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Chronic kidney disease (CKD) is a global health problem with continuously increasing prevalence and mortality. This condition is characterized by a progressive and irreversible decline in kidney function, which is clinically assessed using the estimated glomerular filtration rate (eGFR) as one of the main parameters for staging and monitoring disease progression. Red blood cell distribution width (RDW) is a hematological parameter that reflects the degree of variation in erythrocyte size. In patients with CKD, elevated RDW levels are often associated with oxidative stress and chronic inflammation, which may accelerate kidney damage and increase mortality risk. To analyze the correlation between RDW and eGFR values in patients with chronic kidney disease at ODSK Hospital, North Sulawesi Province. This study used an analytical observational design with a cross‑sectional approach. It was conducted retrospectively using secondary data from the medical records of CKD patients at ODSK Hospital, North Sulawesi Province, from February 2024 to August 2025. This study used a total sampling method with 189 CKD patients who met the inclusion and exclusion criteria.  Based on Spearman-rank correlation analysis, the p‑value obtained was 0.129 (>0.05). There was no significant relationship between RDW and eGFR values in CKD patients at ODSK Hospital, North Sulawesi.Province.

Diabetes mellitus (DM) is a global health problem characterized by increased blood glucose levels. Type 2 diabetes mellitus (T2DM) accounts for 90-95% of all diabetes cases and is characterized by insulin resistance. Persistent hyperglycemia in patients with T2DM increases the risk of various complications, including renal dysfunction. Therefore, monitoring HbA1c levels is important for assessing long-term glycemic control and preventing complications, one of which is impaired kidney function that can be detected through increased blood creatinine levels. To analyze the relationship between HbA1c levels and blood creatinine levels in type 2 diabetes mellitus patients at RSUD ODSK North Sulawesi Province. This study used an observational analytic design with a cross-sectional approach. This study was retrospective using secondary data in the form of medical record data for the period February 2024-August 2025. This study used a total sampling method with 71 patients who met the inclusion criteria. The findings showed that the majority of patients had HbA1c levels >6,5%, while most blood creatinine levels were within the normal range. Based on the results of the Spearman-Rank correlation test, a significance value of 0.040 (p-value <0.05) was obtained. There is a significant relationship between HbA1c levels and blood creatinine levels, with a negative correlation strength in patients with type 2 diabetes mellitus at RSUD ODSK North Sulawesi Province.

Type 2 Diabetes Mellitus (T2DM) is a global health problem with continuously increasing prevalence, covering the majority of diabetes cases worldwide. Persistent hyperglycemia in T2DM progressively damages the kidneys. Early assessment of kidney function, especially through the examination of urea levels and estimated glomerular filtration rate (eGFR) values, is important to predict CKD prognosis and guide therapeutic intervention. To discover the profile of urea levels and eGFR values in Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province. This study is a descriptive quantitative observational study with a cross-sectional design, conducted retrospectively using secondary data from the medical records of Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province during the period February 2024–August 2025 who met the inclusion criteria. From a total sample of 658 Type 2 Diabetes Mellitus patients, the majority of patients had high urea levels (53.3%). Based on sex, the proportion of high urea levels in males (57.2%) was higher compared to females (50.5%). Meanwhile, the distribution of eGFR values showed that the G1 category was the most frequent (23.9%). However, the majority of other patients (75.1%) were already in categories G2 to G5, which indicates a decrease in kidney function. This decrease in kidney function was slightly more detected in male patients (76.1%) compared to female patients (74.4%). Type 2 Diabetes Mellitus patients at ODSK Hospital, North Sulawesi Province, have high urea levels and the majority have decreased eGFR values.

Chronic Kidney Disease (CKD) is a global health problem with a continuously increasing prevalence and mortality rate. Global data indicates that kidney disorders have affected more than 850 million people, with CKD being one of the leading causes of death. North Sulawesi is recorded as one of the provinces with the highest prevalence of CKD. Blood creatinine is used as the primary marker of kidney function, while hypertension is a comorbidity commonly found in CKD patients and can act as both a cause and a consequence of impaired kidney function. Several studies have reported varying results regarding the relationship between creatinine levels and blood pressure. Purpose to analyze the association between serum creatinine levels and blood pressure in chronic kidney disease patients with hypertension at ODSK Hospital, North Sulawesi Province. Methods the research design used an observational analytic cross-sectional design. This study used an observational analytic cross-sectional design. It was a retrospective study utilizing secondary data from medical records for the period of June 2022 to August 2025. Total sampling method was employed with a sample size of 65 patients who met the inclusion criteria. Based on the Spearman correlation test results, the significance values between creatinine and systolic pressure was 0.685, and between creatinine and diastolic pressure was 0.787 (p-value >0.05). There is no significant correlation between serum creatinine levels and blood pressure in chronic kidney disease patients with hypertension at ODSK Hospital, North Sulawesi Province.

The research was intended to cluster the production areas of Indonesia's fishery products especially Skipjack Tuna, Tuna, Mackarel Tuna, and shrimp using data science techniques. The algorithm used was K-means Clustering. The data used was annual production data for each province for the last 3 years (2019 – 2021). Determination of the number of clusters using the Elbow Method. For each commodity, three clusters were obtained, namely clusters with low production, medium production, and high production. For Skipjack Tuna, there were 19 provinces belonging to the low cluster, 13 provinces being medium, and 2 provinces being high. For Tuna, there were 22 provinces in the low cluster, 9 provinces in the middle, and 3 provinces in the high cluster. For Mackarel Tuna, low was 19 provinces, medium was 12 provinces, and high was 3 provinces. For shrimp, 23 provinces were low, 7 provinces were medium, and 4 provinces were high. High production clusters for Skipjack Tuna were North Sulawesi and North Maluku Provinces, Tuna were North Sulawesi, North Maluku and Maluku Provinces, for Mackarel Tuna were Aceh, East Java and Maluku Provinces, and for shrimp were North Sumatra, West Kalimantan, South Kalimantan and East Kalimantan Provinces.

The young generation is a group of people aged 15-35 who are passionate about changing the world, creative, and energetic. The young generation is often considered an agent of change who can bring positive changes in society. In the digital era, there is a need for efforts to preserve and develop regional cultural wealth so that it remains relevant and known by the younger generation. Local culture can help young people develop a sense of pride in their identity and cultural heritage. The Sangihe Islands in the north of North Sulawesi Province, on the Indonesia-Philippines border, have a variety of local cultures, ranging from historical relics, folk beliefs, arts, traditional ceremonies, traditions of managing natural resources both sea and land, the Sasahara sea language, and the tradition of going to sea that makes the Sangihe people excellent sailors. Being in the Indonesia-Philippines border area and as a spice trade route since ancient times has opened up for changes in the culture of society. And the current development with modernization that has invaded the cultural resilience of its people has entered the outermost islands such as Sangihe Talaud. The young generation is currently a major player in the digital world. This article raises the issue of the strategy of the young generation in cultural resilience in the digital era. That the young people of Sangihe play a role in elevating their local culture which is threatened with erosion. Their various social media platforms with creative efforts elevate the nature and culture of Sangihe Talaud, and have proven successful in rediscovering local cultural values. Sangihe Talaud with its natural potential and diverse arts and culture can be a social capital in the cultural resilience of Sangihe Regency as the northern gateway to eastern Indonesia, as the front line of the archipelago on the edge of the Pacific.

The success of implementing patient safety in the emergency department cannot be separated from various factors that influence it, one of which is the workload of medical staff.The availability of facilities also plays a significant role in the implementation of patient safety.The objective of this study is to determine the relationship between nurse workload and the availability of facilities with the implementation of patient safety in the Emergency Department of RSUD ODSK, North Sulawesi Province.The research uses a cross-sectional design.The sample in this study consisted of 30 respondents using the purposive sampling technique.Data collection on workload, facilities, and patient safety was conducted using a questionnaire and analyzed using the chi-square statistical test.The research results showed that the highest workload was the light workload category, with 21 respondents (70%).The most available facilities and infrastructure were found, with 21 respondents (70%).The most common implementation of patient safety was the implementation of patient safety in the good category, with 22 respondents (73.3%).The chi-square test results obtained p values of 0.003 and 0.032, where < α 0.05.Conclusion: There is a relationship between nurse workload and the availability of facilities with the implementation of patient safety in the Emergency Room of RSUD ODSK, North Sulawesi Province.

Background: Cervical cancer is the most common cancer in Indonesia. Cancer has a high mortality rate caused by delays in diagnosis and treatment. Nearly 70% of cancer patients are detected at an advanced stage. This is very unfortunate, because cervical cancer can be found at a stage before cancer occurs (precancerous lesions) which can be treated so that it does not become cancer. The early detection program for cervical cancer in Indonesia is carried out using the Acetic Acid Visual Inspection (IVA) method carried out by trained health workers. In three years (2020-2022), as many as 3,914,885 women aged 30-50 years or 9.3% of the target have undergone early detection of cervical cancer using the IVA method. The highest early detection of targets has undergone early detection of cervical cancer using the IVA method. Early detection was reported by West Nusa Tenggara Province at 34.1%, followed by South Sumatra at 33.5%, and Bangka Belitung Islands at 27.8%. Meanwhile, the province with the lowest early detection coverage is Papua at 0.1%, followed by West Papua at 0.4%, and North Sulawesi at 0.7%. In 2022, of the 2,175,314 women aged 30-50 years who had early detection of cervical cancer, 7,869 (0.36%) had positive VIA examination results and 1,232 (0.06%) were suspected of cervical cancer.

Achievement of Complete Basic Immunization (IDL) in eleven Indonesian provinces in 2022 is still below the national target of 90%. The eleven provinces in question are West Sulawesi, Southeast Sulawesi, Maluku, East Nusa Tenggara, North Kalimantan, Riau, West Kalimantan, West Papua, West Sumatra, Papua and Aceh.The type of research used in this research is descriptive observational research. The data used in this study is secondary data, namely monthly reports on the results of routine immunizations for babies. It was found that the majority of basic immunization coverage for babies born in January 2022 was higher than for babies born in January 2023. Coverage for basic immunization types for babies was highest in 2022. (73.3%) was obtained from Hepatitis B, BCG, and Polio 1 immunization. The highest coverage of basic types of infant immunization in 2023 was obtained from Hepatitis B immunization (73.3%). Hepatitis B immunization received a high score for babies born in January 2022. Coverage of basic immunization types for babies born in January 2022 for types DPT-HB-Hib 1, 2, 3, Polio 2, 3, 4, received 36.7% -73, 3%, and Measles-Rubella got 33.3%. The frequency of immunization against PVC-1 (23.3%), RV-1 (6.7%), and IPV-1 (13.3%) is still low due to not visiting posyandu and giving immunizations past the immunization deadline. The average value of basic immunization coverage for babies born in January 2023 (10%) is lower than babies born in January 2022 (43.3%) with a difference of 33.3%.

This research aims to examine the factors that influence the ability of class IX junior high school students in Kotamobagu City, North Sulawesi Province, Indonesia, to solve story problems, both theoretical and applied. A total of two hundred and four students in the 2023/2024 academic year were selected using a double-phased cluster sampling technique. The research instrument used in this research was theoretical and applied mathematics story test questions created by researchers. The data obtained were analyzed using path analysis. The results of the analysis show that solving theoretical and applied mathematics story problems shows the same tendency, which is influenced both directly by mathematical numerical and verbal abilities and indirectly by the ability to create mathematical models. From these results, teachers must strive to improve numerical and verbal mathematical abilities because these two abilities, directly or indirectly through the ability to create mathematical models together, can improve students' abilities in solving theoretical and applied word problems.

This study investigates the pivotal role played by the Regional Health Office of North Sulawesi Province in managing the COVID-19 patient referral system. The COVID-19 pandemic has placed immense pressure on healthcare systems worldwide, necessitating efficient coordination and management of patient referrals to ensure timely and appropriate care. The Regional Health Office of North Sulawesi Province plays a critical role in overseeing and optimizing the patient referral process, which includes triage, transportation, and coordination among healthcare facilities. This research aims to analyze the effectiveness and challenges faced by the Regional Health Office in managing COVID-19 patient referrals, with a focus on improving the overall healthcare response to the pandemic.

Stunting is a short toddler usually defined as failure to grow in babies and toddlers aged 0-59 months due to chronic malnutrition. on low growth and the cumulative effects of insufficient intake of energy and macronutrients in the long term. in South Sulawesi province in 2021, with an increase in stunting (34.1%). North Toraja is ranked 4th with the highes stunting prevalence . Lembang Issong Kalua' cases of stunting in toddlers consist of 13 children and 6 pregnant women. Implementation method using a quantitative case study approach by collecting data on toddlers and pregnant women to add education about providing additional food for toddlers and pregnant women. discussion result: provision of additional food, distribution of vitamins, counseling on nutritional problems. Preparing food supplies is for measuring food for toddlers and pregnant women. Providing additional food, the stunting rate among toddlers has reduced to only around 13 toddlers to 5 toddlers who are still monitoring the growth of toddlers. Lack of public understanding about stunting and nutritional needs is a socio-economic problem in the community.

The purpose of this study is to analyze the effect of government spending on education and health on the Human Development Index in the border areas of North Sulawesi province in the last eleven years. This study uses secondary data taken from the Central Bureau of Statistics of North Sulawesi and the Directorate General of Financial Balance for the period 2011 – 2021. The analysis used was multiple regression analysis of panel data that combined the data of four districts using a panel data analysis model on the eviews application with data collection of Health, Education and Human Growth Index. Regression testing shows Y = 63.9 + 2.9 X1 + 6.47X2. In the T test, it explains that the Education variable has a significant influence on HDI and the results of the Health variable have a significant influence on HDI, the amount of government spending on education and health can be seen from the R-square of 0.96, meaning that X1 and X2 have a significant influence on Y by 96 percent and the rest by other factors.

Diabetes Mellitus is a metabolic disorder that occurs chronically or chronically because the body does not have enough insulin hormone due to interference with insulin secretion, the insulin hormone does not work as it should or both (Hendry et al., 2023). The International Diabetes Mellitus Federation (IDF) organization estimates that at least 463 million people aged 20-79 years in the world suffered from diabetes mellitus in 2019 or equivalent to a prevalence rate of 9.3% of the total population of the same age. Based on gender, IDF estimates that the prevalence of diabetes in 2019 is 9% in women and 9.65% in men. (Indonesian Ministry of Health, 2020). Prevalence data from the Indonesian Ministry of Health in 2013-2018, there are 4 provinces with the highest prevalence, namely DKI Jakarta 3.4% East Kalimantan 3.1% In Yogyakarta 3.1%, North Sulawesi 3% and Central Java 2.1% ( Research and Development Agency, Republic of Indonesia Ministry of Health, 2019).

The toddler period is a golden period that determines the rate of growth and development of toddlers both physically, mentally and emotionally. Assessment of nutritional status Assessment of nutritional status of toddlers using standard and measurable parameters can be used as a monitoring item for nutritional problems in toddlers. This study aims to describe the findings based on research data conducted in 2021 on 96 toddlers in the working area of the Ranomuut Public Health Center, Manado City, North Sulawesi Province. Primary anthropometric and age data were collected on toddlers 6-24 months and obtained data that 26% of toddlers have nutritional status in the poor category (<2SD) and 74% of them have nutritional status in the good category (? -2 SD to +2SD). Even though there is no urgency found in the results of this study, the conclusions of the research need to be published, and it is hoped that this can be used as a reference for future research.  

Effective COVID-19 patient referral system is crucial to ensure that patients in need of care can receive timely and appropriate treatment. The Regional Health Department of North Sulawesi Province plays a crucial role in the COVID-19 patient referral system in the region. The purpose of this study is to evaluate the role of the Regional Health Department of North Sulawesi Province in the COVID-19 patient referral system. This study was conducted using literature review. The results of the study showed that the Regional Health Department of North Sulawesi Province plays a very important role in coordinating between units within the department, overseeing the implementation of programs and policies, and ensuring the availability of sufficient facilities and medical personnel in the COVID-19 patient referral system. This role has ensured that the COVID-19 patient referral system in North Sulawesi Province runs well and effectively. However, further research can be conducted to deepen the understanding of the COVID-19 patient referral system in the region. Further research can be conducted to compare the COVID-19 patient referral system in other regions in Indonesia, so that a more comprehensive understanding of the role of regional health departments in handling the COVID-19 pandemic in Indonesia can be obtained.