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

Digitalization in the fitness industry is increasingly essential to improve efficiency and service quality. However, many fitness centers still manage data manually, including KRESNA GYM, which faces challenges in member registration, workout scheduling, and facility information delivery. This study aims to design a web-based e-fitness application using the Laravel framework to support digital service management. The development follows the Waterfall model through stages of requirement analysis, design, implementation, testing, and evaluation. The application includes features such as a landing page, admin/member login and registration, management dashboards, workout schedules, equipment guides, and supplement listings. Black-box testing confirms that all features function as expected. This system simplifies administrative processes and enhances member experience, making it effective in supporting digital transformation at KRESNA GYM.

This study aims to examine the role of customer trust as a mediating variable in the relationship between digital marketing strategies and consumer behavior. As digital marketing evolves, companies are required not only to create engaging content but also to build strong trust to influence purchase intention, loyalty, and customer engagement. This research employs a systematic literature review (SLR) following PRISMA guidelines, selecting 52 empirical articles from reputable international databases such as Scopus, Web of Science, EBSCOhost, and ScienceDirect, published between 2015 and 2026. The analysis involved thematic and descriptive synthesis to assess the strength of digital marketing’s impact on customer trust and consumer behavior outcomes. The results indicate that digital marketing has a significant positive effect on customer trust formation (β=0.652; p<0.001). Customer trust functions as a partial mediator that strengthens the impact of digital marketing on purchase intention, loyalty, and engagement. The direct effect of digital marketing on consumer behavior is weaker when trust is not optimally established. These findings emphasize that effective digital marketing strategies must focus on transparency, security, credibility, and personalization to maximize consumer behavior outcomes. Practically, this study provides important implications for companies and digital marketing practitioners, highlighting that successful campaigns rely not only on content and visibility but also on the ability to build customer trust. The study also opens avenues for future research to examine more specific trust dimensions, including platform integrity, information quality, and social proof, within increasingly complex digital marketing contexts.

This study conducts a systematic review of literature concerning the role of Management Information Systems (MIS) in managing Umrah pilgrim data across Indonesia. Employing a Systematic Literature Review (SLR) guided by the PRISMA protocol, the study examined and synthesized 24 peer-reviewed articles published between 2019 and 2026, drawn from Google Scholar, SINTA, and nationally accredited journal portals. Findings indicate that MIS adoption has yielded notable improvements in operational efficiency, data reliability, service transparency, and the overall quality of managerial decision-making within Umrah travel organizations. Web-based MIS remains the predominant technological approach, offering integrated modules for pilgrim registration, document handling, financial tracking, and departure scheduling. At the national level, government-initiated platforms such as SISKOHAT and SISKOPATUH have demonstrated tangible contributions to the administration of Hajj and Umrah services. Nevertheless, persistent obstacles continue to hinder full-scale adoption, including inadequate digital infrastructure in certain regions, inconsistent internet connectivity, and gaps in human resource competencies for operating digital systems. The study argues that embracing MIS is no longer optional for Umrah travel operators; rather, it constitutes a strategic necessity. Future research is encouraged to investigate long-term implementation outcomes, cross-system comparisons, and data security considerations within the broader digital landscape of pilgrimage service management.

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Health communication plays a crucial role in dental practice, particularly in conveying sensitive clinical information or bad news. Barriers to communication can increase patient anxiety, decrease adherence to therapy, and impact the quality of healthcare services. The SPIKES protocol presents a six-stage, systematic and empathetic communication model for conveying clinical information. This study aims to analyze the implementation of the SPIKES protocol as a health communication model in dental practice. The study used a systematic literature review method with data sources from the Scopus, PubMed, and Web of Science databases for the period 2020–2025. Article selection was carried out using the PRISMA approach based on inclusion and exclusion criteria. The results of the study indicate that the implementation of the SPIKES protocol can improve the clarity of information delivery, strengthen the relationship between healthcare professionals and patients, and reduce patient anxiety. In addition, the empathetic approach in SPIKES contributes to increased patient satisfaction and adherence to treatment plans. In conclusion, the implementation of the SPIKES protocol can support the improvement of the quality of clinical communication in dental practice through the delivery of targeted, humanistic, and patient-centered information.

Libraries play a crucial role in broadening the public's knowledge horizons by improving literacy skills. However, the reality at the Samaturu Library in Jambu Malea Village shows that manual management still dominates, leading to various administrative obstacles such as data irregularities, the risk of losing important information, and inefficiencies in tracking daily activities. This condition demands digital transformation to optimize public services at the village level comprehensively and sustainably. This research focuses on the development of a web-based library information system specifically designed to modernize administrative processes to be more systematic, fast, and organized. Built using the PHP programming language and MySQL database, this platform offers an intuitive interface for both staff and members. Its superior features include book data management, membership, activity agendas, announcements, and digitizing the borrowing and return process. Furthermore, the system is capable of automatically generating periodic reports to facilitate library performance evaluation. Based on the results of comprehensive testing using the Black Box Testing method, all system functionality was proven to operate optimally according to the required specifications. Direct user trials also showed very positive responses regarding aspects of ease of navigation and operational time efficiency. The implementation of this system is expected to improve the effectiveness of internal management, accelerate the quality of services to library users, and become a major catalyst in realizing superior digital literacy governance in rural areas.

The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

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

Libraries play a crucial role in broadening the public's knowledge horizons by improving literacy skills. However, the reality at the Samaturu Library in Jambu Malea Village shows that manual management still dominates, leading to various administrative obstacles such as data irregularities, the risk of losing important information, and inefficiencies in tracking daily activities. This condition demands digital transformation to optimize public services at the village level comprehensively and sustainably. This research focuses on the development of a web-based library information system specifically designed to modernize administrative processes to be more systematic, fast, and organized. Built using the PHP programming language and MySQL database, this platform offers an intuitive interface for both staff and members. Its superior features include book data management, membership, activity agendas, announcements, and digitizing the borrowing and return process. Furthermore, the system is capable of automatically generating periodic reports to facilitate library performance evaluation. Based on the results of comprehensive testing using the Black Box Testing method, all system functionality was proven to operate optimally according to the required specifications. Direct user trials also showed very positive responses regarding aspects of ease of navigation and operational time efficiency. The implementation of this system is expected to improve the effectiveness of internal management, accelerate the quality of services to library users, and become a major catalyst in realizing superior digital literacy governance in rural areas

This study aims to design and develop a web-based New Student Admission System (PPDB) Website at MIS Chairul Bariyyah Medan Krio to overcome the limitations of manual registration systems. The method used is Agile, as it supports iterative, flexible, and adaptive system development according to user needs. Data collection techniques include observation, interviews, literature study, and documentation. The system is developed using the Python programming language with the Django framework and MySQL database. The results show that the developed system improves the efficiency of the registration process, minimizes data recording errors, and facilitates real-time management of applicant data. In addition, the Website also serves as an information and promotional medium for the school that can be accessed anytime. Based on Blackbox testing and User Acceptance Test (UAT), the system is proven to run well and is easy to use. Therefore, this web-based PPDB system is effective in improving the quality of Administrative services at MIS Chairul Bariyyah.

The development of information technology has encouraged improvements in public service quality, including at the village government level. In Sunggal Kanan Village, Sunggal District, Deli Serdang Regency, the process of submitting public complaints and aspirations is still carried out manually, resulting in issues related to documentation, transparency, and follow-up actions. This study aims to design and develop a web-based Village Public Complaint and Aspiration Information System using the Rapid Application Development (RAD) method. The RAD method was chosen because it emphasizes fast system development through iterative stages involving active user participation, namely Requirements Planning, User Design, Construction, and Cutover. Data collection techniques included observation, interviews, and literature studies. The developed system provides features such as user registration and login, complaint and aspiration submission forms, report status tracking, and an admin dashboard for managing and following up on reports. The results show that the system improves efficiency, transparency, and accountability in managing public aspirations. Through this system, citizens can submit reports online without visiting the village office and monitor their report status in real time. The implementation of the RAD method proved effective in delivering a system that meets user needs within a relatively short development time.

Wewewa Timur District is an administrative area in Southwest Sumba Regency that has great potential to improve the quality of public services. However, in practice, services at the sub-district level are still faced with various obstacles, such as slow administrative processes, manual data recording, and lack of coordination between service departments. This makes it difficult for government officials to cause problems and has a direct impact on public satisfaction as service recipients. As a solution, the development of a Web-Based Integrated Service Information System is the right step to address community needs and support government performance in Wewewa Timur District. Through this system, the public can access various services on a single digital platform without having to come directly to the sub-district office, and helps officials in accelerating administrative processes. This study uses a software engineering approach to design and implement a Web-Based Integrated Service Information System in Wewewa Timur District. The method used is the Waterfall method, which is a classic method in software engineering with sequential and systematic stages, from needs analysis to system maintenance. Test results using the black box method showed that the software could identify malfunctioning functions, interface errors, data structure errors, and access to external databases, while also producing expected output. Therefore, this system is considered effective in improving the quality of public services in Wewewa Timur District.

This study aims to develop a web-based Electronic Medical Record (EMR) application to improve the efficiency and accuracy of patient data recording at Elopada Community Health Center. The research adopts a system development approach using the waterfall model, including requirements analysis, system design, implementation, and testing. Data were collected through observation, interviews, and documentation. The developed system was evaluated using Black Box Testing to verify the conformity between input and output without considering internal program structures. The results indicate that the EMR system enhances data processing speed, improves recording accuracy, and facilitates access to patient information. These findings are consistent with prior studies showing that EMR implementation improves the quality and efficiency of clinical documentation . Therefore, the proposed system is considered feasible to support the advancement of digital healthcare services.

The development of digital technology has driven significant changes in modern learning methods by integrating various multimedia media. However, multimedia's ability to facilitate learning depends largely on the extent to which its presentation aligns with the principles of learning psychology, particularly those outlined in the Cognitive Theory of Multimedia Learning (CTML). This study aims to examine the role and effectiveness of multimedia in transforming modern learning methods by combining the results of recent empirical research from 2020 to 2024. This study used the Systematic Literature Review (SLR) method by analyzing 22 journal articles obtained from several databases such as Scopus, Web of Science, ScienceDirect, Google Scholar, and Sinta. Research shows that the use of interactive multimedia helps increase student enthusiasm for learning, participation, understanding of concepts, and the ability to remember course material. However, disorganized multimedia design can add unnecessary mental burden, thereby reducing learning effectiveness. These findings suggest that the successful use of multimedia depends not only on the level of technological advancement but also on the quality of learning design that applies cognitive theory. This study provides a comprehensive summary of the latest research and provides tangible benefits for educators in creating effective digital learning content.

This study aims to evaluate the performance of digital information systems, including websites and mobile applications, used by national expedition companies in Indonesia, using standardized technical indicators from Google Web.dev. This research employs a descriptive and evaluative approach with purposive sampling. The research objects comprise five major national expedition companies: JNE, J&T Express, SiCepat, Pos Indonesia, and Lion Parcel. The evaluation is conducted using four main indicators: Performance, Accessibility, Best Practices, and Search Engine Optimization (SEO). The results indicate that, in general, the digital information systems of national expedition companies function adequately; however, there are notable performance variations among companies, particularly in terms of loading speed and mobile performance. Pos Indonesia demonstrates the most balanced overall performance, while several other companies require further optimization, especially in performance efficiency and SEO. This study contributes to the literature by providing an objective technical evaluation of expedition information systems and offering practical recommendations to improve digital service quality, enabling faster, more secure, and more responsive logistics services in a highly competitive industry.

This community service activity aims to design a prototype of a web-based Intellectual Property Rights (IPR) registration information system at the South Sumatra Provincial Industry Office as an effort to support the improvement of public service quality. The main problem faced by partners is the manual registration and management process for IPR data, which has the potential to cause service delays, data recording errors, and difficulties in monitoring the status of IPR applications. This condition requires an information technology-based solution that can improve the efficiency, effectiveness, and transparency of services. The method used in this community service activity is the prototype method, which includes the stages of problem identification, user needs analysis, system design, and initial evaluation of the resulting prototype. The designed information system prototype includes features for online IPR registration, applicant and document data management, and application status monitoring. The results of the activity indicate that the IPR registration information system prototype is able to provide an overview of digital solutions that are in accordance with partner needs and have the potential to improve service efficiency and ease of data management. This activity is expected to become the basis for the development of a more comprehensive and sustainable IPR information system within the South Sumatra Provincial Industry Office.

The increasing complexity of competition in the healthcare industry requires hospitals to adopt adaptive and strategic management practices to enhance organizational competitiveness. This study aims to analyze the role of strategic management in improving hospital competitiveness through a Systematic Literature Review (SLR) approach. A total of 41 national and international scientific articles published between 2014 and 2025 were reviewed, sourced from Scopus, Web of Science, Google Scholar, and Sinta databases, following the PRISMA guidelines for literature selection. The synthesis of findings indicates that strategic management plays a significant role in strengthening hospital competitiveness through clear strategy formulation, consistent implementation, and continuous performance evaluation. Key factors contributing to competitive advantage include strategic leadership, adaptive organizational culture, effective human resource management, utilization of information technology, and integration between strategic planning and operational processes. The results emphasize that hospitals implementing strategic management comprehensively are better equipped to respond to environmental dynamics, improve service quality, and sustain competitive advantage in the long term. This study highlights the importance of strategic management as a foundational element in modern hospital governance and provides a conceptual basis for future empirical research in healthcare management.

This study aims to analyze the performance of Android-based attendance applications used at PT PLN ULP West Sumba by integrating two evaluation methods, namely WebQual 4.0 and Importance Performance Analysis (IPA). This attendance application functions to monitor employee attendance digitally so that it is expected to be able to improve the efficiency and accuracy of data recording. Evaluations are conducted to assess the extent to which the application meets the needs of users as well as the expected performance. WebQual 4.0 is used to measure the quality of user experience in terms of ease of access, interactivity, trust, and satisfaction, while IPA is used to compare the level of user interest with application performance based on four main attributes: system quality, information quality, service quality, and usage quality. The research data was collected through a survey with questionnaires compiled according to WebQual 4.0 and IPA indicators, involving application users at PT PLN ULP West Sumba. The results show that the majority of users are satisfied with the ease of use and performance of the application, but there are aspects that need to be improved, especially the speed of the system and a more user-friendly interface design. The science analysis emphasizes that the quality of systems and information is a crucial factor that must be a priority for development. This research provides strategic recommendations for PT PLN ULP West Sumba to improve the performance of the attendance application and support the company's operational needs in a sustainable manner.