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Flaxseed Ethanolic Extract Modulates Β-Catenin And Dkk1 Expressions During Osteoblast Differentiation Of Dental Pulp-Derived Stem Cells, Nur Sazwi Nordin, Khairani Idah Mokhtar, Omar Abdul Jabbar Abdul Qader, Basma Ezzat Mustafa, Widya Lestari, Deny Susanti Darnis, Thirumulu Ponnuraj Kannan, Azlina Ahmad, Solachuddin Jauhari Arief Ichwan Aug 2026

Flaxseed Ethanolic Extract Modulates Β-Catenin And Dkk1 Expressions During Osteoblast Differentiation Of Dental Pulp-Derived Stem Cells, Nur Sazwi Nordin, Khairani Idah Mokhtar, Omar Abdul Jabbar Abdul Qader, Basma Ezzat Mustafa, Widya Lestari, Deny Susanti Darnis, Thirumulu Ponnuraj Kannan, Azlina Ahmad, Solachuddin Jauhari Arief Ichwan

Journal of Dentistry Indonesia

Background: WNT signaling regulates osteogenic differentiation of mesenchymal stem cells (MSC) through the canonical WNT pathway. β-catenin; an important molecule of WNT pathway, and DKK1; a WNT antagonist, play important roles in regulating bone formation. Although flaxseed (Linum usitatissimum) has various health benefits, including promoting bone health, our previous study showed that flaxseed ethanolic extract (FEE) reduced the osteoblast differentiation potential of stem cells from human exfoliated deciduous teeth (SHED). This study aimed to determine the effects of FEE on WNT pathway-related molecules, β-catenin and DKK1, during osteoblast differentiation of SHED.

Methods: RNA at Day 7, 14, …


Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa Aug 2026

Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa

Journal of Dentistry Indonesia

Background: Class III malocclusion combined with anterior open bite (AOB) is one of the most challenging occlusal problems to treat. The objective of this article was to report a case of an adult female patient diagnosed with Class III malocclusion combined with an anterior open bite and a hyperdivergent facial pattern.

Case Report: Camouflage orthodontic treatment with the extraction of maxillary and mandibular first premolars was used to treat the patient. Anterior teeth were retracted maximally against the Nance holding arch and fixed lingual arch appliances, and box elastics were used to close AOB. At the end of …


The Correlation Between Medication Adherence, Blood Glucose Levels, And Quality Of Life In Patients With Type 2 Diabetes Mellitus At Ciamis Regional Hospital, Amyla Putri Nurul Nazmi, Nur Rahayuningsih, Lusi N Aug 2026

The Correlation Between Medication Adherence, Blood Glucose Levels, And Quality Of Life In Patients With Type 2 Diabetes Mellitus At Ciamis Regional Hospital, Amyla Putri Nurul Nazmi, Nur Rahayuningsih, Lusi N

Pharmacology and Clinical Pharmacy Research

Type 2 diabetes mellitus is a chronic condition requiring continuous treatment, including patient adherence to prescribed medication. This study aimed to explore the relationship between medication adherence, blood glucose levels, and quality of life in patients with type 2 diabetes mellitus at Ciamis Regional Hospital, conducted from January to March 2025, the research employed a quantitative, prospective cross-sectional design involving 49 hospitalized patients. Data included blood glucose levels (RPG, FPG, 2hPG), medication adherence measured using the Medication Adherence Report Scale (MARS-5), and quality of life assessed via the Diabetes Quality of Life-Brief Clinical Inventory (DQOL-BCI). The chi-square test was used …


The Phytochemical Content And Antibacterial Activity Of Purified Extract Of Mangifera Indica L. Against Gram Positive Pathogen, Dewi Andini Kunti Mulangsri, Masduki Faqih, Sugar Arifin, Mutiara Trie Sieya Agustin Aug 2026

The Phytochemical Content And Antibacterial Activity Of Purified Extract Of Mangifera Indica L. Against Gram Positive Pathogen, Dewi Andini Kunti Mulangsri, Masduki Faqih, Sugar Arifin, Mutiara Trie Sieya Agustin

Pharmacology and Clinical Pharmacy Research

The purified extract of arum manis mango leaves contained flavonoid compounds by TLC methods and antibacterial activity against Gram-positive and negative pathogens. This research aimed to identify and determine the phytochemical content (mangiferin and flavonoids content) and antibacterial activity against other Gram-positive pathogens. Purification of ethanol extract of arum manis mango leaves by liquid-liquid fraction method. Determination of total flavonoid content and identification of mangiferin used respectively by aluminum chloride and Thin Layer Chromatography method. The disk diffusion method was used to assay antibacterial activity against S. epidermidis, and B. subtilis bacteria with the concentration of the sample such …


Cost Effectiveness Analysis Of Psychopharmaca Therapy Combination Compared With Psychopharmaca Therapy And Ect Combination In Schizoaffective Inpatients At The Rsj Provinsi Jawa Barat, Yasmin Fadillah, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi Aug 2026

Cost Effectiveness Analysis Of Psychopharmaca Therapy Combination Compared With Psychopharmaca Therapy And Ect Combination In Schizoaffective Inpatients At The Rsj Provinsi Jawa Barat, Yasmin Fadillah, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Mental disorders constitute an economic burden on health, estimated at USD 2.5 trillion in 2010 and expected to increase to USD 6 trillion by 2030. Treatment of schizoaffective disorder involves a combination of medication and psychotherapy. Pharmacoeconomics is an important consideration in drug selection. This study aims to determine the cost-effectiveness of psychopharmaca therapy combination compared with psychopharmaca therapy and ECT combination in schizoaffective inpatients at the RSJ Provinsi Jawa Barat. Data collection was conducted retrospectively from patient medical records for the period December 2023–December 2024. Total costs, based on a health perspective, include psychopharmaca drug costs, inpatient care costs, …


Evaluation Of Antibiotic Use Using The Gyssens Method On Clinical Outcomes In Ischemic Stroke Patients, Juniarto Mende, Graciano A. Maturbongs, Yohana K. A. Mbulang Aug 2026

Evaluation Of Antibiotic Use Using The Gyssens Method On Clinical Outcomes In Ischemic Stroke Patients, Juniarto Mende, Graciano A. Maturbongs, Yohana K. A. Mbulang

Pharmacology and Clinical Pharmacy Research

Ischemic stroke is a health problem that causes death and neurovascular disability worldwide. The inflammatory response due to infection can increase ischemic stroke and increase brain damage through changes in blood pressure, coagulation, immune response, and endothelial function. This study aims to evaluate the rationality of antibiotic use on clinical outcomes in ischemic stroke patients. This study used a cross-sectional design. Retrospective data were taken from the medical records of Jayapura Regional Hospital for the period January 1, 2023, to May 31, 2025. The study subjects were all patients who suffered ischemic stroke and received antibiotics. Evaluation of the rationality …


Retrospective Analysis Of Antimicrobial Resistance Patterns In Gram-Positive And Gram-Negative Blood Isolates, Helman Kurniadi, Timbul Partogi Haposan Simorangkir, Ros Sumarny, Fitria Heldiana Aug 2026

Retrospective Analysis Of Antimicrobial Resistance Patterns In Gram-Positive And Gram-Negative Blood Isolates, Helman Kurniadi, Timbul Partogi Haposan Simorangkir, Ros Sumarny, Fitria Heldiana

Pharmacology and Clinical Pharmacy Research

Bloodstream infections are an important cause of morbidity and mortality, while antimicrobial resistance limits treatment options. This retrospective study evaluated bacterial distribution and antimicrobial susceptibility in blood cultures at RSPAD Gatot Soebroto, Jakarta, using microbiology and medical record data from January-December 2019. Clinically significant isolates were included, while duplicates and contaminants were excluded. Identification and susceptibility testing followed standard procedures and CLSI 2019 guidelines. Data were analyzed descriptively. Among 482 isolates, 246 (51.0%) were Gram-positive and 236 (49.0%) were Gram-negative. The Gram-positive isolates were mainly coagulase-negative staphylococci, including Staphylococcus epidermidis (62, 25.2%), S. hominis (61, 24.8%), and S. haemolyticus (50, …


Analysis Of Pharmacotherapy And Non-Pharmacotherapy Burden From The Ina-Cbgs Package For Cesarean Section Surgery At The Regional General Hospital Dr. Soedarso In 2023, Ananda Rizky Awwaliyah, Nurmainah Nurmainah, Ridha Ulfah Aug 2026

Analysis Of Pharmacotherapy And Non-Pharmacotherapy Burden From The Ina-Cbgs Package For Cesarean Section Surgery At The Regional General Hospital Dr. Soedarso In 2023, Ananda Rizky Awwaliyah, Nurmainah Nurmainah, Ridha Ulfah

Pharmacology and Clinical Pharmacy Research

The prevalence of cesarean sections has been increasing each year. Previous studies show that the cost of medications and medical supplies for cesarean patients accounts for one-third of the total care costs. In the era of National Health Insurance (NHI), medications and medical supplies are considered operational expenses for hospitals rather than sources of income. This condition requires proper medication management and the use of medical supplies. This study aims to analyze the percentage of pharmacotherapy and non-pharmacotherapy, including the types and quantities of medications as well as disposable medical supplies used on patients undergoing cesarean section procedures at the …


Alexithymia In Substance Use Disorders: A Scoping Review Of Therapeutic Approaches, Pratami Diah Herliani, Shelly Iskandar, Angela Vera Herman Efendi Aug 2026

Alexithymia In Substance Use Disorders: A Scoping Review Of Therapeutic Approaches, Pratami Diah Herliani, Shelly Iskandar, Angela Vera Herman Efendi

Pharmacology and Clinical Pharmacy Research

Alexithymia, defined as the inability to recognize and express emotions, has a high prevalence (40–50%) among individuals with substance use disorders (SUD), particularly alcohol use disorder, and is associated with poorer clinical outcomes. Despite this, comprehensive mapping of psychotherapeutic interventions targeting this condition within the SUD population remains limited. This study aimed to systematically map the therapeutic approaches investigated to address alexithymia among individuals with substance use disorders and to summarize the reported outcomes. A scoping review was conducted in accordance with the PRISMA-ScR guidelines using systematic literature searches in the PubMed and Scopus databases. Relevant studies were screened based …


The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea Aug 2026

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …


Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells Aug 2026

Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells

The Qualitative Report

This paper introduces relational–developmental autoethnography (RDA), a qualitative method for exploring psychological growth through personal writing and reflection. Developed through lived experience, RDA traces psychological development through sustained, recursive engagement with personal writing. Drawing on an archive of my journals, letters, clinical records, and correspondence spanning more than 30 years, I show how writing and reflection were first tools for my survival, and later became catalysts for insight, healing, and transformation. RDA is grounded in two developmental frameworks: Dąbrowski’s theory of positive disintegration, which views emotional intensity and inner conflict as signs of developmental potential, and relational-cultural theory, which …


Isolation, Structural Characterization, And In Vitro Bioactivity Assessment Of Extracellular Vesicles Derived From Lacticaseibacillus Paracasei, Dwi Liza Ramadiani, Ratika Rahmasari, Tri Wahyuni, Kusmiati Kusmiati, Herman Irawan, Khatarina Meldawati Pasaribu Aug 2026

Isolation, Structural Characterization, And In Vitro Bioactivity Assessment Of Extracellular Vesicles Derived From Lacticaseibacillus Paracasei, Dwi Liza Ramadiani, Ratika Rahmasari, Tri Wahyuni, Kusmiati Kusmiati, Herman Irawan, Khatarina Meldawati Pasaribu

Pharmaceutical Sciences and Research

The field of study on extracellular vesicles (EVs) has recently focused on probiotic bacteria, due to their ability to exhibit a wide variety of biological activity. Therefore, this study aims to evaluate the effect of nutrient modulation during Lacticaseibacillus paracasei cultivation on EVs production and bioactivity. EVs were isolated by ultrafiltration method and were characterized using NTA and cryo-TEM. An in vitro evaluation was used to assess the bioactivities, antioxidant properties, anti-inflammatory potential, and ability to inhibit α-glucosidase activity. The results showed that the 2 LPEV exhibited the characteristics of vesicles with size of 96.04–100.29 nm. Cultivation in 50% MRS …


The Evaluation Of A Soft Skills Curriculum In Athletic Training Education: A Mixed Methods Study, Emily A. Duckett, Heather Schugar, Alison Gardiner-Shires, Jacqueline S. Hodes Aug 2026

The Evaluation Of A Soft Skills Curriculum In Athletic Training Education: A Mixed Methods Study, Emily A. Duckett, Heather Schugar, Alison Gardiner-Shires, Jacqueline S. Hodes

Clinical Practice in Athletic Training

Context: Developing athletic training students’ soft skills to effectively engage in patient-centered care is integrated throughout multiple Commission on Accreditation of Athletic Training Education Curricular Content Standards. Despite evidence supporting the importance of compassionate care, there is currently data to suggest that health care is experiencing a compassion crisis. The purpose of this study was to investigate the ways pre-professional athletic training students transfer knowledge from a soft skills curriculum to clinical experiences as students in an entry level master’s program.

Methods: This study is an explanatory sequential mixed methods design. Phase 1 includes participants (n = 19) enrolled in …


Building On A Strong Foundation: Celebrating Our Past And Looking Toward The Future, Zachary K. Winkelmann Aug 2026

Building On A Strong Foundation: Celebrating Our Past And Looking Toward The Future, Zachary K. Winkelmann

Clinical Practice in Athletic Training

No abstract


Predictors Of Complete Obliteration And Favourable Outcome After Single-Modality Treatment For Low-Grade Arteriovenous Malformations: A Multicentre Study, Angelica Fuentes, Salem Tos, Natasha Ironside, Georgios Mantziaris, Yuki Shinya, Basel Musmar, Hamza Adel Salim, Nimer Adeeb, Christopher Ogilvy, Douglas Kondziolka, Ali Alaraj, Min Park, Adam Dmytriw, Hussein Zeineddine, Finn Mccarthy, Hussam Abou-Al-Shaar, Ahmed Abdelsalam, Mustafa Baskaya, Cagdas Ataoglu, Anthony Sanchez-Forteza, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Howard Riina, Arwin Rezai, Sahin Hanalioglu, Ufuk Erginoglu, Johannes Pöppe, Davide Simonato, Yan-Lin Li, Sandeep Kandregula, Dhairya Lakhani, Christoph Griessenauer, Rahim Abo Kasem, Alejandro Spiotta, Ajit Puri, Jasmeet Singh, Anna Luisa Kuhn, Jan Karl Burkhardt, Robert Starke, Laligam Sekhar, Michael Levitt, David Altschul, Neil Haranhalli, Malia Mcavoy, Paul Foreman, Osama Zaidat, Mohammad Almajali, Hakeem Shakir, Alfred Pokmeng See, Adib Abla, Aashay Patel, Andrew Nguyen, Matthew Koch, Visish Srinivasan, Peng Roc Chen, Spiros Blackburn, Ketan Bulsara, Peter Kan, Louis Kim, Omar Choudhri, Stavropoula Tjoumakaris, Pascal Jabbour, Amey Savardekar, Hugo Cuellar, Michael Lawton, Bharat Guthikonda, Jacques Morcos, Jason Sheehan Aug 2026

Predictors Of Complete Obliteration And Favourable Outcome After Single-Modality Treatment For Low-Grade Arteriovenous Malformations: A Multicentre Study, Angelica Fuentes, Salem Tos, Natasha Ironside, Georgios Mantziaris, Yuki Shinya, Basel Musmar, Hamza Adel Salim, Nimer Adeeb, Christopher Ogilvy, Douglas Kondziolka, Ali Alaraj, Min Park, Adam Dmytriw, Hussein Zeineddine, Finn Mccarthy, Hussam Abou-Al-Shaar, Ahmed Abdelsalam, Mustafa Baskaya, Cagdas Ataoglu, Anthony Sanchez-Forteza, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Howard Riina, Arwin Rezai, Sahin Hanalioglu, Ufuk Erginoglu, Johannes Pöppe, Davide Simonato, Yan-Lin Li, Sandeep Kandregula, Dhairya Lakhani, Christoph Griessenauer, Rahim Abo Kasem, Alejandro Spiotta, Ajit Puri, Jasmeet Singh, Anna Luisa Kuhn, Jan Karl Burkhardt, Robert Starke, Laligam Sekhar, Michael Levitt, David Altschul, Neil Haranhalli, Malia Mcavoy, Paul Foreman, Osama Zaidat, Mohammad Almajali, Hakeem Shakir, Alfred Pokmeng See, Adib Abla, Aashay Patel, Andrew Nguyen, Matthew Koch, Visish Srinivasan, Peng Roc Chen, Spiros Blackburn, Ketan Bulsara, Peter Kan, Louis Kim, Omar Choudhri, Stavropoula Tjoumakaris, Pascal Jabbour, Amey Savardekar, Hugo Cuellar, Michael Lawton, Bharat Guthikonda, Jacques Morcos, Jason Sheehan

Department of Neurology Faculty Papers

INTRODUCTION: Patient and arteriovenous malformation (AVM) characteristics that portend success after treatment for low-grade brain AVMs remain unknown.

PATIENTS AND METHODS: We utilised the MISTA multicentre registry to identify patients with Spetzler-Martin (SM) grade I or II AVMs treated with stand-alone curative-intent intervention (resection, stereotactic radiosurgery [SRS] or endovascular embolisation). Bivariate and multivariable analyses were performed to identify patient and AVM characteristics predictive of complete obliteration or favourable outcome (complete obliteration without new permanent deficit or post-treatment haemorrhage).

RESULTS: A total of 522 patients were included (292 microsurgery, 152 SRS, 78 embolisation). Complete obliteration rates differed between microsurgery (95.9%), SRS …


Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah Aug 2026

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …


Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou Aug 2026

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …


Provincial Disparities In Adolescent Fertility In Indonesia: An Ecological Analysis Of Child Marriage, Median Age At First Marriage, And Family Development Index, Andi Nisa Fathimiyah Afidah, Milla Herdayati Aug 2026

Provincial Disparities In Adolescent Fertility In Indonesia: An Ecological Analysis Of Child Marriage, Median Age At First Marriage, And Family Development Index, Andi Nisa Fathimiyah Afidah, Milla Herdayati

Kesmas

Adolescent fertility remains a public health concern in Indonesia, with substantial variations across provinces. However, the evidence explaining provincial disparities using population-level indicators remains limited. This study aimed to examine provincial disparities in adolescent fertility and assess the association of child marriage, median age at first marriage among women, and the Family Development Index called iBangga with adolescent fertility across Indonesia. This ecological, cross-sectional study used aggregated data from 34 Indonesian provinces. Descriptive statistics, spatial visualization, Pearson’s correlation, and multiple linear regression analyses were performed. The mean adolescent fertility rate was 25.0 births per 1,000 female adolescents aged 15–19 years, …


Validation Of A Home-Based Tool For Preschool Children Fall Prevention: A Rasch Analysis, Devie Fitri Octaviani, Fatma Lestari, Indang Trihandini, Dadan Erwandi Aug 2026

Validation Of A Home-Based Tool For Preschool Children Fall Prevention: A Rasch Analysis, Devie Fitri Octaviani, Fatma Lestari, Indang Trihandini, Dadan Erwandi

Kesmas

Unintentional falls are a leading cause of injury among preschool children, primarily occurring in home environments, yet validated tools to assess household fall prevention capacity in low- and middle-income countries remain limited. This study aimed to develop and psychometrically validate the Home-Based Preschool Fall Prevention Instrument using the Rasch Measurement Model. A cross-sectional validation study was conducted in Depok City, Indonesia, involving 167 primary caregivers of preschool children enrolled in kindergartens selected through multistage cluster random sampling. The instrument was developed based on an etiological injury model, socio-ecological perspectives, and risk management principles, and comprised four main factors: child, home, …


Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana Aug 2026

Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana

Kesmas

Rheumatoid arthritis (RA) leads to progressive functional impairment and considerable economic burden. This study estimated the annual (12-month) cost per patient among patients with RA and its determinant factors. A descriptive cross-sectional economic study of RA patients who had been treated for at least one year at the outpatient clinic of a national referral hospital in Jakarta, Indonesia, and met the 2010 ACR–EULAR criteria. Data collected from January 2023 to December 2024 were obtained from medical and billing records for demographic characteristics, direct medical costs, and DAS28-based disease activity, whereas non-medical and indirect costs were collected through structured patient interviews. …


Understanding Oral Habits And Malocclusion In School-Aged Children: Insights From Parental And Child Knowledge, Attitudes, And Practices, Maria Laurentia Sanjaya, Evan Raditya Pratomo, Markus Santoso, Agrippine Putricia Asaeli, Eveline Yulia Darmadi, Joy Janny Thenarianto, Jennifer Regina Putri Purwono, Eunike Jacquelyn Widarto Aug 2026

Understanding Oral Habits And Malocclusion In School-Aged Children: Insights From Parental And Child Knowledge, Attitudes, And Practices, Maria Laurentia Sanjaya, Evan Raditya Pratomo, Markus Santoso, Agrippine Putricia Asaeli, Eveline Yulia Darmadi, Joy Janny Thenarianto, Jennifer Regina Putri Purwono, Eunike Jacquelyn Widarto

Kesmas

Malocclusion is a prevalent oral health problem in children associated with oral bad habits, yet the extent to which parental and child knowledge, attitudes, and practices (KAP) influence orthodontic status remains insufficiently understood. This cross-sectional study investigated relationships between parental and child KAP, oral habits, and malocclusion in school-aged children, involving 67 child–parent pairs from an elementary school in Surabaya, Indonesia. Parental and child KAP as well as child-reported oral habits were assessed using a validated questionnaire. Children subsequently underwent standardized clinical orthodontic examinations, including alginate jaw impressions to produce dental study models, which were evaluated using the Index of …


The Association Between Rapid Growth In Children Under The Age Of Five And Adolescent Obesity, Ratu Ayu Dewi Sartika, Fadila Wirawan, Iche Andriyani Liberty, Nurul Husna Mohd Shukri, Siti Arifah Pujonarti, Edy Purwanto, Munaya Fauziah Aug 2026

The Association Between Rapid Growth In Children Under The Age Of Five And Adolescent Obesity, Ratu Ayu Dewi Sartika, Fadila Wirawan, Iche Andriyani Liberty, Nurul Husna Mohd Shukri, Siti Arifah Pujonarti, Edy Purwanto, Munaya Fauziah

Kesmas

Early-life nutrition is a critical predictor of long-term health, yet the association between rapid early-childhood growth and adolescent obesity, particularly in relation to the “double burden of malnutrition,” remains under-researched in Indonesia. This study aimed to analyze the association between rapid growth and adolescent obesity. Data were obtained from the 1997, 2000, and 2014 waves of the Indonesian Family Life Survey (IFLS). This study included 641 children (aged 0–23 months at baseline) with complete anthropometric measurements across all three waves. Rapid growth was defined as an increase in z-scores of >0.67 in weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) between …


Self-Management Interventions For Adults With Type 2 Diabetes Mellitus In Thai Primary Care And Community Settings: A Scoping Review, Sansanee Seetangkham, Supaluk Seetunya, Subhawan Yodprong Aug 2026

Self-Management Interventions For Adults With Type 2 Diabetes Mellitus In Thai Primary Care And Community Settings: A Scoping Review, Sansanee Seetangkham, Supaluk Seetunya, Subhawan Yodprong

Kesmas

Diabetes mellitus is a leading cause of mortality and economic burden, with significant impacts on health outcomes and quality of life. Effective self-management is crucial for controlling Type 2 Diabetes Mellitus (T2DM). Thailand has implemented diverse self-management interventions for adults with T2DM in primary care and community settings, but the components, delivery, duration, and outcomes of these interventions have not been synthesized. Following the Arksey and O’Malley framework, Joanna Briggs Institute guidance, and PRISMA-ScR, five databases were searched from inception to June 2025. Eligible English-language intervention studies involved Thai adults with T2DM in primary care or community settings. Study characteristics …


Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli Aug 2026

Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli

Kesmas

This study developed a system dynamics model to simulate stunting reduction in West Sumatra Province, Indonesia, by integrating infant and toddler health, maternal health, and environmental determinants. Secondary data from 2020–2024 on low birth weight, immunization, malnutrition, exclusive breastfeeding, maternal chronic energy deficiency, iron and folic acid supplement distribution, sanitation, and safe drinking water access were compiled from West Sumatra Provincial Health Office and Statistics Indonesia, and validated through consultation with five stakeholder institutions. Causal Loop Diagrams mapped feedback relationships among determinants and were translated into Stock Flow Diagrams using Powersim Studio 10. The model was validated through structural verification, …


Management Of Peri-Implant Soft Tissue Dehiscence Using Laterally Closed Tunneling With A Connective Tissue Graft: A Case Report, Hisham Tarek Aug 2026

Management Of Peri-Implant Soft Tissue Dehiscence Using Laterally Closed Tunneling With A Connective Tissue Graft: A Case Report, Hisham Tarek

Dentistry

ABSTRACT Peri-implant soft tissue dehiscence is an esthetic complication for which coronally advanced flap with connective tissue grafting remains a predictable treatment, whereas evidence for laterally closed tunneling (LCT) around implants is limited. This single-patient case report describes a 4 × 3 mm labial peri-implant soft tissue dehiscence at an immediately placed implant replacing the maxillary left central incisor. LCT combined with a de-epithelialized free gingival graft and limited implantoplasty was performed. At 24 months, complete coverage was maintained; buccal soft tissue thickness increased from 1.0 to 2.7 mm, keratinized tissue width from 1 to 3 mm, Pink Esthetic Score …


Current Procedural Terminology Codes Combined With Hip And Femur Diagnosis-Related Groups Provide A More Accurate Assessment Of Costs., Robert A. Hymes, Daniel L. Rodkey, Max A. Schulman, Christopher Kuenze, Jeff E. Schulman, Jalen N. Broome, Sydney L. Payne, Greg E. Gaski Aug 2026

Current Procedural Terminology Codes Combined With Hip And Femur Diagnosis-Related Groups Provide A More Accurate Assessment Of Costs., Robert A. Hymes, Daniel L. Rodkey, Max A. Schulman, Christopher Kuenze, Jeff E. Schulman, Jalen N. Broome, Sydney L. Payne, Greg E. Gaski

Jefferson Hospital Staff Papers and Presentations

Introduction: Diagnosis-Related Groups (DRGs) have become the basis of the Center of Medicare & Medicaid Services (CMS) hospital reimbursement system. Wide variability of patient factors and procedures bundled into a single DRG may contribute to significant cost variation and limited usefulness when analyzing economic performance. This investigation sought to analyze variation in hip and femur fracture inpatient costs as assessed by DRG and Current Procedural Terminology (CPT) codes.

Materials and methods: Patients age ≥ 18 treated with operatively managed fractures of the hip and femur at a Level 1 trauma center from 2019 to 2021 were retrospectively reviewed. Patients categorized …


Variation In Meningioma Recurrence Risk Estimates Across Observational Cohorts: The Influence Of Calendar Time, Who Classifications, Geographical Settings, And Healthcare Systems, Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Luca Bertero, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Soichi Oya, Satoru Miyawaki, Nobuhito Saito, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Jennifer Moliterno, Ricardo Prat-Acin, Stéphane Goutagny, Vikram C Prabhu, John T Tsiang, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Karthikeyan Perumal, Mustafa K Baskaya, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W Mcdermott, Fang Wang, Pedro Góes, Manoel Antonio De Paiva Neto, Ricardo Komotar, Michael E Ivan, Aria Jamshidi, Evan Luther, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Olivia Claire Barrett, Randy Jensen, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen, Andrea Daniela Maier Aug 2026

Variation In Meningioma Recurrence Risk Estimates Across Observational Cohorts: The Influence Of Calendar Time, Who Classifications, Geographical Settings, And Healthcare Systems, Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Luca Bertero, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Soichi Oya, Satoru Miyawaki, Nobuhito Saito, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Jennifer Moliterno, Ricardo Prat-Acin, Stéphane Goutagny, Vikram C Prabhu, John T Tsiang, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Karthikeyan Perumal, Mustafa K Baskaya, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W Mcdermott, Fang Wang, Pedro Góes, Manoel Antonio De Paiva Neto, Ricardo Komotar, Michael E Ivan, Aria Jamshidi, Evan Luther, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Olivia Claire Barrett, Randy Jensen, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen, Andrea Daniela Maier

Duncan NRI Faculty and Staff Publications

Purpose: Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables.

Results: Recurrence risk …


Nicotine Pouches: Harm Reduction Or Initiation Pathway? A Pharmacy-Focused Review, Emmanuel Fashesin Souza, Keykavous Parang Aug 2026

Nicotine Pouches: Harm Reduction Or Initiation Pathway? A Pharmacy-Focused Review, Emmanuel Fashesin Souza, Keykavous Parang

Pharmacy Faculty Articles and Research

Background

Nicotine pouches (NPs) are a rapidly growing category of tobacco-free oral nicotine products increasingly available in the community, including pharmacies. Whether NPs primarily function as harm-reduction tools for existing tobacco users or as a novel initiation pathway into nicotine and tobacco use, particularly among youth, remains a critical and unresolved clinical and public health question.

Objectives

To synthesize current evidence on the pharmacology, harm-reduction potential, and initiation risk of NPs; to compare NPs with U.S. Food and Drug Administration-approved nicotine replacement therapy and combustible cigarettes; and to identify implications and counseling priorities for pharmacy practice.

Methods

A narrative evidence …


Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher Aug 2026

Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Scholarly productivity is a key marker of achievement in academic ophthalmology, influencing promotion, research support, and leadership opportunities. Prior studies have reported variation by gender, subspecialty, and rank, but few applied regression methods to identify independent predictors.

Purpose: To evaluate demographic, academic, and subspecialty factors associated with research productivity among U.S. academic ophthalmologists and to identify independent predictors through multivariable regression.

Methods: This cross-sectional study included 4,028 ophthalmologists across 126 accredited U.S. residency programs using the U.S. Academic Ophthalmology Faculty Database (US-AOFD). Faculty demographics and academic information were obtained from institutional websites, and bibliometric data (publications, …


Contextualizing Second Language Anxiety In Multilingual Higher Education: Classroom Conditions And Clinical Settings, Busayo O. Ige Aug 2026

Contextualizing Second Language Anxiety In Multilingual Higher Education: Classroom Conditions And Clinical Settings, Busayo O. Ige

International Journal of Teaching and Learning in Higher Education

In South African universities, multilingual students whose first language is not English face distinct challenges that impact academic participation and success. This qualitative study examines how second language (L2) anxiety shapes first-year students’ classroom and clinical experiences at the University of Cape Town. Drawing on open-ended survey data, the study reveals that fear of negative evaluation, communicative apprehension, and prevailing language ideologies contribute to students’ reluctance to speak, feelings of invisibility, and withdrawal from engagement. Although anxiety tends to lessen over time, it rarely disappears completely. Notably, students experienced anxiety differently across settings: classroom discussions elicited greater fear and self-censorship, …