bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anomalous origin of the left coronary artery from the pulmonary artery: A rare congenital cardiac anomaly masquerading as dilated cardiomyopathy
Authors: Riyaz Anisa , Bhargawa Rashi , Kumar Sneha 
Published: January 2024

ABSTRACT
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a cardiac anomaly which is quite complex and very rarely diagnosed. It can, however, have serious consequences for the patient. It has been divided into two types based on the age of presentation: the infant type and the adult type with different presentations and prognoses. The infant type usually presents with congestive heart failure or sometimes as myocardial infarction. Many of these patients do not make it beyond 1st year of life. The rare adult variant of ALCAPA syndrome may manifest as recurrent chest infections in the pediatric age group, dyspnea on exertion, or sometimes, even as sudden cardiac death. We report the case of a 7-year-old girl who presented with recurrent chest infections and echocardiography (ECG) was suggestive of dilated cardiomyopathy. The definitive diagnosis of ALCAPA was reached only by ECG-gated cardiac computed tomography.
Breaking the mold: Unveiling male breast cancer through a compelling case study
Authors: Singh Swati , Butt Hina Kausar , Tyagi Mayurika Subodhkumar , Dhandayuthapani Sivanesan , Gulati Priyanka 
Published: January 2024

ABSTRACT
Breast cancer in men is rare, it represents <1% of all male cancers, it usually presents between the ages of 60 and 70 years with an age peak at 67 years. Unlike in women, where screening studies are performed, in men, it is usually diagnosed later, because the low incidence of this cancer in male patients and the absence of early signs and symptoms lead to a delayed search for medical attention. Even though more data is emerging about this disease, the poor level of awareness often results in late presentation and delayed diagnosis in our country. The present study reported the case of a 63-year-old man who presented in the outpatient department with a large breast lump and a short history of 2 months; he was diagnosed on fine-needle aspiration cytology with an invasive ductal carcinoma. The case is presented for the rarity and to discuss awareness, regarding early diagnosis, and proper management.
Case report – A rare syndromic association (Goldenhar syndrome)
Authors: Bhargava Rashi , Riyaz Anisa , Anand Aarti , Sharma Yashika 
Published: January 2024

ABSTRACT
Goldenhar syndrome is a diverse and poorly understood continuum of disorders of unknown etiology. It is a complex of developmental disorders (face, ears, eyes, spine, etc.), varying in severity in each patient. The estimated incidence of the syndrome ranges from 1 in 3500 to 5600 live births. The male-to-female ratio is approximately 3:2. Most cases of Goldenhar syndrome occur sporadically, although several case reports have documented occurrences in successive generations that require consideration of autosomal recessive, dominant, or multifactorial inheritance. Since there are other syndromes with similar features, there is still confusion regarding which cases should be classified specifically as Goldenhar syndrome. Goldenhar syndrome is a malformation complex of varying severity, involving the structures arising from the first and second branchial arches, the first pharyngeal pouch, the first branchial cleft and the primordia of the temporal bone. We are presenting a rare case of 2 ½ months old male, with asymmetry of the frontonasal area, left auricle anotia, preauricular tags, epicanthus, and left facial nerve palsy. The child had thoracic hemivertebra and fused right ectopic kidney on left side with grade IV VUR. The child had H type trachea esophageal fistula which was confirmed on CT thorax which was a cause of recurrent chest infections in child.
Developing and Validating a Qualitative Tool for Playtesting Service Learning-Based Accessible Games: A Comprehensive Approach
Authors: Neves Jose Carlos , Sousa Carla , Casimirio Catia 
Published: January 2024

INTRODUCTION: The complex accessibility needs of some players and, in particular, of people with Intellectual Disability (pwID) require greater attention from research due to the lack of tools to support playtesting, particularly those of a qualitative nature and suited to their diversity of experiences and motor and cognitive characteristics.
OBJECTIVES: Recognizing the scarcity of research in media production, particularly games, the study pursues three objectives: firstly, to describe the accessible games developed through a multi-year service learning project involving students from the Videogames Bachelor’s Degree and pwID; secondly, to approach the validation of the Gaming Observation Grid (GOG), a qualitative tool for playtesting sessions; and thirdly, to reflect on service learning as a strategy for bridging the gap between academia and civil society in the context of game design.
METHODS: The research employed a qualitative media ethnography-based approach involving students from the Videogames Bachelor's Degree. Over a span of three years and six consecutive semesters, 59 students actively participated in a service learning project, engaging with pwID and Non-Governmental Organizations (NGOs) in the field. All playtesting activities’ observations were based on GOG, with a total of 273 observed gaming sessions.
RESULTS: The development of 18 videogames, spanning diverse genres and themes, prioritized accessibility based on adjustment settings. GOG emerged as a tailored and feasible instrument, valuable in the broader landscape of inclusive game development. In terms of service-learning outcomes, results highlight students' reflections on the real-world impact of game design and development, underscoring the pedagogical value of service learning in bridging theoretical knowledge and practical application.
CONCLUSION: This study underscores the critical need for enhanced research attention to the complex accessibility requirements of players, particularly pw ID, while emphasizing the relevance of qualitative playtesting tools tailored to their diverse experiences and cognitive-motor characteristics, as well as the inherent value of the experience for the students involved.
Safety and efficacy of modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension
Authors: Zeng Yan , Yang Jian , Zhang Jun-Wen 
Published: January 2024

BACKGROUND
Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension (LSPH). The hemorrhage is fatal and requires safe and effective interventions.
AIM
To evaluate the clinical safety and efficacy of modified endoscopic ultrasound (EUS)-guided selective N-butyl-2-cyanoacrylate (NBC) injections for gastric variceal hemorrhage in LSPH.
METHODS
A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted. Preoperative EUS evaluations were performed. Enrolled patients were divided into modified and conventional groups according to the NBC injection technique. The final selection of NBC injection technique depended on the patients’ preferences and clinical status. The technical and clinical success rates, operation time, NBC doses, perioperative complications, postoperative hospital stay, and recurrent bleeding rates were analyzed, respectively.
RESULTS
A total of 27 patients were enrolled. No statistically significant differences were observed between the two groups regarding baseline characteristics. In comparison to patients in the conventional group, patients in the modified group demonstrated significantly reduced NBC doses (2.0 ± 0.6 mL vs 3.1 ± 1.0 mL; P = 0.004) and increased endoscopic operation time (71.9 ± 11.9 min vs 22.5 ± 6.7 min; P < 0.001). Meanwhile, the two groups had no significant difference in the technical and clinical success rates, perioperative complications, postoperative hospital stay, and recurrent bleeding rates.
CONCLUSION
Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage, with advantages of reduced injection dose and no radiation risk. Drawbacks were time consumption and technical challenge.
Effect of a phthalimide pesticide on human peripheral blood lymphocytes in vitro: induction of DNA damage
Authors: Tsareva Anastasiya A. , Ignatyev Semen D. , Egorova Olga V. , Kotnova Alina P. , Averianova Natalya S. , Ilyushina Nataliya A. 
Published: January 2024

Introduction. Captan is a contact fungicide from the phthalimide class, used in agriculture to combat plant diseases. However, the question of its genotoxicity for humans remains open. Various studies examining the mutagenic activity of captan using different tests have yielded conflicting results. This study aims to investigate the potential of captan to induce DNA damage in human peripheral blood lymphocytes in vitro using single-cell alkaline gel electrophoresis.
Material and methods. The DNA-damaging effect of captan (0; 2.5; 5.0; 10.0; 12.5 and 25 μg/ml) on lymphocytes of 26 donors was assessed with metabolic activation (+S9) and without it (–S9) using DNA comet analysis.
Results. In the absence of metabolic activation, captan exhibited a pronounced genotoxic effect on cells. Statistically significant effects of captan was found on lymphocytes of all donors. The level of DNA-damaging effect on lymphocytes from 20 out of 26 donors depended on the concentration. The fold increase in the “%DNA in the tail of comets” indicator compared to the negative control at a concentration of 25 μg/ml varied in the range of 4,3–226 times. In the presence of the S9 mixture, weak but significant effects meeting the criteria for a positive response were detected only in three donors.
Limitations. The genotoxicity of captan was studied only in vitro.
Conclusion. Captan induces DNA damage in human peripheral blood lymphocytes in vitro in the absence of metabolic activation. Under conditions of metabolic activation, genotoxic effects were low. The levels of DNA damage in peripheral blood lymphocytes of different donors after exposure to captan varied markedly, indicating the necessity to consider individual sensitivity to genotoxicants when utilizing the DNA comet method to assess the potential mutagenic activity of chemicals.
Students’ Ability and Difficulties in Writing at the Tenth Grade
Authors: LLubis Lollo Rosa , Afri Evan 
Published: January 2024

The tenth-grade students in Indonesia had difficulties in writing and this was the background in conducting the study. EFL Indonesia was one of the factors why students in EFL Indonesia had difficulties in writing. There were some indicators to determine students’ ability in writing. This study used five indicators which included content, organization, grammar, vocabulary and style & quality. The approach of the research used a mixed method (combined quantitative and qualitative data). Quantitative data was collected by using a test sheet. This instrument was used to measure students’ ability in writing. Furthermore, qualitative data was collected by interview. This instrument was used to describe students’ difficulties in writing. The subjects of the research consist of 20 students of High School and they were taken by using a random sampling technique. After collecting the data, quantitative data (test sheet) showed an average of 50.7. This score was an unacceptable-not category (below average). Furthermore, the students’ difficulties in writing included internal factors and external factors. The first factors included the lack of organization, developing ideas, grammar, and vocabulary. Meanwhile, the second factor included English learning time was being very short, daily life, and inaccurate curriculum in learning writing.
HUBUNGAN ANTARA KUALITAS PELAYANAN DENGAN LOYALITAS PASIEN DI POLI BEDAH RSUD dr. R. KOESMA TUBAN
Authors: Lukman Hakim  , Hyan Oktodia Basuki  , Mokhamad Nurhadi  
Published: January 2024

Loyalty patient is a patient's willingness to re-use the health care services provided by the hospitals or health clinics. Loyalty patients can occur due to several factors such as good quality service. Therefore, the study aims to determine the correlation between service quality and loyalty of the patients at the surgical departement of RSUD dr. R. Koesma Tuban. The research used a correlational design with cross-sectional approach involving 71 respondents drawn by accidental sampling technique. Data was taken from the questionnaire. Data were analyzed with the contingensi coefficient test. The result showed most respondents have assumed that the hospital by has intermediate (63,4%) and most of the respondents have less loyalty, there are 46.5%. SPSS results showed that H1 is accepted, so there is a correlation between service quality and loyalty of patients ( ρ = 0.000, which obtained a significant value ≤ 0.005). It can be concluded that there is a correlation between service quality and patient loyalty. The description above can be concluded that service quality can affect patient loyalty. Therefore, it is expected the hospital can increase the ISO (International Organization for Standardization) for the sake of good quality and patient satisfaction for the hospital’s income in the future.
THE EFFECTIVENESS OF HEALTH EDUCATION PEER EDUCATION METHOD USING AUDIO VISUAL MEDIA ON TEENAGERS' UNDERSTANDING OF SEX EDUCATION CLASS 11 SMAN 1 Boyolangu Tulungagung
Authors: Ria Anggraini  , Berlian Yuli Saputri  , Ketjuk Herminaju  , Dewi Zuniawati  
Published: January 2024

Free sex is one of the problems of lack of sex education and some of the problems that can result from casual sex in adolescents in the short term include KTD (unwanted pregnancy), abortion, and STDs (Sexually transmitted diseases). This study was conducted from February 20 until March 20, 2023, and aims to see the Effectiveness of Health Education Peer Education Method with Audio Visual Media on Adolescent Understanding of ''Sex Education'' Grade 11 SMAN 1 Boyolangu Tulungagung in 2023. The research design used in this study quasy experimental with Non-equivalent Control Group Design (Pretest Posttest) The population in this study was all grade XI students of SMAN 1 Boyolangu. While the number of research samples was 82 respondents selected using the Purposive Sampling method. Data processing in the form of editing, coding, tabulating, cleaning, and then analyzing data using non-parametric Wilcoxon sign rank test & Mann – Whitney. From the Wilcoxon Test, both methods show that a significant value p = 0.000 < a (0.05), so H1 is accepted meaning that there is an Effect of Health Counseling. From the results of the Mann - Whitney Test, the Mean Rank of the Peer Education method was obtained with a value of 35.43. And the Mean Rank of the audio-visual method with a value of 47.57. It is known that the Mean Rank of the Audio Visual Method is higher than the Peer Education method. The Mann-Whitney test shows a significance value of p= 0.019. So that H1 is accepted, which means that there is an Effectiveness of Health Counseling with Peer Education and Audio Visual Methods. It can be concluded that the audio-visual method is more effective as a means of health counseling on the understanding of sex education in grade 11 adolescents at SMAN 1 Boyolangu Tulungagung in 2023. For this reason, the audio-visual method is recommended for health counseling to increase adolescent understanding of Sex Education.
Keywords: Free Sex; Health Education; Tee
HUBUNGAN ANTARA SELF EFICACY DENGAN KINERJA PERAWAT DALAM MELAKSANAKAN ASUHAN KEPERAWATAN DI RUANG RAWAT INAP RSUD dr. R. KOESMA TUBAN
Authors: Tiara Putri Ryandini  , Mokhamad Nurhadi  
Published: January 2024

Self-efficacy is a sense of confidence in oneself that individuals can face the problems that are being experienced and can provide positive results. Performance is the successful completion of a task or meeting a set target. This study aims to determine the relationship between Self Efficacy with the performance of nurses in carrying out nursing care in the hospital dr. R. Koesma Tuban. This type of research is correlational using a cross-sectional time approach with a population of 39 nurses selected by cluster random sampling technique of as many as 36 nurses. The independent variable is self-efficacy and the dependent is the performance of nurses in carrying out nursing care measured using the Spearmen correlation test. The results of the study were conducted after the analysis using the Spearmen correlation test with significance level ρ = ≤ 0.05. The results of the study on the relationship between self-efficacy with the performance of nurses in implementing nursing care proved that p = 0.000 indicates the value of ρ < ɑ (0.04 < 0.05) which means H1 is accepted that there is a relationship between Self Efficacy with the performance of nurses in implementing nursing care in inpatient hospital dr. R. Koesma Tuban, with a correlation value of 0.468, which is a strong correlation with a positive direction. from the description above it can be concluded that the relationship between Self Efficacy with the performance of nurses in carrying out nursing care in the inpatient hospital dr. R. Koesma Tuban .
Keywords: Implementing Nursing Care, Nurse Performance, Self Efficacy
Analysis of Breakfast Nutrients and Student Study Concentration
Authors: Mawarni Elita Endah , Yuli Fitria  , Fany Anitarini  
Published: January 2024

One of the main targets of the Sustainable Development Goals (SDGs) program in 2030 is related to the development of Indonesian children, where Indonesian children are human resources whose welfare and intelligence must be improved. To support intelligence, concentration is needed in every learning process. The aim is to analyze the relationship between the habit of consuming nutrients in the breakfast menu with learning concentration. The method in this study is Cross-Sectional, with the population being students of the class of 2020 at a private university located in the city of Banyuwangi. Using the purposive sampling technique, the number of respondents was 115 students. Data retrieval of students' food consumption to see the level of nutritional adequacy of breakfast was obtained through data records of breakfast on the day of the test. Learning concentration was measured using the Digit Symbol Substitution Test (DSST) instrument. In addition, data on breakfast habits was obtained by filling out a questionnaire. The statistical test used in this study was the Pearson Chi-Square which was analyzed by the formula, using ρ 0,05. The study showed that most of the subjects had a regular breakfast habit (70%) and before 09.00 am (74.7%). The learning concentration of most of the subjects (64.5%) was classified as good. From the results of the Pearson Chi-Square statistical analysis, it was obtained. There is a significant relationship between the level of energy adequacy (r count = 6,594, r table = 5,991), and protein (r count = 7,874, r table = 5,991), with learning concentration. There is no significant relationship between the level of nutritional adequacy of fat and carbohydrates in the breakfast menu with learning concentration (r count < 5.991).
Keywords: Breakfast Nutrients, Learning concentration, Student
Practitioner Burnout and Productivity Levels in Skilled Nursing and Assisted Living Facilities, Part 1: A Descriptive Quantitative Account
Authors: Coleman Ashley , McLaughlin Ellen , Floren Michael 
Published: January 2024

Abstract
Importance: Understanding burnout among practitioners in skilled nursing facilities (SNFs) and assisted living facilities (ALFs) while considering contextual factors may lead to practices that enhance therapist and patient satisfaction as well as quality of care.
Objective: To examine productivity standards and burnout in the context of setting and role, as reported by therapy practitioners in geriatric settings, and to explore relationships between productivity standards and perceived ethical pressures.
Design: Cross-sectional online survey with descriptive data.
Participants: Practitioners (N = 366) included occupational therapists, physical therapists, speech-language pathologists, and occupational and physical therapy assistants working in SNFs and ALFs in the United States. A survey integrating the Maslach Burnout Inventory: Human Services Survey for Medical Personnel (MBI–HSS) and questions addressing demographics and contextual factors was distributed via social media.
Results: Of 366 practitioners, 20.5% were burned out, exhibiting extreme scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) on the MBI–HSS. Significant relationships between productivity requirements and EE, DP, and PA, after accounting for covariates, were evident. Significant relationships between productivity standards and five of the six ethically questionable behaviors existed. Role affected productivity requirements, specifically between therapists and assistants, whereas setting did not.
Conclusions and Relevance: Productivity standards and related pressures are associated with concerning aspects of burnout among practitioners working in geriatric settings. Advocating for change in defining productivity and incorporating positive support in the work environment may assist in reducing burnout and turnover rates and improve patient satisfaction and care.
Plain-Language Summary: This research highlights the prevalence of burnout and perceived pressures related to productivity requirements among occupational therapy practitioners working in skilled nursing and assisted living facilities.
COMPREHENSIVE REVIEW OF AGILE METHODOLOGIES IN PROJECT MANAGEMENT
Authors: Emmanuel Chibuike Daraojimba  , Chinedu Nnamdi Nwasike  , Abimbola Oluwatoyin Adegbite  , Chinedu Alex Ezeigweneme  , Joachim Osheyor Gidiagba  
Published: January 2024

This comprehensive review paper delves into the application and impact of Agile methodologies in the realm of project management. Agile methodologies, initially rooted in software development, have gained widespread acceptance across various industries due to their flexibility, adaptability, and customer-centric approach. The primary objective of this review is to synthesize the current body of knowledge on Agile methodologies, highlighting their evolution, principles, and diverse applications in project management. The methodology of this review involves a systematic analysis of existing literature, encompassing peer-reviewed journals, industry reports, and case studies. This approach ensures a holistic understanding of Agile methodologies, encompassing both theoretical frameworks and practical implementations. The review categorizes Agile methodologies, such as Scrum, Kanban, and Lean, and examines their unique features and contexts of application. Key findings indicate that agile methodologies significantly enhance project performance, particularly in dynamic and uncertain environments. They foster greater collaboration, continuous improvement, and customer satisfaction. However, challenges such as resistance to change, lack of skilled personnel, and difficulties in scaling Agile practices are also identified. The review concludes that while Agile methodologies offer substantial benefits in project management, their successful implementation requires a cultural shift within organizations, adequate training, and a nuanced understanding of when and how to apply these methodologies. Future research directions include exploring the integration of Agile with traditional project management approaches and its impact on organizational performance in various sectors.
Keywords: Agile Methodologies, Project Management, Industry Adaptation, Scalability, Technological Advancements, Global Economic Shifts, Artificial Intelligence (AI).