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Market levies are a regional taxation category that holds significant promise for increasing regional fiscal resources, complementing local tax revenues. The objectives of this study are; (1) Understanding the Communication Mechanism in the Implementation of Market Service Fee Policy in Gorontalo City. (2) Examination of Resource Availability in the Implementation of Market Service Tax Policy in Gorontalo. (3) Understanding the Bureaucratic Framework in the Implementation of Market Service Tax Policy in Gorontalo City. (4) Examination of the Implementation of Market Service Tax Policy Disposition in Gorontalo City. The method used in this study is a descriptive qualitative method. The results of this study indicate that the communication of market service fee policy has been carried out through systematic formal channels and is supported by a clear bureaucratic structure and division of tasks, but its implementation is still not optimal. This is caused by several obstacles, including unequal understanding and distribution of information among traders, limited resources in terms of both quantity and quality of human resources, budget, and inadequate market facilities. Furthermore, weak coordination and suboptimal implementation of SOPs in the field also impact work consistency, while the disposition or attitude of implementers who have demonstrated commitment but are not yet unified requires a more comprehensive strategic approach. Therefore, integrated efforts are needed, including improving the communication framework, strengthening human resource capacity, improving facilities, stricter supervision, and ongoing coaching to create more effective and professional policy implementation.

This study is motivated by the dynamic changes in digital consumer behavior in e-commerce, particularly in the purchase of electronic products through the Tokopedia platform. The study aims to analyze and synthesize the influence of online reviews and product ratings on purchase decisions using a systematic literature review approach. The method involves a comprehensive examination of global and local scientific literature, with a focus on peer-reviewed journals and empirical studies published between 2021 and 2026. The findings indicate that online reviews and product ratings are capable of reducing consumer uncertainty as well as the functional risks associated with electronic products. Empirical evidence over the past decade suggests that high ratings can build initial confidence in brand quality, while detailed reviews provide crucial technical validation for potential buyers. Overall, these two indicators work synergistically to strengthen consumer trust and serve as key determinants in the final stage of the purchasing decision. The implications suggest that e-commerce platforms and sellers need to prioritize the management of user-generated content and maintain transparency in reputation to remain competitive in a market increasingly reliant on the credibility of online information.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor with deceptively benign histological features but significant potential for local recurrence and distant metastasis. Pelvic LGFMS is extremely uncommon and may mimic gynecological malignancies, leading to diagnostic challenges. This report describes a 39-year-old woman presenting with progressive abdominal enlargement, bloating, early satiety, and dyspnea. Physical and ultrasonographic examinations suggested a malignant ovarian tumor. The patient underwent exploratory laparotomy without preoperative CT scan evaluation. Intraoperatively, multiple solid masses involving the intestines, mesentery, omentum, peritoneum, and ovaries were identified, with the largest measuring 20 × 15 cm. Histopathological examination confirmed the diagnosis of LGFMS. The absence of preoperative cross-sectional imaging contributed to diagnostic difficulty in this case. CT scan and MRI are important for evaluating tumor origin, tissue characteristics, and involvement of surrounding structures. Definitive diagnosis requires histopathology supported by immunohistochemistry, particularly MUC4, and molecular confirmation when available. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis, optimize management, and improve long-term outcomes in patients with pelvic LGFMS.

Elderly people are a vulnerable group experiencing declines in physical, psychological, and cognitive functions, which are often worsened by the lack of social support. Social support in palliative nursing plays an important role in improving the quality of life of the elderly, including maintaining cognitive function. This study aimed to analyze the effect of social support in palliative nursing on the cognitive function of the elderly at PSTW Budi Luhur, Jambi City. This study used a quantitative design with a pre-experimental approach through the one group pretest-posttest method. The research sample consisted of 30 elderly participants selected using a purposive sampling technique. The instruments used were a social support questionnaire and the Mini Mental State Examination (MMSE) to measure cognitive function. Data analysis was conducted using the paired t-test. The results showed that before the intervention, most elderly participants experienced mild cognitive impairment (46.7%), while after the intervention there was an improvement, with most participants being in the normal category (50%). Statistical test results showed a p-value = 0.000 (<0.05), indicating that there was a significant effect of social support in palliative nursing on the cognitive function of the elderly. The conclusion of this study is that social support in palliative nursing has a significant effect on improving the cognitive function of the elderly. Therefore, it is recommended that healthcare workers enhance social support-based interventions to improve the quality of life of the elderly.

Hypertension is a condition where blood pressure increases above normal limits as indicated by systolic and diastolic values ​​during examination. In Karanglangit Village, the community's low level of knowledge regarding risk factors, prevention and treatment of hypertension is an obstacle in controlling this disease. This service activity aims to increase public understanding so that they are able to implement efforts to prevent and manage hypertension independently. The method used is direct counseling with the help of presentation media and educational posters. The activity stages include completing a pre-test, providing material about hypertension, an interactive discussion session, and a post-test. The activity was carried out in January 2026 at the Karanglangit Village Hall, Lamongan District, with 26 PKK women participating. The results show an increase in participants' knowledge, marked by an increase in the average score from 76.92% in the pre-test to 100% in the post-test. The paired t-test showed a significant difference before and after the counseling (p<0.001), so that the activity was considered effective in increasing community knowledge. Apart from that, participants also better understand the importance of a healthy lifestyle, regular check-ups, and compliance in maintaining stable blood pressure.

Neonatal sepsis is a major factor contributing to morbidity and mortality in newborns. C-Reactive Protein (CRP) and leukocytes are laboratory tests used as indicators of inflammation. This study aims to determine the relationship between C-Reactive Protein levels and leukocyte profiles in neonatal sepsis patients. The research method used was an observational analytic with a cross-sectional approach. Neonatal sepsis at PKU Muhammadiyah Yogyakarta in the period 2021-2026 consisted of 30 samples using a total sampling technique. The distribution of respondents was dominated by male gender compared to female gender, who had a low birth weight <2,500 grams. Based on the study, normal CRP levels were found in 21 respondents, which was caused by a delay in increasing CRP levels. Leukocytes had high levels in 18 respondents. Leukocytes are an initial phase of examination in detecting inflammation that does not require a long time, have several different morphological types in detecting inflammation in the body. This study shows that the most dominant increase in leukocyte levels is found in eosinophils and neutrophils. Based on medical record data at PKU Muhammadiyah Hospital Yogyakarta, analysis using the Spearman correlation test yielded a correlation coefficient of 0.261 with a significance value of 0.164 (p > 0.05). The results showed no significant relationship between the studied variables, with a positive direction and weak correlation strength. The conclusion of this study is that there is no significant relationship between C-Reactive Protein levels and leukocyte profiles in neonatal sepsis patients.

Neonatal sepsis is a major factor contributing to morbidity and mortality in newborns. C-Reactive Protein (CRP) and leukocytes are laboratory tests used as indicators of inflammation. This study aims to determine the relationship between C-Reactive Protein levels and leukocyte profiles in neonatal sepsis patients. The research method used was an observational analytic with a cross-sectional approach. Neonatal sepsis at PKU Muhammadiyah Yogyakarta in the period 2021-2026 consisted of 30 samples using a total sampling technique. The distribution of respondents was dominated by male gender compared to female gender, who had a low birth weight <2,500 grams. Based on the study, normal CRP levels were found in 21 respondents, which was caused by a delay in increasing CRP levels. Leukocytes had high levels in 18 respondents. Leukocytes are an initial phase of examination in detecting inflammation that does not require a long time, have several different morphological types in detecting inflammation in the body. This study shows that the most dominant increase in leukocyte levels is found in eosinophils and neutrophils. Based on medical record data at PKU Muhammadiyah Hospital Yogyakarta, analysis using the Spearman correlation test yielded a correlation coefficient of 0.261 with a significance value of 0.164 (p > 0.05). The results showed no significant relationship between the studied variables, with a positive direction and weak correlation strength. The conclusion of this study is that there is no significant relationship between C-Reactive Protein levels and leukocyte profiles in neonatal sepsis patients.

The emergence of Large-Format Printing (LFP) technology has transformed global visual communication by enabling the production of large-scale, high-quality printed materials, significantly influencing Nigeria’s graphic design industry. This study aims to examine the impact of LFP on graphic design practice (GDP) in 21st-century Nigeria and propose strategies for sustainable development while addressing emerging challenges. A mixed-method approach was employed, with a primary qualitative focus through interviews and participant observation, supported by quantitative data collected using a Likert-scale questionnaire to assess designers’ perceptions of LFP’s influence. The findings reveal a dual impact. On the positive side, LFP has enhanced design scale, print quality, creative flexibility, and production efficiency, effectively overcoming the limitations of earlier methods such as letterpress printing, manual clamp offset printing, and hand-painted signboards. However, several challenges persist, including the oversaturation of practitioners, increased design piracy, and issues of color inconsistency, which undermine quality outcomes. These challenges highlight gaps in professional standards and regulation within the industry. The study concludes that while LFP has driven innovation and growth in Nigeria’s graphic design sector, its optimal benefits are constrained by the proliferation of unaccredited freelance designers. Therefore, the study recommends the implementation of targeted training programs and stricter professional accreditation systems through relevant regulatory bodies to ensure sustainable development and maximize the transformative potential of LFP technology.

According to the WHO and the Ministry of Health, hypertension is defined as blood pressure ≥ 140/90 mmHg, consistent with the ESC/ESH guidelines. Hypertension is one of the leading causes of premature death worldwide. Symptoms experienced by patients with hypertension include headaches, sweating, palpitations, snoring, daytime sleepiness, muscle weakness, cramps, and cardiac arrhythmia. Clinical manifestations of hypertensive urgency include elevated blood pressure, severe headache, anxiety, and shortness of breath. Mrs. M, a 68-year-old woman, came to the Samudera Community Health Center complaining of a headache that had worsened approximately 3 days ago. The headache is felt at the back of the head, feeling heavy, and sometimes radiates throughout the entire head. The patient also describes the headache as throbbing. The headache was exacerbated when the patient could not sleep, consumed salty foods, and did not take her medication regularly.  The headache subsides slightly when the patient takes medication and sleeps with their head elevated.  The patient reported that the symptoms were also accompanied by nausea, dizziness, palpitations, and an inability to sleep at night. The patient has been diagnosed with hypertension for approximately 5 years. On physical examination, the patient’s blood pressure was 190/100 mmHg. The patient was advised to adopt a healthy diet by reducing salt intake. The patient was also prescribed the following medications: Captopril 25 mg twice daily, Amlodipine 5 mg once daily, Paracetamol 500 mg three times daily, and Domperidone 10 mg twice daily, to be taken as needed.

This study aimed to determine the relationship between parental involvement and mathematics learning achievement of fourth-grade students at SD Inpres 18 Sorong Regency. The research employed a quantitative approach with a correlational design. The research subjects consisted of all fourth-grade students from classes IV A and IV B, totaling 66 students. Data on parental involvement were collected using a questionnaire, while students’ mathematics achievement data were obtained from documentation of end-of-semester promotion examination scores. Data analysis was conducted using descriptive and inferential statistics. The prerequisite tests included the Kolmogorov–Smirnov normality test with a Monte Carlo approach and a linearity test. Hypothesis testing was carried out using Pearson Product Moment correlation with the assistance of SPSS software. The results showed a positive and significant relationship between parental involvement and students’ mathematics achievement, with a correlation coefficient of r = 0.637 and a significance value of p = 0.000 (p < 0.05). This correlation is categorized as strong. The findings indicate that higher levels of parental involvement in guiding, supervising, and providing emotional support are associated with higher mathematics learning achievement among students. Therefore, parental involvement plays an important role in supporting the mathematics learning success of elementary school students.

Breast cancer is a serious health problem among women, with incidence and mortality rates that continue to rise. The disease is often detected at an advanced stage due to low levels of awareness, knowledge, and skills related to early detection. Among adolescent girls, particularly high school students, knowledge and skills regarding Breast Self-Examination (BSE) remain limited. This is largely due to restricted access to health information, a lack of targeted educational initiatives, and learning methods that are insufficiently engaging. BSE is a simple and effective early detection method that can be performed independently beginning in adolescence. Video-based education is considered an effective tool for enhancing adolescents’ understanding. This study aims to determine the effectiveness of video-based education in improving knowledge and BSE skills among Grade XI female students at MAN (State Islamic Senior High School) 2 Yogyakarta. This study employed a pre-experimental design using a one-group pre-test and post-test approach. The study population consisted of all Grade XI female students at MAN 2 Yogyakarta, with a sample of 59 students selected through purposive sampling on predetermined inclusion criteria. The intervention involved a single session of a BSE educational video lasting approximately seven minutes. It was conducted in 15 groups, with each group accompanied by one facilitator. Data were analyzed using the nonparametric Wilcoxon statistical test. The Wilcoxon test results showed a p-value of 0.000 (p < 0.05) for both knowledge and skills variables, indicating a statistically significant improvement between the pre-test and post-test scores. In conclusion, video-based education was proven effective in improving knowledge and BSE skills among Grade XI female students at MAN 2 Yogyakarta. Future researchers are encouraged to assess BSE skills using a structured checklist based on standardized evaluation criteria.  

Cognitive decline is a common health issue experienced by pre-elderly individuals and can be influenced by dietary patterns and social engagement. This study aims to analyze the relationship between dietary diversity and social engagement with cognitive function in pre-elderly individuals aged 45–59 years in Driyorejo District, Gresik. A cross sectional design was used with a total sample of 70 pre-elderly participants selected through purposive sampling. Data were collected using the Individual Dietary Diversity Score (IDDS) questionnaire for dietary intake, the Index of Social Engagement (ISE) for social involvement, and the Mini Mental State Examination (MMSE) for cognitive function. The results showed that 54,3% of respondents had low dietary diversity, 38,6% had low levels of social engagement, and 35.7% experienced cognitive impairment. The study shows a significant relationship between the diversity of food consumption and social engagement with cognitive function (p <0.05). The more diverse food consumption and the better social involvement, the better the pre -elderly cognitive function.

Background: Nallaswamy Class III alveolar ridge refers to an edentulous alveolar bone that has undergone resorption, resulting in a moderate ridge height with a knife-edge ridge form. This condition is relatively common and has been reported to reach a prevalence of approximately 89% in edentulous mandibles. Objective: To describe the prosthodontic treatment implications in patients with Nallaswamy Class III alveolar ridge using an acrylic resin removable partial denture (RPD). Case Report: A 22-year-old female patient presented to RSGM Soelastri with complaints of discomfort while chewing due to the loss of several posterior teeth in the mandible. The teeth had been extracted three years earlier due to caries and retained roots. Intraoral examination revealed healthy dentition in the maxillary arch and edentulous areas at teeth 35, 36, 45, and 46 in the mandibular arch. The alveolar ridge in the edentulous area showed a knife-edge form with moderate height, consistent with Nallaswamy Class III. Discussion: The condition was classified as Applegate-Kennedy Class III modification 1P with bilateral bounded saddle areas, which may affect mastication, aesthetics, and speech. Conclusion: Partial edentulism with a knife-edge alveolar ridge can be effectively managed using an acrylic resin removable partial denture.

Uterine myoma is a benign smooth muscle tumor of the uterus commonly found in women of reproductive age and may cause symptoms related to mass effect and hematologic disturbances. We report the case of a 41-year-old woman presenting with progressive vaginal pain for 3 months, accompanied by low back pain and impaired daily activities, without vaginal bleeding, vaginal discharge, fever, or urinary or defecatory symptoms. Laboratory examination revealed severe microcytic hypochromic anemia with a hemoglobin level of 4.7 g/dL, while ultrasonography demonstrated a 9.93 × 10.32 cm mass described as symmetric, well circumscribed, and hyperechoic, leading to a working diagnosis of uterine myoma with anemia. The patient was managed with general condition monitoring, intravenous fluids, analgesics, transfusion of four units of packed red cells, and laparotomy as definitive intervention. Following transfusion and surgery, the hemoglobin level increased to 9.4 g/dL and subsequently to 11.0 g/dL, accompanied by improvement in postoperative symptoms and clinical condition. This case demonstrates that a large uterine myoma may present predominantly with pelvic pain and functional impairment in the absence of vaginal bleeding. A comprehensive approach involving systematic evaluation, preoperative correction of anemia, appropriate surgical intervention, and postoperative monitoring is essential to improve safety and clinical outcomes in patients with symptomatic pelvic masses.

The principle of the presumption of innocence is a fundamental principle in criminal law that aims to protect the rights of suspects from the beginning of the legal process. This principle is enshrined in the 1945 Constitution and regulated in Article 8 of Law Number 8 of 1981 concerning the Criminal Procedure Code (KUHAP), which states that a person cannot be considered guilty unless a court decision with permanent legal force declares them guilty. The application of this principle at every stage of examination (investigation, prosecution, and trial) is crucial to ensuring the protection of the rights of perpetrators (suspects or defendants) and preventing the abuse of power that may harm individuals who have not been proven guilty. This research focuses on examining the consequences of violations of this principle in investigations and the protection of suspects’ rights within the criminal justice system, along with efforts to prevent such violations. The method used is a literature review with a juridical-normative approach. The findings indicate frequent neglect of the presumption of innocence, leading to human rights violations. To prevent this, stricter supervision by external monitoring bodies, such as the National Commission on Human Rights, is necessary to safeguard the rights of suspects.

Tinea favosa is a rare but destructive form of chronic dermatophytosis fungal infection. It is marked by the development of scutules (yellowish, cup-like crusts) and can lead to permanent cicatricial alopecia if not treated appropriately. Although its prevalence is decreasing globally, sporadic cases are still common in areas with poor sanitation. Trichophyton schoenleinii is the primary medical cause of Tinea favosa, but it can also be caused by Trichophyton violaceum or Microsporum gypseum. This report discusses a case involving a 7-year-old boy who exhibited classic clinical signs of favus. Diagnostic procedures included a physical examination, direct microscopic examination with 10-20% KOH solution, and culture on Sabouraud Dextrose Agar (SDA) to identify the fungal species. Microscopic examination revealed branching and fragmented hyphae (arthrospores) and air tunnels within the hair shaft. Culture confirmed Trichophyton schoenleinii as the primary etiologic agent. The patient was treated with oral griseofulvin combined with ketoconazole cream for 8–12 weeks. Follow-up showed resolution of the crusts and cessation of the inflammatory process, although areas of fibrosis showed permanent hair loss.

According to the International Agency for Cancer Registry (IACR), breast cancer is the most common cancer among women after lung cancer, and continues to be frequently diagnosed worldwide. In 2022, more than 2.32 million new cases of breast cancer were reported globally, while Indonesia recorded 65,858 cases (16.6% of all cancers). Therefore, adolescent girls need to have adequate knowledge and a positive attitude toward breast self-examination (BSE/SADARI) as part of reproductive health awareness and preventive efforts. This study aims to examine the relationship between knowledge and attitudes regarding SADARI among 10th-grade female students at MAN (State Islamic Senior High School) 3 Sleman. This study employed a quantitative correlational approach with a cross-sectional design, involving a sample of 66 respondents. Data were collected using a questionnaire containing questions related to BSE. The Spearman Rank test showed a p-value of 0.606, which is greater than 0.05 (p > 0.05). This indicates that there is no significant relationship between the level of knowledge and attitudes toward BSE among 10th-grade female students at MAN 3 Sleman. In addition, the correlation coefficient (r) was 0.065, indicating a very weak relationship between knowledge and attitudes. There is no significant relationship between knowledge and attitudes regarding BSE among 10th-grade female students at MAN 3 Sleman. Schools and healthcare providers are encouraged to enhance structured and continuous BSE education and incorporate educational media during health counseling to foster positive attitudes.

Type II Diabetes Mellitus is one of the chronic diseases whose prevalence continues to increase and has become a global health issue. A common complication in patients with Type II Diabetes Mellitus is peripheral circulatory disorders, which can be identified through the Ankle Brachial Index (ABI) examination—a non-invasive method used to detect peripheral artery disease. ABI testing is essential for early detection and prevention of serious complications such as diabetic ulcers.This study aims to describe the Ankle Brachial Index values in patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan in 2025. This research used a descriptive quantitative method with purposive sampling technique. The study sample consisted of 52 respondents from a total population of 109 patients diagnosed with Type II Diabetes Mellitus. Data collection was conducted through observation sheets and measurement of systolic blood pressure in the upper and lower extremities using a sphygmomanometer and stethoscope. The ABI value was calculated based on the ratio between the highest ankle systolic pressure and the highest brachial systolic pressure. Data were analyzed using tabulation techniques and presented in tables and diagrams. The results showed that the majority of respondents had normal ABI values (>0.90), totaling 33 individuals (63.5%), while 19 individuals (36.5%) experienced abnormal ABI values (≤0.90).Conclusion:The study concludes that most patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan had ABI values within the normal range. However, a considerable proportion with abnormal ABI indicates the necessity of routine ABI screening as a preventive measure against peripheral vascular complications in diabetic patients. This study is expected to serve as a reference in developing nursing interventions aimed at improving the quality of life for patients with Type II Diabetes Mellitus.

Clean water availability is an essential component of hospital hygiene and sanitation operations, including hand hygiene, environmental cleaning, linen management, food sanitation, and infection prevention. RSUD Sumbersari Bantul Metro Selatan still relies on one bore well and has limited water storage without a permanent backup source. This study aimed to analyze the adequacy of clean water quantity and quality in supporting hygiene and sanitation operations at RSUD Sumbersari Bantul Metro Selatan in 2026. This study used a descriptive analytic design. Data were collected through observation, interviews, water discharge and consumption measurement, document review, and laboratory examination of clean water samples. The analysis compared water availability, water demand, unit-based distribution needs, and water quality with the standards of Ministry of Health Regulation Number 2 of 2023. The results showed that during January-March 2026, the hospital served 154 inpatients and 1,028 outpatients and had 151 staff members. The total clean water requirement was 715.44 m3/90 days, while the available water was only 414.00 m3/90 days, fulfilling 57.87% of the required amount. The average daily need was 7.95 m3/day, compared with the availability of 4.60 m3/day. High-risk service units, particularly inpatient care, emergency services, intensive care, CSSD, isolation, maternity care, laundry, and nutrition services, require priority water distribution. Laboratory testing found Escherichia coli and total coliform at 19 CFU/100 ml each, exceeding the required standard of 0 CFU/100 ml. In conclusion, the quantity and microbiological quality of clean water at RSUD Sumbersari Bantul have not adequately supported optimal hygiene and sanitation operations.

Type II Diabetes Mellitus is one of the chronic diseases whose prevalence continues to increase and has become a global health issue. A common complication in patients with Type II Diabetes Mellitus is peripheral circulatory disorders, which can be identified through the Ankle Brachial Index (ABI) examination—a non-invasive method used to detect peripheral artery disease. ABI testing is essential for early detection and prevention of serious complications such as diabetic ulcers.This study aims to describe the Ankle Brachial Index values in patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan in 2025. This research used a descriptive quantitative method with purposive sampling technique. The study sample consisted of 52 respondents from a total population of 109 patients diagnosed with Type II Diabetes Mellitus. Data collection was conducted through observation sheets and measurement of systolic blood pressure in the upper and lower extremities using a sphygmomanometer and stethoscope. The ABI value was calculated based on the ratio between the highest ankle systolic pressure and the highest brachial systolic pressure. Data were analyzed using tabulation techniques and presented in tables and diagrams. The results showed that the majority of respondents had normal ABI values (>0.90), totaling 33 individuals (63.5%), while 19 individuals (36.5%) experienced abnormal ABI values (≤0.90).Conclusion:The study concludes that most patients with Type II Diabetes Mellitus at Santa Elisabeth Hospital Medan had ABI values within the normal range. However, a considerable proportion with abnormal ABI indicates the necessity of routine ABI screening as a preventive measure against peripheral vascular complications in diabetic patients. This study is expected to serve as a reference in developing nursing interventions aimed at improving the quality of life for patients with Type II Diabetes Mellitus.