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This research aims to conduct an in-depth analysis of the complex dynamics termed the "Digital Bureaucracy Paradox," a phenomenon that emerged significantly following the implementation of the Work From Anywhere (WFA) policy within the Regional Secretariat of Sorong City. The primary focus this study lies in the strategic dilemma faced by visionary leadership in balancing modern flexible work patterns with the obligation to enforce Civil Servant (ASN) discipline, which has historically been conventional and rigid. Amidst massive digital transformation, local-level bureaucracy is forced to adapt to work models requiring high agility, while simultaneously remaining bound by formalistic disciplinary regulatory standards. Quantitative findings indicate that although digital platforms have been effective as instruments for work instructions, the effectiveness visual supervision remains irreplaceable in maintaining the integrity of working hours, particularly regarding low scores in separating personal and professional matters during WFA. Conversely, submissions the E-Kinerja (E-Performance) system show very high level of administrative compliance, yet do not fully guarantee the quality of substantive outputs. Statistical analysis confirms that adaptive digital leadership has decisive influence on the successful implementation of the Electronic-Based Government System (SPBE). These findings offer  theoretical contribution to the study of bureaucratic behaviour within digital ecosystems and provide practical recommendations for redefining the ASN discipline from formalistic patterns toward a result-based substantive discipline. The synergy between visionary leadership and the strengthening of bottom-up accountability mechanisms through public participation is expected to realise a governance framework that is not only technologically modern but also functionally accountable in the post-pandemic era.

Background: Suboptimal breast milk production during the postpartum period remains a major barrier to successful exclusive breastfeeding. Various non-pharmacological interventions have been developed to address this issue, including oxytocin massage, which is believed to stimulate the release of the oxytocin hormone and facilitate milk ejection. However, findings regarding its effectiveness remain varied, highlighting the need for a comprehensive synthesis of scientific evidence. Objective: This study aims to review and synthesize evidence on the effectiveness of oxytocin massage in increasing breast milk production among postpartum mothers. Methods: A literature review with a narrative review approach was conducted using articles from Google Scholar, PubMed, and Garuda databases published between 2021 and 2025. Keywords included oxytocin massage, breast milk production, and postpartum mothers. Inclusion criteria were original research articles involving postpartum mothers receiving oxytocin massage interventions with full-text access. Article selection followed the PRISMA flow, resulting in 12 eligible studies analyzed narratively. Results: Most studies reported that oxytocin massage improves breast milk production and milk flow, indicated by increased milk volume, improved let-down reflex, higher breastfeeding frequency, and adequate infant intake. The effect is associated with parasympathetic stimulation that promotes oxytocin release and maternal relaxation. Conclusion: Oxytocin massage is a safe and practical complementary intervention to support breast milk production, although further studies with stronger experimental designs are needed.

Mine slopes play a crucial role in ensuring the safety and sustainability of mining activities. Continuous mining operations can alter slope conditions, thereby increasing the potential for instability and slope failures. Slope stability is influenced by the balance between resisting forces and driving forces acting on the rock mass. When the resisting forces are smaller than the driving forces, the slope becomes unstable and failure may occur. Therefore, slope stability analysis is essential to prevent landslide hazards, as it directly affects occupational safety, equipment security, other assets, and overall production continuity. These conditions have encouraged PT Insani Bara Perkasa to develop a more accurate and real-time slope monitoring system. The application of radar-based monitoring was initiated using the CHCNAV PS-2000 system. This study aims to analyze the deformation behavior of mine slopes using radar technology. Data acquisition was conducted at Pit K1 Mahakam, PT Insani Bara Perkasa, covering Area 1 South, AR 2 South, AR 3 South, AR 5 South, AR 6 South, AR 7 West, AR 8 West, AR 9 South, AR 13 South, as well as TA-2, TA-3, and TA-6 areas. The study was carried out from November 2025 to December 2026. The analysis results indicate that most monitoring points are in stable conditions, with indications of a progressive phase observed in the AR 6 South area.

Background: Adolescence is a transitional period from childhood to adulthood, with signs of entering adolescence including physical and psychological changes. The adolescent phase is marked by physiological maturation such as the growth of tissues and body organs. This requires adolescents to have sufficient nutritional intake. If the intake is inadequate, it can lead to disturbances in the body's metabolic processes. Nutrient deficiencies, particularly iron (Fe), can cause nutritional anemia. Low hemoglobin levels can occur due to insufficient nutrient intake from food, especially nutrients that support hemoglobin formation. Objective: The objective of this study is to determine the relationship between hemoglobin levels and BMI scores in female adolescents at SMA N 3 Boyolali. Method: The research design was correlational analytic, with a sample of 76 female students at SMA Negeri 3 Boyolali. The sampling technique used random sampling according to inclusion and exclusion criteria. The research instruments included a digital hemoglobinometer, a digital step-on scale, and a microtoa. Data were analyzed using the Spearman Rank test. Results: Bivariate analysis using the Spearman Rank statistical test showed r = 0.343 with a p-value of 0.002 < 0.05, indicating that Ha was accepted. An r of 0.343 is equivalent to 34.3%, indicating a low strength of association. Conclusion: There is a significant relationship between hemoglobin levels and BMI scores in adolescent girls.

This study comprehensively analyzes the impact of sectarian conflict on mental health in Kirkuk through an ethnoreligious meta-analysis of 42 studies with a total of N=15,427 participants published between 2003 and 2023. The quantitative synthesis indicates a PTSD prevalence of 47.3% (95% CI: 44.2–50.4) among victims of sectarian conflict, with an uneven distribution across groups, where the Turkmen minority records the highest prevalence at 56.8%, exceeding Arab Sunni at 43.2% and Kurdish at 41.5%. Logistic regression analysis demonstrates that direct exposure to sectarian violence increases the risk of major depression by 3.4 times (OR=3.42, p<.001), anxiety by 2.8 times (OR=2.83, p<.001), and psychosomatic disorders by 2.5 times (OR=2.54, p<.001). Further meta-regression identifies duration of conflict exposure (β=.426, p<.001) and intensity of sectarian violence (β=.389, p<.001) as significant predictors of symptom severity. In contrast to the findings of Cummings et al. (2013) and Eltally (2019), which emphasize the general impact of conflict, this study reveals specific intergenerational trauma patterns within distinct ethnoreligious communities, with the highest transmission observed among families of sectarian massacre victims (d=0.82), while simultaneously highlighting variations in communal resilience across groups as a differential determinant of post-conflict psychosocial dynamics.

Dermoid cyst is a benign congenital choristoma frequently found in the periocular region, particularly in children. It results from ectodermal tissue sequestration along embryonic fusion lines. Although generally benign and slow-growing, dermoid cysts may cause cosmetic deformity, mechanical ptosis, or visual disturbance if left untreated. A 4-year-old child presented with a painless, slowly enlarging mass on the upper eyelid that had been noticed since early childhood. Physical examination revealed a well-circumscribed, firm, non-tender mass without signs of inflammation. Visual acuity was within normal limits, and no proptosis was observed. Clinical findings were consistent with a superficial eyelid dermoid cyst. The patient underwent complete surgical excision under general anesthesia. Intraoperatively, the cyst was removed intact without rupture. Histopathological examination confirmed a dermoid cyst characterized by keratinized stratified squamous epithelium lining with adnexal skin structures. Postoperative recovery was uneventful, with good cosmetic outcome and no recurrence during follow-up. Eyelid dermoid cyst can be diagnosed clinically through careful history taking and physical examination. Complete surgical excision is the definitive treatment and provides excellent functional and cosmetic outcomes. Early management is recommended to prevent potential complications and to achieve optimal results.

Lifestyle changes, such as smoking habits, low physical activity, and suboptimal sleep patterns, have the potential to affect various health indicators. However, empirical evidence showing a direct link between lifestyle factors and objective health indicators still shows varying results. This study aims to analyze the relationship between lifestyle factors and health indicators in adult respondents, in an effort to provide an empirical picture of behavioral factors related to health conditions. This study used a quantitative approach with a cross-sectional observational analytic design. Data were obtained from 94 respondents who had complete lifestyle data and health examination results. Lifestyle factors analyzed included smoking habits, exercise frequency, and sleep duration, while health indicators included body mass index (BMI), systolic and diastolic blood pressure, blood sugar levels, cholesterol, uric acid, and pulse rate. Data analysis was performed using descriptive statistics, the Shapiro–Wilk normality test, and the Spearman correlation test according to the characteristics of the data distribution. The results showed that smoking habits were significantly associated with diastolic blood pressure (p < 0.05), exercise frequency was significantly associated with BMI and systolic blood pressure (p < 0.05), and sleep duration was significantly associated with uric acid levels (p < 0.05). Meanwhile, the relationship between lifestyle factors and other health indicators did not show statistical significance. These findings indicate that the influence of lifestyle on health is specific to certain indicators and is not evenly distributed across all health parameters. This study concludes that identifying lifestyle factors relevant to certain health indicators is important as a basis for formulating more targeted health promotion strategies.

The problem that occurs in stroke patients is damage to the autonomic nervous system that regulates intestinal peristalsis, causing a decrease in the defecation reflex and leading to constipation. If constipation is not treated properly, it will affect the quality of life of stroke patients. Constipation can be treated pharmacologically and non-pharmacologically. One non-pharmacological treatment is abdominal massage. Abdominal massage can stimulate the parasympathetic nervous system, which can increase digestive system motility, reduce tension in the abdominal muscles, and have a relaxing effect on the sphincter. The design used in the preparation of the final scientific paper for the nursing study was a one-group pretest-posttest case study with abdominal massage intervention on three respondents who had experienced constipation for ≥ 72 hours. Abdominal massage was given once a day for 10-15 minutes for three consecutive days. The constipation scores using the Constipation Assessment Scale (CAS) were as follows: respondent 1, Mrs. L, from 13 to 6; Mrs. W, from 12 to 11; and Mrs. W, from 15 to 11. There was a decrease in the CAS score before and after the abdominal massage was administered, but it was not yet able to significantly alleviate constipation in stroke patients. The application of this EBP is expected to provide additional information on the administration of abdominal massage to stroke patients experiencing constipation for ≥72 hours.

Software Defined Network is a popular computer network concept today because of the ease of managing network traffic with the control plane. Massive internet usage makes web server services on SDN networks overloaded. There are many load balancing concepts to overcome this problem, one of which is implementing the K-NN algorithm. This study aims to maximize the performance of the K-NN algorithm on SDN networks by optimizing the K value using Grid Search Cross Validation, and adding server status selection logic based on the smallest disk if the server status calculated by K-NN has the same. All implementations of the load balancing concept in this study were created virtually using Open vSwitch and virtualbox. Testing was carried out using CPU, MEMORY, and DISK parameters sent by the server with the help of the psutils component. JMeter software was used for testing by sending data using the POST method. The data type is text/plain with a data size of 1MB, testing was carried out in stages with threads 100, 200, 300, 400. The test results showed that the performance of the K-NN algorithm was running optimally. There was no significant difference in the distribution of the load to the server, this made the optimization and addition of logic successful.

Helminth infections caused by Soil Transmitted Helminths (STH) and Taenia sp. remain a major public health concern in tropical regions, including Indonesia, particularly among elementary school children. This study aimed to identify the presence of eggs and larvae of intestinal nematodes and cestodes in fecal samples collected from elementary school children in Bekoso Village, East Kalimantan. The research employed a descriptive survey method with a cross-sectional approach, and laboratory examinations were conducted using the Kato-Katz technique. A total of 16 fecal samples were examined to detect Ascaris lumbricoides, hookworm, and Taenia sp. eggs. The results showed that 12.5% of samples were positive for hookworm eggs, 12.5% for Taenia sp. eggs, and 6.25% for Ascaris lumbricoides eggs. These findings indicate that poor personal hygiene and inadequate environmental sanitation contribute to an increased risk of intestinal helminth transmission. The study highlights the importance of preventive efforts through the promotion of clean and healthy living behaviors, consistent use of footwear, handwashing with soap, and community participation in mass deworming programs to reduce the prevalence of intestinal helminth infections among elementary school children.

Nutritional status plays an important role in shaping body image among adolescents, particularly female adolescents who experience rapid physical and psychosocial changes. Adolescents with nutritional problems are more likely to feel dissatisfied withitheiribody shape, whichimay lead to unhealthy behaviors such as strict dieting or excessive eating to gain weight. Thisistudy aimed toianalyze theirelationship betweeninutritional statusiand bodyiimage amongifemale adolescentsiat SMK Negeri 1 Palu. This research employedia quantitativeiapproachiwith aicross-sectionalidesign. Aitotal ofi169 femaleistudentsiwere selected using stratified random sampling. Body image data were collected using the Body Self Relation Questionnaire–Appearance Scale, while nutritional status was assessed using Body Mass Index for Age (BMI-for-Age) and Height for Age (HFA). Data were analyzed using the Spearman Rank correlation test. The results indicated that there was no significant relationship between nutritional status based on BMI-for-Age and body image, with a p-value of 0.329. Similarly, no significant relationship was found between Height-for-Age and body image among female adolescents, with a p-value of 0.892. Most respondents were aged 16–17 years, had a negative body image perception, normal BMI-for-Age nutritional status, and normal Height-for-Age category. These findings suggest that body image among female adolescents is not solely influenced by nutritional status but may also be affected by other psychosocial and environmental factors. Therefore, future research is recommended to apply a cohort study design and explore other determinants of body image, such as social media exposure, peer influence, and infectious diseases, to provide a more comprehensive understanding of factors affecting adolescent body image.

Knee osteoarthritis is a degenerative joint disease that commonly affects older adults and causes pain and functional limitations. Age, obesity, a sedentary lifestyle, and comorbidities influence disease severity and response to medical rehabilitation. This study aimed to describe the characteristics of geriatric patients with knee osteoarthritis receiving medical rehabilitation therapy at Ibnu Sina Hospital, Makassar, in 2024. This was a quantitative descriptive study with a cross-sectional design. The results showed that most geriatric patients with knee osteoarthritis undergoing medical rehabilitation at Ibnu Sina Hospital in 2024 were in the 60–70 year age group and were predominantly female. The majority of patients had a body mass index in the overweight to obese category. Most patients had no history of smoking but had one or more comorbidities, particularly hypertension and diabetes mellitus. Medical rehabilitation therapy was generally provided as a combination of several modalities. In conclusion, geriatric patients with knee osteoarthritis receiving medical rehabilitation were predominantly aged 60–70 years, female, overweight or obese, and had comorbidities. These findings highlight the importance of individualized and multidisciplinary rehabilitation approaches based on patient characteristics

Mammae aberrans in the axilla is a developmental abnormality caused by the persistence of breast tissue along the milk line and can cause fluctuating axillary masses due to hormonal stimulation, with a reported prevalence of approximately 0.4–6%. Methods: This article is presented as a descriptive case report based on data from the Department of Surgery at Cut Meutia Regional General Hospital, North Aceh, including medical history, physical examination, routine blood tests, fine needle aspiration biopsy (FNAB), excision, histopathological examination, and follow-up. Results: A 16-year-old female patient complained of a lump in her right axilla for approximately two years, which had enlarged in the last month and caused severe pain before menstruation. Examination revealed a mass measuring approximately 3×3×2 cm, without lymph node enlargement, and normal routine blood tests. Two FNAB punctures showed fat droplets/matrix without epithelial proliferation or malignant cells (benign smear) with the impression of aberrant mammary glands. The patient underwent mass excision; histopathology showed mature fatty tissue and fibrocollagen accompanied by ductular proliferation without signs of malignancy, and at the 1-week follow-up, the pain had disappeared and the lump was no longer visible. Discussion: The cyclic pain pattern associated with menstruation is an important clue for distinguishing aberrant mammary glands from differential diagnoses of axillary masses in adolescents, while excision provides diagnostic certainty and symptom improvement. Conclusion: Mammae aberrans should be considered in adolescents with axillary masses affected by the menstrual cycle, and excision is recommended in symptomatic cases for histopathological confirmation and resolution of complaints.

Health behaviors among youth have undergone a significant transformation, shifting from nightlife culture and alcohol consumption toward healthy lifestyles such as community sports (running and padel). This phenomenon, known as the sober curious movement, is triggered by massive interactions in digital spaces. This study aims to analyze the role of social media as a catalyst in the transformation of the sober curious lifestyle and the increased participation of youth in healthy living through a literature review. This research employs a narrative literature review method. Literature searches were conducted through the Consensus database, Google Scholar, and Garuda, covering the period from 2021 to 2026. Data analysis was performed thematically on articles relevant to the digital health behavior of young adults. Findings indicate that social media acts as a primary catalyst through social norm engineering, whereby health is now viewed as a prestigious social status symbol. Digital platforms provide a space for the younger generation to normalise alcohol-free lifestyles, so that they are no longer considered unusual by their peers. The synergy between educational content and online communities accelerates the continuous internalisation of preventive values. Social media effectively shifts the health paradigm of the younger generation from a mere medical obligation to an aspirational digital identity. Public health practitioners need to optimize this digital potential as a proactive health promotion instrument to foster a fitter society in the future.

Hypertension, a global health issue, is increasingly prevalent and significantly contributes to morbidity and mortality. It often coexists with obesity, a key risk factor for hypertension and vascular complications. The combination of hypertension and obesity leads to metabolic changes, chronic inflammation, and oxidative stress that damage retinal blood vessels, directly affecting visual acuity. This literature review examines the relationship between hypertension, obesity, and visual acuity, analyzing 20 articles published between 2021 and 2025, sourced from PubMed, Google Scholar, and ScienceDirect. The study found a significant association between hypertension and obesity with decreased visual acuity. Obesity not only serves as a comorbidity but also as a mediator, worsening hypertension's effects through mechanisms like insulin resistance and endothelial dysfunction. Longitudinal studies indicate that visual impairment is progressive, while cross-sectional studies highlight its high prevalence in hypertensive obese populations. The review emphasizes the need for routine eye exams, blood pressure control, and weight management as preventive measures. In conclusion, hypertension and obesity together significantly increase the risk of visual impairment, necessitating a multidisciplinary approach to care and promoting preventive strategies to preserve eye health and enhance patients' quality of life.

Oral and dental health problems among elementary school children remain relatively high, particularly dental caries, which is influenced by low levels of knowledge and inadequate toothbrushing skills. Children aged 6–12 years are in the mixed dentition phase and therefore require special attention in maintaining oral hygiene. This community service activity aimed to improve the knowledge and toothbrushing skills of elementary school students through a demonstration method using a dental phantom model. The activity was conducted at SD Inpres Maccini Sombala I in January 2026 and involved elementary school students as participants. The methods applied included oral health education, demonstration of proper toothbrushing techniques using a dental phantom, mass toothbrushing practice, and evaluation through pre-test and post-test as well as direct observation. The results showed an improvement in students’ understanding of the correct timing, frequency, and technique of toothbrushing, namely brushing twice a day after breakfast and before bedtime. In addition, students were able to practice proper toothbrushing techniques more effectively after the demonstration. The use of a dental phantom as an educational medium proved to be effective in increasing students’ interest, understanding, and toothbrushing skills. This activity is expected to help establish good toothbrushing habits from an early age and support promotive and preventive efforts to reduce the prevalence of dental caries among elementary school children.

Stroke is one of the non-communicable diseases that is the leading cause of disability and death in the world. Clinical factors such as hypertension, diabetes mellitus, body mass index (BMI), and unhealthy lifestyle are known to contribute to the incidence of stroke. Oe-Cusse Referral Hospital serves as the main referral center in the treatment of stroke cases, but data on contributing clinical factors and medical treatment and rehabilitation strategies are still limited. This study aims to analyze the clinical factors that contribute to the incidence of stroke and describe medical treatment and rehabilitation strategies in stroke patients at Oe-Cusse Referral Hospital.This study is a quantitative study with a cross-sectional observational design. The research sample amounted to 50 stroke patients who were treated in the January-November 2025 period, selected using purposive sampling techniques. Data were collected through medical records and questionnaires related to medical treatment and rehabilitation. Data analysis was carried out using the SPSS program, including descriptive analysis and logistic regression to see the relationship between clinical factors (hypertension, diabetes mellitus, lifestyle, BMI, and other factors) and stroke incidence. The results of the descriptive analysis showed that the average age of stroke patients was 56.2 ± 9.8 years, with an age range of 39–78 years. The average BMI of the patient was 27.5 ± 3.1 kg/m² which indicates a tendency to be overweight. The average systolic blood pressure of the patient was 150 ± 18 mmHg, indicating the predominance of hypertension in stroke patients. The average length of rehabilitation lasted 6.3 ± 1.8 weeks. Logistic regression analysis showed a significant relationship between clinical factors, especially hypertension, BMI, and diabetes mellitus, and stroke incidence. Clinical factors such as hypertension, high BMI, and diabetes mellitus contribute significantly to the incidence of stroke at Oe-Cusse Referral Hospital.

Prolactinoma is the most common functional pituitary adenoma, particularly in adolescent females, and is typically characterized by amenorrhea and galactorrhea resulting from hyperprolactinemia. However, in certain cases, serum prolactin levels may appear normal due to the hook effect, an immunoassay measurement error caused by extremely high prolactin concentrations that interfere with antigen–antibody complex formation. We report the case of a 17-year-old female presenting with a five-month history of galactorrhea, accompanied by breast pain, headache, and primary amenorrhea. Brain MRI revealed a pituitary mass measuring 1.4 × 0.8 × 0.5 cm, suspicious for prolactinoma, while serum prolactin was within the normal range (17.33 ng/mL). The discrepancy between clinical manifestations, lesion size, and laboratory findings raised suspicion of the hook effect. The patient was treated with dopamine agonists, bromocriptine and cabergoline, and referred for multidisciplinary management involving endocrinology, neurosurgery, and obstetrics–gynecology. Despite the absence of prolactin dilution testing, MRI findings supported the diagnosis of prolactinoma, and the patient demonstrated a favorable clinical response to therapy. This case highlights the importance of recognizing laboratory variability, performing comprehensive hormonal evaluation, and considering prolactin dilution assays when clinical and laboratory findings are discordant, particularly in adolescent patients with suggestive symptoms.

This research aims to analyze the criminal liability of perpetrators of arson and destruction of public facilities during demonstrations in Indonesia, as well as to examine the enforcement of criminal law against these crimes based on applicable positive law. However, in practice, demonstrations are often accompanied by anarchic actions in the form of arson and destruction of public facilities that harm the public interest and disrupt public order. The urgency of this research lies in the need to ensure that criminal liability and criminal law enforcement for acts of arson and destruction of public facilities are carried out individually and proportionally in accordance with the provisions of the old Criminal Code and the National Criminal Code, in order to prevent the general application of criminal law to participants in demonstrations. The results of the first study indicate that criminal liability for perpetrators of arson and destruction of public facilities during demonstrations has basically been regulated in the old Criminal Code and then updated in the National Criminal Code, especially regarding the crimes of arson and destruction of property. While the second enforcement of criminal law against these acts requires proportional and individual application, even though it is carried out in the context of collective mass action.

This study investigates the phenomenon of quasi-social movements that emerged during the August 25, 2025 protests in Indonesia. Quasi-social movements are defined as forms of public mobilization that appear to arise spontaneously, lack formal organizational structures, and are often leveraged for particular political agendas. Using a qualitative method supported by literature review, this research examines social movement theories, the functions of social media, and the socio-political dynamics that shaped the protests. The findings indicate that the protests were not purely the result of spontaneous civic engagement, but were instead driven by top-down mobilization orchestrated by elite actors through digital narratives, disinformation, and the broader influence of communication technology. This phenomenon signals a shift in the relationship between citizens and the state, including evolving patterns of political participation that do not always follow organized forms. The protests further illustrate how mass mobilization in the digital era can be generated through narrative construction and manipulation of public perception. In conclusion, quasi-social movements represent a new pattern of technology-mediated political expression, highlighting the need for more critical perspectives on modern forms of social mobilization.