Publication Search

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.

Banks' Relationship Manager (RM) rotation policies conceal a retention risk: premium customers loyal to individual RMs may migrate following replacement triggered by relational disruption, not service failure. This conceptual study builds a theoretical framework explaining Emerging HNWI customer migration intention following RM turnover, integrating three antecedents adapted from the Service Provider Switching Model (SPSM): Relational Embeddedness (RE) as a mooring factor, Relational Trust toward the former RM (RT) as a paradoxical push factor through the Relational Loss Effect mechanism, and Community-Validated Trust (CVT) as the primary migration inhibitor. CVT is conceptualized as trust formed prior to direct interaction through personal communal validation distinct from reputation trust, social trust, swift trust, and social proof. Three boundary conditions of CVT are explicitly identified for testability and cross-context comparison. Primary contributions: (1) CVT as a SPSM extension for relational disruption contexts; (2) Relational Loss Effect bridging trust theory and paradoxical migration behavior.

Manual server administration introduces operational inefficiencies and elevated risks of human error. This study evaluated the effectiveness of server administration automation utilizing Shell scripting and Cron Job scheduling within a virtualized Linux Debian 12 environment. An experimental method compared manual execution against automated procesases based on execution duration, resource consumption, and error reduction. The findings indicated that the automated system executed backup routines within 0.043 seconds, demonstrating a 95.16% time efficiency increase compared to the manual baseline of 0.89 seconds. Automated monitoring maintained a stable resource allocation, utilizing 275 megabytes of memory and low central processing unit usage between 0.0% and 1.3%. Furthermore, automation reduced operational failures to 0%. In conclusion, this integration significantly optimizes server reliability.

Gatot, a fermented-cassava food, is the culinary icon of Gatot Tourism Village in Sumberpucung Subdistrict, Malang Regency. Cafe Koka, the pioneering gatot business in the area, faces two problems that hold back its growth. Its drying process still relies on sunlight, so production stops during the rainy season and the failure rate reaches 30–40%, while product presentation lacks adequate display facilities, lowering its appeal and selling value. This community-service program installed a 5 kg-per-batch cabinet dryer and two display refrigerators, accompanied by dried-gatot packaging development and staff training. The work followed a Plan-Do-Check-Act cycle combined with participatory mentoring over eight months, evaluating production and marketing indicators. After the program, drying time dropped from 2–4 days to about 4–5 hours, the product failure rate fell to 8–10%, and drying uniformity rose to about 90%. On the marketing side, impulse purchases increased by more than 40%, customer satisfaction with product display reached 4.5 of 5 (n=50), and monthly revenue grew about 175% owing to the new packaged-gatot line. Combining production and marketing technology strengthened the self-reliance of this local-food micro-enterprise.

This study investigates why applicants who have passed the initial admissions stage do not proceed to final enrolment in an Indonesian private higher education context. While student recruitment is often measured by the number of applications received, institutional sustainability depends on the ability to convert applicants into enrolled students. This study employed a descriptive survey design supported by thematic analysis of open-ended responses. Data were collected from 179 applicants who had participated in the admissions process but did not complete final re-registration. The data were analyzed using frequencies, percentages, and thematic categorization. The findings show that conversion failure is influenced by several factors, including waiting for public university admission results, financial constraints, postponement of study plans, family considerations, uncertainty about the institution or study programmed, preference for other institutions, and campus accessibility. A key finding reveals that 58.1% of respondents would reconsider enrolment if scholarships, tuition discounts, or other financial assistance were available. These findings highlight the need for a conversion management strategy through targeted financial aid, transparent cost communication, family engagement, and proactive applicant follow-up.  

Abstract. This research aims to analyze the effectiveness and reliability of production machines in the process of making public street lighting poles (PJU) at PT. XYZ The main problem faced by the company is high machine downtime so that production targets are not achieved. Therefore, a method is needed that is able to measure machine effectiveness as a whole and identify the main causes of production losses. The method applied includes Overall Equipment Effectiveness (OEE) to measure machine effectiveness based on three components, namely availability, performance and quality. The Total Productive Maintenance (TPM) approach is used to identify factors causing low effectiveness through Six Big Losses analysis. Apart from that, Mean Time To Repair (MTTR) and Mean Time Between Failure (MTBF) are calculated to determine the level of machine reliability. The data used includes machine working hours, downtime, operating time, production quantities, defective products, as well as machine damage and repair data. The analysis results are expected to show the level of machine effectiveness and identify the dominant factors causing downtime. Based on these results, improvement proposals are prepared to reduce downtime, increase machine reliability and improve production productivity Keywords: Overall Equipment Effectiveness (OEE), Total Productive Maintenance (TPM), Six Big Losses, Downtime, Efektivitas   Abstrak. Penelitian ini bertujuan untuk menganalisis efektivitas dan keandalan mesin produksi pada proses pembuatan tiang penerangan jalan umum (PJU) di PT. XYZ Permasalahan utama yang dihadapi perusahaan adalah downtime mesin yang tinggi sehingga target produksi tidak tercapai. Oleh karena itu, diperlukan metode yang mampu mengukur efektivitas mesin secara menyeluruh dan mengidentifikasi penyebab utama kerugian produksi. Metode yang diterapkan meliputi Overall Equipment Effectiveness (OEE) untuk mengukur efektivitas mesin berdasarkan tiga komponen, yaitu availability, performance, dan quality. Pendekatan Total Productive Maintenance (TPM) digunakan untuk mengidentifikasi faktor penyebab rendahnya efektivitas melalui analisis Six Big Losses. Selain itu, dilakukan perhitungan Mean Time To Repair (MTTR) dan Mean Time Between Failure (MTBF) untuk mengetahui tingkat keandalan mesin. Data yang digunakan mencakup jam kerja mesin, downtime, waktu operasi, jumlah produksi, produk cacat, serta data kerusakan dan perbaikan mesin. Hasil analisis diharapkan dapat menunjukkan tingkat efektivitas mesin dan mengidentifikasi faktor dominan penyebab downtime. Berdasarkan hasil tersebut, disusun usulan perbaikan untuk mengurangi downtime, meningkatkan keandalan mesin, dan memperbaiki produktivitas produksi Kata kunci: Overall Equipment Effectiveness (OEE), Total Productive Maintenance (TPM), Six Big Losses, Downtime Mesin, Efektivitas Mesin

Ketidaksesuaian kualitas pada proses assembly sepatu kulit kerap memicu siklus rework berulang yang menguras sumber daya waktu maupun biaya produksi secara signifikan. Penelitian ini mengkaji mekanisme pengendalian cacat yang diterapkan pada Product D-01 di Lini C PT XYZ, dengan menggunakan DMAIC sebagai kerangka perbaikan utama serta Pareto, P-Chart, Fishbone Diagram, 5 Whys, Failure Mode and Effects Analysis (FMEA), dan Cost of Quality (COQ) sebagai alat pendukung. Data primer bersumber dari catatan produksi internal perusahaan, pengamatan lapangan, dan wawancara terstruktur bersama pengawas produksi dan staf quality control. Pengukuran baseline menunjukkan bahwa Lini C menyumbang volume cacat paling tinggi di antara seluruh lini yang ada, dengan Product D-01 mencatat 10.487 pair cacat dari total output 80.387 pair, sehingga menghasilkan defect rate sebesar 13,05%. Distribusi Pareto mengidentifikasi wrinkle, incorrect colour, dan not straight sebagai tiga kategori cacat paling kritis. Penilaian FMEA menetapkan Risk Priority Number tertinggi sebesar 245 pada perilaku operator yang terburu-buru selama proses lasting dan brushing. Tindakan korektif mencakup pemasangan SOP visual, implementasi checklist QC pra-shift, verifikasi kondisi mesin secara rutin, dan penyediaan sampel referensi warna serta bentuk yang terstandar. Pemantauan selama dua periode berikutnya mengkonfirmasi penurunan defect rate secara bertahap menjadi 12,80% dan kemudian 11,65%, disertai penurunan estimasi biaya kegagalan internal dari Rp 2,36 juta menjadi Rp 1,86 juta per periode.

Corporate insolvency regimes have long been designed around efficiency, creditor recovery, and procedural certainty, frequently marginalizing the human, social, and distributive consequences of corporate failure. This qualitative literature review seeks to reconceptualize insolvency as a multidimensional institutional process by integrating the principles of humanity, resilience, and equity, with the objective of developing fairness metrics for more inclusive insolvency systems. Drawing on interdisciplinary scholarship from insolvency law, corporate governance, economic sociology, and normative political theory, this study systematically synthesizes peer reviewed literature published between 2000 and 2024 using a structured qualitative thematic analysis. The review identifies three interrelated dimensions shaping inclusive insolvency outcomes. First, humanity-oriented approaches emphasize stakeholder vulnerability, dignity preservation, and procedural justice, particularly for employees, involuntary creditors, small suppliers, and local communities affected by corporate collapse. Second, resilience based perspectives frame insolvency not merely as an endpoint of failure but as an adaptive governance mechanism that enables organizational recovery, institutional learning, and broader systemic stability. Third, equity focused frameworks highlight the importance of proportional and context sensitive loss allocation, stakeholder participation, and intertemporal fairness in distributing the economic and social costs of insolvency. By integrating these dimensions, the study develops a conceptual framework of fairness metrics that extends beyond traditional efficiency-driven indicators, offering normative and analytical tools for evaluating insolvency systems in a more holistic manner. The findings contribute to insolvency scholarship by bridging fragmented theoretical strands and advancing a human-centered and resilience oriented understanding of corporate failure. The review further suggests that insolvency regimes embedding humanity, resilience, and equity are more likely to enhance institutional legitimacy, stakeholder trust, and long term economic sustainability, thereby providing a robust foundation for future empirical research and policy reform.

Marriage at an early age remains widespread, especially among communities with limited education and financial resources. This study aims to analyze the impact of early marriage on harmony in household life. The research model we employed was a library research design. The approach used was descriptive qualitative through literature review, referring to scholarly sources and secondary data from reputable journals published in the last five years. Findings indicate that the mental unreadiness of both parties (husband and wife) who marry at an early age can lead to instability in household life and increase the risk of marital failure or reduced family harmony. Young couples commonly face challenges in maintaining healthy communication, making joint decisions, and coping with financial pressures, all of which contribute to domestic conflict. In addition, emotional immaturity and limited life experience are also primary causes of disharmony within the family. Therefore, there is a need to improve education and public awareness about the importance of age maturity and mental readiness before marriage in order to create stable and harmonious households. Thus, it is necessary to increase education and public awareness about the importance of age maturity and mental readiness before marriage, in order to create a stable and harmonious household.

The coffee shop industry has experienced substantial growth in recent years, creating intense competition that compels businesses to continuously enhance service performance in order to maintain customer satisfaction and market competitiveness. PT Jokopi Indonesia Group has encountered several service-related issues reflected in declining sales performance and recurring customer complaints, indicating the need for a comprehensive evaluation of service quality. This study aims to identify service attributes that fail to meet customer expectations and determine improvement priorities through the integration of the SERVQUAL and Kano methods. A quantitative approach was employed using questionnaire data collected from 50 customers who had prior experience with the company’s services. SERVQUAL was utilized to assess discrepancies between customer expectations and perceived service performance, while the Kano model was applied to classify attributes according to their contribution to customer satisfaction. The findings reveal that all evaluated attributes generated negative gap values, indicating that existing service performance has not yet reached the level expected by customers. The most critical gaps were identified in menu availability, air-conditioning and fan comfort, payment convenience, and straw availability. Kano classification further demonstrates that menu availability and thermal comfort facilities belong to the Must-Be category, meaning that failure to provide these attributes may trigger significant customer dissatisfaction. The integration of SERVQUAL and Kano highlights these attributes as the most urgent areas for improvement. The results provide managerial guidance for developing targeted service enhancement initiatives aimed at strengthening customer satisfaction, retention, and competitive advantage.

The development and performance of high-strength, environmentally friendly, and renewable nunang fiber (Cordia dichotoma)-reinforced polyester composites continue to be refined to achieve optimal performance. This study characterizes the key properties of nunang fiber-reinforced polyester composites with carbon powder fillers. The polyester composites were fabricated using a hot-press method with a nunang fiber volume fraction of 20% (by weight) and varying carbon powder content from 0–10% (by weight). The results of the investigation show that the tensile and bending strengths of the composites increase with increasing carbon powder content up to 2.5%. However, adding carbon powder filler up to 10% to the polyester–nunang fiber composites reduces their tensile and bending strengths. A different trend is observed for the impact toughness of the composites, which increases up to a carbon powder content of 5% and decreases when the carbon powder content reaches 10%. This phenomenon is attributed to the ability to form an optimal fiber-matrix interface between the nunang fibers and the polyester–carbon powder matrix. SEM morphological observations confirmed fiber pull-out failure and matrix failure due to the high stiffness caused by the presence of the carbon powder filler.

This study aims to identify the pragmatic failures of Large Language Models (LLMs) and the biases of Anglophone-based AI moderation algorithms in detecting Indonesian hate speech expressed through sarcasm, satire, euphemism, and local cultural metaphors. It also examines the extent to which AI systems understand and interpret the pragmatic meanings within the corpus. This study employs a qualitative descriptive approach with a comparative design. Data were collected through the documentation of hate speech expressions on social media containing elements of local cultural hatred. The data were analyzed using qualitative descriptive methods with pragmatic and thematic approaches. The findings show that all corpus data contain political satire and indirect hate expressed through irony, sarcasm, absurd metaphors, and popular culture wordplay. Testing with Claude AI showed that the system was capable of identifying the data as implicit criticism and recognizing the pragmatic functions of emoticons and contextual meanings in the utterances. However, the analysis also demonstrated limitations in understanding local sociocultural contexts, particularly the metaphors “daun nangka” and “daun sawit,” which were interpreted merely as absurd humor. These findings indicate that AI detection accuracy does not necessarily reflect a deep pragmatic and cultural understanding within the Indonesian context.

Background: Congestive Heart Failure (CHF) is a condition characterized by the inability of the heart to pump blood optimally, resulting in the accumulation of fluid in the lungs and other organs. This condition frequently causes ineffective airway clearance due to hypersecretion of the airway. Objective: This study aims to describe the comprehensive nursing care provided to Ny. R with Cardiovascular System Disorder: Congestive Heart Failure (CHF) with the main nursing problem of ineffective airway clearance at the Melati Ward of RSUD Banyumas. Method: This study used a descriptive method through a case study approach. Data were collected through interviews, physical examination, observation, and documentation. Results: Two nursing diagnoses were identified: (1) ineffective airway clearance related to airway hypersecretion, and (2) activity intolerance related to an imbalance between oxygen supply and demand. Nursing interventions included airway management and energy management. After two days of implementation (January 27–28, 2026), the first diagnosis was resolved and the second was partially resolved, with continued interventions recommended including monitoring of physical and emotional fatigue, advising bed rest, and monitoring vital signs. Conclusion: Comprehensive nursing care with appropriate interventions can effectively address ineffective airway clearance in CHF patients.

Background: Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood effectively due to structural or functional disorders, commonly manifesting as dyspnea, fluid retention, and peripheral edema. Globally, cardiovascular disease is the leading cause of death, with CHF affecting more than 55-65 million people worldwide. Objective: To perform comprehensive nursing care on patient Ny. A with cardiovascular system disorder: Congestive Heart Failure (CHF) in the Mawar I Ward of RSUD dr. Soeselo, Tegal Regency. Methods: This study used a descriptive method through a case study approach. Data were collected via interview, observation, and physical examination. Results: Four nursing diagnoses were identified: ineffective breathing pattern, hypervolemia, activity intolerance, and knowledge deficit. Interventions included respiratory monitoring, hypervolemia management, energy management, and health education on disease process. After two days of nursing implementation, three diagnoses were resolved and one (hypervolemia) was partially resolved. Conclusion: Nursing care for Ny. A with CHF was carried out through assessment, nursing diagnosis, intervention, implementation, and evaluation. Continued interventions are recommended, including fluid balance monitoring, diuretic collaboration, and edema and ascites monitoring.

A chronic metabolic disease characterized by elevated blood glucose levels due to insulin resistance or impaired insulin secretion is classified as type 2 diabetes mellitus. The prevalence of diabetes continues to rise each year and has become one of the major challenges in global health due to its potential to cause serious complications, such as cardiovascular disease, kidney failure, neuropathy, and vision impairment. In addition to pharmacological therapy, the use of herbal plants is increasingly being developed as a complementary therapy because they are considered safer, more readily available, and contain bioactive compounds with potential antidiabetic properties. This review article aims to assess the effectiveness of several herbal plants namely cinnamon (Cinnamomum cassia), fenugreek (Trigonella foenum-graecum), bitter melon (Momordica charantia), and moringa (Moringa oleifera) in aiding the management of type 2 diabetes mellitus based on various research findings. This study employs a literature review method by collecting and analyzing various national and international scientific publications related to the antidiabetic activity of these four plants. The review results indicate that all plants have potential as adjunct therapies for diabetes because they contain active compounds such as flavonoids, polyphenols, cinnamaldehyde, charantin, quercetin, trigonelline, and saponins, which can help reduce blood glucose levels, optimize cellular response to insulin, increase GLUT4 activity, and help minimize oxidative damage. Based on the study results, moringa and cinnamon plants demonstrated the most consistent effectiveness in contributing to blood sugar control in individuals with type 2 diabetes mellitus. Thus, these herbal plants have the potential to be used as complementary therapies in the management of type 2 diabetes mellitus; however, their use must still adhere to proper dosing and should not replace primary medical therapy.

A chronic metabolic disease characterized by elevated blood glucose levels due to insulin resistance or impaired insulin secretion is classified as type 2 diabetes mellitus. The prevalence of diabetes continues to rise each year and has become one of the major challenges in global health due to its potential to cause serious complications, such as cardiovascular disease, kidney failure, neuropathy, and vision impairment. In addition to pharmacological therapy, the use of herbal plants is increasingly being developed as a complementary therapy because they are considered safer, more readily available, and contain bioactive compounds with potential antidiabetic properties. This review article aims to assess the effectiveness of several herbal plants namely cinnamon (Cinnamomum cassia), fenugreek (Trigonella foenum-graecum), bitter melon (Momordica charantia), and moringa (Moringa oleifera) in aiding the management of type 2 diabetes mellitus based on various research findings. This study employs a literature review method by collecting and analyzing various national and international scientific publications related to the antidiabetic activity of these four plants. The review results indicate that all plants have potential as adjunct therapies for diabetes because they contain active compounds such as flavonoids, polyphenols, cinnamaldehyde, charantin, quercetin, trigonelline, and saponins, which can help reduce blood glucose levels, optimize cellular response to insulin, increase GLUT4 activity, and help minimize oxidative damage. Based on the study results, moringa and cinnamon plants demonstrated the most consistent effectiveness in contributing to blood sugar control in individuals with type 2 diabetes mellitus. Thus, these herbal plants have the potential to be used as complementary therapies in the management of type 2 diabetes mellitus; however, their use must still adhere to proper dosing and should not replace primary medical therapy.

XYZ is a manufacturing company engaged in steel pipe production. In the production process of non-American Petroleum Institute (API) steel pipes, the company still experiences various types of waste, resulting in an inefficient production process. The identified wastes include defects, waiting, transportation, and non-value-added activities, which contribute to increased production time and reduced productivity. This study aims to analyze the major wastes occurring in the non-API steel pipe production process and propose improvements using the Lean Manufacturing approach. The methods employed in this study include Value Stream Mapping (VSM), Value Stream Analysis Tools (VALSAT), Process Activity Mapping (PAM), and Failure Mode and Effect Analysis (FMEA). Data were collected through direct observation, interviews, and documentation of the production process. The results indicate that the dominant wastes affecting the production process are defects, waiting, and transportation. PAM analysis shows that non-value-added activities remain relatively high, leading to production time inefficiencies. Based on the FMEA results, the main causes of waste are machine conditions, work methods, and operator skills. Proposed improvements include periodic machine maintenance, production quality control, work method improvement, and the optimization of material flow.

Circulating tumor DNA (ctDNA) has emerged as a promising liquid biopsy biomarker for real-time monitoring of tumor dynamics. In urothelial carcinoma (UC), effective monitoring of treatment response remains a clinical challenge due to the limitations of conventional imaging and invasive procedures. This systematic review aims to synthesize the existing evidence on the association between ctDNA dynamics and treatment response monitoring across various stages and therapeutic settings. A comprehensive systematic review was conducted. We included cohort studies, randomized controlled trials, and meta-analyses that evaluated ctDNA in UC patients undergoing treatment. Data were extracted on patient population, methodology, treatment, sampling strategy, clinical outcomes, and statistical associations. The review encompassed 80 studies. Baseline ctDNA positivity was strongly prognostic, associated with a 4- to 6-fold increased risk of recurrence or death (HR 4.23-6.56). Dynamic ctDNA clearances or significants reduction during treatment, were strongly associated with improved outcomes. Showing hazard ratios for adverse events as low as 0.10-0.31. ctDNA demonstrated time advantages of 53-90 days over radiographic detection. ctDNA is a potent tool for monitoring treatment response in urothelial carcinoma. It provides superior prognostic and offers a significant lead time for detecting treatment failure. Future research must focus on standardizing methodologies and validating ctDNA-guided therapeutic.

Introduction: Congestive Heart Failure (CHF) is a complex clinical syndrome caused by the inability of the heart to pump blood adequately to meet the body's metabolic demands. This condition may result in dyspnea, edema, activity intolerance, fatigue, and reduced quality of life. Comprehensive nursing care is essential to address patients' needs and improve health outcomes. Methods: This study employed a descriptive case study approach. Data were collected through interviews, observation, physical examination, and medical record review. Nursing care was provided using the nursing process, including assessment, nursing diagnosis, planning, implementation, and evaluation. Results: The assessment of Mrs. T identified four nursing diagnoses: ineffective breathing pattern, hypervolemia, activity intolerance, and knowledge deficit. Nursing interventions included semi-Fowler positioning, fluid balance monitoring, passive Range of Motion (ROM) exercises, and health education. Following two days of nursing implementation, three nursing diagnoses were resolved, namely ineffective breathing pattern, activity intolerance, and knowledge deficit. Hypervolemia was partially resolved due to persistent fluid imbalance. Discussion: The findings indicate that the application of systematic nursing care can improve several clinical problems experienced by CHF patients. However, fluid balance management remains a challenge, highlighting the importance of patient adherence to fluid restriction and continuous monitoring to prevent worsening symptoms.

Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood adequately to meet the metabolic needs of the body. CHF is one of the most prevalent cardiovascular disorders globally, nationally, and locally, contributing to significant morbidity and mortality. This study aims to describe a comprehensive nursing care process applied to a patient (Mr. R) diagnosed with CHF at the Mawar 1 Ward of RSUD dr. Soeselo, Tegal Regency. This study used a descriptive case study design. Data were collected through interviews, physical examination, observation, and medical record documentation on February 9–11, 2026. Three nursing diagnoses were identified: ineffective airway clearance related to airway hypersecretion, fatigue related to physiological conditions (chronic disease), and knowledge deficit related to insufficient information exposure. Nursing interventions applied included airway management (semi-Fowler positioning, oxygen therapy, effective coughing technique), energy management (range-of-motion exercise, gradual activity), and health education about CHF. After 2×24 hours of nursing care, all three nursing diagnoses were resolved: airway clearance improved (SpO₂ increased from 91% to 95%, respiratory rate decreased from 28 to 23 times/minute), fatigue decreased, and patient knowledge about CHF improved. Systematic nursing care significantly improved the patient's condition in CHF management.