Background/Objectives: Acetyl-CoA carboxylase (ACC) inhibitors block the initial step of de novo lipogenesis and potentially ameliorate liver pathology in nonalcoholic fatty liver disease (NAFLD). However, increased expression of glycerol-3-phosphate acyltransferase 1 resulting from reduced PUFA may cause hypertriglyceridemia. This systematic review and meta-analysis assessed the efficacy and safety of dual ACC 1/2 inhibitors in adult NAFLD patients, either with or without metabolic dysfunction. Methods: Six databases were searched for randomized controlled trials (RCTs). The primary outcomes were changes in liver fat and fibrosis. Study quality was assessed using the RoB 2 tool. Pooled mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. Results: Six RCTs comprising 655 participants were included; most had low risk of bias. Interventions included firsocostat, clesacostat, and combined regimens with semaglutide, selonsertib, and cilofexor or ervogastat. Compared with placeo, ACC inhibitor monotherapy significantly reduced liver fat (mean difference [MD]: −48.38; 95% CI: −58.54 to −38.22; p < 0.00001) and ALT (MD: −16.07; 95% CI: −24.97 to −7.17; p = 0.0004) but increased ALP (MD: 11.95; 95% CI: 6.98, to 16.92; p < 0.00001) and GGT levels (MD: 23.90; 95% CI: 12.58 to 35.23; p < 0.0001). Hypertriglyceridemia risk was markedly elevated (odds ratio [OR]: 10.33; 95% CI: 4.93 to 21.65; p < 0.00001). No significant improvement in fibrosis was observed by magnetic resonance elastography. Serious adverse events were infrequent, and overall treatment-emergent adverse events were comparable between groups; however, the incidence of hypertriglyceridemia was consistently more frequent with ACC inhibitors. Conclusions: Dual ACC 1/2 inhibitors reduce hepatic steatosis and ALT levels but do not improve fibrosis. Their consistent association with hypertriglyceridemia raises concerns regarding potential long-term cardiometabolic risks, particularly in NAFLD patients with metabolic dysfunction.

Objectives: During the second coronavirus disease 2019 (COVID-19) surge, cases increased sharply due to low awareness and compliance with measures to limit disease spread. Health literacy (HL) is an important component of public health initiatives, and schools are potential sources of health education to increase HL via the presentation of COVID-19 educational modules.Methods: This cross-sectional study involved an online questionnaire administered to students from 5 high schools in Surabaya and Sidoarjo, Indonesia, 6-7 weeks after the start of government-issued directives restricting public gatherings. We collected data on each respondent’s age, gender, parental education, and socioeconomic variables. HL was determined by the Health Literacy Measure for Adolescents. We additionally measured their attitudes and behaviors related to preventing the spread of COVID-19. The students were asked if they watched the COVID-19 module at school, their feelings about vaccination, and preferred online sources of COVID-19-related information.Results: Most of the 432 respondents had viewed COVID-19 modules at school. Module exposure was associated with significantly higher total and domain-specific HL and more positive attitudes toward government-issued COVID-19 restrictions on travel and public gatherings (p<0.05). However, behaviors to prevent COVID-19 spread and vaccine acceptance were not associated with module exposure. Most students chose social media as their source of COVID-19-related information.Conclusions: Schools can provide information to increase adolescents’ HL and the public’s support for health initiatives to prevent or limit the spread of COVID-19.

Introduction: Health literacy on the coronavirus disease 2019 (COVID-19) affects people’s capability to ascertain their health and health care quality during the pandemic. The objective of this study was to determine the levels of health literacy about COVID-19 vaccines and vaccinations (Vaccines and Vaccinations literacy-VL) in the Indonesian adult general population, assessing the perceptions of the respondents about current adult immunization and beliefs about vaccinations in general, and analyzing correlations of these variables with the VL levels. Methods: A cross-sectional study using a rapid survey was administered via the Internet. Data were analyzed using descriptive and inferential statistics; the internal consistency of the VL scales was evaluated using Cronbach’s alpha coefficient; the inter-correlation between the functional and interactive-critical VL questions, the underlying components (factors) and each question’s load on the components were identified using a Principal Component Analysis (PCA). An alpha level lesser than 0.05 was considered significant. Results: Responses to functional- and interactive/ critical- VL questions were acceptable and showed internal consistency (Cronbach’s alpha = 0.817 and 0.699, respectively), lowest values observed were 0.806 for functional scale and 0.640 for the interactive-critical scale. The PCA demonstrated that there were two components accounting for 52.45% of the total variability. Approximately 60% of respondents were females (n=686). Almost all respondents used the internet to seek information regarding COVID-19 and COVID-19 vaccinations. Many used at least one social media actively with 74.4% of respondents sometimes believing the validity of this information. Conclusions: High scores were observed in both functional- and interactive/ critical-VL, and were quite in a balance between sexes in the prior VL and higher in females for the latter; these were also closely related to the educational level and age group. It is crucial to increase public health literacy in managing the pandemic.

Context: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide, yet pharmacological treatment options remain limited. Therapeutic agents that modulate both metabolic and hepatic pathological pathways are urgently needed. Aims: To identify chemical constituents from the ethanolic extract of Clinacanthus nutans and predict their interactions with validated molecular targets implicated in MASLD using in silico methodologies. Methods: Metabolite profiling was conducted using ultra-high-performance liquid chromatography–mass spectrometry (UHPLC–MS). Identified compounds were evaluated for drug-likeness based on Lipinski, Ghose, and Veber criteria. Compounds meeting these criteria were subjected to ADMET profiling and molecular docking against 20 MASLD-associated targets using validated docking protocols. The potential compound underwent molecular dynamics analysis. Results: Seventeen compounds were identified from the C. nutans extract. Six metabolites, along with stearidonic acid, demonstrated favorable pharmacokinetic properties. Among these, a thiophene-based benzoic acid derivative and tagalsin Q exhibited strong binding affinities toward CCR2, ChREBP, and SGLT2, with interaction profiles comparable to native ligands. Conclusions: Metabolites of C. nutans possess predicted bioactivity against CCR2, ChREBP, and SGLT2, supporting their potential utility as multi-target phytotherapeutic agents for MASLD.

The phytochemical profile and hepatoprotective, antioxidant, and lipid-modulating effects of the ethanolic extract of Clinacanthus nutans leaves were examined in male C57BL/6 mice fed a cholesterol-supplemented western diet. After 15 weeks of feeding, the untreated mice developed steatosis, lobular inflammation, and ballooning hepatocytes, with NAFLD activity scores ≥5, indicative of metabolic dysfunction-associated steatohepatitis (MASH). Treatment with Clinacanthus nutans extract at doses of 100, 200, and 400 mg/kg from week 8 to 15 significantly reduced the liver-to-body weight ratio and NAFLD activity score, with dose-dependent histological improvement, particularly reduced lobular inflammation. AST, ALT, and hepatic malondialdehyde levels were significantly lowered in the treated groups, with effects exceeding those of atorvastatin. However, Clinacanthus nutans extract did not attenuate the elevated LDL-to-HDL ratio. In conclusion, Clinacanthus nutans extract effectively prevented the progression from simple steatosis to steatohepatitis, likely through antioxidative mechanisms attributable to its high tannin content.