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Risk factors for melasma have been identified at several points such as the use of birth control pills, cosmetics, sun exposure, estrogen therapy, decreased thyroid and ovarian function, ovarian tumors, nutrition, drugs that are classified as phototoxic or photoallergic, and epilepsy drugs. This article aims to determine the incidence of melasma and its risk factors. This study uses articles collected from the Google Scholar database. The data collection step uses the keyword "Risk Factor Melasma" according to the title and keyword criteria. The articles used are publications in the 2018-2023 year range. The stages of analysis are carried out using VOSviewer software for visualization and trend analysis in the form of bibliometric maps. The bibliometric approach was applied to identify publication patterns, research developments, and relationships among topics related to melasma risk factors. Based on the visualization results, 100 selected documents were published within 5 years, from 2018 to 2023. The findings provide an overview of the main research trends and contribute to a better understanding of the incidence of melasma and the factors associated with its occurrence

Cutaneous fungal infections caused by Malassezia furfur remain a significant health concern in tropical regions, highlighting the need for safe and effective alternative therapies. Moringa oleifera L. leaves are reported to contain various secondary metabolites, including flavonoids, tannins, and saponins, which exhibit potential antifungal activity. This study aimed to develop a topical suspension formulation of Moringa oleifera leaf extract and to evaluate the effect of varying extract concentrations on the physical characteristics of the preparation. An experimental method was employed using four formulations: F0 as the control, and F1, F2, and F3 containing 9%, 10%, and 11% extract, respectively. Evaluation parameters included organoleptic properties, homogeneity, pH, viscosity, and adhesiveness, as well as stability testing using a cycling test method for 12 days. The results demonstrated that all formulations exhibited good organoleptic characteristics, homogeneity, and viscosity. The pH values remained within the acceptable range for skin preparations, although slight fluctuations were observed during storage. Adhesiveness also showed variations across several testing cycles. Overall, the formulations met acceptable physical quality criteria and demonstrated potential for further development as topical suspensions; however, formulation optimization is still required to enhance stability during storage.

Cutaneous fungal infections caused by Malassezia furfur remain a significant health concern in tropical regions, highlighting the need for safe and effective alternative therapies. Moringa oleifera L. leaves are reported to contain various secondary metabolites, including flavonoids, tannins, and saponins, which exhibit potential antifungal activity. This study aimed to develop a topical suspension formulation of Moringa oleifera leaf extract and to evaluate the effect of varying extract concentrations on the physical characteristics of the preparation. An experimental method was employed using four formulations: F0 as the control, and F1, F2, and F3 containing 9%, 10%, and 11% extract, respectively. Evaluation parameters included organoleptic properties, homogeneity, pH, viscosity, and adhesiveness, as well as stability testing using a cycling test method for 12 days. The results demonstrated that all formulations exhibited good organoleptic characteristics, homogeneity, and viscosity. The pH values remained within the acceptable range for skin preparations, although slight fluctuations were observed during storage. Adhesiveness also showed variations across several testing cycles. Overall, the formulations met acceptable physical quality criteria and demonstrated potential for further development as topical suspensions; however, formulation optimization is still required to enhance stability during storage.

Background: Adenoid hypertrophy is a condition characterized by enlargement of the adenoid tissue which can cause nasopharyngeal obstruction and potentially affect the function of the Eustachian tube. Dysfunction of the Eustachian tube may disrupt middle ear ventilation and increase the risk of otitis media. The degree of adenoid hypertrophy can be objectively assessed using a lateral nasopharyngeal radiograph by calculating the adenoid–nasopharyngeal ratio (A/N ratio). Objective: This study aimed to determine the relationship between adenoid hypertrophy based on the adenoid–nasopharyngeal ratio and the incidence of otitis media. Methods: This study was a quantitative research with an analytic observational design using a cross-sectional approach. Data were obtained from the medical records of patients with adenoid hypertrophy who underwent lateral nasopharyngeal radiographic examination at RSI Purwokerto from 2022 to 2025. The sample consisted of 31 patients who met the inclusion and exclusion criteria. Data analysis was performed using the Spearman correlation test because the data were not normally distributed based on the Shapiro–Wilk test. Results: The results showed that most of the subjects were male (17 subjects, 54.8%) and female (14 subjects, 45.2%). The median age of the subjects was 7 years with an age range of 4–9 years. The median adenoid–nasopharyngeal ratio was 0.90 with a range of 0.68–0.99. Otitis media was found in 11 subjects (35,5%), while 20 subjects (64,5%) did not experience otitis media. The Spearman correlation test showed a correlation coefficient of r = 0.015 with a p-value of 0.936 (p > 0.05), indicating that there was no significant relationship between the adenoid–nasopharyngeal ratio and the incidence of otitis media. Conclusion: There was no statistically significant relationship between adenoid hypertrophy based on the adenoid–nasopharyngeal ratio and the incidence of otitis media.

Medical students need to take the Competence test as Doctor Profession Program (UKMPPD) to be passed and earned their medical profession. Exams are one of the most common stressors experienced by medical students and the body will respond to these stressors in the form of feelings of depression or anxiety. Anxiety and depression itself can affect student performance during exam preparation. The purpose of this study was to determine the relationship between anxiety and depression on the preparation of the Professional Doctoral Program Competency Test (UKMPPD) for students of the Faculty of Medicine, University of Pattimura. The method used is quantitative analysis with cross sectional research design and total sampling technique. The sample is all the student population of the Faculty of Medicine, University of Pattimura who meet the inclusion and exclusion criteria, totaling 90 respondents. The results showed that the majority of respondents experienced mild anxiety symptoms, which is 37% during the CBT exam and 34% during the OSCE exam. The majority of respondents also did not experience depression, which is 68% during the CBT and 70% during the OSCE and the majority had an optimal level of preparation for UKMPPD, which is 63% during the CBT and 64% during the OSCE. Data analysis using the chi square test showed a significant relationship between anxiety symptom and the level of preparation for UKMPPD both CBT (p=0.030) and OSCE (p=0.012). There was no significant relationship between depression symptom and the level of preparation for UKMPPD for both CBT (p=0.123) and OSCE (p=0.07). It can be concluded that there is a significant relationship between anxiety and preparation for UKMPPD, but there is no significant relationship between depression and preparation for UKMPPD.

This study aims to map the trends, integration forms, effectiveness, and contribution of ethnomathematics in elementary school mathematics learning toward national cultural preservation. A systematic literature review (SLR) approach following the PRISMA 2020 protocol was employed. Searches across four academic databases (Scopus, Google Scholar, CrossRef, and Semantic Scholar) yielded 1,176 articles, from which 30 articles met the inclusion criteria. Results indicate that ethnomathematics research in elementary schools has increased significantly during 2023–2026, particularly following the implementation of Kurikulum Merdeka. The three most dominant forms of integration are digital modules and media (53.3%), traditional games (33.3%), and ethnomathematics-based worksheets (13.3%). Geometry and measurement is the most researched mathematics topic (50.0%), and conceptual understanding shows the most significant improvement (40.0%). Beyond improving mathematics achievement, ethnomathematics integration contributes to cultural preservation through cultural contextualization in learning (60.0%), strengthening cultural identity and values (26.7%), and active local cultural preservation (10.0%). The study recommends teacher training, curriculum policy strengthening, cross-sector collaboration, and further research to sustain ethnomathematics implementation in Indonesian elementary schools.

This study explores Indonesian EFL student teachers’ experiences of learning to write news articles through blogging in a Journalism course. The study was motivated by the need to provide meaningful and genre-based writing practice for EFL student teachers, who often face difficulties in generating ideas, organizing information, meeting genre expectations, and writing for authentic aences. Employing a qualitative case study design, the study involved twenty undergraduate student teachers from a private Islamic university in Tangerang, Indonesia; all participants completed an online quetaire, and five volunteers joined follow-up semi-structured interviews. The questionnaire data were alysed descriptively, while the interview data were examined thematically. The findings indicate that blogging supported regular writing practice, helped students understand news text structure, enouraged clearer organization of headlines, leads, and supporting details, and increased engagement by allowing students to publish and share their work. Blogging also promoted peer interaction and selfevaluation because students could read, compare, and comment on one another’s posts. However, some paticpants eprienced challenges related to technical blogging skills, uncertainty about writing standards, limited peer feedback, and discomfort with public online publication. The study concludes that blogging can serve as a useful platform for EFL news writing when it is supported by explicit istrucion, relevant tasks, clear assessment criteria, structured feedback, and ethical awareness in using digital and AI-driven tools.

Diarrhea has the potential to cause an Extraordinary Event (KLB) and is currently a leading cause of mortality in Indonesia, especially in children. Antibiotics are necessary for diarrhea caused by bacteria, but irrational antibiotic prescribing can increase the risk of antibiotic resistance. This literature review was conducted to provide an overview of the level of rationality of antibiotic use in pediatric patients with diarrhea in several Indonesian health facilities. The literature review was conducted by reviewing articles obtained through a Google Scholar search using the keywords "rationality of antibiotic use," "diarrhea," "children," and "evaluation of antibiotic use." Articles were selected using inclusion and exclusion criteria, resulting in 10 suitable articles. The study results indicate that the evaluation methods for antibiotic use include the Gyssens criteria, World Health Organization criteria, Ministry of Health Decree Standards, the 2012 World Gastroenterology Organization Guidelines, and the Rational Drug Use Module. Commonly used evaluation parameters include appropriate indication, appropriate drug, appropriate dose, and appropriate patient. Most parameters have obtained rational results, but there are several studies that are not rational in the appropriate indication, appropriate drug, and appropriate dose categories. Variations in the results of rational antibiotic use at each health facility are influenced by patient characteristics, policies at the health care facility, and the level of compliance of health workers with therapy guidelines.

Diarrhea has the potential to cause an Extraordinary Event (KLB) and is currently a leading cause of mortality in Indonesia, especially in children. Antibiotics are necessary for diarrhea caused by bacteria, but irrational antibiotic prescribing can increase the risk of antibiotic resistance. This literature review was conducted to provide an overview of the level of rationality of antibiotic use in pediatric patients with diarrhea in several Indonesian health facilities. The literature review was conducted by reviewing articles obtained through a Google Scholar search using the keywords "rationality of antibiotic use," "diarrhea," "children," and "evaluation of antibiotic use." Articles were selected using inclusion and exclusion criteria, resulting in 10 suitable articles. The study results indicate that the evaluation methods for antibiotic use include the Gyssens criteria, World Health Organization criteria, Ministry of Health Decree Standards, the 2012 World Gastroenterology Organization Guidelines, and the Rational Drug Use Module. Commonly used evaluation parameters include appropriate indication, appropriate drug, appropriate dose, and appropriate patient. Most parameters have obtained rational results, but there are several studies that are not rational in the appropriate indication, appropriate drug, and appropriate dose categories. Variations in the results of rational antibiotic use at each health facility are influenced by patient characteristics, policies at the health care facility, and the level of compliance of health workers with therapy guidelines.

Knee septic arthritis is an orthopedic emergency that requires prompt and appropriate management to prevent permanent joint damage and systemic complications. Inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used for diagnosis and monitoring of treatment response; however, their prognostic value after surgical debridement remains variable. This systematic review aimed to evaluate the role of ESR, CRP, and platelet count as prognostic indicators following irrigation and/or surgical debridement in patients with knee septic arthritis. A literature search was conducted in January using PubMed, Google Scholar, ScienceDirect, Wiley Online Library, SpringerLink, and Semantic Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) tools. Fifteen studies meeting the inclusion criteria were qualitatively analyzed. The findings indicate that elevated preoperative CRP levels and delayed postoperative CRP reduction are associated with unfavorable clinical outcomes, including failure of infection eradication and the need for repeat debridement. Although ESR is consistently elevated during the acute phase, its slower decline limits its short-term prognostic utility. Platelet count may increase as part of the systemic inflammatory response but shows inconsistent prognostic value.

Indonesia, as a country located at the intersection of three tectonic plates, is highly vulnerable to earthquakes. This has led to the development of various innovations in earthquake-resistant housing. An interesting phenomenon can be found in Sigi District, Central Sulawesi, where several vernacular houses of the Kaili people constructed with a hybrid design (wooden frame and mud walls) have proven to withstand the major earthquake that struck Palu, Central Sulawesi, in 2018. This study aims to examine the architectural typology of non-engineered hybrid houses within the Kaili community using a qualitative descriptive approach and typological analysis. Data collection involved direct observation, interviews, and literature reviews, with a focus on the spatial and physical systems of the buildings. The sample for the study was determined through purposive sampling with specific criteria. Data analysis was conducted using a qualitative descriptive approach. The results of the study indicate that, despite changes in materials due to adaptations to technological advancements and reconstruction policies, the spatial layout and fundamental structure of the houses have maintained traditional philosophies. These houses demonstrate the integration of cultural values, local knowledge about seismic activity, and the use of local materials, which allow for both structural flexibility and some rigidity, contributing to the buildings’ resilience. These findings highlight the importance of combining technical and cultural approaches in designing earthquake-resistant houses within a local context.

Antimicrobial resistance is a persistent threat to hospital care, particularly when empirical therapy relies on broad-spectrum antibiotics without continuous evaluation of local use and susceptibility patterns. This literature review aimed to synthesize evidence from four Indonesian hospital-based studies regarding antibiotic utilization, rationality assessment, and bacterial resistance profiles. A structured narrative review was conducted using four selected articles provided by the author. Data were extracted for study design, setting, population, antibiotic evaluation method, dominant antibiotic classes, rationality indicators, resistance profile, and stewardship implications. The four studies were descriptive and hospital-based, using retrospective records, concurrent observation, ATC/DDD with DU 90%, qualitative rationality criteria, and antibiogram data. The synthesis showed a consistent concentration of antibiotic use in broad-spectrum groups, especially third-generation cephalosporins, penicillins, quinolones, and macrolides. In a Bandung public hospital, total antibiotic consumption reached 95,719.01 DDD, with penicillins, cephalosporins, quinolones, macrolides, and sulfonamides included in the DU 90% segment. In intensive care, ceftriaxone was the most frequently used antibiotic and most rationality indicators were appropriate, although clinically significant drug interactions were still identified. In pediatric acute respiratory infection inpatients, cefotaxime and ceftriaxone dominated empirical therapy. Resistance mapping in Denpasar highlighted relevant Gram-positive and Gram-negative pathogens and recommended antibiotics according to susceptibility levels. Overall, the reviewed evidence supports an integrated antimicrobial stewardship model combining ATC/DDD-DU 90% surveillance, qualitative rationality evaluation, antibiogram-based empirical guidance, and periodic feedback to prescribers.

Introduction: Ramadan fasting is a religious practice observed by Muslims by abstaining from food and drink from dawn until sunset. These changes may increase the need for oral and dental healthcare. However, some Muslims still perceive that undergoing dental treatment while fasting may invalidate the fast, leading many patients to delay or avoid dental visits during Ramadan. Objective: This study aims to review and analyse various scientific literature regarding the safety and permissibility of dental procedures for patients who are observing fasting during Ramadan. Methods: This study used a narrative review method by searching scientific articles through PubMed, ScienceDirect, and Google Scholar databases using keywords relevant to the research topic. Articles were selected based on predetermined inclusion and exclusion criteria. Results: The review findings indicate that most dental procedures, such as local anaesthesia administration, scaling, restorative treatment, and tooth extraction, generally do not invalidate fasting as long as no material or fluid is intentionally swallowed. The use of suction devices, isolation of the treatment area, and proper scheduling of dental procedures are important factors in minimizing the risk of swallowing fluids during treatment. Conclusion: Most dental procedures can be safely performed on fasting patients while still considering both medical aspects and Islamic principles. Patient education regarding the safety of dental procedures during fasting should be improved to prevent delays in treatment and complications in oral health.

This study was conducted based on the low level of student activeness and understanding in IPAS learning at the elementary school level. The objective of this research was to determine the effectiveness of the role play method in improving students’ activeness and learning outcomes. This study employed a classroom action research approach involving 27 students. The data were collected through observation and evaluation of student learning outcomes. The findings revealed a significant improvement in both student participation and understanding after the implementation of the role play method. Students became more active in asking questions, responding to the teacher, and participating in classroom activities. In terms of learning outcomes, 85.2% of students were able to answer questions correctly and demonstrated good understanding, while the remaining 14.8% also achieved the minimum criteria. These results indicate that learning through direct experience enhances students’ comprehension. The implication of this study suggests that the role play method can be used as an effective alternative teaching strategy to create an interactive, engaging, and student-centered learning environment in elementary education.

This study aimed to develop Matif (Interactive Mathematics) video media on the topic of equivalent fractions for fourth-grade elementary school students and to determine its validity, effectiveness, and student responses. The research employed a Research and Development (R&D) method using the ADDIE model. It was conducted at SD Muhammadiyah Gresik during the first semester, involving 19 fourth-grade students. Data collection techniques included interviews, expert validation sheets for content and media, learning effectiveness tests, and student response questionnaires. The development process followed five ADDIE stages. (1) Analysis involved curriculum analysis, needs analysis, and student characteristics analysis. (2) Design focused on creating the learning flow and storyboard. (3) Development produced the video media, which was validated by experts. The material expert validation score reached 97.5%, and the media expert validation score was 91.6%, both categorized as very valid. These results indicate that the material is highly appropriate, clear, and easy to understand, while the media demonstrates excellent quality in visual, audio, typography, language, and usability aspects. (4) Implementation involved testing the media on students, with an N-Gain score of 0.8405, categorized as high, indicating that the media effectively improves students’ understanding. (5) Evaluation was conducted through student response questionnaires, resulting in a score of 95.5%, categorized as very good, showing that students found the media engaging, easy to use, and helpful. Overall, the Matif video media meets the criteria of validity and effectiveness, making it suitable as an innovative learning alternative, with potential for further development through enhanced animations and varied exercises.

Picky eating behavior is a common feeding problem among preschool-aged children. Children who exhibit picky eating tendencies often reject various types of food, especially new or unfamiliar ones, placing them at risk of an imbalanced intake of macronutrients such as energy, protein, fat, and carbohydrates. Inadequate nutritional intake over the long term may negatively impact a child's nutritional status and growth. This study aims to examine the relationship between picky eating behavior and the adequacy of macronutrient intake including energy, protein, fat, and carbohydrates and nutritional status among preschool children at Lab School 1 Kindergarten, State University of Surabaya. This research utilized a quantitative design with a cross-sectional approach. The study population consisted of 60 preschool children aged 4–6 years (48–73 months), selected using total sampling. After applying inclusion and exclusion criteria, a total of 37 respondents were included. Data were collected using the Child Eating Behavior Questionnaire (CEBQ) to assess picky eating behavior, interviews with the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to evaluate macronutrient intake, and anthropometric measurements to determine nutritional status. Data analysis was conducted using the Spearman Rank correlation test. The results showed a significant relationship between picky eating behavior and energy intake (p=0.002; r=0.495), fat intake (p=0.002; r=0.502), carbohydrate intake (p=0.006; r=0.443), and nutritional status (p=0.002; r=-0.493) among preschool children at Lab School 1 Unesa. However, no significant relationship was found between picky eating behavior and protein intake (p=0.064; r=0.307).

A feasibility study is a critical stage in the planning of hospital establishment to ensure investment viability, particularly from a financial perspective. This community service program aims to provide reinforcement in the preparation of a feasibility study for the establishment of a Regional Public Hospital (RSUD) in Barukan Village, Tengaran District, Semarang Regency, through financial feasibility analysis conducted by financial experts. The implementation method was carried out through partner needs identification, delivery of financial analysis materials, interactive discussions, and assistance in developing financial models encompassing cash flow projections, discounted payback period (DPP), net present value (NPV), internal rate of return (IRR), and sensitivity analysis, all of which yielded feasible and acceptable results. The outcomes of the activity demonstrated an improvement in partners' understanding of financial feasibility analysis as well as their ability to interpret investment assessment criteria. In addition, the activity yielded an early-stage draft encompassing the financial feasibility aspects, which is intended to guide stakeholders in making informed decisions related to the founding of the Semarang Regency Regional Public Hospital. This activity contributes to strengthening the planning of healthcare facility investment in an effective and sustainable manner.

This research aims to: (1) find out the overview of Investment Interests, Information Technology Advancements, and Investment Knowledge; (2) analyze the influence of Information Technology Advancement and Investment Knowledge on Investment Interest both partially and simultaneously. The population in this study is 1,280 students of the Faculty of Economics and Business, Nusa Nipa University. Based on the Slovin formula, the sample in this study amounted to 98 people. Sample distribution was carried out using proportionate stratified random sampling technique. Data were collected through questionnaires and analyzed using descriptive and statistical methods of multiple linear regression. Hypothesis testing is carried out through the F test and the t test. The results of the descriptive analysis showed that the Investment Interest variable was in the good criteria, the Information Technology Advancement variable was in the good criteria, and the Investment Knowledge variable was in the good criteria. The results of the t-test statistics show that partially the variable of Information Technology Advancement has a positive and significant effect on Investment Interest. Furthermore, the variable of Investment Knowledge has a positive and significant effect on Investment Interest. The statistical results of the F test show that simultaneously the variables of Information Technology Advancement and Investment Knowledge have a significant effect on Investment Interest. The results of the determination analysis showed that the two independent variables in this study were able to explain the variation in the fluctuation of Investment Interest in the Capital Market in students of the Faculty of Economics and Business, Nusa Nipa University by 33.2%. Keywords: Information Technology Advancement, Investment Knowledge, Investment Interest

This study aims to analyze the effect of personalized marketing on customer satisfaction and customer retention, as well as to explain the role of customer satisfaction as a mechanism linking marketing personalization to customers’ decision to remain with a brand. The background of this study is based on the increasing use of data-driven marketing strategies, product recommendations, personalized promotions, and digital communication tailored to customer preferences. In an increasingly competitive business environment, companies are required not only to attract new customers but also to retain existing customers through relevant, convenient, and valuable experiences. This study employed a quantitative explanatory approach, with the population consisting of customers who had received personalized marketing from a particular company or brand. The sampling technique used was purposive sampling, with the criteria that respondents had received personalized promotions and had made repeat purchases. The total sample consisted of 110 respondents. Data were collected using a structured questionnaire with a five-point Likert scale and analyzed using Partial Least Squares Structural Equation Modeling. The findings show that personalized marketing has a positive and significant effect on customer satisfaction. This indicates that promotions, recommendations, and marketing messages that are relevant to customer needs can create more positive customer experiences. Customer satisfaction is also found to have a positive and significant effect on customer retention, meaning that satisfied customers are more likely to make repeat purchases, continue using products or services, and avoid switching to competitors. In addition, personalized marketing has a direct effect on customer retention, although its effect becomes stronger when mediated by customer satisfaction. The implications of this study emphasize that companies need to develop personalization strategies that are not only data-driven but also relevant, ethical, non-intrusive, and oriented toward customer value. Therefore, personalized marketing can serve as an important strategy for improving customer satisfaction and maintaining long-term customer retention.

Pneumonia is one of the leading causes of morbidity and mortality among children aged 0–18 years worldwide. Appropriate treatment is crucial for improving treatment outcomes and preventing complications and antibiotic resistance. This literature review aims to analyze treatment options for pneumonia in pediatric patients based on articles published in PubMed from 2024 to 2025. The method used involved searching for articles with the keywords “(Case Reports) AND (pneumonia) AND (in children)” using filters for free full text, case reports, English language, human subjects, and the 0–18-year-old age group. Of the 71 articles identified, 10 met the inclusion criteria. The review results indicate that pneumonia treatment in children is dominated by the use of antibiotics and supportive care. In cases of severe pneumonia and necrotizing pneumonia, intensive antimicrobial therapy, close monitoring, and management of complications are required. Modern diagnostic tests such as bronchoalveolar lavage fluid (BALF), rapid syndromic arrays, and metagenomic next-generation sequencing (mNGS) help identify pathogens more quickly and accurately, thereby allowing for more targeted therapy. Additionally, corticosteroids and immunoglobulins are used as adjunctive therapies in cases of severe inflammation. Accurate diagnosis and individualized therapy selection play a crucial role in improving clinical outcomes for pediatric pneumonia patients.