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Agentic artificial intelligence (AI) systems capable of autonomous goal-directed behavior, multi-step planning, tool use, multi-agent coordination, and iterative self-correction represent a transition from passive clinical AI tools toward systems that can participate in complex healthcare workflows. However, empirical evidence remains fragmented across clinical decision support, patient monitoring, and administrative applications, and no systematic synthesis has evaluated which agentic principles have been technically demonstrated and which have accumulated sufficient evidence to support responsible clinical deployment. We conducted a PRISMA-informed systematic review of peer-reviewed empirical studies published between January 2025 and April 2026. Searches across five bibliographic databases and Google Scholar, supplemented by citation tracking, identified 443 unique records for screening, of which 25 met the predefined PICOS and quality appraisal criteria. Evidence was synthesized using an evidence-informed seven-principle framework derived from the integration of agentic AI, clinical AI, and healthcare governance literature. This framework provides a structured lens for examining how agentic principles are evaluated individually and in combination, enabling a deployment-readiness perspective that extends beyond capability-focused assessments alone. The evidence base was concentrated on technical capability principles, whereas human oversight, safety, compliance, and equity-related evaluation received comparatively limited attention. Most studies remained at the laboratory, benchmark, or proof-of-concept stage, and none reported demographic-stratified performance outcomes. Overall, the findings suggest a structural asymmetry in agentic healthcare AI: empirical research is advancing agentic capabilities more rapidly than it is generating evidence for the oversight, safety, equity, and governance mechanisms required for responsible clinical translation.

Document-level sentiment analysis assigns a single polarity label to an entire review, often obscuring opinion diversity within multi-sentence submissions. This limitation is particularly evident in reviews of multi-service platforms, where users frequently express heterogeneous opinions toward different aspects of the platform in the same review. To address this challenge, this study proposes a sentence-level sentiment analysis framework for Indonesian Gojek app reviews collected from the Google Play Store. The proposed framework introduces a two-stage segmentation strategy that combines punctuation-aware rules with conjunction-aware splitting based on coordinating and adversative conjunctions (e.g., tapi [but], padahal [even though]) to identify opinion boundaries and decompose mixed-sentiment reviews into independently classifiable sentence units. A total of 14,730 raw reviews collected between May and July 2025 were subjected to data cleaning and quality filtering, resulting in 7,187 valid reviews that were further segmented into 14,187 sentence-level instances. Each instance was manually annotated by three annotators using a four-class labeling scheme consisting of app-positive, app-negative, app-neutral, and service categories. Sentiment-level inter-annotator agreement, computed on the subset of instances unanimously categorized as app-related by all three annotators (n = 4,384), achieved substantial agreement (Fleiss'  = 0.636). Hyperparameter optimization was conducted using Optuna with the Tree-structured Parzen Estimator (TPE) sampler across four experimental scenarios. The best performance was achieved by IndoBERTweet under Stratified K-Fold evaluation, attaining an accuracy of 0.751 and a macro F1-score of 0.729, outperforming all IndoBERT configurations. The results demonstrate the effectiveness of domain-adaptive pre-training on informal Indonesian text and highlight the value of conjunction-aware segmentation for preserving fine-grained opinion structures in mixed-sentiment reviews. These findings suggest that domain-aligned language representations provide a practical and effective solution for sentence-level sentiment analysis of Indonesian app reviews.

This study aims to obtain a comprehensive understanding of the Juz ‘Amma memorization strategy implemented at Madrasah Diniyah Takmiliyah Baitul Azhar, evaluate its effectiveness, and examine the assessment mechanisms applied in Qur’anic learning. The research employed a qualitative field-study approach, focusing on learning activities as the primary object of investigation. Data were collected through direct observation of the learning process, in-depth interviews with the madrasah principal and teachers (ustadz/ustadzah), and documentation analysis related to the memorization program. The data were analyzed through data reduction, data presentation, and conclusion drawing to generate accurate and in-depth findings. The results indicate that the memorization program utilizes a combination of talaqqi, takrir (repetition), sima’i, and small halaqah methods. These strategies have proven effective in improving students’ memorization abilities, as reflected in increased reading fluency, better tajwid accuracy, and the achievement of memorization targets. In addition, the madrasah implements a structured and continuous evaluation system consisting of daily assessments, weekly reviews, and final examinations for each juz. The evaluation focuses on memorization fluency, recitation accuracy, and overall memorization quality. The study concludes that integrating diverse memorization methods with systematic evaluation significantly enhances the effectiveness of Qur’an memorization learning in Islamic educational institutions.  

Circulating tumor DNA (ctDNA) has emerged as a promising liquid biopsy biomarker for real-time monitoring of tumor dynamics. In urothelial carcinoma (UC), effective monitoring of treatment response remains a clinical challenge due to the limitations of conventional imaging and invasive procedures. This systematic review aims to synthesize the existing evidence on the association between ctDNA dynamics and treatment response monitoring across various stages and therapeutic settings. A comprehensive systematic review was conducted. We included cohort studies, randomized controlled trials, and meta-analyses that evaluated ctDNA in UC patients undergoing treatment. Data were extracted on patient population, methodology, treatment, sampling strategy, clinical outcomes, and statistical associations. The review encompassed 80 studies. Baseline ctDNA positivity was strongly prognostic, associated with a 4- to 6-fold increased risk of recurrence or death (HR 4.23-6.56). Dynamic ctDNA clearances or significants reduction during treatment, were strongly associated with improved outcomes. Showing hazard ratios for adverse events as low as 0.10-0.31. ctDNA demonstrated time advantages of 53-90 days over radiographic detection. ctDNA is a potent tool for monitoring treatment response in urothelial carcinoma. It provides superior prognostic and offers a significant lead time for detecting treatment failure. Future research must focus on standardizing methodologies and validating ctDNA-guided therapeutic.

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

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

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

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

This article examines the urgency of strengthening Islamic creed (aqidah) as a preventive instrument in addressing religious radicalism. The rise of extremism is not merely driven by sociological factors, but is also rooted in a theological crisis, namely textual interpretations that give rise to exclusivism and takfiri doctrines. Employing a conceptual literature review method, this study deconstructs the pathology of radicalism and reconstructs the preventive dimensions of aqidah. The findings reveal that ideological mitigation is grounded in three dimensions of aqidah: Tawhid as a means of liberating reason from group arrogance, wasathiyyah (moderation) in maintaining tolerance, and the absolute integration of faith with social morality. To be effective, these values must be institutionalized within Islamic education through the transformation of critical pedagogy, the strengthening of religious digital literacy, and the development of an inclusive school culture. Strengthening aqidah is therefore not merely a transfer of dogma, but the formation of a moderate worldview as a strong shield against the infiltration of radical ideologies.

Dengue fever remains a major global health challenge, particularly in tropical regions, due to the high transmission of Dengue virus by Aedes aegypti and the limited sustainability of current control strategies. Artocarpus odoratissimus, an endemic Bornean plant, contains diverse secondary metabolites with potential pharmacological activities; however, a systematic synthesis of its biomedical relevance to Dengue is still lacking. This study aimed to systematically evaluate the biomedical potential of A. odoratissimus in Dengue prevention and control through a systematic literature review. This study employed a systematic literature review method following the PRISMA 2020 guidelines. Literature searches were conducted in Scopus, ScienceDirect, SpringerLink, PubMed, Google Scholar, Garuda, SINTA, and other relevant scientific databases for publications from January 2016 to February 2026. A total of 303 records were identified, and after duplicate removal, title and abstract screening, and full-text eligibility assessment, 23 studies were included for narrative synthesis. The findings revealed that A. odoratissimus contains major bioactive compounds, including flavonoids, phenolics, arylbenzofurans, stilbenoids, and prenylated chalcones, which demonstrate antioxidant, anti-inflammatory, immunomodulatory, and potential antiviral activities based on in vitro and molecular docking studies. Fruit peel, seeds, and stem bark exhibited the strongest biological evidence, particularly in reducing oxidative stress, inhibiting inflammatory mediators, and potentially interacting with Dengue viral target proteins. Furthermore, several species within the Artocarpus genus showed larvicidal and ovicidal activities against Aedes aegypti, highlighting the potential development of A. odoratissimus as a plant-based biolarvicide candidate.

Dengue fever remains a major global health challenge, particularly in tropical regions, due to the high transmission of Dengue virus by Aedes aegypti and the limited sustainability of current control strategies. Artocarpus odoratissimus, an endemic Bornean plant, contains diverse secondary metabolites with potential pharmacological activities; however, a systematic synthesis of its biomedical relevance to Dengue is still lacking. This study aimed to systematically evaluate the biomedical potential of A. odoratissimus in Dengue prevention and control through a systematic literature review. This study employed a systematic literature review method following the PRISMA 2020 guidelines. Literature searches were conducted in Scopus, ScienceDirect, SpringerLink, PubMed, Google Scholar, Garuda, SINTA, and other relevant scientific databases for publications from January 2016 to February 2026. A total of 303 records were identified, and after duplicate removal, title and abstract screening, and full-text eligibility assessment, 23 studies were included for narrative synthesis. The findings revealed that A. odoratissimus contains major bioactive compounds, including flavonoids, phenolics, arylbenzofurans, stilbenoids, and prenylated chalcones, which demonstrate antioxidant, anti-inflammatory, immunomodulatory, and potential antiviral activities based on in vitro and molecular docking studies. Fruit peel, seeds, and stem bark exhibited the strongest biological evidence, particularly in reducing oxidative stress, inhibiting inflammatory mediators, and potentially interacting with Dengue viral target proteins. Furthermore, several species within the Artocarpus genus showed larvicidal and ovicidal activities against Aedes aegypti, highlighting the potential development of A. odoratissimus as a plant-based biolarvicide candidate.

This study designs and implements an up-down counter system based on an AT89C2051 microcontroller programmed in assembly using the MC-51 application. The system modifies an existing digital clock board by mapping the display selector pins, seven-segment segment pins, pushbuttons, and buzzer to the microcontroller ports. The research method consists of literature review, hardware identification, algorithm design, assembly programming, program downloading, and functional testing using a 5 V DC supply. The implementation uses a four-digit common-cathode seven-segment display and a multiplexing routine to show the counter value in real time. The functional test shows that the system can display the initial value, increase the value through the up button, and decrease the value through the down button. The display is readable during operation, and the program can run on the target circuit after being downloaded to the AT89C2051. This study confirms that assembly programming on MC-51 can be applied to implement a simple counter system on a reused digital clock circuit. The main limitations are the absence of explicit button debouncing, overflow and underflow protection, quantitative response-time measurement, and non-volatile data retention.

Batik motif classification has attracted growing attention in visual computing due to its role in cultural heritage preservation, textile informatics, museum documentation, and automated cataloging. Although many studies report high classification accuracy, robustness under real-world acquisition conditions remains insufficiently understood. Batik images are frequently affected by illumination variation, blur, folds, watermark overlays, wearable deformation, scale inconsistency, and background clutter, creating challenges that extend beyond conventional image-noise assumptions. Existing studies largely focus on improving classification performance, while the interactions among acquisition variability, feature representation, evaluation practice, and deployment constraints remain fragmented. This systematic literature review addresses this gap by synthesizing batik classification research through a robustness-aware perspective. Using query expansion, backward and forward citation chaining, relevance screening, and thematic coding, 116 candidate records were identified, resulting in 50 highly relevant studies for detailed analysis. The review reveals that robustness is shaped less by denoising alone than by the combined effects of acquisition conditions, representation design, evaluation realism, and deployment context. Handcrafted descriptors remain competitive for small datasets and structured motifs due to their data efficiency and interpretability, whereas deep learning models achieve the highest reported accuracy when supported by sufficient data diversity and realistic augmentation. Hybrid representations emerge as the most consistently balanced approach, combining local texture stability with higher-level abstraction across heterogeneous acquisition settings. The review further identifies recurring robustness failure patterns, including background dependency, illumination instability, motif-scale inconsistency, wearable deformation, and source-shift vulnerability. Based on these findings, a robustness-oriented research agenda is proposed, emphasizing cross-acquisition evaluation, representation-stability analysis, batik-specific robustness benchmarks, acquisition-aware augmentation, and deployable lightweight or hybrid architectures. The study contributes a domain-specific synthesis that reframes batik motif classification from an accuracy-centric task toward a robustness-aware visual recognition problem.

This study was conducted to analyze the relationship between students’ critical thinking skills and mathematical problem-solving abilities through a literature review approach. The study is based on the importance of mastering higher-order thinking skills in the mathematics learning process, particularly when students are faced with complex problems related to real-life situations. The method used in this research was a literature review by examining various relevant scientific journals and academic books published between 2021 and 2026. The data analysis process was carried out through stages of identification, classification, evaluation, and synthesis of the collected sources. The findings revealed a significant and positive relationship between critical thinking skills and students’ mathematical problem-solving abilities. Critical thinking skills play an important role in helping students understand problems, process and analyze information, select appropriate solution strategies, and systematically review the results obtained. Students with strong critical thinking skills generally demonstrate more optimal mathematical problem-solving abilities. In addition, the implementation of learning models such as Problem-Based Learning and contextual approaches has been considered effective in improving both abilities. Therefore, critical thinking skills are regarded as an essential aspect that needs to be developed in mathematics learning in order to enhance students’ mathematical problem-solving abilities.

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.

Allergic rhinitis (AR) is a chronic inflammatory disorder of the nasal mucosa mediated by immunoglobulin E (IgE) in response to allergen exposure. This condition has become a significant global health concern because of its increasing prevalence and substantial impact on quality of life, sleep, cognitive function, and work productivity. AR is also commonly associated with other atopic diseases, including asthma and atopic dermatitis. This article aims to review the current understanding of allergic rhinitis, focusing on epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and evidence-based management strategies. This study used a narrative literature review method by analyzing scientific articles, clinical guidelines, and peer-reviewed journals published between 2015 and 2025. Literature sources were obtained from PubMed, Google Scholar, and relevant medical databases using keywords related to allergic rhinitis, IgE, diagnosis, and immunotherapy. The findings indicate that allergic rhinitis involves complex immune mechanisms characterized by Th2 lymphocyte activation, IgE production, and inflammatory mediator release. Diagnosis is primarily established clinically and supported by allergy testing such as skin prick tests or serum-specific IgE measurement. Intranasal corticosteroids remain the first-line therapy for moderate to severe cases, while antihistamines and leukotriene receptor antagonists are used as adjunctive therapies. Allergen immunotherapy has shown effectiveness in modifying disease progression and improving long-term outcomes. In conclusion, allergic rhinitis is a manageable chronic disease that requires a comprehensive and individualized treatment approach involving environmental control, pharmacotherapy, and immunotherapy.

Nature tourism is one of the sectors that plays an important role in supporting the development of regional tourism, including in Lahat Regency, which has significant waterfall tourism potential. Currently, many visitors share their reviews and experiences through digital platforms such as Google Maps. This review can be used as a source of information to understand the public's evaluation of the quality of tourist attractions. This study aims to examine public perception of tourist attractions in Lahat Regency using the Support Vector Machine (SVM) method. Research data were collected through scraping from Google Maps, totaling 500 reviews from five tourist attractions, namely Curup Maung, Curup Buluh, Senyawe Waterfall, Panjang Waterfall, and Green Canyon. The research stages include data preprocessing, consisting of cleaning, case folding, normalization, tokenization, stopword removal, and stemming. After that, feature extraction was carried out using the TF-IDF method and the classification process using the SVM algorithm. Based on the research results, the Support Vector Machine (SVM) method is able to perform sentiment classification quite well, although the accuracy level varies for each tourist attraction. Curup Maung and Panjang Waterfall achieved the highest accuracy level of 90%. Nevertheless, most visitor reviews were dominated by negative sentiments. This indicates that there are still several aspects that need to be improved, particularly related to tourist facilities and services. This research is expected to serve as a consideration for tourism managers and local governments in efforts to improve management quality as well as the development of tourism in Lahat Regency.

The development of digital media has transformed virtual public spaces into major arenas for shaping public opinion on religious issues, including Islamic law and sharia in Indonesia. Discussions surrounding sharia on social media are frequently accompanied by stigma and misperceptions influenced by media framing, digital algorithms, and identity polarization. This study aims to analyze the construction of stigma toward Islamic law in the digital era, identify forms of sharia misperception in the Indonesian public sphere, and explain factors contributing to the reproduction of such stigma. This research employs a qualitative approach based on an integrative literature review combined with digital media discourse analysis. Data were collected through scientific literature reviews, social media observations, and analysis of digital content related to sharia discourse. The findings reveal that sharia is often associated with violence, anti-democracy, restrictions on women’s rights, and opposition to modernity due to media simplification and emotionally driven digital content. In addition, low levels of religious digital literacy and the prevalence of echo chambers reinforce the spread of stigma toward Islamic law in virtual public spaces. This study emphasizes the importance of strengthening religious digital literacy and promoting moderate and inclusive Islamic narratives in contemporary digital society.

This study aims to examine the role of the government in implementing gender political education in schools in Bengkulu Province. Within the context of Indonesia's national education system, gender equality remains a crucial issue that requires sustained attention, particularly in formal educational institutions. As the primary policymaker, the government plays a strategic role in ensuring that educational policies, curricula, teaching practices, and school environments promote the principles of gender equality and inclusiveness. This research employs a library research method by reviewing various scientific publications, policy documents, laws and regulations, government reports, and relevant academic sources related to gender and education. The findings reveal that the government has introduced several regulations and programs to support gender-responsive education and enhance equal opportunities for all students. However, the implementation of these policies in schools across Bengkulu Province continues to face significant challenges. These include limited teacher competence in gender-sensitive instruction, inadequate availability of gender-responsive learning materials, insufficient monitoring and evaluation mechanisms, and the persistence of patriarchal cultural values that influence educational practices. Therefore, this study recommends strengthening policy implementation, providing continuous gender-based teacher training, developing inclusive learning resources, and integrating gender political education into local curriculum content to promote greater gender awareness and equality in schools throughout Bengkulu Province.

This study aims to determine the production process and the level of consumer acceptance of Bandung nagasari cake utilizing stevia as a natural sweetener and butterfly pea flower extract (Clitoria ternatea) as a natural coloring agent. The research employed a quantitative approach with an experimental method through organoleptic testing involving 20 panelists. Data collection techniques consisted of literature review, questionnaires, and organoleptic evaluation covering taste, texture, aroma, and appearance. The obtained data were analyzed using descriptive quantitative analysis with percentage calculations. The findings indicated that the Bandung nagasari formulation containing stevia and butterfly pea flower extract was more preferred than the formulation using granulated sugar. Approximately 90% of panelists preferred the taste attribute due to its healthier perception, while 80% of panelists favored the texture, aroma, and appearance attributes because of the softer texture and the attractive natural coloration produced by the butterfly pea flower extract. Furthermore, the product demonstrated a shelf life of 12 hours at room temperature and up to 3 days under refrigerated storage conditions. The study concludes that the incorporation of stevia and butterfly pea flower extract may serve as an innovative development of traditional Bandung nagasari cake without eliminating its traditional characteristics and shows favorable consumer acceptance.