bluuebunny/crossref_metadata_2025 huggingface dataset:
Temps et objet
Authors: Vanier Alain
Published: April 2024

Si le concept est le temps de la chose, peut-être plus radicalement peut-on affirmer que le temps c’est l’objet en tant qu’il est la chose comme séparée. L’objet est témoin du temps en tant que cet objet particulier de la psychanalyse n’est jamais repérable dans l’espace que sous les espèces d’un substitut, puisqu’il n’y est présent qu’absent, tout comme il n’est jamais présent dans le temps, ni dans le passé et pas plus dans l’avenir, où il est espéré, il est l’instant même comme ce qui échappe radicalement et qui n’émerge que dans le heurt surprenant de la rencontre comme Réel. Or c’est cette fonction de la rencontre et du temps, du bon moment en quoi réside tout l’art de l’analyste et la fonction de sa technique.
L’objet du détail
Authors: Dissez Nicolas
Published: April 2024

Le détail est, dans la vie courante, ce qui dénote, surprend et qu’à ce titre nous négligeons, ce dont nous ne voulons habituellement rien savoir. Dans le champ clinique, il est au contraire essentiel à la position du praticien de pouvoir prendre en compte sa fonction pour permettre de réinterroger une situation clinique particulière, voire de renouveler de la théorie comme telle. D’où le détail tire-t-il son pouvoir étrange de venir surprendre, déranger mais également subvertir tout savoir constitué ? L’étymologie du terme détail – dé-taillier – permet de considérer que sa fonction est d’opérer, dans le champ de la représentation, une découpe inédite, inattendue, voire inconvenante, qui vient cerner le registre de l’objet dit  a . On en donnera ici quelques illustrations extraites de l’enseignement de Jacques Lacan, comme de son expérience personnelle.
A = A, équation : la vérité ! Contribution à l’histoire du rationalisme morbide
Authors: Allen David Frank , Martin Lucien , Dapussy Liliane , Macary-Garipuy Pascale , Borgnis Desbordes Emmanuelle
Published: April 2024

Thésard du Pr Henri Claude, le Dr Klein publia son livre en 1937 : cette publication aux Éditions Médicales fut complétée par un fascicule de quelques pages vers 1938. Hongrois, Klein fréquenta Joseph Gabel avant la Seconde Guerre mondiale, on perd sa trace vers 1941. Klein fut pour Gabel ce que le président Schreber fut pour Freud.
Les clés de la nouvelle candidature de Donald Trump
Authors: de Charentenay Pierre
Published: April 2024

Nous sommes encore à plusieurs mois de l’élection présidentielle américaine. Tous les sondages donnent un large avantage à Donald Trump. Est-ce une garantie de victoire pour novembre 2024 ? Les institutions américaines sauront-elles l’arrêter ? L’Amérique est-elle prête à sacrifier la démocratie pour apaiser quelques-unes de ses angoisses : la place de l’immigration, la peur de la Chine, l’intérêt du soutien à l’Ukraine ?
Rire avec Pierre Dac : du loufoque à la résistance
Authors: Le Breton David
Published: April 2024

En situation d’oppression, l’humour est un art sociologique intuitif qui joue sur la corde raide. En détendant l’atmosphère, en affichant un air tranquille, celui qui lance un mot d’esprit ou une répartie amusante dissout la gravité du moment pour lui ou son groupe et rappelle que rien n’est perdu. Pendant la Deuxième Guerre mondiale, l’humoriste Pierre Dac (1893-1975) devient une figure de la Résistance, grâce à ses interventions sur Radio Londres.
L’agenda territorial et la politique de cohésion comme instruments de lutte contre les géographies du mécontentement
Authors: Böhme Kai
Published: April 2024

Cet article analyse la fragmentation spatiale croissante au sein de l'Europe, qui constitue une menace pour l'avenir du continent en éloignant de plus en plus les personnes et les régions. Ce phénomène, exacerbé par les méga-tendances et les transitions sociétales, souligne le besoin d'efforts accrus en matière de cohésion et de perspectives tournées vers l'avenir pour tous les territoires européens. L'article examine de manière critique les politiques publiques existantes, telles que l'Agenda Territorial 2030 et la Politique de Cohésion, en mettant en lumière leurs limites et la conceptualisation vague de la cohésion. Le papier discute de la manière dont la fragmentation spatiale se manifeste dans les disparités sociétales, les inégalités régionales croissantes et la montée de l'euroscepticisme, soulignant la complexité de ces défis. Böhme appelle à des politiques robustes et ciblées pour permettre aux régions d'échapper aux pièges du développement et insiste sur la nécessité d'améliorer la gouvernance, l'innovation et l'éducation. L'article conclut en soulignant la nécessité de repenser le ciblage géographique des financements et d'adopter une perspective plus large sur la cohésion pour aborder efficacement la fragmentation et les disparités croissantes en Europe.
Appel à contributions
Authors: Louveaux François , Louveaux Marie-José
Published: April 2024

Fidèle à sa vocation de faire le lien entre la recherche et les enseignants, L’Information géographique propose une nouvelle rubrique « géographies enseignées ». De l’école à l’université comment des enseignements de géographie aident à construire de jeunes adultes responsables et engagés.
De l’idée en littérature : le cas Senancour
Authors: Le Scanff Yvon
Published: April 2024

L’œuvre de Senancour propose une image de la pensée qui rompt avec le paradigme classique et ouvre vers l’ambition romantique d’une pensée immédiate, voire immanente. Elle se caractérise par sa naturalité ; c’est une pensée du chemin plus que de la méthode : une rêverie, à savoir une idée-paysage plus qu’une idée-machine. C’est une Idée esthétique singulière, singulative même, qui donne accès à une forme de connaissance comme par effraction (l’abduction) et qui la différencie de l’idée philosophique par sa circonstancialité, son affectivité (esthétique de l’idée).
Poésie et pensée de l’inconscient. Baudelaire et Nerval
Authors: Marchal Bertrand
Published: April 2024

S’interrogeant sur le constat qui est à l’origine de ce volume, celui d’un vide philosophique entourant le romantisme français, cet article voudrait montrer que ce vide, relatif, est moins dû au romantisme français lui-même qu’au désintérêt — quand ce n’est pas l’ignorance — des philosophes pour lui, et pour illustrer cela, s’attache à montrer comment, chacun à sa manière, deux poètes emblématiques de ce romantisme, Nerval et Baudelaire, ont contribué à ce qu’on peut appeler l’invention de l’inconscient.
Au-delà de l’art engagé ? Renouvier et Guyau interprètes et critiques de Victor Hugo
Authors: Haber Stéphane
Published: April 2024

Charles Renouvier (1815-1903) et Jean-Marie Guyau (1854-1888) ont été, chacun à sa manière, des commentateurs avisés de l’œuvre de Hugo. Critiques, l’un comme l’autre, de « l’art pour l’art », ils prirent également en compte le motif hugolien de l’art « utile », immanent à la vie, participant aux combats éthiques et politiques du présent, mais en cherchant à l’infléchir ou à le redéfinir sur de nouvelles bases, plus larges. Cette tentative prometteuse s’est heurtée cependant à un certain nombre de limites.
De l’amplification à la dissociation : aspects de la cadence dans les Mörike-Lieder d’Hugo Wolf
Authors: Boiffin Nicolas
Published: April 2024

Cet article présente une étude des cadences chez Hugo Wolf (1860-1903) basée sur le recueil des 53 Gedichte von Eduard Mörike pour voix et piano (1888). L’analyse harmonique croisée avec l’étude de la métrique poétique montre que l’étirement dans le temps des zones cadentielles entre en conflit d’une part avec la clôture formelle des strophes, d’autre part avec les éléments isolés du vers. En ce sens, la cadence constitue un point de tension entre texte et musique.
Topiques, narrativité et effets dramatiques du « Rex tremendae » de la Grande Messe des morts de Berlioz
Authors: Kiuchi Mariko
Published: April 2024

L’expression originale du « Rex tremendae » de la Grande Messe des morts de Berlioz a longtemps fait l’objet de critiques. Les choix du compositeur concourent non seulement à un audacieux remaniement du texte liturgique, tel un livret d’opéra, mais également à la construction d’une forme par juxtaposition d’éléments musicaux hétérogènes. Quels sont alors les styles musicaux mis en œuvre ? Comment le compositeur procède-t-il pour attirer l’attention et susciter les réactions émotionnelles du public ? Le présent article a pour objectif de mettre en lumière la forme narrative du mouvement et, surtout, la stratégie rhétorique du compositeur concourant à élaborer une architecture hautement dramatique. Cette étude se fonde sur une analyse par les topiques et par les signes des vecteurs rhétoriques. Cette analyse révèle ainsi que Berlioz exploite une série de topiques plutôt conventionnels pour l’époque. Grâce à certains procédés musicaux qui agissent directement sur les attentes de l’auditeur – l’alternance fréquente de différents topiques, l’intervention de silences inattendus et l’emploi fréquent de l’accord de septième diminuée dont la résolution est interrompue par les silences soudains –, Berlioz agit sur les différents processus inférentiels possibles pour produire une série d’imprévus et accumuler la tension jusqu’à son paroxysme. L’analyse montre finalement et avant tout que la nature éminemment dramatique de ce Requiem se révèle dans l’agencement subtil d’intrigues purement musicales.
Une double absence dans les quartiers populaires ?
Authors: Lévêque Antoine
Published: April 2024

Alors que la ségrégation urbaine est aujourd’hui bien renseignée, alors qu’une attention fine est désormais déployée à l’égard de l’inscription territoriale des comportements politiques, c’est à la médiation des intérêts sociaux dans l’action publique et à ses traductions territoriales que cet article est consacré. En revenant sur le traitement de la desserte en transport en commun des quartiers populaires de Vaulx-en-Velin – l’une des communes les plus pauvres en France –, nous interrogeons l’évolution du rapport de l’offre politique aux espaces populaires de l’abstention. À mesure que les élus perdent leur ancrage dans les sociabilités populaires marquées par une démobilisation électorale, c’est aussi la façon de représenter les intérêts sociaux dans l’action publique urbaine qui évolue. Dans cette commune, l’intégration progressive des maires aux espaces de gouvernement de l’agglomération n’a pas empêché la relégation des quartiers populaires dans l’action publique. Celle-ci résulte notamment de leur socialisation aux cadrages et aux dispositifs d’action qui circulent dans ces espaces et produisent une hiérarchie des territoires.
À qui s’adressent les dispositifs participatifs dans les quartiers populaires ?
Authors: Lang Marion
Published: April 2024

Depuis le début des années 2000, les dispositifs participatifs se multiplient dans les quartiers populaires, cherchant à toucher des individus présentés par les pouvoirs publics comme souffrant d’un déficit de citoyenneté. Le développement d’un panel de dispositifs et de procédures de participation publique a transformé les tissus associatifs et fait émerger des « entrepreneur·es de participation ». Basé sur une enquête ethnographique dans deux quartiers de Marseille et Barcelone, l’article prend pour point de départ ces entrepreneur·es qui jouent un rôle central dans l’appropriation locale de la participation publique. Il interroge leur contribution à la mise en œuvre de la participation et montre comment leur position oscille entre intermédiaires et destinataires des dispositifs délibératifs. Les entrepreneur·es, en tant qu’intermédiaires, sont chargé·es par les agents et agentes administratives de mobiliser un public habitant lors des réunions de participation. L’étude des logiques de mobilisation montre pourtant que les agent·es institutionnels sont peu attentifs aux pratiques sélectives des entrepreneur·es. En outre, on assiste à une fermeture de certains dispositifs participatifs autour des entrepreneur·es qui en deviennent les principaux publics.
Quand le care s’immisce dans les logiques économiques : la présence du soin dans le soutien à l’entrepreneuriat en quartier prioritaire
Authors: Clément Lorena
Published: April 2024

En interrogeant la présence du care dans la politique de soutien à l’entrepreneuriat en quartier prioritaire, l’article décentre le regard des logiques marchandes et instrumentales pour s’intéresser à l’attention portée à autrui dans les activités économiques. Pour ce faire, il s’intéresse aux liens interpersonnels de soin qui organisent l’action et l’accompagnement entrepreneuriaux en s’appuyant sur une enquête de terrain qualitative menée entre 2018 et 2020. En se nourrissant de travaux qui mêlent la géographie des inégalités aux sciences de gestion critiques, celle-ci révèle des pratiques implicites de soin de la part de conseillers et d’entrepreneurs. Bien que ces pratiques de care fondent un rapport de sollicitude aux autres et au monde qui s’oppose à l’image d’un entrepreneuriat individuel et marchand, elles restent d’ordre interindividuel et réduisent peu les inégalités structurelles.
Efficacy of Liposomal Bupivacaine in Reducing Opioid Use After Posterior Lumbar Spinal Decompression and Fusion
Authors: McClure Amber , Silveri Olivia C. , Foddrell Megan , Duteil Karen , Madarász Laura E. , Silveri Christopher P.
Published: April 2024

Background:

Despite improvements in drug therapy and treatment of lumbar spinal disorders, dependence on opioid medication for postoperative pain control remains a concern nationwide. This study assessed the ability to diminish the reliance on opioid medication postoperatively with the Food and Drug Administration-approved local anesthetic liposomal bupivacaine in open posterior lumbar decompression and fusion procedures. In addition, the possible effects of this modality on other parameters were studied regarding patients and their recovery.

Materials and Methods:

A retrospective chart review of 198 patients who underwent an open posterior lumbar laminectomy and fusion surgery with instrumentation treated by a single surgeon in a single institution was conducted. Ninety-nine patients who received liposomal bupivacaine administered intraoperatively were then matched by age, sex, and procedure with the same number of patients treated prior to the availability of liposomal bupivacaine. We evaluated how the use of liposomal bupivacaine affected the requirement for postoperative opioid medication, as well as related changes in length of stay, the use of antiemetics, and urinary retention postoperatively.

Results:

The patients who received liposomal bupivacaine required less than half of the morphine milligram equivalents of narcotic medications during their hospital stay compared with patients who did not receive liposomal bupivacaine (approximately 57% reduction).

Conclusion:

The findings of this study suggest that the addition of liposomal bupivacaine to traditional pain management modalities can augment pain management for patients undergoing posterior lumbar surgery, as evidenced by the significant decrease in postoperative morphine milligram equivalents required. [
Orthopedics
. 2024;47(4):244–248.]
Diagnosis and Management of Common Pediatric Cutaneous Infections
Authors: Gurnani Pooja , Monir Reesa L. , Schoch Jennifer J.
Published: April 2024

Dermatologic concerns are common in the general pediatrician's practice. Herein, we review the most commonly encountered cutaneous bacterial, viral, and superficial fungal infections in the pediatric population. We describe clinical presentation, pathogenesis, and current treatments. The goal of this guide is to increase pediatricians' comfort in diagnosing and managing common skin infections, as well as determining when a dermatology referral may be necessary.

[
Pediatr Ann
. 2024;53(4):e138–e145.]
Fast Zombies and Social Rights: The Case of Umberto Lenzi’s Nightmare City (1980)
Authors: Iozzia Alberto
Published: April 2024

In the tense atmosphere that preceded the May 1981 Italian referendums on abortion, Umberto Lenzi’s Nightmare City is released. Included in several ‘Best Zombie Movies’ lists, Nightmare City is important for at least two reasons; first, because it inaugurates a significant and eventually successful variation on the zombie image: the fast zombie; second, as a commentary on the most salient social debate of the late 1970s and early 1980s – the one on the self-determination of Italian women. The aesthetic and the metaphorical levels of Lenzi’s film are strictly connected and the infected people running around drinking the blood of others are the embodiment of a reactionary response to the ongoing social transformation. Nightmare City joins the Italian political dispute of the late 1970s by openly opposing the women’s freedom of choice and by channeling and amplifying the most conservative side of that quasi-eschatological battle.
Measures and Preventions of Cyber Policies in Smart Cities
Authors: Chauhan Dipti , Jain Jay Kumar
Published: April 2024

Smart cities are gradually becoming a reality rather than a distant vision. Governments, companies, and everyday people are using technology more and more these days to boost productivity at work and at home. On the one hand, smart cities have enacted a number of modifications in an effort with the goal of revolutionizing people's lives. On the other side, while smart cities offer improved quality of life and more convenience, there are also increased hazards to cyber security, including data leaks and malicious cyberattacks. As smart cities are evolving with more connected, as well as enhanced digital infrastructures becoming more sophisticated, these services will become increasingly exposed to cyber intrusions. Cities can only be as strong as their weakest link, and even the tiniest flaws can be used to deadly advantage. Governments must invest more money in cyber security and threat reduction as a result. In this proposed chapter we will be discussing about the measures need to be taken for the development of Smart city and what are the preventions of cyber policies in smart cities.
AI and Equity in Higher Education
Authors: Diene Amdy
Published: April 2024

This thought-provoking chapter is systematic research based on theories from literature review and empirical data exploring AI's potential impact on educational equity in higher learning. The atuhors examine how AI-powered systems might inadvertently perpetuate biases, affecting marginalized students disproportionately. This chapter discusses institutions' responsibility to implement AI in ways that support inclusivity and diversity. In addition, it highlights initiatives that prioritize fairness and transparency in AI algorithms. AI systems can perpetuate existing biases if not designed with the right in mind. Additionally, if an AI system is not transparent about its decision-making processes, identifying or rectifying potential biases will be nearly impossible. Readers will gain a deeper understanding of AI's challenges and opportunities in reshaping education, focusing on ensuring that no student is left behind.
Sustainable Islamic Financial Inclusion
Authors: Kismawadi Early Ridho
Published: April 2024

The study investigates the convergence of digital transformation, artificial intelligence (AI), and Islamic finance. In particular, it examines the ethical consequences that may arise from the integration of Generative AI in the sustainable development of Islamic financial services and products. This research fills a void in the current body of knowledge by examining the ethical consequences of generative AI in the context of Islamic finance. Using an interdisciplinary framework that integrates Islamic finance and technological ethics, the study seeks to make scientific and practical contributions. At the intersection of AI technology and Islamic finance, it is anticipated that new theories will emerge, as well as ethical principles that will serve as a guide for technology developers, policymakers, and Islamic financial institutions. The study has the potential to lead in creating a sustainable and inclusive Islamic finance ecosystem by ethically integrating Generative AI.
Unraveling the Fabric of Serverless Computing
Authors: Boopathi S.
Published: April 2024

This chapter provides a comprehensive overview of the evolving landscape of serverless computing, focusing on the technologies and tools that shape its ecosystem. Starting with an introduction to serverless architecture, the chapter delves into the benefits and challenges of adopting serverless computing. It explores key technologies such as function-as-a-service (FaaS), backend-as-a-service (BaaS), and event-driven architecture, highlighting their roles in enabling scalable and cost-effective solutions. Additionally, the chapter discusses popular tools and platforms used for developing, deploying, and managing serverless applications. Through this exploration, readers gain insights into the latest trends, best practices, and considerations for leveraging serverless computing effectively in modern IT environments.
Review of Grid-Cloud Distributed Environments
Authors: Dhabliya Dharmesh , Ojha Ananta , Gill Amandeep , Uchil Asha , Dhablia Anishkumar , Kumar Jambi Ratna Raja , Gupta Ankur , Pramanik Sabyasachi
Published: April 2024

Users who may be geographically distant from organizations must be provided with up-to-date info. Replication is one approach to make such data accessible. The process of duplicating and maintaining database items across many databases is known as distributed database replication. Distributed databases safeguard application availability while providing quick local access to shared data. Distributed databases are often divided up into pieces or replica divisions. In distributed databases, fragmentation is advantageous for utilization, effectiveness, parallelism, and security. Locality of reference is strong if data items are found in the location where they are utilized the most. Users may still query or edit the remaining pieces even if one is unavailable. It's critical to manage fragmented data replication availability even in the event of a failure. Failure scenarios include a server that responds improperly or returns an inaccurate value. Enabling fault tolerance and data management systems like SAS, Oracle, and NetApp is the only way to fix these errors. This study reviews the research on data replication and fragmentation techniques used in cloud environments. It is easy to implement, takes into consideration cloud databases, considers both fragmentation and replication strategies, and is focused on enhancing database performance. All the necessary information to implement the approach is included in the chapter.
Neuroleadership Strategies
Authors: Joy Sebin , Kumar Arti Arun , Nair Sridevi
Published: April 2024

In the ever-evolving landscape of the modern era, organizations face the ongoing challenge of maintaining motivated and engaged employees. Despite the substantial body of research on this topic, many organizations still struggle to effectively promote engagement and motivation among their employees. This research aims to investigate the application of neuroleadership strategies in addressing this issue. The SCARF model, based on neuroscience principles, provides a valuable framework for understanding neuroleadership strategies which address social and emotional triggers that impact engagement and motivation. It can be effectively used to drive motivation and engagement in the workplace by addressing the fundamental social and emotional needs of employees. This study employs a quantitative approach which assesses the 321 employees from different organizations in India. The results of the study would provide leaders with practical insights to boost motivation and engagement in organizations and thereby improve the effectiveness of the organization.
Neuroscience of Leadership
Authors: Shukla Rishi Prakash , Taneja Sanjay , Saluja Shefali
Published: April 2024

This chapter delves into the dynamic intersection of neuroscience and leadership, examining the transformative influence of brain-based approaches on key aspects such as decision-making, emotional intelligence, stress management, and social dynamics. Real-world examples illustrate the practical implications for leaders, while ethical considerations and emerging technologies in neuroleadership research offer a glimpse into the future of this evolving field. The exploration underscores the potential for neuroscience to enhance leadership effectiveness, fostering empathetic, ethical, and resilient leaders in an ever-changing world.
Security and Privacy Considerations in Cloud-Based Data Processing Solutions for Sensitive Data
Authors: Vashishth Tarun Kumar , Sharma Vikas , Sharma Kewal Krishan , Kumar Bhupendra , Chaudhary Sachin , Panwar Rajneesh
Published: April 2024

This book chapter explores the crucial aspects of security and privacy considerations in cloud-based data processing solutions for sensitive data. As organizations increasingly leverage cloud computing for their data processing needs, concerns regarding the protection of sensitive information have become paramount. The chapter discusses the challenges and potential threats associated with cloud-based data processing, highlighting the importance of implementing robust security measures to safeguard sensitive data. The chapter delves into various security and privacy considerations that must be addressed when adopting cloud-based data processing solutions. It covers topics such as data encryption, access control mechanisms, secure data transmission, and secure storage. Additionally, it examines the role of authentication and authorization mechanisms, as well as the importance of auditing and monitoring activities to ensure compliance with data protection regulations.
NMRA-Facilitated Optimized Deep Learning Framework
Authors: Thirumalraj Arunadevi , Chandrashekar Rakesh , B. Gunapriya, , Balasubramanian Prabhu kavin
Published: April 2024

Recycling and landfilling are two of the primary means by which garbage is destroyed in the context of waste management. Many urban areas struggle with improper waste collection, transportation, and disposal. This chapter depicts a competent waste management scheme architecture predicated on internet of things. In addition, two new benchmark datasets to classify waste, which are unified collections of open-source datasets with standardized annotations for all types of waste are presented here. The architecture of the faster region convolutional neural network (FRCNN) is based on the widely used VGG-16 for feature extraction from input images. In addition, the detected garbage is classified into one of seven different types using the naked mole-rat algorithm's (NMRA) hyper-parameter tuning to progress the classification accuracy. The classifier is trained using unlabeled images in a semi-supervised manner. On the test dataset, the proposed method achieves an average precision of 70% in waste detection and an accuracy of 93% in classification.
An Optimized Predictive Model Using Deep Learning
Authors: Dhir Saru , Sharma Sahil
Published: April 2024

Plant diseases cause disaster to the quantity and quality of agricultural products. It is important to recognize plant pathogens at the initial stage for the sake of global health and well-being. Many researchers have been inspired to improve the performance of plant disease detection systems because of the popularity of deep learning. AlexNet and other similar structural designs were used in most of the studies. In this chapter, four learning techniques are used to evaluate—convolutional neural network, DenseNet, AlexNet and VGG16—designs on a plant-Village dataset for plant disease identification and ordering in this study. In this chapter, the proposed methodology VGG16 with PSO overtakes state-of-the-art results in plant disease ordering with an accuracy percentage.
Long-term efficacy and safety of a bioresorbable polycaprolactone-based injectable in female stress incontinence
Authors: Mojsović Andelo , Beulens Alexander J.W. , Koldewijn Evert L.
Published: April 2024

A fully bioresorbable polycaprolactone (PCL)-based bulking agent was evaluated for safety and efficacy in female patients with mild to moderate stress urinary incontinence (SUI) who attempted and failed prior pelvic floor muscle training. A total of 44 adult female subjects with mild or moderate SUI (median age 60 and 57, respectively) were treated by transurethral sub-mucosal injection. Safety was evaluated at 6-, 12-, and 24-month follow-up visits. Efficacy was assessed at the same intervals with the Stamey grading system (SGS). SGS improvement was shown in both the mild and moderate SUI groups. At 24 months, most participants were continent: 78.1% in the mild SUI group and 66.7% in the moderate SUI group. All participants in the moderate SUI group showed an improvement in the SGS grade, and most participants were continent. The study shows that the PCL-based bioresorbable bulking agent treatment seems to be a safe and effective treatment option for women with mild to moderate SUI who attempted and failed prior pelvic floor exercises.
A Randomised Controlled Trial on the Effect of Hamulectomy on Hearing Outcomes in Cleft Palate Patients - A Comparative Study
Authors: Mathew P. C. , Goyal Manoj , Mittal Neeti
Published: April 2024

Introduction:

Cleft palate, a common congenital craniofacial defect, requires surgical repair and many surgical approaches have been employed for the same to reduce the risk of post-operative complications and improve outcomes. In order to achieve tension free closure, fracture of pterygoid hamulus has been advised. However, the effect of this manoeuvre on auditory functions remains debatable. The study was designed to evaluate the effect of hamulectomy on auditory function during the post-operative period after palatoplasty.

Materials and Methods:

The present study enrolled 100 participants aged 10 months–2 years with isolated cleft palate defect. They were randomly divided into two groups: palatoplasty with hamulectomy (n = 50) and palatoplasty without hamulectomy (n = 50). Hearing outcomes were evaluated using objective measures (otoscopy, tympanometry, and otoacoustic emission [OAE] tests) at 1-month and 6-month post-operative follow-up visits. The Chi-square test was used to analyse the data and significance level was kept at P ≤ 0.05.

Results:

The findings of otoscopy, tympanometry and OAE tests were statistically similar between the two study groups (P > 0.05; Chi-square test) at both one month and six months follow-up visits. Another noteworthy observation was improvement in auditory function during follow-up period indicating recovery of middle ear function following palatoplasty.

Discussion:

The addition of hamulectomy to the palatoplasty treatment may improve the hearing outcomes for cleft palate patients and can be adopted to achieve tension free closure.
Case Series of Berry syndrome: A rare constellation of fatal cardiac anomalies
Authors: Tandayu Kevin Moses Hanky Jr , Kurniawati Yovi , Atmosudigdo Indriwanto Sakidjan , Lilyasari Oktavia
Published: April 2024

Berry syndrome is an extremely rare constellation of several congenital cardiac anomalies consisting of aortopulmonary window, aortic origin of the right pulmonary artery (AORPA), interrupted aortic arch or hypoplastic aortic arch or coarctation of the aorta, and an intact ventricular septum with high neonatal mortality rates. The disease is fatal with high mortality (90%) in the neonatal period with surviving patients mostly developing pulmonary hypertension. We describe the clinical presentation and diagnostic clues in two patients with Berry syndrome.
Are children with mitral valve prolapse more anxious?
Authors: Beyazal Meryem , Orun Utku Arman , Sayici Ilker Ufuk
Published: April 2024

Background:

Mitral valve prolapse (MVP) is a common valvular disease in children. Symptoms in children with MVP are not explained by the severity of mitral regurgitation alone. Hence, we sought to correlate symptom status with the incidence of anxiety disorder in this population.

Materials and Methods:

Groups were as follows: (a) MVP; n = 115; mean age: 13.5 ± 3.06 years and (b) control; n = 53; mean age: 15.1 ± 13.2. The Screen for Child Anxiety-Related Emotional Disorders (SCAREDs) scale was filled by all participants. The SCARED scores of 25 and above determined a warning for anxiety disorders.

Results:

The mean SCARED scale values of MVP and control groups were 29.2 ± 13.08 and 24.9 ± 14.17, respectively (P = 0.065). Although the SCARED scale score was higher among the MVP patients, no significant difference was found between the groups in terms of the mean SCARED score, or the number of participants with a score of 25 or more. While girls with MVP had higher anxiety scores compared to boys with the disorder, there was no difference with respect to SCARED scores in children with MVP and the general population when analyzed separately by gender. Moreover, the SCARED scale score was significantly higher in symptomatic MVP patients than in asymptomatic cases.

Conclusion:

Children with MVP did not have higher anxiety scores compared to those without the syndrome. However, MVP patients with higher anxiety scores may benefit from a psychiatric assessment since higher scores correlate with symptoms.
Comparison of risk stratification scoring system as a predictor of mortality and morbidity in congenital heart disease patients requiring surgery
Authors: Fakhri Dicky , Damayanti Ni Made Ayu Sintya , Nurhanif Muhammad
Published: April 2024

Backgrounds:

Risk stratification systems have been important in reducing morbidity and mortality among congenital heart disease (CHD) patients requiring cardiac surgery. Multiple risk stratification scoring systems have been developed, including Aristotle Basic Complexity Score (ABC), Aristotle Comprehensive Complexity Score (ACC), Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery (STS-EACTS), and Risk Adjustment in Congenital Heart Surgery (RACHS-1). This study aims to access the superior risk stratification scoring system model in predicting mortality and morbidity.

Methods:

The authors used Embase, PubMed, Scopus, and ProQuest as the primary databases for searching and included studies from hand searching. The area under the receiver operating characteristic curve was compared.

Results:

A total of 11 articles were included in this review. The AUC of ABC for predicting mortality ranges from 0.59 to 0.71, and morbidity ranges from 0.673 to 0.743. The AUC of ACC score for predicting mortality ranges from 0.704 to 0.87, and a study revealed the AUC of morbidity is 0.730. The AUC of RACHS-1 for predicting mortality ranges from 0.68 to 0.782. The AUC of STS-EACTS for predicting mortality ranges from 0.739 to 0.8 and 0.732 for predicting morbidity.

Conclusion:

ABC, ACC, RACHS-1, and STS-EACTS have acceptable to excellent discriminatory ability in predicting mortality and morbidity among CHD patients requiring cardiac surgery.
Failure to wean off after a routine total anomalous pulmonary venous connection operation: An uncommon association
Authors: Dhanak Riddhi , Halder Vikram , Shah Ritesh , Mishra Amit , Kothari Shyam S.
Published: April 2024

A 6-month-old infant was operated on for supracardiac total anomalous pulmonary venous connection (TAPVC) with usual anatomy. The vertical vein was ligated. Weaning from bypass was attempted twice but was unsuccessful. Coronary sinus atresia was suspected and identified on the opening of the right atrium. A smooth postoperative course occurred after unroofing the coronary sinus. Coronary sinus atresia should be remembered as an uncommon association with TAPVC.
Dapsone – Reinventing the Wheel or Rekindling Possibilities?
Authors: Bhat Ramesha M , Madhumita Monisha , Monteiro Rochelle Cheryl
Published: April 2024

Dapsone, once a fabric dye, is a versatile pharmaceutical for treating diseases like leprosy, malaria, and HIV-AIDS-related pneumonia. Discovered in 1908 but not utilized for its antimicrobial properties until the 1930s, dapsone faced initial setbacks due to toxicity, prompting the development of a safer derivative, Promin. Chemically, dapsone's lipid-soluble nature allows for extensive distribution throughout the body and involves complex metabolism, with a variable elimination half-life. Its clinical efficacy is due to its bacteriostatic action, inhibiting dihydrofolic acid synthesis, and its anti-inflammatory effects on neutrophils. Dapsone's dosing is tailored to the individual's condition and is approved for various dermatological conditions. However, its use is limited by contraindications in certain anemic conditions and potential side effects such as hemolytic anemia and methemoglobinemia, necessitating careful monitoring and management strategies to mitigate risks. Despite these challenges, dapsone's broad therapeutic utility and ongoing research into its mechanisms maintain its status as a significant medical therapy.
Unresolved Malady of Pyoderma Gangrenosum: A Study of its Profile and Outcome in a Tertiary Care Center
Authors: Prathibha JP , Madhukara J , Bhat Pernaje Ishwara , Gowda Inchara
Published: April 2024

Introduction:

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of uncertain etiology characterized by rapidly progressive, painful skin ulcers, and is often difficult to diagnose. The common underlying disease associations include rheumatoid arthritis (RA), inflammatory bowel disease (IBD), autoimmune inflammatory conditions, and malignancies, both hematological and solid organ tumors.

Aims and Objectives of the Study:

Assess the demographics, clinical presentation and associated systemic diseases, and response to treatment of patients with pyoderma gangrenosum.

Materials and Methods:

In this retrospective study, all cases diagnosed as PG were evaluated along with disease associations and outcomes over a 5-year period.

Results:

A total of 42 patients’ charts were studied of which, ulcerative PG was seen in 86.4%, pustular in 16.8%, bullous in 14.4%, and vegetative in 2.4% patients, respectively. Thirty-six percentage of them had RA, 12% had non-RA connective tissue disease, 9.6% had IBD, 9.6% had chronic liver disease, and 4.8% had malignancy. Positive pathergy was seen in 57% of our study patients. Multiple morphological types with recurrences were more common in patients with positive pathergy. Mortality was seen in 9.6% of patients. Statistics: Descriptive statistics were reported as mean with standard deviation, number, and percentages. Association between the clinical characteristics of the variables was done using Chi-square test.

Conclusion:

PG with multiple morphological types with multifocality is frequently associated with exacerbation of the underlying disease. RA was the most common association found. Recurrent disease was more common in older patients (>40 years).
A Case of Herpes Zoster Simulating Pemphigus Vulgaris Flare
Authors: Babu C Rahul , Mathew Pretty , Joy Bifi , Rajiv Sridharan , Praveen P Aparna
Published: April 2024

Pemphigus vulgaris is an autoimmune bullous disorder caused by autoantibodies directed against desmogleins. There is an increased risk for developing herpes zoster in pemphigus vulgaris due to the prolonged and high doses immunosuppressant therapy. Here, we present a 52-year-old female patient with extensive pemphigus vulgaris who developed herpes zoster while on treatment which resulted in a diagnostic confusion and a Tzanck smear acted as a lifesaver revealing both multinucleated giant cells and acantholytic cells. Hence, a prompt decision of reducing the immunosuppressant and initiation of IV acyclovir helped the patient to recover faster. This case highlights the relevance of simple bedside investigation like Tzanck smear and reminds the clinician once again to be open to all possibilities.
Atypical Rare Presentations of Cutaneous Tuberculosis: A Report of Two Cases
Authors: Srihari Sahana , Ranugha P S S , Shastry Veeranna , Betkerur Jayadev B
Published: April 2024

Cutaneous tuberculosis (TB) is the result of a chronic infection by Mycobacterium TB. The clinical manifestations are variable and depend on the interaction of several factors. TB and malignancy present global threats claiming millions of lives and inflicting formidable suffering worldwide. We present two cases of atypical, rare presentations of cutaneous TB. Cases of concurrent scrofuloderma and lupus vulgaris (LV) with miliary tuberculosis of the lung and cutaneous tuberculosis; atypical presentation of LV with concurrent HIV in a 10 year old child. Concurrent presentation of cutaneous TB with internal organ involvement is a rare entity in an immunocompetent asymptomatic individual like our patient. HIV coinfection with cutaneous TB has not been described in any of the childhood series published from India and ours is probably the first report of its kind. It is imperative that physicians have a high index of suspicion to quickly and effectively diagnose and treat these substantially morbid skin conditions.
Saddled by the Saddle Nose: A Case of Wegener's Granulomatosis
Authors: Shilpa Kanathur , Ramesh Heera , Somashekhar Sachin , Leelavathy B
Published: April 2024

Wegener's Granulomatosis with polyangiitis (GPA) is a systemic disease of unknown etiology characterized by necrotizing granulomatous inflammation, tissue necrosis, and variable degrees of vasculitis in small- and medium-sized blood vessels. The classical clinical triad consists of involvement of the upper airways, lungs, and kidneys. Saddle-nose deformity is a well-recognized complication of GPA but more commonly occurs due to leprosy, trauma, cocaine abuse, and sarcoidosis. Since this entity is not commonly encountered in our country, we present a unique case of a middle-aged woman presenting with saddle-nose deformity and the diagnostic dilemmas faced by us. This case is being reported due to its rarity in Indian literature.
Palmoplantar Erythrodysesthesia: An Unusual Side Effect of Lenvatinib
Authors: Dhinoja Niraj Virendrabhai , Hirma Shubhangi P , Bodar Priyanka Dilipbhai , Vora Rita Vipul
Published: April 2024

Palmoplantar erythrodysesthesia also known as hand-foot syndrome is an intense, painful erythema of the palms and soles due to chemotherapeutic drugs. The most commonly implicated drugs are multi-kinase inhibitors such as sorafenib, sunitinib, doxorubicin, cytarabine, and docetaxel. The most effective management is withdrawal or reduction of drugs. Oral and topical corticosteroids and dimethyl sulfoxide are other treatment options. A 67-year-old male patient of hepatocellular carcinoma taking tablet lenvatinib presented with multiple tender erythematous plaques and patches over the bilateral palms and dorsum of the fingers after 1 month of initiation of therapy. The patient was successfully treated with dose reduction of lenvatinib and topical corticosteroids and is maintained on medium potency corticosteroid.
A Knee Pain Referred to a Dermatologist
Authors: Suprakasan Aravind , Sudhir Nayak UK , Kudva Ranjini
Published: April 2024

A painful lesion on the skin can arise from any of the cutaneous structures. A 51-year-old man presented with left knee pain of 1-year duration that got aggravated by contact with clothing or light touch. His symptoms failed to improve despite multiple visits to orthopedics and neurologists. On examination, a 1 cm × 2 cm tender nodular lesion was present on the left knee with surface scaling. Dermoscopy showed peripheral scaling with a rich vascular network interlaced with structureless white areas. The lesion was excised, and histopathology showed fibrocollagenous tissue along with a well-circumscribed encapsulated tumor composed of islands and nests of monomorphic cells with round centrally placed nuclei, reported as a glomus tumor. Post excision, the patient was asymptomatic, and no recurrence was observed. Glomus tumors are classically described to arise from fingertips or extremities. Atypical sites can also be involved, with very few cases reported in the literature.
A Study of the Clinical Patterns of Hair Loss in Female Patients
Authors: Prabhu Sweta R. , Madhusudhana M , Bhute Soumya , Naveen Kikkeri N. , Athanikar S. B.
Published: April 2024

Background:

Hair loss is the one of the most common complaints in dermatologic patients. The proper cause of female pattern hair loss is still unclear. Many studies have been done on the individual patterns of hair loss but there are very few studies available about the different clinical patterns of hair loss in females in a single study.

Objectives:

To evaluate the clinical patterns of hair loss in females which manifest in various disorders.

Materials and Methods:

120 subjects were studied in a hospital based descriptive study with detailed history, general physical examination, detailed hair, scalp, cutaneous examination, clinical tests, routine haematological investigations, biopsy where indicated.

Results:

Maximum subjects were in the age group of 20 – 40 years (66.6%). Majority of the subjects presented with a diffuse hair loss (55.8%). In our study although majority of the cases were not associated with any illness (52.5%), among the ones associated with illness the most common associated illness was history of COVID-19 (25.8%). Very few presented with scarring hair loss (5%).

Conclusion:

Telogen Effluvium was the most common cause of hair loss with maximum prevalence among females aged 20 to 40 years, with majority having hair loss over a period of 6 weeks to 6 month without any concurrent illness. The findings of this study provide baseline information on common clinical presentation of hair loss among women in our setting, thus helping in early clinical diagnosis and planning appropriate treatment.
A microbial assessment of instrumentation and noninstrumentation laser disinfection technique: An in vivo study
Authors: Alex Anaida Clara , Geeta I. B. , Chandra R. Vinay , Arvind B.
Published: April 2024

Introduction:

The present study compares the reduction in microbial count of instrumentation versus noninstrumentation laser disinfection technique.

Methods:

Thirty patients with periapical lesions ranging 3–5 mm in single-rooted teeth were selected for the study. The groups were divided into two main groups: Group 1 – instrumentation technique and Group 2 – noninstrumentation technique subjected to laser disinfection. Group 2 was again subdivided into two groups: Group 2A – only laser disinfection and Group 2B – laser disinfection and medicament. The groups were analyzed for the reduction in microbial count. The Kruskal-Wallis test was used to compare mean differences in colony-forming unit (CFU) counts. Post operative mean CFU between the three groups were compared using Dunn’s Post Hoc analysis. The level of significance was set at P < 0.05.

Results:

Significant differences were noted in mean CFU counts between Group 1 and Groups 2A and 2B (P = 0.006 and P = 0.001, respectively). Among Groups 2A and 2B, the reduction in the microbial count of Group 2B is better than 2A although not significant.

Discussion:

The use of Er:YAG laser allows for effective use in disinfection due to its favorable properties such as antimicrobial effect, photoacoustic streaming, vapor bubbles effect, and lack of negative thermal impact on the periodontium.

Conclusion:

Significant shifts were observed in both the groups, but the impact of the shift was greater in the laser-assisted groups. Noninstrumentation laser disinfection technique shows promising results when compared to conventional techniques.
An Innocuous-Looking Abdominal Wall Swelling in an Endometrial Cancer Survivor
Authors: Choudhary Deepti , Jain Pankhuri , Kumar Rahul , Garg Pankaj Kumar
Published: April 2024

This case report describes a rare example of a solitary abdominal wall metastasis in a middle-aged endometrial cancer (EC) survivor 3 years following disease-free status. Following induction chemotherapy, she had a margin-negative surgical excision of the abdominal tumor. Surprisingly, the patient has been disease-free for more than 3 years after the operation. This emphasizes the necessity of addressing single metastasis amenable to surgical resection, as well as the need for diligent monitoring to discover recurrences sooner. Understanding rare locations of recurrence, such as the abdominal wall, is critical for optimum EC therapy and care. The data given in this article adds to the existing body of information on atypical presentations and recurrent EC therapy. Additional research is required to develop evidence-based guidance.