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In current construction, there are still areas that utilize natural materials such as aggregates from rivers as construction materials, one of which is in the Dumoga, Bolaang Mongondow, North Sulawesi. The communities in this area still use natural aggregates from the river in the concrete mixture in the development process. The purpose of this study was to provide information to the public about the material characteristics and quality of concrete using coarse and fine aggregates from the Ongkak River, Dumoga. Therefore, this research aims to compare the results of concrete compressive strength of several mixtures in the field (1: 1.5: 2.5) (1: 2 : 3) (1 : 2.5: 3.5) (1 : 3 : 3) and (1 : 3: 4). Based on the results of the compressive strength, the optimal compressive strength value on average at 28 days is in the specimens with mixed variations (1: 1.5: 2.5) is 24.178 MPa, followed by mix (1: 2.5: 3,5) of 17.094 MPa, mixture (1: 2 : 3) of 15.459 MPa, mix (1 : 3: 4) of 13.737 MPa, and mix (1 : 3 : 3) of 12.250 MPa respectively.

Geographically, Indonesia has the longest coastline in both Asia and the world. This makes coastal areas vulnerable to various crimes, especially those using the sea and the coast as an alternative. Therefore, it is necessary to strengthen through community empowerment in coastal areas as part of the duties of the Indonesian Navy as written in RI Law Number 34 of 2004 Article 9 (e), which is to maximize its role in empowering maritime defense areas. The purpose of this study is to analyze the empowerment of coastal communities carried out by the Indonesian Navy in supporting Indonesia's maritime defense strategy. The research method used is descriptive qualitative method. The result of this research is that by empowering coastal communities as Komcad Matra Laut, in addition to increasing Indonesia's maritime defense, it can also improve welfare and human resources in coastal areas. Defense and the economy support each other so that peace and prosperity can be created for the Indonesian people. Suggestions from this study are that synergy between the Indonesian Navy and the City and Provincial Governments is needed in empowering coastal communities as Marine Command Command in supporting Indonesia's maritime defense.

Understanding factors related to suboptimal adherence to antiretroviral therapy (ART) and detectable viral load (VL), especially among vulnerable populations, is needed to improve HIV outcomes. The Caribbean is highly impacted by HIV and socioeconomic inequalities, but few studies have been conducted there to explore food insecurity among people with HIV and factors associated with viral suppression in this vulnerable population. Using baseline data from a pilot intervention trial among people living with HIV and food insecurity in the Dominican Republic, we examined psychosocial and behavioral factors associated with viral suppression, ART adherence, and competing needs. Among participants (n = 115), 61% had a detectable VL; the strongest factor associated with detectable VL was having missed taking ART in the last six months due to not having food (OR = 2.68, p = 0.02). Greater odds of reporting missed ART doses due to not having food were associated with severe food insecurity (OR = 4.60, p = 0.006), clinical depression (OR = 2.76, p = 0.018), Haitian background (OR = 6.62 p = 0.017), and internalized HIV stigma (OR = 1.09, p = 0.041), while lower odds were associated with social support (OR = 0.89, p = 0.03) and having health insurance (OR = 0.27, p = 0.017). Ensuring that people with HIV and food insecurity have food to take with their ART is essential for viral suppression.

The government has made tourism as one of the leading sectors in development. So that it makes all levels of government seem to be competing to develop tourist attractions. Tourist objects that have good selling points and are difficult to imitate by other regions are religious tourism objects and based on local wisdom. This research was conducted using a qualitative design to explore the management of religious tourism objects and based on local wisdom in North Sulawesi Province. Research data were collected through direct interviews, using google forms and utilizing google scholars and researchgate. Data analysis was carried out inductively and validity strengthening through focus group discussions. Research findings North Sulawesi province has tourism objects that can be developed through religious concepts and local wisdom. However, it requires improving the management of attractions/attractions, tourism marketing, infrastructure and accessibility, tourism facilities/facilities, managing resources, character and culture as well as community participation.

Good toilet sanitation management will not only provide added value in service satisfaction but is also a reflection of personal and environmental hygiene. However, toilet sanitation is one of the problems that people often complain about when they are in government offices. The availability of good toilet sanitation facilities has not been a concern of the government until now. This research was conducted using a qualitative design, collecting data directly or using google form and making direct observations of the condition of the toilet and its management. Data collection was also carried out using researchgate, google scholars and google scholars. By using systematic literature review technique data analysis and the use of primary data, it was found that the management of toilet sanitation in government offices was not good as seen from the quality of cleanliness and availability of facilities. There is no work unit available and responsible for toilet sanitation hygiene. The government can fix this by collaborating with third parties with a cleaning service workforce outsourcing system.

Introduction: Chronic kidney disease (CKD) patients undergoing routine hemodialysis (HD) have a high prevalence of protein-energy malnutrition (PEM) and inflammation. The combination of inflammation and PEM is associated with cardiovascular disease and poor outcomes. Interleukin-6 (IL-6) is an inflammatory factor that runs parallel to endothelial damage and is closely related to the nutritional status of CKD HD patients. The tool to assess nutrition status is Malnutrition Inflammation Score (MIS) and to assess endothelial damage is Asymmetric Dimethylarginine (ADMA). It is currently unclear whether there is a correlation between inflammation, malnutrition, and endothelial dysfunction. Therefore the aim of this study is to determine the correlation between IL-6, MIS and ADMA in CKD HD patients. Methods: A cross-sectional design with analytic observational study was conducted on end stage renal disease patient who undergo routine hemodialysis for at least 2 years with the duration of hemodialysis is 4-5 hours and at least twice per week. IL-6 was examined by kit (ELISA) and ADMA using LC-MS/MS at a certified laboratory in Manado city. History taking and physical examination were used to calculate MIS. Data analysis was done using SPSS version 22. Results: There were 30 participants consisting of 22 men (72%) and 8 women (28%). The median age of the subjects was 56.50 years. There was a statistically significant positive correlation between IL-6 and ADMA (r = 0.440, p = 0.015), MIS and ADMA (r = 0.378, p = 0.039), and IL-6 and MIS (r = 0.682, p = 0.0001). Conclusion: There was a significant correlation between IL-6, MIS and ADMA.