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Esophageal atresia with tracheoesophageal fistula is a congenital anomaly requiring early diagnosis and prompt surgical correction. Gross type D esophageal atresia, characterized by both proximal and distal tracheoesophageal fistulas, is an exceedingly rare variant that poses significant diagnostic and operative challenges. We report a case of a full-term female neonate with a birth weight of 3,200 grams who presented with hypersalivation since the first day of life, accompanied by coughing and choking during feeding. Orogastric tube insertion failed, with the tube arrested at approximately 15 cm. The patient was referred with a diagnosis of neonatal pneumonia and suspected esophageal atresia with tracheoesophageal fistula. Physical examination revealed tachypnea, chest wall retraction, and respiratory distress requiring ventilatory support. Babygram demonstrated the orogastric tube tip arrested at the proximal esophageal pouch with distal gastrointestinal air. Contrast esophagography confirmed proximal esophageal atresia at the upper thoracic level with suspected proximal fistula. Associated findings included bilateral pneumonia, right upper lobe atelectasis, and vertebral anomalies suggestive of VACTERL association. Intraoperative findings confirmed Gross type D esophageal atresia with proximal and distal tracheoesophageal fistulas. Both fistulas were excised, followed by primary esophageal anastomosis and transanastomotic nasogastric tube placement. Gross type D esophageal atresia is a rare congenital anomaly that should be considered in neonates presenting with hypersalivation, failed orogastric tube insertion, and respiratory distress. Anatomical subtype confirmation relies on intraoperative findings. Early surgical repair can be performed successfully; however, associated anomalies necessitate careful long-term follow-up.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor with deceptively benign histological features but significant potential for local recurrence and distant metastasis. Pelvic LGFMS is extremely uncommon and may mimic gynecological malignancies, leading to diagnostic challenges. This report describes a 39-year-old woman presenting with progressive abdominal enlargement, bloating, early satiety, and dyspnea. Physical and ultrasonographic examinations suggested a malignant ovarian tumor. The patient underwent exploratory laparotomy without preoperative CT scan evaluation. Intraoperatively, multiple solid masses involving the intestines, mesentery, omentum, peritoneum, and ovaries were identified, with the largest measuring 20 × 15 cm. Histopathological examination confirmed the diagnosis of LGFMS. The absence of preoperative cross-sectional imaging contributed to diagnostic difficulty in this case. CT scan and MRI are important for evaluating tumor origin, tissue characteristics, and involvement of surrounding structures. Definitive diagnosis requires histopathology supported by immunohistochemistry, particularly MUC4, and molecular confirmation when available. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis, optimize management, and improve long-term outcomes in patients with pelvic LGFMS.

This study aims to analyze the level of student satisfaction in paying tuition fees (UKT) through the BRImo application at Universitas Negeri Gorontalo. The research applies the service quality (SERVQUAL) framework, which consists of five dimensions: tangibles, reliability, responsiveness, assurance, and empathy. A qualitative descriptive approach was employed, with data collected through in-depth interviews, direct observations, and documentation. Participants included students who actively use the BRImo application for UKT payments as well as staff responsible for tuition management. Data analysis followed a systematic process involving data reduction, data display, and drawing conclusions to ensure accuracy and clarity of findings. The results indicate that using the BRImo application for tuition payment offers significant convenience and efficiency, allowing students to complete transactions without physically visiting the university payment office. Despite these benefits, several challenges were identified, including failed transactions, delays in payment confirmation, and suboptimal responses from customer service staff. Overall, the study concludes that student satisfaction with tuition payments via BRImo is considered fairly good. Nevertheless, improvements in reliability and responsiveness are recommended to further enhance the user experience and optimize the quality of service provided.  

Marriage confirmation services are often hampered by manual procedures, leading to delays and administrative errors. This study aims to design and implement a web-based Marriage Confirmation Information System to facilitate registration, document uploads, and online monitoring of verification status and court schedules. The system was developed using the PHP programming language and MySQL database using the Waterfall method, encompassing analysis, design, implementation, and testing. The results show that the system is capable of optimally performing all managerial functions, from document validation to report automation. Black Box testing confirmed that all features functioned as expected and were easy to use. In addition to improving bureaucratic efficiency, the system ensures data security through login encryption and provides transparency through real-time status tracking. The presence of this platform significantly saves time and transportation costs for the public, as bureaucratic processes can be monitored from anywhere. In conclusion, this system successfully supports the digitalization of public services and improves the quality of administration within the Office of Religious Affairs (KUA) and Religious Courts, thereby realizing more effective, efficient, accountable, and modern governance for all levels of society

This study examines the comparison between litigation and Alternative Dispute Resolution (ADR) in resolving business conflicts in Indonesia. The increasingly complex nature of business activities has led to a variety of conflicts, such as breach of contract, share ownership disputes, and payment issues, which require efficient resolution methods that provide legal certainty. This study aims to explore the characteristics, procedures, advantages, and disadvantages of dispute resolution through litigation and ADR, which include negotiation, mediation, conciliation, and arbitration. The method applied is normative juridical, drawing on legislation, legal doctrine, and relevant literature. The research findings indicate that litigation offers stronger legal certainty through binding court decisions and organized procedures, but is often time-consuming, expensive, and produces win-lose outcomes. On the other hand, ADR offers flexibility, confidentiality, efficiency, and the opportunity to reach mutually beneficial solutions, although in some situations it requires court confirmation for enforcement. Therefore, the choice of dispute resolution method needs to be adjusted to the nature of the conflict, the relationship between the parties, and the need for legal certainty.

This study aims to investigate the determinants of job performance by integrating the variables of capability, social interaction, and Organizational Citizenship Behavior (OCB) as a moderating variable. The phenomenon of employee turnover and discrepancies in staff discretionary behavior within the hospital setting serves as the primary rationale for this study. Using a quantitative approach, data were collected from 240 respondents at Magelang City Islamic Hospital through purposive sampling. Data analysis was conducted using Structural Equation Modeling (SEM) based on AMOS software to test the causal relationships among variables in the structural model. The research findings provide empirical confirmation that individual capabilities and the quality of social inter-actions have a positive and significant influence on stimulating the formation of OCB. Furthermore, statistical test results demonstrate that capabilities, social interactions, and OCB simultaneously make a significant contribution to improving employee work performance. The presence of OCB is identified as a crucial factor capable of strengthening organizational performance outcomes. The practical implications of this study emphasize the need for hospital management to formulate human resource development strategies focused on strengthening technical skills and social cohesion to mit-igate the impact of turnover and accelerate the sustainable performance of healthcare services.

This research aims to explore the satisfaction–revenue nexus by examining the effect of tourist satisfaction on Revenue Per Available Room (RevPAR) performance in three-star hotels across Southeast Asia. Grounded in Expectation–Confirmation Theory and the Service-Profit Chain framework, the study conceptualizes tourist satisfaction as a strategic intangible asset that contributes to financial performance through both direct and indirect mechanisms. A mixed-methods sequential explanatory design was employed. Quantitative panel data were collected from 312 three-star hotels in Indonesia, Malaysia, Thailand, Vietnam, and the Philippines over the period 2019–2024 and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) and panel regression techniques. The results indicate that tourist satisfaction has a positive and statistically significant direct effect on RevPAR. Furthermore, occupancy rate partially mediates this relationship, suggesting that satisfaction enhances revenue performance primarily through demand stabilization and increased room utilization. Qualitative findings from managerial interviews further confirm that guest satisfaction strengthens online reputation, repeat visitation, and revenue consistency. This study contributes empirical evidence to the literature on satisfaction-driven financial performance in mid-scale hospitality markets and offers strategic implications for revenue optimization in competitive Asian contexts.  

Drug stockouts in hospitals pose significant risks to service quality, patient safety, and operational efficiency. This study aimed to analyze how drug demand planning and procurement processes at Johar Baru Regional General Hospital contribute to stockout occurrences and to develop data-driven recommendations based on supply chain management principles. A qualitative descriptive design was employed using data triangulation. Data were collected through in-depth interviews with the Head of the Pharmacy Installation, procurement staff, and warehouse pharmacists, complemented by direct observation and analysis of 2024 planning and procurement documents. Thematic analysis was conducted with the support of NVivo software to identify patterns and relationships among key variables, including drug demand planning, procurement, and inventory management.Findings reveal that stockouts stem from interconnected weaknesses in planning accuracy, procurement coordination, and inventory control systems. Effective stock management depends not only on increasing supply but also on improving data quality, integrating inventory information systems with operational workflows, and enhancing cross-functional collaboration. Recommended strategies include implementing a minimum stock alert system integrated with the Hospital Management Information System (HMIS), strengthening standard operating procedures for stockout response and procurement confirmation, improving integration between HMIS, the National Formulary, and budgeting systems, and applying consumption based planning methods combined with ABC VEN analysis to optimize inventory control.

This study is motivated by the increasing complexity of financing coordination between the National Health Insurance (BPJS Kesehatan) and supplementary health insurance providers under the Coordination of Benefits (KAPJ) scheme, which creates potential claim disputes and administrative risks for hospitals. Although Minister of Health Decree No. HK.01.07/MENKES/1117/2025 regulates payment allocation and membership verification mechanisms, it does not explicitly recognize pre-admission confirmation as a preventive legal protection instrument. This research aims to analyze the normative position of pre-admission confirmation within the KAPJ framework, conceptualize it as a preventive legal protection mechanism, and formulate a proportional implementation model. The study employs a normative juridical method using statutory and conceptual approaches through literature review of relevant regulations and scholarly works. The findings indicate that pre-admission confirmation possesses implicit normative legitimacy through membership verification obligations and system integration requirements, and functions as a risk allocation mechanism that clarifies payment responsibilities prior to service delivery. Its implementation enhances legal certainty, reduces fraud potential, and minimizes claim disputes, provided that access to emergency medical services remains guaranteed.

The use of cosmetics, especially day creams, is increasing along with the high public interest in facial skin care. However, day cream products are still found to potentially contain hydroquinone, a skin whitening agent whose use is restricted because it can cause harmful side effects on skin health. This study aims to identify the presence and determine the levels of hydroquinone in day cream products circulating in District X, Sukoharjo Regency, and to assess their compliance with the regulations of the Food and Drug Monitoring Agency (BPOM). This study was a descriptive analytical study using a purposive sampling technique. A total of 15 day cream products were analyzed, consisting of 8 BPOM-registered products and 7 products not registered with BPOM. Qualitative analysis was conducted using color reaction tests with FeCl₃, Benedict’s, and o-phenanthroline reagents. Furthermore, quantitative analysis was performed using the High Performance Liquid Chromatography (HPLC) method to accurately and specifically confirm the presence and determine the levels of hydroquinone. The results showed that the color reaction test has limitations in specifically identifying hydroquinone. HPLC confirmation revealed the presence of hydroquinone in several day cream samples, with concentrations ranging from 0.024% to 0.150%. These findings indicate the need for stricter monitoring of day cream distribution to ensure the safety of cosmetic products for the wider public.

Mammae aberrans in the axilla is a developmental abnormality caused by the persistence of breast tissue along the milk line and can cause fluctuating axillary masses due to hormonal stimulation, with a reported prevalence of approximately 0.4–6%. Methods: This article is presented as a descriptive case report based on data from the Department of Surgery at Cut Meutia Regional General Hospital, North Aceh, including medical history, physical examination, routine blood tests, fine needle aspiration biopsy (FNAB), excision, histopathological examination, and follow-up. Results: A 16-year-old female patient complained of a lump in her right axilla for approximately two years, which had enlarged in the last month and caused severe pain before menstruation. Examination revealed a mass measuring approximately 3×3×2 cm, without lymph node enlargement, and normal routine blood tests. Two FNAB punctures showed fat droplets/matrix without epithelial proliferation or malignant cells (benign smear) with the impression of aberrant mammary glands. The patient underwent mass excision; histopathology showed mature fatty tissue and fibrocollagen accompanied by ductular proliferation without signs of malignancy, and at the 1-week follow-up, the pain had disappeared and the lump was no longer visible. Discussion: The cyclic pain pattern associated with menstruation is an important clue for distinguishing aberrant mammary glands from differential diagnoses of axillary masses in adolescents, while excision provides diagnostic certainty and symptom improvement. Conclusion: Mammae aberrans should be considered in adolescents with axillary masses affected by the menstrual cycle, and excision is recommended in symptomatic cases for histopathological confirmation and resolution of complaints.

Social media, initially projected as a democratic discourse space, has instead become trapped in the echo chamber phenomenon, narrowing the intellectual horizons of its users. This research aims to analyze the echo chamber phenomenon on social media through the lens of Max Horkheimer’s critical theory, specifically the concept of the "Eclipse of Reason." The method used in this study is qualitative descriptive with a literature study and philosophical analysis approach. The results indicate that social media algorithms have shifted objective reason into instrumental reason, where truth is measured solely by efficacy and confirmation of personal beliefs. The analysis in this article concludes that social media functions as an "eclipse of reason" machine that stifles the critical reasoning abilities of individuals. This process occurs when reason is no longer used to critically dissect reality but serves merely as a technical tool to adapt to homogeneous information flows. The death of critical reason is not merely a technical byproduct of algorithms but a manifestation of the dominance of formal rationality that sidelines human values in the digital sphere.

The rapid growth of Sharia-based e-commerce reflects the increasing demand among Muslim consumers for transactions that comply with Islamic principles. However, digital transaction practices still raise various concerns, particularly regarding the clarity of contracts (akad), payment security, and information transparency. This study aims to explain Muslim consumers’ perceptions of the application of the legal maxim al-yaqīn lā yazūlu bi al-shakk in Sharia e-commerce transactions, with a focus on students of the State Islamic University of North Sumatra. This research employs a descriptive qualitative approach, using in-depth interviews with 10 informants as the primary data source, supported by questionnaire data to identify general tendencies in respondents’ perceptions. The findings reveal that although most respondents understand the maxim theoretically, they have not been able to apply it effectively in digital transaction contexts. The uncertainties experienced by respondents are predominantly triggered by technical factors, such as delays in payment confirmation, rather than shakk in the fiqh sense. Moreover, limited understanding of digital contract mechanisms contributes to uncertainty regarding the moment when a contract is considered legally valid. Information transparency emerges as a key factor in fostering yaqīn, particularly in relation to the clarity of product descriptions and transaction procedures. This study concludes that the application of al-yaqīn lā yazūlu bi al-shakk in Sharia e-commerce remains suboptimal due to limited digital fiqh literacy and insufficient technological reliability, highlighting the need for enhanced digital muamalah education and improved information quality on Sharia e-commerce platform.

Abstract. The development of digital media, especially YouTube, has made this platform not only a means of entertainment, but also a source of information, education, and self-reflection for students. Viewer satisfaction in consuming YouTube content is influenced by the quality of content presented by creators. This study aims to evaluate the impact of the quality of Nadia Omara's YouTube channel content on viewer satisfaction among students at Muhammadiyah University Kotabumi. This study applies a quantitative approach through a survey method. Data were collected through a closed questionnaire with a Likert scale distributed to 98 respondents selected using purposive sampling. The independent variable in this study is content quality, while the dependent variable is viewer satisfaction. Data analysis was conducted through validity testing, reliability testing, linearity testing, and simple linear regression analysis. Hypothesis testing was performed using the t-test (partial test) with the help of SPSS version 26 software. The results showed that the quality of Nadia Omara's YouTube channel content had a positive and significant effect on viewer satisfaction. This is evidenced by a regression coefficient value of 0.865 and a t-value of 11.937 with a significance level of 0.000 (< 0.05). These findings support the Uses and Gratifications Theory and Expectation Confirmation Theory, which emphasize the active role of the audience in evaluating media based on the fulfillment of needs and conformity with expectations empirically among college students.

The aim of this study is to analyze verbal and non-verbal communication in an English as a Foreign Language (EFL) classroom by using the Sinclair and Coulthard (1975) model of classroom discourse. Although many studies have examined verbal interaction in EFL classrooms, few have discussed how verbal and non-verbal communication work together to support effective learning. To fill this gap, this research focuses on identifying the types and frequency of verbal and non-verbal communication used by the teacher and students during classroom interaction. This study used a descriptive qualitative method. The data were taken from an 80-minute video recording of an eleventh-grade English class at MAS Darul Quran. The recording was transcribed and analyzed based on Sinclair and Coulthard’s framework, which includes three main levels: Exchange (Informing, Directive, Question–Answer), Move (Initiation, Response, Feedback), and Act (Questioning, Explaining, Agreeing, Refusing, Revising, Appraising). The findings show that the classroom interaction was mainly teacher-centered. The teacher dominated the talk through Initiation moves, mostly in the form of questions, explanations, and instructions, while students gave short and simple responses. Feedback was used less often and mostly as short praise or confirmation. The teacher also used various non-verbal behaviors such as gestures, eye contact, movement, and changes in voice tone to direct attention and motivate students. The results suggest that combining verbal and non-verbal strategies can create a more interactive and engaging classroom atmosphere that supports student participation and understanding.

This study addresses the urgent need for digital transformation at Percetakan Rajawali, a printing company currently reliant on manual order processes, which leads to service delays, recording errors, and lack of transparency. The research aims to design and implement a web-based online ordering information system to facilitate customer orders, accelerate confirmation and order tracking, and improve the efficiency of order data management. Adopting the linear and sequential Waterfall methodology, the study progressed through stages of system analysis, design, coding, testing, and maintenance. The key findings include the successful design of a comprehensive system featuring product catalogs, an online ordering module with real-time cost calculation, integrated payment management, and an admin dashboard for order processing. The system is designed with user-centered and secure principles, expected to significantly enhance operational efficiency, service speed, and customer satisfaction by providing an integrated, transparent, and accessible online ordering platform.

The development of information technology has encouraged restaurants and cafés to function not only as dining places, but also as venues for hosting various events. However, the event reservation process at Rumah Makan Ny. Hartini and Café Rain is still carried out manually through logbooks, telephone calls, and WhatsApp, resulting in problems such as unorganized data, delayed confirmations, and miscommunication with customers. In addition, the manual system limits access to information regarding venue availability, reservation schedules, and additional facilities required by customers. This study aims to develop a web-based event reservation information system using the prototyping method. The system design was carried out using Unified Modeling Language (UML), including use case diagrams, activity diagrams, and class diagrams to model user interactions, process flows, and system structure. The results of the study show that the developed system is able to automate the reservation process, customer data recording, reservation confirmation, schedule management, and additional facilities management. This system improves operational efficiency, data accuracy, and service quality, while also making it easier for customers to make reservations independently and obtain information quickly and accurately.

This study aims to examine the implementation of audit procedures on accounts payable at PT XYZ by KAP Ramli & Rekan, with a focus on compliance with Auditing Standards and effectiveness in detecting material misstatements. Accounts payable are a key component of financial statements representing the company’s obligations to suppliers, requiring accurate presentation for assessing liquidity and capital structure. The study applies a descriptive qualitative method, collecting primary data through interviews with audit staff at KAP Ramli & Rekan and secondary data from relevant literature. The findings show that the audit procedures comply with professional standards, covering comprehensive stages including engagement acceptance, audit planning, risk and materiality assessment, and substantive testing. The planning process incorporates the COSO framework for evaluating internal control, establishes audit objectives based on the five management assertions, and utilizes ATLAS software and Microsoft Excel. KAP Ramli & Rekan apply control testing and substantive procedures, including external confirmations, inspection of supporting documents, review of aging payables, and subsequent payment testing. Risk assessment indicates low inherent and control risks, while detection risk is mitigated through substantive procedures. Overall Materiality is set at 60% of revenue and profit before tax, Performance Materiality at 3% of Overall Materiality, and Threshold Materiality at 3% of Performance Materiality. The study concludes that the audit procedures implemented by KAP Ramli & Rekan align with applicable Auditing Standards and are effective in addressing audit risks related to accounts payable. The implications highlight the importance of enhancing audit quality practices, particularly the effectiveness of planning and internal control evaluation in accounts payable audits.

This study investigates the clinical handover process as a critical component of patient safety and healthcare service quality in hospital settings. Inconsistent communication, incomplete documentation, and the absence of standardized procedures were identified as major problems contributing to communication failures and potential adverse events. The objective of this research was to develop and test a structured and effective handover model that could improve communication accuracy and documentation reliability among healthcare professionals. A mixed methods design was employed, consisting of a qualitative phase (in-depth interviews, observations, and document analysis) to explore real-world handover practices, followed by a quantitative phase using a pretest–posttest design to evaluate the effectiveness of the proposed model. The study proposes an integrated handover model based on SBAR-IM (Situation, Background, Assessment, Recommendation, Intervention, Monitoring) strengthened by Quality Control (QC) and Mutual Confirmation (MC) mechanisms. The findings demonstrate a significant improvement in handover quality after implementation, with communication scores increasing from 74 to 84.5 and documentation scores improving from 48.3 to 63.0 (p < 0.05). Qualitative results further revealed reduced communication errors, improved clarity of clinical information, and enhanced interprofessional collaboration. This study concludes that the proposed SBAR-IM–based QC–MC model is effective, practical, and suitable for improving patient safety and healthcare service quality in hospital environments.

This study examines the challenges encountered by auditors in evaluating the fairness of notes payable and equity accounts as part of the financial statement audit process. These accounts carry a high risk of misstatement when recognition, measurement, or disclosure does not align with applicable standards. The purpose of this research is to provide an in-depth overview of the procedures, techniques, and professional judgments applied by auditors in assessing the fairness of both accounts, including issues related to misclassification, incomplete audit evidence, and limited responses from third-party confirmations. This study employs a descriptive qualitative method through a literature review of relevant academic publications. The findings indicate that auditors frequently face obstacles such as the mixing of accrued interest with the principal amount, low confirmation response rates, and inadequate supporting documentation. These challenges require auditors to perform alternative procedures and strengthen substantive testing to obtain sufficient and appropriate audit evidence. The implications of this study highlight the need for consistent application of auditing standards, comprehensive documentation, and effective communication with clients to ensure financial statements present a true and fair view.