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Delti Srimiyati; Tati Karyawati

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Background: Sectio Caesarea (SC) is a surgical procedure to deliver the fetus through an incision in the abdominal and uterine wall. Patients with a history of previous sectio caesarea frequently experience acute pain, risk of infection, and lack of knowledge regarding post-SC contraception, requiring comprehensive nursing care. Objective: To describe the application of nursing care in a patient with post-operative sectio caesarea with a history of sectio caesarea indication. Methods: This study used a descriptive method with a case study approach. Data were collected through interviews, observation, documentation, and relevant literature review. Results: Assessment of Ny. S revealed three nursing diagnoses: acute pain, knowledge deficit, and risk of infection. Interventions included pain management, family planning (KB) health education, and infection prevention through wound care. Following nursing interventions, the knowledge deficit resolved completely, while acute pain and risk of infection were partially resolved. Conclusion: Systematic nursing care can effectively address nursing problems in post-SC patients and improve patient health outcomes.

Mutiarawati Mutiarawati; Reny Eka Saputri; Nora Rahmanindar

Jurnal Sains dan Kesehatan (JUSIKA) 2026 Universitas Muhamadiyah Manado

Preeclampsia is one of the leading causes of maternal mortality and may result in various complications during pregnancy and childbirth. In Tegal Regency, preeclampsia contributed to 27% of maternal deaths in 2024; therefore, studies on childbirth characteristics among mothers with this condition are needed. This study aimed to identify the characteristics of childbirth events in mothers with preeclampsia at Dr. Soeselo Slawi Regional Hospital, Tegal Regency. A descriptive design with a retrospective approach was used by reviewing the medical records of 202 mothers who delivered with preeclampsia during 2025. Data were analyzed univariately and presented as frequency distributions and percentages. The results showed that most mothers underwent operative delivery (62.38%), while spontaneous and induced labor accounted for 37.13% and 0.50%, respectively. Most deliveries occurred at preterm gestational age (62.38%), followed by term (36.14%) and postterm (1.49%) deliveries. Maternal and obstetric complications included bleeding (6.93%), fetal distress (4.95%), eclampsia (1.49%), and HELLP syndrome (0.99%). Most neonates had normal birth weight (82.18%) and did not require NICU care (95.05%), although low birth weight (17.82%) and NICU admission (4.95%) were still identified. The maternal clinical condition was dominated by blood pressure of 140–159/90–109 mmHg (75.74%). Proteinuria was found in 46.53% of respondents, with moderate proteinuria (+2) as the predominant category (38.30%). In conclusion, childbirth among mothers with preeclampsia was dominated by operative and preterm deliveries. These findings emphasize the importance of early detection and optimal management of preeclampsia to reduce maternal and neonatal complications and improve the quality of maternal-infant health services overall.

Bintang Nur Izzah; Tati Karyawati

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels due to insufficient insulin production or ineffective insulin utilization. The prevalence of DM in Indonesia reached 11.7% in the 2023 National Health Survey, with Brebes Regency recording 568 DM cases in 2025 and increasing to 157 cases in Tonjong Village in January 2026. This case study aims to describe comprehensive nursing care for Ny. M, a 52-year-old patient diagnosed with endocrine system disorder (diabetes mellitus), in the family of Tn. I at Karang Anyar Village, Tonjong District, Brebes Regency. The method used was a case study with data collection through interview, observation, physical examination, blood glucose measurement, and literature review conducted on December 26–28, 2025. The assessment found subjective data: the patient frequently felt fatigue, tingling in both legs, excessive thirst, and increased urination frequency. Objective data: pale and fatigued face, blood pressure 150/100 mmHg, pulse 95x/min, respiration 22x/min, temperature 36.7°C, and random blood glucose (RBG) 155 mg/dl. Two nursing diagnoses were established: blood glucose instability and readiness for enhanced knowledge. Interventions implemented included hyperglycemia management (monitoring blood glucose, dietary education, complementary herbal therapy with ginger and honey), and health education regarding DM complications. Evaluation results showed that after 2 days of nursing visits, fatigue decreased, blood glucose improved (RBG 130 mg/dl), and the patient's knowledge about DM complications was resolved.

Santi Puspitasari; Marthia Ikhlasiah

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

High consumption of sugar-sweetened beverages (SSBs) has become an increasing public health concern, particularly among adolescents. Excessive SSB intake is a major risk factor for various non-communicable diseases, including type 2 diabetes mellitus, cardiovascular diseases, obesity, dental caries, and certain types of cancer. This study aimed to analyze the factors associated with the level of sugar-sweetened beverage (SSB) consumption among adolescents. This study employed a descriptive literature review approach. Data were obtained from national and international journals relevant to the topic of SSB consumption among adolescents. The selected articles were analyzed to identify factors associated with SSB consumption. The findings indicated that SSB consumption among adolescents is influenced by several factors, including individual factors (gender and knowledge), socioeconomic factors (peer influence and pocket money allowance), environmental factors (mass media exposure and beverage availability), and psychological factors (stress level and preference for sweet tastes). This study highlights that SSB consumption is a multifactorial behavior influenced by various interacting determinants. Therefore, comprehensive interventions targeting both individual and environmental factors are needed to reduce SSB consumption among adolescents.

La Emrin; Lajusu Lajusu; La Jidi

JURNAL ILMIAH PENDIDIKAN KEBUDAYAAN DAN AGAMA 2026 CV. ALIM'SPUBLISHING

D Dowry (mahar) is an obligation of a groom to his bride in Islamic marriage, symbolizing respect and responsibility. In the Buton community, mahar also develops as a customary tradition known as boka, which carries both symbolic and socio-cultural meanings. This study aims to analyze the concept of mahar according to the Shafi’i school of law and its implementation in Taduasa Village, South Buton Regency. This research uses a qualitative method with data collection techniques including interviews, documentation, and literature review. The findings show that mahar is viewed as a symbol of respect for women and is determined based on lineage and social status. According to the Shafi’i school, such practices are permissible as long as they are based on mutual agreement and do not burden the groom. However, excessively high dowry amounts in some cases may hinder marriage. This study concludes that the mahar tradition in Taduasa Village remains consistent with Shafi’i principles but should be adjusted to the Islamic values of ease and public welfare.

Victor Verry Kalare

Coram Mundo : Jurnal Teologi dan Pendidikan Agama Kristen 2026 Sekolah Tinggi Teologi Injili Arastamar (SETIA) Ngabang

This article aims to explain the theological meaning and implications of the word "worship" (προσκυνέω/proskuneō) in Matthew 2:2 in the context of the birth of Jesus Christ, and its relevance to the worship practices of the church today. This study uses a qualitative method with a contextual-historical analysis approach to the biblical text, supported by a review of theological literature related to worship in the Christian tradition. The results of the study indicate that proskuneō does not only refer to an act of reverence, but also contains the meaning of acknowledgment of divine authority, an attitude of humility, and a deep spiritual commitment. In the context of Matthew 2:2, the actions of the Magi represent theological, relational, and transformative worship. These findings confirm that true worship involves acknowledging God's sovereignty, a readiness for sacrifice, and an openness to renewal of life. The practical implication for the church today is the need to enrich the understanding and practice of worship that goes beyond the liturgy, but is manifested in personal intimacy with God, acts of social benevolence, and service that reflects a God-fearing life. This article contributes to a biblical understanding of worship and its application in the context of the believer's spiritual life.

Pungkas Sari Wismaningrum; Hatta Abdi Muhammad; M. Wira Anshori; Muliono Muliono

Mandub: Jurnal Politik, Sosial, Hukum dan Humaniora 2026 STAI YPIQ BAUBAU, SULAWESI TENGGARA

The phenomenon of Generation Z’s political electability in the 2024 Legislative Election reflects a shift in patterns of political representation at the local level. The success of Generation Z candidates in securing legislative seats in Jambi City has become a noteworthy phenomenon, particularly amid the dominance of politicians from older generations. This study aims to analyze the political personal branding strategies employed by Generation Z candidates in building their electability in the 2024 Legislative Election in Jambi City. The research adopts a qualitative approach, with data collected through interviews, documentation, and literature review. The analysis is based on Peter Montoya’s Personal Branding theory, which consists of specialization, Leadership, Personality, Distinctiveness, visibility, unity, persistence, and goodwill. The findings reveal that the electability of Generation Z candidates is influenced not only by their young age or social media presence but also by their ability to establish social closeness with the community, maintain consistency in political behavior, engage in intensive interpersonal communication, and actively participate in social and community activities. Personal branding strategies that are developed consistently and sustainably have proven effective in fostering public trust and strengthening political legitimacy at the local level. The study concludes that political personal branding is one of the key factors contributing to the electability of Generation Z candidates in the 2024 Legislative Election in Jambi City.

Upi Urpiyah; Marthia Ikhlasiah; Lastri Lastri

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

The Free Nutritious Meal Program (MBG) is a free school lunch initiative in Indonesia introduced during the administration of Prabowo Subianto. This study aims to examine the effectiveness of the government's MBG (Free Nutritious Meal) program on kindergarten students' learning interest through a literature review approach. The background of this study is based on the issue of low student learning interest, which is influenced not only by pedagogical factors but also by physical conditions, particularly nutritional intake. This research employed a qualitative approach using a literature review method. The data sources consisted of scientific articles published within the last five years and accessed through Google Scholar. Data were collected through documentation studies, while thematic synthesis was used for data analysis. The findings indicate that the MBG program has a significant positive impact on improving students' learning interest, particularly in terms of attention, motivation, participation, and attendance. The results also reveal that meeting students' physiological needs contributes to their cognitive and emotional readiness to learn. However, the effectiveness of the program is influenced by the quality of its implementation and management in the field. Therefore, more optimal program management and continuous evaluation are needed to maximize its impact on improving the quality of learning.

Ade Saputra Dinata; Meydilah Ayunafisah; Vera Ayu Lestari

Mandub: Jurnal Politik, Sosial, Hukum dan Humaniora 2026 STAI YPIQ BAUBAU, SULAWESI TENGGARA

The government policy known as the Free Nutritional Meal Program (MBG) aims to improve public nutrition and reduce stunting rates in Indonesia. The purpose of this study is to examine the MBG Program from a political perspective, particularly considering political dynamics, legal risks, and fiscal issues. This research was conducted through literature review, reviewing various journals and academic sources. The results indicate that the MBG not only has social impacts but also influences political interests, poses risks to legal enforcement, and disrupts the sustainability of the state budget. Therefore, for the program to be successful and sustainable, strong regulations and oversight are required. Furthermore, this populist program is often utilized as an instrument for power legitimacy, demanding compromises between the executive and legislative branches during its budget approval process. Without a detailed legal framework, the policy's implementation is highly vulnerable to overlapping institutional authority and potential misappropriation of funds. Ultimately, technology-based monitoring strategies and accountable governance are the main keys to maintaining the stability of the State Budget (APBN).

Ashyfa Retno Anggraini; Shela Enjelina Saragih; Tresya A. Simalango; Silfanny Anastasia Putri; Charissa Zahra +2 more

JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL 2026 CV. ALIM'SPUBLISHING

A chronic metabolic disease characterized by elevated blood glucose levels due to insulin resistance or impaired insulin secretion is classified as type 2 diabetes mellitus. The prevalence of diabetes continues to rise each year and has become one of the major challenges in global health due to its potential to cause serious complications, such as cardiovascular disease, kidney failure, neuropathy, and vision impairment. In addition to pharmacological therapy, the use of herbal plants is increasingly being developed as a complementary therapy because they are considered safer, more readily available, and contain bioactive compounds with potential antidiabetic properties. This review article aims to assess the effectiveness of several herbal plants namely cinnamon (Cinnamomum cassia), fenugreek (Trigonella foenum-graecum), bitter melon (Momordica charantia), and moringa (Moringa oleifera) in aiding the management of type 2 diabetes mellitus based on various research findings. This study employs a literature review method by collecting and analyzing various national and international scientific publications related to the antidiabetic activity of these four plants. The review results indicate that all plants have potential as adjunct therapies for diabetes because they contain active compounds such as flavonoids, polyphenols, cinnamaldehyde, charantin, quercetin, trigonelline, and saponins, which can help reduce blood glucose levels, optimize cellular response to insulin, increase GLUT4 activity, and help minimize oxidative damage. Based on the study results, moringa and cinnamon plants demonstrated the most consistent effectiveness in contributing to blood sugar control in individuals with type 2 diabetes mellitus. Thus, these herbal plants have the potential to be used as complementary therapies in the management of type 2 diabetes mellitus; however, their use must still adhere to proper dosing and should not replace primary medical therapy.

Selfin Yunus Tamabitte

Coram Mundo : Jurnal Teologi dan Pendidikan Agama Kristen 2026 Sekolah Tinggi Teologi Injili Arastamar (SETIA) Ngabang

This study aims to explore how the inquiry approach functions as a pedagogical strategy in Christian Religious Education to enhance students’ spiritual discernment. The background of this research arises from the tendency of learning practices that remain predominantly focused on cognitive aspects, thereby not fully cultivating spiritual sensitivity in life decision-making. This study employs a qualitative method with a descriptive-analytical approach through a review of theological and pedagogical literature, conceptual analysis, and reflection on classroom learning practices. The analysis focuses on the relationship between the core elements of inquiry questioning, investigating, dialoguing, and reflecting on knowledge and the process of developing the ability to discern God’s will in the real-life contexts of students. The findings indicate that inquiry effectively creates a reflective learning experience that integrates cognitive, affective, and behavioral dimensions, enabling students not only to understand faith teachings theoretically but also to consider Christian values in concrete situations. This approach encourages active participation, constructive and critical dialogue, and fosters habits of faith reflection, moral sensitivity, and personal responsibility. Thus, inquiry is proven to be a relevant pedagogical method for achieving the theological goal of Christian Religious Education, namely the formation of spiritual discernment that guides students’ attitudes, decisions, and actions in daily life.

Ashyfa Retno Anggraini; Shela Enjelina Saragih; Tresya A. Simalango; Silfanny Anastasia Putri; Charissa Zahra +2 more

JURNAL ILMIAH KESEHATAN MASYARAKAT DAN SOSIAL 2026 CV. ALIM'SPUBLISHING

A chronic metabolic disease characterized by elevated blood glucose levels due to insulin resistance or impaired insulin secretion is classified as type 2 diabetes mellitus. The prevalence of diabetes continues to rise each year and has become one of the major challenges in global health due to its potential to cause serious complications, such as cardiovascular disease, kidney failure, neuropathy, and vision impairment. In addition to pharmacological therapy, the use of herbal plants is increasingly being developed as a complementary therapy because they are considered safer, more readily available, and contain bioactive compounds with potential antidiabetic properties. This review article aims to assess the effectiveness of several herbal plants namely cinnamon (Cinnamomum cassia), fenugreek (Trigonella foenum-graecum), bitter melon (Momordica charantia), and moringa (Moringa oleifera) in aiding the management of type 2 diabetes mellitus based on various research findings. This study employs a literature review method by collecting and analyzing various national and international scientific publications related to the antidiabetic activity of these four plants. The review results indicate that all plants have potential as adjunct therapies for diabetes because they contain active compounds such as flavonoids, polyphenols, cinnamaldehyde, charantin, quercetin, trigonelline, and saponins, which can help reduce blood glucose levels, optimize cellular response to insulin, increase GLUT4 activity, and help minimize oxidative damage. Based on the study results, moringa and cinnamon plants demonstrated the most consistent effectiveness in contributing to blood sugar control in individuals with type 2 diabetes mellitus. Thus, these herbal plants have the potential to be used as complementary therapies in the management of type 2 diabetes mellitus; however, their use must still adhere to proper dosing and should not replace primary medical therapy.

Dionisius Derson Lajang; Agusto Royfanto Kewuan; Febriano Yonathan Irgy Wete

Coram Mundo : Jurnal Teologi dan Pendidikan Agama Kristen 2026 Sekolah Tinggi Teologi Injili Arastamar (SETIA) Ngabang

This article examines the impact of dehumanization in the era of Artificial Intelligence (AI) on the formation of the personality of future priests in light of the teachings of Pastores Dabo Vobis, particular number 43-44, as well as from Philosophical and theological perspectives. The development of AI brings significant changes in the way human think, relate, and build their self-identity. On the one hand, AI offers great opportunities to support intellectual formation through access to information, pastoral simulations, and digital learning. However, on the other hand, the dominance of technology has the potential to cause dehumanization, namely a reduction in the quality of interpersonal relationships, the depth of reflection and sensitivity. This study employs a literature review method, examining relevant theological, philosophical, and scientific literature. The findings indicate that excessive reliance on AI can disrupt the development of the human dimension in seminarians, particularly regarding affective maturity, relational competence, and the integrity of personal identity. From a philosophical perspective, humans are understood as free, rational, and relational beings; thus, reducing humans to mere components of an algorithmic system contradicts their very nature. Meanwhile, theology affirms human dignity as the Imago Dei, which cannot be replaced by technology. Therefore, a critical and prudent formation approach is required, one that positions AI as an aid, not a substitute for human relationships.

Nelciyani Padudung

Coram Mundo : Jurnal Teologi dan Pendidikan Agama Kristen 2026 Sekolah Tinggi Teologi Injili Arastamar (SETIA) Ngabang

This research aims to examine how the functions of Christian counseling (preventive, curative, developmental, and pastoral) can be integrated into the practice of Christian Religious Education as an effective strategy to support adolescents’ faith development. The background of this study arises from the fact that adolescents experience a crisis of faith that is not only related to theological aspects but also affects their psychological and emotional well-being. On the other hand, christian religious education practices in schools often remain focused on the transfer of doctrinal knowledge without being balanced by adequate personal guidance. This study applies a qualitative method through literature review and conceptual analysis of christian counseling theory, theories of adolescent faith development, and pedagogical practices in christian religious education. The findings indicate that integrating Christian counseling functions into the design of christian religious education learning can create a dialogical, reflective, and pastoral classroom atmosphere, providing opportunities for adolescents to develop spiritual discernment, self-awareness, and the ability to make responsible moral decisions. This article discusses the relevance of counseling to adolescents’ spiritual development, the characteristics of their faith development, the challenges of implementing counseling in Christian educational institutions, and the design of learning based on dialogue, reflection, and mentoring. In this way, the integration of christian counseling in christian religious education is considered a holistic approach that enriches the meaning of faith education and supports adolescents’ faith growth in a contextual, profound, and sustainable manner.

Aqiilah, Inge Najwa; Saptono, Ristu; Syaifuddin, Akhmad

Journal of Computing Theories and Applications 2026 Universitas Dian Nuswantoro

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.

Prakash, Chandra; Sisodia, Avneesh; Lind, Mary

Journal of Computing Theories and Applications 2026 Universitas Dian Nuswantoro

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.

Ike Lestari; Muhammad Rusdy

JURNAL ILMIAH PENDIDIKAN KEBUDAYAAN DAN AGAMA 2026 CV. ALIM'SPUBLISHING

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.  

Helen Desi Maria Pasaribu; Nur Chofifa Mamonto; Sabina Rusdi; Chanaya Queen Tampung; Naysilla Timomor +3 more

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2026 STIKES Columbia Asia Medan

Medical waste is a by-product of healthcare activities that may have negative impacts on human health and the environment if not properly managed. This study aims to examine strategic planning for medical waste management in healthcare facilities and evaluate the risk of environmental contamination in the digital era. The method used was a literature review by examining various relevant scientific sources. The findings indicate that medical waste management still faces several challenges, including non-compliance with established standards, limited human resources, and the risk of environmental pollution. The utilization of digital technologies such as the Internet of Things (IoT), Artificial Intelligence (AI), RFID, and Blockchain has the potential to improve the effectiveness of monitoring and managing medical waste. Therefore, strategic planning supported by digital technology, human resource capacity building, and regulatory compliance is essential for achieving safe and sustainable medical waste management.

Muhammad Rizki Fadil; Fabian Gamal Sutrisno; Siti Fira Rahmawaty; Archie Fontana Iskandar

Jurnal Sains dan Kesehatan (JUSIKA) 2026 Universitas Muhamadiyah Manado

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.

Aristya Ika Wardani

Jurnal Riset Rumpun Ilmu Kesehatan 2026 Pusat riset dan Inovasi Nasional

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.