 (2024): Sriwijaya Journal of Forensic and Medicolegal
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjfm.v2i2.200

Abstract

Introduction: Detecting malingered psychiatric symptoms presents a significant challenge in Indonesian forensic evaluations, potentially impacting justice and resource allocation. Current methods rely heavily on clinical judgment and psychometric testing, lacking objective biomarkers. This study explored the potential of combining functional magnetic resonance imaging (fMRI) with machine learning (ML) to identify neural patterns differentiating malingered from genuine psychiatric symptoms in an Indonesian forensic context. Methods: This case-control study included 90 Indonesian male participants referred for forensic psychiatric evaluation (visum et repertum psychiatricum): 30 diagnosed genuine psychiatric patients (schizophrenia/psychotic depression), 30 individuals identified as malingerers, and 30 healthy controls. Participants underwent clinical assessment, psychometric testing (including symptom validity tests - SVTs), and an fMRI scan using a symptom-endorsement paradigm designed to probe cognitive control and deception-related neural activity. Preprocessed fMRI data were analyzed using group-level GLM and machine learning (Support Vector Machine - SVM; Random Forest - RF) classifiers trained on extracted features (ROI activation, functional connectivity) to distinguish malingerers. Performance was evaluated using k-fold cross-validation. Results: fMRI results indicated significantly greater activation in the malingering group compared to genuine patients and controls in prefrontal (dlPFC, vlPFC) and anterior cingulate cortex (ACC) regions during feigned symptom endorsement (p<0.001, FWE-corrected). An SVM classifier using combined ROI activation and functional connectivity features achieved the highest accuracy (83%), sensitivity (80%), specificity (86%), and AUC (0.88) in distinguishing malingerers from genuine patients. Conclusion: These findings suggest that integrating fMRI and ML techniques holds promise as an objective, supplementary tool for detecting malingered psychiatric symptoms within Indonesian forensic evaluations. While promising, the moderate accuracy highlights the need for further validation, consideration of ethical implications, and adaptation to the Indonesian context before any potential clinical application.
Co-Authors Brenda Jaleel Despian Januandri Jason Willmare Kristianti, Silvia Reza Andrianto Sonya Syarifah Taufiq Indera Jayadi Vita Amanda Wisnu Wardhana Putra