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This study aims to analyze the effect of the implementation of the Flipped Classroom model with a Deep Learning approach on the critical thinking and collaboration skills of Phase F XI students on the digestive system material. The study used a mixed methods with an embedded experimental design type. The research sample consisted of one experimental class that received Flipped Classroom learning with a Deep Learning approach and one control class that received Problem Based Learning (PBL) learning. Data on critical thinking skills were collected through essay tests, while collaboration skills were obtained through observation sheets. Quantitative data analysis used One-Way MANCOVA and qualitative analysis was carried out through data reduction, data presentation, and drawing conclusions assisted by NVivo. The results showed a simultaneous significant effect between the learning model on students' critical thinking and collaboration skills after controlling for initial abilities with a significance value of 0.002 (p<0.05). The average posttest critical thinking of the experimental group was 71.69 higher than the control group at 62.53. Meanwhile, the collaboration skills of both groups showed a relatively balanced increase. The ANCOVA results showed that the Flipped Classroom model with a Deep Learning approach significantly impacted critical thinking skills, but did not show a significant difference in collaboration skills. The research findings indicate that the integration of Flipped Classroom and Deep Learning is effective in improving students' critical thinking skills and supporting 21st-century learning.

California papaya leaves (Carica papaya L.) are known to contain various active compounds that have the potential to stimulate appetite and boost metabolism, making them a promising candidate for development as a pharmaceutical formulation. This study aims to design a capsule formulation of California papaya leaf extract with appropriate excipients and to evaluate its ability to increase body weight through preclinical testing using a zebrafish (Danio rerio). The extract was obtained via maceration with 96% ethanol and formulated into capsules using the wet granulation method in four variations (F0–F3). Physical evaluations included organoleptic properties, flowability, angle of repose, loss on drying, disintegration time, weight uniformity, and stability testing using the cycling test method. The results indicated that all formulas met the physical requirements, with disintegration times of 3–4 minutes and loss on drying <15%. Formula F2 exhibited the most optimal physical characteristics; however, stability testing revealed a decline in physical properties after extreme temperature treatment. Efficacy tests showed a significant increase in zebrafish weight (p < 0.05), with F3 yielding the best results. A high survival rate (≥80%) suggests the formulation is relatively safe. In conclusion, California papaya leaf extract capsules demonstrate significant potential as an agent to promote weight gain.

Adolescents face significant barriers in accessing reproductive health services due to fears of privacy breaches and social stigma. In primary healthcare facilities, healthcare professionals are often trapped in a dilemma between the obligation to maintain medical confidentiality based on professional ethics and national regulatory demands requiring parental involvement for underage patients. This study aims to analyze the practice of protecting adolescent patient data privacy at Mardi Saras Primary Clinic and identify the gap between practical implementation and the norms of medical ethics and applicable legal regulations. This study employs a socio-legal research method with a qualitative approach. Data were collected through in-depth interviews with doctors and nurses, observation of service procedures, and study of the clinic's Standard Operating Procedures. The results indicate that although Mardi Saras Primary Clinic has implemented basic confidentiality protocols such as closed consultation rooms, there are substantial weaknesses in informed consent management, which still heavily relies on parental presence for all adolescent cases. This practice is driven by healthcare professionals' fear of legal risks, thereby ignoring the principle of developing autonomy in adolescents. These findings indicate a disparity between rigid administrative compliance and the spirit of protecting adolescent health rights within national regulations. The implication of this study underscores the urgency of developing specific SOPs that are sensitive to adolescent rights, as well as the need for continuous training for healthcare professionals regarding the legal and ethical boundaries of maintaining confidentiality for underage patients without compromising legal safety aspects.

Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy associated with high morbidity, reduced survival, and impaired quality of life. Radiotherapy (RT) has been widely used as a bladder-preserving strategy, particularly for patients unsuitable for surgery or systemic chemotherapy. RT may also enhance tumor immunogenicity through programmed death-ligand 1 (PD-L1) upregulation, providing a rationale for combination therapy with immunotherapy. This study aimed to evaluate the effectiveness of combining immunotherapy and radiotherapy in MIBC treatment. A systematic review was conducted following PRISMA 2020 guidelines using the PICO framework. Literature searches were performed in PubMed, Embase, Cochrane, ClinicalTrials.gov, Web of Science, and Scopus databases for studies published between 2016 and 2025. Risk of bias was assessed using the Cochrane Risk of Bias Tool and ROBINS-I. Of 105 identified studies, five met the inclusion criteria and were included in the final analysis. Only one Phase II randomized controlled trial demonstrated low risk of bias in randomization and allocation concealment. ROBINS-I assessment indicated moderate to serious risk in confounding and participant selection domains. Clinical findings showed promising outcomes, with complete response rates ranging from 35%–50% and partial response rates from 25%–40%. Median overall survival ranged from 24–30 months, with favorable disease-free and progression-free survival outcomes. Combined immunotherapy and radiotherapy demonstrate potential to improve survival and disease control in MIBC; however, further rigorous clinical studies are needed to optimize patient-centered treatment strategies.  

The digitalization of tax administration has become one of the Indonesian government's strategic initiatives to improve efficiency, transparency, and taxpayer compliance. However, the implementation of digital tax systems among Micro, Small, and Medium Enterprises (MSMEs), particularly distributor-sector MSMEs in Batam City, still faces various administrative and technical challenges. This study aims to examine the experiences, risk perceptions, and adaptation strategies of distributor MSME actors in responding to the digitalization of tax administration following the implementation of the Harmonization of Tax Regulations Law (UU HPP). The research employed a qualitative approach using a phenomenological method. Data were collected through in-depth interviews with seven distributor MSME owners in Batam City who had utilized digital tax systems such as e-Filing and Coretax. The findings indicate that most business actors still experience limitations in technical understanding, concerns regarding reporting errors, and difficulties adapting to changes in digital tax systems and regulations. To address these challenges, MSME actors developed several adaptation strategies, including the use of tax consultants, hybrid manual-digital bookkeeping systems, and informal assistance through the internet and business networks. This study highlights that the success of tax digitalization requires a more adaptive approach, stable systems, and policies that are aligned with the characteristics of local MSMEs.

Background: Menstruation is a natural physiological process that indicates the functional maturity of the female reproductive system. Menstrual cycle disorders can be influenced by several factors, including stress and obesity. Stress may cause hormonal changes through the hypothalamic-pituitary axis, leading to decreased luteinizing hormone (LH) levels and menstrual irregularities. Obesity can also affect ovarian function and disrupt the menstrual cycle. Objective: To determine the relationship between stress and obesity with menstrual cycle disorders among female adolescents at SMAN 1 Majene in 2026. Methods: This study used an analytical observational design with a cross-sectional approach. Data on stress levels, obesity status, and menstrual cycle disorders were collected simultaneously from 84 female respondents. The chi-square test was used to analyze the relationships among variables. Results: The analysis showed a significant relationship between stress and menstrual cycle disorders (p = .006; α < .05). A significant relationship was also found between obesity and menstrual cycle disorders (p = .002; α < .05). Many obese respondents experienced irregular menstrual cycles. Conclusion: There is a significant relationship between stress and obesity with menstrual cycle disorders among female adolescents at SMAN 1 Majene.

Medical waste is a by-product of healthcare activities that may have negative impacts on human health and the environment if not properly managed. This study aims to examine strategic planning for medical waste management in healthcare facilities and evaluate the risk of environmental contamination in the digital era. The method used was a literature review by examining various relevant scientific sources. The findings indicate that medical waste management still faces several challenges, including non-compliance with established standards, limited human resources, and the risk of environmental pollution. The utilization of digital technologies such as the Internet of Things (IoT), Artificial Intelligence (AI), RFID, and Blockchain has the potential to improve the effectiveness of monitoring and managing medical waste. Therefore, strategic planning supported by digital technology, human resource capacity building, and regulatory compliance is essential for achieving safe and sustainable medical waste management.

Human Papillomavirus (HPV) infection is typically the cause of cervical cancer, one of the cancers with a high death rate among women. Despite their widespread use, conventional therapeutic approaches still have drawbacks, such as the emergence of cancer cell resistance and severe side effects. Natural compounds are now used as safer alternative treatments as a result. Soursop leaves (Annona muricata L.) are one plant that has been shown to have anticancer potential. Through phytochemical screening, compound identification using GC-MS, cell viability testing using the MTT Assay, and BCL2 gene expression analysis using qPCR, this study attempts to examine the potential of soursop leaf extract as an anticancer agent against cervical cancer cells (HeLa cells). The results of the phytochemical examination showed that steroids, phenolics, and alkaloids were present. Ostole, bisacumol, and ricinoleic acid were found to be the predominant components when the active chemicals were identified by GC-MS. With an IC²₀ value of 5.01 μg/mL, the MTT experiment demonstrated that soursop leaf extract could decrease cell viability as the concentration rose. Furthermore, BCL2 gene expression was significantly reduced, especially in treatments with doses of 500 and 1000 μg/mL, according to the results of qPCR gene expression analysis. The overall findings suggest that soursop leaf extract may be used as a natural anticancer treatment against HeLa cells by lowering the expression of the BCL2 gene.

The development of an economic activity in a city is often one of the influences on changes in the use of residential space in the surrounding area. One of the phenomena that we can see in big cities in Indonesia is the use of residences as rental housing such as boarding houses and rents aimed especially at workers in foreign areas. This study aims to analyze the use of residential space by the community as temporary residence for employees of Mie Gacoan restaurant in Serang City, Banten, and see how it affects the spatial dynamics of the residential area. This study uses a primary and secondary data-based case study method with a qualitative descriptive approach. The results of the study show that the existence of economic activities around residential areas can encourage an increase in the need for temporary housing for workers in rural areas. This phenomenon makes some people take advantage of their residences by making them rental residences such as boarding houses and rented ones. This can affect the spatial structure of the residential area, such as increasing population density, increasing activities in the residential environment, and the presence of small economic activities by the community. Therefore, this phenomenon states that the development of economic activity in an urban area can trigger changes in the use of space in the surrounding residential area.

This community service study investigates a marketing training program implemented by theology students of STT Kadesi Bogor at the GPIA Sidoasri congregation in Sumbermanjing Wetan District, Malang Regency, East Java. The program targeted eighteen women members of the congregation to improve their economic capacity through the marketing of low-cost everyday clothing via three channels: door-to-door sales, a small storefront at the church, and online commerce through TikTok. The study applied a pre- test/post-test design evaluated using the Normalized Gain (N-Gain) method to measure changes in knowledge and skill across five indicators: marketing knowledge, selling skills, online media usage, basic financial recording, and entrepreneurial motivation. Results indicated a moderate-to-high N-Gain across all measured indicators, with an average N-Gain score of 0.656 (moderate category), and the highest individual gain in entrepreneurial motivation (0.76, high category). Sales data over the three-month period (January–March 2025) recorded a total profit of Rp1,967,500 across 345 garments sold, representing an income supplement of approximately 27–35% relative to participants' baseline household income for the most active participants. A marked sales decline in February and March was attributed to seasonal demand shifts ahead of Eid al-Fitr, as consumers redirected purchases toward formal Muslim attire. The program demonstrated that congregation-based economic empowerment rooted in a biblical theology of work, stewardship, and the dignity of labor can yield measurable and holistic socioeconomic outcomes for Christian women in rural communities.

Fractures are one of the most common musculoskeletal disorders caused by trauma, repetitive stress, or pathological factors. Supracondylar femur fracture is a type of femur fracture occurring at the distal 12 cm of the femur, and Open Reduction and Internal Fixation (ORIF) is the primary surgical intervention. Post-operative ORIF patients commonly experience impaired physical mobility and impaired skin integrity. This study aimed to provide comprehensive nursing care to a patient post-ORIF for right supracondylar femur fracture in the Mawar 2 Ward of RSUD dr. Soeselo, Tegal Regency. A descriptive method with a nursing process approach was used, employing interview, observation, documentation study, and literature study. Nursing assessments conducted on February 8, 2026 revealed that the patient (Ny. S, female, 68 years) experienced pain at the surgical site with a scale of 7, inability to move both lower extremities (muscle strength score 2), and a post-operative wound approximately 10 cm in length with redness and edema. Two nursing diagnoses were established: impaired physical mobility related to neuromuscular disorders and impaired structural bone integrity, and impaired skin/tissue integrity related to invasive procedure effects. Nursing interventions included mobilization support, pain management, wound care, and collaborative administration of medical therapy. After two days of nursing implementation, both diagnoses were partially resolved. Discharge planning focused on gradual mobilization, independent wound care, and high-protein and high-calorie diet to accelerate recovery.

This study aims to identify and evaluate the cultural tourism potential of Kalurahan Grogol in Gunungkidul Regency to inform the development of a community-based cultural tourism village. The research employed a qualitative descriptive approach supported by quantitative scoring techniques using a 1–5 Likert scale across four assessment dimensions: cultural value, physical value, tourism value, and experiential value. The analysis applied Du Cros and McKercher’s Market Appeal–Robusticity Matrix to map the market attractiveness and cultural robustness of each cultural asset. Data were collected through semi-structured interviews, observations, and documentation studies of 46 tangible and intangible cultural assets in Kalurahan Grogol. The findings reveal that most cultural assets exhibit moderate to high cultural robustness, indicating that local cultural practices remain active and socially sustained within the community. Prominent cultural assets such as Rasulan, Karawitan Lestari Budoyo, Reog Sedyo Laras, Gejlok Lesung, Sega Berkat, and Tempe Godhong are positioned in Quadrant A1, characterized by high market appeal and high robustness, making them highly potential as leading cultural tourism attractions. Meanwhile, assets in Quadrants B and C present opportunities to develop creative, educational, spiritual, and wellness-based experiential tourism products. The study also finds that several sacred traditions categorized in Quadrant D are more appropriately preserved through non-commercial approaches. The absence of cultural assets in the D3 category indicates that the cultural system of Kalurahan Grogol remains adaptive and regenerative amid modernization. This research contributes theoretically by extending the application of the Market Appeal–Robusticity Matrix into the context of community-based cultural tourism villages. It provides strategic recommendations for sustainable cultural tourism development that remain sensitive to local cultural authenticity.

Background: Hepatocellular Carcinoma (HCC) is an abnormal cell growth in the liver characterized by increased number of dividing liver cells accompanied by malignant transformation. A common paraneoplastic phenomenon in HCC patients is hypoglycemia, which arises due to hepatic dysfunction impairing gluconeogenesis and glycogenolysis, as well as tumor-mediated IGF-II production. This condition causes hypoglycemia as a primary nursing problem requiring comprehensive nursing care. Objective: To describe the nursing care process for a patient with HCC focusing on blood glucose instability management and knowledge deficit intervention. Methods: This study used a descriptive qualitative method through a case study approach. Data were collected through interview, observation, documentation study, and literature review. Results: Two nursing diagnoses were identified: blood glucose instability related to hepatic dysfunction and knowledge deficit related to lack of information exposure. Nursing interventions performed included hypoglycemia management and disease process education. After 2x24 hours of nursing implementation, both diagnoses were partially resolved, as GDS values remained fluctuating and behavioral change had not been fully achieved. Conclusion: Comprehensive nursing management through routine blood glucose monitoring, dextrose administration, nutritional modification, and health education can improve blood glucose stability and patient knowledge in HCC patients.

Breast cancer remains a major global health challenge, with treatment effectiveness often limited by drug resistance and the toxic side effects of chemotherapy on normal cells. The exploration of bioactive compounds from natural sources through a medicinal chemistry approach offers a promising alternative strategy. This study aims to examine the molecular mechanisms of action and Structure-Activity Relationships (SAR) of various natural compound scaffolds as potential breast anticancer agents. The method employed was a systematic narrative literature review of 15 recent scientific articles evaluating computational parameters, including molecular docking, as well as in vitro and in vivo activities. The results indicate that polyphenols, flavonoids such as quercetin and EGCG, and curcumin possess strong cytotoxic activity and high binding affinity toward cancer-related target macromolecules. SAR analysis demonstrates that key structural features, including the number and position of free phenolic hydroxyl groups, the presence of gallate ester groups, and conjugated diketone systems, play a crucial role in determining ligand receptor complex stability. These interactions are supported by hydrogen bonding, hydrophobic interactions, and favorable steric compatibility within receptor binding sites. Computational findings further suggest that structural optimization can enhance ligand selectivity and improve pharmacokinetic properties. This study concludes that natural phytochemical scaffolds have significant potential as lead compounds and provide a rational basis for Computer-Aided Drug Design in developing more potent, selective, multi-target, and safer breast anticancer therapies.

This study aims to analyze the dynamics of urban growth, land use change, and settlement development in Wamena City during 2020–2025. The research employed a quantitative descriptive approach using satellite imagery and population data obtained from the Central Bureau of Statistics (BPS) of Jayawijaya Regency. The analysis was conducted through satellite image interpretation to identify land use changes and the expansion of built-up areas.The results indicate that the built-up area in Wamena City increased from 1,250 hectares in 2020 to 2,012 hectares in 2025. Meanwhile, the population increased from 44,315 people to 49,102 people during the same period. Land use changes were dominated by the conversion of open land into residential areas and other urban facilities. Settlement growth generally followed the main road networks, city center, and areas surrounding Wamena Airport. Population growth, urbanization, economic activities, and infrastructure development were identified as the main factors influencing urban growth dynamics in Wamena City. These conditions resulted in reduced open spaces and increased urban density.

This research is motivated by the low critical thinking skills of third-grade students in learning Pancasila symbols and the limited use of interesting, interactive learning media in the classroom. The purpose of this study is to develop the Magic Letter Spinwheel learning media, determine its feasibility, and examine the improvement of students’ critical thinking skills after using the media. This study employed a Research and Development (R&D) method with the ADDIE development model, consisting of Analysis, Design, Development, Implementation, and Evaluation stages. The research subjects were third-grade students of SDN Sumber 02, Blitar Regency. Data were collected through observation, interviews, validation questionnaires from media and material experts, as well as pretests and posttests. The data were analyzed descriptively using qualitative and quantitative approaches, including feasibility percentages and the N-Gain test. The development results show that the Magic Letter Spinwheel is an interactive learning medium in the form of a spinning wheel containing Pancasila symbols, questions, and learning activities that encourage students to think critically. This medium is designed with an attractive display and is supported by light features and an automatic rotation button to increase students’ learning interest. Based on expert validation, the media is declared feasible for classroom use. The implementation of the Magic Letter Spinwheel can improve students’ critical thinking skills through active, enjoyable, and student-centered learning activities. Therefore, this media is suitable for use in Pancasila Education learning to support the development of critical thinking skills among third-grade elementary school students.

Teachers, as professionals, play a crucial role in managing learning in the classroom. One essential skill that teachers must have is managerial skills, which involve organizing learning activities, setting up the learning environment, and applying suitable methods for learning tasks. In the context of differentiated learning focused on student needs, teacher managerial competence is vital for designing and managing instruction tailored to each student's requirements. Differentiated learning is an approach that emphasizes meeting the needs, interests, and learning styles of individual students. This study was conducted using a literature review method, drawing data from various sources including books, articles, and relevant previous research. The review shows that for successful differentiated learning, teachers need to implement managerial strategies for identifying students’ learning needs, managing content, processes, learning products, and conducting regular formative assessments. Furthermore, teachers must create an environment that supports the learning process through strong collaboration among students, between teachers and students, and with parents. Therefore, improving teacher managerial skills is one way to achieve inclusive learning and accommodate student diversity.

Environmental-based diseases remain a major public health issue associated with unsafe drinking water, inadequate sanitation, poor hygiene behavior, improper household waste management, and unsafe domestic wastewater disposal. Community-Based Total Sanitation, known in Indonesia as Sanitasi Total Berbasis Masyarakat or STBM, is a community empowerment approach designed to change hygiene and sanitation behavior through five pillars. This article aims to develop an STBM program planning design and an impact evaluation model for reducing environmental-based diseases, particularly diarrhoeal disease. This study used a narrative review method by analyzing national regulations, official guidelines, global WASH reports, and recent scientific literature. The proposed program design includes situation analysis, multisectoral advocacy, community triggering, household mentoring, strengthening sanitation facilities, monitoring, verification, and impact evaluation. The evaluation model uses process, output, outcome, and impact indicators, with diarrhoea incidence as the main measurable health indicator. The findings indicate that an integrated STBM program supported by community participation, valid baseline data, and periodic evaluation can strengthen the prevention of environmental-based diseases. This article recommends implementing STBM as a sustainable community-based public health intervention rather than a short-term sanitation activity. 

Background: Community nursing is a service process that is a combination of nursing and public health. Family nursing care is health services focused on the family where the entire process from assessment, diagnosis, planning, implementation to evaluation involves all family members both in healthy and sick conditions. The elderly are individuals in the age range of 60 years and above. Stroke is a disorder of brain function that appears suddenly accompanied by clinical signs both local and global in nature that last more than 24 hours caused by disruption of blood flow to the brain. Objective: To provide family nursing care to Tn. W with Neurological System Disorders: Stroke in Karangjati Village RT 02 RW 05 Tonjong District, Brebes Regency. Methods: This scientific paper is compiled using a descriptive narrative study approach following the stages of the nursing process including assessment, diagnosis, intervention, implementation, and evaluation. Data collection techniques include interviews, observation, physical examination, and documentation studies. Results: Nursing diagnoses that emerged were physical mobility impairment and knowledge deficit. Nursing interventions for physical mobility impairment included recognizing health problems and understanding stroke management, particularly related to mobilization through passive and active range of motion (ROM) exercises. For knowledge deficit, interventions included health education about stroke using educational media. Conclusion: After implementation over three days (December 27–29, 2025), the physical mobility impairment problem was partially resolved and knowledge deficit was resolved. It is expected that patients can increase their knowledge about health, particularly stroke disease.  

This research examines the potential application of the Right to Be Forgotten (RTBF) in Indonesia's criminal justice system, focusing on individuals who have been acquitted or have completed their sentences. The study explores the legal, social, and ethical implications of RTBF in relation to criminal records, aiming to assess how it could support the rehabilitation and reintegration of acquitted individuals. In Indonesia, criminal records often remain publicly accessible long after a person has been legally exonerated, creating barriers to social reintegration due to the stigma associated with past accusations. The study investigates the gaps in the current legal framework, such as the lack of provisions for the removal or anonymization of criminal records for acquitted individuals, and explores how RTBF could promote justice and fairness. The research uses a literature review methodology, analyzing relevant legal texts including Law No. 11 of 2008 on Information and Electronic Transactions (ITE Law), Law No. 39 of 1999 on Human Rights, and the 1945 Indonesian Constitution. The review critically evaluates the challenges and opportunities of implementing RTBF, focusing on balancing privacy rights with public safety concerns. The findings suggest that RTBF could reduce the negative impact of criminal records on individuals who have been acquitted, facilitating their reintegration into society. However, the study also highlights the challenges in implementing RTBF due to societal and legal factors. Legal reforms recommendations allow individuals to request the removal of criminal records, aligning Indonesia's legal system with international human rights standards.