Medicine and Health Sciences Commons^™

Targeting Safety: Hazard Identification And Risk Assessment In The Work Of Wood Carving In Tunjungsekar, Malang City, Using The Hiradc Method, Resti Novita Sari, Awanda Putra Pratama, Maharani Rohma Hidayanti, Nadia Rosalinda, Nurmila Kurnia, Shalma Khoirun Nisa, Anita Sulistyorini

Preventia: The Indonesian Journal of Public Health

The furniture industry in Tunjungsekar Subdistrict has become one of the leading industrial centers in Malang City, successfully boosting the local economy by employing 90 percent of the workforce. However, this industry faces productivity challenges due to an ergonomically unfavorable work environment. Therefore, practical actions and in-depth analysis are needed to improve the work environment issues. This study aims to identify hazards and assess risks associated with the work of wood carving artisans in Tunjungsekar, Malang City, using the HIRADC (Hazard Identification, Risk Assessment, and Determining Control) method. Identification was carried out through direct observation and interviews with artisans, followed …

Relationship Between Personal Hygiene And Environmental Sanitation To The Presence Of Escherichia Coli Bacteria In Food, Erica Ardhana Fathimah Azzahra, Vivi Novianti, Muhammad Al-Irsyad

Preventia: The Indonesian Journal of Public Health

Food safety is one of the significant public health issues, especially in developing countries. The extraordinary incidence of food poisoning and a high number of cases of gastrointestinal infections in Malang City indicate infection with the bacteria that cause dysentery, namely E.coli. This study evaluated hygiene-sanitation practices at food stalls in Area Terusan Ambarawa Malang City. This study aimed to identify Escherichia coli bacteria in 11 food stalls and assess the relationship of environmental sanitation and personal hygiene of food handlers to the presence of E.coli. This study used a quantitative descriptive design with a cross-sectional approach, data collection using …

Effective Anterior Cruciate Ligament Injury Prevention Programming In Young Female Athletes: An Evidence-To-Practice Review, Janay Ward, Kina M. Ingram, Jackson Biffle, Emily E. Hildebrand, Peter Lisman

Clinical Practice in Athletic Training

Anterior cruciate ligament (ACL) injuries are common in adolescents, in particular females participating in sports requiring frequent jumping, pivoting, and rapid acceleration. Consequently, the prevention of ACL injury is a principal concern of athletic trainers and other sports medicine professionals. Neuromuscular training (NMT) programs have been effective in reducing ACL injury risk in athletic populations, though additional clarity on programmatic factors, such as exercise selection, timing, and training dosage is warranted. Therefore, the primary purpose of this evidence-to-practice review was to present which components of NMT programs have been found to be most effective in reducing ACL injury incidence in …

Roselle And Red Ginger: A Potential Combination Of Medicinal Plants For Hypertension Therapy, Ranum Wanudya Yunas, Siti Irma Rahmawati, Fadlina Chany Saputri, Asep Bayu, Giuseppina Chianese, Masteria Yunovilsa Putra

Pharmaceutical Sciences and Research

Hypertension is a prevalent cardiovascular condition that significantly increases the risk of heart disease and stroke. Effective management is essential to prevent severe complications. Roselle (Hibiscus sabdariffa L.) and red ginger (Zingiber officinale var. rubrum) are two medicinal plants known for their antihypertensive properties. Roselle contains bioactive compounds such as anthocyanins that exhibit vasodilatory and angiotensin-converting enzyme (ACE) inhibition, while red ginger is rich in gingerols and shogaols, which possess anti-inflammatory and vasodilatory properties. The complementary mechanisms of action of these two plants, including ACE inhibition, antioxidant activity, and modulation of vascular tone, result in a more …

Decreasing Antibiotic Turnaround Time In The Medical Intensive Care Unit: A Quality Improvement Project, Kacie Wright

Doctor of Nursing Practice Final Project Abstract

Purpose: This QI project aimed to increase the percentage of first-dose antibiotics administered within one hour of order placement to 80% in the ICU by 12/31/24.

Background: Antibiotic Turnaround Time (ATT) is the time between antibiotic order placement and administration. Prolonged ATT can cause adverse outcomes by delaying treatment. In 2023, only 54% of first-dose antibiotics were given within the EBP standard of one-hour in our 36-bed Medical ICU.

Methodology: The Six Sigma DMAIC model identified barriers and interventions to achieving target ATT using stakeholder input, process mapping, and root cause analysis. Multidisciplinary Plan-Do-Study-Act (PDSA) cycles were created to evaluate …

Wilson’S Disease Presenting As Acute Hepatitis In Pregnancy With Successful Maternal And Neonatal Outcomes: A Case Report, Paribesh Gyawali, Ranjan Regmi, Shambu Khanal, Rajan Bhandari, Shivani Gupta, Gunjan Arora

Graduate Medical Education Research Journal

Background: Wilson’s disease is a rare genetic disorder characterized by copper accumulation, leading to multi-organ symptoms. It affects between 1 in 30,000 to 1 in 100,000 individuals, with a mean age at diagnosis of 13.2 years. The diagnosis may be overlooked due to its numerous presentations, which can range from non-specific symptoms such as fever, fatigue, and behavioral changes to fulminant hepatic failure. Its clinical manifestations vary widely, making diagnosis during pregnancy particularly challenging. Wilson’s disease complicates pregnancy, as untreated cases can lead to significant morbidity and mortality; excess copper can disrupt metabolic processes and contribute to recurrent miscarriages.

Case: …

Pumping Iron, Straining Hearts: Androgen Building Cardiomyopathy In A Middle Aged Bodybuilding Enthusiast, Milan Terzic, Yash B. Patel

Graduate Medical Education Research Journal

A 46-year-old bodybuilder presenting with new onset dyspnea found to have a new onset non-ischemic cardiomyopathy (CM) attributed to exogenous trenbolone and testosterone use. Steroid cessation and guideline-directed heart failure therapy led to notable recovery in left ventricular function supported by global longitudinal strain, ejection fraction and symptomatology.

Anabolic steroid-induced CM involves multiple mechanisms including lipid disturbances, hypertrophy, reduced receptor sensitivity, and cell damage. This case emphasizes the importance of recognizing anabolic steroid misuse as a potential cause of non-ischemic cardiomyopathy in middle aged men. With prompt discontinuation of steroids, remained abstinence and early initiation of guideline-directed medical therapy, myocardial …

The Use Of Abdominal Fascial Plane Blocks For Post-Operative Analgesia In Intestinal Rehabilitation Patients – A Retrospective Comparative Study, Brittany A. Brown, Lauren E. Costello, Elizabeth C. Ternent-Recht, Trevor J. Wilke, Cale A. Kassel

Graduate Medical Education Research Journal

Background: Short gut syndrome affects both pediatric and adult patients often requiring multiple surgical procedures to improve intestinal function. Identifying methods to improve pain control and reduce opioid consumption is an important consideration for this patient population.

Methods: A retrospective chart review of 115 patients less than 12 years of age undergoing abdominal procedures between August 1, 2012, and December 31, 2019, was performed. From this group, 64 patients had a perioperative abdominal wall fascial plane block performed and were compared to 51 patients who did not have a block performed.

Results: Mean opioid use defined as morphine equivalent daily …

A Novel Interactive Video Module For Providers Improves Knowledge Of Best-Practices For Treating Alcohol Use Disorder, Patrick Twohig, Zachary P. Slocum, Alena Balasanova, Nathalie Khoury, Allison Ashford, Kyle Scholten, Josh Warner, John Gallagher, Thoetchai Peeraphatdit

Graduate Medical Education Research Journal

Background: Despite the availability of efficacious treatment for alcohol use disorder (AUD), providers and patients are often unaware of available treatment options and how to pursue them. Prior studies have found that providers desire more training to effectively treat AUD. Our aim was to develop a standardized video to educate providers about AUD treatment.

Methods: Prospective single-center cohort study evaluating the impact of a novel, interactive educational video module (EVM) for providers about AUD treatment. The EVM discusses treatment, motivational interviewing (MI) and harm reduction strategies, and case examples. The EVM was hosted on our hospital’s website, and available to …

Factors Associated With Healthcare Students’ Cognitive Levels Measured By The Classroom Test Of Scientific Reasoning., Alberto J. De Armendi, Amir L. Butt, Kathryn M.L Konrad, Mohanad Shukry, Edmund A. Marek Ii

Graduate Medical Education Research Journal

Introduction: Healthcare student acceptance into graduate and professional school is based on Grade Point Average (GPA), Graduate Record Examination (GRE) scores, interviews, and letters of recommendation, but not on cognition levels. However, educators need to understand students’ cognitive levels to facilitate constructivist learning theory and inquiry-based learning. The aim of this study is to understand the influence of cognition in healthcare students through the administration of the Classroom Test of Scientific Reasoning (CTSR).

Methods: Medical and baccalaureate nursing students were enrolled to answer demographic questions and complete the CTSR. The CTSR rubric score were used to define four operational cognitive …

Perioperative Outcomes And Mortality In Liver Transplant Patients 65 And Older, Nathaniel S. Pester, Trevor J. Wilke, V K. Shostrom, Cale A. Kassel

Graduate Medical Education Research Journal

Background: The number of patients over the age of 65 awaiting liver transplantation (LT) continues to grow and an increasing number of patients will undergo liver transplantation. While age is not an absolute contraindication to liver transplantation, understanding the risks to older patients remains essential to ensure good outcomes with the limited number of grafts available.

Methods: This retrospective study included patients undergoing LT at the University of Nebraska Medical Center. A total of 421 patients were enrolled and stratified to patients under 65 years old (351 patients) and patients over 65 (70 patients). Geriatric patients were defined as aged …

Prosthetic Valve Endocarditis With Cardiobacterium Hominis: A Case Report, Kaci Griffin, Timothy Jang, Rees Adomako, Jasmine R. Marcelin, Jonathan H. Ryder

Graduate Medical Education Research Journal

Background: Cardiobacterium hominis (C. hominis) is an uncommon cause of infective endocarditis and often presents sub-acutely with fevers, cardiac murmurs, or embolic phenomena. We present a rare case of C. hominis infective prosthetic valve endocarditis that presented with new-onset atrial flutter and systemic emboli.

Case: A 38-year-old male presented to the emergency department with palpitations, shortness of breath, and chest tightness and was found to be in atrial flutter. He underwent a transesophageal echocardiogram-guided cardioversion and was incidentally found to have a one-centimeter echodensity on the ventricular side of his prosthetic aortic valve. (Figure 1.) He …

Effective Strategies In Improving Internal Medicine In-Training Exam Performance - A Systematic Review, Derek Clar, Ryan Juneau, Valentina Mcneal, Dhara Patel, Prutha Patel, Amro Ilaiwy

Graduate Medical Education Research Journal

Background: The IM-ITE is administered annually to provide residents and program leadership with a measure of the residents' knowledge compared with that of their peers nationwide. Several approaches have been used to improve IM-ITE scores as a means of achieving higher first-time board examination pass rates. While these interventions helped improve outcomes in target programs, it remains unclear whether one approach was superior to another and how different program demographics may have played a role in the outcome of the intervention. Objective: To identify the most effective methods used to improve IM-ITE scores in the literature. Methods: We searched MEDLINE …

Occupational Therapy Using Cbt To Improve Work Productivity In Schizophrenia: A Case Study, Artha Nisa Thohiroh Triyantari, Reza Nur Arsyi, Muhammad Luthfi, Ayleen Alicia K, Hermito Gideon, Zulfa Khoirunisah, Putri Dirgantara, Purnama Betty R. Sitorus

Jurnal Fisioterapi Terapan Indonesia

Schizophrenia is a chronic mental disorder that often impairs an individual's social and occupational functioning, including productivity-related activities. Patients with schizophrenia frequently face challenges in maintaining employment or running an independent business due to cognitive and emotional disturbances affecting their adaptive skills. This single-case study integrates Cognitive Behavioral Therapy (CBT) into occupational therapy to enhance productivity in a schizophrenia patient through an entrepreneurial activity—independently opening a coffee shop. The study subject is a 50-year-old male diagnosed with schizophrenia undergoing psychosocial rehabilitation at RSJ Dr. Soeharto Heerdjan. The CBT-based intervention was designed to develop adaptive thinking patterns and occupational skills through …

Enhancement Of Functional Ability In Supraspinatus Tendinitis Using Ultrasound And Isotonic Exercise: Case Study, Tu Lidya Ike Putri, Christabelle Aurelia

Jurnal Fisioterapi Terapan Indonesia

Supraspinatus tendinitis is an inflammation of the supraspinatus tendon caused by the supraspinatus muscle tendon overlapping with the caput longus bicep tendon so that friction and repetitive pressure occur over a long period of time and result in damage to the supraspinatus muscle tendon and supraspinatus tendinitis occurs. Characterized by complaints of pain around the shoulder followed by limitation of motion in the shoulder joint. The clinical question arises "can the application of ultrasound and isotonic exercise reduce pain and functional ability improvement?". To be able to answer this question, an evidence search was conducted on 3 data bases, namely …

Perbandingan Konservatif Fisioterapi Dengan Core Stability Exercise Pada Kasus Nyeri Punggung Bawah, Angria Pradita, Nurul Halimah

Jurnal Fisioterapi Terapan Indonesia

ABSTRACT: Low back pain is a major complaint caused by multifactorial conditions. The most common factors of low back pain complaints are due to age, occupation and gender. This study aims to compare the differences in therapeutic effects of conservative physiotherapy with the provision of electrotherapy, namely; microwave diathermy combined with transcutaneous electrical nerve stimulation (TENS), core stability exercise techniques and a combination of electrotherapy with core stability exercise (CSE). This type of research is quasi experimental with a pre-post test design in a population of 90 low back pain patients who seek treatment at the Physiotherapy clinic. By using …

Treating Type Ii Medial Tibial Stress Syndrome With Primal Reflex Release Technique: A Novel Approach, Shelli Green, Jenna Morogiello, Kurrel Fabian, James May, Alan Nasypany

Clinical Practice in Athletic Training

Five NCAA Division I cheerleaders (age 20 ± 1.4; 3 males, 2 females) presented with Medial Tibial Stress Syndrome (MTSS). Following an evaluation, all patients diagnosed with MTSS were treated using Primal Reflex Release Technique (PRRT). Immediate improvements in reported pain were demonstrated after one treatment. Improvements in perceived dysfunction were demonstrated after 4.2 (± 0.84) treatments over 15.4 (± 5.86) days with no time lost. All improvements were maintained at two-week follow-up. Type II MTSS patients treated with PRRT may experience an immediate, lasting reduction in pain, improvement in function, and shorter time to overall resolution.

A Descriptive Examination Of Perceived Stress And Coping Among Athletic Trainers Employed In The National Collegiate Athletic Association, Stephanie M. Singe, Elisabeth M. Mckenna, Alexandrya Cairns, Christianne Eason

Clinical Practice in Athletic Training

Time and work demands are high for the collegiatea athletic trainer, which can increase work stress and burnout may result. High perceived levels of stress and burnout can impact an athletic trainer’s mental health and wellness. Data were collected via an online descriptive, cross-sectional survey (Qualtrics) examining the perceived stress and coping strategies used among athletic trainers employed in the collegiate setting. Respondents completed the pereceived stress scale (ɑ=.90), and a series of close-ended questions related to their self-reported strategy of coping. Data was collected during September of 2022. We had 987 (men 371, women 607, did not disclose 9) …

Driving After A Concussion In Adolescents And Young Adults, What Is The Current Research And Consensus?, Melanie Kwok, Tamara Valovich Mccleod

Clinical Practice in Athletic Training

N/a

Comparison Of Patellar Taping And Strapping For Treating Patellofemoral Pain, Kaison Ames, Eric G. Post

Clinical Practice in Athletic Training

Among collegiate athletes, patellofemoral pain (PFP) represents nearly one-third of all sport-related injuries. There have been multiple studies using a patellar tendon strap as an intervention to treat PFP that showed an improvement in knee pain, as well as studies showing improvement in knee pain when using patellar taping for PFP. However, there is very limited research written that compares the effectiveness of a patellar tendon strap versus a patellar tendon taping technique for patients with PFP. Therefore, the purpose of this study was to compare the effectiveness of patellar taping versus patellar strapping to reduce PFP in collegiate athletes. …

Thoracic Mobility And The Effects It Has On The Human Body: An Evidence To Practice Review, Megan Kurzec, Barton E. Anderson

Clinical Practice in Athletic Training

Decreased thoracic mobility, stability, and strength are prevalent issues in athletes, contributing to various musculoskeletal problems. This Evidence to Practice Review synthesizes findings from a guiding systematic review that identified exercises targeting the thoracic spine in athletes. The review included a comprehensive search across six databases, five journals, and five social media platforms, yielding 38 exercises designed to improve thoracic mobility, motor control, work capacity, and strength. Despite the low level of evidence (Level D), these exercises are widely used in clinical practice. This review provides a framework for exercise prescription, offering athletic trainers a range of exercise options to …

Gender Disparities And Burnout Among Emergency Physicians: A Systematic Review By The World Academic Council Of Emergency Medicine-Female Leadership Academy For Medical Excellence., Suman Thakur, Vivek Chauhan, Sagar Galwankar, Fatimah Lateef, Pia Daniel, Zeynep Cakir, Katia M. Lugo, Samjhana Basnet, Busra Bildik, Siham Azahaf, Sevilay Vural, Busra H. Difyeli, Lisa Moreno-Walton

School of Medicine Faculty Publications

Background: The Female Leadership Academy for Medical Excellence, members of the World Academic Council of Emergency Medicine, conducted this systematic review, which explores gender disparities in burnout among emergency physicians (EP) using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Burnout is a critical issue in healthcare, particularly in emergency medicine where high stress and demanding work environments prevail. Methods: Following PRISMA guidelines, we searched PubMed and Epistemonikos for studies using MBI-HSS to measure burnout in EPs. Inclusion criteria encompassed peer-reviewed, English-language articles reporting burnout by sex. Data extraction focused on proportions of burnout and its subcomponents, mean scores, and odds …

Partnerships To Improve Access To Healthcare For Refugees And Immigrants In Philadelphia, Jessica Deffler, Chelsea Salas-Tam, Jenna Gosnay, Marc Altshuler

Department of Family & Community Medicine Faculty Papers

The United States has welcomed refugees since World War II. Currently, the world is experiencing an unparalleled refugee crisis that calls for action by nations across the globe. There are over 82 million people who are forcibly displaced from their homes today (UNHCR Global Trends, Forced displacement in 2020. [cited 2021 Sep 28]. Available from: https://www.unhcr.org/flagship-reports/globaltrends/). Over the last decade, Philadelphia has become home to hundreds of refugees from countries in Southeast and Central Asia, Africa, the Middle East, as well as many others. For newly arrived refugees, finding stable housing, medical care, and employment is difficult due to cultural, …

Automated Segmentation Of The Ulnar Nerve In Mri Using Deep Learning Techniques, Akhil Nagulapalli

Theses

Cubital Tunnel Syndrome (CuTS), a condition caused by compression of the ulnar nerve, results in numbness, tingling, pain, and even muscle atrophy, affecting fine motor skills and diminishing patient quality of life. Accurate diagnosis of CuTS is challenging, as current diagnostic methods—including clinical exams, nerve conduction studies, and unaided MRI—often lack the precision to reliably identify the nerve and detect compression in its early stages. Deep learning-based segmentation offers a promising solution, enabling precise and automated identification of nerve structures in MRI images, which could significantly improve diagnostic accuracy and support timely intervention.

A novel deep learning model for segmenting …

Head-To-Head Comparison Of Aptamer- And Antibody-Based Proteomic Platforms In Human Cerebrospinal Fluid Samples From A Real-World Memory Clinic Cohort, Raquel Puerta, Yun Ju Sung, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

High-throughput proteomic platforms are crucial to identify novel Alzheimer's disease (AD) biomarkers and pathways. In this study, we evaluated the reproducibility and reliability of aptamer-based (SomaScan

Approved Car-T Therapies Have Reproducible Efficacy And Safety In Clinical Practice, Daniel Goyco Vera, Hiral Waghela, Mohamed Nuh, Jonathan Pan, Premal Lulla

Faculty, Staff and Students Publications

CAR-T cell therapy has established itself as a highly effective treatment for hematological malignancies. There are currently six commercial CAR-T products that have been FDA approved for diseases such as B-ALL, LBCL, MCL, FL, MM, and CLL/SLL. "Real-world" studies allow us to evaluate outcomes from the general population to determine their efficacy and safety compared to those who were included in the original trials. Based on several well conducted "Real-world" studies that represent diverse populations, we report that outcomes from the original trials that led to the approval of these therapies are comparable to those in practice.

Addressing Unprofessional Behaviors In The Clinical Learning Environment: Lessons From A Multi-Year Virtual, Intergenerational, Interdisciplinary Workshop, Stacey Rose, Anita Kusnoor, Phuong Huynh, Jocelyn Greely, Yesenia Rojas-Khalil, Doris Kung, Anne Gill, Nadia Ismail, Nital Appelbaum

Faculty, Staff and Students Publications

INTRODUCTION: Optimizing the clinical learning environment (CLE) is a medical education priority nationwide.

MATERIALS AND METHODS: We developed a virtual, one-hour workshop engaging students, housestaff and faculty in small-group discussions of five case scenarios adapted from reported unprofessional behaviors in the CLE, plus didactics regarding mistreatment, microaggressions and bystander interventions.

RESULTS: Over two sessions (2021-2022), we engaged 340 students and 73 faculty/housestaff facilitators. Post-session surveys showed significant improvement in participants' ability to recognize and respond to challenges in the CLE.

DISCUSSION: Our innovative workshop, including scenarios derived from institutional reports of unprofessional behaviors, advanced participants' knowledge and commitment to improve …

Investigating The Bioactivity Potential And Standardization Of Two Stingless Bee Propolis From East Kalimantan, Paula Mariana Kustiawan, Muhammad Ali Syahbana, Rika Pratika, Muhammad Nor Ichsan, Ika Ayu Mentari, Indah Hairunnisa, Irfan Muris Setiawan, Putri Hawa Syaifie, Donny Ramadhan, Chanpen Chanchao

Pharmaceutical Sciences and Research

The standardization of raw materials from nature is essential before they are made into products. Until now, there is still limited information regarding the standardization of propolis from stingless bees. This research aims to determine the bioactivity with standardized specific and non-specific parameters of ethanol extracts from Homotrigona apicalis and Homotrigona fimbriata propolis. The methods include organoleptic tests, tests for water-soluble and ethanol-soluble compound content, drying shrinkage tests, specific gravity tests, water content tests, metal contamination tests, phytochemical screening, and determining total phenolic and flavonoid content. The free radical scavenging capacity was measured using the DPPH (1,1-diphenyl-2-picrylhydrazyl) method, and antimicrobial …

Single-Step Synthesis Of Activated Carbon From Arabica Spent Coffee Ground Using K2co3 As Activator Agent, Ghina Ivana Mieldan, Yuliusman Yuliusman

Journal of Materials Exploration and Findings

Activated carbon is a nanomaterial that is often used as an effective adsorbent. Activated carbon raw materials can use biomass, such as coffee grounds, which can be found along with the growth of public interest in coffee drinks. Chemical activators are used for activation to increase biomass carbon's adsorption capacity. Using K₂CO₃ activator to increase the specific surface area of activated carbon is more harmless than KOH. The use of spent coffee grounds as carbon source and food additive K₂CO₃ as an activator can make food-grade activated carbon that can be used for food. …

Utilizing Water Hyacinth (Eichhornia Crassipes) From Srandakan Bantul, Indonesia For ‘Bright Fever Patch’ As An Alternative Children’S Fever Therapy, Anggita Kamalia Niswara, Nabillah Ainun Kusrinanti, Rizqi Amalia Firdaus, Azis Ikhsanudin

Pharmaceutical Sciences and Research

In 2022, Indonesia experienced a public health crisis involving acute kidney failure in children, traced to paracetamol syrup contaminated with ethylene glycol and diethylene glycol. This underscores the urgent need for safer antipyretic alternatives. This study investigates the antipyretic potential of transdermal patches formulated with ethanol extract of water hyacinth (Eichhornia crassipes) leaves sourced from Srandakan, Bantul, Yogyakarta. Extract concentrations of 0.8%, 1.0%, and 1.2% were tested, alongside a negative control (no extract) and a positive control (paracetamol). The patches underwent evaluations for organoleptic properties, weight uniformity (0.41±0.02 to 0.52±0.02 g), thickness (0.36±0.03 to 0.41±0.03 mm), water absorption …