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

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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

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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

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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

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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

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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.

Sexually Transmitted Infections in Children and Adolescents Who Are Victims of Sexual Violence: Prevalence, Risk Factors, and Challenges for Healthcare Services

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Sexual violence against children and adolescents is a global public health issue with far-reaching impacts on the victims’ physical, psychological, and social health. One important but often overlooked physical health consequence is the risk of sexually transmitted infections (STIs). Children and adolescents who are victims of sexual violence are in a very vulnerable condition for contracting STIs due to power imbalances, limited ability to give consent, and delays in obtaining adequate medical examinations and services. This article aims to comprehensively review the literature on the prevalence, types of STIs, related factors, and the implementation of screening and healthcare services for children and adolescents who are victims of sexual violence. The method used is a literature review of relevant international research articles, including retrospective studies, cross-sectional studies, cohort studies, and clinical audits, obtained from reputable scientific databases. The review results indicate that the prevalence of STIs among children and adolescents who are victims of sexual violence varies across studies, with the most frequently reported types of STIs including Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, Mycoplasma genitalium, human papillomavirus, and HIV. The factors most consistently associated with STIs include adolescent age, female sex, sexual violence with penetration, repeated violence, commercial sexual exploitation, and delayed medical examination after the incident. Additionally, this review identifies significant gaps in the implementation of STI screening, medical follow-up, and the continuity of healthcare services for victims. The conclusion of this study emphasizes the importance of strengthening integrated, risk-based, and trauma-sensitive healthcare services in the management of children and adolescents who are victims of sexual violence, in order to improve early detection and prevent complications from sexually transmitted infections.

 

Perception and Comparison of Modern Management Theories

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Management has taken place in human actions since ancient times. Over time, scientists and researchers developed ways and approaches to get the best advantages of managing organizations and employees. Many theories appeared in this field to improve management techniques, such as classical, neoclassical, and modern theories. However, this paper aims to focus on and explore modern theories’ features (Quantitative, System, and Contingency theories). As well as studying the development of the theories and comparing them.

The study is a literature review and has a descriptive nature, and the researcher relied on secondary data, using Google Scholar as the main database, to provide a deep insight into the perception of management modern theories.

the results of comparing the theories indicated that the quantitative theory depends on mathematical procedures to analyze and make decisions, which means it is a numerically based approach. This theory applies logical or reasoning practices. The system approach depends on dividing the system into sub-parts, and all parts are related to and follow a super system. The system theory is a goal-oriented approach, so all sub-parts move toward one goal. The contingency theory depends on making decisions according to the situation. As it considers the internal environment of the organization as well as the external environment so the organization’s response is related to the changes in the environment.

the study concludes that none of the theories can be used alone. The theories have to be integrated to achieve the ultimate benefits for the organizations because using modern management theories separately could cause failure. Quantitative, System, and Contingency theories have some limitations if used separately, but together could achieve the organization’s goals and objectives perfectly.

Biomedical-Based Nanotechnology for Oral Cancer as an Innovative Strategy for the Head and Neck Region: A Comprehensive Scoping Review of Future Perspectives

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Nanotechnology is transforming medical practice, and maxillofacial surgery is beginning to benefit from its applications, particularly in the diagnosis and treatment of oral carcinoma. This review aimed to evaluate the impact, efficacy, and current challenges of nanotechnology in oral cancer management. A systematic literature search was conducted in PubMed, ScienceDirect, and Scopus, following PRISMA Extension for Scoping Reviews (PRISMA-ScR). Artificial intelligence software (Rayyan) was used to support article screening. The search strategy included the terms “nanotechnology,” “carcinoma,” “oral cavity,” and “nanotechnology in oral carcinoma,” with Boolean operators (“AND/OR”) and a date filter from 2014 to 2024. A total of 47 articles were identified in databases and 820 through reference screening; 12 met the inclusion criteria.

Evidence shows that nanotechnology-based therapies achieve an average tumor reduction of 43% and improve mouth opening by 35%. Severe complications were reported in 25% of cases, and the overall survival rate reached 70%. These outcomes indicate that nanotechnology may increase treatment precision, reduce adverse effects, and improve patient quality of life.

Despite its potential, clinical application remains limited due to insufficient large-scale trials and the need for long-term toxicity assessment. Continued research and clinical validation are essential to integrate nanotechnology into routine maxillofacial oncology practice.