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Left ventricular hypertrophy (LVH) can be identified through both electrocardiography (ECG) and echocardiography, with echocardiography recognized as the gold standard for the assessment of LVH. This imaging modality determines the presence of LVH by evaluating the left ventricular mass index (LVMI). For diagnostic purposes, LVH is defined in males as a left ventricular mass index greater than 115 g/m² and in females as greater than 95 g/m². Despite the high accuracy of echocardiography in diagnosing LVH, access to this examination is not universal across all healthcare facilities. Consequently, electrocardiography, a widely available, non-invasive, and cost-effective diagnostic tool, serves as an alternative for the diagnosis of LVH. Several criteria exist for the electrocardiographic assessment of LVH, including the Sokolow-Lyon and Cornell voltage criteria. However, the sensitivity of these electrocardiographic methods remains relatively low, with reported sensitivities of 17% for the Sokolow-Lyon criteria and 35% for the Cornell criteria. In left ventricular hypertrophy, the interstitium experiences changes characterized by fibrosis and other deposits. These alterations can reduce the expression of hypertrophic myocardial tension and limit the diagnostic capabilities of surface electrocardiograms. Additionally, several factors influence electrical tension, including variations in chest wall thickness, heart muscle activity, the distance of the electrode from the left ventricle, and lung activity. The presence of these limiting factors can increase the rate of false negatives in diagnosis. In 2017, Peguero and Lo Presti introduced novel criteria for the diagnosis of LVH, defined by evaluating the deepest S wave and summing it with the S wave in lead V4. According to these new criteria, LVH is identified as ≥ 2.8 mV in men and ≥ 2.3 mV in women. The Peguero-Lo Presti criteria demonstrate improved sensitivity when compared to traditional criteria such as Sokolow-Lyon and Cornell, offering enhanced diagnostic accuracy.

Knee osteoarthritis is one of the most prevalent musculoskeletal disorders in the elderly, characterized by progressive degeneration of articular cartilage, chronic pain, joint stiffness, and reduced functional capacity. In Indonesia, the prevalence of knee osteoarthritis is notably high, affecting over 30% of individuals aged above 60 years. This condition leads to significant health burdens, impaired quality of life, and increased economic costs. Non-pharmacological management strategies such as hydrotherapy and quadriceps exercise are widely recommended to relieve pain and improve joint function. Hydrotherapy utilizes the physical properties of water including buoyancy, hydrostatic pressure, viscosity, and warmth to reduce joint loading, enhance circulation, and promote relaxation. Quadriceps exercise, on the other hand, focuses on strengthening the quadriceps muscle to stabilize the knee joint, thereby reducing pain and improving functionality. The combination of these two interventions is expected to provide greater benefits than a single modality. Research Design: This study employed a quasi-experimental design with a one-group pre-post test approach on 12 elderly respondents with knee osteoarthritis at OSF Magdalena Daemen BSB Convent. Pain was measured using the Visual Analogue Scale (VAS) before and after the intervention, which consisted of hydrotherapy and quadriceps exercise administered twice a week for four weeks. Results: The findings showed a decrease in the mean pain score from 4.42 to 3.08, with the Wilcoxon test yielding p = 0.001 (p < 0.05), indicating a significant difference in pain levels before and after the intervention. Conclusion: The combination of hydrotherapy and quadriceps exercise is effective in reducing pain in patients with knee osteoarthritis.

This study discusses the regulatory arrangement and investment climate in East Nusa Tenggara Province (NTT) as a strategic effort to increase investment attractiveness. Although it has great potential in the agriculture, fisheries, and tourism sectors, investment development in NTT has not been optimal due to overlapping regulations, complex bureaucracy, and lack of efficiency in licensing services. Based on the Stufenbau theory from Hans Kelsen, synchronization between Regional Regulation Number 3 of 2025 and Law Number 25 of 2007 is needed so that there are no conflicts or legal vacancies that can hinder the certainty of doing business. In addition, local governments have implemented various strategies to improve the investment climate, such as improving basic infrastructure, simplifying bureaucracy, promoting regional potential, developing human resources, and strengthening security and order. Other efforts are also being made through the digitization of licensing services and cooperation with the private sector to expand investment networks. Thus, an integrated regulatory and policy arrangement is expected to be able to create a competitive and sustainable investment climate in the NTT region.

The purpose of this research is to analyze and find out how the company's growth, capital structure and company size affect stock prices in sub-sector, ceramics, porcelain and glass companies listed on the IDX for the 2018-2023 period. This research is an associative quantitative research using secondary data taken from the company's annual financial statements. The sampling technique in this study uses purposive sampling. In this study, 48 samples were obtained for 6 years (20182023). The analysis tool used in the regression analysis of panel data was conducted using E-views 13. Based on the research that has been carried out, it can be concluded that the company's growth partially has a significant effect on the stock price, the company's capital structure and size partially do not have a significant effect on the stock price. Then  the company's growth, capital structure and company size simultaneously have a significant effect on the stock price of companies in the ceramics, porcelain and glass sub-sector listed on the IDX for the 2018-2023 period.

This study aims to determine and analyze the Professionalism of Apparatus in the Implementation of Public Services at the Investment and One-Stop Integrated Services Office of Gorontalo City. Viewed from the aspects of: (1) Competence, (2) Effectiveness, (3) Efficiency, and (4) Responsibility. This research method uses a Qualitative Approach with a Descriptive type. Data collection techniques used in this study are observation, interviews, and documentation. The results of the study indicate that in the competence dimension, the apparatus has had adequate technical capabilities, evidenced by mastery of the OSS system and participation in various training. The effectiveness dimension is also quite good, indicated by the timeliness of service even though sometimes hampered by OSS network disruptions. In the efficiency dimension, services have run optimally through the use of online systems that save time and costs, and received support from the SKM results with a value of 90.17 in the "very good" category. Meanwhile, in the responsibility dimension, the apparatus shows high discipline and work commitment, although there are still several cases of delays and permission to leave the office during working hours. Overall, it can be concluded that the professionalism of the Gorontalo City DPMPTSP apparatus in providing public services is classified as good, but still requires improvement, especially in the aspects of effectiveness and responsibility.

Kidney trauma is a relatively common urological injury, often resulting from high-speed motor vehicle accidents, falls, or violent incidents. The kidneys are vulnerable to both blunt and penetrating trauma, with blunt mechanisms accounting for approximately 90% of all renal injuries. This paper reviews the anatomy of the kidney, mechanisms of injury, classification according to the American Association for the Surgery of Trauma (AAST), diagnostic evaluation, imaging modalities, and current management strategies. Most renal traumas are managed conservatively based on hemodynamic stability, while surgical exploration is indicated in severe or vascular injuries. Understanding the mechanism of injury and applying appropriate diagnostic evaluations are essential to determine the correct management approach and improve patient outcomes. Moreover, advancements in imaging techniques, such as CT scans, have significantly improved the accuracy of diagnosing renal injuries. Early intervention and appropriate monitoring are crucial in preventing complications such as hemorrhage or renal failure. This review aims to provide a comprehensive overview of renal trauma management to aid clinicians in improving patient care and optimizing recovery.

The rapid growth of online transportation services has significantly transformed urban mobility patterns, including in Abepura District, Jayapura City. This study is grounded in the concept of smart mobility, which emphasizes technological integration, efficiency, and accessibility within the smart city framework. The theoretical foundation draws on consumer preference theory and the Customer Satisfaction Index (CSI) model. A quantitative approach was applied through questionnaires distributed to 100 respondents, supported by secondary data on digital infrastructure and local transport regulations. The analytical methods included conjoint analysis to identify user preferences, CSI analysis to assess smart mobility readiness, and spatial analysis to map infrastructure support. The findings indicate that fare and safety are the most influential attributes shaping user preferences, followed by application usability, transport mode, and travel time. Maxim emerged as the most widely used application, followed by Grab and Gojek. The CSI score reached 77.60%, categorized as “highly ready,” though gaps remain in intermodal integration and waiting time efficiency. Spatial analysis confirmed that the coverage of 16 BTS towers in Abepura adequately supports online transportation operations. In conclusion, online transportation services in Abepura District demonstrate strong readiness to support the implementation of smart mobility, yet further improvements are needed in modal integration and operational efficiency to ensure sustainable and inclusive urban mobility.

Pleural effusion is the accumulation of fluid in the pleural cavity, which is a common clinical condition requiring rapid and accurate diagnosis. Imaging modalities such as chest X-ray and ultrasound (USG) of the chest play a crucial role in identifying and evaluating this condition. Chest X-ray remains the most widely used initial screening tool due to its availability and ease of use. However, chest USG offers higher sensitivity, especially in detecting small effusions, assessing fluid characteristics, and guiding diagnostic and therapeutic procedures. Additionally, USG provides real-time imaging, enhancing the safety and effectiveness of interventions such as aspiration or drainage. Although both modalities are important, USG provides more detailed information, particularly in evaluating more complex pleural fluid conditions. This review discusses the latest evidence regarding the sensitivity, specificity, advantages, and limitations of both imaging techniques. Understanding the complementary roles of chest X-ray and USG is essential for optimizing diagnostic strategies, ultimately improving clinical outcomes and enabling more effective management of pleural effusion.

Osteoarthritis of the knee is a degenerative condition of the knee joint characterized by the thinning of cartilage, leading to friction between the femur and tibia. This condition results in pain, limited joint mobility, and reduced strength of the quadriceps and hamstring muscles. Physiotherapy plays a crucial role in reducing these symptoms through modality-based approaches and structured exercise therapy. This study is a case study involving a single patient with right knee osteoarthritis. Data were collected through direct observation and evaluation of therapeutic outcomes. Interventions were conducted over four sessions using Transcutaneous Electrical Nerve Stimulation (TENS) to reduce pain, Ultrasound to enhance blood circulation and reduce inflammation, and exercise therapy focusing on improving muscle strength and joint range of motion. After four therapy sessions, there was a reduction in pain intensity, improved strength of the quadriceps and hamstrings, and increased joint range of motion. These results demonstrate that the combination of TENS, ultrasound, and exercise therapy is effective in improving function and quality of life for patients with right knee osteoarthritis. This study emphasizes the importance of a multimodal physiotherapy approach in managing chronic musculoskeletal disorders.

This research aims to determine the effect of organizational support, work environment, and communication on employee performance at the Investment and One-Stop Integrated Services Office (DPM-PTSP) of Muaro Jambi Regency, both partially and simultaneously. The method used is quantitative analysis with a population and sample consisting of all 44 employees, determined through a saturated sampling technique. Data were collected using a Likert scale-based questionnaire, and the analysis was carried out using multiple linear regression with the help of SPSS software. The results of the study showed that (1) organizational support has a positive and significant effect on employee performance, (2) work environment has a positive and significant effect on employee performance, (3) communication has a positive and significant effect on employee performance, and (4) organizational support, work environment, and communication simultaneously have a positive and significant effect on employee performance. The recommendations/suggestions from this research are expected to improve employee performance by enhancing organizational support through fair task distribution, reward programs, and development opportunities; creating a comfortable and well- equipped work environment that encourages productivity; and strengthening effective communication between superiors and subordinates as well as among employees through regular meetings and discussion forums.

Intellectual capital represents information that reflects the quality of human resources and the knowledge assets owned by a business unit. This study aims to examine the influence of intellectual capital on business performance in creative sector MSMEs, specifically in the fashion and beauty industries in Surabaya. Data were collected through questionnaires distributed to business owners to capture their understanding of the components of intellectual capital and its impact on business performance. The study employs a quantitative method with a correlational approach to analyze the relationships between variables. The results of significance tests indicate that intellectual capital overall has a notable impact on business performance. Specifically, Human Capital, Structural Capital, Relational Capital, Technological Capital, and Business Capital exert a positive influence, demonstrating that the quality of human resources, organizational structure, business relationships, technology utilization, and business assets are key factors in improving MSME performance. Conversely, Customer Capital shows a negative influence, highlighting the need for more effective strategies in managing and leveraging customer-related resources. These findings confirm that intellectual capital significantly affects the performance of creative sector MSMEs, suggesting that proper management and development of each component of intellectual capital is essential for enhancing competitiveness, sustaining growth, and ensuring the long-term success of small and medium enterprises.

This study aims to analyze the effect of liquidity, firm size, and capital structure on firm value in the banking sector listed on the Indonesia Stock Exchange (IDX) during the 2020–2024 period. The background of this research lies in the crucial role of the banking sector in maintaining national economic stability and the need for investors to access financial information that accurately reflects a company’s value. Referring to signaling theory, financial reports are viewed as signals to investors regarding the firm’s prospects and performance. This study employs a quantitative method using secondary data from the annual financial reports of nine banks selected through purposive sampling, resulting in 45 observations. The independent variables include liquidity (Loan to Deposit Ratio), firm size (log of total assets), and capital structure (Debt to Equity Ratio), while the dependent variable is firm value measured by the Price to Book Value (PBV). Data analysis was conducted using panel data regression with SPSS. The results show that firm size has a significant positive effect on firm value, while liquidity and capital structure have no significant impact. Simultaneously, all three variables significantly affect firm value, with an Adjusted R² of 0.493. These findings highlight that effective asset management and optimal funding policies are key to enhancing the firm value of banking institutions in Indonesia.

Osteoarthritis is a degenerative joint disease whose exact cause is not yet fully understood. This condition is characterized by damage to the articular cartilage, resulting in pain, joint stiffness, decreased muscle strength, muscle spasms, and reduced functional activity of the patient. Several factors contribute to the development of osteoarthritis, including age, gender, race, genetic factors, smoking habits, history of trauma, type of occupation or physical activity, exercise habits, and obesity. The prevalence of osteoarthritis increases with age; among individuals aged 65–74 years, approximately 39% experience knee osteoarthritis and 23% experience hip osteoarthritis. In those over 70 years old, almost all individuals, both men and women, show symptoms of this condition. Osteoarthritis is a chronic progressive disease characterized by inflammation of the articular cartilage and synovial membrane, which causes persistent pain, joint stiffness, decreased muscle strength, and reduced mobility. Physiotherapy management for this condition aims to reduce pain, improve muscle strength, and enhance joint function. Common therapeutic modalities used include Shortwave Diathermy (SWD), Transcutaneous Electrical Nerve Stimulation (TENS), and the Hold Relax exercise technique, which helps relax muscles and increase joint range of motion

The general problem faced by cooperatives is the low quality of Human Resources (SDM) managerial in managing the entities owned by these members. So the specific objective of this community service is directed at constructing the management's understanding of entrepreneurial-based cooperative management which is derived to answer 3 (three) specific problems, namely: (1) what is meant by cooperative entrepreneurship towards prosperous members?; (2) why is cooperative entrepreneurship important for student cooperative managers towards prosperous members? and (3) how to internalize cooperative entrepreneurship in student cooperative managers towards prosperous members? The method used is Focus Group Discussion (FGD) with participants being the management of the Student Cooperative (Kopma) al-Kautsar UIN Sayyid Ali Rahmatullah Tulungagung. The results of the service show that Kopma members have the same insight in perceiving cooperative entrepreneurship, namely the entrepreneurial spirit of members. Entrepreneurial spirit is a member modality shown by the creativity and independence of members. Meanwhile, the strategy to internalize cooperative entrepreneurship is by translating cooperative values ​​reflected in a responsible attitude implemented in the form of an Annual Members Meeting (RAT).

Trigger finger is a condition where the flexor tendons stiffen from excess pressure, causing pain, stiffness, and limited range of motion when straightening a bent finger. The purpose of this study was to evaluate the effects of three weeks of physiotherapy interventions, including TENS, massage, stretching, and strengthening, on patient recovery. One patient with trigger finger disease in the right third digiti was the subject of this case study. The results obtained were a decrease in pain on movement T0: 9 to T2: 6, pain on pressure T0: 8 to T2: 5, an increase in the strength of the right wrist and hand muscles from T0: 3 to T2: 4 and the left part from T0: 4 to T2: 5, and an increase in the range of motion of the metacarpohalangeal joint of the right finger III from T0: S = 30 ̊ - 0 ̊ - 50 ̊ to T2: S = 30 ̊ - 0 ̊ - 60 ̊ and the proximal interphalangeal of the right finger III from T0: S = 0 ̊ - 0 ̊ - 90 ̊ to T2: S = 30 ̊ - 0 ̊ - 105 ̊. Thus, the provision of physiotherapy intervention to patient Mr. S is said to be effective in reducing the condition of the problem experienced.

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disorder that presents significant diagnostic challenges due to its heterogeneous clinical manifestations and symptom overlap with other neurological conditions. Early and accurate diagnosis is critical for initiating timely interventions and improving patient outcomes. Traditional diagnostic approaches rely heavily on clinical expertise and manual interpretation of neuroimaging data, such as structural MRI, Diffusion Tensor Imaging (DTI), and functional MRI (fMRI), which are inherently time-consuming and prone to interobserver variability. Recent advances in Artificial Intelligence (AI) and Deep Learning (DL) have demonstrated potential for automating neuroimaging analysis, yet existing models often suffer from limited generalizability across modalities and datasets. To address these limitations, we propose a Transformer-augmented deep learning ensemble framework for automated ALS diagnosis using multi-modal neuroimaging data. The proposed architecture integrates Convolutional Neural Networks (CNNs), Recurrent Neural Networks (RNNs), and Vision Transformers (ViTs) to leverage the complementary strengths of spatial, temporal, and global contextual feature representations. An adaptive weighting-based fusion mechanism dynamically integrates modality-specific outputs, enhancing the robustness and reliability of the final diagnosis. Comprehensive preprocessing steps, including intensity normalization, motion correction, and modality-specific data augmentation, are employed to ensure cross-modality consistency. Evaluation using 5-fold cross-validation on a curated multi-modal ALS neuroimaging dataset demon-strates the superior performance of the proposed model, achieving a mean classification accuracy of 94.5% ± 0.7%, precision of 93.9% ± 0.8%, recall of 92.9% ± 0.9%, F1-score of 93.4% ± 0.7%, spec-ificity of 97.4% ± 0.6%, and AUC-ROC of 0.968 ± 0.004. These results significantly outperform baseline CNN models and highlight the potential of transformer-augmented ensembles in complex neurodiagnostic applications. This framework offers a promising tool for clinicians, supporting early and precise ALS detection and enabling more personalized and effective patient management strategies.

This study aims to develop an interactive learning medium on the Gimkit platform with the topic of modal verbs at the A1 level. The research method applies a qualitative approach using the model of Richey & Klein (2017), which consists of three stages: (1) planning, (2) development, and (3) evaluation. The data source of this study is the book Grammatik aktiv A1–B1 by Friederike Jin and Ute Voß (2014), Chapter 5, pages 16–18, focusing on the topics: (1) conjugation of modal verbs in the present tense, (2) conjugation of modal verbs in the past tense, and (3) comparison of modal verbs in the present and past tenses. The learning medium was validated by a material expert with a score of 95 and by a media expert with a score of 90; both results fall into the category “very good.” Based on these results, the Gimkit learning medium on the topic of modal verbs is considered suitable and effective for teaching German at the A1 level in senior high schools, both for independent learning and for classroom instruction.

This study links Liquidity, profitability, value, capital structure. Moderator (IDX property firms, 2022–2024). Using quantitative methods with multiple linear, moderated regression analysis (MRA), 76 companies were examined. Results show liquidity (Current Ratio) negatively affects firm value, indicating that excessive current assets reduce efficiency and investor appeal. ROE lacks impact, showing profit instability. Capital structure shows no moderating effect.These findings emphasize the need for efficient asset management and consistent profitability enhance firm value, regardless of capital structure.

This study aims to examine the influence of mentality and capital on the entrepreneurial interest of Development Economics students at Universitas Muhammadiyah Sumatera Utara. Multiple linear regression analysis and descriptive correlational approaches are employed in this quantitative approach. 39 students using a variety of sampling methodologies made up the sample. The study's findings show that, partially and concurrently, financial and mental resources significantly and favorably influence entrepreneurial interest. Entrepreneurial desire is influenced by both mental and capital factors, according to the determination coefficient value of 36.7%.

This study aims to explain and test the hypotheses regarding the effect of Profit Growth, Capital Structure, and Liquidity Ratio on Earnings Quality. A quantitative approach with an associative method was employed to examine the influence of Profit Growth, Capital Structure, and Liquidity Ratio on Earnings Quality at PT BFI Finance Indonesia Tbk during the 2016–2023 period. The data analyzed are secondary data obtained from financial statements and earnings quality records listed on the Indonesia Stock Exchange. The analysis was conducted using multiple linear regression with both partial and simultaneous hypothesis testing. The partial analysis results indicate that Profit Growth has a negative and significant effect, Capital Structure has a negative and insignificant effect, while Liquidity Ratio has a positive and insignificant effect on Earnings Quality. Simultaneously, the three variables were found to have a significant effect on Earnings Quality. The contribution of Profit Growth, Capital Structure, and Liquidity Ratio to Earnings Quality is 60.7%, while the remaining 39.3% is influenced by other variables not included in this study.