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Ballast water plays a crucial role in maintaining ship stability during shipping, but it also carries environmental and human health risks due to the heavy metals it carries. This study aims to examine the health risks posed by exposure to heavy metals in ballast water and to assess the effectiveness of management practices implemented in the maritime industry. Using a literature review method, this study examines various scientific sources related to the content of heavy metals such as lead (Pb), cadmium (Cd), copper (Cu), and zinc (Zn) in ballast water, as well as their impacts on human health and marine ecosystems. The results indicate that heavy metals in ballast water can cause long-term toxic effects such as neurological disorders, kidney damage, and respiratory and reproductive disorders. The greatest risk is experienced by maritime workers who are directly exposed through inhalation or skin contact during the ballast water sampling and processing process. To minimize these risks, strict work safety protocols, improved ballast water treatment technology, and regular monitoring of heavy metal levels are required. Thus, this study emphasizes the importance of strengthening ballast water management policies and practices that are oriented towards human health and environmental sustainability.  

The use of medicinal plants has been an important part of people's lives since the time of our ancestors. Before the advent of modern medicine, people used various types of plants to treat mild to severe illnesses, such as fever, cough, wounds, digestive disorders, and skin diseases. Inventory of medicinal plants plays a very important role in exploring the potential of existing natural resources, especially as an effort to support the development of traditional medicine. The purpose of this study is to identify the types of medicinal plants used by local communities in traditional medicine. The method used in this study is a descriptive method through direct surveys at the research location. The findings obtained in the field concluded that all types of plants mentioned in this study are very beneficial for the people of Duhiadaa District, because they can help in treating various types of diseases experienced by the community. The types of diseases that can be treated include hypertension, gout, stomach acid, cholesterol, kidney disease, diabetes, inflammation, cancer, wounds, diarrhea and digestive disorders.

Chronic kidney disease (CKD) is a growing global health concern that frequently remains undiagnosed until advanced stages. Early detection through simple laboratory screening is essential to prevent disease progression and associated cardiometabolic complications. This community service program aimed to assess kidney function using serum creatinine and estimated glomerular filtration rate (eGFR), while increasing public awareness regarding CKD prevention. A total of 59 participants were included, with a mean age of 39.15 ± 15.39 years (range 16–75 years), predominantly female (74.58%). The mean serum creatinine level was 1.0 ± 0.19 mg/dL, and the mean eGFR was 91.08 ± 20.53 mL/min/1.73 m². Most participants demonstrated normal kidney function (28.8%) or mild decline (21.6%). A progressive reduction in eGFR with increasing age was observed, reflecting the physiological decline in nephron mass and renal perfusion. The program also provided education on kidney-protective practices, including optimal blood pressure control, diabetes management, adequate hydration, and avoidance of nephrotoxic agents. This intervention improved participants’ understanding of CKD risk factors and the importance of regular screening. In conclusion, serum creatinine and eGFR evaluation offer simple, accurate, and practical tools for early CKD detection, supporting promotive–preventive strategies to slow disease progression and enhance quality of life in at-risk populations.

Hypertension is a highly prevalent non-communicable disease often referred to as "The Silent Killer" because it rarely shows symptoms until it causes serious complications such as stroke, kidney failure, and heart disease. This community service activity aims to optimize the Mobile Blood Pressure Monitoring Program as a hypertension screening method in Sanahu Village. The methods used include participant data collection, blood pressure checks with a manual sphygmomanometer, and health education on hypertension prevention. A total of 96 participants participated in this activity, and the results showed that 58 participants (60.4%) were hypertensive. This program has proven effective in reaching communities with limited access to health services and raising public awareness about the importance of early detection of non-communicable diseases. In addition, this activity succeeded in providing knowledge to the community about how to prevent hypertension and the importance of maintaining a healthy lifestyle, which is expected to reduce the incidence of hypertension in the future.

Depression is one of the mental health problems that often arise in patients with chronic diseases, such as diabetes mellitus, hypertension, and chronic kidney failure. This condition not only impacts the patient's quality of life, but also affects the treatment process and the burden on the family. However, mental health literacy in the community is still low, so targeted preventive and curative efforts are needed. The Community Service Program (PKM) aims to improve people's mental health through educational interventions with scientific booklet media that are easy to understand and apply. The activity method is carried out in a participatory manner, including the preparation stage, socialization, educational implementation, and evaluation. Education is provided to the community with a focus on preventing depression through a healthy lifestyle, stress management skills, and early intervention efforts by seeking professional support. Evaluation is carried out through pre-post tests, observations, and group discussions. The results of the activity showed an increase in public knowledge about depression, a change in attitudes to be more open in expressing feelings, as well as practical skills in relaxation, maintaining sleep patterns, and building social support. Participants also better understand the importance of seeking professional help when depressive symptoms are getting worse. The conclusion of this PKM is that the scientific booklet has proven to be effective as a preventive and curative educational intervention medium, and can be an innovative strategy in improving the mental health of people affected by chronic diseases.

Background: Dietary adherence is a crucial component in the management of patients with chronic kidney disease (CKD) undergoing hemodialysis. Non-adherence may lead to metabolic imbalance, increased morbidity, and reduced quality of life.Objective: To identify factors associated with dietary non-adherence among patients with CKD undergoing hemodialysis at Imelda Hospital, Medan. Methods: A cross-sectional study was conducted among patients undergoing routine hemodialysis. Data were collected using structured questionnaires assessing knowledge, attitudes, and family support related to dietary adherence. Statistical analysis was performed using chi-square tests and logistic regression with a significance level of p < 0.05. Results: Knowledge, attitudes, and family support were significantly associated with dietary non-adherence (p < 0.05). Family support was identified as the most influential factor. Conclusion: Dietary non-adherence among hemodialysis patients is influenced by knowledge, attitudes, and family support. Strengthening patient education and family-centered nursing interventions is essential to improve dietary adherence.

Chronic kidney disease is an increasingly prevalent health issue that requires more precise clinical data-based early detection methods to enable timely and appropriate treatment. This study focuses on developing a predictive model for chronic kidney disease using the Light Gradient Boosting Machine (LightGBM) algorithm and enhancing its performance through hyperparameter optimization with the Grey Wolf Optimizer (GWO). The dataset used originates from public sources and undergoes several preprocessing steps, including missing value imputation, categorical feature encoding, outlier handling, initial feature selection, and stratified data splitting to maintain model quality. Three modeling approaches were evaluated: LightGBM with default parameters, LightGBM enhanced using Random Search, and LightGBM optimized with GWO. The experimental results indicate that the baseline model already performs well, Random Search improves accuracy and F1-score, and GWO achieves the highest AUC-ROC value despite requiring longer computation time. Significance testing through cross-validation shows that the performance differences among the three models are not statistically significant, suggesting that the observed improvements are not strong enough to determine a definitively superior optimization method. The feature importance analysis highlights that clinical indicators such as creatinine levels, glomerular filtration rate, blood pressure, and urine protein contribute most prominently to the prediction. Overall, the study demonstrates that LightGBM is a reliable model for early detection of chronic kidney disease, and hyperparameter optimization still offers added value that can support the development of AI-based clinical decision-support systems

Chronic diseases such as chronic kidney disease (CKD), diabetes, and heart disease remain major causes of mortality worldwide, highlighting the need for accurate and interpretable diagnostic models. However, conventional machine learning methods often face challenges of limited generalization, feature redundancy, and class imbalance in medical datasets. This study proposes an integrated classification framework that unifies three complementary feature paradigms: classical tabular attributes, deep latent features extracted through an unsupervised Long Short-Term Memory (LSTM) encoder, and quantum-inspired features derived from a five-qubit circuit implemented in PennyLane. These heterogeneous features are fused using a feature-wise attention mechanism combined with an AdaBoost classifier to dynamically weight feature contributions and enhance decision boundaries. Experiments were conducted on three benchmark medical datasets—CKD, early-stage diabetes, and heart disease—under both balanced and imbalanced configurations using stratified five-fold cross-validation. All preprocessing and feature extraction steps were carefully isolated within each fold to ensure fair evaluation. The proposed hybrid model consistently outperformed conventional and ensemble baselines, achieving peak accuracies of 99.75% (CKD), 96.73% (diabetes), and 91.40% (heart disease) with corresponding ROC AUCs up to 1.00. Ablation analyses confirmed that attention-based fusion substantially improved both accuracy and recall, particularly under imbalanced conditions, while SMOTE contributed minimally once feature-level optimization was applied. Overall, the attention-guided AdaBoost framework provides a robust and interpretable approach for clinical risk prediction, demonstrating that integrating diverse quantum, deep, and classical representations can significantly enhance feature discriminability and model reliability in structured medical data.

Chronic kidney disease (CKD) is a progressive and irreversible decline in kidney function that, if left untreated, can lead to serious complications. Ultrasonography (USG) is a widely used imaging modality for detecting CKD, yet its interpretation remains highly dependent on the radiologist’s expertise. This study aims to develop a CKD detection system using a convolutional neural network (CNN) on kidney ultrasound images based on estimated glomerular filtration rate (eGFR), and to evaluate the system’s performance. This research employed a research and development (R&D) approach with an experimental design. The dataset consisted of kidney ultrasound images from CKD and non-CKD patients with corresponding eGFR values. The methodology included image preprocessing, CNN model training, and accuracy evaluation using classification metrics. The results demonstrated that the developed CNN model achieved a total accuracy of 97% on internal test data and 95.8% on external validation. The model’s sensitivity reached 100% for the normal category, 91.67% for CKD stage 4, and 90% for CKD stage 5. Specificity exceeded 96% across all categories, with high precision and F1-scores above 94% for all classes. This system has proven to be effective as a diagnostic support tool for automatically detecting CKD through kidney ultrasound imaging. Its advantages lie not only in accurately classifying CKD from USG images but also in correlating the classification results with patients' eGFR values. This provides more precise clinical information and supports appropriate CKD staging and management planning.

Based on data from the South Nias District Health Office, the number of hypertension cases at Bawomataluo Public Health Center increased steadily from 2022 to 2024. This condition posed a high risk of leading to severe complications such as heart disease, stroke, kidney failure, and damage to other organs. This study aimed to examine the factors influencing compliance with blood pressure control among hypertensive patients within the working area of Bawomataluo Public Health Center in the year 2025. This research employed a quantitative method using an analytic survey design with a cross-sectional approach. The population consisted of 185 individuals who had been diagnosed with hypertension over the past six months (from July to December 2024). A purposive sampling technique was used to select 127 participants. Data analysis included univariate, bivariate, and multivariate analyses. Using logistic regression with the forward method, the results showed that knowledge had a significance value of 0.002 with an Exp(B) of 5.680; family support had a significance value of 0.000 with an Exp(B) of 6.740; motivation had a significance value of 0.000 with an Exp(B) of 6.947; and self-confidence had a significance value of 0.001 with an Exp(B) of 5.706. Among these, motivation was identified as the most dominant factor due to having the highest odds ratio (Exp(B)). The findings indicated that knowledge, family support, motivation, and self-confidence significantly affected compliance with blood pressure control among hypertensive patients at Bawomataluo Public Health Center. Motivation emerged as the most influential factor. It was recommended that the health center actively provide support and encouragement to patients suffering from hypertension.

Chronic Kidney Disease (CKD) is a major global health issue that can lead to serious complications and long-term medical care. This study aims to identify key clinical factors associated with CKD status using binary logistic regression analysis. The dataset, obtained from Kaggle, contains 400 patient records with various clinical and demographic attributes. The dependent variable is CKD status (positive or negative), while the independent variables include age, blood pressure, hemoglobin level, urine albumin level, and serum creatinine. Initial analysis involved descriptive statistics and multicollinearity checks, followed by model estimation and evaluation using likelihood ratio and Wald tests. The final model identified four significant predictors: blood pressure, hemoglobin, urine albumin, and serum creatinine. The model achieved a high classification accuracy of 95.50% and an Area Under the ROC Curve (AUC) of 98.78%, indicating excellent predictive performance. These results highlight the importance of these clinical indicators in early CKD detection and support their use in risk assessment models for kidney disease screening Keywords: Chronic Kidney Disease, Binary Logistic Regression, Likelihood Ratio Test, Wald Test, Classification Accuracy

Chronic Kidney Disease (CKD) or chronic kidney failure is a condition that occurs due to a decrease in the kidney's ability to maintain balance in the body so that hemodialysis therapy is needed to replace the kidney function. Hemodialysis therapy can cause various physical effects and mental conditions of patients so that it can affect the patient's quality of life. Objective : to determine the relationship between anxiety levels and quality of life of CKD patients undergoing hemodialysis at Lakipada Hospital. Research Method : the research design used is quantitative research with a Cross Sectional approach, using a " saturated sampling" sampling technique with a sample size of 40 respondents. The independent variable is the level of anxiety and the dependent variable is the quality of life. Data were analyzed using the Chi-Square statistical test at a significance level of α <0.05. Research Results : it was found that there was a relationship between anxiety levels and quality of life in CKD patients undergoing hemodialysis with a p-value = 0.000. Conclusion : there is a relationship between anxiety levels and quality of life in CKD patients undergoing hemodialysis.

Preeclampsia is a complex illness that can cause health issues and even death for both the mother and the fetus. The three signs of preeclampsia include elevated blood pressure (up to 140/90 mmHg), proteinuria (high protein in the urine), and edema. Preeclampsia is linked to a number of characteristics, including as parity, age, education, occupation, history of hypertension, multiple pregnancies, history of diabetes mellitus, and kidney disease. The purpose of this study is to identify the variables linked to the prevalence of preeclampsia in Tidore Regional Hospital patients who are pregnant or giving birth. This study employs a case control methodology and a descriptive analytical approach. Up to 132 respondents, comprising 66 case groups and 66 control groups, were sampled by accidental sampling. Medical records of moms who had preeclampsia were used as secondary data. A p-value of 0.001 (Sig. <0.05) indicated a relationship between parity and the incidence of preeclampsia; a p-value of 0.001 (Sig. <0.05) indicated a relationship between employment and the incidence of preeclampsia; a p-value of 0.000 (Sig. <0.05) indicated a relationship between the incidence of preeclampsia and a history of diabetes mellitus and kidney disease. preeclampsia at Tidore Regional Hospital with a p-value of 0.042 (Sig. <0.05).

Nephrolithiasis, commonly known as kidney stone disease, can be experimentally induced in animal models using ethylene glycol (EG) in combination with ammonium chloride, which closely mimics calcium oxalate stone formation in humans. This condition is associated with significant renal tissue injury, including glomerular atrophy, tubular necrosis, and hyaline droplet accumulation, ultimately impairing kidney function. The present study aimed to investigate the histopathological changes in the kidneys of EG-induced rats and evaluate the nephroprotective potential of combined avocado (Persea americana) and gooseberry (Physalis angulata) leaf extracts. A total of 30 male Sprague Dawley rats were randomly divided into five groups: a standard control (no induction), a negative control (EG-induced without treatment), a positive control (EG-induced and treated with a commercial nephroprotective agent), and two treatment groups receiving the combined extracts at different doses. Nephrolithiasis induction was performed over 28 days, followed by oral administration of the respective treatments. At the end of the experiment, kidney tissues were collected and processed for histological examination using hematoxylin-eosin staining to assess the extent of tissue damage. The negative control group exhibited the most severe histopathological alterations, with hyaline droplet formation reaching 15.0 ± 5.25%. In contrast, extract-treated groups demonstrated a marked reduction in tissue damage, with the most significant improvement observed in the group receiving 300 mg/kg avocado extract and 100 mg/kg gooseberry extract, which recorded hyaline droplet formation of only 5.27 ± 2.74%, a result comparable to that of the standard control group. These findings suggest that the combination of P. americana and P. angulata leaf extracts confers protective effects against EG-induced renal injury. Therefore, this herbal combination may represent a promising natural nephroprotective agent that warrants further investigation in preclinical and clinical settings.

Chronic kidney disease (CKD) is a metabolic disorder that is increasingly prevalent among the productive-age population and can significantly impair quality of life, particularly due to its progressive nature and often asymptomatic presentation in the early stages. Routine assessments of kidney function—such as estimated glomerular filtration rate (eGFR) and serum creatinine levels—are essential for the early detection of kidney impairment. The Community Service Program (PKM) conducted in Grogol Village aimed to raise public awareness regarding the importance of early screening for kidney dysfunction. Among the 71 participants involved in the activity, 9 individuals (12.68%) had elevated serum creatinine levels, 4 individuals (5.63%) showed evidence of stage 3a kidney function decline, and 31 individuals (43.66%) were identified with stage 2 kidney function decline. Only 36 participants (50.7%) had normal kidney function. These results underscore the necessity of early detection efforts to prevent the progression of CKD and to promote sustained public awareness on the importance of maintaining kidney and metabolic health.   Keywords: Chronic Kidney Disease, Creatinine, eGFR, Early Detection, Productive Age

Hypertension is one of the health problems, especially for hajj pilgrims, because hypertension is one of the entry points or risk factors for diseases such as heart disease, kidney failure, diabetes mellitus, and stroke. In 2024, cases of hajj pilgrims suffering from hypertension were 1,822 people (38.66%). This study aims to analyze the factors related to the incidence of hypertension in hajj pilgrims at the Aceh Embarkation. Quantitative research with a Cross Sectional Study approach using secondary data. The population is all hajj pilgrims at the Aceh Embarkation in 2024 totaling 4,713 people. The research sample is the total population. Bivariate data analysis with the chi-square test and multivariate with logistic regression. The results of the study obtained variables that have a significant relationship with hypertension are age (OR = 3.5; 95% CI: 3.08–3.95; p-value = 0.0001), family history (OR = 2; 95% CI: 1.74-2.25; p-value = 0.0001). Obesity (OR = 1.3; 95% CI: 1.14–1.44; p-value = 0.0001), diabetes (OR = 1.5; 95% CI: 1.28–1.75; p-value = 0.0001) and poor physical fitness OR = 1.7; 95% CI: 1.48–1.89; p-value = 0.0001). The conclusion of this study is that the age variable is the most dominant variable with the incidence of hypertension in the Aceh Embarkation Hajj pilgrims.

Diabetes is a chronic disease that makes the body lose its ability to produce insulin or begin to use it less efficiently leading to high blood sugar. Without proper treatment, over time, this disease can lead to more serious health problems such as heart disease, vision loss, and kidney disease. Early detection and prevention are crucial in mitigating these risks. This study focuses on conducting an early screening for diabetes among high school students at SMA Negeri 1 Palu. Additionally, this activity aims to educate students at SMA Negeri 1 Palu on the importance of maintaining a healthy lifestyle by managing their sugar intake according to daily caloric needs. The program utilized an interactive educational approach, incorporating demonstration tools and discussions to enhance engagement and understanding. A total of 68 students participated in this initiative which was evaluated through a final assessment measuring knowledge improvement and awareness of diabetes prevention.

Gout is an inflammatory arthritis caused by the accumulation of uric acid crystals. Dietary adherence is one of the managements of gout. The purpose of this study is to determine the influence of peer group therapy on the dietary adherence of gout sufferers in Mentor Village, Sumberasih District, Probolinggo Regency. This study uses a one-group pre-post test design (pre-experiment) research design. The total population was 36 respondents with gout, the sample studied was 33 respondents with gout using the Purposive Sampling technique, In accordance with the inclusion criteria willing to be a respondent, Permanent Resident of Mentor Village, Patients who have gout, Gout level value above seven point zero for men and Women more than six point zero Exclusion criteria Patients with comorbidities that interfere with the research (kidney, janttung, lung and so on), Patients do not participate in the entire activity or resign.Peer group therapy was carried out four times in 14 days. Statistical Test for dietary adherence using the Wilcoxon Test. The results of the study Before peer group therap was coalited, the Gout Diet Compliance value was moderate,  24 respondents (72.7%),while the after tritmen value of goud diet compliance of  31 respondents (93.9%), The results of the Wilcoxon statistical test,obtained p value = 0.000. This shows that Peer Group therapy affects dietary adherence of gout patients. Peer Group Therapy is a program that can be applied to gout patients who have low dietary adherence. Nurses are expected to be able to use Peer Group Therapy as a health promotion program. 

Kidney failure is one of the diseases that increases every year and becomes a major health problem in the world, the occurrence of failure is a risk of heart and blood vessel disease and increases morbidity and mortality. The purpose of this study was to determine the experience of dialysis patients' families in helping to prepare food at home. The research method used was a qualitative descriptive study. The location of this study was carried out in the Hemodialysis Room of the Imelda Buruh Indonesia General Hospital, Medan . The time of this study conducted in March to July 2024. The number of participants in this study was 6 participants . Research data were collected through in-depth interviews with participants and analyzed thematically. The results of the study consisted of 3 (three) themes, namely: (1) Eating habits , (2) obstacles or challenges in preparing food, (3) family support for patients. The conclusion of this study is that all participants expressed that the eating patterns of patients with hemodialysis therapy showed normal eating patterns, but when hemodialysis was carried out, patients felt weak and their appetite decreased, but all patients still ate 3 times a day in small portions . Overall, participants provided strong support for patients, both moral support, material in efforts to provide patient food needs, reminding patients to eat regularly according to doctor's recommendations, and faithfully accompanying them during hemodialysis. Although obstacles and challenges were found from both patients and families in overall food management, they could be overcome.

Reported that hypertension contributes to around 9.4 million deaths worldwide each year. This makes it one of the main risk factors for cardiovascular disease and related deaths. The prevalence of hypertension in individuals aged 18-39 years shows a figure of around 7.5%. At the global level, stroke, heart disease, and hypertension rank first, second, and twenty-ninth in causes of death. In Indonesia, the percentage of deaths from 50 diseases that cause death shows that stroke contributes 23.48%, heart disease 9.89%, and hypertension 3.02%. This study is a quantitative descriptive study with a cross-sectional approach that aims to describe the blood pressure profile in students. The population in this study were active students aged 18-23 years. The sampling technique used the purposive sampling method. The results showed that the average blood pressure in men tended to be higher than in women. Blood pressure in male students was an average of 128.9 / 83.25 mmHg and women 118.25 / 76 mmHg. The average blood pressure in men is included in the pre-hypertension category. Various factors cause hypertension at a young age, mainly caused by lifestyle, diet, smoking behavior and lack of physical activity. High blood pressure in young adults is strongly associated with an increased risk of heart and kidney disease later in life. Therefore, various forms of prevention are needed, especially related to behavioral changes so that complications do not occur in the future.