Medicine and Health Sciences Commons^™

Reinforcement Learning Improves Llm Accuracy And Reasoning In Disease Classification From Radiology Reports, Yishu Wei, Yi Lin, Adam Flanders, George Shih, Yifan Peng

Department of Radiology Faculty Papers

Accurate disease classification from radiology reports is essential for many applications. While supervised fine-tuning (SFT) of lightweight LLMs improves accuracy, it can degrade reasoning. We propose a two-stage approach: SFT on disease labels followed by Group Relative Policy Optimization (GRPO) to refine predictions by optimizing accuracy and format without reasoning supervision. Across three radiologist-annotated datasets, SFT outperformed baselines and GRPO further improved classification and enhanced reasoning recall and comprehensiveness.

Time And Dose Dependent Effects Of Adipose-Derived Stromal Vascular Fraction Exosomes On Human Dental Pulp Stem Cell Proliferation, Sylva Dinie Alinda, Anggraini Margono, Indah Julianto, Dini Asrianti Bagio

Journal of Dentistry Indonesia

Background: Cell proliferation is essential for tissue repair and immunomodulation in regenerative dentistry. Adipose-derived stromal vascular fraction (AD-SVF) is a promising autologous source for tissue engineering. Its exosomes (AD-SVF Exo), as cell-free products stable under ischemic conditions, represent an ethical and attractive modality for dental tissue regeneration and broader regenerative applications. Prior study indicates that AD-SVF Exo can enhance human dental pulp stem cell (hDPSC) migration and proliferation, particularly at low concentrations, but their detailed time- and dose-dependent proliferative effects remain unclear. This study aimed to investigate the time- and dose-dependent effects of low-concentration AD-SVF Exo on hDPSC proliferation …

Comparison Of Chop And R-Chop For Treatment Non-Hodgkin Lymphoma, Yogyakarta, Indonesia: A Cost-Effectiveness Analysis, Woro Supadmi, Rizky Gustinanda, Lalu M. Irham, Riat El Khair

Pharmacology and Clinical Pharmacy Research

CHOP and R-CHOP are commonly used chemotherapy regimens for Non-Hodgkin Lymphoma (NHL). While R-CHOP has demonstrated clinical benefits, its higher cost raises concerns regarding economic efficiency, particularly in middle-income countries such as Indonesia. This study aimed to compare direct medical costs and clinical outcomes of CHOP and R-CHOP regimens among NHL patients treated at a national referral hospital in yogykarta. A retrospective cohort study was conducted using medical record data of NHL patients who received CHOP or R-CHOP chemotherapy at Dr. Sardjito General Hospital Yogyakarta, between 2020 and 2023, with follow-up extended until April 30, 2025. Clinical outcomes included overall …

Balanced Scorecard In Healthcare Facilities: A Ten-Year Review Of Strategies To Improve Organizational Effectiveness, Larasati Tunggadewi, Sofa Dewi Alfian, Auliya A Suwantika

Pharmacology and Clinical Pharmacy Research

The Balanced Scorecard (BSC) has increasingly been adopted as a strategic performance management framework within healthcare organizations. Evidence from the past decade shows varied implementation outcomes, shaped by institutional readiness, leadership commitment, and the maturity of health information systems. This narrative review synthesizes findings from 47 scientific articles selected through a systematic screening process, covering studies conducted in hospitals, primary health centers, and pharmacy units in Indonesia, Morocco, Iran, China, and other countries. The studies employed case study and descriptive cross-sectional designs using both quantitative and qualitative approaches. Overall, BSC implementation contributed to improvements in service performance across the financial, …

Exploring Protein-Protein Interactions: A Promising Avenue For Biomarker And Anti-Tb Drug Development, Rajwa Dwifauza Suryanto, Maritsa Widati Aqila Rumawan, Imam Adi Wicaksono

Pharmacology and Clinical Pharmacy Research

In 2023, tuberculosis (TB) reached its highest incidence with 8.2 million new cases reported by the World Health Organization (WHO). The virulence of Mycobacterium tuberculosis (MTB) is strongly governed by protein-protein interactions (PPIs) that regulate essential processes such as cell wall biosynthesis, immune evasion, and persistence. This study aims to map and analyze the mechanisms of key PPIs in MTB using a scoping review approach. Data was retrieved from PubChem and related literature with the keyword ``PPIs Network TB''. Our findings highlight crucial PPI-driven mechanisms, including the role of DprE1/DprE2 in arabinogalactan synthesis, VapB4/VapC4 in stress response and self-toxicity, ESX-1 …

Low To Moderate Intensity Home-Based And Online Exercise For Cognitive Health In Older Adults: A Narrative Review, Novita Salim, Melisa Intan Barliana, Anna Meiliana

Pharmacology and Clinical Pharmacy Research

Cognitive decline represents one of the most pressing public health challenges associated with global population ageing, prompting growing interest in accessible and scalable exercise-based interventions. This narrative review synthesizes evidence from 15 randomized controlled trials to compare the cognitive effects of 3 exercise modalities in older adults across varying cognitive and functional profiles: conventional aerobic and resistance training, exergame-based interventions, and dual-task or multicomponent training. Interventions were evaluated on their capacity to improve global cognition, executive function, working memory, and attention, with additional consideration of adherence, supervision format, and implementation feasibility. The evidence consistently demonstrates that dual-task and multicomponent training …

Evaluation Of Drug Use In Inpatient Care: A Retrospective Study At A Tertiary Hospital In Bandung, Indonesia (2024), Aliya Rosyidah Fitrianti, Athoya Delarosa, Husna Muharram Ahadi, Imam Adi Wicaksono, Falerina Puspita

Pharmacology and Clinical Pharmacy Research

Rational drug use is a critical component of improving healthcare quality. However, irrational prescribing remains a significant concern, particularly in developing countries like Indonesia. This study evaluates drug use patterns at a Type B hospital in Bandung using WHO standard: average number of drugs per prescription, percentage of generic drugs, antibiotics, injections, and adherence to the National Formulary. A retrospective, descriptive observational method was applied, using 2024 inpatient Drug Use Evaluation (DUE) data. Findings reveal an average of 3.4 drugs per prescription—slightly above the WHO standard (≤ 3.3); 68.4% of prescriptions used generic drugs (meeting the WHO standard ≥ 59%); …

Comparative Analysis Of The Quality Of Life Of Schizophrenic Patients On Antipsychotic Treatment Between Aripiprazole Monotherapy And Combination Of Risperidone-Clozapine At Mental Hospital In West Java, Taufiqurahman Taufiqurahman, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Quality of life (QoL) is a critical outcome measure in schizophrenia management, yet antipsychotic side effects may negatively impact patients' well-being. Objective: This study aimed to compare the QoL of schizophrenia patients receiving aripiprazole monotherapy versus a risperidone-clozapine combination at West Java Mental Hospital. An analytical observational study with a cross-sectional design was conducted at the outpatient clinic of West Java Mental Hospital from March to May 2025. The Indonesian version of the WHOQOL-BREF questionnaire was used to assess QoL. A total of 58 outpatients with schizophrenia who met the inclusion criteria were enrolled, comprising 28 patients in the aripiprazole …

Adherence To Malaria Treatment And Its Associated Factors: A Narrative Review, Lafie Urwatul Wutsqo, Eli Halimah, Sofa Dewi Alfian

Pharmacology and Clinical Pharmacy Research

Malaria is an infectious disease that remains a global health concern, particularly in Asia and Africa. The success of malaria medication largely depends on patients' adherence to the prescribed therapeutic regimen. This article aims to identify the level of adherence to malaria treatment and the factors that influence it, based on observational studies. A narrative review was conducted using the PRISMA approach, involving 12 articles published between 2019 - 2023 from various countries. The results indicate that adherence levels vary widely, ranging from 15.6% to 93.31%, depending on respondent characteristics and the intervention strategies implemented. Factors influencing adherence include patient-related …

Patterns Of Adverse Drug Reactions In Tuberculosis Treatment: A Literature Review, Jasmine R. Aisyah, Ivan S. Pradipta, Widya N. Insani

Pharmacology and Clinical Pharmacy Research

Tuberculosis (TB) treatment is often interrupted by adverse drug reactions (ADRs). However, few studies have thoroughly examined these ADR patterns in TB treatment, and no research has assessed the prevalence of ADRs in specific organs. This narrative review describes the patterns of ADRs in tuberculosis treatment, including how common each type is and its impact on organs across different countries and populations. A structured narrative literature review was conducted to identify relevant original studies published in PubMed database between 2019 and 2025. The search combined Medical Subject Headings (MeSH) and free-text terms related to ``tuberculosis'' and ``adverse drug reactions''. Eligible …

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …

The Relationship Between Obesity Among Children And Adolescents With Dietary Intake And Physical Activity: A Scoping Review, Devi Dwi Yolani, Tania Okta Wardhani, Rani Aqilah Ni’Matul Maula, Almira Sitasari, Tri Siswati

Indonesian Journal of Public Health Nutrition (IJPHN)

Childhood and adolescent obesity remain a significant public health issue worldwide. This review summarizes research on the relationship among obesity, physical activity, and diet. This study aims to investigate the relationship between children's and adolescents' obesity, their physical activity levels, and diet. A scoping review was conducted by assessing 81 research journal articles from 2014 to 2023 from electronic databases such as Google Scholar and PubMed. The search strategy used Boolean operators as follows: (“child*” OR “adolescent”) AND (“obesity”) AND (“diet” OR “food intake”) AND (“physical activity”), selected based on the inclusion criteria of children and adolescents aged 1-18 years …

Integrating Nutrition Education To Improve The Effectiveness And Sustainability Of Makan Bergizi Gratis Programs, Akifa Laila Rusyda, Dewi Firda Sari, Ida Fransiska Pandiangan, Putri Mulifajar Gintings

Indonesian Journal of Public Health Nutrition (IJPHN)

The Makan Bergizi Gratis (MBG) program represents Indonesia's strategic effort to strengthen human capital by addressing malnutrition among school-aged. However, evidence suggests that school feeding alone is insufficient without structured nutrition education to promote sustained behavioral change. The present study examines opportunities and feasibility for embedding nutrition education within MBG implementation. Two-stage design was performed, including curriculum content reviews and qualitative case study design. A systematic curriculum content analysis was conducted across the school-based curriculum (KTSP) (2006), K-13 curriculum (2013 – 2017), and the Merdeka curriculum (2022 - present), using predefined nutrition competencies and behavioral domains as analytical frameworks. Purposive …

The Effect Of Education Using The Lecture Method And Puzzle Games On The Level Of Knowledge And Attitude Toward Balanced Nutrition Among Students Of Sdn Pakintelan 01 In Gunung Pati District, Semarang City, Erlin Nurlina, Syifa Qolbiyah Nasir

Indonesian Journal of Public Health Nutrition (IJPHN)

Fulfilled nutritional needs play an important role at school age. The beginning of nutritional problems occurs due to knowledge factors, so it is necessary to implement efforts to provide information about balanced nutrition. Nutrition education research using lecture and puzzle game methods was conducted at SDN Pakintelan 01 aimed at determining changes in the level of knowledge and attitudes of students regarding balanced nutrition. The type of research is Quasy Experiment and uses a pretest-post test design with control group design. The sampling technique uses stratified random sampling. The number of samples of the control group given education (lecture method) …

Fiber Content, Total Sugar, And Glycemic Index Of Jackfruit Seed And Pigeon Pea Flour Snack Bar, Dhiyaa Septi Kirana, Tesa Rafkhani

Indonesian Journal of Public Health Nutrition (IJPHN)

Diabetes Mellitus (DM) in Indonesia is the 7th leading cause of death. Diets high in sugar and glycemic index, and low in fiber are known to trigger hyperglycemia. Snack bars high in fiber and low in glycemic index are known to reduce blood glucose levels. This research aims to determine a snack bar formulation made from jackfruit seed and pigeon pea flour and analyze fiber content, total sugar, and glycemic index value. This study used a completely randomized design analyzing three different proportions of jackfruit seed and pigeon pea flour, namely F1 (30%:70%), F2 (40%:60%), and F3 (50%:50%) with two …

Food Fortification Strategies To Address Micronutrient Deficiencies In Cambodia: A Scoping Review Of Policy Implementation, Industry Capacity, And Public Health Outcomes, Sokha Yem, Sreypeov Tun, Sokunthea Kem

Indonesian Journal of Public Health Nutrition (IJPHN)

Background: Micronutrient deficiencies remain a major public health challenge in Cambodia, with iron deficiency anaemia, iodine deficiency disorders, zinc deficiency, and vitamin A deficiency disproportionately affecting women of reproductive age and children under five. Food fortification—the deliberate addition of essential micronutrients to commonly consumed foods—has been widely recognised as a cost-effective population-level intervention to address nutritional gaps. Objective: To systematically map and synthesise existing evidence on food fortification strategies in Cambodia, focusing on policy implementation, industry production capacity and compliance, regulatory enforcement, and public health outcomes. Methods: A scoping review was conducted following the Arksey and O’Malley methodological framework and …

Volume 12 Full Text, Bjur Staff

Butler Journal of Undergraduate Research

No abstract provided.

Exploring Gender As An Analytical Framework In The 2018-2019 Revolution And Ongoing Civil War: The Role Of Gendered Violence And Sudanese Women's Resistance, Ami John

Butler Journal of Undergraduate Research

This paper will interrogate the intersection of gender, war, and political upheaval within Sudan while focusing on the role of women in both the 2019 resistance and the ongoing conflict and revolution. By the end of 2018, mass protests had called for the ousting of Omar al-Bashir, the long-standing Sudanese president. This event set off a chain reaction which led to events that fueled the long-standing rivalry between the two militant groups that were active in Sudan, the Rapid Support Forces (RSF) and the Sudanese Armed Forces (SAF). The tension caused by this rivalry created unforeseen circumstances for the local …

Front Matter And Table Of Contents, Bjur Staff

Butler Journal of Undergraduate Research

No abstract provided.

Bioactive Constituents And Pharmacological Activities Of Curcuma Zedoaria: A Mini-Review, Abdulmutalib Allaq, Muneer M. Saleh Mohammed Saleh Alsayadi, Mustapha Salihu, Hasan M. Agha, Amena Hassan Hassan Gheeth, Fatimah Salim, Norrizah Jaafar Jaafar Sidik

AUIQ Complementary Biological System

Curcuma zedoaria Rosc. (white turmeric) is a rhizomatous medicinal plant in the Zingiberaceae family, widely used in traditional Asian medicine. In recent years, increasing scientific attention has focused on its diverse pharmacological properties and bioactive constituents. This mini review summarises current knowledge of the phytochemical composition and biological activities of C. zedoaria, with particular emphasis on its antimicrobial, antioxidant, anti-inflammatory, and anticancer effects. Phytochemical investigations using analytical techniques such as GC–MS and HPLC have revealed the presence of numerous bioactive compounds, including sesquiterpenes (example, germacrone, curzerenone, and curdione) and curcuminoids, which contribute to its therapeutic potential. Experimental studies demonstrate …

Evaluation Of Circulating Hpg80, Ca15-3, Estrogen And Progesterone As Biomarkers In Breast Cancer Patients, Safa Khaldoon, Emad Yousif, Khawla A. Kasar, Muna Bufaroosha, Rahimi Yusop

AUIQ Complementary Biological System

It is very important to find reliable biomarkers for early detection and monitoring of treatment response because breast cancer is still one of the most common cancers in women around the world. The goal of this study was to find out how clinically important different biochemical markers are in Iraqi women with breast cancer. Some of these signs are progesterone (PG), oestrogen (E2), cancer antigen 15-3 (CA15-3), and circulating progastrin (hPG80). There were 100 women in this study, and they were all between the ages of 20 and 70. There were three groups of people who took part: a healthy …

Synergistic Endocytic Receptor Ligand Receptor Protein 2 In T2dm, Wafaa Raji Alfatlawi

AUIQ Complementary Biological System

Purpose: The glycoprotein molecule known as megalin is present on the proximal renal tubular epithelial cells. With an emphasis on megalin and cubilin levels in T2DM and IR patients, an area that obviously needs more research, this study attempts to give an outline of current knowledge of megalin function in relation to vitamin D and its metabolite (vitamin D receptor and vitamin D binding protein). Materials and Methods: This was a case control comparative study conducted at a endocrine and diabetes center in AL-Imamain Kadumain teaching hospital in Baghdad-Iraq. Study subjects were divided into three groups: 25 with T2DM with …

Veratridine Suppresses Rictor-Mtorc2 Signaling Pathway In Colon Cancer Patient-Derived Xenograft Cells, Morgan Daniel Montgomery

Honors Thesis

Colorectal cancer (CRC) remains the second deadliest and fourth most common cancer in the world. The metastatic form of CRC is especially devastating due to a lack of effective and safer therapeutic options. Another challenge includes an increasing number of younger patients. Among critical signaling pathways overactivated in CRC, mTORC2 plays a key role in the progression of metastatic CRC, yet there is no selective mTORC2 inhibitor in the clinic. Interestingly, a natural plant alkaloid from the Veratrum genus, Veratridine (VTD), shows promise as VTD can upregulate UBXN2A, a colon-specific tumor suppressor protein. UBXN2A works with E3 ligases to ubiquitinate …

Acute Effects Of Olympic Lifting Post-Activation Potentiation On Baseball Pitching Velocity And Ball Flight: A Crossover Study, Brent Hauser Pourciau

Doctoral Dissertations and Projects

This quantitative study evaluated the acute effect of an Olympic lifting-based post-activation potentiation (PAP) warm-up on fastball performance in collegiate baseball pitchers. Using a randomized, counterbalanced within-subjects crossover design (N = 13), each participant completed two warm-up conditions in a single indoor session: (a) a standard dynamic baseball warm-up and (b) the same standard warm-up followed by a brief Olympic-lifting PAP sequence (1 x 3 clean pulls at 80% predicted one-repetition maximum [1RM], 1 x 3 power cleans at 80% predicted 1RM, and 1 x 3 power jerks at 60% predicted 1RM, with 2-minute rests between sets) and a 3-minute …

A Functional Nutrition Literature Review For Brain Fog And Adhd-Like Symptoms In Adults, Natalie Elisani Aldahondo-Matos

Department of Nutrition Student Projects

Attention-deficit/hyperactivity disorder (ADHD) and ADHD-like symptoms, such as difficulty concentrating, mental fatigue, and problems with executive functioning, are increasingly recognized in adults. Although medication is commonly used to manage ADHD, there is growing interest in whether nutrition may also play a role in supporting brain function and attention. Several nutrients involved in brain health including omega-3 fatty acids, vitamin B12, magnesium, iron, and choline  have been suggested as potential contributors to cognitive performance and attention. However, the research examining the connection between diet and ADHD symptoms is still limited and sometimes shows mixed results.

The purpose of this project was …

Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND/AIM: We examined gene expression profiles in abdominal aortic aneurysm (AAA) lesions vs. normal aortas by cDNA microarray and real-time quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR).

MATERIALS AND METHODS: Phosphorus (³²P)-labeled cDNA from AAA specimens (mean AAA size 6.65 cm) and normal aortas were hybridized with a 588-gene microarray primarily of the cardiovascular system. The results were validated by qRT-PCR.

RESULTS: A total of 35 out of the 588 genes were differentially expressed, with either log₂ ratio of AAAs/controls ≥1 (upregulated; 20 genes) or ≤-1 (downregulated; 15 genes) in AAA lesions vs. normal aorta, and …

Autoantibody Reactivity In Hidradenitis Suppurativa: Characterizing Keratinocyte And Apocrine Gland Targets Across Disease Progression And Anti-Tnf-Α Treatment, Talla Hamouche

Student Theses and Dissertations

Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease associated with impaired quality of life, representing one of the highest burdens among dermatological conditions. This debilitating disorder primarily affects apocrine-gland-bearing and flexural skin areas, most commonly the axillae, breast, buttocks, and groin. As lesions recur and new sites emerge, surgical excision does not guarantee prevention of disease reestablishment. Despite its substantial burden, HS remains among the least understood and most treatment-resistant inflammatory diseases. The mechanisms underlying this chronicity and the frequent failure of conventional anti-inflammatory therapies remain unresolved. An underappreciated autoimmune dimension may contribute to HS pathogenesis: the clonal …

Garlic Breath And Beads Of Sweat: The Effects Of Garlic And Chili Peppers On The Growth And Ph Of Streptococcus Mutans., Lena Pitzer

Honors Projects

The purpose of this project is to provide a quantifiable and repeatable measurement of how the presence of garlic and chili pepper during the growth of a carious dentine strain of Streptococcus mutans affects the growth of the strain and surrounding pH level.This research project examines two possible alternative agents, garlic and chili peppers, due to the known antimicrobial effects of their active components, allicin and capsaicin. Prepared garlic and chili extracts were used during disk diffusion to assess and measure the zones of inhibition. The anticipated results are that there will be inhibition present with both the garlic and …

Cross-Sectional Associations Of Metabolically Healthy Obesity, Lifestyle Factors, And Steatotic Liver Disease In Adults From The Fels Longitudinal Study, Ariana L. Garza, Audrey C. Choh, John Blangero, Cici X. Bauer, Stefan A. Czerwinski, Miryoung Lee

School of Medicine Publications

Objective: To examine the associations of metabolic health and obesity phenotypes with liver fat accumulation and hepatic steatosis in adults. Methods: We analyzed 676 non-Hispanic white adults (18–95 years; 55.8% female) from the Fels Longitudinal Study using a cross-sectional design. Participants were classified into metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO) phenotypes. Metabolically unhealthy status was defined as the presence of ≥1 metabolic dysfunction, consistent with prior epidemiological definitions; secondary analyses using ≥2 were also performed. Obesity was defined using DXA-derived body fat percentage. Liver fat (%) was …

2026 - The Thirtieth Annual Symposium Of Student Scholars

Symposium of Student Scholars Program Books

The full program book from the 30th Annual Symposium of Student Scholars, held on April 22-24, 2026. Includes abstracts from the presentations and posters.