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Down Syndrome (DS) is a genetic disorder characterized by trisomy of chromosome 21 and is inherently associated with clinical manifestations such as hypotonia, joint laxity, and neuromuscular deficits, all of which collectively contribute to impaired postural control and balance. These balance impairments significantly affect the attainment of motor milestones, performance of daily activities, and increase the risk of falls. This study aims to analyze the effectiveness of core stability training in improving balance among children with DS. A narrative review approach was employed by conducting a literature search across electronic databases including PubMed, Scopus, Google Scholar, and ResearchGate. Inclusion criteria consisted of primary studies (RCTs, quasi-experimental designs) published within the last ten years (2015–2025) that examined core stability interventions targeting balance or postural control in children with DS. A review of 10 relevant studies demonstrated that core stability training, either as a standalone intervention or combined with other modalities (e.g., treadmill training or balance training), resulted in significant improvements in both static and dynamic balance. These improvements are facilitated through the strengthening of deep trunk muscles (such as the multifidus, transversus abdominis, and rectus abdominis), which play a crucial role in proximal stabilization and force transfer to the extremities. In conclusion, core stability training is an effective and recommended intervention modality within physiotherapy rehabilitation programs to enhance the quality of life and motor independence of children with Down Syndrome.  

Non-communicable diseases (NCDs) are chronic health conditions that affect not only physical but also psychological well-being, including increased anxiety. Untreated anxiety can reduce quality of life and treatment adherence. Acupressure, as a form of complementary therapy, offers a safe and non-invasive approach to managing anxiety. This narrative review aims to evaluate the effectiveness of acupressure in reducing anxiety among patients with NCDs. Articles were searched using Google Scholar with keywords such as "acupressure", "anxiety", and various chronic diseases. Six studies with experimental and quasi-experimental designs were selected based on inclusion criteria, involving patients with cancer, chronic kidney disease, and osteoarthritis. The findings consistently demonstrated that acupressure reduced anxiety levels, whether performed by a therapist or self-administered, with commonly used points including ST36, LI4, and PC6. This review concludes that acupressure is an effective complementary therapy that can be incorporated into holistic care strategies for anxiety management in patients with NCDs.

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of peripheral vertigo, characterized by brief episodes of vertigo due to otoconia displacement. Although most previous studies have focused on intrinsic factors such as age, gender, osteoporosis, and metabolic disorders, evidence regarding the role of environmental factors, particularly occupational noise exposure, is limited. Chronic noise has the potential to affect vestibular function through both sensory and vascular mechanisms. This study aims to narratively review the effect of occupational noise exposure on the risk of BPPV by integrating clinical, epidemiological, and experimental findings. The method used is a literature-based narrative review of the PubMed, Scopus, Web of Science, and Google Scholar databases without year restrictions, using the keywords "BPPV", "occupational noise exposure", "vestibular dysfunction", "VEMP", and "otoconia displacement". The search results obtained 25 relevant articles linking BPPV to otolith, hormonal, vascular, lifestyle factors, and occupational noise exposure. The results indicate that chronic noise can cause sensory damage (otoconia and vestibular hair cells), vascular disorders (hypertension, cardiovascular disorders, and inner ear microvascular circulation disorders), and exacerbate lifestyle comorbidities (sedentary lifestyle, osteoporosis, hypertension, diabetes). The discussion confirms that these multifactorial mechanisms explain the susceptibility of industrial workers to BPPV despite normal hearing function. The conclusion of this study is that workplace noise exposure has been shown to play a significant role as a risk factor for BPPV, therefore, prevention strategies, vestibular health monitoring, and healthy lifestyle interventions need to be optimized in occupational health programs.

Low back pain (LBP) is one of the most common musculoskeletal complaints globally and is the main cause of decreased work productivity. One of the risk factors that has been widely studied in the literature is prolonged sitting duration. Prolonged sitting activities cause increased static pressure on the lumbar spine, fatigue of the supporting muscles, as well as a decrease in local blood flow that can trigger chronic pain. This study is a literature review with a meta-analytical approach that aims to analyze the relationship between long-term sitting and the incidence of LBP. The review process was carried out following PRISMA guidelines through searches on PubMed, Scopus, ScienceDirect, and Google Scholar databases for publication in 2020–2025. Of the 20 previous studies analyzed, most showed a positive association between sitting time and an increased risk of LBP, both in adults, adolescents, and children. Sitting for more than 6 hours per day increases the risk of LBP by 33%, especially in individuals with low physical activity. In addition, longer sitting durations with poor posture and minimal active rest were found in the group of office workers and professional drivers who had a high prevalence of LBP. Physical activity has been shown to play a protective role against the risk of LBP, while ergonomic interventions such as lumbar support can reduce pain complaints. Although most studies were observational, the consistency of results supports the importance of prevention through reduced sitting time, increased physical activity, and ergonomic work environment settings. These findings provide a scientific basis for multidimensional interventions to effectively reduce the incidence of LBP.  

Atherosclerosis, as the leading cause of cardiovascular disease, can be triggered by a high-fat diet that causes hyperlipidemia. Fern leaves (Diplazium esculentum) contain various bioactive compounds (alkaloids, phenols, flavonoids, terpenoids) with antioxidant and anti-inflammatory potential, which are suspected to inhibit the formation of atherosclerotic lesions. This study aims to determine the effect of administering fern leaf extract on the histopathological features of the aorta in Wistar rats induced by a high-fat diet. This laboratory experimental study used 25 male Wistar rats divided into five groups: (A) normal control, (B) negative control (high-fat diet), (C) positive control (high-fat diet + simvastatin), (D) treatment I (high-fat diet + fern leaf extract 600 mg/kgBW), and (E) treatment II (high-fat diet + fern leaf extract 1200 mg/kgBW). The treatment was administered for 21 days. On the 22nd day, the aorta was taken and processed into histopathological preparations using Hematoxylin-Eosin (H&E) staining. The number of foam cells was counted at 400x magnification. Data were analyzed using the One-Way ANOVA test followed by the Tukey test. There were differences in the number of foam cells between groups. The post-hoc test showed a significant difference between group B (high-fat diet) and all other groups (p<0.001). There was no significant difference between group E (extract 1200 mg/kgBW) and group C (simvastatin) (p=0.783), nor between group D (extract 600 mg/kgBW) and group C (p=0.075). Fern leaf extract (Diplazium esculentum) is able to reduce the number of foam cells in the aorta of Wistar rats induced by a high-fat diet.

Arabica coffee (Coffea arabica) contains various bioactive compounds such as caffeine, polyphenols, flavonoids, and alkaloids that have the potential to produce diverse pharmacological effects on both the autonomic and central nervous systems. The variation in its chemical composition is influenced by factors such as cultivar, post-harvest processing, and preparation methods, resulting in biological responses that are dose-dependent and not always linear. This study aimed to evaluate the pharmacological activity of arabica coffee simplicia powder at three concentrations (1%, 2%, and 4%) by observing parasympathomimetic, parasympatholytic, sympathomimetic, sympatholytic, analeptic, central nervous system stimulation and depression, as well as muscle relaxation parameters. The research was conducted using a laboratory experimental design with test animals administered orally according to the designated concentrations. The results showed that some parameters increased at higher concentrations, such as parasympathomimetic activity (51.85%) and central nervous system stimulation (63.74%), while other parameters demonstrated decreasing or biphasic patterns, such as sympatholytic activity, which was high at 1% and 4% but low at 2%, and analeptic activity, which dropped sharply at 2% and increased again at 4%. These response patterns align with literature indicating that caffeine and polyphenols such as chlorogenic acid may interact synergistically or antagonistically, generating complex pharmacological effects through mechanisms involving adenosine modulation, excitatory neurotransmitters, the enteric nervous system, as well as antioxidant and anti-inflammatory pathways. Overall, this study demonstrates that arabica coffee simplicia exhibits multipotential pharmacological activity, with responses strongly influenced by concentration and the composition of its bioactive compounds, thereby providing a basis for further research on the phytopharmaceutical potential of arabica coffee.

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.

Smartphone addiction refers to excessive smartphone use that can have physical and psychological impacts. The purpose of this study was to provide psychoeducation to increase knowledge about self-management in an effort to reduce smartphone addiction. This study used a pre-experimental research design with a one-group pretest-posttest design on 32 students. Data collection used the Smartphone Addiction Scale-Short Version questionnaire and additional questionnaires developed by the researcher. The results of the paired sample t-test showed an increase in scores after the psychoeducational intervention (p < 0.05). These findings indicate that psychoeducation can be used as an effective approach to preventing and reducing smartphone addiction in adolescents. These findings can provide new insights into the importance of preventing smartphone addiction through psychological and educational approaches that can be applied in the context of adolescent education and health. This study makes an important contribution to the prevention and management of smartphone addiction, with implications for the development of psychoeducational programs that can be implemented in educational and health settings to support adolescent well-being.

This study investigates the determinants of capital structure within the healthcare industry, focusing on the influence of asset structure, profitability, and company size. Given the capital-intensive nature of healthcare—characterized by significant investments in medical technology and infrastructure—understanding how these firms balance debt and equity is critical for financial sustainability and operational growth. Using a quantitative approach, this research analyzes a panel dataset of healthcare companies listed on the Indonesian Capital Market from 2018 to 2023. Furthermore, the capital structure is quantified by the debt-to-equity ratio. Meanwhile, asset structure, profitability, and company size are measured by the ratio of fixed assets to total assets, return on assets, and the natural logarithm of total assets, respectively. Moreover, the data are analyzed using multiple linear regression, supported by the classical assumption testing. As a result, asset structure has a significant positive impact on capital structure, aligning with the static trade-off theory. Conversely, profitability demonstrates a significant negative relationship with capital structure, supporting the pecking order theory. Finally, company size positively affects capital structure, indicating that larger firms have greater access to debt financing. These findings suggest that healthcare managers should optimize their asset utilization and internal reserves to maintain an efficient capital structure that supports long-term healthcare delivery and investor confidence.

Free trade is one of the central issues in the dynamics of the global economy, sparking debates about the extent to which the state should be involved in economic activities. Each economic system holds a different perspective on the relationship between market mechanisms and state intervention. This article aims to analyze the concept of free trade and the role of the state from the perspective of various economic systems, namely liberal, socialist, mixed, and Islamic economic systems. The research method employed is a literature review, examining relevant sources such as books, scholarly journals, and other academic references. The findings indicate that the liberal economic system tends to emphasize market freedom with minimal state involvement, whereas the socialist system positions the state as the main regulator in trade. The mixed economic system seeks to balance the roles of the market and the state, while Islamic economics permits free trade as long as it is conducted in accordance with the principles of ethics, justice, and social responsibility. This article is expected to contribute academically to a better understanding of the differing approaches of economic systems toward free trade and the role of the state in addressing global economic challenges.

Business competition in the culinary sector continues to increase along with changes in people's consumption patterns towards ready-to-eat food. One product that is quite popular is fried dim sum, which is known for its variety of flavors and relatively affordable prices. In this competitive environment, understanding how consumers perceive product price and quality is crucial for businesses to maintain and increase customer interest in purchasing goods. Consumer perceptions of product price and quality when they choose fried dim sum are the subject of this study. Informants were selected purposively in this study, which used a qualitative and descriptive approach, namely consumers who have purchased and consumed fried dim sum products. Data collection methods included comprehensive interviews, direct observation, and supporting documentation. The collected data were analyzed using an interactive analysis model developed by Miles and Huberman through steps such as data reduction, data presentation, and discovery. The results show that consumers view price as an indicator related to the affordability and suitability of the product value. Price is considered acceptable if it is commensurate with perceived quality. In addition, product quality, including taste, texture, cleanliness, and packaging, is a primary factor considered before making a purchase. Positive perceptions of product quality increase customer trust and encourage repeat purchases. This study concluded that customer perceptions or opinions about price and product quality influence fried dim sum purchasing decisions. Therefore, culinary businesses need to prioritize proportional pricing and maintain consistent product quality to enhance business competitiveness.

Brebes Regency is one of the main national centers of shallot production in Indonesia, where agricultural land dynamics play a crucial role in sustaining production performance. Rapid infrastructure development and land-use change have raised concerns regarding the sustainability of shallot cultivation areas. This study aims to analyze spatial–temporal changes in shallot cultivated area and production in Brebes Regency during 2023–2024 and to examine the relationship between land area changes and production levels at the sub-district scale. A descriptive quantitative approach based on spatial analysis was employed using Geographic Information Systems (GIS). Spatial data consisted of administrative boundary maps, while non-spatial data included shallot cultivated area and production data obtained from the Brebes Regency Office of Agriculture and Food Security. Data integration and analysis were conducted using QGIS through attribute joining and inter-annual comparison. The results indicate that total shallot cultivated area increased from 26,331 ha in 2023 to 28,628 ha in 2024, accompanied by a significant rise in production from 289,942.05 tons to 409,106.90 tons. Spatial analysis reveals that major production centers remain concentrated in the central and northern sub-districts, particularly Wanasari, Larangan, Bulakamba, and Tanjung. Although a positive relationship between land expansion and production increase is evident, variations among sub-districts suggest that productivity and local conditions also play important roles. The findings highlight the effectiveness of GIS-based analysis in supporting spatially informed agricultural land management and policy formulation.

The implementation of the zoning-based admission policy (PPDB) in Semarang City continues to face challenges related to the accuracy of distance measurement and the transparency of information provided to the public. This study aims to examine the application of Geographic Information Systems (GIS) in defining zoning boundaries for public junior high schools in Semarang City and integrating the results into a web-based information platform. A quantitative descriptive approach was employed, incorporating spatial analysis through a 3-kilometer buffer radius using QGIS software. The results indicate that buffer analysis is effective in delineating priority domicile zones based on school coordinate data. These findings are integrated into a GIS-based website that presents visual information on school locations, enrollment capacity, and final score calculation mechanisms in accordance with current regulations. The proposed system contributes to improving information transparency, enabling the public to better understand admission opportunities while supporting government decision-making in promoting equitable access to education. For future development, the use of road network analysis is recommended to obtain more realistic distance estimations.

This study aims to analyze the implementation of affective learning strategies in Akidah Akhlak subjects to enhance students' self-control at MTs Muhammadiyah 02 Purbalingga. Affective learning strategies focus on character development through the inculcation of religious values such as patience, honesty, and discipline, aimed at helping students manage their emotions, thoughts, and behavior in daily life. The research employed a qualitative method with a descriptive approach. Data were obtained through in-depth interviews with Akidah Akhlak teachers, the principal, and students, as well as classroom observation. Data analysis was conducted using thematic coding to identify patterns in the implementation of affective learning strategies and their impact on students' self-control. The findings indicate that the implementation of affective learning strategies is carried out through five main stages: receiving, responding, valuing, organization, and characterization. Each stage involves structured approaches, such as using inspirational stories from the Qur'an and Hadith, group discussions, value reflections, and case study simulations. These strategies successfully enhanced students' self-control, particularly in emotional regulation, wise decision-making, and consistent behavior aligned with Islamic values. This study concludes that affective learning strategies play a vital role in improving students' self-control. Systematic and collaborative implementation can assist madrasahs in producing a generation that is faithful, knowledgeable, and morally upright, in line with the vision of Islam.

The selection of this research topic is based on the important role of packing machines in the noodle production process. As consumer demand continues to increase and industrial competition becomes more intense, optimizing production efficiency is a critical requirement for manufacturing companies. This study focuses on the Tokiwa W500 Packing Machine used at PT. Indofood CBP Sukses Makmur, Noodle Division, Semarang. The research method involves a comprehensive review of the machine control system to evaluate its operational performance. Data collection was conducted through direct observation, structured interviews with machine operators, and relevant literature review. The review emphasizes system performance, operational efficiency, and the level of automation, while identifying potential areas for improvement. The results indicate that the Tokiwa W500 Packing Machine operates in a stable and consistent manner during the noodle packaging process. However, opportunities were identified to enhance the automation system in order to improve production efficiency and reduce the risk of human error. This study is expected to contribute to the development of more effective and optimized control systems for industrial packing machines.

This community service program aims to analyze the effectiveness of utilizing TikTok Shop as a digital marketing platform for UMKM Izzata Hijab located in Paciran District, Lamongan Regency. The main problem faced by the partner is the suboptimal management of digital marketing, particularly in content strategy planning, posting consistency, and the utilization of TikTok Shop features, resulting in marketing activities that have not yet provided maximum impact on improving marketing performance. The implementation method of this community service employed a mentoring and training model, which included stages of interviews, observation, and documentation throughout the mentoring process. The results indicate that the planned and sustainable implementation of digital marketing strategies through TikTok Shop is able to increase brand awareness, expand promotional reach, enhance customer interaction, and positively impact product sales. The effectiveness of the community service program is influenced by posting consistency, visual content quality, digital communication understanding, and the partner’s responsiveness to customers. This community service confirms that TikTok Shop digital marketing assistance is an effective strategy in supporting the improvement of marketing performance of UMKM Izzata Hijab in the digital era.

This community service program aims to strengthen the managerial capacity of red lemongrass farmers in AMKE Oro-Oro Ombo, Batu, East Java, through training on cash bookkeeping, income analysis, and farming feasibility evaluation. The main problems faced by farmers are limited knowledge of financial management, lack of systematic bookkeeping, and inability to evaluate the profitability of their businesses, which often results in inaccurate decision-making and low competitiveness. The method applied included participatory training, mentoring, and simulation of financial records and feasibility analysis. The results of the program demonstrate that participants gained a better understanding of the importance of structured financial recording. Farmers who previously relied only on sales revenue calculations without considering fixed and variable costs are now able to prepare cash books, identify expenses, and evaluate profit margins accurately. Cash bookkeeping has proven to improve financial transparency and accountability, while income analysis has equipped farmers with the skills to assess their business sustainability. The feasibility evaluation, using indicators such as R/C and B/C ratios, showed that red lemongrass farming is profitable but still requires efficiency improvements to increase long-term sustainability. Overall, this training has enhanced farmers’ managerial skills, encouraged independent decision-making, and strengthened their capacity to face price fluctuations and market competition. The program is expected to support the continuity and competitiveness of red lemongrass agribusiness in AMKE Oro-Oro Ombo

The empowerment program for Micro, Small, and Medium Enterprises (MSMEs) in Takaras Village, Manuhing Subdistrict, Gunung Mas Regency, was carried out to address the problem of low business visibility due to limited promotional media and minimal use of digital technology. Most MSMEs still relied on traditional word-of-mouth promotion, which restricted market reach and reduced competitiveness. To overcome this, the KKN Reguler I Team Group 55 of the University of Palangka Raya implemented activities consisting of informational banner installation and business location registration on Google Maps. The methods included field surveys, banner design planning using simple digital tools, direct assistance in location registration, and banner installation at business sites. The program involved 26 MSMEs, of which 18 received banner support. The installation of banners provided a clearer visual identity for each business, while the use of Google Maps significantly improved consumer accessibility to business locations and services. The results showed that the combination of offline (banners) and online (Google Maps) promotion was effective in increasing product visibility, attracting more customers, and strengthening consumer trust. This initiative also encouraged MSMEs to adopt digital technology in their marketing strategies. Overall, the program made a tangible contribution to the digital transformation of local MSMEs and laid the foundation for sustainable community economic competitiveness

The development of Islamic Religious Education in Banjar Land represents a long historical process marked by social, political, and religious transformations. Since the era of traditional da‘wah conducted by ulama through halaqah, surau-based instruction, and religious study circles (majelis taklim), the Islamic education system in this region has continuously evolved, eventually giving rise to formal educational institutions such as madrasahs and Islamic-based schools. This study aims to chronologically describe these historical dynamics, examine the factors influencing educational change, and analyze the roles of ulama, the Banjar Sultanate, and community institutions in the transformation of Islamic education. The research employs a qualitative method with a historical approach, involving the stages of heuristics, source criticism, interpretation, and historiography. Data were collected from scholarly literature, local manuscripts, and the works of Banjar ulama. The findings indicate that the transformation of Islamic education in Banjar Land, from the period of Islamization to the emergence of madrasahs and Islamic Religious Education in public schools, occurred through at least three major phases: (1) family- and community-based traditional da‘wah through langgar (prayer houses) and halaqah institutions; (2) the establishment of modern madrasahs in the twentieth century as a response to colonialism and modernity; and (3) the integration of Islamic education into the formal national education system in the post-independence era. This study affirms that Islamic education in Banjar Land possesses distinctive characteristics, is adaptive in nature, and is deeply rooted in local culture.

Learning Al-Qur’an and Hadith in secondary schools is still largely influenced by traditional assessment practices that prioritize written examinations and memorization, which are insufficient to capture students’ actual competencies. This situation often leads to less meaningful learning and limits the development of students’ deep understanding and Islamic character. In essence, Al-Qur’an and Hadith education is intended not only to ensure mastery of theoretical content but also to encourage the internalization and application of Islamic values in everyday life. For this reason, authentic assessment is viewed as a suitable approach because it evaluates learning outcomes in a more comprehensive manner, covering cognitive, affective, and psychomotor aspects. This study aims to analyze the implementation of authentic assessment in Al-Qur’an and Hadith learning at the secondary school level and to examine its effectiveness in improving students’ understanding and learning engagement. The research employed a quantitative method, with data collected through a Google Form questionnaire distributed to students and analyzed using descriptive analysis. The results demonstrate that authentic assessment contributes to deeper conceptual understanding, enhances practical skills such as proper Qur’anic recitation based on tajwid rules and hadith memorization, and promotes active, confident, and responsible learning attitudes. Overall, authentic assessment provides more meaningful learning experiences and represents an effective alternative assessment strategy to improve the quality of Al-Qur’an and Hadith learning in secondary schools.