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Contagion: Scientific Periodical Journal of Public Health and Coastal Health
Published by Universitas Islam Negeri Sumatera Utara
ISSN : -     EISSN : 26850389     DOI : 10.30829/contagion
Core Subject : Health,
Health Professions Public Health
Contagion: Scientific Periodical Journal of Public Health and Coastal Health, A Scientific Periodic Journal of Public Health published by the Public health Study Program of The Faculty of Public Health UINSU Medan. This Journal prioritiez the collaboration of lecturers and students with scope of the discussion is about Public Health, Health and Islam, and Coastal Health. This Journal is published twice, published on June and December.
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Articles 627 Documents
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Vesicolithiasis Concealing a Migrated Intravesical Copper Intrauterine Device Successfully Treated by Cystolithotripsy and Endoscopic Removal: A Case Report Patria Putrapratama; Trisula Utomo; Wikan Kurniawan
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.31198

Abstract

Migration of a copper intrauterine device (Cu-IUD) into the urinary bladder is a rare and often delayed complication of long-term IUD use that may present with vesicolithiasis and recurrent urinary tract infection (UTI), while the migrated device may be concealed by stone formation, making diagnosis challenging. We report the case of a 34-year-old woman who presented with a four-month history of lower urinary tract symptoms (LUTS) and recurrent UTI, with a history of Cu-IUD insertion four years earlier without routine follow-up. Urologic ultrasonography revealed a hyperechoic bladder lesion suggestive of a bladder calculus. Cystoscopy followed by single-session cystolithotripsy revealed a T-shaped encrusted calculus concealing a migrated Cu-IUD. Cystolithotripsy was performed using a stone punch, followed by transurethral extraction of the underlying device, with a total operative duration of approximately 30 minutes. Inspection of the removed device confirmed a copper-containing T-shaped IUD, while stone analysis demonstrated a predominantly struvite, infection-related composition. At the two-week follow-up, the patient experienced complete symptom resolution, with no residual stone or foreign body identified on radiographic evaluation, indicating that intravesical Cu-IUD migration should be considered in women with recurrent UTI and vesicolithiasis, particularly in those with a history of IUD insertion without routine follow-up, and that single-session endoscopic cystolithotripsy with extraction of the migrated device is a safe, feasible, and minimally invasive treatment option with favorable clinical outcomes. Keywords: Vesicolithiasis, Intrauterine Device Migration, Cystolithotripsy, Urinary Tract Infection, Case Report
Effectiveness of Amomum Cardamomum and Zingiber Officinale Roscoe as Complementary Therapy for the Intensity of Emesis Gravidarum at Makassar City Health Center Rahmiyani Saad; Leli Leli; Syahridayanti Syahridayanti; Isah Fitri Weni; Siti Mahadia Watimena
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.30563

Abstract

Emesis gravidarum is a complaint that is often experienced by pregnant women in the first trimester and has the potential to affect the quality of life if not handled appropriately. Herbal complementary therapy has the potential to be a safe non-pharmacological alternative. This study aims to evaluate the effectiveness of a combination of cardamom (Amomum cardamomum) and red ginger (Zingiber officinale Roscoe) in reducing the intensity of emesis gravidarum in pregnant women in the first trimester. This quantitative research uses a quasi-experimental design with a one-group pretest-posttest design. The research was carried out from May to July 2026 at the UPT Bara-Baraya Health Center, Makassar City. A total of 30 pregnant women in the first trimester who met the inclusion criteria were selected through purposive sampling. The intervention was in the form of brewing a combination of cardamom and red ginger drinks taken twice a day for 10 consecutive days. Measurement of the severity of emesis gravidarum was carried out before and after the intervention using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) instrument. Data were analyzed using univariate and bivariate analyses with the Wilcoxon Signed-Rank test. Before the intervention, the majority of respondents were in the moderate emesis category (76.7%) with an average PUQE score of 7.60 ± 1.61. After 10 days of intervention, the majority of respondents switched to the mild category (90.0%) with an average PUQE score of 4.70 ± 1.24. There was a decrease in the average PUQE score of 2.90 points. The results of the statistical test showed a significant decrease in the intensity of emesis gravidarum (Z = -4.703; p < 0.001) with a large effect size (r = 0.86; CI 95%: 0.74–0.93). No serious side effects were found during the intervention period. The administration of a combination of cardamom and red ginger improved overall medication adherence, based on daily consumption records, i.e., 30/30 participants consumed 100% of the prescribed dose. This is effective in reducing the intensity of emesis gravidarum in pregnant women in the first trimester. This intervention has the potential to be integrated into antenatal services in primary health facilities, although further research in the Randomized Controlled Trial (RCT) design is still needed. Keywords: Emesis gravidarum, Amomum cardamomum, Zingiber officinale Roscoe, Pregnant women, Complementary therapy
Comparative Antibacterial Activity of Beluntas (Pluchea indica L.) Leaf Ethanolic Extracts Obtained by Maceration and Ultrasound-Assisted Extraction Against Three Acne-Associated Bacteria: An In Vitro Study Ernoviya Ernoviya; Zulfikri Zulfikri
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.29913

Abstract

Rising resistance of acne-associated Gram-positive bacteria, including Cutibacterium acnes (formerly Propionibacterium acnes), Staphylococcus epidermidis, and Staphylococcus aureus, to first-line macrolide and tetracycline antibiotics has become a global dermatological and public-health concern, intensifying the search for plant-derived antibacterial alternatives. Beluntas (Pluchea indica L., Asteraceae) is widely used in Indonesian traditional medicine and contains flavonoids, tannins, saponins, and caffeoylquinic acids; however, the influence of extraction technique on its antibacterial potency against acne-associated bacteria has not been systematically evaluated. This study aimed to compare the in vitro antibacterial activity of P. indica leaf ethanolic extracts prepared by 5-day cold maceration and 60-minute ultrasound-assisted extraction (UAE, <20 kHz) against C. acnes, S. epidermidis and S. aureus. Powdered leaves were extracted with 70% ethanol using either 5-day cold maceration or 60-min UAE. Following concentration with a rotary evaporator, six concentrations (10–60%, w/v) were evaluated using the agar well diffusion method on Mueller–Hinton agar for S. aureus, S. epidermidis and blood agar for C. acnes. Inhibition-zone diameters were interpreted according to the Davis–Stout classification. Phytochemical screening confirmed the presence of flavonoids, triterpenoids, glycosides, saponins and tannins. Maceration produced larger inhibition zones than UAE for all three organisms at every concentration tested (single-measurement values). The largest inhibition was observed against S. aureus with the 60% maceration extract (20.30 mm; very strong category) followed by S. epidermidis (14.70 mm; strong) and C. acnes (13.65 mm; strong). The susceptibility ranking was S. aureus > S. epidermidis > C. acnes. P. Ethanolic leaf extracts of P. indica obtained through maceration exhibited stronger antibacterial activity than those through UAE against acne-associated Gram-positive bacteria. These preliminary findings suggest that beluntas leaf extract is a promising plant-based antibacterial candidate that may help reduce reliance on synthetic antibiotics and support its further development as a complementary or preventive anti-acne ingredient, pending confirmatory studies incorporating appropriate replication and controls. Keywords: Acne Vulgaris, Antimicrobial Resistance, Dermatological Phytotherapy, Maceration, Pluchea Indica, Ultrasound-Assisted Extraction
Effect of a Blended Clinical Learning Model on Delivery Care Competency Among Professional Midwifery Students Lolita Nugraeny; Siti Hajar; Eliya Wardayani
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.29937

Abstract

Delivery care competency is a fundamental ability that midwifery professional students must master to provide safe, effective, and high-quality maternal health services. Conventional clinical education alone does not consistently build this competency, creating a need for learning models that combine structured self-paced preparation with supervised hands-on practice. This study aimed to analyze the effectiveness of a blended clinical learning model, compared with conventional clinical learning, in improving delivery care competency scores among professional midwifery students. Novelty: Unlike previous studies that examined blended learning in general nursing or midwifery theory courses, this study evaluates a structured seven-stage blended clinical learning model specifically designed for intrapartum (delivery) care practicum, integrating a Learning Management System (LMS), video demonstration, laboratory simulation with formative OSCE, bedside teaching, and structured clinical reflection. A quasi-experimental design with a pretest-posttest control group approach was used. Sixty midwifery professional students undergoing clinical practice in maternity care were allocated by purposive sampling into an intervention group (n = 30) and a control group (n = 30). The intervention group received a four-week blended clinical learning program; the control group received conventional clinical learning. Delivery care competency was measured with an Objective Structured Clinical Examination (OSCE) checklist and a clinical competency observation sheet (content validity by three experts). Data were analyzed with paired t-tests and independent t-tests after Shapiro-Wilk normality tests and Levene’s tests for homogeneity of variance confirmed the assumptions for parametric testing. Delivery care competency scores in the intervention group increased significantly from 68.45 ± 5.21 to 87.32 ± 4.11, compared with an increase from 69.11 ± 5.10 to 75.24 ± 5.42 in the control group. The between-group difference in post-intervention scores was statistically significant (p < 0.001; mean difference = 12.08, 95% CI 9.59–14.57; Cohen’s d = 2.51). Blended clinical learning produced a significantly greater improvement in delivery care competency—including labor assessment, clinical decision-making, delivery skills, therapeutic communication, documentation, and clinical reasoning—than conventional learning. These findings support blended clinical learning as a practical strategy for strengthening intrapartum clinical education in midwifery professional programs, provided it is implemented with adequately trained preceptors and structured reflection sessions. Keywords: Blended Clinical Learning, Delivery Care Competency, Midwifery Students; Clinical Reasoning, Maternity Care.
The Effect of Prenatal Yoga on Anxiety, Discomfort, and Labor Experience in Third-Trimester Pregnant Women: A Mixed-Methods Sequential Explanatory Study Munawaroh Munawaroh; Dewi Suri Damayanti; Rahmi Andrita Yuda
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.29520

Abstract

A woman will experience physical and psychological changes during her pregnancy. Physical changes can cause discomfort, and psychological changes can cause anxiety. This study examined changes in anxiety and discomfort following prenatal yoga and explored childbirth experiences among third-trimester pregnant women.  The study employed a mixed-methods sequential explanatory design. Quantitative data were collected through purposive sampling of 25 respondents who participated in four weekly 60-minute prenatal yoga sessions. Six participants were purposively selected from the quantitative sample for in-depth interviews. Data collection employed an anxiety questionnaire, the Hamilton Anxiety Rating Scale (HARS), and a discomfort questionnaire, followed by in-depth interviews with selected informants. Quantitative data were analyzed using the Wilcoxon signed-rank test, and qualitative data were analyzed using thematic analysis. The average anxiety before prenatal yoga was 12.8, and after prenatal yoga it was 3.64, with P = 0.001. The average discomfort before prenatal yoga was 3.76, and after prenatal yoga it was 0.92, with a P-value of 0.001. Participants generally reported reduced anxiety and discomfort after participating in prenatal yoga. Some participants described vaginal deliveries lasting 2 to 7 hours; participants who underwent cesarean section (CS) described feeling better prepared and reported easier recovery.  Anxiety and pregnancy-related discomfort scores decreased after prenatal yoga, and interviewed participants described positive childbirth experiences. These findings should be interpreted in light of the one-group design. Keywords: Prenatal Yoga, Anxiety, Discomfort, Labor Experience
Effectiveness of Complementary Therapies for Breast Milk Production and Related Lactation Outcomes: A Systematic Review Ani Wulandari; Shafiah Shafiah; Ernawati Ernawati; Fatimah Azzahra; Qorinah Estiningtyas Sakilah Adnani
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.30763

Abstract

Difficulties with breast milk production remain a concern among postpartum women and may contribute to early breastfeeding discontinuation. Complementary therapies have been explored to support lactation; however, the available evidence remains heterogeneous. This systematic review aimed to synthesize the evidence regarding  complementary therapies for breast milk production and related lactation outcomes among postpartum and breastfeeding women. PubMed, ScienceDirect, and Google Scholar were searched for original studies published in English or Indonesian between 2021 and 2025. Eligible studies included postpartum or breastfeeding women who received herbal galactagogues, aromatherapy, reflexology, massage, or mind-body therapies, compared with usual care, placebo, or control interventions. Outcomes of interest included breast milk volume, perceived milk sufficiency, and other lactation-related  measures. Risk of bias was assessed using RoB 2 and ROBINS-I tools, and findings were synthesized narratively. Eleven studies were included, comprising seven randomized controlled trials (RCTs) and four quasi-experimental studies. Overall, the findings were favorable but heterogeneous. Herbal galactagogues consistently increased breast milk volume across various preparations. Manual and mind-body therapies, such as emotional management combined with oxytocin massage, significantly increased key lactation hormones, including oxytocin (p = 0.007) and prolactin (p = 0.006). Lavender aromatherapy was associated with adequate milk supply in up to 83.3% of mothers. Foot reflexology increased milk volume (23.51 vs. 12.43 mL), although the difference  did not reach statistical significance (p = 0.065). Complementary therapies may improve certain lactation outcomes; however, the overall  certainty of the evidence remains limited because of heterogeneity and small sample sizes. Further high-quality randomized controlled trials are needed to establish the effectiveness and safety of these interventions.    Keywords: Breastfeeding, Complementary Therapies, Human Milk, Lactation, Postpartum
Subchronic Toxicity of Cep-cepan (Castanopsis costata (Blume) A.DC.) Leaf Ethanol Extract on the Liver and Kidney Histopathology of Female White Mice (Mus musculus) Pratiwi Rukmana Nasution; Hilda S; Zulfikri Zulfikri; Fatwa Hasbi; Khairun Nida
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.29911

Abstract

Castanopsis costata  (cep-cepan ) leaves are traditionally used in North Sumatra and have demonstrated antidiabetic, analgesic, anti-inflammatory, and antioxidant activities. However, their safety following repeated administration remains inadequately characterized, and comparative toxicological data within the Castanopsis genus and the broader Fagaceae family remain limited. This study aimed to evaluate the 28-day subchronic oral toxicity of C. costata leaf ethanol extract based on liver and kidney histopathological findings in female mice. An experimental post-test-only control group design was employed. Twenty female mice (n = 5 per group; four groups; total N = 20) were randomly allocated to a control group receiving 0.5% Na-CMC and three treatment groups receiving C. costata leaf ethanol extract at doses of 250, 500, and 1000 mg/kg body weight (BW) orally once daily for 28 days, following an adapted OECD Test Guideline 407. On day 29, the animals were euthanized; liver and kidney tissues were collected, processed using hematoxylin-eosin staining, and evaluated using a semiquantitative histopathological scoring system. Data were analyzed using the Shapiro-Wilk and Kruskal-Wallis tests. Phytochemical screening identified alkaloids, flavonoids, tannins, steroids/triterpenoids, and anthraquinone glycosides, whereas saponins were not detected. The extract yield was 11.39%. Kidney histopathology scores did not differ significantly among groups (H = 7.028; p = 0.071), and glomerular and tubular architecture remained preserved across all dose levels. In contrast, liver histopathology scores differed significantly among groups (H = 46.793; p < 0.001). Mild, non-diffuse hepatocellular degeneration and isolated apoptosis or necrosis lesions affecting less than 5% of the hepatic parenchyma increased with dose and were most pronounced at 1000 mg/kg BW, whereas steatosis and fibrosis were absent at all grouops. These field-level statistical findings should be considered preliminary pending reanalysis using the individual animal, rather than the microscopic field, as the unit of analysis. Under the conditions of this study, repeated administration of C. costata leaf ethanol extract for 28 days did not induce structural renal alterations but was associated with mild, dose-dependent hepatic histopathological changes that became evident at 500 mg/kg BW and were most pronounced at 1000 mg/kg BW. Doses up to 250 mg/kg BW showed no discernible histopathological changes in either organ, supporting the extract’s relative safety at this dose for the parameters evaluated, whereas the 1000 mg/kg BW dose warrants caution pending biochemical confirmation. Further studies incorporating serum biochemical analyses, corrected animal-level statistical re-analysis, and longer-term toxicity assessments are recommended before prolonged use can be considered. Keywords: Castanopsis costata, subacute toxicity, subchronic toxicity, hepatic histopathology, liver, kidney
Physician Adherence to Common Cold Clinical Practice Guidelines: an Electronic Medical Record Audit Using SIMKES Khanza Hariyanto Hariyanto; Merita Arini
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.29558

Abstract

Common cold (ICD-10 J00) is a self-limiting viral infection; however, inappropriate antibiotic prescribing remains a global concern. Electronic Medical Records (EMR) can facilitate clinical audits, but evidence from Indonesian primary care settings remains limited. This study aimed to assess physician adherence to Clinical Practice Guidelines (CPG) for common cold using SIMKES Khanza EMR at Sehati Kudus Primary Clinic. A retrospective clinical audit was conducted on 753 EMR records from July to December 2025 using a 32-item CPG-based checklist. Data were analyzed descriptively using SPSS version 26. The results showed that overall physician adherence to common cold Clinical Practice Guidelines (CPGs) was 59.9%, with a mean adherence score of 19.19 out of 32 assessment items, categorized as sufficient. The highest adherence was observed in EMR documentation completeness (80.8%) and diagnosis (65.0%), whereas adherence was lower in anamnesis (55.5%), physical examination (52.7%), and management (45.5%). The management component, which included non-pharmacological therapy, symptomatic treatment, and rational antibiotic use, demonstrated the lowest adherence, highlighting important gaps in evidence-based management practices despite good documentation quality. Physician adherence to common cold CPG was suboptimal, particularly in management-related practices. Although SIMKES Khanza facilitated structured clinical documentation and supported EMR-based clinical audits, improvements in clinical assessment, patient education, and adherence to evidence-based management recommendations are needed. Regular clinical audits and quality improvement initiatives may help strengthen guideline implementation in primary care settings. Keywords: Common Cold, Guidelines Adherence, Electronic Medical Records, Primary Health Care
Animated Video Media Intervention on Dental Caries Prevention on Students' Knowledge SDN 01 Bandar Buat Padang City Yulia Rahmad; Salwa Septianofrian
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.28834

Abstract

Dental caries is a public health problem with a high prevalence among school-aged children. at SD Negeri 01 Bandar Buat, Padang City, there were 322 cases of dental caries recorded, so an attractive health promotion strategy is needed that is in accordance with the characteristics of the digital generation. To determine the effect of animated video-based health promotion on knowledge of dental caries prevention in fifth-grade students of SD Negeri 01 Bandar Buat, Padang City. This study used a pre-experimental design with a one-group pretest-posttest design. The sample consisted of 86 fifth-grade students selected using purposive sampling. The instrument was a dental caries prevention knowledge questionnaire that had been tested for validity and reliability. Media-based health promotion was carried out once through the screening of a 2–3-minute educational animated video. Data analysis used the Wilcoxon Signed-Rank Test with α=0.05. The average knowledge score increased from 14.38 (median 15) before media-based health promotion to 19.72 (median 20) afterward, with an average increase of 5.34 points or 37.10%. Before the media was provided, 54 students (62.8%) had sufficient knowledge, while after the media was provided, all students (100%) were in the good category. The Wilcoxon test showed a significant difference between the pretest and post-test scores (p<0.001; Z=-8.085). Health promotion based on animated video media not only increased knowledge but also has the potential to encourage student empowerment as peer educators and build collective awareness about dental health in the school environment. Animated video is an effective health promotion media in increasing knowledge of dental caries prevention and has the potential to be integrated into the School Dental Health Program (UKGS) as a relatively cost-effective, easily replicated, and appropriate strategy for the digital generation. These findings can be a basis for local health and education institutions to adopt animated media as an innovation in efforts to prevent dental caries more widely in the school environment.Keywords: Student Empowerment, Educational Videos, School Children's Oral Health; Media-Based Health Promotion, Knowledge, Dental Caries Prevention.
Precision Desensitization In The Imlifidase Era: A Systematic Review of Biomarkers, Risk Stratification Models, and Personalized Treatment Algorithms For Hla-Incompatible Kidney Transplantation Aldy Ridho Pangestu; Tanaya Ghinorawa
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 8, No 3 (2026): Contagion
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v8i3.29280

Abstract

Highly human leukocyte antigen (HLA)-sensitized kidney transplant candidates with positive crossmatch have limited access to transplantation, prolonged exposure to dialysis, and increased mortality. Imlifidase, an IgG‑cleaving enzyme, can rapidly convert positive crossmatch to a negative crossmatch; however the roles of immunological biomarkers, risk stratification, and personalized treatment protocols remain insufficiently defined. The study systematically searched PubMed, Web of Science, and the Cochrane Library for clinical studies involving adult HLA‑incompatible kidney transplant candidates or recipients treated with imlifidase. Studies reporting donor‑specific antibodies (DSA) or calculated panel reactive antibody (cPRA) together with crossmatch conversion, antibody‑mediated rejection (AMR), patient and graft survival, and safety outcomes were included. Results were synthesized descriptively because of substantial clinical and methodological heterogeneity. Four clinical studies of imlifidase‑treated HLA‑incompatible kidney transplant recipients and one narrative review on biomarker‑based risk models and personalized algorithms met the eligibility criteria, although the narrative review was used solely to provide  conceptual context . Across the clinical cohorts, sample sizes ranged from 19 to 41 recipients, all of whom were highly sensitized, with median or mean cPRA values ranging from 90–100%. Imlifidase converted a positive crossmatch to a negative crossmatch in 89.5–100% of recipients within 24 hours, with short‑ to mid‑term patient survival rates of 87.5–100% and graft survival rates of 84–100%. Early AMR occurred in 22–39% of recipients and was consistently associated with DSA rebound emerging within 3–15 days after imlifidase administration. Current evidence indicates that imlifidase  provides a viable desensitization strategy for highly sensitized, crossmatch‑positive patients who otherwise have limited transplantation options; however, this benefit is tempered by a substantial burden of early AMR associated with DSA rebound. Reliance on small, nonrandomized cohorts and heterogeneous immunosuppressive and monitoring protocols limits the certainty of the available evidence, underscoring the need for prospective multicentre studies to validate composite biomarker‑based risk models and personalized treatment algorithms in imlifidase‑enabled HLA‑incompatible kidney transplantation.Keywords: Imlifidase, Kidney Transplantation, HLA-Incompatible, Desensitization, Donor-Specific Antibodies.

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