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Aerobic capacity, commonly measured by maximal oxygen uptake (VO₂max), is a key indicator of physical fitness and athletic performance, particularly in endurance sports. Recent attention has focused on the role of respiratory muscle function in supporting exercise performance, as respiratory muscle fatigue during high-intensity or prolonged activity may reduce ventilatory efficiency and exercise tolerance. This literature review aims to examine current evidence regarding the effects of Respiratory Muscle Training (RMT), including Inspiratory Muscle Training (IMT), on aerobic capacity in athletes. Relevant studies were identified through electronic databases such as PubMed, Scopus, and Google Scholar using keywords related to respiratory muscle training, VO₂max, and athletes. The reviewed studies generally reported improvements in inspiratory muscle strength, reduced respiratory muscle fatigue, and enhanced ventilatory efficiency following RMT interventions. These physiological adaptations may contribute to better exercise tolerance and overall athletic performance. However, evidence regarding direct improvements in VO₂max remains inconsistent across studies. The findings suggest that RMT can be used as a complementary strategy alongside conventional training programs to support aerobic performance. In addition, improved respiratory muscle function may provide benefits in health promotion and rehabilitation by reducing dyspnea and increasing exercise tolerance. Further well-designed studies are needed to clarify the extent of RMT’s contribution to improving VO₂max in athletic populations.

This study analyzes the implementation of the Central Papua One-Stop Service Information System (Sipersateng) at the Central Papua Provincial Secretariat as a model for administrative innovation in the New Autonomous Region (DOB). The main focus of the study is to explore how a region with extreme infrastructure limitations can leapfrog or institutionalize towards an agile and transparent digital bureaucracy. Using a qualitative descriptive-analytical method with a case study approach, this research involved in-depth interviews, participant observation, and documentation studies to capture the dynamics of the transition from manual to digital systems. The results show that Sipersateng successfully reduced administrative process time by up to 60%. This success was driven by three main dimensions: institutional legitimacy through strong leadership commitment, technical resilience through offline-syncing features to address internet signal fluctuations, and significant changes in work culture. Adaptation strategies such as peer-mentoring methods for senior officials and mandatory policies through gubernatorial instructions proved effective in breaking down organizational cultural resistance. This study concludes that Sipersateng is not merely a technical tool, but rather a manifestation of Frontier Digital Bureaucracy that is able to mitigate the risk of maladministration and build public accountability in the newly formed province. This innovation demonstrates that geographic limitations are not a major barrier to achieving clean governance if supported by inclusive and adaptive system design. These findings provide a theoretical contribution to the public management literature on digitalization in regions with high structural challenges.

Aerobic capacity, commonly measured by maximal oxygen uptake (VO₂max), is a key indicator of physical fitness and athletic performance, particularly in endurance sports. Recent attention has focused on the role of respiratory muscle function in supporting exercise performance, as respiratory muscle fatigue during high-intensity or prolonged activity may reduce ventilatory efficiency and exercise tolerance. This literature review aims to examine current evidence regarding the effects of Respiratory Muscle Training (RMT), including Inspiratory Muscle Training (IMT), on aerobic capacity in athletes. Relevant studies were identified through electronic databases such as PubMed, Scopus, and Google Scholar using keywords related to respiratory muscle training, VO₂max, and athletes. The reviewed studies generally reported improvements in inspiratory muscle strength, reduced respiratory muscle fatigue, and enhanced ventilatory efficiency following RMT interventions. These physiological adaptations may contribute to better exercise tolerance and overall athletic performance. However, evidence regarding direct improvements in VO₂max remains inconsistent across studies. The findings suggest that RMT can be used as a complementary strategy alongside conventional training programs to support aerobic performance. In addition, improved respiratory muscle function may provide benefits in health promotion and rehabilitation by reducing dyspnea and increasing exercise tolerance. Further well-designed studies are needed to clarify the extent of RMT’s contribution to improving VO₂max in athletic populations.

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.

This study aims to analyze the effect of homework load and extended study hours on students’ learning stress levels. The background of this research is based on increasing academic demands that may affect students’ psychological conditions. This study employs a qualitative approach with data collected through observation and interviews. The results indicate that excessive homework load and prolonged study duration significantly contribute to higher levels of learning stress. Students tend to experience physical and mental fatigue, decreased motivation, and difficulty managing time between study and rest. In addition, pressure to achieve high academic performance further exacerbates stress levels. Other factors such as lack of environmental support and less varied teaching methods also influence students’ stress. Furthermore, students often report feelings of anxiety and emotional exhaustion when academic tasks accumulate without adequate rest periods. This condition not only affects their psychological well-being but also reduces concentration and learning effectiveness in the classroom. Therefore, balanced learning load management, appropriate task distribution, and more effective and humanistic teaching strategies are needed to reduce learning stress and improve the quality of education. Schools and educators are encouraged to consider students’ cognitive capacity and mental health in designing assignments and study schedules to create a more supportive learning environment.

Background: Community nursing is a specialty field that combines nursing science skills, public health sciences, and social assistance in addressing individual and family health problems, including non-communicable diseases such as gout arthritis. Gout arthritis is a metabolic disease characterized by pain and joint inflammation due to the accumulation of purine crystals (hyperuricemia). The WHO reports a prevalence of gout arthritis reaching 3.74% globally, while in Indonesia the prevalence reaches 11.9% based on health worker diagnosis. In Brebes Regency, the prevalence reaches 13.67%, with 3,078 sufferers out of 22,550 productive-age population. Objective: To provide comprehensive community nursing care to Ny. R with musculoskeletal system disorder: gout arthritis in Tonjong Village, Tonjong District, Brebes Regency. Method: This study uses a case study approach with data collection through interview, observation, physical examination, and documentation study conducted on December 26–28, 2025. Results: Assessment findings showed that Ny. R, a 60-year-old woman, had a history of gout arthritis for 3 months with uric acid levels of 9.6 mg/dL, complaining of pain and aching in the left foot with pain scale 3. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management, uric acid level monitoring, lemongrass stem decoction foot soak complementary therapy, and health education using leaflets. After 2 days of implementation, uric acid levels decreased to 8.2 mg/dL and pain scale decreased to 2. Conclusion: Community nursing care through complementary therapy (lemongrass stem decoction foot soak) and health education effectively reduced pain and improved knowledge about gout arthritis in Ny. R.

Background: Gout arthritis is a metabolic disease caused by excessive uric acid levels in the blood (hyperuricemia), which leads to monosodium urate crystal deposition in the joints. Globally, the prevalence of gout arthritis ranges from 1–4% of the general population. In Indonesia, the national prevalence reaches approximately 7.3% based on medical diagnosis, and in Brebes Regency, cases reach 62.4%. At the Tonjong Health Center service area, the prevalence of gout arthritis in Karanganyar Hamlet, Tonjong Village, reaches 2.04%. Gout arthritis requires comprehensive nursing care including pain management and health education to prevent recurrence. Objective: To implement nursing care for Ny. S, family of Tn. S, with musculoskeletal system disorder: gout arthritis in Karanganyar Hamlet, Tonjong Village, Tonjong District, Brebes Regency. Method: This study used a case study design with a single patient/family subject. Data collection was conducted through interview, observation, physical examination, and study documentation on December 26–27, 2025 at the patient's home. Results: Assessment revealed Ny. S (72 years) experienced acute pain in the right knee joint with a pain scale of 3/10 and uric acid level of 7.3 mg/dL, along with knowledge deficit regarding gout arthritis. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management education, non-pharmacological therapy (turmeric decoction), pharmacological therapy (allopurinol), and health education. Implementation was conducted over two visits. Evaluation results showed that acute pain was partially resolved (pain scale reduced to 2/10, uric acid 7.2 mg/dL) and knowledge deficit was resolved. Conclusion: Nursing care for patients with gout arthritis through pain management and health education can reduce pain intensity and improve family knowledge about the disease. Non-pharmacological intervention with turmeric decoction contributed to decreasing uric acid levels and pain. Keywords: gout arthritis, acute pain, knowledge deficit, family nursing care, non-pharmacological therapy

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.

Sexuality education is crucial for equipping adolescents and fostering healthy, responsible behavior. Lack of knowledge and understanding regarding sexuality education can increase the risk of sexual behavior, which can impact physical and mental health, and reduce concentration during learning. This activity aims to increase the knowledge of students at SMK Bhakti Indonesia Medika in Pangkalanbun Regency regarding education on preventing sexual harassment in the school environment. The outreach activity was conducted in May 2026 with 43 students aged 15-16 years, using a pretest-posttest method, leaflets, and PowerPoint presentations. The results showed an increase in the average student knowledge score from 50 to 95 after the education. The majority of students were 16 years old, and some had boyfriends. These findings indicate that the education provided in schools is very effective and useful as a warning to take the first step in preventing sexual harassment in the school environment for adolescents. This education can be recommended for regular replication to strengthen a safe and responsive school culture to child protection issues.

XYZ is a manufacturing company engaged in steel pipe production. In the production process of non-American Petroleum Institute (API) steel pipes, the company still experiences various types of waste, resulting in an inefficient production process. The identified wastes include defects, waiting, transportation, and non-value-added activities, which contribute to increased production time and reduced productivity. This study aims to analyze the major wastes occurring in the non-API steel pipe production process and propose improvements using the Lean Manufacturing approach. The methods employed in this study include Value Stream Mapping (VSM), Value Stream Analysis Tools (VALSAT), Process Activity Mapping (PAM), and Failure Mode and Effect Analysis (FMEA). Data were collected through direct observation, interviews, and documentation of the production process. The results indicate that the dominant wastes affecting the production process are defects, waiting, and transportation. PAM analysis shows that non-value-added activities remain relatively high, leading to production time inefficiencies. Based on the FMEA results, the main causes of waste are machine conditions, work methods, and operator skills. Proposed improvements include periodic machine maintenance, production quality control, work method improvement, and the optimization of material flow.

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).

Work stress is a critical occupational health concern among midwives working at primary healthcare facilities. This cross-sectional study aimed to analyze factors associated with work stress among 30 midwives, including age, marital status, length of service, and dual-role conflict. Data were collected using structured questionnaires measuring work stress (9 valid items) and dual-role conflict (6 items), and analyzed through univariate, bivariate (Fisher's Exact Test and Chi-Square), and multivariate (binary logistic regression) analyses. Results showed that 43.3% of midwives experienced high work stress and 53.3% reported high dual-role conflict. Bivariate analysis revealed significant associations between work stress and marital status (p=0.009) and dual-role conflict (p=0.004), while age (p=0.633) and length of service (p=0.586) were not significant. Multivariate analysis identified dual-role conflict as the primary determinant of work stress (OR=15.762; 95% CI: 2.149–115.631; p=0.007). Healthcare facility management should develop gender-responsive policies and workplace stress intervention programs to reduce dual-role conflict and work stress among midwives.

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.

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.

Preeclampsia is a pregnancy complication that significantly contributes to maternal and neonatal morbidity and mortality worldwide. Globally, it affects approximately 3–8% of pregnancies and causes more than 70,000 maternal deaths each year. In Indonesia, preeclampsia accounts for around 30% of the 4,151 maternal deaths reported in 2024. In Padang City, there were 254 cases in 2023 and 129 cases in 2024, with Puskesmas Bungus having the highest prevalence (7.2% and 3.77%). This study aimed to analyze the association between body mass index (BMI), history of hypertension, and history of preeclampsia with the incidence of preeclampsia among pregnant women at Puskesmas Bungus, Padang. This study used a quantitative case-control design involving 50 cases and 50 controls. Data were analyzed using chi-square and logistic regression tests. The results showed significant associations between obesity (p=0.031; OR=2.897), history of preeclampsia (p=0.006; OR=13.821), and history of hypertension (p=0.002; OR=17.216) with the incidence of preeclampsia. Multivariate analysis identified history of hypertension as the most dominant factor associated with preeclampsia. This study concludes that obesity, history of hypertension, and history of preeclampsia are significant risk factors for preeclampsia among pregnant women. Strengthening early detection and routine antenatal care for high-risk pregnancies is necessary to reduce maternal complications associated with preeclampsia.

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.  

Human Papillomavirus (HPV) infection is typically the cause of cervical cancer, one of the cancers with a high death rate among women. Despite their widespread use, conventional therapeutic approaches still have drawbacks, such as the emergence of cancer cell resistance and severe side effects. Natural compounds are now used as safer alternative treatments as a result. Soursop leaves (Annona muricata L.) are one plant that has been shown to have anticancer potential. Through phytochemical screening, compound identification using GC-MS, cell viability testing using the MTT Assay, and BCL2 gene expression analysis using qPCR, this study attempts to examine the potential of soursop leaf extract as an anticancer agent against cervical cancer cells (HeLa cells). The results of the phytochemical examination showed that steroids, phenolics, and alkaloids were present. Ostole, bisacumol, and ricinoleic acid were found to be the predominant components when the active chemicals were identified by GC-MS. With an IC²₀ value of 5.01 μg/mL, the MTT experiment demonstrated that soursop leaf extract could decrease cell viability as the concentration rose. Furthermore, BCL2 gene expression was significantly reduced, especially in treatments with doses of 500 and 1000 μg/mL, according to the results of qPCR gene expression analysis. The overall findings suggest that soursop leaf extract may be used as a natural anticancer treatment against HeLa cells by lowering the expression of the BCL2 gene.

This study aims to analyze the effect of cutting parameters on surface roughness in the turning process of AISI 1045 steel. The investigated parameters include cutting speed, feed rate, and depth of cut. A quantitative approach was employed using multiple linear regression analysis with SPSS software. The dataset consisted of 30 simulated experimental observations with varying cutting parameter conditions. Prior to regression analysis, classical assumption tests including normality, multicollinearity, and heteroscedasticity tests were conducted to ensure the validity of the model. The results indicated that all assumptions were satisfied. The findings reveal that simultaneously, all independent variables have a significant effect on surface roughness with a coefficient of determination of 82.1%. Partially, Feed rate and cutting speed significantly influence surface roughness, while depth of cut does not show a significant effect. Feed rate is identified as the most dominant variable affecting surface roughness, where an increase in Feed rate leads to higher roughness values. In contrast, increasing cutting speed tends to reduce surface roughness. This study highlights the importance of controlling cutting parameters, particularly Feed rate and cutting speed, to improve machining quality. The results provide practical implications for manufacturing industries in optimizing machining parameters to achieve better surface quality and process efficiency.

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

This study aims to analyze the dynamics of urban growth, land use change, and settlement development in Wamena City during 2020–2025. The research employed a quantitative descriptive approach using satellite imagery and population data obtained from the Central Bureau of Statistics (BPS) of Jayawijaya Regency. The analysis was conducted through satellite image interpretation to identify land use changes and the expansion of built-up areas.The results indicate that the built-up area in Wamena City increased from 1,250 hectares in 2020 to 2,012 hectares in 2025. Meanwhile, the population increased from 44,315 people to 49,102 people during the same period. Land use changes were dominated by the conversion of open land into residential areas and other urban facilities. Settlement growth generally followed the main road networks, city center, and areas surrounding Wamena Airport. Population growth, urbanization, economic activities, and infrastructure development were identified as the main factors influencing urban growth dynamics in Wamena City. These conditions resulted in reduced open spaces and increased urban density.