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Diabetes Mellitus is a complication caused by severe disturbances, particularly in the metabolic composition of carbohydrates, fats, and proteins in the body. The level of patient compliance in taking medication is one of the factors that determine the success of diabetes mellitus therapy. Compliance with treatment plays a crucial role in controlling metabolic conditions, especially in diabetes mellitus patients. The impact of non-compliance with medication in type II diabetes mellitus patients will increase uncontrolled blood sugar levels, which can lead to various complications of organ damage. The purpose of this study was to examine the relationship between medication compliance and blood sugar levels in type 2 diabetes mellitus patients at Harapan Anda Islamic Hospital in Tegal City. This study used a quantitative cross-sectional approach. The sample size was 58 respondents using a purposive sampling technique. Data analysis techniques used univariate and bivariate analysis (chi-square). Characteristics of 58 patients suffering from type 2 diabetes mellitus at Harapan Anda Islamic General Hospital, Tegal City, most of them are aged 46-60 years, with female gender, with most of them having junior high school education, some with working status, with a duration of suffering for >5 years, most with moderate medication adherence and most with normal blood sugar levels. There is a relationship between medication adherence and blood sugar levels in type 2 diabetes mellitus patients at Harapan Anda Islamic General Hospital, Tegal City (0.000). It is hoped that it can provide valuable information for diabetes sufferers about the importance of medication adherence to blood sugar levels so that blood sugar levels can be controlled.

Patients admitted to the Intensive Care Unit (ICU) frequently experience physiological disturbances that significantly affect their sleep quality. These disturbances are triggered by various factors, including repeated medical procedures, environmental noise, discomfort from medical devices, intensive interactions with healthcare workers, inappropriate lighting that disrupts circadian rhythms, pain, and the underlying disease process. Sleep disturbances in ICU patients may slow down the healing process, elevate blood pressure, trigger metabolic disorders, and increase the risk of serious complications such as stroke. This study aims to examine the relationship between anxiety levels and sleep quality among compos mentis patients in the ICU of Sultan Agung Islamic Hospital, Semarang. The research employed a correlational design with a cross-sectional method. A total of 30 respondents were included based on specific criteria. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using the Chi-Square test to determine the relationship between the two variables. The findings showed that the distribution of male and female respondents was balanced (15 respondents each). The most common medical diagnosis was post-laparotomy (10 respondents), with the dominant age category being late elderly (10 respondents). Anxiety levels were predominantly in the moderate category (18 respondents), while the majority of respondents demonstrated poor sleep quality (17 respondents). Statistical analysis revealed a p-value of 0.001, indicating a significant relationship between anxiety levels and sleep quality. In conclusion, the study highlights that higher levels of anxiety are associated with poorer sleep quality among compos mentis patients in the ICU. These findings emphasize the importance of nursing interventions aimed at reducing anxiety to improve patient sleep quality and support recovery.

This study discusses the application of the K-Means Clustering algorithm in the car rental ordering system. The objective is to help group booking data based on certain patterns such as car type, booking frequency, and rental duration. The clustering results are expected to improve service efficiency and help companies better understand customer preferences. The research was conducted using historical car rental booking data from a rental company. The results show that the K-Means method can successfully cluster booking data into several useful clusters for business decision-making. This extended paper also explores theoretical concepts of clustering, related studies, limitations of the method, and potential future enhancements such as integrating predictive analytics. It highlights the importance of transforming large volumes of raw booking data into actionable business intelligence to support marketing strategies, fleet management, and customer segmentation.  

Background: Dysmenorrhea is a common menstrual pain experienced by adolescent girls, often interfering with daily activities. Curcuma xanthorrhiza contains curcuminoids with anti-inflammatory and analgesic properties, making it a potential non-pharmacological treatment for menstrual pain. A preliminary study in Batuwarno Village showed a high prevalence of dysmenorrhea among adolescents. Objective: To determine the effect of Curcuma xanthorrhiza consumption on the reduction of dysmenorrhea in adolescents in Batuwarno Village. Methods: This study used a pre-experimental design with a one-group pretest-posttest approach. The sample consisted of 24 adolescent girls with dysmenorrhea, selected using consecutive sampling. The intervention involved administering 200 ml of boiled Curcuma xanthorrhiza twice a day for one day. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention. Data were analyzed using the Wilcoxon test. Results: The average pain score before the intervention was 6.54, and after the intervention, it decreased to 1.50. The Wilcoxon test yielded a Z value of -4.448ᵇ, where the negative Z value indicates that the more the intervention is given, the more the experienced pain decreases. The resulting p-value was 0.000 (p < 0.05), indicating a significant effect of Curcuma xanthorrhiza administration on the reduction of dysmenorrhea. Conclusion: Curcuma xanthorrhiza is effective in reducing dysmenorrhea in adolescents and can be considered a non-pharmacological alternative for managing menstrual pain.

Introduction: The increase in life expectancy among the elderly has directly contributed to the rise in the global elderly population. According to global data, the number of elderly individuals is projected to reach 1.4 billion by 2030. This demographic growth is often accompanied by various health problems associated with aging, such as the decline in vital organ function and the emergence of degenerative diseases. One of the most common degenerative diseases among the elderly is hypertension. Hypertension is widely known as a “silent killer” because it can lead to serious complications, including stroke and heart disease, if not managed properly. A common complaint experienced by individuals with hypertension is headache, particularly in the posterior region, which significantly affects the patient’s quality of life. Management of hypertension can be carried out through pharmacological therapy with antihypertensive drugs as well as non-pharmacological interventions. One of the non-pharmacological approaches increasingly being applied is isometric handgrip exercise, which involves static muscle contractions performed at light to moderate intensity. Method:This study aimed to evaluate the effect of isometric handgrip exercise on pain reduction in patients with hypertension. The research design employed a descriptive case study involving one individual with hypertension who experienced pain complaints. The study was conducted on September 16–18, 2024, at Roujin Home X. The instruments used included observation, interview, and the provision of isometric handgrip exercise therapy. Pain measurement was carried out using a numerical rating scale before and after the intervention. Results:The three-day intervention demonstrated a significant reduction in pain levels. On the first day, the patient reported a pain score of 6, which decreased to 4 on the second day, and further declined to 2 on the third day after the intervention. Conclusion:The findings of this study indicate that isometric handgrip exercise is an effective non-pharmacological method for alleviating acute pain in patients with hypertension. This simple intervention has the potential to be applied as a complementary therapy in elderly care facilities to improve the quality of life of individuals living with hypertension.

A 64-year-old male patient presented to the emergency department (ED) of RS Cut Meutia with complaints of left-sided chest pain radiating to both arms, which had been occurring for two days prior to his hospital admission. The chest pain was described as sharp, sudden, and progressively worsening, and it persisted without relief from positional changes. The pain intensity was rated as 9/10 and was accompanied by cold sweats and nausea. The patient had a history of type 2 diabetes mellitus for 15 years and had been on antidiabetic medications, although he could not recall the names of the medications. The patient was a smoker but had quit smoking upon being diagnosed with diabetes. Vital signs and general status were within normal limits upon examination. Local examination of the heart revealed a murmur on auscultation. Laboratory results showed anemia, leukocytosis, hyperglycemia, and hypercholesterolemia. Electrocardiography (EKG) indicated signs of inferior STEMI (ST-Elevation Myocardial Infarction). The patient was treated with furosemide 1 amp/12 hours, atorvastatin 1x20 mg, arixtra 1x0.25 mg, aspilet 1x8 mg, clopidogrel 1x75 mg, nitrokaf retard 2x2.5 mg, and bisoprolol 1x2 mg, along with non-pharmacological management, including three-way catheter insertion and oxygen therapy at 2-4 liters per minute. Acute Coronary Syndrome (ACS) carries a poor prognosis if not managed promptly and correctly. Understanding the appropriate management of ACS is crucial in preventing further myocardial occlusion and improving patient outcomes. Therefore, rapid and accurate intervention is vital in improving the prognosis for patients with ACS.

Tonsillitis is an inflammation of the pharyngeal tonsils, commonly caused by viral infections, and typically resolves on its own without medical intervention. The first-line treatment for tonsillitis generally involves supportive care, such as analgesics and hydration, to alleviate symptoms. However, in cases of chronic or severe tonsillitis that cannot be managed conservatively, tonsillectomy is the recommended surgical procedure. Tonsillectomy is typically performed by an ENT specialist, and candidates for this surgery must meet the absolute and relative criteria outlined in the 2004 Health Technology Assessment (HTA) Indonesia clinical guidelines. Although tonsillectomy is a common procedure, one of the serious complications that can arise post-surgery is hemorrhage, which can lead to fatal consequences if not managed appropriately. Post-tonsillectomy bleeding is a significant cause of mortality and requires immediate and effective management. Effective management of post-tonsillectomy hemorrhage is crucial to prevent life-threatening situations that may develop without appropriate intervention. Bleeding can be addressed through close observation, bedside interventions, or additional surgery if necessary, with the initial focus on stabilizing the patient's hemodynamics and controlling active bleeding. Given the high incidence and severity of post-operative bleeding, it is vital for healthcare professionals to identify patients who experience this complication and those at high risk, providing timely and appropriate interventions to reduce the risk of fatality. Therefore, in-depth knowledge of post-tonsillectomy hemorrhage management is essential for ENT specialists in daily clinical practice.

Improving the quality of education is one of the main priorities in developing a highly competitive human resource. In this context, excellent leadership serves as a key element that determines the direction, strategy, and success of educational transformation across all levels of education, from primary education to higher education. This article examines the urgency of visionary, inspirational, and adaptive leadership in driving the improvement of educational quality in a dynamic and complex era of change. Using a qualitative approach through literature review, policy document analysis, and observation of leadership practices, the study finds that effective educational leadership can foster a positive organizational culture, enhance motivation and participation among all stakeholders, and optimize innovation and professionalism among educators. Beyond managerial skills, excellent leadership is characterized by moral integrity, communication proficiency, collaborative abilities, and strategic decision-making skills that significantly impact learning quality. The findings indicate that educational reform cannot succeed without strong, consistent, and quality-oriented leadership. Furthermore, the development of leadership capacity within the educational ecosystem, including school principals, higher education leaders, and program administrators, should be a priority agenda in formulating policies and educational practices in Indonesia. Therefore, this article provides important implications for policymakers, educational practitioners, and researchers to design sustainable, innovative, and responsive leadership development programs. It also emphasizes the significance of leadership as a key factor in achieving high-quality, sustainable education capable of competing at the global level. The study underscores that investing in leadership development is not only a strategy to enhance educational outcomes but also a necessary step in ensuring that Indonesia’s education system can adapt to rapid changes and meet international standards.

Environmental management auditing is a strategic tool used to assess an organization’s performance in environmental management. Its main objectives are to enhance compliance with regulations, identify environmental risks, and strengthen corporate social responsibility. This study uses a bibliometric approach to analyze trends and research opportunities in the field of environmental management auditing during the period 2015–2025. Utilizing the Publish or Perish and VOSviewer software, this study examines 200 publications obtained through Google Scholar, revealing citation patterns, author collaborations, and frequently occurring keywords in the literature. The analysis results show that topics such as auditing, disclosure, governance, and big data dominate the existing literature, reflecting significant attention to transparency and data management in environmental audits. Additionally, there is a noticeable shift toward the use of technology in environmental auditing practices, including the use of big data and analytics to support audit processes. Bibliometric visualization also identified several areas with low density, such as implementation and environmental information, indicating potential research opportunities. This suggests that although significant research has been conducted, there is still room for further development, particularly regarding the implementation of environmental management audits across various industries. This study provides valuable insights into the development of more adaptive, multidisciplinary environmental auditing strategies that align with sustainable development goals.

This study aims to analyze the structure and composition of vegetation on the banks of the Ira River (Wae Ira), Negeri Kamarian, Kairatu District, West Seram Regency. Riparian vegetation plays an important role in maintaining the stability of river ecosystems, both in terms of ecological, hydrological, and biodiversity aspects. The method used in this study is a combination of the continuous strip sampling method and the line plot sampling method, which are applied to four levels of vegetation growth, namely seedlings, saplings, poles, and trees. The results of the analysis show that the vegetation structure in the study area is divided into four strata, with varying species compositions in each stratum. The dominant species found include Pulai (Alstonia scholaris), Pulaka (Cyrtosperma merkusii), Buah rao (Dracontomelon mangiferum), and Salam (Syzygium polyanthum). The highest Importance Value Index (INP) at the tree level is owned by Pulai (Alstonia scholaris) at 54,2. The highest vegetation density is at the seedling level with 52000 individuals/ha and the lowest at the tree level with 341 individuals/ha. The Shannon-Wiener diversity index (H') ranges from 1.87–2.65, indicating a moderate level of diversity. The results of this study indicate that the Ira River border area still has a relatively good vegetation structure and composition, although there are ecological pressures that cause dominance by certain species

As an archipelagic country, Indonesia has significant potential for the utilization of renewable energy, particularly wind energy in maritime areas with low wind speeds (3–6 m/s). This study aims to design and test a vertical Savonius wind turbine system equipped with a Perturb and Observe (P&O) Maximum Power Point Tracking (MPPT) algorithm as a power source for shipboard water heating systems. The research method applied is Research and Development (R&D), integrating several components such as a DC generator, full-wave bridge rectifier, INA219 current sensor, anemometer cup sensor, ESP32 microcontroller, and a monitoring interface utilizing Google Spreadsheet and a 20x4 LCD. The system was tested under two operating conditions: without MPPT and with MPPT. The experimental results show that the application of the MPPT algorithm successfully increased power output by up to 272.64% while maintaining voltage stability despite varying wind speeds. Nevertheless, the average output power of 2.605 W remained insufficient to meet water heating requirements within a short time. For example, charging a 12V 50Ah battery would require approximately 9.6 consecutive days of operation, highlighting the system’s limitations in high-demand scenarios. Despite these constraints, the findings demonstrate that the vertical Savonius wind turbine integrated with MPPT has strong potential as a clean and environmentally friendly alternative energy solution for maritime applications, particularly for small-scale onboard electrical loads. This study contributes to renewable energy utilization in the shipping sector and provides a foundation for further technological development and optimization.

This preliminary study was conducted as the foundation for developing an animated video-based learning media using Canva. The main objective of this research is to present the initial data collected during the early investigation phase, which will serve as the basis for creating innovative, research-based learning media in the future. The development model applied in this research is the Plomp model, and the study has currently reached the preliminary investigation stage. Data were collected using several instruments, including interviews, classroom observations, and student needs assessment questionnaires. The results of the needs assessment revealed that the learning media currently used in schools is considered less effective, leading to difficulties for students in understanding the subject matter. Furthermore, 91.33% of students agreed that the development of an animated video-based learning media using Canva would be beneficial and support the learning process. These findings indicate a strong need for engaging, interactive, and technology-integrated learning media. The selected topic for development is “Food and the Digestive System,” which is part of the curriculum for grade XI students in senior high schools (SMA/MA), as this topic is often perceived as challenging. By utilizing Canva to create animated videos, it is expected that students’ learning motivation, conceptual understanding, and classroom engagement will significantly improve. The results of this preliminary study serve as an essential foundation for the next stages of development, ensuring that the final product will provide an effective and enjoyable learning experience tailored to students’ needs.

Pulau Ketam, a small fishing village in Selangor, Malaysia, faces persistent economic challenges despite its abundance of marine resources and longstanding tradition of herbal knowledge. Limited access to modern markets, dependence on middlemen, and a lack of digital literacy have restricted the community’s ability to fully benefit from its local assets. This study aims to explore the implementation of digital branding strategies as a means of empowering local communities and strengthening the marketing of seafood and herbal products. Employing a community-based participatory approach, the research integrates digital marketing training, brand development workshops, and the establishment of an e-commerce platform tailored to local needs. Data collection was carried out through surveys of 150 local entrepreneurs, focus group discussions with community leaders, and performance metrics analysis over a six-month period. The intervention generated a 65% increase in online sales, a 40% improvement in product visibility, and notable progress in community digital literacy. Findings reveal that structured digital branding programs not only enhance entrepreneurial capacity and market competitiveness but also support the preservation of cultural identity and traditional knowledge systems. This study contributes to the growing body of literature on rural digital transformation by providing empirical evidence that community empowerment through technology adoption can lead to sustainable economic development. The results suggest that similar models can be replicated in other marginalized communities to bridge digital gaps, strengthen local economies, and promote inclusive growth.

This study aims to analyze the effect of job satisfaction and organizational commitment on employee productivity at the Semarak Dana Mojokerto Savings and Loan Cooperative.  The problem of low discipline and performance of marketing staff is an important background, given the limited empirical studies on human resource factors in micro cooperatives in Indonesia.  This study uses a quantitative approach with a total sampling technique on 35 respondents.  The instrument, in the form of a questionnaire, consisted of 28 statement items measured on a 1–5 Likert scale, with validity and reliability tests showing good results (Cronbach's Alpha > 0.70). Multiple linear regression analysis was used with the help of SPSS 26. The results of the study show that job satisfaction has a significant positive effect on productivity (β = 0.723, p < 0.05), as does organizational commitment (β = 0.555, p < 0.05). Simultaneously, these two variables contribute to an increase in employee productivity with a coefficient of determination of 77.8%.  These findings support the theories of Locke (1976) and Meyer & Allen (1991) and are in line with previous studies, although the context of micro cooperatives provides unique characteristics. The practical implications of this study encourage cooperatives to strengthen their reward systems, provide training, and improve work SOPs, particularly in marketing services. The limitations of this study lie in the small sample size and cross-sectional design. Future research is recommended to use a larger sample, a longitudinal approach, and include moderator variables such as work motivation or organizational culture.

This study aims to analyze the performance of state-owned enterprises (BUMN) from a financial aspect based on the financial ratios stated in the Ministerial Decree No. KEP-100/MBU/2002 at PT. Adhi Karya (Persero) Tbk for the 2019-2023 period. This type of research is quantitative descriptive research. Using secondary data in the form of related company financial reports. The sampling technique was carried out using the purposive sampling method and obtained 5 financial reports from the company PT Adhi Karya (Persero) Tbk for the 2019-2023 period. The results of the study showed that the ROE calculation results experienced a drastic decline in 2020 with a value of 0.43% and began to increase in the following years, ROI increased in 2021 with a value of 22.99% but decreased again in the following year and showed unstable performance, The cash ratio showed significant growth and reached its highest value in 2023 at 18.03%, the current ratio showed unstable performance, reaching its lowest point in 2021 at 101.52%, The collection period value reached its highest point in 2023 with a total of 124.06 days, inventory turnover experienced an increase in performance so that in 2023 it was recorded at 103.37 days, TATO showed unstable performance reaching its lowest value in 2022 with a value of 87.36%, and Total Equity to Total Assets reached its lowest value in 2021 at 14.18% and began to increase in the following year.

This study aims to analyze the prediction of financial distress using the Altman Z-Score, Springate, and Zmijewski methods at PT Sri Rejeki Isman Tbk in 2019-2023. This type of research is descriptive research with a quantitative approach. Using secondary data with documentation techniques and literature studies in the form of related company financial reports, books, articles, journals and other publications related to the research topic. The sampling technique was carried out using a purposive sampling method. The sample in this study was obtained using a purposive sampling technique and obtained as many as 5 financial reports from the company PT Sri Rejeki Isman Tbk for the period 2019-2023. The results of the study show that the results of calculations using the Altman Z-Score method indicate that in 2019-2023 PT Sri Rejeki Isman Tbk experienced fluctuations in the company consistently still in the category of bankruptcy, the Springate method shows that the company experienced a decline in its financial performance, and the Zmijewski method shows that companies that experience fluctuations in financial performance conditions, Although there are fluctuations in the X-Score value and improvements in certain years.

This community service activity aims to improve the literacy of residents in Penambangan Village through the implementation of a QR Code-based digital library at the Educational Center. The background of this program lies in the low level of literacy in rural areas, which is strongly influenced by the limited access to reading materials and the absence of library facilities. In the current digital era, the need for fast, easy, and affordable access to information has become increasingly important. Therefore, the application of simple technology such as QR Codes is considered an innovative solution to bridge the literacy gap between rural and urban communities. The method used in this activity was Participatory Action Research (PAR), which emphasizes active involvement of the community. The stages of the program consisted of initial observation to identify literacy needs, collaborative planning with local residents, implementation of the QR Code-based digital library, and reflection to evaluate achievements and challenges. This method ensured that the community was not only an object but also an active subject in the process of improving literacy. The results show an increase in reading interest and access to digital literacy, especially among young people. QR Codes installed at several strategic points enabled residents to access various digital reading resources using smartphones. Nevertheless, some obstacles were identified, including limited internet infrastructure and low digital literacy among the older population. Despite these challenges, the program successfully demonstrated that simple, technology-based approaches can significantly enhance literacy in rural areas. In conclusion, the implementation of a QR Code-based digital library supported by a PAR approach can serve as an effective alternative to increase literacy in rural communities. The success of the program strongly depends on collaboration among local residents, academics, and stakeholders to ensure its sustainability in the long term.

This study aims to analyze the effect of Service Quality, Price Perception, and Facilities on Customer Satisfaction at Barbershop Alsasumo Batam. The method used in this study is quantitative, with primary and secondary data collected through questionnaires. A sample of 243 respondents was determined using Slovin's formula and simple random sampling technique. Data analysis was performed using SPSS 27 software. Based on regression analysis, the following regression equation was obtained: Y = 0.172 + 0.401X1 + 0.367X2 + 0.284X3 + e. The results of the study indicate that Service Quality (X1), Price Perception (X2), and Facilities (X3) have a positive and significant impact on Customer Satisfaction (Y). The t-values for each variable are 8.504 for Service Quality, 8.725 for Price Perception, and 6.939 for Facilities, with a t-table value of 1.969. Simultaneously, all three independent variables significantly influence Customer Satisfaction with an F-value of 136.457, which is higher than the F-table value of 2.65. The coefficient of determination (R²) of 0.631 indicates that 63.1% of the variation in Customer Satisfaction is explained by these three variables, while the remaining 36.9% is influenced by other factors not covered in this study. These findings emphasize that Service Quality, Price Perception, and Facilities significantly affect Customer Satisfaction at Barbershop Alsasumo Batam.

Attendance is an essential activity in both educational institutions and companies, serving as an indicator of discipline, presence, and individual responsibility. Conventional attendance systems that still rely on manual journals often face several problems, such as vulnerability to manipulation, data loss, and physical damage. Meanwhile, modern methods such as fingerprint, QR code, RFID, and GPS are not entirely ideal since each has its own limitations in terms of cost, accuracy, user convenience, and potential misuse. For instance, fingerprint systems raise hygiene concerns due to shared use, while QR code and GPS methods are prone to fraud and location spoofing. To address these challenges, this study proposes a face-based attendance simulation system by integrating the YOLOv8 algorithm for face detection and Local Binary Pattern Histogram (LBPH) for face recognition. YOLOv8 was chosen for its ability to detect faces in real time with high speed and accuracy, while LBPH is employed for face recognition due to its robustness in handling variations in facial features and its relatively low computational requirements. This makes the system efficient even when implemented on medium-specification devices. The system was tested on 25 participants with a total of 250 attendance attempts. Based on the confusion matrix analysis, the system achieved outstanding performance with 98.4% accuracy, 98.4% precision, 100% recall, and a 99.2% F1-score. Furthermore, the system automatically recorded attendance dates and times with an average latency of 69.185 ms, proving its capability to operate quickly and reliably in real-world scenarios. Nevertheless, several limitations were observed, such as decreased accuracy when the face moved too quickly during image capture, as well as potential performance degradation under extreme lighting conditions. Despite these challenges, the proposed system demonstrates excellent performance and offers a promising solution for efficient, hygienic, and fraud-resistant attendance management applicable to both educational and professional environments.

The research findings indicate that, on a partial basis, only the Work-Life Balance variable has a significant effect on employee performance, with a significance value of 0.029 and a t-value of 2.311. In contrast, the Physical Work Environment and Interpersonal Communication variables show no significant impact, with significance values of 0.774 (t-value -0.290) and 0.217 (t-value 1.264), respectively. Simultaneously, the three variables do not exhibit a significant influence on performance, as evidenced by a significance value of 0.056 on an F-value of 2.845. The coefficient of determination (Adjusted R²) of 0.240 suggests that the model explains only 24% of the variability in employee performance. These results imply that employee performance at PT Daihatsu Jolo Abadi is more strongly influenced by work-life balance than by the physical work environment or social interactions in the workplace. Therefore, strengthening work-life balance should be a strategic priority for enhancing performance, alongside exploring other relevant variables for future studies.