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Background: Automatic segmentation of the thyroid gland in ultrasonography (USG) images using deep learning requires a user-friendly interface to support diagnostic and educational processes. Purpose: This study aims to develop and implement a Graphical User Interface (GUI) that integrates a deep learning U-Net model for interactive and efficient segmentation and visualization of thyroid USG images. Method: The development method employed the Rapid Application Development (RAD) approach using MATLAB programming language. The GUI is designed to load transverse and sagittal USG images, display automatic segmentation results, and calculate thyroid gland volume based on dimensions measured automatically from the segmentation output. Testing was conducted using USG image data from 15 volunteers, and GUI functionality was evaluated using black box testing. Result: The GUI successfully displayed USG images and segmentation results with a responsive 4-panel interface; zoom, pan, and image navigation features functioned well. Automatic segmentation occurred in real-time after image input, and volume measurement results appeared automatically. Black box testing evaluation showed all GUI features operated as expected. The average Dice Similarity Coefficient (DSC) of 0.91 indicates high performance of the U-Net model in thyroid segmentation, consistent with previous findings. Statistical testing confirmed no significant difference between volume measurements using the application and manual methods (p = 0.953). Conclusion: This GUI implementation facilitates users in performing deep learning-based segmentation and visualization of thyroid USG images, improving efficiency and accuracy in thyroid volume measurement. The GUI has potential applications in clinical practice and radiology education.

Preeclampsia remains a major contributor to maternal morbidity and mortality, particularly in developing countries such as Indonesia. Early detection and integrated management at the primary healthcare level are essential to prevent disease progression and improve maternal outcomes.  Modifiable risk factors such as maternal obesity, inadequate calcium intake, and poor clinical management contribute significantly to disease progression (WHO, 2021; Zhang et al., 2020). This study aimed to evaluate the effectiveness of an Integrated Maternal Health Model (IMHM) combining risk assessment, nutritional intervention, and clinical management for early prevention and control of preeclampsia in primary healthcare settings. A quasi-experimental cohort study was conducted among 104 pregnant women, consisting of 52 preeclamptic and 52 normotensive participants in community health centers in Medan, Indonesia. Data were collected across four antenatal visits, including blood pressure measurements, proteinuria (dipstick), calcium intake, supplementation adherence, and antihypertensive therapy. Statistical analyses included bivariate and longitudinal tests. The results showed that maternal obesity, history of preeclampsia, and hypertension were significant risk factors. Adequate calcium intake demonstrated a protective effect against preeclampsia (p < 0.05), consistent with recent evidence indicating that calcium supplementation can reduce the risk of preeclampsia by up to 49%. However, calcium supplementation did not significantly influence blood pressure among normotensive pregnant women. Antihypertensive therapy, particularly intensive nifedipine regimens, showed significant differences in blood pressure patterns across visits (p < 0.05). In addition, proteinuria levels significantly decreased over time (p < 0.001), indicating improvement in renal function. In conclusion, the IMHM is effective in improving maternal outcomes through a multi-component approach integrating clinical, nutritional, and monitoring strategies. This model provides a practical and scalable framework for early prevention and management of preeclampsia in primary healthcare settings.

Anxiety is a common psychological issue among pregnant women in the third trimester, often triggered by fear of childbirth, concerns about fetal health, and hormonal changes. If not properly addressed, it may negatively affect both maternal and fetal outcomes. Non-pharmacological approaches, such as music therapy, are increasingly used to promote relaxation and emotional well-being. This study aimed to determine the effect of music therapy using spiritual songs on the anxiety levels of third-trimester pregnant women at GMIM Siloam Sonder Minahasa Hospital. A pre-experimental design with a one-group pretest–posttest approach was applied. The sample consisted of 30 pregnant women selected through total sampling. Anxiety levels were measured before and after the intervention using a validated instrument, and the data were analyzed using the Wilcoxon signed-rank test. The findings revealed a significant reduction in anxiety levels following the intervention. The statistical test showed a p-value of 0.000 (p < 0.05), indicating a significant effect of spiritual music therapy on reducing anxiety. These results suggest that spiritual songs can provide emotional comfort, enhance relaxation, and foster a sense of peace among pregnant women. In conclusion, music therapy using spiritual songs is an effective, safe, and complementary non-pharmacological intervention to reduce anxiety in third-trimester pregnant women and can be considered as part of maternal healthcare support.

The effectiveness of hypertension prevention in communities depends critically on individuals’ knowledge of risk factors and their attitudes toward healthy behaviors. This study examines the relationship between mothers’ knowledge and attitudes toward hypertension prevention behavior in South Polongbangkeng District, Takalar Regency, 2026. An observational analytic quantitative design with a cross-sectional approach was employed. A total of 200 mothers were selected as respondents. Data were collected using structured questionnaires assessing knowledge, attitude, and hypertension prevention behavior, then analyzed using chi-square test at a significance level of α = 0.05. Results showed that the majority of respondents had good knowledge (89.0%), good attitudes (91.0%), and good hypertension prevention behavior (77.0%). Statistical tests revealed a significant association between mothers’ knowledge and hypertension prevention behavior (p = 0.000) and between mothers’ attitudes and hypertension prevention behavior (p = 0.000). It is concluded that mothers’ knowledge and attitudes are significantly associated with hypertension prevention behavior. Health workers are recommended to strengthen health education and promotion programs targeting mothers to support hypertension prevention in the community.

Background: Trigeminal neuralgia (TN) is often associated with neurovascular compression in the trigeminal nerve root entry zone, necessitating the simultaneous visualisation of nerves and blood vessels. Fusion of 3D SPACE and 3D TOF MRA images provides an integrated neurovascular view; however, not all hospitals have fusion software. This study developed a MATLAB-based image fusion method as an alternative and evaluated its equivalence to hospital-based fusion software.Methods: This study employed a descriptive quantitative research design, conducted in November 2025 at Diponegoro National Hospital and Dr Kariadi General Hospital in Semarang. A total of 16 brain MRI datasets (3D SPACE and 3D TOF MRA) were fused using hospital software and the MATLAB fusion application (MATLAB R2025b GUI). The fusion results were assessed by specialist radiologists. Diagnostic performance metrics (sensitivity, specificity, NDP, NDN, accuracy) were calculated, and paired differences were tested using the McNemar test. Intra-observer reliability was assessed using percentage agreement and Cohen’s Kappa.Results: MATLAB fusion yielded a sensitivity of 90.91%, specificity of 80.00%, NDP of 90.91%, NDN of 80.00%, and accuracy of 87.50%; the McNemar test (p=1.000) indicated no significant difference. Intra-observer reliability was very good (percent agreement 94%; Kappa 0.875). These findings indicate that MATLAB-based fusion is equivalent to hospital software fusion on the study data and has the potential to serve as an alternative in facilities without fusion software, provided that registration standardisation and user training are in place.

The most frequent complaint among pregnant women, particularly during the second and third trimesters, is sleep difficulties. Emotional disorders, physical exhaustion, and a higher chance of pregnancy difficulties can all result from poor sleep. Back massage combined with lavender aromatherapy is one non-pharmacological treatment that has been shown to be safe for enhancing the quality of sleep. The purpose of this study was to evaluate the impact of lavender back massage on pregnant women's sleep quality. Thirty third-trimester pregnant women in the West Halmahera Community Health Center (Puskesmas) operating area participated in the study, which employed a pre-experimental design and a one-group pretest-posttest methodology. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the quality of sleep. According to the findings, the majority of respondents (76.7%) experienced poor sleep quality before to the back massage, with an average PSQI score of 11.2. The PSQI score dropped to 6.1 following three days of lavender back massages, indicating a substantial improvement in sleep quality. The Wilcoxon statistical test revealed a substantial increase in sleep quality following the intervention, with p = 0.000. According to the study's findings, back massage with lavender can be suggested as a safe supplemental therapy in prenatal care services as it effectively improves pregnant women's sleep quality.

Background: Anemia in pregnancy is a significant public health problem that can increase the risk of maternal and fetal complications. One of the main strategies to prevent anemia is the administration of Multiple Micronutrient Supplements (MMS), which provide essential vitamins and minerals during pregnancy. However, the effectiveness of MMS in preventing anemia is closely related to the level of knowledge pregnant women have about its use. Therefore, understanding the relationship between knowledge about MMS and anemia incidence is crucial to improving maternal health outcomes (Rahmawati et al., 2023). Objective: This study aims to determine the relationship between pregnant women’s knowledge level about Multiple Micronutrient Supplements (MMS) and the incidence of anemia among pregnant women in the working area of Dr. Hi. Zainal Umar Sidiki Hospital, North Gorontalo. Methods: This research employed an analytical observational design with a cross-sectional approach. A total of 30 pregnant women were selected as the sample using purposive sampling techniquesResults: The study found that the majority of participants who had high knowledge levels about MMS had a lower incidence of anemia, while those with low knowledge levels had a higher incidence. These results highlight that knowledge about MMS strongly influences pregnant women’s adherence and effectiveness in preventing anemia. Conclusion: There is a significant relationship between pregnant women’s knowledge level about Multiple Micronutrient Supplements (MMS) and the incidence of anemia. Improving maternal knowledge about MMS through health education, counseling, and guidance from healthcare providers is essential to prevent anemia and support optimal pregnancy outcomes.

This study aims to design and develop a functionally efficient and operationally effective Internet of Things (IoT)-based air quality monitoring system for radiology departments. The system utilises a DHT22 sensor integrated with an ESP32 microcontroller to monitor the temperature and humidity of diagnostic rooms in real time, and to display the data via the UdaraKu mobile application. The research method employed a quantitative experimental approach focused on measuring system performance, specifically the accuracy of the temperature and humidity sensors. The research model used was the Research and Development (R&D) method, aimed at transforming conventional air quality monitoring in radiology into a real-time digital system based on IoT. The research results indicate that the IoT-based monitoring system is capable of maintaining room temperature and humidity stability within the ideal range, namely 22–24°C and 50–60% RH, in accordance with international standards. This improvement in environmental stability has a direct impact on reducing noise in digital radiography images, as evidenced by an increase in the Signal-to-Noise Ratio (SNR). Instrument validation demonstrated a high level of reliability with a Cronbach’s Alpha value of 0.848, reinforcing the reliability of the data and the system. Overall, the IoT-based air quality monitoring system has proven effective in controlling noise in digital radiography images, improving the quality of diagnostic services, and supporting patient safety principles and operational efficiency within radiology departments.

Anemia during pregnancy remains a major public health concern with significant implications for maternal and fetal health. One contributing factor to its high prevalence is the limited knowledge among pregnant women regarding early detection. Health education serves as a crucial promotive-preventive strategy to enhance awareness of anemia’s signs, symptoms, and risks. This study aimed to analyze the effectiveness of health education in improving knowledge of early detection of anemia among pregnant women in the Galala Community Health Center working area. A pre-experimental one-group pretest–posttest design with a quantitative approach was employed. The sample consisted of 30 pregnant women selected using total sampling. Respondents received structured health education on early detection of anemia, and their knowledge levels were assessed before and after the intervention using a questionnaire. Data were analyzed using univariate and bivariate methods, with the Wilcoxon signed-rank test applied due to non-normal distribution. Results indicated a significant improvement in knowledge after education (p = 0.000), with most respondents shifting from poor or moderate knowledge to good knowledge. The study concludes that health education effectively increases pregnant women’s knowledge of anemia detection and should be systematically integrated into antenatal care to prevent anemia and improve maternal health outcomes.

Background: Thel postpartum periodl is al recovery phase involving lphysical and psychologicall changes, during which mothersl often experience fatigue due to increased cortisol levels. Excessive fatigue can interfere with the breastfeeding process and reduce motivation for exclusive breastfeeding. Lavender aromatherapyl is al non-pharmacologicall therapy containing linalool with sedative effects to provide relaxation and reduce fatigue levels. lObjective: This studyl aimed tol determine thel effect ofl lavender aromatherapy onl reducing fatigue in postpartuml mothers atl Puskesmas Ibu, West Halmahera Regency. Methods: Thisl study was al Pre-Experimentall study withl a Onel Group lPretest-Posttest lDesign. The studyl population consisted of lall postpartum mothersl at Puskesmas Ibu, with a total sampling technique of 30 respondents. The research instrument used anl observation lsheet, and ldata analysis wasl performed usingl the Paired Sample T-Testl (α = 0.05). Results: The majorityl of lrespondents' characteristics were inl the agel range of 20-35 yearsl (76.7%), had Senior High School education (60%), were unemployed/housewives (70%), and were primiparous (60%). The resultsl of thel Paired Samplel T-Testl showed al mean fatigue score before the intervention of 27.33, which decreased to 11.50 after the intervention (mean difference 15.833) with a lp-value = l0.000. lConclusion: There isl al significant effectl ofl lavender aromatherapyl administration on reducing fatigue lin postpartum lmothers at Puskesmas Ibu, Halbar Regency. Lavender aromatherapy is effective as a complementary therapy to aid postpartum maternal recovery.

Background: Diabetes Mellitus (DM) is a disease that cannot be completely cured or cannot even be completely cured. The vile shard plant is empirically used by the community to treat diabetes (DM). This study aims to conduct phytochemical screening and test the activity of 96% ethanol extract of kejibeling leaves (Strobilanthes crispus (L.) Bl.) as a herbal antidiabetic in male white mice (Mus musculus) with alloxan induction. Method: This research is an experimental laboratory research with a true experimental posttest control design using a completely randomized design (CRD) with 5 treatments and 5 replications. Treatment P1 (without treatment) as normal control (N), P2 as positive control (+), P3 as negative control (-), P4 kejibeling leaf extract 250 mg/kg BW, P5 kejibeling leaf extract 500 mg/kg BW. Result:The results of phytochemical screening showed the presence of alkaloids, flavonoids, tannins, saponins, terpenoids and steroids. SPSS results show that the data is normally distributed (p>0.05) and homogeneous (p>0.05). The results of the ANOVA on the treatment of giving keji beling leaf extract 250 mg/Kg BW showed a sig. 0.393 (p>0.05) and treatment of 500 mg/Kg BW obtained a sig value. 0.517 (p>0.05). Conclusion:The conclusion from the research results shows that administering doses of 250 mg/kg BW and 500 mg/kg BW of keji beling leaf extract can reduce blood sugar levels in mice. It is hoped that the results of this research will be useful for the community as an antidiabetic therapy using kejibeling leaves (Strobilanthes crispus (L.) Bl.).

This study evaluates the effectiveness of the Free Nutritious Meal Program (MBG) in improving students' cognitive abilities based on nutritional status in Brangsong Village, Indonesia. The research used a mixed-methods approach, combining quantitative and qualitative designs. Quantitative data were collected from 30 student beneficiaries via questionnaires and analyzed using descriptive statistics and Pearson correlation coefficients. Qualitative data were gathered through in-depth interviews with managers of the Nutrition Fulfillment Service Unit (SPPG), school authorities, students, and parents, and analyzed thematically. The results show a positive and significant relationship between nutritional status and academic achievement, but no significant relationship with students' cognitive ability. Nutrient intake, however, was positively and significantly associated with both cognitive ability and academic achievement. The strongest relationship was observed between cognitive ability and academic achievement. These findings suggest that the MBG program effectively supports academic achievement by improving nutrient intake and cognitive ability. However, its impact on students’ nutritional status has not been uniformly distributed.

Exclusive breastfeeding (EBF) is essential for infant growth and immunity during the first six months of life. Despite its benefits, many primiparous mothers face challenges in maintaining EBF due to lack of experience, stress, and insufficient support. Husband support has been identified as a crucial social factor that can influence a mother’s confidence and success in breastfeeding. This study aimed to examine the relationship between husband support and the success of exclusive breastfeeding among primiparous mothers in the Kalibaru Public Health Center area. A cross-sectional correlational design was employed, with 90 primiparous mothers selected through purposive sampling. Data were collected using structured questionnaires measuring husband support, including emotional, informational, and instrumental dimensions, and exclusive breastfeeding practice, following the World Health Organization (WHO) definition. Descriptive statistics summarized participants’ demographic characteristics and levels of support, while inferential analysis using the Chi-square test and Pearson correlation determined the association between husband support and EBF success. The results indicated that higher levels of husband support were significantly associated with successful exclusive breastfeeding among primiparous mothers (p < 0.05). Among the types of support, emotional and informational support were particularly influential in enhancing maternal confidence and overcoming breastfeeding challenges. These findings suggest that encouraging husband involvement through prenatal education, counseling, and family-based interventions can improve EBF rates. In conclusion, husband support plays a vital role in the successful practice of exclusive breastfeeding among first-time mothers. Health programs should actively involve fathers to provide emotional, informational, and practical support, thereby promoting optimal breastfeeding outcomes and infant health in the community.

Patient-Centered Care (PCC) is a healthcare approach that places the patient at the center of every interaction and clinical decision-making. However, a preliminary study at Tarumajaya Hospital showed that 58% of healthcare workers had not yet optimally implemented the PCC approach. This study aimed to analyze the influence of self-efficacy and social support on the implementation of Patient-Centered Care, with safety culture as a mediating variable, at Tarumajaya Hospital. The research method used was quantitative analytic with a cross-sectional design. The study sample used a saturated sampling technique of 132 healthcare workers, consisting of doctors, nurses, and medical support staff. Data analysis used Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results showed that self-efficacy and social support had a positive and significant effect on safety culture and PCC implementation. Safety culture also had a positive and significant effect on PCC implementation. Furthermore, safety culture was shown to mediate the influence of self-efficacy and social support on PCC implementation. The coefficient of determination value indicates that the model has strong ability to explain variations in PCC.

Background: Accurate detection of renal cysts on CT urography requires high diagnostic precision, while manual interpretation by radiologists is susceptible to inter-observer variability and potential delays in clinical decision-making. These challenges underscore the need for a reliable automated detection system to support radiological assessment. Objective: This study aims to develop and evaluate the performance of the Neo-ZasAI application based on the YOLOv8 algorithm for the automatic identification of renal cysts. Methods: Employing a Research and Development design using the ADDIE model, the study encompassed needs analysis, model design, software development, system implementation using 200 CT urography images, and diagnostic performance evaluation. Classification results generated by Neo-ZasAI were compared with radiologist readings through confusion matrix analysis and ROC–AUC assessment. Results: The findings indicate that Neo-ZasAI achieved an accuracy of 97,5%, sensitivity of 96%, specificity of 99%, positive predictive value of 98,9%, and negative predictive value of 96,1%. The ROC analysis yielded an AUC of 0.988 (p < 0.001), demonstrating excellent discriminative capability and high concordance with radiologist interpretations as the diagnostic gold standard. Conclusion: These results suggest that Neo-ZasAI is capable of performing rapid, consistent, and accurate renal cyst detection and is thus feasible for implementation as a clinical decision support system in radiology, with potential integration into PACS workflows and further development to enhance model generalizability.

Background: Adolescence is a transitional phase marked by biological changes, one of which is menstruation. A common problem during menstruation is dysmenorrhea or lower abdominal pain, which can interfere with quality of life and daily activities. One non-pharmacological effort to address this is consuming dark chocolate, which contains magnesium and triggers the release of endorphins as a natural pain reliever. Methods: This study used a quantitative method with a pre-experimental design through a one-group pretest-posttest design. The research population and sample consisted of 30 adolescent girls experiencing menstrual pain, selected using total sampling technique. Data analysis used the Wilcoxon Test to examine the effect before and after the intervention. Results: Before consuming dark chocolate, the majority of respondents experienced moderate pain (76.7%) and severe pain (16.7%). After the intervention, a significant reduction in pain level occurred, with 90% of respondents falling into the mild pain category and no respondents experiencing severe pain. The mean pain level decreased from 2.07 to 1.20 with a p-value = 0.000. Conclusion: The administration of dark chocolate has a significant effect on reducing the level of dysmenorrhea pain in adolescents at Puskesmas Ibu.

Pregnancy is a crucial period that requires intensive maternal health monitoring. Prenatal exercise is a non-medical intervention that is beneficial for improving physical fitness, reducing pregnancy complaints, and preparing mothers for childbirth. This study aims to determine whether there is a relationship between the knowledge and attitudes of pregnant women and the implementation of prenatal exercise at the Dolik Community Health Center. This study design was quantitative descriptive analytic with a cross-sectional approach. The sample consisted of 28 pregnant women selected using purposive sampling. Data were collected through a structured questionnaire regarding knowledge, attitudes, and implementation of prenatal exercise, then analyzed using the Chi-Square test. The results showed that the majority of pregnant women had good knowledge (60.7 %) and a positive attitude towards prenatal exercise (64.3%). Bivariate analysis showed a significant relationship between knowledge and implementation of prenatal exercise (p = 0.021) and between attitude and implementation of prenatal exercise (p = 0.034). Mothers with good knowledge and positive attitudes were more likely to regularly participate in prenatal exercise. This study shows a relationship between knowledge and attitudes and implementation of prenatal exercise, so increasing education and fostering positive attitudes are important strategies to encourage participation of pregnant women.

Background: Regular antenatal care is essential to ensure maternal and fetal health during pregnancy and to prevent complications. The level of maternal education plays an important role in shaping health knowledge, attitudes, and behaviors related to pregnancy care. Mothers with higher education levels tend to have better awareness and understanding of the importance of routine pregnancy check-ups. However, irregular antenatal visits are still found in several regions, including the working area of the Gandasuli Community Health Center, South Bacan District, South Halmahera Regency, North Maluku Province.Objective: This study aimed to analyze the relationship between mother’s education level and the regularity of pregnancy check-ups at the Gandasuli Community Health Center, South Bacan District, South Halmahera Regency, North Maluku Province.Methods: This study employed a quantitative analytical design with a cross-sectional approach. The sample consisted of 30 pregnant women selected using a total sampling technique. Data were collected using structured questionnaires and maternal health records to assess education level and the regularity of antenatal care visits. Data analysis was performed using the Wilcoxon test.Results: The results of the Wilcoxon test showed a significant relationship between mother’s education level and the regularity of pregnancy check-ups, with a p-value of 0.000 (p < 0.05). Conclusion: There is a significant relationship between mother’s education level and the regularity of pregnancy check-ups at the Gandasuli Community Health Center. Improving maternal education and strengthening health education programs are essential to increase compliance with routine antenatal care visits and improve maternal and fetal health outcomes.  

Exclusive breastfeeding for the first six months of life is an important effort to improve infant health and survival. Although the benefits of exclusive breastfeeding are widely known, its practice is still not optimal in various regions due to the influence of social and cultural factors. This study aims to analyze the relationship between socio-cultural factors and the practice of exclusive breastfeeding in breastfeeding mothers. The study used a descriptive analytical design with a cross-sectional approach. The sample consisted of 30 mothers with infants aged 6–12 months at the Kobe Community Health Center, selected using an accidental sampling technique. Data were collected through interviews using a structured questionnaire and analyzed univariately and bivariately using the Chi-square test and Fisher's Exact Test. The results showed that 56.7% of mothers successfully provided exclusive breastfeeding. Husband's support and family traditions had a significant relationship with the practice of exclusive breastfeeding, with p = 0.030 and p = 0.040, respectively. Mothers who received high husband's support and were in a supportive family environment had a greater chance of successfully providing exclusive breastfeeding. This study concluded that socio-cultural factors play an important role in determining the success of exclusive breastfeeding.

Sleep disturbances are a common complaint among perimenopausal women due to hormonal, psychological, and physiological changes, which impact their health and quality of life. Safe and easy-to-apply non-pharmacological approaches, such as lemongrass aromatherapy (Cymbopogon citratus), have the potential to be a supportive alternative in overcoming sleep disturbances during this phase. However, empirical evidence regarding the effect of lemongrass aromatherapy on the sleep quality of perimenopausal women is still limited, especially in the context of primary health care in Indonesia. This study aims to analyze the effect of lemongrass aromatherapy on the sleep quality of perimenopausal women. This study used a quantitative approach with a one-group pretest–posttest pre-experimental design. The sample consisted of 30 perimenopausal women selected using total sampling technique in the working area of Pustu Paring Lahung UPT Tumpung Laung. The intervention in the form of lemongrass aromatherapy through inhalation was carried out regularly before bedtime. Sleep quality was measured before and after the intervention using a standardized questionnaire. Data analysis was performed descriptively and bivariately using Fisher's Exact Test. Descriptively, there was an improvement in sleep quality after the administration of lemongrass aromatherapy, marked by a decrease in the proportion of poor sleep quality and an increase in good sleep quality. However, the statistical test results showed that the relationship between sleep quality before and after treatment was not statistically significant (p = 0.515). Lemongrass aromatherapy showed a tendency toward clinically significant improvement in sleep quality, but this was not statistically significant. Further research with a stronger design and longer intervention duration is needed to confirm the effectiveness of lemongrass aromatherapy on the sleep quality of perimenopausal women.