bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated Scalp Hematoma
Authors: Ghorui Arnab , Kumar Chandra Mohan , Banerjee Amrita 
Published: August 2023

Background:
Congenital fibrinogen disorder is a rare autosomal recessive blood coagulation disorder, where majority of patients present with bleeding, whereas a few may paradoxically develop thrombosis. While many of the affected children have prolonged umbilical cord bleeding during the neonatal period, manifestations may go unnoticed till adolescence. We describe such a child with congenital afibrinogenemia

Clinical Description:
A 12-year-old boy presented with painless diffuse scalp swelling for 2 weeks without any antecedent history of trauma, hemarthrosis, muscle hematoma, or any skin bleed, except a history of prolonged bleeding post trauma since toddler age. Examination revealed diffuse, boggy, nonpulsatile swelling over the entire scalp, more prominent on the right side, without any focal neurological deficit. A noncontrast computed tomography head showed a scalp hematoma without any intracranial bleeding. Blood investigations revealed extremely elevated prothrombin time (PT) and activated partial thromboplastin time (aPTT) with normal platelet counts and normal platelet morphology on peripheral smear. A detailed coagulation work-up revealed an extremely high thrombin time and an almost undetectable Factor I (fibrinogen) level. Genetic analysis revealed a homozygous single-base pair deletion in exon 5 of the fibrinogen gene of alpha chain, thus confirming the diagnosis of congenital afibrinogenemia.

Management:
The child was managed with multiple fresh frozen plasma transfusions and serial PT/aPTT monitoring. Once PT and aPTT were normalized, transfusions were discontinued. The child is currently on regular follow-up maintaining a fibrinogen level of more than 0.5 g/L. Genetic counseling was done for the family.

Conclusion:
Congenital afibrinogenemia may be detected late in adolescence with atypical bleeding manifestations. Awareness of this entity may help the physician to suspect this disease. Early and appropriate investigations can be conducted to identify the condition, so that appropriate management can be initiated.
Psychiatric comorbidity in patients with migraine: A standardized interview-based study
Authors: Sharma Preeti , Kumar Santosh , Dixit Vidhata , Sharma Chandra Shekhar , Chaudhury Suprakash 
Published: August 2023

Background:
Comorbidity of various psychiatric conditions with migraine is common and important. A thorough analysis of mental conditions in migraine is essential to encourage the holistic care of such patients.

Aim:
To assess psychiatric comorbidity in patients with migraine using a well-standardized clinical diagnostic tool.

Methods:
This cross-sectional study was conducted in the outpatient department of a tertiary care hospital in North India. Persons with migraine attending the facility were enrolled as per the inclusion and exclusion criteria set for this study. The ICD-10 mental disorder symptom checklist was the principal tool to assess the psychiatric comorbidity in the patients.

Results:
Total Patients recruited were 146 out of which 70.5% had a psychiatric comorbidity. Depressive disorder (17.1%) was the most common while delusional disorder (4.1%) was the least common psychiatric disorder comorbid with migraine. Other comorbid psychiatric diagnoses were recurrent depressive episodes (6.8%), dysthymia (10.3%), bipolar affective disorder (7.5%), panic disorder (5.5%), generalized anxiety disorder (8.2%), mixed and other anxiety disorders (6.2%), obsessive-compulsive disorder (6.2%), post-traumatic stress disorder (4.8%), adjustment disorders (5.5%), dissociative (conversion) disorders (6.8%), and somatoform disorders (6.2%). Lower socioeconomic status and the presence of aura with migraine are two important patient-related factors linked with the occurrence of any psychiatric comorbidity in migraine.

Conclusion:
The prevalence of comorbid psychiatric disorders in migraine patients is very high. The relationship between demographic and medical information of people with migraine with individual psychiatric comorbidities is complex.
Co-Infection between Dengue Virus and SARS-CoV-2 in Cali, Colombia
Authors: Agudelo-Rojas Olga Lucia , Rebellón-Sánchez David Esteban , Llanos Torres Julio , Zapata-Vásquez Isabel Lucia , Rodríguez Sarita , Robles-Castillo Sebastián , Tejada Vega Alejandro , Parra-Lara Luis Gabriel , Rosso Fernando 
Published: August 2023

ABSTRACT.
The co-occurrence of COVID-19 with endemic diseases is a public health concern that may affect patient prognosis and outcomes. The objective of this study was to describe the clinical characteristics of patients with dengue virus (DENV) and SARS-CoV-2 co-infections and compare their outcomes against those of COVID-19 patients without dengue. A cross-sectional study was conducted in patients with SARS-CoV-2 infection who attended a single center in Cali, Colombia, from March 2020 to March 2021. All patients who were tested by both real-time polymerase chain reaction for SARS-CoV-2 and IgM/NS1 for DENV were included. Dengue was diagnosed as having either an IgM- or an NS1- positive test. A total of 90 patients were included (72 with COVID-19 only and 18 with co-infection). Patients with co-infection had more dyspnea (61.1% versus 22.2%; P = 0.003) as well as higher oxygen desaturation (53.3% versus 13.4%; P = 0.002) and neutrophil-to-lymphocyte ratio (5.59 versus 3.84; P = 0.038) than patients with COVID-19 alone. The proportion of patients classified with moderate to severe COVID-19 was higher in the co-infection group (88.3% versus 47.8%; P = 0.002). Also, co-infection was associated with an increased need for mechanical ventilation (P = 0.06), intensive care unit (ICU) initial management (P = 0.02), and ICU admission during hospitalization (P = 0.04) compared with COVID-19 only. The ICU mortality rate was 66.6% in patients with co-infection versus 29.4% in patients infected with only SARS-CoV-2 (P < 0.05). The possibility of DENV and SARS-CoV2 co-infection occurred in the convergence of both epidemic waves. Co-infection was associated with worse clinical outcomes and higher mortality in ICU-admitted patients than in patients with the COVID-19 only.
Area-Based Sociodemographic Factors Associated with Latent Tuberculosis Infection in a Low-Prevalence Setting
Authors: Campbell Jeffrey I. , Tabatneck Mary , Wilt Grete E. , Sun Mingwei , He Wei , Musinguzi Nicholas , Hedt-Gauthier Bethany , Lamb Gabriella S. , Goldmann Don , Sabharwal Vishakha , Sandora Thomas J. , Haberer Jessica E. 
Published: August 2023

ABSTRACT.
Area-based sociodemographic markers, such as census tract foreign-born population, have been used to identify individuals and communities with a high risk for tuberculosis (TB) infection in the United States. However, these markers have not been evaluated as independent risk factors for TB infection in children. We evaluated associations between census tract poverty, crowding, foreign-born population, and the CDC’s Social Vulnerability Index (CDC-SVI) ranking and TB infection in a population of children tested for TB infection in Boston, Massachusetts. After adjustment for age, crowding, and foreign-born percentage, increasing census tract poverty was associated with increased odds of TB infection (adjusted odds ratio [aOR] per 10% increase in population proportion living in poverty: 1.20 [95% CI, 1.04–1.40]; P = 0.01), although this association was attenuated after further adjustment for preferred language. In separate models, increasing CDC-SVI ranking was associated with increased odds of TB infection, including after adjustment for age and language preference (aOR per 10-point increase in CDC-SVI rank: 1.08 [95% CI, 1.02–1.15]; P = 0.01). Our findings suggest area-based sociodemographic factors may be valuable for characterizing TB infection risk and defining the social ecology of pediatric TB infection in low-burden settings.
Mosquito Repellent Efficacy of Australian Blue Cypress Callitris intratropica Essential Oil and a Topical Formulation under Laboratory and Field Conditions
Authors: Koinari Melanie , Amos Brogan , Townsend Michael , Karl Stephan 
Published: August 2023

ABSTRACT.
Mosquito repellents are important for personal protection against nuisance and potentially infectious mosquito bites. Repellent activity of Australian blue cypress essential oil (EO) and a commercially formulated skin lotion containing blue cypress EO (topical formulation) were compared with 20% DEET (N, N-diethyl-3 toluamide) against mosquitoes under laboratory and field conditions in North Queensland, Australia. On a volunteer’s forearm, 1 mL of candidate material was applied to approximately 600 cm2 of exposed skin. When blue cypress EO was applied at various concentrations (0.5%–10.5%), it did not fully prevent mosquito landing or biting. However, a dose–dependent increase, approaching 80% protection, was observed at high EO concentrations. On the basis of these results, three concentrations (5%, 10%, and 20%) of blue cypress EO were selected for complete protection time (CPT) experiments. Topical formulation (undiluted) was also included in CPT experiments. Although some protection was afforded, mosquito landing/probing were still recorded immediately after application for both blue cypress EO and its topical formulation. Specifically, protection declined for blue cypress EO from 80% to 70% (laboratory) and from 93% to 50% (field) within 1 hour. For topical formulation, protection declined from 85% to 75% in the laboratory and from 63% to 50% in the field. In comparison, DEET maintained a 100% protection throughout the testing period of up to 1 h, and there was no landing/probing observed in volunteers who had applied DEET. To conclude, both blue cypress products provided some protection against mosquito bites, which decreased soon after application.
Inpatient Morbidity and Mortality of Severely Underweight Children Was Comparable to That of Severely Wasted Children in Dhaka, Bangladesh
Authors: Islam Md Ridwan , Nuzhat Sharika , Alam Jinat , Huq Sayeeda , Chisti Mohammod Jobayer , Ahmed Tahmeed 
Published: August 2023

ABSTRACT.
Both wasting and undernutrition are responsible for multiple morbidities and increased mortality in younger children hospitalized for acute illnesses. The question of whether children who are suffering from severe underweight are as vulnerable as children suffering from severe wasting needs to be researched further. We aimed to compare the morbidity and mortality of severely underweight but not severely wasted (SU-nSW) children with that of severely wasted (SW) children admitted to inpatient wards of a hospital. Data from 12,894 children aged < 5 years were collected using cross-sectional methods from Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh between March 2019 and December 2021. After exclusion of non-desired populations (N = 8,834), comparisons between SU-nSW (N = 1,876) and SW (N = 2,184) children were observed. The risk of morbidities and mortality among SU-nSW and SW children was analyzed after adjusting for age and sex. Inpatient morbidities were mostly similar among children with sepsis (adjusted odds ratio [aOR]: 0.90; 95% CI: 0.69, 1.19; P = 0.472) and convulsions (aOR: 0.84; 95% CI: 0.51, 1.37; P = 0.475). Dehydration (aOR: 0.71; 95% CI: 0.62, 0.81; P < 0.001) and hypokalemia (aOR: 0.58; 95% CI: 0.42, 0.79; P = 0.001) were more likely associated with SW children than with SU-nSW children. Pneumonia/severe pneumonia was more likely to affect SU-nSW children (aOR: 1.24; 95% CI: 1.02, 1.48; P = 0.018). Death was comparable between the two groups (aOR: 1.32; 95% CI: 0.70, 2.49; P = 0.386). This study underscores the importance of implementing present treatment guidelines for severe acute malnutrition in the facility-based management of severely underweight children as well.
Impacts of the COVID-19 Lockdown on Healthcare Inaccessibility and Unaffordability in Uganda
Authors: Bose Bijetri , Alam Shamma A. , Pörtner Claus C. 
Published: August 2023

ABSTRACT.
Several studies have reported adverse consequences of the COVID-19 lockdowns on the utilization of healthcare services across Africa. However, little is known about the channels through which lockdowns impacted healthcare utilization. This study focuses on unaffordability as a reason for not utilizing healthcare services. We estimate the causal impacts of the COVID-19 lockdown on healthcare inaccessibility and affordability in Uganda relative to the nonlockdown periods of the pandemic. We use nationally representative longitudinal household data and a household fixed-effects model to identify the impact of the lockdown on whether households could not access medical treatment and whether the reason for not getting care was the lack of money. We find that the lockdown in Uganda was associated with an 8.4% higher likelihood of respondents being unable to access healthcare when treatment was needed relative to the nonlockdown periods. This implies a 122% increase in the share of respondents unable to access healthcare. As lockdown restrictions eased, the likelihood of being unable to access medical treatment decreased. The main reason for the increase in inaccessibility was the lack of money, with a 71% increase in the likelihood of respondents being unable to afford treatment. We find little evidence that the effects of the lockdown differed by wealth status or area of residence. Our results indicate the need for policymakers to consider immediate social support for households as a strategy for balancing the disruptions caused by lockdowns.
THE BLENDED LEARNING: THE TENTH GRADERS’ PERCEPTION OF FACE-TO-FACE AND ONLINE EFL LESSON AT SMAN 4 TARAKAN
Authors: Muliawaty Wandha , Errie Diru Achmad , Arifin Arifin , Ulfaika Romlah 
Published: August 2023

The objective of this research is to obtain perceptions from the tenth-grade students of SMAN 4 Tarakan which is undergoing blended learning. This study used a quantitative approach with a survey method. The subject of the research was 36 students of X-4 at SMAN 4 Tarakan. The data collected was a closed questioner using Likert scale. The results showed that more students admit that they are more motivated and perform better when taking EFL class that are conducted face-to-face. This is in line with the results of the study which showed that in terms of motivation, students were categorized as very motivated when doing face-to-face learning for the EFL class. In addition, students are also categorized as very good in terms of achievements when participating in EFL class which are conducted face-to-face. So it can be concluded that students prefer and need face-to-face learning more than online learning in English class.
PENINGKATAN KETERAMPILAN PESERTA DIDIK DALAM MENULIS KARANGAN MELALUI PENGGUNAAN MEDIA FLIP CHART
Authors: Vilda Ghasya Dyoty Auliya 
Published: August 2023

A B S T R A K
Penggunaan media memiliki peran yang sangat penting untuk menyampaikan pesan dalam pembelajaran. Media flip chart dapat dipandang sebagi salah satu langkah alternatif dalam mengatasi permasalahan pembelajaran, terutama dalam melatih keterampilan menulis peserta didik pada jenjang sekolah dasar. Latar belakang penelitian ini di awali dari kesulitan yang dialami peserta didik kelas III di sekolah dasar dalam menulis karangan deskripsi di sekolah dasar. Tujuan dari penelitian ini adalah untuk mengetahui penggunaan media flip chart dalam pembelajaran menulis karangan deskripsi peserta didik di sekolah dasar. Adapun jenis penelitian ini merupakan penelitian tindakan kelas dengan mengadaptasi model spiral yang dikembangkan oleh Kemmis Mc Taggart dengan desain tiap siklusnya berupa perencanaan, pelaksanaan, pengamatan, dan refleksi. Teknik pengumpulan data yang digunakan dalam penelitian ini antara lain observasi, angket dan tes. Berdasarkan hasil penelitian yang telah dilakukan pada peserta didik kelas III sekolah dasar negeri 17 Pontianak Kota dapat disimpulkan bahwa media flip chart dapat meningkatkan keterampilan menulis karangan peserta didik di sekolah dasar. Adapun rekomendasi dari penelitian ini salah satunya adalah penggunaan beragam media dalam pembelajaran sangat dianjurkan untuk dapat membantu peran guru dalam membelajarkan peserta didik, khususnya dalam pembelajaran menulis.

A B S T R A C T
The use of media has a very important role to convey messages in learning. Flip chart media can be seen as an alternative step in overcoming learning problems, especially in training students' writing skills at the elementary school level. The background of this research begins with the difficulties experienced by third grade students in elementary school in writing descriptive essays in elementary school. The purpose of this study was to determine the use of flip chart media in learning to write descriptive essays for students in elementary schools. The type of this research is classroom action research by adapting the spiral model developed by Kemmis Mc Taggart with the design of each cycle in the form of planning, implementation, observation, and reflection. Data collection techniques used in this study include observation, questionnaires and tests. Based on the results of research that has been carried out on third grade students of State Elementary School 17 Pontianak City, it can be concluded that flip chart media can improve students' writing skills in elementary schools. The recommendations from this study, one of which is the use of various media in learning is highly recommended to be able to help the teacher's role in teaching students, especially in learning to write.
PENERAPAN ACTIVE LEARNING PADA PEMBELAJARAN IPA UNTUK MENINGKATKAN KEMANDIRIAN BELAJAR PESERTA DIDIK
Authors: Nelyza Fita , Ruslaini Ruslaini , Novika Trisnia 
Published: August 2023

The purpose of this study was to determine the Improvement of the Learning Independence of Class V Students of SD Negeri Kandang in Natural Science Learning on ecosystem materials through the Application of Active Learning. The sample in this study were all students in grade V SD Negeri Kandang, totalling 16 people consisting of 11 girls and 5 boys. The method used in this study was to calculate the percentage of the answers to the questionnaire. Data collection techniques consisted of observation, test, questionnaire. The results showed that the learning independence of Class V SD Negeri Kandang students in science subjects could be increased through the application of Active Learning learning strategies, this can be seen based on the evaluation results from meetings I and II that there was a change in the average value obtained. The pre-test is 68.1 and the post-test is 80.9. So the application of Active Learning in science learning can increase the learning independence of class V SD Negeri Kandang students.
Abstrak
Tujuan penelitian ini untuk mengetahui Peningkatan Kemandirian Belajar Peserta Didik Kelas V SD Negeri Kandang dalam Pembelajaran IPA materi ekosistem melalui Penerapan Pembelajaran Active Learning. Sampel dalam penelitian ini adalah seluruh peserta didik kelas V SD Negeri Kandang yang berjumlah 16 orang yang terdiri dari 11 perempuan dan 5 orang laki laki. Teknik pengumpulan data terdiri dari observasi, angket dan test. Hasil penelitian menunjukkan bahwa Kemandirian belajar peserta didik Kelas V SD Negeri Kandang pada mata pelajaran IPA dapat meningkat melalui penerapan strategi pembelajaran Active Learning, hal ini dapat diketahui berdasarkan hasil evaluasi dari pertemuan I dan II bahwa adanya perubahan nilai rata-rata yang diperoleh. Pada test awal (Pre-test) yaitu 68,1 dan pada test akhir (post-test) yaitu 80,9. Maka Penerapan Active Learning pada pembelajaran IPA dapat meningkatkan kemandirian belajar peserta didik kelas V SD Negeri Kandang.
Personalized 3D printed implants in the treatment of extensive chest wall tumors: clinical cases
Authors: Valiev A. K. , Kononets P. V. , Kharatishvili T. K. , Salkov A. G. , Petrochenko N. S. , Shin A.  R. , Sytov A. V. , Efimenko O. 
Published: August 2023

3D printing has opened new opportunities for the development of personalized systems for prosthetics of extensive chest wall defects after radical surgical interventions for malignant tumors. However, risk factors for an adverse outcome of such operations have not yet been identified.Clinical cases. A 65-year-old man with primary chondrosarcoma of the V rib, underwent surgical resection of three ribs, plasty with local tissues, and an individual 3D printed titanium implant was installed on the sternum and IV-VI ribs. Follow up for 26 months showed no complaints or signs of recurrence. A 52-year-old woman with radiation-induced soft tissue sarcoma of the chest wall, that developed 9 years after radiation for breast cancer, underwent resection of four ribs and pectoral muscles and a 3D printed titanium implant was installed on the sternum and II-V ribs. The operation was complicated by the marginal necrosis of the soft tissue flap and infection of the endoprosthesis, which required removal of the metal structure and reconstruction using TRAM flap. After 9 months, a local recurrence of the tumor was diagnosed. Discussion. As a factor of a positive outcome in a man should be noted a thick layer of subcutaneous fat with muscle tissue, due to which plastic surgery was performed, covering the defect without tension. An extensive resection of the pectoral muscles in a woman created a tissue deficit. Another factor of an unfavorable outcome can be considered the radio-induced nature of the sarcoma. Further research is needed to improve the strategy for selecting patients with malignant tumors of the chest wall for prosthetics.
HUBUNGAN JUMLAH ANAK DALAM KELUARGA DENGAN STATUS GIZI PADA BALITA DI DESA PANDANSARI KECAMATAN SENDURO KABUPATEN LUMAJANG
Authors: DEVID TRIO ISSADIKIN  
Published: August 2023

Status gizi merupakan ukuran keadaan tubuh seseorang yang dapat dilihat dari makanan yang dikonsumsi dan penggunaan zat gizi dalam tubuh. Status gizi yang baik dalam menjaga derajat kebugaran dan kesehatan, membantu tumbuh kembang anak.
Jumlah anak dalam keluarga adalah jumlah tanggungan anak dalam keluarga baik anak kandung, anak tiri maupun anak angkat yang tinggal bersama dalam satu tempat tinggal. Keluarga dengan dua orang anak memberikan kesempatan kepada anak untuk belajar berbagi, bergiliran dan menahan dorongan untuk mendapatkan perhatian orang tua dan sebaliknya orang tua dapat memberikan pendidikan dan perhatian yang memadai.
Sedangkan keluarga yang memiliki anak lebih dari dua memerlukan usaha yang lebih besar dan terkadang mengalami kesulitan menghadapi anak dengan berbagai karakter dan suasana hati yang berbeda-beda. Pada akhirnya orang tua tidak konsisten dalam melakukan pola asuh yang optimal.

Tujuan penelitian ini adalah menganalisis hubungan jumlah anak dalam keluarga dengan status gizi balita di Desa Pandansari Kecamatan Senduro Kabupaten Lumajang. Dalam penelitian ini, peneliti menggunakan uji korelasional dengan desain cross sectional. Pendekatan teknik pengambilan sampel yang digunakan peneliti adalah Multistage random sampling dengan jumlah sampel sebanyak 245 balita. Analisis data menggunakan Regresi Logistik. Hasil penelitian menunjukkan bahwa terdapat hubungan yang signifikan jumlah anak dalam keluarga dengan status gizi balita di Desa Pandansari Kecamatan Senduro Kabupaten Lumajang (p value = 0,000 < α = 0,05. Perawat dapat menerapkan perannya dalam melakukan peran edukasi tentang pentingnya nutrisi yang optimal pada bayi dan anggota keluarga lainnya, selain itu perawat juga memberikan edukasi tentang pentingnya membatasi jumlah anak dalam keluarga.