bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimization of trauma care to victims of older age groups with fractures of the proximal femur
Authors: Кучеев И.О. , Кабанов М.Ю. , Линник С.А. , Семенцов К.В. , Гуманенко Е.К. , Кондратьев И.П. , Цололо Я.Б. , Поликарпов А.В. 
Published: February 2023

Цель исследования - улучшение исходов лечения пациентов старших возрастных групп с переломами проксимального отдела бедренной кости (ППОБК) путем разработки алгоритма оказания медицинской помощи с учетом характера перелома и коморбидного фона пациента. В статье изложены подходы к выбору тактики и техники помощи пострадавшим старших возрастных групп с ППОБК. В исследование вошли 4 491 пациент с ППОБК, проходивший лечение в Госпитале для ветеранов войн с 2010 по 2019 г. Все больные были разделены на две группы в зависимости от тактики применяемого лечения: 1-я - 2 082 больных, пролеченных в 2010-2014 гг. с применением традиционных подходов; 2-я - 2 409 человек, лечение которых осуществляли по разработанному алгоритму, учитывающему характер перелома и тяжесть коморбидной патологии. Результаты были оценены по шкале Лекена, а качество жизни - по шкале ВОЗ. В 1-й группе хорошие исходы были достигнуты через 1 год у 126 (10,5 %) пациентов, через 3 года - у 111 (9,1 %); во 2-й группе через 1 год были достигнуты отличные исходы у 103 (6 %), хорошие - у 960 (55,7 %), а через 3 года отличные исходы - у 87 (5,4 %), хорошие - у 843 (52,3 %). Таким образом, использование предложенного алгоритма оказания помощи пациентам с ППОБК позволяет достоверно (p<0,001) улучшить исходы лечения этой категории пострадавших.
The objective of the study was to improve the treatment outcome of patients of older age groups with fractures of the proximal femur by developing an algorithm for providing medical care while taking into account the nature of a fracture and the comorbid background of a patient. The article describes approaches to the choice of tactics and techniques of medical assistance to patients of older age groups with fractures of the proximal femur. 4 491 patients with fractures of the proximal femur who had been treated at the Hospital for War Veterans in Saint Petersburg from 2010 to 2019 were included for analysis. All the patients were divided into two groups depending on the tactics of the treatment used. Group 1 (2 082 patients) were treated in 2010-2014 using traditional methods. Group 2 (2 409 patients) were treated according to the developed algorithm while taking into account the nature of a fracture and the severity of comorbid pathology. The results were evaluated by the Leken’s functional index, and the quality of life was assessed by WHO scale. In patients of the 1st group, good outcomes were achieved after a year in 126 (10,5 %), after 3 years in 111 (9,1 %), while in the second group after a year, excellent outcomes were achieved in 103 (6 %) cases, good in 960 (55,7 %), and after 3 years excellent in 87 (5,4 %), good in 843 (52,3 %). Thus, the use of the proposed algorithm for providing care to patients with fractures of the proximal femur significantly (p<0,001) improves the treatment outcomes for this category of patients.
Prospects for silver economy development in the russian megapolis
Authors: Шестакова Н.Н. , Джанелизде М.Г. , Скворцова М.Б. 
Published: February 2023

В статье исследованы теоретические подходы к развитию серебряной экономики в мире и практическая ценность продвижения ее модели для РФ. Предложено авторское определение категории «серебряная экономика» с выделением двух векторов ее развития: экономика - для пожилых и пожилые - для экономики. Цель исследования - оценка потенциального спроса на продукты серебряной экономики. В соответствии с ней в работе представлена первая часть результатов социологического (экспертного) опроса, проведенного авторами в Санкт-Петербурге. Исследование позволило установить ассортимент специализированной высокотехнологичной продукции для населения старших возрастов, который оценивается как весьма скудный, а уровень локализации серебряной экономики с точки зрения производства товаров в Санкт-Петербурге - как невысокий.
The article examines theoretical approaches to the development of a silver economy in the world and the practical value of promoting its model for the Russian Federation. Based on the consideration of various interpretations of this concept, the author’s definition of the category «silver economy» is proposed with the allocation of two vectors of its development: economy - for the elderly and the elderly - for the economy. The purpose of the study was to assess the potential demand for silver economy products: in accordance with it, the paper presents the results of a specific sociological (expert) survey conducted by the authors in St. Petersburg. The conducted research allowed us to establish that the awareness of the involved expert community regarding the production of specialized goods for the elderly population in St. Petersburg is generally low; the range of specialized high-tech products for the elderly population is estimated as very poor, and the level of localization of the silver economy in terms of the production of goods in St. Petersburg is low.
Analisis Kebutuhan Pengembangan Media Interaktif Menggunakan Adobe Animate
Authors: Dini Maielfi  , Wahyuni Sisri , Nurpatri Yeni 
Published: February 2023

Saat proses perkuliahan terlihat mahasiswa kesulitan memahami materi perkuliahan karena konten IPA khususnya Konsep Dasar biologi sarat dengan konsep dan prinsip abstrak. Kecenderungan proses dalam belajar IPA yang abstrak dapat mengakibatkan sulitnya mahasiswa dalam memahami materi pembelajaran. Konsep sains abstrak yang dikemukakan secara verbal belum sepenuhnya bisa dicerna oleh mahasiswa (Ismiyanti, 2020). Media pembelajaran yang digunakan sebelumnya yaitu hanya berupa power poin yang belum interaktif dan belum mengoptimalkan kemampuan mahasiswa. Penggunaan media pembelajaran yang kurang relevan terhadap materi pembelajaran dapat mengakibatkan proses pembelajaran menjadi kurang efektif sehingga mahasiswa tidak dapat memahami materi pembelajaran secara menyeluruh, menyebabkan kualitas pembelajaran menjadi rendah dan pembelajaran menjadi membosankan. Tujuan riset ini yaitu menganalisis kebutuhan pengembangan media interaktif dengan memakai adobe animate. Dalam proses mengumpulkan data untuk analisis kebutuhan pengembangan media interaktif menggunakan adobe animate digunakan kuesioner dan wawancara dengan metode penelitian kuantitatif. Subjek pada penelitian ini yaitu mahasiswa PGSD semester 1 TA 2022/2023. Analisis kebutuhan mahasiswa dilakukan melalui aktivitas wawancara, dan pemberian kuesioner. Pada kuesioner ini terdapat pernyataan dan pertanyaan yang berkaitan dengan kebutuhan mahasiswa terhadap media interaktif menggunakan adobe animate. Hasil penelitian didapatkan penggunaan media pembelajaran interaktif menggunakan Adobe Animate sangat dibutuhkan.
Kegiatan Lesson Study dalam Model Pembelajaran Heuristik Vee Sebagai Jawaban Tantangan Pembelajaran Abad 21
Authors: Cahyaningtyas Tiara Intan , Yudhaningtyas Sesaria Prima , Amelia Rizki 
Published: February 2023

Tujuan penelitian ini adalah untuk mengetahui keefektifan model pembelajaran tersebut dalam menjawab tantangan pembelajaran Abad 21 dan mengetahui masalah-masalah yang dihadapi siswa selama pembelajaran sehingga dapat dicarikan solusinya. Kegiatan lesson study akan mampu memperjelas awaban dari tujuan peneltian yang diharapkan. Penelitian ini merupakan penelitian kualitatif, yang dilakukan dalam bentuk kegiatan lesson study yang terdiri dari 3 tahapan utama yaitu Plan, Do, dan See. Pengumpulan data meliputi data observasi, LKS Vee Map dan wawancara siswa. Hasil penelitian menunjukkan bahwa kegiatan lesson study dalam model pembelajaran heuristik vee mampu menjawab tantangan pembelajaran Abad 21 dan mampu mengidentifikasi masalah-masalah yang muncul selama pembelajaran sehingga dapat diperbaiki untuk pembelajaran selanjutnya.
PENERAPAN MODEL PEMBELAJARAN BASED LEARNING (PBL) UNTUK MENINGKATKAN PEMAHAMAN SISWA KELAS IV PADA MATERI PENJUMLAHAN PECAHAN DI SEKOLAH DASAR NEGERI 3 CILEULEUY
Authors: Nurfaidah Siti Sholiha 
Published: February 2023

This research was motivated by the low mathematical understanding of the fourth grade students of SDN 3 Cileuleuy on the matter of adding fractions. Based on the results of observations, only 3 students out of 11 students obtained test scores above/equal to the KKM 70. So this study aims to improve students' mathematical understanding of fraction addition material in class IV SDN 3 Cileuleuy through the use of Model Pembelajaran Based Learning (PBL) models. The research method used is Classroom Action Research (CAR). The research design consisted of 2 cycles where the research subjects were 11 students of class IV SDN 3 Cileuleuy consisting of 8 male students and 3 female students. Data collection techniques were carried out through tests (evaluation tests) and non-tests (observations and documentation). The data analysis technique used is descriptive quantitative to analyze the results of evaluation tests and qualitative descriptive analysis to analyze the results of student evaluations. The results showed that there was an increase in students' mathematical understanding from before giving the action until the second cycle. Individual completeness before giving the action is 3 students with classical completeness reaching 27% and the average value obtained is 63.18. Then in the first cycle, 7 students obtained individual mastery with an average value of 70.27 and classical learning completeness of 63%. In the second cycle, individual mastery increased to 10 students with an average value of 81.89 and classical learning completeness increased to 85%. Based on the results obtained, it can be concluded that the use of the Problem Based Learning (PBL) model can improve students' mathematical understanding of ordinary fractions in the fifth grade of SDN 3 Cileuleuy in the 2022/2023 academic year.
Late Presentation of Factor XIII Deficiency with Recurrent Muscle Hematomas
Authors: Kumar Sudesh , Bhattacharya Piyali , Kumari Anamika 
Published: February 2023

Background:
Plasma factor XIII is a proenzyme that gets activated in the final step of the coagulation cascade. Its physiological role is to stabilize clot formation by catalyzing the cross-linkage of fibrin. Factor XIII deficiency is a rare autosomal recessive disorder.

Clinical Description:
A 10-year-old boy presented with acute-onset swelling of the arm following a minor fall. There were no constitutional symptoms. There was a significant history of similar swellings 2 years earlier that had required surgery. The past and family history were otherwise noncontributory. The child was hemodynamically stable. Local signs suggested a hematoma or tumor. There was no pallor, icterus, petechiae, or ecchymosis. The remaining examination was normal. Provisional diagnoses included nonaccidental trauma or an underlying primary or secondary bleeding diatheses, tumor, or chronic osteomyelitis.

Management:
Soft-tissue ultrasonography showed a hematoma. The radiograph was normal. Hemograms, first-line tests for coagulopathy, infective biomarkers, and liver and kidney function tests were normal. There were no stigmata of neglect or physical/emotional abuse in the child. Since the clinical phenotype was of a bleeding disorder, but supportive investigations were inconclusive, we suspected factor XII deficiency. Specific levels showed zero activity. Fresh frozen plasma was administered due to the nonavailability of factor XIII. The hematoma was managed surgically. The child was discharged after genetic counseling and is receiving monthly cryoprecipitate. He is asymptomatic till now.

Conclusion:
Factor XIII deficiency should be suspected when there are clinical indicators of a bleeding diathesis, but supportive tests are not deranged.
Severe Hereditary Spherocytosis Presenting with Non-Immune Fetal Hydrops
Authors: Mallakmir Snehal , Merchant Rashid , Kabra Nandkishor S. , Ahmed Javed 
Published: February 2023

Background:
Hereditary spherocytosis (HS) is characterized by spherocytes on the peripheral smear and heterogeneous clinical presentation (mild, moderate, moderate/severe, and severe) depending upon the severity of hemolytic anemia, jaundice, and splenomegaly. The underlying cause is defects in various red blood cell membrane proteins due to pathogenic mutations. Genotype-phenotype correlation is known.

Clinical Description:
We report a consanguineous family with a healthy daughter, multiple pregnancy losses due to fetal hydrops, and the current daughter. She was diagnosed with fetal anemia at 22 weeks gestation, developed fetal hydrops, was born premature and developed respiratory distress, severe anemia, severe jaundice, and postnatal hemolysis.

Management:
The case was managed since intrauterine life till date by multispecialty coordination. Intrauterine transfusions were given during pregnancy. In the neonatal period, she received surfactant for respiratory distress syndrome, double volume exchange transfusion and phototherapy for the jaundice, and repeated blood transfusions for the hemolytic anemia, that is still continuing. Rational and sequential investigations were planned and a systematic approach used. She was diagnosed with severe HS due to a homozygous likely pathogenic variant in the SPTA1 gene (affecting formation of spectrin), and heterozygous variant of uncertain significance in the ANK1 gene (that encodes ankyrin). At 3 years she has transfusion dependent hemolytic anemia, moderate splenomegaly, and age appropriate growth and development.

Conclusions:
HS is a rare but manageable (albeit challenging) cause of nonimmune hydrops fetalis. Genetic diagnosis allows precise management and family counselling.
Pediatric Miller Fisher Syndrome Mimicking Anti-Histaminic Drug Toxicity
Authors: Natarajan Gowsinivedha , Serane Vikneswari Karthiga , Jegadeesan Podhini , Palanisamy Soundararajan 
Published: February 2023

Background:
Miller Fisher syndrome (MFS) is a rare condition in childhood, characterized by acute-onset ataxia, ophthalmoplegia, and areflexia. It is mostly preceded by viral and bacterial infections, and the pathogenesis is speculated to be an immune response to cross-reacting antigens. We describe a case of acute ataxia which was initially misdiagnosed as antihistaminic toxicity and later emerged to be MFS.

Clinical Description:
A 4.5-year-old girl presented with acute-onset ataxia, giddiness, and limb pain, following toxic ingestion of an antihistaminic drug (chlorpheniramine) that had been prescribed for an upper respiratory infection. The absence of waning symptoms, new manifestations, and undetectable drug levels prompted us to consider an alternate diagnosis.

Management:
Magnetic resonance imaging of the cranium and spine was unremarkable. Hence, a central nervous system infection was considered. Cerebrospinal fluid (CSF) analysis revealed albumin-cytologic dissociation, a negative viral panel, and sterile culture. Serum anti-GQ1b antibody of immunoglobulin G type was positive. A nerve conduction study revealed absent H-reflexes in both gastrocnemius muscles. A diagnosis of MFS was made based on clinical features, CSF albumin-cytologic dissociation, positive anti-GQ 1b antibody, and absent H reflexes. She was treated with intravenous immunoglobulin therapy, following which there was an improvement in 1 week and complete recovery within 3 months.

Conclusion:
Although a rare entity, we need to consider MFS in the differential diagnosis of ataxia when the neurological signs persist beyond the expected time duration so that investigations can be planned accordingly and timely immunotherapy initiated.
Anti-N-methyl-D-Aspartate Receptor Encephalitis
Authors: Malhotra Deepti , Sane Sudhir , Mane Shivaji , Hajirnis Omkar 
Published: February 2023

Background:
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an auto-immune encephalitis with prominent neuropsychiatric manifestations that may be paraneoplastic.

Clinical Description:
A teenage girl presented with an acute illness of 4 days with symptoms of generalized weakness of all four limbs, behavioral abnormalities, and a generalized convulsion. On examination, the child was hemodynamically stable and disoriented to time, place, or person. There was the loss of recent memory. The remaining neurological and systemic examination was normal. The differential diagnoses considered were toxic or metabolic encephalopathy, neurological Wilson's disease, acute intermittent porphyria, autoimmune encephalitis, and neuropsychiatric systemic lupus erythematosus. Investigations were planned for the causes that could not be excluded by history, examination, and baseline investigations. Salient reports were normal brain magnetic resonance imaging (MRI), nonspecific electroencephalogram abnormalities, and absence of pleocytosis and biochemical abnormalities but positive anti-NMDAR antibodies in the cerebrospinal fluid. A right adnexal cystic solid mass was identified in the abdominal ultrasound with the radiological appearance of an ovarian teratoma or germ cell tumor on MRI. Alpha-fetoprotein levels were raised.

Management:
The patient underwent right salpingo-oophorectomy. The histopathological diagnosis was an immature ovarian teratoma. The patient received first-line and then second-line immunotherapy (when there was no response), as well as chemotherapy. Signs of improvement appear after 6 weeks, with complete recovery within 6 months.

Conclusion:
Pediatric ovarian teratoma-associated anti-NMDAR encephalitis is rare, but neuropsychiatric symptoms should prompt the clinician to think of this diagnosis in girls. Early treatment is associated with a good prognosis.
A Rare Case of Intra-Renal Paraganglioma in a Child Masquerading as Renal Cell Carcinoma
Authors: Manekar Aditya Arvind , Sahoo Subrat Kumar , Tripathy Bikasha Bihary , Nayak Prasant , Sable Mukund Namdev , Mohanty Manoj Kumar 
Published: February 2023

Background:
Renal cell carcinomas (RCCs) are rare in children, accounting for around 2% of all pediatric renal tumors. Paragangliomas are extra-adrenal locations of phaeochromocytomas. They originate from chromaffin cells arising along the sympathetic paraganglia and are secretory in most cases. Sequential imaging is often required to ascertain the etiology of a renal mass; ultrasound (USG), contrast-enhanced computerized tomography scan (CECT), and magnetic resonance imaging (MRI). Tissue diagnosis is confirmatory.

Clinical Description:
An 11-year-old girl presented with a right-sided abdominal and flank pain that was dull aching and nonradiating. She had no history of jaundice, hematuria, dysuria, bowel symptoms, sweating, palpitations, or syncope. The vitals were stable, without tachycardia or hypertension. No abnormal findings were found on clinical examination. Initially, the possibility of a renal stone was considered.

Management and Outcome:
Baseline blood tests were normal. Abdominal USG detected a heterogeneous mass in the right kidney. CECT ascertained that it was very vascular and exhibited contrast enhancement, suggesting a renal tumor. MRI showed that the right renal artery was acting as the feeding vessel to the tumor. RCC was suspected based on imaging. The vascular nature prevented us from performing a Tru-cut biopsy. A right-sided nephrectomy was planned, preceded by angiography and embolization of the right renal artery to reduce vascularity. Intraoperative episodes of hypertension were noted. Gross appearance suggested RCC; however, histopathology revealed evidence of an intrarenal PGL.

Conclusions:
Diagnosing a nonfunctional PGL in an asymptomatic patient is challenging and may only be possible by intraoperative histopathology.
Coping with Schooling Bullying Using the "bucket-Filling' Metaphor as a Management Strategy
Authors: Malhi Prahbhjot , Bharti Bhavneet 
Published: February 2023

Background:
Childhood bullying is a widespread global public health problem that is associated with several adverse long-term physical and mental health problems. The present case report describes the successful implementation of an intervention that focused on improving the socio-emotional skills of a victimized child.

Clinical Description:
SP, an 8-year-old foster boy was being bullied by his peers at school. This led to him appearing distracted, easily frustrated, scholastic deterioration, and refusal to go to school. He was brought to us by his concerned parents for the evaluation and management. Psychometric testing revealed that the child did not have any intellectual impairment or symptoms of specific learning disability, behavioral, or mood disturbances.

Management and Outcome:
An intervention that focused on metaphors "bucket filling" (i.e., being kind and considerate), "bucket dippers" (i.e., being mean and hurtful words) was used, the lesson being that one must learn to keep the lid of their own bucket on, so that others cannot empty it. Multiple sessions were taken and assignments given in which the parents were actively involved with the child. After 2 months, the child was better adjusted at school and had made a new friend. The bullying too had declined.

Conclusions:
Pediatricians need to be able to recognize the symptoms that could indicate bullying. Once recognized, appropriate referrals should be made to competent professionals. Early childhood programs that foster socio-emotional learning using novel strategies are beneficial.
Troublesome Teeth, Search for Stones – Enamel-Renal Syndrome
Authors: Reddy Soumya , Arumugam Niranjana , Iyengar Aparna 
Published: February 2023

Background:
Enamel-renal syndrome (ERS), is a rare autosomal recessive disorder involving family with sequence similarity 20 member A (FAM20A) gene. This unique syndrome is characterized by severe enamel hypoplasia, intrapulpal calcification, nephrocalcinosis, or nephrolithiasis. This case report highlights the early presentation and incidental detection of chronic kidney disease (CKD) in a young child with enamel defects.

Clinical Description:
A 10-year-old girl, with no significant past or family history, presented with delayed tooth eruption and abnormal shaped teeth. She was detected to have generalized gingival hyperplasia and multiple unerupted teeth. Suspecting amelogenesis imperfecta, she was screened for coexisting systemic conditions. On evaluation, abdominal ultrasound demonstrated bilateral nonobstructive nephrolithiasis. Further renal workup done showed an abnormal creatinine (stage 2 CKD) and mild metabolic acidosis. Reduced urinary citrate excretion with no evidence of hypercalciuria was noted on extensive urine assessment. Genetic testing revealed a novel pathogenic variant in FAM20A, confirming the diagnosis of ERS.

Management:
The child was initiated on citrate supplements, salt restriction, and adequate hydration. She was advised of dental interventions, including pulp therapy and full-coverage restoration of decayed teeth. The family was counseled about the need for close monitoring of growth, renal function, and progression of nephrolithiasis.

Conclusion:
Prompt screening for renal associations in oro-dental and systemic disease must be undertaken to ensure early detection of kidney disease and timely institution of appropriate treatment. In children diagnosed to have kidney involvement, the importance of regular follow-up with clinical, biochemical, and imaging modalities, even during adulthood, must be emphasized.