Pulmonary Hernia Following Blunt Chest Trauma

/in /by

Defined as a protrusion of the lung parenchyma through the chest wall, traumatic lung hernias constitute a rarely described condition occurring more from penetrating rather than blunt trauma. We report the case of a 17-year-old patient with no prior medical history who was admitted to the emergency department following a motorcycle accident with a protruding thoracic mass. Clinical examination found a soft, reducible bulge on the left anterior 4th intercostal space. A CT scan of the chest demonstrated rib fractures with no lung or muscle laceration. Surgical correction of the defect allowed total disappearance of the bulge, as well as significant pain management, and postoperative recovery was satisfactory. Post-traumatic intercostal lung herniation is a poorly described, challenging entity for which minimally invasive surgical correction of the chest wall defect and reduction of the hernia should be considered whenever feasible.

The Effect of Financial Performance and Ownership Structure on Financial Distress with Good Corporate Governance as a Moderating Variable in Non-Regional Government Conventional Banks

/in /by

This study aims to analyze the effect of financial performance and ownership structure on financial distress, with Good Corporate Governance (GCG) as a moderating variable in non-regional government conventional banks in Indonesia during the 2019-2024 period. Employing a quantitative approach with panel data regression analysis on 17 banks listed on the Indonesia Stock Exchange, the results indicate that financial performance has a significant effect on financial distress, while ownership structure does not have a significant effect. Furthermore, GCG is proven to moderate the relationship between financial performance and financial distress; however, it does not moderate the effect of ownership structure on financial distress. These findings emphasize the importance of implementing GCG principles in strengthening financial performance and mitigating the risk of financial distress in the conventional banking sector.

Analysis of Risk Factors and Mapping of Helminth Infection Incidence in the Working Area of Nulle Public Health Center, South Central Timor Regency

/in /by

Background: Soil-Transmitted Helminth (STH) infections remain a public health concern in tropical regions, particularly among school-aged children, while local data and risk mapping in the service area of Nulle Primary Health Center are limited.

Objective: To estimate the prevalence of STH infection, identify water, sanitation, and hygiene (WASH)–related risk factors, and spatially map infection clusters among primary schoolchildren in South Central Timor, Indonesia.

Methods: A cross-sectional survey was conducted in seven primary schools from 10–16 June 2025, involving 263 students. Data on WASH-related behaviors and environmental conditions were collected using structured questionnaires. Stool samples were examined using the direct smear method with 2% eosin and 2% lugol’s iodine. Bivariate analysis was performed using Fisher’s exact test with α = 0.05. Geographic household coordinates of STH-positive cases were mapped using ArcGIS to identify spatial clusters.

Results: The prevalence of helminth infection was 4.6% (12/263). The most common species identified was Ascaris lumbricoides (83.3%), followed by Trichuris trichiura and mixed infections (each 8.3%). Handwashing habits, nail trimming, consumption of raw food, use of footwear, latrine ownership, and household water source were significantly associated with infection (p<0.05). GIS mapping revealed high-risk areas in Nulle, Tublopo, and Benlutu villages, characterized by high soil humidity, suitable temperature and soil type, as well as poor sanitation conditions.

Conclusion: STH infection in the Nulle area remains a concern, influenced by hygiene behaviors and environmental conditions. Location-based promotive and preventive efforts are essential to reduce infection rates.

Understanding the Social Media Rollercoaster: How Resilience and Vulnerability Shape Teen Mental Health

/in /by

Background: Social media is a central part of adolescent life, yet its impact on mental health is highly variable.

Objective: To present a synthesized, three-layer framework explaining how individual traits, social environments, and digital behaviors interact to buffer or exacerbate the relationship between social media use and adolescent mental health.
Methods: We analyzed key findings from recent studies (2020-2025) identified via a systematic PubMed search, focusing on moderators such as personality, coping styles, social support, and digital literacy.

Results: An adolescent’s experience is shaped by three key layers: The Inner Self (personal traits and coping), the Social Environment (interpersonal support), and Digital Engagement (online skills and use patterns). Low self-esteem, maladaptive coping, lack of social support, low digital literacy, and younger age are key factors that increase vulnerability to negative outcomes from social media use.

Conclusion: The impact of social media is not uniform but conditional. Effective support requires targeted interventions that build self-esteem and coping skills, foster supportive communication, and teach critical digital literacy. This multi-layered approach can help teens navigate the digital world with greater resilience.

Does Work–Life Balance Matter? Examining the Effects of Flexible Work Arrangements and Work Overload on Employee Performance at the Regional Office of the Directorate General of Taxes, Special Region of Yogyakarta

/in /by

Employee performance in the public sector is increasingly influenced by the adoption of flexible work policies and rising job demands. However, empirical evidence explaining how flexible work arrangements and work overload jointly affect performance, particularly through psychological mechanisms, remains limited in highly regulated public institutions. This study examines the effects of flexible work arrangements and work overload on employee performance, with work–life balance serving as a mediating variable among civil servants at the Regional Office of the Directorate General of Taxes, Special Region of Yogyakarta. A quantitative research design was employed using a census survey of 139 civil servants. Data were collected through structured Likert-scale questionnaires and analyzed using Partial Least Squares–Structural Equation Modeling (PLS-SEM). The results show that flexible work arrangements have a positive and significant effect on both employee performance and work–life balance. Work–life balance also positively and significantly influences employee performance. In contrast, work overload does not have a significant direct effect on employee performance but demonstrates a positive and significant relationship with work–life balance. Mediation analysis indicates that work–life balance partially mediates the relationship between flexible work arrangements and employee performance and fully mediates the relationship between work overload and employee performance. These findings suggest that within a highly regulated public sector environment, employee performance is shaped less by workload intensity and more by employees’ ability to maintain a balanced integration of work and personal life. This study contributes to the public sector human resource management literature by clarifying the mediating role of work–life balance in linking flexible work policies and workload conditions to performance outcomes.

The Effectiveness of Pineapple Juice (Ananas comosus (L.) Merr) in Preventing the Formation of Calcium Oxalate Crystals In Vitro

/in /by

Background: Kidney stones (urolithiasis), particularly those composed of calcium oxalate (CaOx), remain a global health issue with a high recurrence rate. Non-pharmacological approaches using natural compounds are considered valuable alternatives to invasive treatments. Pineapple (Ananas comosus) contains citric acid and bromelain, which have potential inhibitory effects on CaOx crystallization, although scientific evidence is still limited.

Methods: A true experimental study with a post-test only control group design was conducted using four crystallization parameters (Tmax, SN, SA, and percentage of inhibition) across five groups: negative control, positive control (0.5% potassium citrate), and pineapple juice at concentrations of 25%, 50%, and 100%. Absorbance measurements were performed using a UV-Vis spectrophotometer at two-minute intervals for 60 minutes. Data were analyzed using Shapiro–Wilk, Levene’s Test, Kruskal–Wallis, and Dunn’s Post Hoc tests with a 95% confidence level.

Results: Pineapple juice exhibited strong inhibitory activity against CaOx crystal formation. All treatment concentrations reduced SN by more than 90% and achieved complete aggregation inhibition, along with increased Tmax compared to the negative control. The 25% concentration produced the most optimal inhibition effect, showing substantial SN reduction and a significant rise in Tmax. The Kruskal–Wallis test showed significant differences between groups for SN and Tmax, though pairwise comparison with Dunn’s Post Hoc indicated no significant differences after correction.

Conclusion: Pineapple juice effectively inhibited CaOx crystallization in vitro by delaying nucleation and preventing crystal aggregation, suggesting its potential role as a natural non-pharmacological preventive agent for kidney stone formation.

Factor Analysis Which Influential on Compliance Paying Contributions to Independent BPJS Participants in the Working Area of The Kolono Community Health Center South Konawe Regency in 2025

/in /by

Background: The National Health Insurance (JKN) program organized by the Social Security Agency (BPJS) Health has a strategic role in ensuring fair, equitable, and sustainable access to health services for all Indonesians. However, the level of compliance with BPJS Mandiri participant contributions remains a problem, especially in areas with limited access to health services and diverse socio-economic conditions. Low compliance with contribution payments can impact the sustainability of the national health insurance system financing.

Objective: This study aims to analyze the factors that influence compliance with BPJS Mandiri participant contributions in the Kolono Community Health Center working area, South Konawe Regency, in 2025.

Method: The study used a quantitative approach with a cross-sectional design. The research sample consisted of 48 respondents selected through a non-probability sampling technique. Data collection was carried out using a structured questionnaire that measured motivation variables, perceptions of BPJS Kesehatan, distance to health care facilities, and income levels. Data were analyzed using statistical tests to see the relationship between independent variables and compliance with contribution payments. Results: The study showed that motivation had a significant relationship with compliance with premium payments (p = 0.046; r = 0.246), although with a weak relationship strength. Participant perceptions were significantly related to compliance (p = 0.000; r = 0.566) with a moderate level of relationship. Distance to health service facilities also showed a significant relationship (p = 0.000; r = 0.576), confirming the importance of service accessibility. In addition, income was significantly related to compliance with premium payments (p = 0.003; r = 0.374).

Discussion: Simultaneously, these four variables contributed 52.8% to compliance with BPJS Mandiri premium payments.

Conclusion: These findings indicate that increasing compliance requires a comprehensive approach through education, improving service quality, and policies that expand access and financial support for low-income communities.

Optimizing Reverse Logistics in Manufacturing Production Processes

/in /by

This study investigates the optimization of reverse logistics in manufacturing enterprises, emphasizing its role as an essential component of modern supply chain management and a strategic instrument for sustainable development. The paper first reviews and systematizes the theoretical foundations of reverse logistics, clarifying its concepts, characteristics, and scope of application, as well as its linkages with supply chain management and the circular economy. On this basis, an analytical framework is developed to evaluate the level of reverse logistics implementation in manufacturing firms in Vietnam, with a focus on product return management, reverse material flow handling, internal coordination mechanisms, and the integration of environmental objectives into production and business strategies.

The analysis of empirical evidence highlights several key challenges in the adoption of reverse logistics, including limitations in managerial capabilities, infrastructure, financial and technological resources, and insufficient awareness of the long-term economic and environmental benefits. In response, the study proposes a set of comprehensive and feasible solutions aimed at improving internal governance, enhancing coordination across supply chain stages, and promoting the adoption of management models consistent with circular economy principles. These measures are expected to improve operational efficiency, reduce environmental impacts, and strengthen the competitive position of manufacturing enterprises in the context of economic integration and increasing sustainability requirements.

The Relationship Between Non-Steroidal Anti-Inflammatory Drug (NSAID) Consumption and the Incidence of Gastritis among Outpatients at the Internal Medicine Clinic of RSUD Prof. Dr. W.Z. Johannes Kupang

/in /by

Background: Gastritis is an inflammatory condition of the gastric mucosa with high prevalence worldwide, especially in developing regions. At RSUD Prof. Dr. W. Z. Johannes Kupang, reported cases increased from 99 in 2021 to 257 in 2023. This research focuses on identifying the association between the type, frequency, and duration of Non-Steroidal Anti-Inflammatory Drug (NSAID) use and gastritis among outpatients.

Methods: An analytical observational approach with a cross-sectional design was applied involving 56 patients selected through purposive sampling at the Internal Medicine Clinic. Data were obtained from questionnaire-based interviews and medical record reviews. Bivariate testing was conducted using the contingency coefficient correlation method in SPSS.

Results: Thirteen of the 56 participants (23%) were confirmed with gastritis. NSAID use was reported in 84% of respondents, mainly non-selective preparations. Most consumed NSAIDs only when symptoms appeared and for less than five days. Statistical analysis indicated no significant association for frequency (p=0.052) or duration of intake (p=0.052), and a weak significance for NSAID class (p=0.047).

Conclusion: NSAID usage patterns showed no meaningful relationship with gastritis incidence among outpatients at RSUD Prof. Dr. W. Z. Johannes Kupang, which may relate to the low intensity and short duration of use.

Evaluation of the Effectiveness of Tomato (Solanum lycopersicum L.) Juice in Inhibiting Calcium Oxalate Crystal Formation In Vitro

/in /by

Background: Nephrolithiasis is a major urological problem worldwide with a high recurrence rate, reaching approximately 50% within the first 5–10 years after the initial episode. Around 70–80% of kidney stones consist predominantly of calcium oxalate (CaOx). The imbalance between urinary promoters (calcium, oxalate) and inhibitors (citrate, magnesium) leads to supersaturation and crystal formation. Citrate functions as a strong natural inhibitor, although conventional medical therapy may involve considerable costs and adverse effects. Tomatoes (Solanum lycopersicum L.) are an affordable local commodity containing high levels of citrate and magnesium, and therefore hold potential as a natural antilithiasis agent.

Objective: To evaluate the effectiveness of tomato juice in inhibiting calcium oxalate crystal formation using a synthetic urine model.

Methods: An in vitro experimental study was carried out using a post-test only design with a control group. Samples were divided into five groups with three replications: Negative Control (no treatment), Positive Control (Potassium Citrate 0.5%), and three treatment groups of Tomato Juice at 25%, 50%, and 100% concentrations. Crystal formation was induced using CaCl₂ and Na₂C₂O₄ in synthetic urine. Absorbance was measured using a UV–Vis spectrophotometer (620 nm) at two-minute intervals for 60 minutes. Measured parameters included Slope of Nucleation (SN), Slope of Aggregation (SA), and percentage of inhibition.

Results: Tomato juice demonstrated statistically significant inhibitory activity against CaOx crystallization kinetics (p < 0.05 for SN and SA). The 25% concentration produced the highest inhibition rate (approximately 65%), comparable to the positive control (70%). The 50% and 100% concentrations yielded inhibition values of approximately 38% and 37%, respectively, indicating a dose–response pattern that did not increase proportionally with concentration.

Conclusion: Tomato juice effectively inhibited calcium oxalate crystal formation in vitro, particularly during the aggregation phase. The optimal effect was observed at the 25% concentration, suggesting a non-linear dose–response possibly influenced by the balance between citrate content and endogenous oxalate in tomatoes.