bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pheochromocytoma Multisystem Crisis: A Case Study
Authors: Endicott Barbara , Wagoner Caleb , Hibner Jessie , Eckroth Josh 
Published: June 2021

IntroductionKnown as the “great mimic,” pheochromocytoma is rare and difficult to diagnose. When a pheochromocytoma begins to cause end-organ damage, it becomes pheochromocytoma multisystem crisis, an even more rare and deadly diagnosis.Clinical FindingsN.R., a 63-year old man, presented to the emergency department 1 day after receiving a cortisone injection for a nondisplaced wrist fracture. His chief concern was a “racing heart and chest pressure.” N.R. was admitted to the telemetry unit after routine electrocardiography showed atrial fibrillation and elevated blood pressure. Symptoms quickly progressed, and N.R. was transferred to the intensive care unit where he received noninvasive positive pressure ventilation.DiagnosisA computed tomography scan revealed a 7-cm right intra-adrenal mass, and an echocardiogram showed a markedly reduced ejection fraction. N.R. received a preliminary diagnosis of pheochromocytoma multisystem crisis, although confirmatory laboratory test results were pending. N.R. became progressively more hemodynamically unstable and his respiratory status worsened, and by the end of hospital day 2 he had been intubated and was receiving multiple vasoactive medications intravenously. On hospital day 7, N.R. was transferred to a facility for definitive surgical intervention.ConclusionThis case represents the importance of timely interventions by nursing staff, clear communication between staff on different shifts, and real-time education by physicians to nursing staff. This collaborative milieu empowered nurses to use their experience and critical thinking to make clinical decisions in providing care.
The Correlation between Sleep Quality and the Prevalence of Obesity in School-Age Children
Authors: Elizabeth Beatrix , Wanda Dessie , Apriyanti Efa 
Published: June 2021

Background The prevalence of obesity increases year by year. Sleep quality is considered to be one of the obesity causes. The current average sleep range of children in Indonesia was 6-7 hours. This study aims to analyze whether the sleep quality affects the prevalence of obesity in children. Design and methods This study used prospective cohort as the research method. The samples consisted of 37 primary schoolage children (4th-6th grade) from West Java and Sumatra. The respondents were selected using snowball sampling technique due to pandemic situation during data collection period. The data were collected by using PSQI and sleep logs (within a month). Results The statistical results show that there were 19 obese and 18 non-obese children. Fourteen out of 19 obese children were boys, while among not obese children, the number of boys and girls were similar. Twelve out of 19 obese children had poor sleep quality (63.2%), while most of the non-obese children had good sleep quality (83.3%). Based on the chi-square statistic, the pvalue = 0.011 < (0.05) indicating that H0 was rejected, which means there was a correlation between sleep quality and obesity, with OR=8.571 (95% CI: 1.818-40.423). In another words, the children with poor sleep quality were likely to experience obesity 8.6 times greater than those who had good sleep quality. Conclusions This study found there were correlations between dietary intake, physical activity, sleep quality, and obesity in school-age children. The most dominant factor related to obesity in school-age children is the habitual sleep efficiency (OR=12.354).
Effectiveness of Self-Management on Adherence to Self-Care and on Health Status among Elderly People with Hypertension
Authors: Putri Silvia Elki , Rekawati Etty , Wati Dwi Nurviyandari Kusuma 
Published: June 2021

Background Adherence to self-care is the goal of nursing care for elderly people with hypertension to give them optimal functional health status. The purpose of this paper is to determine the effectiveness of self-management on adherence to self-care and management of health status elderly people living with hypertension in Pekanbaru City. Design and methods This study design was quasi-experimental with a pre-post test with a control group. The self-management intervention was provided through four home visits to elderly people living with hypertension with a caregiver. Samples were taken by the consecutive sampling technique, and a total number 134 elderly people were participants. The instruments used were the adherence to self-care questionnaire and the Short Form 12 Health Survey (SF12) for elderly people. Results The results showed that most of the respondents with hypertension were 60-74 years of age (84.3%), were female (67.9%), of Minang ethnicity (48.5%), had completed primary school (44%), were unemployed (81.3) %), had a family history of hypertension (50%), were non-smokers (52.2%), and had never drunk alcohol (95.5%). The effects of self-management were positive on adherence to caring for themselves (p<0.001) and on health status (p<0.001). The most influencing factor on self-care compliance and health status after being controlled by confounding variables was self-management (p<0.001). Conclusions This study recommends that nursing interventions on self-management for elderly people with hypertension in the community and should be integrated into the Community Health Nurses’ (Perkesmas) program in Indonesia.
PENINGKATAN KEAKTIFAN PESERTA DIDIK DALAM PEMBELAJARAN ONLINE MATEMATIKA DENGAN MENGGUNAKAN MEDIA GOOGLE CLASSROOM
Authors: Erning Yustiana Dewi  , Alfian Mubarok  
Published: June 2021

Berdasarkan hasil angket dan pengamatan peserta didik kelas VIII D terdapat peningkatan keaktifan peserta didik dalam pembelajaran online dengan media Google Classroom. Penelitian Tindakan Kelas ( PTK ) ini dilakukan mulai dari observasi Pra siklus ke siklus I dan Siklus II yang bertujuan untuk mengetahui meningkatnya keaktifan peserta didik dalam kegiatan pembelajaran dengan media Google Classroom. Sesudah dilaksanakan penelitian, dapat disimpulkan bahwa rata-rata peningkatan keaktifan peserta didik dalam pembelajaran pada Pra siklus sebesar 41,87%, pada fase Siklus I sebesar 49,37% dan pada fase siklus II sebesar 65,62%. Pada fase siklus II indicator kerja penelitian sudah terlampaui, maka penelitian ini dihentikan hanya sampai pada fase Siklus II. Sehingga bisa diambil kesimpulan dari penelitian ini bahwa pembelajaran daring dengan menggunakan media Google Classrom dapat meningkatkan keaktifan belajar peserta didik. Hasil penelitian ini diharapkan bisa mendorong para pendidik untuk ikut melakukan penelitian ini dan memotivasi pendidik lain untuk melakukan penelitian tindakan dengan tema dan media pembelajaran daring yang lainnya sebagai upaya meningkatkan profesionalisme sebagai seorang pendidik.
Inflammatory myofibroblastic tumor of caecum presenting as recurrent intussusception: A case report
Authors: Barolia Dr.Dinesh Kumar , Singh Aditya Pratap , Bathia Dr. Harsha Vinod , Parmar Vipal H , Mehta Bhavana Asit , Mehta Shraddha 
Published: June 2021

Background: Inflammatory myofibroblastic tumor is an uncommon tumor. It commonly affects the lung but it can be found anywhere in the body.
Case Report: We are reporting a case of caecal mass presenting as recurrent intussusceptions. Histopathology and immunohistochemistry confirmed it to be an inflammatory myofibroblastic tumor of caecum. Immunohistochemistry of tumor cells were positive for vimentin, smooth muscle actin, MIB 1, and CD 45 in lymphoid cells in the stroma of the tumor.
Conclusion: Recurrent intussusception should be kept as one of the differential diagnosis in patient with caecal mass with recurrent abdominal pain. Inflammatory myofibroblastic tumor of the caecum is unusual in paediatric patients and may present as recurrent intussusception.
Accidental Magnet Ingestion in A Toddler: A Diagnostic Dilemma
Authors: Ng Benjamin Wei Liang , Ooi Wei Keong , Ramanathan Prahalad , Toh Teck Hock 
Published: June 2021

Foreign body ingestion is common in children. Ingestion of foreign bodies with magnetic properties are less common, but can be associated with more severe complication, especially involving multiple magnets. We present a 16-month-old boy with developmental delay who developed small bowel perforation following multiple magnet ingestion. He had three days history of vomiting and abdominal distension associated with pain, suggestive of an acute intestinal obstruction. Abdominal imaging confirmed foreign body ingestion, and an exploratory laparotomy revealed two magnets attracted across the intestinal lining with resultant intestinal obstruction and perforation. Surgical removal of the magnets and the necrotic bowel tissue was complicated by post-operative wound dehiscence. After secondary suturing, the child subsequently made a complete recovery. We discuss the diagnostic dilemma in multiple magnet ingestion along with the importance of early recognition and prompt management due to the risk of more severe gastrointestinal complication associated with delayed intervention.
Desfechos perinatais relacionados a idade materna e comorbidades gestacionais nos nascimentos prematuros
Authors: Gomes Tabatha Gonçalves Andrade Castelo Branco , Queiroz Murilo Neves de , Costa Ana Beatriz Martins Peres , Moreira Alessandra de Cássia Gonçalves 
Published: June 2021

Objetivo: descrever os desfechos perinatais do binômio no nascimento prematuro, de acordo com a idade materna e as principais comorbidades gestacionais. Métodos: estudo descritivo e retrospectivo, com inclusão de todos os nascimentos prematuros de 2015. As mães foram divididas em grupos de acordo com idade e presença ou não de doença hipertensiva e diabetes. Foi analisado o tempo de internação e o desfecho clínico materno-infantil. Resultados: doença hipertensiva foi a principal indicação de internação materna de UTI; poucos casos de diabetes. Conclusão: idade materna elevada e síndrome hipertensiva gestacional apresentaram maior tempo de internação e maior porcentagem de óbitos neonatais.
Character Education Values Used in the Avengers: Endgame Movie
Authors: Arbi Anggun Purnomo 
Published: June 2021

Abstract
This research was aimed to describe the character education values used in the Avengers: End Game Movie. Movie is described as the series of moving pictures combined with sound effects. Character education values .This study applied library research as it described the results of study. The data of this study were the phenomena and facts classified into the character education values. The source of data were the facts or phenomena shown in the movie scenes and the movie transcription of Avengers: Endgame. This study used two instruments called: the researcher himself and the documentation. The object of this study was a movie entitled “Avengers: Endgame”. In collecting the data of this research, the researcher used documentary technique including watching the movie, reading the movie’s screenplay and taking a note. The researcher used the theory of content analysis (Ary, 2010) to analyze the data. Based on the results of the study, the researcher found nine types of character education values covering responsible, love and affection, honesty, hardworking, tolerant, curious, patriotic, creative, and communicative.
VIOLÊNCIA OBSTÉTRICA: ARMADILHA DE UM CRIME CULTURALMENTE NORMATIZADO
Authors: Madureira Lauryen Silva Santos , Cordeiro Taiana Levinne Carneiro 
Published: June 2021

A violência obstétrica é caracterizada pela imposição de intervenções danosas à integridade física, psicológica e/ou sexual de mulheres grávidas, que está ou acabou de dar à luz, acometida pelos profissionais de saúde, bem como pelas instituições, sejam elas públicas ou privadas. O presente artigo visa analisar a violência obstétrica e como essa prática vem crescendo no mundo, tornando o momento feliz e especial de uma mãe em um momento traumático. Nessa perspectiva, objetiva-se em um primeiro momento, uma explanação histórico-social de como a mulher foi inserida em hospitais, a construção conceitual e das formas de manifestações desse tipo de violência sob o olhar da violência de gênero e dos direitos das mulheres, pontuando sobre o direito material violado nos dispositivos constitucionais, as garantias protecionistas das parturientes e dos seus recém-nascidos, bem como dos direitos tutelados atingidos pela violência obstétrica, como por exemplo, a dignidade da pessoa humana. Pontuar sobre as iniciativas na esfera brasileira, com recomendações através de portarias e resoluções, como também inciativas legislativas nos âmbitos municipais, estaduais e federais, em especial a Lei federal 11.108/05, que mudou a Lei do SUS garantindo a presença de acompanhante para gestante e parturientes. Em seguida, para a perfeita compreensão do Direito Penal, é imprescindível o estudo da teoria do bem jurídico, bem como do Direito Penal enquanto ultima ratio legis e a necessidade de atuação do sistema jurídico penal, como instituto punitivo, fundamental na busca de uma finalidade social. Utilizando a metodologia exploratória, por meio de uma pesquisa bibliográfica, desenvolvida a partir de material já elaborado, constituído de livros, monografias, dissertações, teses e artigos científicos. Finalmente, diante da pesquisa feita, percebeu-se uma falha legislativa na proteção das vítimas de violência obstétrica, uma vez que a inexistência de um tipo penal específico sobre o tema tem provocado nas vítimas uma sensação de insegurança e impunibilidade.
Going rogue: Reconceptualizing government employees’ contentious politics on Twitter
Authors: Espinoza Vasquez Fatima , Proferes Nicholas , Cooper Troy B. , Oltmann Shannon M. 
Published: June 2021

In 2016, following the election of President Donald Trump, dozens of Twitter accounts emerged, purporting to represent a network of resistance within the U.S. government. These alt- and rogue- Twitter accounts, known as Rogue Twitter, shared tweets aiming to rebuke the administrations new information restrictions on federal agencies.
Using established social movement theories, we investigated if Rogue Twitter is an online social movement. We qualitatively analyzed 43,569 original tweets from 102 Rogue accounts. We evaluated the tweets on three dimensions: Their attempts to challenge state institutions (macro-level), their organizing and mobilizing strategies (meso-level), and their shared understandings (micro-level).
We found that the Rogue Twitter Movement exemplifies how online social movements engage in coordinated contentious activity via an online platform. Members of this network collectively framed as their main grievance the State’s control of information. Accordingly, their mobilization repertoire focused on calling the attention of the State and the public by openly criticizing the new information control policies. They strategically released controlled scientific information and demonstrated dissent by satirizing Trump. Moreover, they supported off-line political activity by promoting protests like the Science March. This study shows how incorporating multidisciplinary approaches yields nuanced understandings of protest in Internet platforms like Twitter.
Frequency of conjunctivitis among farmers of district vehari, Punjab, Pakistan
Authors: Abideen Zain ul , Sohail Ahmed , Perveen Ishrat , Faridi Tallat anwar , Ayyub Hafsa 
Published: June 2021

Conjunctivitis is very common type of ocular problem occurring worldwide due to many type of microorganism and if not managed appropriately and timely can lead to corneal perforation or blindness
Objective:
To find out the frequency of conjunctivitis among farmers in District Vehari.­
Method:
It was community based, cross sectional descriptive study, quantitative method was applied. The villages were selected randomly and subjects were communicated by door to door approach and examined personally with the help of ophthalmoscope and torch light.
Result:
A Total 200 Farmers were examined during the study period in which 33 (16.5%) Farmers were found to have conjunctivitis. Among these 29 (14.5%) patients had bacterial and 4 patients (2%) had viral conjunctivitis. And no patient was found to had allergic conjunctivitis.
Conclusion:
Protective measures are very important to protect eyes from any sort of pathogens and in this study maximum population were not using any protective measures while doing almost 6 hours outdoor work. Literacy rate was very poor because maximum number of patients were not getting treatment from qualified eye specialist instead of having bacterial conjunctivitis.
Review Probable Ingredients for Trans Free Margarine with Omega-3 Fatty Acids
Authors: Ajmal Muhammad , Nadeem Muhammad , Batool Maryam , Khan Imran Taj 
Published: June 2021

Margarine is widely used as table spread, in cooking and bakery products. Awareness of consumers regarding the intake of omega fatty acids has led the food industry to develop foods which are rich sources of omega fatty acids. Harmful effects of trans on the development of cardiovascular diseases have steered the researchers to find out wide range of trans free options, without compromising on functional and physical properties of fats. Nutritionists recommend margarine for the growing and school going babies, it is usually manufactured from the combination of hard and soft fats, followed by the addition of vitamins A, D and E. However, little is known regarding the supplementation of margarines with omega fatty acids of chia oil. This paper summarizes the physical and chemical characteristics of few ingredients that may be used in the formulation of trans free margarine with higher magnitude of omega fatty acids.
Quantification of Cr(VI)-Thymoquinone Complex Using Cyclic Voltammetry
Authors: Kishwar Farah , Khan Khalid Mohammed , Perween Rubina , Anwar Anila , Akhtar Nasir 
Published: June 2021

Quantitative studies of Cr(VI)- thymoquinone complex have been performed by cyclic voltammetry. For this purpose glassy carbon, platinum and saturated calomel electrodes were used as working, auxiliary and reference electrodes, respectively. The effects of concentrations and metal-ligand ratios on Cr(VI)- thymoquinone complex were investigated. Effect of concentration was found to follow Randles-Sevcik equation. Calibration curve method with linear regression line confirms that cyclic voltammetry can be used for quantification of Cr(VI)-thymoquinone complex for pharmaceutical assay. Complete complex formation seems to occur at metal ligand ratio 1:1. Results indicate quasi-reversible electron transfermechanism. E° and diffusion coefficient of complex at different concentrations and metal ligand ratios were also calculated and found to be 0.244±0.01 V and 3.45´10-5 cm2s-1, respectively. The values of transfer coefficients, a and b, were found to be 0.716±0.02-1.231±0.01 and 0.814±0.01-0.906±0.01, respectively.
Effect of Storage on Physicochemical Characteristics of Some Selected Vegetable Oils
Authors: Karim Zahida , Ikram Farhat , Karim Aneela , Khan Khalid Mohammed 
Published: June 2021

The quality of fats and oils is analysed by several physical and chemical parameters that are dependent on the source of oil as well as processing and storage conditions. In the present study, refractive index, peroxide, saponification, and acid values of different branded and unbranded vegetable oils were determined. Storage stability of oil samples were investigated and fastest deterioration was observed when samples were exposed to day light. UV radiations also caused oxidative damage, as indicated by the increased peroxide values for the samples exposed to UV radiations for 0, 5 and 10 min, respectively. Direct sunlight and UV rays are particularly found responsible for the degradation of oil quality.
Drinking Water Quality in Urban Areas of Pakistan: A Case Study of Gujranwala City
Authors: Haydar Sajjad , Nadeem Obaidullah , Hussain Ghulam , Rashid Haroon , Majeed Rashid 
Published: June 2021

A study was conducted to evaluate the drinking water quality of Gujranwala city. Samples were collected from 16 locations including: 4 tube wells, 4 overhead reservoirs (OHR) and 8 house connections. Twelve physicochemical and two bacteriological parameters were tested, before and after monsoon and compared with National Standards for Drinking Water Quality (NSDWQ). The results demonstrated that most of the physicochemical parameters, except lead, nickle and chromium were within NSDWQ before and after monsoon. Bacteriological and heavy metal contamination was found before and after the monsoon. Possible reasons of contamination are: no disinfection, old and leaking water pipes, poor drainage duringmonsoon and possible cross connections between water and sewerage lines. It is recommended to practice disinfection, laying of water and sewerage pipes on opposite sides of streets and periodic water quality monitoring.
Ambient Air Quality of Karachi City as Reflected by Atmospheric Particulate Matter (PM10) Concentrations
Authors: Hashmi Durdana Rais , Shareef Akhtar 
Published: June 2021

The present study examines the variation of ambient aerosol (PM10) concentrations in Karachi, city. Samples were collected from ten different locations, representative of urban background, residential, traffic and industrial areas from 2007 to 2011. At each location, PM10 was measured continuously from 08:00 am to 06:00 pm at local time. The maximum 10 h average particulate matter (PM10) mass concentrations were found at Tibet Centre (440.1mg/m3) and minimum at PCSIR Campus (21.7mg/m3) during 2008. A rising trend during 2008 may be due to the civil works for bridges and extension of roads at different locations in Karachi. The results also suggest that urban traffic and industrial areas appeared to have higher PM10 concentration than residential and background areas.
THE USE OF PROJECT BASED LEARNING AND PEER ASSESSMENT TO IMPROVE STUDENTS’ SPEAKING SKILL FOR YOUNG LEARNERS
Authors: Endah Widyastuti Dwi 
Published: June 2021

Project Based Learning is a learning method to encourage knowledge building through collaborative learning and usually integrated with real world concerns. Peer Assessment is an effective way to may help learners reflect on their own project work and improve their speaking skill. In addition the peer-assessment is useful as guidance for the students’ projects. This research aimed to find out the impact of project based learning and peer assessment learning to improve students’speaking skill and the benefits of PBL and Peer Assessment. This research was conducted at the seventh grade of SMPN 2 Babelan-Bekasi, from 12 September until 10 October 2017. It involved only one class is the students of VII.1 in SMPN 2 Babelan-Bekasi. This class consists of 30 students with 17 females and 13 males. This research was a classroom action research that consist of three cycles. Each cycles has four steps, they are; planning, acting, observing and reflecting. The researcher answered the research questions by using four instruments such as observation, interview, test and questionnaire. The results of this research revealed that first, PBL and Peer Assessment could improve students` speaking skill. Second, talked a lot, they were participating each other, it motivated them to speak more, to be an enthusiasm and to be independent learner. Besides, the number of errors in speaking components was significantly decreased after they were encouraged to assess by peer. Based on the theories and previous studies, it can be concluded that there were positive effects; the peer assessment which apply in Project Based Learning (PBL) has positive in teaching speaking. Peer assessment helped the students in speaking English and peer corrective about their performance, so it built their motivation in developing of speaking skill.