bluuebunny/crossref_metadata_2025 huggingface dataset:
PREVALENCE AND RISK FACTORS FOR NON-COMMUNICABLE DISEASES (NCDS)- DIABETES, HYPERTENSION, AND OBESITY
Authors: Sharma Chandra Prakash , Kaushik Pratap Bhan , Mal. Fatehpuria Chandan , Mittal Manish
Published: January 2025

Background: Non-communicable diseases (NCDs), including diabetes, hypertension, and obesity, are
leading contributors to global morbidity and mortality. Urbanization and lifestyle changes have further
increased their prevalence, creating signicant public health challenges, particularly in diverse rural and urban settings. This
study aimed to assess the prevalence and risk factors of NCDs in rural and urban health centers of Udaipur, India. Methods: A
cross-sectional study was conducted at rural and urban health centers in Udaipur, with 180 participants from each setting. A
structured questionnaire was used to collect demographic, lifestyle, and clinical data. Standardized tools measured blood
pressure, blood glucose levels, and body mass index (BMI). Statistical analysis included chi-square tests for categorical
variables and independent t-tests for continuous variables to compare rural and urban populations.Results: The prevalence of
hypertension was higher in urban areas (38.9%) compared to rural areas (29.4%). Similarly, obesity was more common among
urban participants (42.8%) than their rural counterparts (23.9%). However, the prevalence of diabetes showed less variation,
with rates of 18.3% in urban areas and 15.6% in rural areas. Urban participants demonstrated signicantly higher sedentary
behavior and consumption of processed foods, while rural participants reported lower health literacy and healthcare access.
Discussion: The study highlights signicant urban-rural disparities in the prevalence of NCDs, reecting differing lifestyles
and socio-economic factors. Urban areas face challenges from sedentary behaviors and unhealthy diets, while rural areas are
limited by inadequate healthcare access and awareness. These ndings emphasize the need for tailored public health
interventions addressing the unique challenges of each setting. Conclusion: Addressing NCDs requires integrated efforts
focusing on lifestyle modications, improved healthcare access, and enhanced health literacy in both urban and rural areas.
These interventions can mitigate the growing burden of NCDs and promote equitable health outcomes.
CLINICO-RADIOLOGICAL EVALUATION OF HEMOPTYSIS IN A TERTIARY CARE CENTER IN RAJASTHAN
Authors: M. S Vishnu. , Khangarot Suman , Sharma Amit Kumar , Mittal Anish
Published: January 2025

Objective: This study aimed to determine the clinical and radiological prole of patients presenting with
hemoptysis at a tertiary care center in Rajasthan, India, and to estimate the prevalence of various causes.
Design: This was a prospective, observational, cross-sectional study conducted at the Department of Respiratory Medicine,
Government Medical College, Kota, Rajasthan, over one year. Participants: The study included 123 patients over 18 years old
presenting with hemoptysis who consented to participate. Results: The study found that the severity of hemoptysis increased
with age. The most common cause of hemoptysis was tuberculosis, either active or sequelae, found in approximately 57.7% of
the patients. Recurrent hemoptysis and diabetes were also identied as signicant risk factors for severe hemoptysis. Bilateral
lesions on chest X-rays with extensive lung destruction and the presence of cavitary lesions were positively associated with
severe hemoptysis. Conclusion: This study highlights the importance of considering age, history of tuberculosis, recurrent
hemoptysis, and comorbidities like diabetes when evaluating and managing hemoptysis.
A COINCIDENCE PAR RARITY: A RARE CASE REPORT OF PENILE SQUAMOUS CELL CARCINOMA
Authors: Kothari Saloni Anil , Vaishnav Avanish
Published: January 2025

Background: Penile cancer is a rare malignancy, with signicantly higher incidence rates in low-income
countries like India as compared to the Western world. India is among the countries with the highest
incidence of penile cancer globally, with rates reaching up to 3.32 per 100,000 men in certain regions. Various unique challenges
arise in managing penile carcinoma due to cultural, social, and healthcare factors prevalent, especially in India, demanding
improved awareness and healthcare infrastructure for effective prevention and management. In this context, we present a 52-
year-old male patient who initially presented with a penile ulcer. After the thorough examination patient was conrmed with
moderately differentiated SCC. The ulcer was managed surgically through a total peno-scrotectomy and perineal
urethrostomy. Following the surgical procedure, histopathological examination of the specimen revealed squamous cell
carcinoma (SCC), with tumor-free excision margins. This case report sheds light on the importance of regular diagnosis and
appropriate surgical intervention in the management of penile cancer, especially in resource limited settings.
THE SUNSHINE EFFECT: A CROSS-SECTIONAL LOOK AT VITAMIN D AND ASTHMA SEVERITY
Authors: Thiriveedhi Sreeram , Chundu Umesh Chandra , Korrapati Rakesh , Nelluri Pavan Sai
Published: January 2025

Background: Asthma is a chronic respiratory condition characterized by airway inammation and
bronchoconstriction. Recent research explorative suggests that Vitamin D may inuence the severity of
asthma symptoms, yet the relationship remains unclear due to insufcient longitudinal studies and clinical trials. Objective:
This is a cross-sectional study focusing on identifying the correlation between bronchial asthma severity and vitamin -D levels.
Methodology: A total of 96 participants exhibiting symptoms persistent with asthma were enrolled in this study. Patients with
suspected bronchial asthma underwent spirometry to assess FEV1, FVC, and FEV1/FVC ratio. After administering 400 µg of
salbutamol, spirometry was repeated, and an increase in FEV1 ≥ 15% conrmed the diagnosis. Blood samples were collected
from diagnosed patients to measure circulating 25-hydroxyVitamin D levels using a DiaMetrix ELISA Kit. Pearson's correlation
coefcient was used to analyze the relationship between Vitamin D levels and asthma severity. The correlation between
Vitamin D levels and asthma severity was analyzed using Pearson's correlation coefcient and P value. A signicant Results:
negative correlation was found between serum Vitamin D levels and asthma severity (r = -0.736, p < 0.01). Low Conclusion:
Vitamin D levels are signicantly associated with asthma, suggesting a potential role for Vitamin D in asthma management.
Further research is needed to explore whether Vitamin D supplementation could be a therapeutic strategy to improve asthma
control.
A STUDY OF ASSOCIATED INJURIES OF POSTERIOR CRUCIATE LIGAMENT TEAR
Authors: Reddy M Muni Sankar , J Jishnu , Venugopal S. M. , Bajjuri Avinash , Dusaa Tejaswi
Published: January 2025

Background And Aim: Posterior cruciate ligament (PCL) tears, though less common than anterior cruciate ligament
(ACL) tears,are significant knee injuries that often occur with associated damage to other knee structures.This aimed to
investigate the incidence of associated injuries in patients with confirmed PCL tears Methodology: A prospective
observational study was conducted at BIRRD Hospital,Tirupati,a tertiary care orthopaedic hospital over a period of one
year (October 2023 – September 2024).All patients presenting with confirmed PCL tears (either isolated or combined
with other knee injuries) were included. The study involved both clinical evaluation and imaging studies to diagnose
PCL tears and any associated injuries. Results: The study included 45 subjects.The data on demographics, causes of
injury, and associated injuries was collected through clinical assessment and MRI imaging and analysed. The results
demonstrated that the most common associated injuries were ACL tears (20%), medial meniscal tears (18%), and
collateral ligament injuries (10%). Conclusion: This study provides valuable insight into the nature and frequency of
associated injuries in PCL tears, highlighting the common occurrence of ACL tears, meniscal injuries, and collateral
ligament damage. Our study results reinforces the importance of considering multi-ligament involvement in patients
with PCL tears.
STUDY TO ASSESS CLINICAL AND SOCIODEMOGRAPHIC PROFILE OF ACUTE RESPIRATORY INFECTION IN CHILDREN ADMITTED TO TERTIARY CARE CENTER : A RETROSPECTIVE OBSERVATIONAL STUDY”
Authors: Pattanshetty Neha , Devadas Sahana , Chinnappa Gayathri Devi , Rangaiah Ambica , G B Shantala , K Lakshmi , P Sujatha
Published: January 2025

Objective : To assess the clinical and sociodemographic profile of children with acute respiratory infection admitted to
a tertiary care centre. In this retrospective observational study, all paediatric patients who met Study Design: the
specified inclusion criteria were enrolled in the research during a period of six months. Data pertaining to
demographics such as age, gender, parental occupation, parental educational background and housing situation was
gathered. Respiratory specimens (Nasopharyngeal/Throat swabs) were obtained from all patients. Reverse
transcription polymerase chain reaction (RT-PCR) technique was employed on the respiratory specimens. The outcomes
were assessed based on the length of hospitalization, necessity for intensive care unit (ICU) intervention, occurrence of
complications, and patients' immunization statuses. In the 6 month study period, there were 450 chi Results: ldren
admitted with ARI, out of which 186 nasooropharyngeal swabs were sent and RSV was confirmed through RT -PCR in 0/23
in March, 0/31 in April, 0/23 in May, 12/23 in June(52%), 20/36 in July(55%),35/50 (70%) swabs sent in August. 310/450
(68.8 %) children developed pneumonia. 320/450 (71%) cases had malnutrition and 342/450 (76%) cases were
immunized upto date. 210/450 (46.6%) and 180/450 (40 %) cases belonged to Lower middle and Upper lower
Socioeconomic class as per Modified Kuppuswamy Classification respectively. Out of overall cases, 190/450 (42%)
cases had received an antibiotic course for superadded bacterial infection and rest 260/450 (57.7 %) cases were
managed symptomatically. All patients recovered completely and were discharged from the hospital. Conclusion:
Increased preventive methods and treatment which includes good nutrition and immunization are key strategies to
reduce outbreak of the disease.
KEY FACTORS INFLUENCING URINARY LEAK AFTER PERCUTANEOUS NEPHROLITHOTOMY: INSIGHTS AND IMPLICATIONS
Authors: Sreenivasa Reddy Guddety , Pudakalkatti Sanjay R , Ramaiah Keshavamurthy
Published: January 2025

Background: Percutaneous nephrolithotomy (PCNL) is the standard treatment for large or complex renal stones.
Despite its high success rates, complications such as prolonged urinary leakage (PUL) are significant concerns,
occurring in 5–15% of cases. This study investigates predictors of PUL following PCNL, focusing on anatomical and
procedural factors.Methods: A retrospective cohort study of 225 PCNL patients was conducted.Data on demographic,
anatomical (hydronephrosis grade, parenchymal thickness), stone characteristics (volume, location), and procedural
factors (surgery time,number of punctures) were analyzed.Urinary leakage was categorized as leakage persisting >24
hours post-nephrostomy removal. Statistical analyses included t-tests, chi-square tests, and multivariate logistic
regression. Results: Prolonged urinary leakage occurred in 23 patients (10%). Key predictors included higher
hydronephrosis grade (mean: 2.39 vs. 0.98, p<0.001), thinner parenchymal thickness (mean: 15.97 mm vs. 20.11 mm,
p<0.001),larger stone volume (mean:810.14 mm³ vs.684.56 mm³,p=0.04),and longer surgery time (mean:92.4 min vs.
81.0 min, p=0.01). Multiple punctures and lower calyceal access were also associated with increased risk. Skin-toparenchymal length showed no significant correlation with leakage. Conclusion: Higher grades of hydronephrosis,
reduced parenchymal thickness,larger stones,prolonged surgery, and multiple punctures are significant predictors of
urinary leakage after PCNL.Preoperative imaging and meticulous surgical planning can mitigate these risks.
BLOOD MANAGEMENT IN ORTHOPAEDIC SURGERY
Authors: Sree B. Kavya , KG Varaprasad , Venugopal SM , Deepak K.
Published: January 2025

Blood management in orthopaedic surgery has become an essential component in modern surgical practice,aiming to
minimize the need for allogeneic blood transfusions and improve patient outcomes. Blood transfusions, though lifesaving, are associated with several risks, including infections, immune reactions, iron overload, and increased hospital
stay.Effective blood management strategies in orthopaedic surgery focus on optimizing preoperative blood conditions,
reducing anticipated blood loss, and utilizing the patient's own blood or blood substitutes. Key elements in reducing
transfusion requirements include the correction of preoperative anemia (erythrocyte shock),assessing anticipated and
acceptable blood loss, and tailoring transfusion thresholds to individual patient needs. Methods to reduce blood
transfusion include preoperative optimization of erythrocyte stock through iron supplementation, erythropoiesisstimulating agents, and autologous blood donation. Intraoperatively, techniques such as minimally invasive surgery,
tranexamic acid, haemostatic agents, and cell salvage systems are employed to minimize blood loss. Additionally, the
use of blood substitutes, such as haemoglobin-based oxygen carriers and perfluorocarbons, presents potential
alternatives to allogeneic blood. Overall,blood management strategies in orthopaedic surgery aim to enhance patient
safety, reduce transfusion-related risks, and optimize recovery. By minimizing blood loss and optimizing the use of the
patient's own blood, orthopaedic surgeons can reduce the complications associated with transfusions and improve
clinical outcomes in surgeries like total hip replacements (THR), total knee replacements (TKR), and major trauma
surgeries.
OUTCOME OF VALVE SURGERY AT RAJENDRA INSTITUTE OF MEDICAL SCIENCES RANCHI, JHARKHAND, INDIA: 5 YEARS FOLLOW UP
Authors: Kumar Rakesh
Published: January 2025

Background: Rheumatic heart disease is a disease of poverty and negligence. It is very much prevalent in India leading to
arrhythmia, congestive heart failure, multi-Valvular heart disease requiring open heart surgery in the form of valve repair or
replacement. Last five years patients operated at RIMS Ranchi were included in this study. 1. To Aims And Objective:
compare our follow up strategy with recent trend of follow up in valve surgery worldwide. 2. To know complications related
to valve surgery, how to minimize and overcome with complications. Material & Methods: This retrospective review is
based on a single Institution experience between February 1, 2019 and January 31, 2024 with 300 consecutive cases males (n
166) and female (n 134) surgeries, in which RHD was the primary diagnosis to ascertain valve surgery and outcomes
expected for surgical treatment. Valve replacement and repair were performed as surgical procedure. Mechanical
prosthetic heart valve (Tilting Disk/Bi-leaflet), Tissue valve, valve ring were used as prosthesis. All patients underwent
echocardiography to assess successful valve surgery. Results: Out of 300 patients underwent valvular surgery on regular
follow up we found following complications 1. Deranged INR-6 2. Bleeding: Intracranial or generalized- 4 3. Stuck valve-3 4.
Recurrence of Valvular lesson in case of repair-1 5. Infective Endocarditis-1, 6. Stroke-3. Conclusion: Rheumatic heart
disease is endemic in India. Early diagnosis and prevention is the key to limit the disease burden. Timely intervention and
surgical intervention in suitable cases is best way to treat the patient. Regular follow up is compulsory to identify
complications and its management. Valvular heart surgery is very safe in Rajendra Institute of Medical Sciences, Ranchi with
risks equivalent to National and International standards. Most of the complications can be treated if reported early.
The effectiveness of nursing in intermediate care related to an integrated concept of dependency: a case study using the Modified Barthel index
Authors: Falchi Sara , Quirini Silvio , Ugenti Nikita Valentina , Longobucco Yari , Scalorbi Sandra
Published: January 2025

Introduction. A new care setting was established In modern society, called intermediate care (IC). It refers to residential structures aimed at link hospital and patient’s home, ensuring improved and personalized continuity of care and achieve better health outcomes. Patients admitted in this setting are usually elderly, with high levels of dependency. One of the most used assessment tools for dependency is Barthel Index (BI) and its modified version: the Modified Barthel Index (MBI). The aim of this paper is to verify if care in community hospital (intermediate care) improves patient independence (measured with Modified Barthel Index), and this improvement is linked to an appropriate care model.
Methods. A case study of a hypothetical patient has been developed, according to the Rosenberg Model. Data emerging from the case study has been compared with international literature. Care dependency is very a broad concept and includes both objective data and patient’s perceptions. Care dependency, therefore, could be described and assessed from an objective and a subjective point of view, in term of person’s affect. The case-analysis provides possible indicators regarding the meaning of dependency and is the start point for a targeted assessment of Nursing Diagnoses (NDs).                                                                                                                                         
Results. The functional domains of NANDA-I taxonomy 2024-2026 related to dependency were identified through the case analysis. Each ND was examined with reference to objective and subjective diagnostic indicators, thus highlighting the diagnoses related to each 14-independence topic presented by Hillcoat-Nallétamby. The MBI has been used as nursing outcome together with other psycho-social indicators.
Discussion. MBI is proved to be an indicator of the effectiveness of nursing care provided in the intermediate care settings. However, in order to define a patient as independent, the physical domain should be integrated with his/her psychosocial experiences according to identified Nursing Diagnosis.          
Conclusion. An integrated nursing assessment leads to the identification of the Nursing Diagnosis influenced by the experience of dependency. Nursing Plan should include patient’s emotions and other aspects related to his/her social life.
Use of Non Pharmacological Therapies for Pain Management in Children: A Survey of Pediatric Healthcare Provides
Authors: Maffeo Marina , Bianchi Asia , Fogli Beatrice , Meucci Veronica , Nicolosi Biagio , Ciofi Daniele
Published: January 2025

Introduction. Pediatric pain management is a complex challenge, particularly in settings such as intensive care units and in postoperative care, where the use of analgesic drugs can result in significant side effects. The use of non-pharmacological therapies (NPTs) has been shown to be effective in reducing both pain and anxiety. Since they are safe and free of side effects, they are therefore suitable for reducing the adverse effects of pharmacotherapy and improving the compliance of pediatric patients.
Methods. A descriptive survey was carried out by means of an ad hoc questionnaire with multiple-choice questions and was open to 202 voluntary healthcare personnel of pediatric departments of a Tuscany pediatric health agency with non-probability convenience sampling. The questionnaire assessed knowledge, skills and attitudes toward NPTs, with a statistical analysis of qualitative and quantitative variables.
Results. Forty-six percent of participants considered NPTs effective for pain control, but a significant proportion (54%) remained skeptical. Pediatric nurses demonstrated greater expertise in the use of NPTs, with 91% showing sufficient knowledge compared to 63% in other professions (Odds Ratio = 6.1; CI: 2.8–13; p < 0.0001).
Conclusions. The study highlights the need for specific and ongoing educational programs on provision NPTs for healthcare personnel. Integration of NPTs into care plans could reduce dependence on analgesics, helping both to significantly reduce pain and to ensure a more holistic approach.
The Influence of the Clinical Context on nursing organizational well-being: A Cross-sectional study
Authors: Della Bella Valerio , Fiorini Jacopo , Zaghini Francesco , Sili Alessandro
Published: January 2025

Introduction. A healthcare organization that promotes the well-being of its nurses ensures better quality and safety for patients. Studies have focused on investigating nurses' experiences without examining the differences related to specific clinical contexts in determining their organizational well-being. This study aims to identify which variables in specific nursing clinical contexts are associated with their reported organizational well-being.
Methods. A descriptive cross-sectional study was conducted using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. A convenience sample of nurses from different departments (e.g., medicine, surgery, emergency room) was recruited in different hospital settings across Italy. Data were collected through a web survey comprising validated instruments that investigated organizational well-being and associated variables (e.g., work-home conflicts, relationships, resources). Descriptive and inferential analyses were conducted.
Results. The study included 272 nurses. In medical departments, organizational well-being was associated with nurses' relationships with physicians (r = 0.35, p < 0.001), colleagues (r = 0.32, p < 0.01), and head nurse (r = 0.23, p < 0.05), available resources (r = 0.46, p < 0.001), workload (r = -0.23, p < 0.05), and work-home conflicts (r = -0.49, p < 0.001). In surgical departments, it was associated with available resources (r = 0.36, p < 0.01), relationships with the head nurse (r = 0.47, p < 0.001), and work-home conflicts (r = -0.29, p < 0.01). In emergency departments, it was associated with nurses' relationships with physicians (r = 0.24, p < 0.05) and head nurses (r = 0.29, p < 0.01), available resources (r = 0.42, p < 0.001), workload (r = -0.25, p < 0.01), and work-home conflicts (r = -0.38, p < 0.001). The mean scores for workload and relationships with the head nurse differed among the considered departments.
Discussion. The results underlined differences in organizational well-being perception depending on the clinical context. Relationships with physicians and colleagues were only associated with nurses' well-being in specific clinical settings. In contrast, work-family conflicts, availability of resources, and relationships with the head nurse were common clinical context variables influencing the organizational well-being perceived by nurses. This study adds to the existing literature by highlighting how different clinical environments shape nurses' organizational well-being, emphasizing the need for tailored organizational interventions to address context-specific challenges.
Healthcare Associated Infections Management inside Intensive Care Units: “What do nurses think about their head nurses?” A qualitative pilot study
Authors: Cappelli Eva , Fiorini Jacopo , Canzan Federica , Livigni Lucilla , Carnevale Angelica , Sili Alessandro
Published: January 2025

Introduction. Preventing and controlling Healthcare Associated Infections (HAIs) caused by Multi Drug Resistant Organisms (MDROs) is one of the primary goals in high-risk settings like Intensive Care Units (ICUs). The leadership style of the head nurse can result in a reduction of infection rates, such as bloodstream and urinary tract infections; however, it is unclear how leadership can encourage nurses to adhere to Infection Prevention Control (IPC) programs. This study aims to explore the role of the head nurse in encouraging the clinical care team to adhere to IPC practices for preventing and controlling MDRO infections in the ICU.
Methods. In 2024, a single-centre interpretative phenomenological study was conducted following the Consolidated Criteria for Reporting Qualitative (COREQ). Nurses and head nurses from three ICUs were recruited. Data were collected through semi-structured interviews and analysed thematically.
Results. Eleven nurses and two head nurses were recruited. The results identified four themes that facilitate the management of HAIs by MDROs: a) awareness of the infection problem, b) head nurse supervision, c) information sharing, and d) distribution of responsibilities. The involvement of leadership and learning through feedback from head nurses are perceived not as barriers but as added value that promotes the dissemination of best practices.
Conclusions. Recognising the role of the head nurse in the management of HAIs by MDRO would represent an important driver for change in high-risk infection settings. It would enable healthcare organisations to intervene not only with nurses directly involved in patient care but also with middle managers who implement the hospital's directives and produce nursing sensitive outcomes.
The Clinical Learning Environment Experience of the Student Nurse of the Generation Z: a Convergent Parallel Mixed Method Study
Authors: Lommi Marzia , Covelli Giuliana , Ivziku Dhurata , Barretta Giorgia , Pozzuoli Gianluca , Porcelli Barbara , Guarente Luca , Ricci Simona
Published: January 2025

Background. The internship represents an experience that incorporates numerous meanings and values that involve nursing students globally, particularly for those belonging to Generation Z.
Aims. 1) to assess the students' perceptions of the clinical learning environments, 2) to identify the elements that contribute to determining the clinical learning environment, and 3) to compare quantitative and qualitative results to highlight key elements that can support the development of targeted educational strategies for nursing students.
Design. Convergent parallel mixed-method study
Participants. Students attending the first, second and third years of the bachelor degree in nursing.
Methods. Quantitative and socio-demographic data were collected with a questionnaire that included the Clinical Learning Environment and Supervision plus Nurse Teacher (CLES-T) scale. Qualitative data were collected with the internship diaries. The qualitative data transformed into dummy variables were finally correlated with the quantitative data using a biserial point correlation to explore their relationships.
Results. We received answers from 63 students, half of them females, who reported experiencing a positive clinical learning environment. Simple linear regressions showed that the variables age, course year, being a student worker or with health care work experience, previous volunteering are all positively correlated with the total scale and with each dimension of the CLES-T. The content analysis of the internship diaries revealed 7 main categories describing the experience of the clinical learning environment of nursing students of Generation Z. Finally, it was possible to outline a summary scheme that describes the key elements that contribute to the success of the internship and the learning experience.
Conclusions. The key success factors emerging from the study include meaningful relationships with tutors, staff, and peers, effective management of emotional aspects, development of professional identity, intrinsic motivation, and the acquisition of practical skills through feedback and support. A positive and well-organized clinical learning environment facilitates these outcomes, promoting role awareness and responsibility. These findings can be applied to nursing education by developing targeted educational strategies such as structured mentoring programs, emotional training, and practical simulations. Integrating these elements enables educators and institutions to overcome challenges in clinical internships, enhancing students' preparation and fostering the development of competent and confident nurses.
Risk Factors for Skin Injuries in Hospitalized Children: a Retrospective Study
Authors: Nicolosi Biagio , Parente Eustachio , Fontani Irene , Idrizaj Sabina , Stringi Daiana , Bamonte Claudia , Longobucco Yari , Buccione Emanuele , Maffeo Marina , Granai Valentina , Gregorini Mirco , Ciofi Daniele
Published: January 2025

Background. Skin injuries in hospitalized pediatric patients can slow recovery, increase infection risk, pain, stress, length of stay, and healthcare costs, while reducing family quality of life. The prevalence and incidence of these injuries vary by environment, comorbidities, and specific pathologies.
Objective. To identify the main risk factors related to skin lesions in hospitalized children
Methods. This retrospective, observational, monocentric study aims to identify the main risk factors for skin injuries in hospitalized children.
Results. A study of 880 hospitalized children aged 0-17 from January 2019 to December 2020 found that 133 developed skin injuries. Factors increasing risk included longer hospital stays, comorbidities, forced bed rest, and the number of medical devices. Each additional hospitalization day and lower weight raised the risk. Continence was protective. Injuries mainly affected the perineum, upper limbs, face, lower limbs, abdomen, and occiput. These findings emphasize the need for tailored prevention strategies for pediatric patients due to their unique characteristics.
Conclusions. This study underscores the need for further research to develop effective prevention protocols specifically for pediatric populations, emphasizing the role of comprehensive risk factor assessment and resource allocation to mitigate skin injury risks in hospitalized children.
How Problem-Based Learning Enhances Critical Thinking? An Analysis of Contexts, Methods, and Findings from Previous Research
Authors: Verawati Ni Nyoman Sri Putu , Rokhmat Joni , Harjono Ahmad , Makhrus Muh , Sukarso AA
Published: January 2025

This review critically evaluates the effectiveness of Problem-Based Learning (PBL) in fostering critical thinking (CT) through a systematic analysis of experimental and quasi-experimental studies from the past decade. It synthesizes evidence across diverse contexts to identify factors influencing the success of PBL, emphasizing its contextual adaptability and methodological diversity. Notably, this review not only compiles existing evidence but also provides a nuanced analysis of the contextual and methodological elements affecting PBL's success in enhancing CT. The findings reveal that while PBL is generally effective, its superiority over traditional methods is not guaranteed, with some studies reporting comparable outcomes. High-achieving students particularly benefit from PBL, although its impact on problem-solving skills—a vital component of CT—is less pronounced. These insights underline the need for tailored PBL strategies to address its limitations and optimize its benefits. This review suggests integrating complementary methods such as technology and collaborative tools to enrich PBL. Future research should explore innovative adaptations that enhance all dimensions of CT across varied educational settings, thereby maximizing the pedagogical potential of PBL. This comprehensive evaluation provides critical insights for educators and policymakers aiming to advance CT development in contemporary education.
Business Incubation Based on Technopreneurship Learning Factory: Model Design and Expert Perspectives
Authors: Indriaturrahmi Indriaturrahmi , Prayogi Saiful , Gummah Syifa'ul
Published: January 2025

This study aims to design and validate a business incubation model based on a technopreneurship learning factory, addressing the gap between academic learning and industry demands in the context of Industry 4.0. The increasing unemployment rate among university graduates, exacerbated by a lack of practical skills and industry alignment, highlights the urgency for innovative educational approaches. The proposed model integrates theoretical knowledge with entrepreneurial simulations, fostering design thinking and competitive advantage in technopreneurship. Employing a developmental research approach, the model was evaluated through expert validation involving specialists in education, business, and technology. The validation process emphasized content and construct validity, ensuring the model's alignment with both academic and industrial requirements. The results confirmed its theoretical soundness and practical relevance, marking a significant step in revitalizing entrepreneurship education programs. This model provides a framework for universities to bridge the skills gap and enhance their role in preparing students for the modern labor market. Future research should focus on piloting the model across diverse disciplines and institutions to assess its adaptability and long-term impact. By fostering industry-academic collaboration, this study contributes to the development of a sustainable technopreneurship ecosystem, advancing innovation while addressing the challenges of traditional entrepreneurship education.
Teaching Factory Based on Scientific Creativity to Enhance Students' Soft Skills and Sustainable Entrepreneurship
Authors: Samsuri Taufik , Habibi Habibi , Ikhsan Muhamad
Published: January 2025

This study aimed to assess the validity and effectiveness of a Teaching Factory (TEFA) model based on scientific creativity in enhancing students’ soft skills and fostering sustainable entrepreneurship. The TEFA approach was validated through expert evaluations and tested through two production processes involving 15 university students. The research focused on improving soft skills such as communication, teamwork, creativity, leadership, and time management, alongside sustainable entrepreneurship skills like opportunity identification, resource utilization, and entrepreneurial action. Data were collected using observation sheets and analyzed through descriptive statistics and ANOVA to compare students' performance across the two production processes. The results showed significant improvements in students' soft skills and sustainable entrepreneurship, with the TEFA approach based on scientific creativity proving highly effective. Average soft skill scores increased from "Poor" to "Good" after the intervention, and similar improvements were observed in sustainable entrepreneurship scores. The structured pedagogical cycle employed—encompassing need identification, curriculum development, implementation, evaluation, and reflection—successfully bridged the gap between theoretical knowledge and practical application in entrepreneurship education. However, a limitation of the study was its small sample size, indicating the need for further research with larger and more diverse populations. These findings suggest that the TEFA approach based on scientific creativity can be a valuable addition to university entrepreneurship programs, better preparing students for the challenges of the global business landscape.
A Huge Chromophobe Renal Cell Carcinoma: About a Rare Entity and Literature Review
Authors: Jendouzi Omar , Sobhi Aya , Azizi Mounia , Ameur Ahmed
Published: January 2025

Renal cell carcinoma (RCC) is a tumour with a variable clinical course. Size is a prognostic factor correlated with venous invasion, lymph node or distant metastases. We report the clinical case of a 32-year-old female with no underlying disease who underwent in our structure a nephrectomy for a huge renal tumor (more than 20 cm in size). The histopathological finding revealed a chromophobe cell carcinoma and the evolution was favorable with no recurrence or metastasis.
Chronic Otitis Media Complicated of Cerebral Abscess: About A Case
Authors: Costa A. Da , Amri G. El , Idoubba S. , Oubenjah J. , Arabi M. , Benariba F. , Errami N.
Published: January 2025

We present a case of a 23-year old patient who has chronic otitis media, complicated by a brain abscess followed by a meninges syndrome resistant to anti-bithicotherapy. We report the interest of diagnosis by CT and MRI imaging and cytobacteriological study and antibiogram according to the germ incriminates. The patient received a stereotactic drainage puncture, or the bacterial study and otological sampling were in favor of Pseudomonas aerogenosas and antibiotic therapy. A closed technique tympanoplasty is then performed with excision of an aggressive cholesteatomy and reconstruction of the bone frames of the case as well as ossiculoplasty.
A Pigmented Malignant Tumor of Skin is not Always a Melanoma
Authors: Tbouda M. , Miry A. , Aggouri H. , Oqbani K. , Abbaoui S.
Published: January 2025

A few cases of pigmented squamous cell carcinoma have been reported in the literature. We report a case of pigmented squamous cell carcinoma with diagnosis confirmed by histological and immunohistochemical examinations. The differential diagnosis is with pigmented basal cell carcinoma and melanoma. We report in this article a case of pigmented squamous cell carcinoma whose diagnosis was confirmed by an anatomopathological study. The management of this type of tumor is based on wide excision.
A Rare Genetic Disorder of Protein C Deficiency Induced Acute Ischemic Stroke in Young Adult
Authors: Pyatla Priyanka Reddy
Published: January 2025

The liver produces the 62-kD vitamin K-dependent glycoprotein known as protein C (PC) as a zymogen. PC is activated by attaching to the thrombin-thrombomodulin complex, with protein S (PS) serving as a cofactor. Among its numerous functions, PC functions as a naturally occurring anticoagulant. A homozygous or heterozygous deficiency places the individual at risk for thrombosis, specifically venous thromboembolism, and causes major events like myocardial infarction (MI), deep vein thrombosis, pulmonary embolism, or a fatal stroke. A 21yrs male patient came to ER department with the chief complaints of Giddiness, Chest pain, seizures, and 2 episodes of vomiting with elevated blood pressure 200/140 mmhg. He had no past medical history; Patient CT scan of brain showed normal findings But MRI revealed acute infarcts in brain. Also reduced protein c functional activity, Normal Protein S, Increased WBC count and increased APTT levels. All other laboratory investigations were normal. Patient was treated with antihypertensive, Antiplatelet, Anti-hyperlipidaemias drugs, eventually patient vitals became normal and discharged.
Assessing the Translation of the Iraqi Constitution Based on Appraisal Theory
Authors: Al-Asady Areej Abdilmun’im
Published: January 2025

This research focuses entirely on evaluating the translation of the Iraqi constitution through the lens of appraisal theory. This theory provides a framework of linguistic resources used to convey attitudes. It consists of three primary systems: attitude, engagement, and graduation, each further divided into various subsystems. The study is structured into three main sections. The first section explores the concept of appraisal theory, while the second provides an overview of constitutional language and the Iraqi constitution. The third section is dedicated to analyzing selected data, focusing on five specific provisions. The study concludes with a summary of the key findings.
Evaluasi Penggunaan Banner Kampanye Bapak Rizki Eri Munadi S.E. Calon Legislatif PDI Perjuangan Kota Banjarmasin Daerah Pemilihan 3 Tahun 2024 (Studi Deskriptif Kualitatif)
Authors: Norwahyuliadi Dedi , Rakhmadiansyah Rakhmadiansyah , Syahrin Alfi , Ningsih Novia Septia
Published: January 2025

Penelitian ini bertujuan untuk mengevaluasi efektivitas penggunaan banner kampanye Bapak Rizki Eri Munadi, SE sebagai calon legislatif PDI Perjuangan Kota Banjarmasin pada daerah pemilihan 3 tahun 2024. Penelitian ini menggunakan pendekatan kualitatif dengan metode deskriptif, melibatkan analisis visual dan wawancara mendalam dengan pemilih, tim sukses, serta pakar komunikasi politik. Fokus penelitian adalah menilai desain, lokasi pemasangan, pesan yang disampaikan, dan dampaknya terhadap kesadaran dan preferensi pemilih. Hasil penelitian menunjukkan bahwa banner kampanye memiliki kontribusi signifikan dalam memperkuat citra kandidat, terutama melalui visualisasi yang menarik dan penyampaian pesan yang sederhana namun efektif. Namun, ditemukan pula beberapa kelemahan, seperti lokasi pemasangan yang kurang strategis di beberapa area dan pesan yang tidak selalu relevan dengan prioritas pemilih. Selain itu, penelitian ini juga mengidentifikasi pentingnya sinkronisasi antara media kampanye visual dengan strategi komunikasi lainnya untuk meningkatkan dampak kampanye secara keseluruhan. Temuan penelitian menyarankan bahwa penggunaan banner harus lebih strategis, baik dalam hal desain maupun distribusinya, untuk mencapai pemilih dengan lebih efektif. Dengan optimalisasi elemen-elemen tersebut, banner kampanye dapat berfungsi sebagai alat pendukung yang lebih kuat dalam meningkatkan elektabilitas kandidat. Penelitian ini memberikan kontribusi bagi pengembangan strategi komunikasi politik yang berbasis data dan relevan dengan konteks pemilihan legislatif lokal.
Efeitos do Cigarro Eletrônico no Aparelho Respiratório
Authors: Santos Elaíne Apolinário dos , Silva Pedro Augusto Barbosa , Aguiar Giovanna Maria Lemos , Alencar Waleska Paiva , Provin Larissa Luana , Brito Gabriel Teixeira , Silva Rayanne Monique dos Santos , Santos Priscila Parente
Published: January 2025

Introdução: O uso do cigarro eletrônico (CE) vem aumentando nos últimos anos. O CE apresenta uma solução de inalação que passa por aquecimento no equipamento para ser utilizado, apresentando diferentes sabores, composição e conteúdo de nicotina. Esse uso tem se mostrado tóxico ao pulmão, devido aos componentes presentes no aerossol, como aldeídos voláteis presentes nos aromatizantes e metais oxidantes. Partículas finas e ultrafinas desses componentes podem afetar as vias aéreas mais distais e alvéolos. Objetivo: Analisar os efeitos que o cigarro eletrônico apresenta no aparelho respiratório. Método: Trata-se de uma revisão integrativa dos últimos 5 anos, do período de 2019 a 2024, utilizando a base de dados da Medline com os descritores: "cigarro" "eletronico" "efeitos" "respiratorios". Foram encontrados 46 artigos, sendo eles submetidos aos critérios de seleção. Os critérios de inclusão são artigos disponibilizados na íntegra e que se relacionavam à proposta estudada. Os critérios de exclusão foram artigos disponibilizados na forma de resumo, relatos de caso e artigos que não se relacionavam à proposta estudada. Resultados e Discussão: Observa-se um aumento das chances de apresentar sintomas respiratórios nos pacientes que utilizam o CE, sintomas como sibilo, rinite, dispneia e sintomas bronquiais. Nota-se um aumento das citocinas pró-inflamatórias, efeitos imunossupressores, com favorecimento de lesões respiratórias em infecção viral, lesão no DNA, além do potencial aumento, embora menor quando se comparado aos usuários de tabaco, do efeito carcinogênico a longo prazo. Conclusão: Nessa perspectiva, evidencia-se o impacto que o uso do CE tem na morbimortalidade dos indivíduos.
Impactos Ototóxicos de Fármacos Antineoplásicos: Uma Revisão Sistemática
Authors: Helou de Oliveira Luciano , Lazzarini Bulla Leticia , Nascimento dos Santos Isadora , Cristina de Jesus Porral Calvino Helen
Published: January 2025

A ototoxicidade induzida por medicamentos antineoplásicos é um efeito colateral relevante em pacientes em tratamento contra o câncer, especialmente aqueles submetidos à quimioterapia. Fármacos como cisplatina e outros agentes à base de platina têm sido associados a danos auditivos e vestibulares, afetando a qualidade de vida dos pacientes. A perda auditiva pode ser irreversível e bilateral, impactando diretamente na comunicação e bem-estar dos pacientes. O estudo abordou os efeitos ototóxicos de medicamentos antineoplásicos a partir de uma revisão sistemática da literatura, utilizando as diretrizes do PRISMA. Diversos fatores podem influenciar a gravidade da ototoxicidade, incluindo a dose do medicamento, a combinação de fármacos, a idade do paciente e a presença de comorbidades. O monitoramento audiológico regular é fundamental para detectar precocemente os efeitos ototóxicos e permitir a intervenção adequada. Este trabalho destaca a importância de estratégias de prevenção e acompanhamento para reduzir os danos causados pela ototoxicidade, promovendo melhor qualidade de vida para os pacientes em tratamento oncológico.
EMPOWERING THE YOUNG GENERATION IN INCREASING TOURISM THROUGH THE ART OF "GENDANG SISIBAH" AS AN EFFORT TO STRENGTHEN THE CULTURAL IDENTITY OF THE PAKPAK COMMUNITY
Authors:   Universitas Negeri Medan, Saragi Tasya Amelia , Sagala Revayani ,   Universitas Negeri Medan, Amalia Nila Dwi ,   Universitas Negeri Medan, Sulistyani Shiwi ,   Universitas Negeri Medan, Febriani Anggi Nur ,   Universitas Negeri Medan, Arief Syamsul ,   Universitas Negeri Medan, Siallagan Lasenna ,   Universitas Negeri Medan
Published: January 2025

Youth as pillars of the nation are expected by society to carry out their status and role optimally, have a nationalist spirit, and have self-resilience in the influence of globalization. Youth can channel their potential by participating in improving the regional tourism sector through the art of "Genderang Sisibah" which is a collection of perfect musical instruments. In research using qualitative research with literature review or literature study methods, the aim of this research is to find deeper meanings to the art object "Genderang Sisibah", the idea of ??applying tradition to the tourism sector by empowering the younger generation of Pakpak and strengthening efforts cultural identity, with research steps, finding information, understanding, finding meaning, drawing conclusions with development ideas that will be given. The results of the research are appropriate tourism strategies and are the key to success in promoting Sisibah Drum art so that it attracts tourist interest.

Keywords: Culture, Pakpak, Young Generation, Sisibah Drum, Tourism.
ANALYSIS OF DENOTATIVE MEANING IN THE NOVEL MIDNIGHT DIARIES BY MALIO HARTIGAN BY SKYSPHIRE
Authors:   Universitas Sultan Ageng Tirtayasa, Amalia Indah Putri , Farida Hilda ,   Universitas Sultan Ageng Tirtayasa
Published: January 2025

This article discusses the denotative meaning in the novel Midnight Diaries by Malio Hartigan by Skysphire. Denotative meaning is an objective meaning, so the meaning is concrete according to the actual meaning. Denotative meaning is also referred to as lexical meaning, dictionary meaning, or literal meaning. Through this research, the author aims to identify how denotative meaning is used to construct important elements in the novel, such as the depiction of setting, characters, and events. This research will also explore how the literal meaning contained in the text creates a clearer and more purposeful reading experience.

This research uses a descriptive qualitative method with text analysis to explore the meaning of language according to literary context. Data were collected through observation of language in the novel and identification of elements containing denotative meaning. The analysis was conducted systematically, starting from coding, context interpretation, to the presentation of findings related to the function of denotative meaning in the novel.

The results of the analysis show that this novel uses denotative meaning to clarify the background of the story, describe the conflict experienced by the main character, and create a certain atmosphere that supports the storyline. Through this analysis, readers are expected to understand how denotative meaning functions in shaping the narrative and enriching the reading experience. Furthermore, the analysis shows that the use of denotative meaning helps the reader to understand the narrative.

Keywords: text analysis, denotative meaning, novel