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Diabetes mellitus is a chronic disease that requires long-term pharmacological therapy, increasing the risk of Drug Related Problems (DRPs). DRPs can affect the success of therapy, increase the risk of complications, and reduce the patient's quality of life. This article aims to identify the use of antidiabetic drugs, the characteristics of DRPs, and their clinical implications. The method used was a literature review of articles from 2016-2026 that are relevant to the analysis of DRPs in diabetes mellitus patients. The results of the study indicate that metformin is the most widely used antidiabetic drug, both as a single therapy and in combination. The dominant types of DRPs include drug interactions, inappropriate drug selection, inappropriate dosages, omissions from therapy, and use of drugs without indications. These DRPs can cause hypoglycemia, failure to achieve glycemic control targets, an increased risk of complications, and increased duration and cost of treatment. Based on the results of the study, it is concluded that DRPs remain a challenge in the management of diabetes mellitus therapy, requiring more optimal monitoring and an active role of pharmacists through medication review to improve the safety, effectiveness, and quality of treatment.

This study aims to analyze the influence of organizational culture and leadership on work discipline in employees of the Woja District Office, both partially and simultaneously. Using a saturated sample, all employees in the agency were directly involved as respondents as many as 45 respondents. Primary data were collected through a structured questionnaire and analyzed using multiple linear regression analysis techniques. The results of the study showed that partially, organizational culture had a positive and significant effect on employee work discipline, while leadership did not have a significant influence independently. However, simultaneous testing proves that organizational culture and leadership together have a positive and significant influence on shaping employee work discipline. These findings indicate that although personal leadership style is not the primary determinant of discipline that has been bound by bureaucratic regulations, the synergy between internalizing strong work culture values and leadership support remains an important combination for an orderly work ecosystem. This research provides practical implications for government organizations in strengthening work culture, increasing leadership effectiveness, and creating a work environment that is able to encourage employee compliance, responsibility, and productivity in a sustainable manner.

This study compared the performance of SARIMA and Prophet models in forecasting daily close prices of three major Indonesian banking stocks: BBCA, BBRI, and BMRI, using data from January 2020 to March 2026. Data were retrieved via the yfinance library, preprocessed, and split into 80% training and 20% testing sets. SARIMA modeling followed the Box-Jenkins procedure, while Prophet was configured with a Lag-1 regressor, weekly and monthly seasonality, Indonesian public holidays, and log transformation. Model performance was evaluated using MAPE, MSE, and Dstat metrics. Results showed that SARIMA outperformed Prophet in MAPE and MSE across all six stock-variable combinations, with MAPE values ranging from 1.3368% to 1.9386% for SARIMA and 1.5992% to 2.2300% for Prophet. However, Prophet demonstrated marginally higher Dstat values in several series. Both models achieved "Very Good" forecasting accuracy. A web-based forecasting system was also developed using Streamlit to make the models accessible to investors.

This study aims to compare the performance of three boosting algorithms, namely XGBoost, LightGBM, and CatBoost, to predict the success of MSMEs. The data used consists of 250 entries with 13 attributes that include business actor characteristics, initial capital, industry experience, financial record-keeping, internet utilization, business planning, partnerships, and the target variable success. The pre-processing stage includes checking for missing values, standardizing numerical attributes, and splitting the data into 80% training data and 20% test data. The evaluation results show that XGBoost provides the best performance with an accuracy of 0.92, precision of 0.8333, recall of 0.8333, F1-score of 0.8333, and ROC-AUC of 0.9715. LightGBM has an accuracy of 0.88, while CatBoost achieves an accuracy of 0.90. The research results show that XGBoost has the best ability to classify successful and unsuccessful MSMEs. The feature importance results also show that the success of MSMEs is influenced by a combination of several key factors. This research emphasizes that boosting algorithms are effectively used as predictive models to support the analysis of MSME success.

The purpose of this study is to identify the level of influence  of job description and workload on the job satisfaction of monthly contract employees at PT Multi Garmenjaya. Through  a cross-sectional  survey method, this study applies a descriptive and associative research design. The data collection was carried out through the distribution of a combination  of online (Google Form) and offline (print questionnaire) questionnaires to 87 respondents who were selected as a sample of the entire population totaling 677 monthly contract employees. Based on the results of hypothesis testing, it was found that the position description variable had a positive and partially significant influence on employee job satisfaction, with a calculated t-value of 5.529 and a significance level of 0.0000. On the other hand, the workload variable was also found to show a positive and significant influence on employee job satisfaction partially, with a calculated t  value of 1.327 and a significance value of 0.188. When tested simultaneously, the two independent variables were proven to have a significant effect on the job satisfaction of contract employees, with  an F score of 27.772 and a significance value of 0.0000. As for the Adjusted R Square value,  a value of 0.384 was obtained. This figure means that the ability of the variable job description and workload in explaining the ups and downs of the job satisfaction of PT Multi Garmenjaya's monthly contract employees is 38.4%. Meanwhile, the other percentage, which is 61.6%, is influenced by other factors or variables that are not studied and studied in this research model.

This study aims to describe the utilization of multimodal media in teaching news text reading skills among seventh-grade junior high school students. The research employed a quantitative approach with a descriptive research design. The data were collected through questionnaires distributed to 61 seventh-grade students as the research respondents. The research instrument used a Likert scale covering aspects of students’ perceptions, comprehension, motivation, participation, and readiness toward the use of multimodal media in learning news text reading skills. The data were analyzed using descriptive quantitative techniques through percentage calculations and interpretation of respondents’ answers. The findings revealed that most students showed positive responses toward the use of multimodal media. A total of 72.1% of students agreed that learning through printed and digital media made the learning process more engaging. In addition, 59% of students stated that digital media helped them understand news content more clearly, while 60.7% felt more active during learning activities using multimodal media. The use of multimodal media also increased students’ motivation, self-confidence, and reading comprehension skills in understanding news texts. The findings indicate that the combination of printed and digital media creates a more interactive and effective learning environment that aligns with students’ literacy needs in the digital era. Therefore, multimodal media can serve as an alternative instructional strategy to improve students’ news text reading skills in junior high schools. The implications of this study highlight the importance of integrating digital and printed media in Indonesian language learning to enhance students’ reading literacy quality.

Communication is a crucial element in the learning process, particularly in the education of students with special needs who possess diverse characteristics, abilities, and communication requirements. These differences require teachers to implement adaptive communication strategies to ensure that learning messages are effectively conveyed and understood by students. This study aims to analyze the communication at SLB YPAC Medan. The subjects of this study specifically focused on third-grade students with intellectual disabilities (tunagrahita) and slow learners. The. The study adopted a qualitative approach using a case study method. Data were collected through observation, in-depth interviews, and documentation, and analyzed using the Miles and Huberman model, which includes data reduction, data display, and conclusion drawing. The findings reveal that teachers apply communication strategies through a combination of verbal and nonverbal communication. Verbal communication involves the use of simple language, repetition of learning materials, and step-by-step instructions tailored to students’ abilities. Meanwhile, nonverbal communication is expressed through facial expressions, body movements, eye contact, and the use of visual learning media to clarify instructional messages. In addition, interpersonal approaches emphasizing patience, attention, empathy, and emotional closeness were found to enhance the effectiveness of teacher–student interactions. Supporting factors include adequate school facilities, psychological services, and therapy programs, while inhibiting factors involve differences in students’ characteristics and limitations in their communication abilities. This study concludes that adaptive communication strategies that accommodate individual student needs play a significant role in creating an effective, comfortable, and supportive learning environment for students with special needs.

Pressure sensitive labels (PSLs) made of polyethylene (PE) white are widely used in the packaging industry due to their flexibility, moisture resistance, and ease of application on various substrates. This study aimed to examine the effect of glossy and matte lamination on the tensile strength and color difference (ΔE) of PE white PSLs. An experimental method was employed, with tensile testing conducted using a universal testing machine (UTM) in accordance with ASTM standards and color measurement performed using a spectrodensitometer based on the CIE Lab system. The samples were divided into three treatment groups, namely no lamination, glossy lamination, and matte lamination, with ink coverage controlled at two design conditions, full ink and minim ink. The results indicated that lamination type significantly affected both the mechanical and visual characteristics of the labels. In the tensile strength test, the highest mean value was obtained by one treatment group, indicating superior resistance to tensile loading. In terms of color stability, higher ΔE values indicated greater color change and lower lightfastness, whereas lower ΔE values reflected better color retention. Overall, the findings show that the combination of lamination type and ink coverage influences the performance of PE white PSLs in both mechanical strength and color stability.

Evaluating food portions and types in the Free Nutritious Meal (MBG) program is generally still performed manually, which is time-consuming and potentially subjective. This study aims to develop an automated deep learning-based system to efficiently detect food types and estimate their nutritional value. The method used is a quantitative experiment integrating the YOLOv11m architecture for real-time object detection and the Google Gemini 2.5 Flash Large Language Model (LLM) for contextual nutritional estimation reasoning. The model training utilized a dataset of 2,630 food tray images categorized into five classes (fruit, side dish, staple food, vegetable, milk) that had undergone an augmentation process. The results showed that the YOLOv11m model achieved excellent performance with a mean Average Precision (mAP@0.5) of 0.9727 and the highest F1-score of 0.9522 at a confidence threshold of 0.1. Furthermore, validation of the LLM integration demonstrated a high prediction agreement rate of 85%. In conclusion, the combination of the YOLOv11m algorithm and LLM reasoning is capable of detecting and validating nutritional classification quickly and precisely, showing strong potential as an objective nutritional evaluation monitoring solution for large-scale MBG program implementation.

Braking performance is an important aspect of motorcycle safety because it relates to the vehicle’s ability to reduce speed and stop properly. In a hydraulic disc brake system, braking is influenced by mechanical and hydraulic factors, especially disc brake diameter and master cylinder pressure. Disc brake diameter determines the effective braking radius, while master cylinder pressure generates hydraulic pressure that is transmitted to the caliper. This study aims to analyze the effect of disc brake diameter and master cylinder pressure variations on the braking distance and braking time of a 110 cc motorcycle. This research used a quantitative experimental method with a Honda Revo Injection 110 cc motorcycle as the test object. The disc brake diameter variations were 190 mm, 220 mm, and 260 mm, while the master cylinder pressures were 2 bar, 4 bar, and 6 bar. Each treatment combination was tested three times at an initial speed of 40 km/h on a dry and flat asphalt road. Braking distance was obtained from front wheel rotation data recorded by a magnetic digital counter, while braking time was determined from video recordings. The data were analyzed using Two-Way ANOVA and response optimization. The results showed that increasing disc brake diameter and master cylinder pressure reduced braking distance and braking time. The best combination was obtained at a 260 mm disc brake diameter and 6 bar master cylinder pressure, producing a braking distance of 12.8 m and a braking time of 2.3 s.

Background: The rising global burden of hypertension presents a massive public health challenge, with its mitigation heavily tied to modifiable dietary factors. Among these, the escalating intake of sugar-sweetened beverages (SSBs) has emerged as a significant dietary risk. Objectives: This study aims to synthesize recent epidemiological evidence regarding the association between various types of sweetened beverages and the risk of hypertension. Methods: A narrative-analytical review was conducted by retrieving observational studies and meta-analyses published between 2023 and 2026 from the Scopus database using explicit keyword combinations targeting SSBs, prospective cohorts, and blood pressure outcomes. Findings: Synthesized data reveals that high consumption of traditional SSBs significantly increases hypertension risk by 13% (RR: 1.13) and elevates systolic blood pressure in children, primarily driven by excess liquid calories. Artificially sweetened beverages (ASBs) show a 14% risk increase in observational data, potentially confounded by reverse causation, whereas acute pure fructose ingestion triggers rapid transient blood pressure elevation. Energy drinks induce rapid 24-hour blood pressure spikes due to high caffeine content. Conversely, 100% pure fruit juice exerts a protective effect (RR: 0.74) via endothelial-improving polyphenols, while honey demonstrates a neutral effect. Implications: Public health policies must implement aggressive regulatory interventions, such as taxation on SSBs and energy drinks, alongside targeted dietary counseling that differentiates between harmful liquid sugars and protective natural fruit juices.

The opening of the wrench opening for M14 bolts is broken in use as a problem encountered in field activities. The manufacturing objective is to obtain an M14 mm wrench-ring wrench from forged steel measuring 200x6.5 mm. The manufacturing method includes: wrench design on one end and ring wrench design on the other end for bolt size M14 mm, cutting sufficient volume of steel material after forging according to the design, wrench forging on one end and ring wrench forging on the other end for bolt size M14, Chromium plating; finishing of wrench gap and hexagon for ring wrench with a distance of 22 mm, and quality-dimension-standard inspection. TThe manufacturing results are in the form of a paired wrench with an M14 mm ring wrench made of forged steel coated with chromium measuring 200x6.5 mm with a total production cost of IDR 30,000/unit, and a process duration of 3 minutes/unit which has the impact that the paired wrench with a ring wrench for M14 mm bolts measuring 200x6.5 mm can be used for M14 bolts in general with an opening width of 22 mm for both ends as a wrench or ring wrench.

Type 2 diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia due to impaired insulin secretion, insulin resistance, or a combination of both. HbA1c levels are used as an indicator of long-term glycemic control in patients with type 2 diabetes mellitus. Insulin therapy is one of the treatment options given to help achieve glycemic control targets. The purpose of this study was to determine the difference in HbA1c levels of type 2 diabetes mellitus patients with insulin and non-insulin therapy at PKU Muhammadiyah Gamping Hospital. This research method used a descriptive study with a cross-sectional approach. The subjects in this study were 80 type 2 diabetes mellitus patients who had used insulin and non-insulin therapy for less than 1 year, using Purposive Sampling techniques and data analysis using SPSS with Chi-Square and Mann-Whitney tests. This study has obtained ethical approval from PKU Muhammadiyah Gamping Hospital. This study shows that the characteristics of gender and age of type 2 DM patients with insulin and non-insulin therapy are dominated by women at 60.0% and 43.3%, while elderly patients at 60.0% and 53.3%. Of the 50 patients using insulin, 45 patients (90.0%) had controlled HbA1c and 5 patients (10.0%) were uncontrolled. Meanwhile, all non-insulin patients, 30 patients (100%), had uncontrolled HbA1c. Based on this study, there is a significant difference in HbA1c levels between type 2 diabetes mellitus patients with insulin and non-insulin therapy with a p-value <0.001. Patients using insulin therapy tend to have better glycemic control than patients not using insulin therapy.

Diesel engines are widely used in the transportation and industrial sectors due to their high thermal efficiency and good operational durability. However, increased fuel consumption due to inefficiency of the injection system remains a common problem. Injector characteristics, particularly nozzle diameter and injection pressure, are important factors that affect the quality of fuel atomization, air-fuel mixing, and combustion efficiency. An inappropriate combination of parameters can cause suboptimal combustion and increase fuel consumption. This study aims to analyze the effect of variations in nozzle diameter and injection pressure on fuel consumption efficiency in diesel engines. The method used is an experiment with variations in nozzle diameter of 0.150 mm, 0.152 mm, and 0.154 mm and injection pressures of 400 bar, 420 bar, and 440 bar. Tests were conducted at engine speeds of 500 rpm, 1000 rpm, and 1500 rpm with a fuel consumption measurement time of one minute for each parameter combination. Fuel consumption was measured using the volumetric method and analyzed through the fuel volumetric flow rate, fuel mass flow rate, Brake Power (BP), and Brake Specific Fuel Consumption (BSFC). The results showed that the combination of a nozzle diameter of 0.150 mm and an injection pressure of 400 bar produced the lowest BSFC value, thus providing the best fuel consumption efficiency. Meanwhile, the combination of a nozzle diameter of 0.152 mm and an injection pressure of 420 bar showed the closest condition to optimal because it was able to provide a balance between atomization quality and the amount of fuel injected, resulting in efficient and stable combustion. Thus, the efficiency of a diesel engine is influenced by the balance of nozzle size and injection pressure, not solely by the lowest fuel consumption.

Type 2 diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia due to impaired insulin secretion, insulin resistance, or a combination of both. HbA1c levels are used as an indicator of long-term glycemic control in patients with type 2 diabetes mellitus. Insulin therapy is one of the treatment options given to help achieve glycemic control targets. The purpose of this study was to determine the difference in HbA1c levels of type 2 diabetes mellitus patients with insulin and non-insulin therapy at PKU Muhammadiyah Gamping Hospital. This research method used a descriptive study with a cross-sectional approach. The subjects in this study were 80 type 2 diabetes mellitus patients who had used insulin and non-insulin therapy for less than 1 year, using Purposive Sampling techniques and data analysis using SPSS with Chi-Square and Mann-Whitney tests. This study has obtained ethical approval from PKU Muhammadiyah Gamping Hospital. This study shows that the characteristics of gender and age of type 2 DM patients with insulin and non-insulin therapy are dominated by women at 60.0% and 43.3%, while elderly patients at 60.0% and 53.3%. Of the 50 patients using insulin, 45 patients (90.0%) had controlled HbA1c and 5 patients (10.0%) were uncontrolled. Meanwhile, all non-insulin patients, 30 patients (100%), had uncontrolled HbA1c. Based on this study, there is a significant difference in HbA1c levels between type 2 diabetes mellitus patients with insulin and non-insulin therapy with a p-value <0.001. Patients using insulin therapy tend to have better glycemic control than patients not using insulin therapy.

Agentic artificial intelligence (AI) systems capable of autonomous goal-directed behavior, multi-step planning, tool use, multi-agent coordination, and iterative self-correction represent a transition from passive clinical AI tools toward systems that can participate in complex healthcare workflows. However, empirical evidence remains fragmented across clinical decision support, patient monitoring, and administrative applications, and no systematic synthesis has evaluated which agentic principles have been technically demonstrated and which have accumulated sufficient evidence to support responsible clinical deployment. We conducted a PRISMA-informed systematic review of peer-reviewed empirical studies published between January 2025 and April 2026. Searches across five bibliographic databases and Google Scholar, supplemented by citation tracking, identified 443 unique records for screening, of which 25 met the predefined PICOS and quality appraisal criteria. Evidence was synthesized using an evidence-informed seven-principle framework derived from the integration of agentic AI, clinical AI, and healthcare governance literature. This framework provides a structured lens for examining how agentic principles are evaluated individually and in combination, enabling a deployment-readiness perspective that extends beyond capability-focused assessments alone. The evidence base was concentrated on technical capability principles, whereas human oversight, safety, compliance, and equity-related evaluation received comparatively limited attention. Most studies remained at the laboratory, benchmark, or proof-of-concept stage, and none reported demographic-stratified performance outcomes. Overall, the findings suggest a structural asymmetry in agentic healthcare AI: empirical research is advancing agentic capabilities more rapidly than it is generating evidence for the oversight, safety, equity, and governance mechanisms required for responsible clinical translation.

This study aims to obtain a comprehensive understanding of the Juz ‘Amma memorization strategy implemented at Madrasah Diniyah Takmiliyah Baitul Azhar, evaluate its effectiveness, and examine the assessment mechanisms applied in Qur’anic learning. The research employed a qualitative field-study approach, focusing on learning activities as the primary object of investigation. Data were collected through direct observation of the learning process, in-depth interviews with the madrasah principal and teachers (ustadz/ustadzah), and documentation analysis related to the memorization program. The data were analyzed through data reduction, data presentation, and conclusion drawing to generate accurate and in-depth findings. The results indicate that the memorization program utilizes a combination of talaqqi, takrir (repetition), sima’i, and small halaqah methods. These strategies have proven effective in improving students’ memorization abilities, as reflected in increased reading fluency, better tajwid accuracy, and the achievement of memorization targets. In addition, the madrasah implements a structured and continuous evaluation system consisting of daily assessments, weekly reviews, and final examinations for each juz. The evaluation focuses on memorization fluency, recitation accuracy, and overall memorization quality. The study concludes that integrating diverse memorization methods with systematic evaluation significantly enhances the effectiveness of Qur’an memorization learning in Islamic educational institutions.  

Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy associated with high morbidity, reduced survival, and impaired quality of life. Radiotherapy (RT) has been widely used as a bladder-preserving strategy, particularly for patients unsuitable for surgery or systemic chemotherapy. RT may also enhance tumor immunogenicity through programmed death-ligand 1 (PD-L1) upregulation, providing a rationale for combination therapy with immunotherapy. This study aimed to evaluate the effectiveness of combining immunotherapy and radiotherapy in MIBC treatment. A systematic review was conducted following PRISMA 2020 guidelines using the PICO framework. Literature searches were performed in PubMed, Embase, Cochrane, ClinicalTrials.gov, Web of Science, and Scopus databases for studies published between 2016 and 2025. Risk of bias was assessed using the Cochrane Risk of Bias Tool and ROBINS-I. Of 105 identified studies, five met the inclusion criteria and were included in the final analysis. Only one Phase II randomized controlled trial demonstrated low risk of bias in randomization and allocation concealment. ROBINS-I assessment indicated moderate to serious risk in confounding and participant selection domains. Clinical findings showed promising outcomes, with complete response rates ranging from 35%–50% and partial response rates from 25%–40%. Median overall survival ranged from 24–30 months, with favorable disease-free and progression-free survival outcomes. Combined immunotherapy and radiotherapy demonstrate potential to improve survival and disease control in MIBC; however, further rigorous clinical studies are needed to optimize patient-centered treatment strategies.  

The study aims to analyze the influence of consumption behavior, projected through cultural, social, personal, and psychological factors, through Generation Z's decision to use the Quick Response Code Indonesian Standard (QRIS). The focus subjects were taken from undergraduate students of Economics at Surabaya State University from 2021 to 2024 who are active users of QRIS. Using an associative quantitative approach using primary data to be collected using an online questionnaire distribution. The data analysis technique applied Structural Equation Modeling–Partial Least Square (SEM-PLS) using SmartPLS 4 software. The results of the study showed that four factors of consumption behavior, namely cultural factors, social factors, personal factors, and psychological factors, have a positive and significant impact on students' decisions to use QRIS. Evaluation of the F-square value F2 shows that psychological factors (internal motivation, perceived ease, security, and trust) are the most dominant predictors with the largest effect value of 0.434 in influencing the decision to adopt this digital payment system technology. These findings indicate that a combination of students' internal motivation, the digital culture inherent in the campus environment, and the demands of practicality in Generation Z's lifestyle strengthen the decision to use QRIS in daily economic activities.  

Background: Community nursing is a service process that is a combination of nursing and public health. Family nursing care is health services focused on the family where the entire process from assessment, diagnosis, planning, implementation to evaluation involves all family members both in healthy and sick conditions. The elderly are individuals in the age range of 60 years and above. Stroke is a disorder of brain function that appears suddenly accompanied by clinical signs both local and global in nature that last more than 24 hours caused by disruption of blood flow to the brain. Objective: To provide family nursing care to Tn. W with Neurological System Disorders: Stroke in Karangjati Village RT 02 RW 05 Tonjong District, Brebes Regency. Methods: This scientific paper is compiled using a descriptive narrative study approach following the stages of the nursing process including assessment, diagnosis, intervention, implementation, and evaluation. Data collection techniques include interviews, observation, physical examination, and documentation studies. Results: Nursing diagnoses that emerged were physical mobility impairment and knowledge deficit. Nursing interventions for physical mobility impairment included recognizing health problems and understanding stroke management, particularly related to mobilization through passive and active range of motion (ROM) exercises. For knowledge deficit, interventions included health education about stroke using educational media. Conclusion: After implementation over three days (December 27–29, 2025), the physical mobility impairment problem was partially resolved and knowledge deficit was resolved. It is expected that patients can increase their knowledge about health, particularly stroke disease.