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Explainable Artificial Intelligence (XAI) has become a critical area of research within artificial intelligence, focusing on improving the transparency and interpretability of machine learning (ML) models, often referred to as "black-box" models. The need for XAI techniques arises from the inherent complexity of ML models, which can make their decision-making processes difficult for users to understand. This study investigates various XAI techniques, including LIME (Local Interpretable Model-agnostic Explanations) and SHAP (SHapley Additive exPlanations), to assess their impact on model interpretability without significantly compromising predictive performance. A comparative experimental design was used, applying these XAI methods to different ML models, including deep neural networks and ensemble methods, within large-scale enterprise data analytics systems. The results indicate that XAI methods significantly enhance model transparency and decision traceability, allowing users to understand the influence of individual features on predictions. While a slight reduction in predictive accuracy was observed, especially with simpler models, the trade-off between interpretability and performance was deemed acceptable, particularly in fields requiring transparency, such as healthcare, finance, and autonomous systems. The use of XAI in enterprise data systems has practical implications for fostering trust and enabling informed decision-making among stakeholders. Furthermore, the study discusses the challenges and limitations of applying XAI techniques, such as complexity, scalability, and model-specific limitations. Future research is suggested to focus on developing more scalable and efficient XAI methods, enhancing their applicability across various model types, and addressing the challenges of real-time applications. This will be crucial in ensuring the widespread adoption of XAI in critical domains, promoting the ethical use of AI while maintaining predictive accuracy.

Diabetes mellitus (DM) is a global health problem characterized by increased blood glucose levels. Type 2 diabetes mellitus (T2DM) accounts for 90-95% of all diabetes cases and is characterized by insulin resistance. Persistent hyperglycemia in patients with T2DM increases the risk of various complications, including renal dysfunction. Therefore, monitoring HbA1c levels is important for assessing long-term glycemic control and preventing complications, one of which is impaired kidney function that can be detected through increased blood creatinine levels. To analyze the relationship between HbA1c levels and blood creatinine levels in type 2 diabetes mellitus patients at RSUD ODSK North Sulawesi Province. This study used an observational analytic design with a cross-sectional approach. This study was retrospective using secondary data in the form of medical record data for the period February 2024-August 2025. This study used a total sampling method with 71 patients who met the inclusion criteria. The findings showed that the majority of patients had HbA1c levels >6,5%, while most blood creatinine levels were within the normal range. Based on the results of the Spearman-Rank correlation test, a significance value of 0.040 (p-value <0.05) was obtained. There is a significant relationship between HbA1c levels and blood creatinine levels, with a negative correlation strength in patients with type 2 diabetes mellitus at RSUD ODSK North Sulawesi Province.

This study investigates the levels of asprosin and irisin in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN), and evaluates their relationships with insulin resistance, glycemic control, and renal function. Additionally, it explores their diagnostic performance as potential non-invasive biomarkers for the early detection of DN using ROC curve analysis. A controlled prospective study was conducted involving 130 participants, categorized into healthy controls, T2DM patients, and T2DM with DN. Serum asprosin, irisin, and insulin levels were measured using ELISA, while biochemical and renal parameters such as fasting blood glucose, HbA1c, creatinine, urea, and eGFR were assessed using standard spectrophotometric techniques. ROC analysis was employed to assess the diagnostic accuracy of asprosin and irisin. Asprosin levels were significantly elevated, while irisin levels were markedly reduced in DN patients compared to T2DM and control groups (p < 0.001). Moreover, DN patients exhibited higher levels of fasting glucose, HbA1c, HOMA-IR, creatinine, and urea, with lower eGFR, indicating substantial renal dysfunction. ROC analysis revealed that asprosin had an AUC of 0.910 (95% CI: 0.839–0.981), with 90.0% sensitivity and 88.9% specificity at a cutoff value of 11.27 ng/mL. Irisin showed an AUC of 0.886 (95% CI: 0.812–0.960), with 95.0% sensitivity and 71.1% specificity at a 158.25 ng/mL cutoff. Asprosin and irisin are strongly associated with insulin resistance and renal impairment in patients with T2DM and DN. Their high diagnostic performance supports their utility as promising non-invasive biomarkers for the early detection and monitoring of diabetic nephropathy progression.

Aortic dissection is a cardiovascular emergency characterized by a tear in the aortic intima layer and the formation of a false lumen, posing risks of fatal complications such as rupture and organ malperfusion. Stanford type B dissections may be managed conservatively; however, complicated cases require intervention. Thoracic Endovascular Aortic Repair (TEVAR) has emerged as the preferred modality, offering lower perioperative morbidity and mortality compared to open surgery. To report the first TEVAR procedure performed in Manado on a patient with Stanford type B aortic dissection, highlighting the technical approach, operative challenges, and clinical outcomes. A 62-year-old male with a history of hypertension and chronic chest pain was referred following a CT angiography that revealed a Stanford type B aortic dissection with an entry site in the proximal descending aorta. TEVAR was performed with stent-graft placement in zone 2 and a chimney graft to preserve perfusion of the left subclavian artery (LSA). Intraoperative aortography confirmed false lumen exclusion without endoleak. The patient showed significant clinical improvement and recovered without postoperative complications. The procedure was technically and clinically successful, with no major complications. Postoperative evaluation confirmed stable stent position and maintained LSA perfusion. This case demonstrates that TEVAR can be safely implemented in non-tertiary regional hospitals with thorough preparation. The first TEVAR procedure in Manado illustrates that this technique can be an effective solution for complicated type B aortic dissections. This experience marks a milestone in the development of endovascular services in resource-limited settings and may serve as a reference for similar institutions in Indonesia.

This Study analyzes the fulfillment of dowry requirements as mutamawwal property according to KHI Articles 30-38 and assesses the suitability of crypto assets as dowry under the positive law regime of the Marriage Law, including its implications for the protection of wives’ rights and legal certainty in the digital era. The research employs a qualititative method with a normative juridical approach through literature study of primary sources (the Qur’an, hadith, KHI, Law No. 1 of 1974, Bappebti and OJK regulations, an MUI fatwas) and secondary sources comparising journals, theses, and dissertations on crypto dowry and maqasid syariah, analyzed descriptively-analitycally and comparatively bertween Islamic law and positive law. The findings that demonstrate that normatively, crypto assets can be classified as valuable property within the KHI framework provided they meet the following criteria: possessing economic value, having clear specifications regarding type and amount, being transferable through legal mechanisms (such as gifts or wallet transfers), and being mutually agreed upon by boh parties. Consequently, they are valid as dowry with the value determined at the time of the marriage contract to minimize the impact or price volatility. However, it still poses potential value disputes, necessitating the strengthening of administrative guidelines at the KUA (office of Religious Affairs) and the enhancement of digital forensic capacty in Religious Courts. The study recommends further harmonization among the KHI, crypto asset regulations, and religious fatwas through the development of technical guidelines for crypto dowries oriented toward mashlahah and the protection of wives’ rights in the 4.0 era.

This study aims to describe the implementation of multisensory strategies in improving the early reading skills and comprehension of dyslexic children in grade 2 of Bugel 2 Public Elementary School. The subject of the study was a student with dyslexia characteristics who had shown difficulties in phonological aspects, letter recognition, reading syllables, and reading comprehension. The method used was direct observation using an early reading test instrument, a comprehension test, and a learning behavior observation sheet. The results showed that the implementation of multisensory strategies (Visual-Auditory-Kinesthetic-Tactile) through letter tracing activities, reading with the help of sounds, arranging letter cards, and reading together exercises was able to improve reading accuracy, strengthen letter-sound relationships, and foster students' self-confidence. Thus, multisensory strategies were proven effective in helping dyslexic children master early reading skills and comprehend simple texts. This study provides an important contribution to the development of more inclusive and effective teaching methods, especially for students with dyslexia, who require a more holistic and comprehensive approach to improve their literacy skills. As a suggestion, the implementation of this strategy can be expanded by involving more students and considering variations in the types of texts and teaching materials used.

Epistaxis, or more commonly known as nosebleeds, is one of the most frequently encountered medical emergencies in the field of ENT. Epistaxis is a condition in which blood flows from the nasal cavity. Although often considered a minor disorder, epistaxis can be a sign of a more serious medical condition, especially if it occurs repeatedly or in large amounts. Globally, the prevalence of epistaxis is estimated to be around 21.7%, with a wide range of variation between countries, namely between 3 and 60 cases per 100,000 population per year. This paper aims to review the aspects of diagnosis and management of epistaxis based on the latest literature. The method used in this study was a search and analysis of various scientific publications, guidelines, and relevant current journals. The discussion covers the identification of types and signs of epistaxis, emergency management, and tampon insertion strategies. Understanding the appropriate and rapid diagnosis and management is essential to prevent the condition from worsening.

This study aims to analyze the implementation of the worship habituation curriculum in the formation of students' religious character at SMP IT Ma'Wattaibin Banjarejo. This study uses a qualitative approach with a case study type. Data was collected through in-depth interviews, observations, and documentation involving principals, teachers, and students. Data analysis is carried out through the stages of data reduction, data presentation, and conclusion drawing with source triangulation techniques and techniques to maintain the validity of the data. The results of the study show that the worship habituation curriculum is implemented in a structured and integrated manner in school culture through congregational prayer activities, daily prayers, recitals of the Qur'an, and habituation of Islamic manners. The implementation of the curriculum contributes significantly to the formation of students' religious character, especially in the aspects of discipline, responsibility, and awareness of worship. In addition, the habit of worship also has a positive impact on the formation of spiritual attitudes, social behavior, and harmonious relationships between students and the school environment. This study concludes that the worship habituation curriculum managed as a school-based curriculum has a strategic role in strengthening the religious character of students in integrated Islamic schools.

The prohibition of proposing to a woman during her ‘iddah period constitutes an Islamic legal provision that is firmly grounded in the normative foundations of the Qur’an and fiqh. This provision aims to preserve the clarity of lineage, protect women’s dignity, and maintain order within the legal framework of marriage. This article examines, from a normative perspective, the prohibition of proposing to a woman during her ‘iddah according to the Shāfi‘ī school of law. The study employs a normative legal research method with a qualitative approach through library research, drawing upon the Qur’an, hadith, and authoritative (mu‘tabar) Shāfi‘ī fiqh texts. The findings indicate that the Shāfi‘ī school strictly prohibits explicit proposals to women during all types of ‘iddah, including ‘iddah resulting from revocable divorce (ṭalāq raj‘ī), irrevocable divorce (ṭalāq bā’in), annulment (fasakh), and death. As for indirect proposals (ta‘rīḍ), they are permitted only for women whose ‘iddah is not accompanied by a right of reconciliation, such as ‘iddah due to death and ‘iddah of ṭalāq bā’in, while remaining prohibited during ‘iddah raj‘ī. This legal ruling reflects the prudence of the Shāfi‘ī school in preventing the occurrence of invalid marriage contracts and affirms the function of ‘iddah as an instrument of Islamic legal regulation rather than merely a biological waiting period.

The aim of this study is to analyze verbal and non-verbal communication in an English as a Foreign Language (EFL) classroom by using the Sinclair and Coulthard (1975) model of classroom discourse. Although many studies have examined verbal interaction in EFL classrooms, few have discussed how verbal and non-verbal communication work together to support effective learning. To fill this gap, this research focuses on identifying the types and frequency of verbal and non-verbal communication used by the teacher and students during classroom interaction. This study used a descriptive qualitative method. The data were taken from an 80-minute video recording of an eleventh-grade English class at MAS Darul Quran. The recording was transcribed and analyzed based on Sinclair and Coulthard’s framework, which includes three main levels: Exchange (Informing, Directive, Question–Answer), Move (Initiation, Response, Feedback), and Act (Questioning, Explaining, Agreeing, Refusing, Revising, Appraising). The findings show that the classroom interaction was mainly teacher-centered. The teacher dominated the talk through Initiation moves, mostly in the form of questions, explanations, and instructions, while students gave short and simple responses. Feedback was used less often and mostly as short praise or confirmation. The teacher also used various non-verbal behaviors such as gestures, eye contact, movement, and changes in voice tone to direct attention and motivate students. The results suggest that combining verbal and non-verbal strategies can create a more interactive and engaging classroom atmosphere that supports student participation and understanding.

Background: Sexually Transmitted Infections (STIs) represent a global public health challenge. The increasing number of Sexually Transmitted Infection (STI) cases is a serious concern worldwide. A lack of education or minimal knowledge, along with risky behavior, contributes significantly to the high STI rates, particularly among the young age group. Purposes: The objective of this study is to conduct a comprehensive analysis of the major types of Sexually Transmitted Infections (STIs)—namely Gonorrhea, Hepatitis B, HIV/AIDS, Syphilis, and HPV—by identifying their risk factors and determining the most effective prevention strategies. Method:The researchers employed a literature review method. The data search process was conducted systematically on Google Scholar, limiting sources only to articles available in full text and having open access. Results: The literature review concludes that the factors of knowledge, attitude, behavior, and age significantly influence an individual's risk of contracting Sexually Transmitted Infections (STIs). Therefore, prevention efforts must be carried out comprehensively, encompassing promotive (awareness enhancement), preventive (prevention), curative (treatment), and rehabilitative (recovery) activities. Practically, this prevention must include sexual health education, adoption of safe sexual behavior, implementation of routine health checks (screening), and vaccination (specifically for Hepatitis B and HPV). Conclusion: Overall, controlling the spread of STIs requires active and collaborative roles from all parties—including the government, health workers, and the community. The main key to suppressing the spread and burden of STI diseases in the community is through improving appropriate sexual health education, improving access to health services, and periodic health screening.  

The body may experience insulin resistance or an insufficient production of the hormone, blood sugar levels rise continuously, leading to a chronic metabolic condition called Type 2 Diabetes Mellitus. Among non-pharmacological approaches proven effective in managing hyperglycemia, physical exercise particularly the Prolanis workout program has shown notable benefits. This study assesses how joining the Prolanis Exercise Program influences blood glucose reduction in Type 2 Diabetes patients at Kuta Baro Health Center, Aceh Besar. This research utilized a quasi-experimental method applying a one-group pretest–posttest framework. Participants, numbering 25 individuals, were selected through an accidental sampling process.. Throughout a four-week implementation of the Prolanis Exercise Program, measurements of blood glucose levels were taken both prior to and subsequent to the program. The findings revealed a notable decline in mean blood sugar levels, decreasing from 158.84 mg/dL before the intervention to 121.92 mg/dL afterward. Based on the Paired Samples t-Test (p < 0.05), the Prolanis Exercise intervention was found to have a significant effect in lowering blood glucose levels. This finding demonstrates that regular participation in Prolanis Exercise serves as an effective non-pharmacological approach for controlling Type 2 Diabetes Mellitus. Community Health Centers are advised to consistently continue developing and facilitating routine Prolanis Exercise activities, in addition to providing ongoing education on healthy lifestyles to patients. Patients are expected to actively engage in this program as part of their diabetes self-management.

Type 2 Diabetes Mellitus (T2DM) is a global health problem with continuously increasing prevalence, covering the majority of diabetes cases worldwide. Persistent hyperglycemia in T2DM progressively damages the kidneys. Early assessment of kidney function, especially through the examination of urea levels and estimated glomerular filtration rate (eGFR) values, is important to predict CKD prognosis and guide therapeutic intervention. To discover the profile of urea levels and eGFR values in Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province. This study is a descriptive quantitative observational study with a cross-sectional design, conducted retrospectively using secondary data from the medical records of Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province during the period February 2024–August 2025 who met the inclusion criteria. From a total sample of 658 Type 2 Diabetes Mellitus patients, the majority of patients had high urea levels (53.3%). Based on sex, the proportion of high urea levels in males (57.2%) was higher compared to females (50.5%). Meanwhile, the distribution of eGFR values showed that the G1 category was the most frequent (23.9%). However, the majority of other patients (75.1%) were already in categories G2 to G5, which indicates a decrease in kidney function. This decrease in kidney function was slightly more detected in male patients (76.1%) compared to female patients (74.4%). Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province, have high urea levels and the majority have decreased eGFR values.

Acute pain is a complex phenomenon frequently experienced by post-surgical patients. If not properly managed, it can hinder the recovery process and increase the risk of chronic complications. This study aims to conduct an in-depth analysis of the concept of acute pain in surgical patients from a nursing perspective to improve the quality of care. The method used was a narrative literature review, analyzing various research articles and clinical protocols related to surgical pain management. The study findings indicate that acute post-surgical pain involves sensory and emotional dimensions influenced by the type of surgical procedure, individual pain threshold, and the effectiveness of pharmacological and non-pharmacological interventions. Furthermore, the role of nurses in conducting accurate pain assessments and patient education is a key factor in successful pain management. The implications of this study emphasize the importance of implementing integrated multimodality pain management protocols and improving nurses' competency in conducting intensive monitoring. Optimizing pain management is expected to accelerate patient mobilization, shorten hospital stays, and increase patient satisfaction with nursing services.

Introduction: Triglycerides are a lipids fractions that play an important role in energy metabolism, but high levels in the blood are strongly associated with increased risk of cardiovascular disease, metabolic syndrome, and type 2 diabetes. The prevalence of hypertriglyceridemia tends to increase, including in urban area such us West Jakarta which have high risk consumption patterns. This community service activity aimed to raise public awareness about the importance  lipid profile management with screen triglyceride levels in community of Kelurahan Kota Bambu. Method: The activity was conducted in June 2025, involving 168 adult participants. The method was used was health education on the role of triglycerides and their risk,, followed by laboratory testing using the Nesco BL-101 5in1 Lipid Panel Monitoring System. Triglyceride level was classified into normal, borderline, high, and very high categories according to the NCEP ATP III guidelines. Results: The average triglyceride level of the participants was 181.21 mg/dL, with a range of 47–830 mg/dL. The triglyceride levels of the majority of participants were in the normal category, but the proportion with high and very high triglyceride levels was significant, indicating the existence of a risk group that needs attention. Conclusion: This activity confirms that simple triglyceride testing at the community level can be an effective step in early detection, education, and prevention

This study examines and critically analyzes speaking tasks in Netzwerk Neu A1.1 (Chapters 1–6) by evaluating their alignment with principles of German as a Foreign Language (DaF), Task-Based Language Teaching (TBLT), and the Common European Framework of Reference for Languages (CEFR). Using qualitative content analysis, 26 speaking tasks were identified, coded, and categorized based on task type, CEFR communicative activity (spoken interaction or spoken production), interaction mode, and levels of learner output. The findings show that template-based tasks dominate the textbook, accounting for 69.2% of activities, while guided and free production tasks are relatively limited. Spoken interaction is the most prevalent communicative activity (76.9%), reflecting an emphasis on dialogic formats such as short exchanges and role plays. Although this design provides appropriate structural support for beginner learners, the limited use of open-ended and autonomous tasks may restrict the development of fluency, communicative flexibility, and strategic competence. Interviews with seven learners and two instructors reveal that while tasks are generally perceived as accessible and confidence-building, they are also considered repetitive and insufficiently authentic. The study underscores the need to balance structured support with opportunities for spontaneous language use in beginner DaF textbooks.

Physical condition is a very important aspect to support a student's achievement, so condition factors must be considered by students. The aim of this research was to determine and assess the level of physical condition of football extracurricular students at SMA Negeri 1 Purwosari. This type of research uses a quantitative descriptive survey design, the variable studied is the level of physical condition. In this study, the samples were taken from all students who were active in taking part in extracurricular football at SMA Negei 1 Purwosari, totaling 30 students. The results of the physical condition of extracurricular football students at SMA Negeri 1 Purwosari obtained several criteria, namely: the 30 meter sprint test of 30 students got a frequency of 15 with a percentage of 50% and was included in the poor category. In the T-test, the frequency was 15 with a percentage of 50% and was included in the medium criteria. In the Sit and Reach test, the frequency was 19 with a percentage of 63.3% and was included in the good criteria. In the Standing Long Jump test, the frequency was 20 with a percentage of 66.7% and was included in the medium criteria. In the Yo-yo Test, the frequency was 13 with a percentage of 47.6% and was included in the medium criteria. In the Push-up test, the frequency was 20 with a percentage of 66.7% and was included in the medium criteria. It is hoped that by conducting this research, students can further improve their physical condition so they can play optimally.

Technological innovation in Christian Religious Education learning strategies aims to improve students' learning literacy comprehensively. In an era of globalization and rapid technological advancement, Christian Religious Education is required to adapt to digital learning media to ensure relevance and effectiveness. The use of various technologies, such as interactive learning videos, educational applications, and e-learning platforms, increases student motivation and active engagement in understanding Christian values ​​and integrating faith with knowledge. Learning strategies using attractive digital technology, a hybrid learning model that combines face-to-face and bold learning, and improving teacher competency are key to the successful implementation of this innovation. The research method used is descriptive qualitative based on a literature review that examines relevant scientific literature, books, and documents on technological innovation in religious education and improving learning literacy. Content analysis was conducted by grouping data based on themes such as technology type, learning strategy, and its impact on student literacy. The research results show that the integration of technology in Christian Religious Education learning provides a significant opportunity to create a technologically savvy young generation that is both mature in faith and character, and able to face the challenges of the times with steadfastness.

This research aims to determine the extent to which interactive quizzes can help improve students' understanding of Economics lessons in the Merdeka Curriculum, which focuses on a Deep Learning approach implemented at SMA Negeri 4 Surakarta. The results show that quite a few students have difficulty grasping economic concepts. The lack of participation and learning motivation, combined with the dominance of the lecture method, makes the learning process tend to be one-way. Conversely, the application of digital technology by educators is still very limited. This research uses a descriptive qualitative approach, collecting data thru observation, interviews, and documentation. A total of five students from the eleventh grade were selected based on purposive sampling techniques who had already taken economics lessons. The results show that the quiz format contributes to increasing students' interest, attention, and participation due to the presence of visual elements, screen animation, and a game-like atmosphere. However, obstacles such as slow internet connectivity or a slightly longer completion time than estimated did arise, although they did not hinder overall learning activities. Essentially, implementing this type of quiz aligns with the direction of the Merdeka Curriculum, which emphasizes in-depth conceptual understanding while also encouraging self-study habits, training the ability to reflect on the material, and creating a classroom atmosphere that tends to be more dynamic.

One type of contract that is very important for the operations of Islamic financial institutions, especially for benefit-based services such as multi-service financing and gold pawnbroking. However, in its application, several problems continue to arise. The most prominent is the incompatibility with Financial Accounting Standards (PSAK) 107 and other Islamic accounting standards in terms of recording and disclosing ijarah transactions. This condition can cause the financial statements of Islamic financial institutions to be less transparent and accountable. Therefore, this study aims to examine how ijarah contracts are used and to what extent the application of ijarah accounting helps Islamic financial institutions become more financially transparent. The research was conducted by reviewing relevant literature, including the provisions of the Accounting and Auditing Organization for Islamic Financial Institutions (AAOIFI), PSAK 107, and the fatwa of the Indonesian Ulema Council's National Sharia Board (DSN-MUI). The study shows that the proper use of ijarah accounting, which includes the recognition of ujrah income, the recording of asset gains, and the consistent disclosure of costs, can increase information transparency and stakeholder confidence in financial reports.