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From Silent Clones to Myeloma: Unraveling the Genetic Clues Behind MGUS and Smoldering Myeloma
Get PDFMonoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are distinct precursor conditions within the disease progression spectrum that can potentially lead to multiple myeloma (MM). This analysis elucidates the marked disparity in progression kinetics between these precursor states—with MGUS demonstrating an annual conversion rate of approximately 1% versus the substantially elevated 10-15% progression rate observed in SMM—thus emphasizing the critical necessity for precise risk stratification methodologies. The molecular pathogenesis underlying progression encompasses complex genetic and epigenetic perturbations, including chromosomal aberrations, somatic mutations, and dysregulation of epigenetic regulatory mechanisms such as DNA methylation patterns and histone modification profiles. The incorporation of molecular biomarkers, particularly recurrent chromosomal translocations and driver gene mutations, into prognostic algorithms has demonstrably enhanced the discriminatory capacity to identify high-risk patient subsets who may derive benefit from intensified surveillance protocols and preemptive therapeutic interventions. The translational integration of comprehensive genetic and genomic profiling into clinical decision-making paradigms for MGUS and SMM patients carries profound implications, facilitating individualized surveillance strategies and potentially enabling precision medicine approaches that may interrupt or slow down the advancement to symptomatic multiple myeloma
Compliance of Scaffolder Workers in using Full Body Harness through Rewards and Punishment as Intervening Variable
Get PDFIn the context of occupational safety, compliance refers to the adherence to safety protocols designed to protect workers from various risks and hazards. A high level of compliance is crucial, particularly in high-risk sectors such as construction, where violations of safety procedures can lead to fatal accidents. This study aims to examine the extent to which scaffolding workers comply with the use of personal protective equipment (PPE), specifically the full body harness, through the application of rewards and punishments. A mixed methods approach was employed, combining quantitative analysis using SEM-PLS with qualitative insights obtained from interviews. The findings reveal that two variables had no statistically significant effect: compliance on the use of full body harness (p-value = 0.992 > α = 0.05) and rewards on punishment (p-value = 0.887 > α = 0.05). However, four variables showed statistically significant relationships: compliance on punishment, motivation on punishment, punishment on the use of full body harness, and rewards on the use of full body harness (p-value < α = 0.05). Furthermore, all indirect relationships involving the use of PPE through punishment were found to be insignificant. These results suggest that companies should develop more comprehensive strategies, policies, and standard operating procedures (SOPs), and ensure consistent communication and socialization of safety practices across all operational activities
Service Management and Patient Satisfaction in Independent Midwifery Clinical Practice
Get PDFMidwifery services in independent clinical practices play a crucial role in the primary healthcare system, particularly in providing care for mothers and children. This study aims to analyze the relationship between service management and patient satisfaction levels in independent midwifery clinical practices (PMB). A descriptive qualitative approach was employed, using the PRISMA method to trace and analyze data from various scholarly sources related to service management and patient satisfaction in PMBs. Key dimensions from the SERVQUAL model reliability, responsiveness, empathy, assurance, and tangible aspects served as the main indicators for assessing service quality. Case studies from several PMBs demonstrate that the use of simple technologies, effective communication, and efficient time management contribute significantly to high levels of patient satisfaction. Conversely, unstructured management practices negatively affect perceptions of care. The findings underscore the importance of enhancing midwives’ managerial capacity, developing standard operating procedures (SOPs), and conducting routine evaluations of patient experiences to maintain service quality. These results offer strategic insights into strengthening PMBs as a responsive and high-quality pillar of maternal healthcare services
Analysis of the Role of Information Technology Management in Improving Public Services in Sesumpu Village
Get PDFThis study aims to analyze the role of information technology management in improving public services in Sesumpu Village. With a qualitative approach, data were collected through interviews, observations, and document analysis. The results of the study indicate that the application of information technology has accelerated the administrative process, increased communication efficiency, and strengthened coordination between village officials. Supporting factors include government support, enthusiasm of village officials, and community participation. However, obstacles such as limited human resources, inadequate infrastructure, and low digital literacy are still major challenges. The recommended strategies include developing online service applications, increasing internet network capacity, continuous staff training, and educating the community to improve the use of technology. These findings demonstrate the importance of a strategic and inclusive approach to information technology management in order to create more efficient and transparent public services
Analysis of Healthcare Services Based on Local Wisdom and Holistic Care in Relation to Patient Loyalty: JEL Classification: I10, I12, I18, L84, M31
No full textHealth services that focus solely on medical aspects often fail to address patients’ comprehensive needs. Integrating local wisdom and holistic care offers a strategic approach to enhance service quality. Local wisdom reflects community cultural values, while holistic care addresses physical, psychological, social, and spiritual dimensions. Together, they can strengthen hospital image, increase satisfaction, and build loyalty. PKU Muhammadiyah Karanganyar Hospital, grounded in religious and cultural values, is well-positioned to apply this model. This study analyzes the influence of services based on local wisdom and holistic care on patient loyalty, with hospital image and satisfaction as mediators. A quantitative cross-sectional design was used, involving 205 patients surveyed with closed-ended questionnaires. Data were analyzed using SEM-PLS with SmartPLS software. Findings show that services rooted in local wisdom positively influence hospital image, though modestly. Holistic care has a stronger impact on both image and satisfaction. Mediation analysis indicates that hospital image and satisfaction significantly link service provision to loyalty. Hospital image has a moderate effect on loyalty, while satisfaction plays a more direct role. The results suggest that cultivating a strong image and delivering comprehensive care are essential to fostering loyalty. Holistic care emerges as the dominant factor shaping positive perceptions and satisfaction. The study concludes that integrating cultural values with holistic care effectively strengthens patient relationships. Such a strategy should be a cornerstone of hospital service improvement
Analysis of Quality Control of Fabric Products Using Statistical Quality Control (SQC) Methods and Failure Mode and Effect Analysis (FMEA)
Get PDFCompanies in the industrial world, both manufacturing and service industries, are required to face market competition in order to compete and survive. One thing that companies need to pay attention to is the quality of the products produced. Good product quality will make consumers like the product. Therefore, improving product quality must be considered by the company. One of the companies that produces fabric, namely PT. XYZ, has a problem of not knowing the level of quality of the fabric produced, so this study aims to determine the quality of the product and provide suggestions for improvement to the company. There are defects in fabric production, namely double weft with a percentage of 27.7%, loose weft 26.7%, broken warp 24.5% and thick weft 21.2%. Improvement proposals are given to the highest percentage of defects, namely double weft with the following proposals: Carrying out machine maintenance and replacing the new gun eye so that the gun eye is not blunt, replacing the roller on the worn warping machine with a new roller, providing comprehensive and intensive training to workers on how to use the machine effectively and correctly. It is hoped that this research can help the company improve the quality of the fabric products produced
Experimental Study on the Utilisation of Independent Wire Fibre Core Steel Wire Rope Braces to Enhance the Stability of a 2d Concrete Portal against Lateral Forces
Get PDFStructural stability in construction, especially in buildings exposed to lateral forces due to earthquakes, is very important to consider. This research aims to explore the effectiveness of using Independent Wire Fibre Core (IWFC) steel wire rope braces in strengthening two-dimensional (2D) concrete portals. The method used is a series of laboratory tests to measure the performance of concrete portals equipped with IWFC braces. Concrete portals with dimensions of 1.00 m in the width direction and 1.50 m in the height direction were tested with lateral loading to simulate the effects of earthquakes. The test results showed that the use of IWFC braces increased the load resistance capacity of the portal by 16.13%, from 14.00 kN to 26.13 kN, and reduced the deviation by 30.43%, from 2.30 mm to 1.68 mm. In addition, the analysis showed an increase in the response modification factor (R) from 4.69 to 5.03, while the Cd value of the non-braced portal was 3.29 using braces was 3.02 and the Ω0 value of the non-braced portal was 3.50 and after using braces was 2.84. These findings open up opportunities for the application of better structural strengthening techniques in order to improve the safety and stability of buildings in earthquake-prone areas
Case Reporting System with Tracking and Chat Machine Learning for The Department of Women's Empowerment and Child Protection Manado
Get PDFThis study aims to develop a more interactive, responsive, and participatory web-based case reporting system for the public, particularly within the Department of Women’s Empowerment and Child Protection (DWECP) of Manado City. The developed system, named LABRRAK, integrates two key components: (1) a machine learning-based chatbot that utilizes the Google Dialogflow platform with Natural Language Processing (NLP) technology to automatically respond to user inquiries; and (2) a real-time case tracking feature based on a finite state machine algorithm, allowing reporters to directly monitor the progress of their cases. This research adopts a Research and Development (R&D) method combined with the Agile development model, which emphasizes an iterative and evaluative process through sprint stages. This approach enables the system to adapt to changing user needs and enhance its features based on direct feedback. Each sprint cycle concludes with testing using the Black Box Testing method to ensure that all system functionalities perform as expected. The testing results demonstrate that all core features, including case reporting, chatbot conversations, status tracking, and the administrative analytics dashboard, function optimally and meet user requirements. LABRRAK’s innovation lies in its integration of dynamic status tracking and two-way communication features into a single, unified digital platform. The system is expected to accelerate case handling, improve transparency, and strengthen accountability in addressing cases of violence against women and children. Furthermore, LABRRAK has the potential to serve as a prototype for the development of other inclusive, technology-driven public service systems in the social sector
Application of Design Thinking in Designing User Interface Prototype of Worker Health Screening Application at PT Petrokimia Gresik
Get PDFThe application of digital technology in the worker health screening process is an important need in the industrial work environment, especially in supporting the effectiveness and efficiency of the OHS medical team's work. This research aims to design a user interface for the AppSheet-based worker health screening application using the Design Thinking approach. This method was chosen because it is centered on user needs and is able to produce innovative solutions through the stages of Empathize, Define, Ideate, Prototype, and Testing. Data collection was conducted through interviews and observations of five respondents from the OHS medical team and five department representatives. Assessment of the design was carried out using the usability testing method, with efficiency, effectiveness, and System Usability Scale (SUS) parameters. The results showed that the Design Thinking approach was able to produce an application interface that meets user needs, improves understanding of workflows, and minimizes recording errors. The developed application not only supports the digital health evaluation process, but also has the potential to reduce administrative burden and improve the quality of medical services at PT Petrokimia Gresik
Risk Mitigation Strategy for CNC Plasma Cutting Machine Damage Using The House of Risk Method and Root Cause Analysis
Get PDFPT XYZ as a national strategic industrial company has a high dependence on the reliability of production machines, one of which is the CNC Plasma Cutting machine. Damage problems that occur on the machine can disrupt the smooth production process and pose a significant operational risk. In 2024, this machine experienced 35 breakdowns which resulted in a decrease in plate cutting output from the target of 1560 tons to 1417 tons. This study aims to identify the risk of machine failure and formulate mitigation strategies using the House of Risk (HOR) and Root Cause Analysis (RCA) methods. HOR is used to identify risk events, risk agents, and determine mitigation priorities based on the Aggregate Risk Potential (ARP) value, while RCA is used to find the main root cause of selected risks. The results showed that there were 5 mitigation actions that could potentially increase the cutting output by 8.8%, from 1417 tons to 1542 tons in 12 months. The combination of the HOR and RCA methods provides a comprehensive approach to risk mitigation, supporting the achievement of the slaughter output target