bluuebunny/crossref_metadata_2025 huggingface dataset:
SANITATION ENVIRONMENTAL DETERMINANTS WITH EVENTS OF DIARRHEA IN CHILDREN IN RESIDENTIAL SOLID WORK AREA HEALTH PUBLIC HEALTH CENTER RUMBAI PEKANBARU CITY
Authors: Rasyid Zulmeliza , Meliyanti Rezki , Susanti Nurvi , Harnani Yessi
Published: March 2020

Diarrhea is a condition where a person defecating with soft or liquid consistency (three times or more) in one day. Pekanbaru City Health Department data obtained by the number of diarrhea cases in Puskesmas Rumbai handled in 2013 totaled 670 cases (28%), the year 2014 amounted to 827 cases (35%). The purpose of this study is Knowledgeable picture and determinants of environmental sanitation with the incidence of diarrhea in infants in the densely populated area Puskesmas Rumbai Pekanbaru This type of research is an analytic-quantitative with cross sectional design. The sample amounted to 102 infants. Methods of data collection is done by interviews and data collection tools were questionnaires. Quota sampling using sampling techniques. Computerized data processing. The data analysis univariate and bivariate with chi-square test. The results were obtained landfills value of p = 0.001 and OR = 3.13, waste water management, with p = 0.004 and OR = 3.60, type of latrine with a value of p = 0.002 and OR = 5.60, the distance means clean water cesspools with p = 0.001 and OR = 10.29. So we can conclude all the variables associated with the incidence of diarrhea in the densely populated area Puskesmas Rumbai Pekanbaru It is expected that the health center Rumbai Pekanbaru doing outreach to the community about the importance of environmental sanitation hygiene so that children are not susceptible to diarrheal diseases.
A Sociolinguistic Study on the Development of Grammar System of Treatment Expression
Authors: Yonemoto Akira
Published: March 2020

Analysis of the language in which honorific expressions are developed has revealed various findings. The social and cultural background can be considered by analyzing the history of the honorifics, etc., but the honorifics are often used in colloquial language. Is also an issue of this research. Since honorifics reflect not only their practical aspects but also society, culture, and ideas, it is one clue to know from the history and usage of honorifics, and there is room for sociolinguistic analysis and consideration. Is an area where there are still many.
Public Policy Implementation: Study on Educational Budgeting of Palopo
Authors: Amir Ahyar
Published: March 2020

This study aims to analyze the content of the policy in the implementation of the Education Budget in the Palopo City Budget and to analyze the policy context in the implementation of Palopo Regional Educational Budgeting in the. This study uses a qualitative approach through the use of interviews, direct observation in the field and analysis of written materials as the main data source. From the research results obtained, the indicator of interest that is influenced shows the interests of the school become more attentive and more accommodated. Implementation of Free Education in the field where the school benefits in the form of the use of free education funds for additional incentives from teaching hours of teachers outside of school hours and additional operational costs, the use of free education at the elementary level more budget absorbed for intensive teachers and for junior high school budgets more absorbed in the costs of supporting school activities such as stationery for the office and teaching and learning activities. In the implementation of free education, the decision-making process is carried out through deliberations that involve all interested parties (students' parents through the school committee and the school itself). Characteristics that are different from each school makes it difficult for schools to implement free education programs. The existence of this free education program makes the active role of parents in paying attention to the learning of students to be reduced.
The “Belt and Road” Initiative and Overseas Chinese in Southeast Asia
Authors: Yonemoto Akira
Published: March 2020

Since China's proposal of the “Belt and Road” initiative in 2013, the relationship between China and Southeast Asia has continued to develop. This achievement is inseparable from a large number of overseas Chinese living in Southeast Asia. As an indispensable and unique force to promote the construction of the “Belt and Road”, the Southeast Asians Chinese have played an irreplaceable role: such as support of Chinese culture spreading, building confidence and disambiguation among countries, and economic and trade cooperation. The problems and challenges facing Chinese culture in Southeast Asia are not only related to the development of Chinese society in Southeast Asia but also the current development of Chinese native culture. To overcome the problems and challenges encountered in the process of inheriting Chinese culture in Southeast Asia, we must clearly understand the status of overseas Chinese and the role that overseas Chinese can play to maximize their role and influence as carriers and bridges.
Socio-Cultural Change of Society Against Health in the Village of Panciro, Gowa Regency
Authors: Negara Ifan Surya
Published: March 2020

This study aims to determine the social and cultural changes of the community towards health in the Village of Panciro, Gowa Regency. This research method uses a qualitative approach and descriptive type. Data sources of this research are interviews and documentation. Activities in data analysis include data reduction, data display, and conclusion drawing. The results showed that traditional treatments or modern treatments can be a comparison in society, but all returned with that choice, in which both have the same goal of treating illness and healing albeit in different ways between the two. There are community norms that are strongly held by the Gowa community where men should not be shaking hands with a woman who is not his mahram (not related by blood), so a woman must be treated by a doctor of the same sex. The Government of Gowa Regency pays attention to the health sector by cutting the administration process to hasten the queue so that this can be a trigger for people to prefer treatment at the hospital rather than traditional medicine.
Apparatus Professionalism and Public Service Ethics
Authors: Insani Nurul
Published: March 2020

To make changes in the organization and increase the professionalism of the apparatus it is important to redefine what the organization wants to achieve, build a payroll system that promotes the value of fairness and build organizational structures that allow for rapid decision-making processes. many factors can affect the professionalism of the apparatus, including the organizational culture that arises and crystallizes in bureaucratic traffic, organizational goals, organizational structure, work procedures in bureaucracy, incentive systems. Public service providers must study ethical norms that are universal because they can be used as guidelines for their behavior in providing services to the community.
Practical Implementation of an Indoor Robot Localization and Identification System using an Array of Anchor Nodes
Authors: AL-Forati Israa , Rashid Abdulmuttalib
Published: March 2020

This paper proposes a low-cost Light Emitting Diodes (LED) system with a novel arrangement that allows an indoor multi-robot localization. The proposed system uses only a matrix of low-cost LED installed uniformly on the ground of an environment and low-cost Light Dependent Resistor (LDR), each equipped on bottom of the robot for detection. The matrix of LEDs which are driven by a modified binary search algorithm are used as active beacons. The robot localizes itself based on the signals it receives from a group of neighbor LEDs. The minimum bounded circle algorithm is used to draw a virtual circle from the information collected from the neighbor LEDs and the center of this circle represents the robot’s location. The propose system is practically implemented on an environment with (16*16) matrix of LEDs. The experimental results show good performance in the localization process.
Review of the biological aspects in the periodontal ligament and alveolar bone associated with compression
Authors: Azevedo Andrea Castilho Soares de , Ferreira Lydia M. , Aloise Antonio Carlos
Published: March 2020

Background: Tissue remodeling requires protein degradation through a process directly dependent on metalloproteinases — enzymes capable of degrading the majority of proteins in this system. This process is regulated by some enzyme inhibitors, and balance between enzyme and inhibitor activity is fundamental to tissue integrity and health. Bone resorption and formation, and the molecules involved in these processes, raise questions on possible differences in tissue behavior in the system. Histological studies of tissues surrounding teeth that have been subjected to such forces show the presence of tension (associated with bone formation) and compression, which induce bone resorption. The duration of load application is an important parameterin osteoclastogenesis. The present study aimed to analyze the biological aspects associated with in vitro compression of the PL and alveolar bone. To this end, we reviewed articles describing the biological events that occur in the PL and alveolar bone during load application on this system and the possible influence of culture medium on the expression of molecules involved in response to such an event.

Methods: This literature review included articles published between March 2008 and January 2018 describing in vitro laboratory tests and data on load application and its associated biological events in the human PL and alveolar bone, including studies on molecular-expression events and pathways involved in the process.

Conclusions: Intermittent compressive forces stimulate bone resorption in orthodontic treatment, while cyclical forces induce cellular apoptosis at lighter loads than do compressive forces. Both 2D and 3D cell-culture systems seem to reproduce the physiology of evaluated tissues and are reliable analytical models for research purposes.
DISTRIBUTION OF TRAFFIC SPEED IN DIFFERENT TRAFFIC CONDITIONS: AN EMPIRICAL STUDY IN BUDAPEST
Authors: Zefreh Mohammad Maghrour , Török Ádám
Published: March 2020

Fundamental diagram, a graphical representation of the relationship among traffic flow, speed, and density, has been the foundation of traffic flow theory and transportation engineering for many years. Underlying a fundamental diagram is the relation between traffic speed and density, which serves as the basis to understand system dynamics. Empirical observations of the traffic speed versus traffic density show a wide-scattering of traffic speeds over a certain level of density, which would form a speed distribution over a certain level of density. The main aim of the current research is to study on the distribution of traffic speed in different traffic conditions in the urban roads since the distribution of traffic speed is necessary for many traffic engineering applications including generating traffic in micro-simulation systems. To do so, the traffic stream is videotaped at various locations in the city of Budapest (Hungary). The recorded videos were analysed by traffic engineering experts and different traffic conditions were extracted from these recorded videos based on the predefined scenarios. Then their relevant speeds in that time interval were estimated with the so-called “g-estimator method” using the outputs of the available loop detectors among the videotaped locations. Then different parametric candidate distributions have been fitted to the speeds by Maximum Likelihood Estimation (MLE) method. Having fitted different parametric distributions to speed data, they were compared by three goodness-of-fit tests along with two penalized criteria (Akaike Information Criterion – AIC and Bayesian Information Criterion – BIC) in order to overcome the over-fitting problems. The results showed that the speed of traffic flow follows exponential, normal, lognormal, gamma, beta and chisquare distribution in the condition that traffic flow followed over-saturated congestion, under saturated flow, free flow, congestion, accelerated flow and decelerated flow respectively.
AN INTEGRATED DEMATEL–IF-TOPSIS METHODOLOGY FOR LOGISTICS CENTERS’ LOCATION SELECTION PROBLEM: AN APPLICATION FOR ISTANBUL METROPOLITAN AREA
Authors: Uyanik Cihan , Tuzkaya Gulfem , Kalender Zeynep Tuğçe , Oguztimur Senay
Published: March 2020

Logistics Centers (LCs) are among the most important facilities for rapid, cost effective, environmental friendly and secure logistics services to the urban logistics problems. Finding proper locations to LCs has an important effect on their success. In this study, LCs’ location selection problem for Istanbul Metropolitan area is investigated. Istanbul is a leading city of Turkey in many categories including various industries, import/export amounts, transportation infrastructure and population density. However, industrialization and urbanization have introduced numerous problems to Istanbul. New projects are continuously being announced for the problems of metropolis, however, they may also bring new problems if they are not punctiliously planned and applied. Hence, in this study, it is aimed to propose a systematic Multi-Criteria Decision-Making (MCDM) approach for the LCs’ location selection problem of Istanbul. In this approach, an integrated DEcision-MAking Trial and Evaluation Laboratory (DEMATEL) and Intuitionistic Fuzzy (IF) Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method is utilized. DEMATEL is used to analyse the decision criteria and IF-TOPSIS is used to evaluate candidate locations for LCs. Considering the vagueness inherent to this decision-making problem, IF sets are used for the evaluation process. Results are compared with the results of IF-VIKOR (VIše Kriterijumska Optimizacija kompromisno Rešenje – multi-criteria optimization and compromise solution) technique.
Correlation of Expression Transforming Growth Factor-Î²1, E-cadherin, and Ki-67 in Meningiomas
Authors: Apriyanto Apriyanto , Darwin Eryati , Arifin Muhammad Z. , Harahap Wirsma A.
Published: March 2020

BACKGROUND: Meningioma is the most common primary intracranial tumors in adults, accounts for 36% of total intracranial tumors. Obtaining the clinicopathological characteristics of patients with meningioma and investigating, the association between signaling pathways with disease progression could provide a basis for therapeutic development.AIM: This study aims to investigate the expression of transforming growth factor-Î²1 (TGF-Î²1), E-cadherin, and Ki-67 in meningiomas.MATERIALS AND METHODS: This study examined the expression levels of E-cadherin, Ki-67, and TGF-Î²1 with respect to the WHO grade in patients with meningioma. A total of 62 meningioma samples were analyzed. By the WHO criteria, 54 specimens were diagnosed as the WHO Grade 1, 6 as Grade 2, and 2 as Grade 3. Grade 1 was classified as low-grade meningioma, while Grade 2 and Grade 3 were classified as high-grade meningioma (HGM).RESULTS: In this study, the mean age diagnosis was 41.97 Â± 9.79 years old, with female: male ratio of 8:1. There was no association between age, sex, and tumor location with the progression of meningioma. Immune-characterization revealed that HGM was associated with the higher number of Ki-67+ cells (p < 0.0001) and lower expression of TGF-Î²1 and E-cadherin (p < 0.001). The number of Ki-67+ cells was inversely correlated with TGF-Î²1 and E-cadherin (p < 0.05). TGF-Î²1 expression was positively correlated with E-cadherin expression (p < 0.0001).CONCLUSION: This study concluded that HGM was highly proliferative (high Ki-67+) and invasive (low E-cadherin), with dysregulated TGF-Î²1 signaling. In addition, younger age at diagnosis and high female: male ratio in our series suggests that Indonesian females might possess specific risk factors for having meningioma.
Rituximab and Cyclophosphamide in Antisynthetase Syndrome–related Interstitial Lung Disease: An Observational Retrospective Study
Authors: Langlois Vincent , Gillibert André , Uzunhan Yurdagül , Chabi Marie-Laure , Hachulla Eric , Landon-Cardinal Océane , Mariampillai Kuberaka , Champtiaux Nicolas , Nunes Hilario , Benveniste Olivier , Hervier Baptiste
Published: March 2020

Objective

Antisynthetase syndrome (AS)-related interstitial lung disease (ILD) has a poor prognosis. Intravenous cyclophosphamide (IV CYC) and rituximab (RTX) are the main treatments currently used for moderate to severe ILD. Here, we compare the efficacy of CYC followed by standard immunosuppressive treatment (IST) versus RTX in AS-related ILD.

Methods

This observational retrospective study was conducted between 2003 and 2016 in 3 tertiary care centers. All patients with AS-related ILD and treated with CYC or RTX with at least 6 months of follow-up were included. Pulmonary progression-free survival (PFS), defined according to the American Thoracic Society guidelines, was assessed at 6 months and 2 years. All severe adverse events (AE) were recorded.

Results

Sixty-two patients were included. Thirty-four patients received 2–12 monthly IV CYC pulses, followed by standard IST in 30 cases (88%). The RTX group included 28 patients. Following the initial Day 1 to Day 15 infusions, RTX was repeated every 6 months in 26 cases (93%) and 15 patients (54%) concomitantly received another IST. The median steroid dose was similar between both groups. Although RTX and CYC demonstrated similar PFS at 6 months (92% vs 85%, respectively), RTX was superior at 2 years (HR 0.263, 95% CI 0.094–0.732, P = 0.011). Interestingly, lower diffusing lung capacity for carbon monoxide (DLCO) at baseline was independently predictive of poor 2-year PFS [0.965 (0.936–0.995), P = 0.023]. Forced vital capacity and DLCO improved in both groups without significant differences. Serious AE were similar in both groups.

Conclusion

Despite similar PFS at 6 months, RTX was associated with a better 2-year PFS compared to CYC in patients with AS-related ILD.
Five-year Evolution Patterns of Physical Activity and Sedentary Behavior in Patients with Lower-limb Osteoarthritis and Their Sociodemographic and Clinical Correlates
Authors: Bitar Sarah , Omorou Abdou Y. , Van Hoye Aurélie , Guillemin Francis , Rat Anne-Christine
Published: March 2020

Objective

The present study aimed to identify trajectories of physical activity (PA) components (frequency, duration, intensity, and type) and screen-based sedentary behavior (SB) as well as baseline predictors of each trajectory in patients with hip and/or knee osteoarthritis (OA).

Methods

We included 878 patients with a 5-year follow-up from the KHOALA cohort. PA and SB were measured by the Modifiable Activity Questionnaire. We used group-based trajectory analysis to identify the trajectories of PA components and screen-based SB, and multivariable logistic regression to determine predictors of the identified trajectories.

Results

Two groups of trajectories were identified for each PA component and 3 for SB. High and decreasing PA duration was associated with female sex (OR 0.3, 95% CI 0.1–0.5) as was low and stable, more so than high and decreasing prevalence of weight-bearing activities (OR 0.6, 95% CI 0.4–0.9). Patients with impaired patient-reported outcome measures and obese patients often featured low versus high and decreasing prevalence of weight-bearing activities. Predictors of moderate and high versus low and slightly increasing screen-based SB trajectories were male sex, age < 60 years, single status (OR 1.5, 95% CI 1.1–2.1), obesity (OR 2.1, 95% CI 1.4–3.1), smoking (OR 2.0, 95% CI 1.1–3.7), and less physical jobs. Predictors of moderate and high versus low screen-based SB trajectories were all sociodemographic: male sex, age < 60 years, single status, obesity, smoking, and less physical jobs.

Conclusion

Sociodemographic and clinical predictors of trajectories vary between PA components; they are associated mainly with PA frequency and type. No clinical characteristics were associated with screen-based SB.
The Association of an Increasing Waist Circumference and Risk of Incident Low Physical Function in Adults with Knee Osteoarthritis
Authors: Christiansen Meredith B. , Thoma Louise M. , Master Hiral , Voinier Dana , White Daniel K.
Published: March 2020

Objective.

To investigate an 8-year change in waist circumference (WC) with the risk of incident low physical function over 1 year in adults with, or at risk of, knee osteoarthritis (OA).

Methods.

Data from the Osteoarthritis Initiative were used. Change in WC was measured from study enrollment (0 month) to the 96-month visit and classified as Increase (≥ 5cm gain) or Maintain (< 5cm gain). We identified World Health Organization (WHO) risk category based on WC at study enrollment as Large WC (males ≥ 102 cm, females ≥ 88 cm) or Small WC (males < 102 cm, females < 88 cm). The outcome was incident low physical function (≥ 28 Western Ontario and McMaster Universities Osteoarthritis Index physical function subscale) at the 108-month visit. To investigate the association of the 8-year change in WC with the risk of low physical function, we calculated risk ratios (95% CI) and adjusted for potential confounders. We repeated the analyses stratified by the WHO disease risk category.

Results.

The Increase WC group had 1.43 (95% CI 1.04–1.96) times the risk of incident low physical function compared to adults in the Maintain WC group. Adults with a Large WC at baseline who increased WC had 1.55 (95% CI 1.00–2.37) times the risk of incident low physical function compared to those who maintained WC. Adults with a Small WC at baseline who increased WC had 1.97 (95% CI 0.84–4.63) times the risk compared to those who maintained WC.

Conclusion.

Increasing WC increases the risk of incident low physical function in the following year. Maintaining WC may mitigate developing low physical function.
Antinuclear Antibodies Testing Method Variability: A Survey of Participants in the College of American Pathologists’ Proficiency Testing Program
Authors: Naides Stanley J. , Genzen Jonathan R. , Abel Gyorgy , Bashleben Christine , Ansari M. Qasim
Published: March 2020

Objective

This study was conducted to determine the spectrum of laboratory practices in antinuclear antibody (ANA) test target, performance, and result reporting.

Methods

A questionnaire on ANA testing was distributed by the Diagnostic Immunology and Flow Cytometry Committee of the College of American Pathologists (CAP) to laboratories participating in the 2016 CAP ANA proficiency survey.

Results

Of 5847 survey kits distributed, 1206 (21%) responded. ANA screening method varied: 55% indirect immunofluorescence assay, 21% ELISA, 12% multibead immunoassay, and 18% other methods. The name of the test indicated the method used in only 32% of laboratories; only 39% stated the method used on the report. Of 644 laboratories, 80% used HEp-2 cell substrate, 18% HEp-2000 (HEp-2 cell line engineered to overexpress SSA antigen, Ro60), and 2% other. Slides were prepared manually (67%) or on an automated platform (33%) and examined by direct microscopy (84%) or images captured by an automated platform (16%). Only 50% reported a positive result at the customary 1:40 dilution. Titer was reported to endpoint routinely by 43%, only upon request by 23%, or never by 35%. Of the laboratories, 8% did not report dual patterns. Of those reporting multiple patterns, 23% did not report a titer with each pattern.

Conclusion

ANA methodology and practice, and test naming and reporting varies significantly between laboratories. Lack of uniformity in testing and reporting practice and lack of transparency in communicating the testing method may misdirect clinicians in their management of patients.
Analysis of Anti-RNA Polymerase III Antibody-positive Systemic Sclerosis and Altered GPATCH2L and CTNND2 Expression in Scleroderma Renal Crisis
Authors: Stern Edward P. , Guerra Sandra G. , Chinque Harry , Acquaah Vanessa , González-Serna David , Ponticos Markella , Martin Javier , Ong Voon H. , Khan Korsa , Nihtyanova Svetlana I. , Harber Mark , Burns Aine , Mayes Maureen D. , Assassi Shervin , Fonseca Carmen , Denton Christopher P.
Published: March 2020

Objective

Scleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis (SSc) strongly associated with anti-RNA polymerase III antibody (ARA) autoantibodies. We investigated genetic susceptibility and altered protein expression in renal biopsy specimens in ARA-positive patients with SRC.

Methods

ARA-positive patients (n = 99) with at least 5 years’ follow-up (49% with a history of SRC) were selected from a well characterized SSc cohort (n = 2254). Cases were genotyped using the Illumina Human Omni-express chip. Based on initial regression analysis, 9 single-nucleotide polymorphisms (SNP) were chosen for validation in a separate cohort of 256 ARA-positive patients (40 with SRC). Immunostaining of tissue sections from SRC or control kidney was used to quantify expression of candidate proteins based upon genetic analysis of the discovery cohort.

Results

Analysis of 641,489 SNP suggested association of POU2F1 (rs2093658; P = 1.98 × 10−5), CTNND2 (rs1859082; P = 5.58 × 10−5), HECW2 (rs16849716; P = 1.2 × 10−4), and GPATCH2L (rs935332; P = 4.92 × 10−5) with SRC. Further, the validation cohort showed an association between rs935332 within the GPATCH2L region, with SRC (P = 0.025). Immunostaining of renal biopsy sections showed increased tubular expression of GPATCH2L (P = 0.026) and glomerular expression of CTNND2 (P = 0.026) in SRC samples (n = 8) compared with normal human kidney controls (n = 8), despite absence of any genetic replication for the associated SNP.

Conclusion

Increased expression of 2 candidate proteins, GPATCH2L and CTNND2, in SRC compared with control kidney suggests a potential role in pathogenesis of SRC. For GPATCH2L, this may reflect genetic susceptibility in ARA-positive patients with SSc based upon 2 independent cohorts.
The Challenge of Very Early Systemic Sclerosis: A Combination of Mild and Early Disease?
Authors: Blaja Elisabeth , Jordan Suzana , Mihai Carmen-Marina , Dobrota Rucsandra , Becker Mike Oliver , Maurer Britta , Matucci-Cerinic Marco , Distler Oliver
Published: March 2020

Objective.

To address the hypothesis that very early patients with systemic sclerosis (SSc) are a heterogeneous group with mild or early disease, we analyzed the extent of heterogeneity in clinical, epidemiological, and immunological characteristics of these patients.

Methods.

We performed an analysis of very early SSc patients from the Zurich cohort, who fulfilled neither the 2013 American College of Rheumatology (ACR)/European League Against Rheumatism nor the 1980 ACR classification criteria, but had a clinical expert diagnosis of SSc with Raynaud phenomenon (RP) and additional features of SSc (puffy fingers, SSc-specific antibodies, SSc pattern on nailfold capillaroscopy, or any organ involvement characteristic for SSc). Disease duration was defined from first RP symptom.

Results.

One hundred and two patients fulfilled the inclusion criteria and were analyzed. Their clinical presentation was heterogeneous with the large majority presenting with RP, antinuclear antibodies, and nailfold capillaroscopy changes, but with varying presentations of other features such as SSc-specific antibodies and early signs of organ involvement. While 54.1% (52/96) of patients had a disease duration of < 5 years, as many as 29.1% (28/96) of patients had a disease duration of > 10 years, indicating long-standing mild disease. Patients with very early, potentially progressive disease did not differ from patients with long-standing mild disease in terms of their clinical features at first presentation.

Conclusion.

This study showed that patients with very early SSc are a mixture with mild or early disease. This needs to be considered in clinical practice for risk stratification and for the study design of patients considered as early SSc.
Enthesitis-related Arthritis: Prevalence and Complications of Associated Uveitis in Children and Adolescents From a Population-based Nationwide Study in Germany
Authors: Walscheid Karoline , Glandorf Karen , Rothaus Kai , Niewerth Martina , Klotsche Jens , Minden Kirsten , Heiligenhaus Arnd
Published: March 2020

Objective.

Enthesitis-related arthritis (ERA) represents a subgroup of juvenile idiopathic arthritis (JIA) that is regularly accompanied by anterior uveitis. This study describes the prevalence and characteristics of ERA-related uveitis.

Methods.

Cross-sectional data from the National Pediatric Rheumatological Database (NPRD) were used to characterize ERA-related uveitis (ERA-U). In addition to sociodemographic variables, we documented the occurrence of uveitis and course of disease, including symptoms, visual acuity, and complications, as well as JIA characteristics such as disease activity (Juvenile Arthritis Disease Activity Score 10), functional ability (Childhood Health Assessment Questionnaire score), laboratory variables, and treatment.

Results.

In the years from 2002 to 2014, there were 3778 (15.2%) of a total of 24,841 JIA patients recorded in the NPRD who had ERA, and 280 (7.4%) of them had developed uveitis. Detailed ophthalmological documentation by a uveitis add-on module was available for 22.9% of these patients. Uveitis onset was acutely symptomatic in 63% of patients. Patients with uveitis were more frequently male, HLA-B27–positive, younger at ERA onset, and they had higher erythrocyte sedimentation rate values at first uveitis documentation than those without uveitis. Uveitis was diagnosed at a mean age of 11.5 (± 3.9) years (50% within 2 years after ERA onset). Systemic treatment with corticosteroids and synthetic and biologic disease-modifying antirheumatic drugs was associated with a (not significantly) lower risk of developing uveitis.

Conclusion.

The course of disease in ERA-U patients is frequently similar to HLA-B27–associated uveitis in adults; however, a subgroup of patients presents with asymptomatic uveitis.
Not Every Picture Tells a Story: A Content Analysis of Visual Images in Patient Educational Resources About Gout
Authors: Krasnoryadtseva Alina , Derksen Christina , Dalbeth Nicola , Petrie Keith J.
Published: March 2020

Objective.

The aim of this study was to evaluate which concepts about gout and its treatment are reflected in images in online educational resources about gout.

Methods.

A Google search was performed to identify English-language patient resources from medical and health organizations and health education websites in 7 countries: Australia, Canada, Ireland, New Zealand, South Africa, UK, and USA. Two raters independently coded the images in the resources into 5 main categories: clinical presentations of gout, urate/monosodium urate (MSU) crystals, medicines, food/healthy lifestyle, and other advice for people with gout.

Results.

In total, 103 resources were identified; 28 resources without images were excluded. Seventy-one educational resources with a total of 310 images were included in the study sample. Of the 310 images, clinical presentations of gout were depicted in 92 images (30%), food/healthy lifestyle in 73 images (24%), urate/MSU crystals in 50 (16%), medicines in 14 (5%). Urate-lowering medication was shown only in 1 image (0.3%) and just 6 images (2%) depicted a serum urate target. Ninety-one images (29%) did not convey specific information about gout.

Conclusion.

Key concepts about gout and treatment are underrepresented in the images used in educational resources for patients. A large proportion of the images do not convey useful information about gout or its management.
Correlation of a Modified Disease Activity Score (DAS) with the Validated Original DAS in Patients with Juvenile Dermatomyositis
Authors: Clairman Hayyah , Dover Saunya , Whitney Kristi , Marcuz Jo-Anne , Bell-Peter Audrey , Feldman Brian M.
Published: March 2020

Objective.

Juvenile dermatomyositis (JDM) is a rare disease in children that is treatable, but patients may suffer from long-term effects. Clinical trials are needed to find better treatments for affected patients. Among validated tools for evaluating disease activity clinically is the Disease Activity Score (DAS), but it is not routinely collected in all clinics. We developed a modified DAS (DASmod), which can be scored using data routinely collected by our clinical staff and has been used in previous studies. The aim of this study was to determine if our DASmod correlates with the validated DAS in patients with JDM.

Methods.

In this study, we used DASmod (scored 0–12) and DAS (scored 0–20) scores for patients with JDM in our clinic. We analyzed the correlation between the DASmod and the validated DAS.

Results.

For 51 patients seen in our JDM clinic, the median (IQR) DASmod score was 2.0 (0–4.0) and the DAS score was 3.0 (0–5.5). Scores on the 2 tools were highly positively correlated (r = 0.94, P < 0.001, 95% CI 0.89–0.96). The linear regression was significant [R2 = 0.88, F (1, 49) = 357.60, P < 0.001] and in this dataset, the tools can be used interchangeably with the regression equation: DAS score = –0.26 + 1.5*DASmod.

Conclusion.

If the regression equation from this dataset is successfully tested against future datasets, then further research collaborations between centers that collect different data related to disease activity in children with JDM will be facilitated.
Les états du moi et leur interaction selon J. Grégoire : une introduction
Authors: Dejean Hélène
Published: March 2020

Dans cet article, l’auteure nous montre comment elle s’est approprié le travail de José Grégoire sur les états du moi. Cette compréhension de la construction des états du moi, qui entraîne un changement de perspective, éclaire également pour l’auteure la compréhension de la formation du scénario. La vignette, relatant l’application de la théorie de la perspective de l’interaction dans la pratique, nous plonge au cœur d’un moment de thérapie. Hélène Dejean nous propose « d’ouvrir notre regard » : à la lecture de cet article, c’est chose faite. F. H.
Porte-« deuil » : Interférences subjectives, sociales et politiques au sujet des portés-disparus à Chypre
Authors: Petrou Michaël A.
Published: March 2020

Cet article vise à mettre en évidence, à travers un exemple spécifique, les interférences entre la souffrance personnelle, les phénomènes sociaux et les choix politiques. Depuis l’invasion turque de Chypre en 1974, plusieurs centaines de personnes sont considérées comme des portées disparues. Malgré les exhumations d’ossements récemment identifiés avec un nombre considérable de personnes disparues, le processus de leur deuil demeure inachevé. L’article s’efforce de montrer comment le deuil entravé des disparus chypriotes grecques est lié à une série de processus de deuil non résolus, de nature plus générale, principalement en ce qui concerne le traumatisme collectif de l’invasion et ses conséquences : les familles des disparues sont chargées de la fonction de porte-« deuil »: en faveur de la communauté et des stratégies politiques.
Lignes de failles générationnelles à propos des enfants juifs cachés en France pendant la seconde guerre mondiale
Authors: Feldman Marion
Published: March 2020

Cet article se propose d’identifier les modalités de transmission des traumatismes à leurs enfants vécus par les enfants juifs cachés pendant la Seconde Guerre mondiale. Après avoir rappelé le vécu si singulier de ces enfants devenus adultes, puis à travers l’analyse d’une situation de recherche clinique, nous montrons les processus à l’œuvre. Le premier concerne un vécu douloureux avec une transmission ambivalente du mortifère et des pulsions de vie ; le second correspond au fait que les enfants juifs cachés ont représenté une génération particulière ayant un vécu spécifique. La discussion s’articule autour des notions importantes de filiation, de transmission d’une crypte et d’un héritage transgénérationnel complexe mais également de la contrainte à la transformation et à la narrativité.
La fragilisation des métacadres sociaux dans le contexte de l’exil : quelles répercussions sur la transmission psychique ?
Authors: Bourguignon Manon , Katz-Gilbert Muriel
Published: March 2020

Lors de catastrophes sociales (Kaës, 2009) l’effondrement des métacadres sociaux déstabilise les formations métapychiques qui sont à la fois conditions de la vie psychique et de sa transmission. En situation d’exil politique, en quoi et comment sont-ils fragilisés, dans la transmission des métacadres psychiques et en particulier des contrats identificatoires ? Ces questions sont explorées ici dans le cas de sujets descendants d’exilés politiques chiliens vivant en Suisse, particulièrement sous l’angle du remaniement des appartenances affiliatives. Si nos résultats témoignent de la singularité du travail de subjectivation de l’héritage et la diversité des mouvements de transmission à la nouvelle génération, ils mettent surtout en évidence que l’étayage sur la dimension groupale favorise la reconstruction des garants métapsychiques soutenant ainsi le processus de transmission. A l’inverse, lorsque cette dimension fait défaut, la transmission de la négativité se perpétue et s’enracine.
Comment faire coopérer une équipe pluridisciplinaire dans un projet entrepreneurial ?
Authors: Verzat Caroline , Liu Tiphaine
Published: March 2020

À quelles conditions des équipes entrepreneuriales peuvent-elles coopérer alors que les étudiants proviennent d’écoles très différentes ? L’article étudie le cas du programme Matrice faisant travailler ensemble 15 étudiants volontaires issus de Sciences Po et de l’école 42, dont les relations à l’entrepreneuriat et à l’apprentissage sont radicalement opposées. L’analyse des contrats d’apprentissage des étudiants au départ, de leurs débriefings en fin de parcours et du journal du coach, met en évidence les freins et les leviers de la coopération ainsi que l’impact du système de formation en termes de création d’activité et de transformation socioprofessionnelle.
Disrupter la formation et l’accompagnement des entrepreneurs : le cas LiveMentor
Authors: Verzat Caroline , Prétot Anaïs , Schlumberger Édouard
Published: March 2020

L’entretien explique l’origine, l’offre et les enjeux d’organisation et de croissance du système de formation et d’accompagnement entrepreneurial LiveMentor. La disruption repose sur une offre en ligne à bas coût et sur l’industrialisation du processus de formation / accompagnement dans le domaine de la stratégie et des outils de marketing digital, qui sont au cœur de l’activité des travailleurs indépendants offrant leurs produits ou services sur internet.
Enseigner l’entrepreneuriat, accompagner les étudiants : question(s) de légitimité
Authors: Le Pontois Sandrine
Published: March 2020

La question de la légitimité des enseignants en entrepreneuriat est une question rarement posée. En constante évolution, l’éducation en entrepreneuriat est un espace générateur d’innovation dans tous les domaines : pédagogies, contenus, activités. Les changements induits font naturellement l’objet de résistances de la part des acteurs en lien avec les institutions, Écoles ou Universités, qui questionnent ainsi le bien-fondé de ces démarches. Des tensions émergent et remettent en cause la légitimité de l’enseignant dans l’exercice de ses fonctions. Établie sur une revue de littérature intégrative, cette recherche propose une définition plurielle de la légitimité de l’enseignant en entrepreneuriat. En identifiant les acteurs à l’œuvre dans ce processus, elle souligne les différentes tensions pesant sur la légitimité de l’enseignant. La recherche identifie des leviers permettant le développement professionnel et académique de ce dernier, tout en renforçant sa légitimité perçue.
L’échec dans les parcours professionnels : une analyse processuelle et interactionniste par les tensions identitaires et leur résolution
Authors: Demaret Julie , Gilson Adeline
Published: March 2020

Les mécanismes qui conduisent à l’échec individuel dans des parcours professionnels et leur mode de résolution constituent un point aveugle de la recherche en gestion. Cet article propose un modèle d’analyse de l’échec dans les parcours professionnels qui croise quatre dimensions : les transactions objective et subjective (Dubar, 2015), les tensions et les stratégies identitaires. Six cas d’échecs et quatre stratégies identitaires (manipulation des résultats, compétence, suivisme et fuite) sont identifiés à partir d’une étude longitudinale couplant 87 entretiens et des observations auprès de contrôleurs de gestion et de conseillers bancaires de trois organisations. Notre recherche montre l’importance de la dimension relationnelle et subjective de l’échec dont la résolution nécessite la mise en place de stratégies évolutives. Notre approche interactionniste et processuelle nous permet ainsi d’aborder les échecs les plus masqués dans les organisations.
Certifié « Cadre administratif de pôle » LTD . L’encastrement identitaire pour légitimer un nouveau rôle
Authors: Burellier Franck , Orvain Jacques , Angelé-Halgand Nathalie , Ruiller Caroline , Laude Laëtitia , Baret Christophe , Gavault Sophia , Louazel Michel
Published: March 2020

La nouvelle gouvernance hospitalière a créé un nouveau rôle de cadre administratif de pôle d’activité, rôle totalement inédit dans les hôpitaux. Censé assister le chef de pôle, en collaboration avec un cadre coordonnateur, ce cadre administratif n’a cependant pas une ligne de fonctionnement claire, d’autant plus dans un environnement qui, lui, est fortement institutionnalisé. Nous posons dans ce travail la question de la légitimation de ce nouveau rôle au sein des équipes de pôle : comment les cadres administratifs procèdent-ils pour légitimer leur rôle aux yeux de leurs collègues ? Pour y répondre, nous mobilisons la littérature concernant la légitimation de nouvelles pratiques ainsi que celle relative au travail identitaire ; puis nous utilisons une étude de 4 cas d’équipes de pôle « Mère-Enfant » en France, comprenant chacune un cadre administratif, à partir d’une démarche qualitative (30 entretiens, 8 observations de réunions). Nos résultats montrent comment les cadres administratifs de pôle s’attèlent à insérer leur identité dans le fonctionnement des équipes de pôle, tout en justifiant l’utilité de leur rôle auprès de ces acteurs. Nous discutons finalement le concept d’encastrement identitaire en lien avec la théorie néo-institutionnelle et celle du travail identitaire, ainsi que les implications pour la gestion des équipes de pôle.
Watizat ? Informer en contexte d’urgence
Authors: Doyen Pauline
Published: March 2020

Le droit à une information exacte, transmise dans une langue que les personnes exilées comprennent, est loin d’être assuré en France, bien que la législation l’impose. Les supports d’information disponibles sont souvent inadaptés au contexte d’urgence et insuffisants par rapport aux besoins identifiés. Le Guide de la demandeuse et du demandeur d’asile à Paris , par Watizat, tente de pallier ces écueils tout en relevant le défi d’une mise à jour constante et d’une traduction accessible au plus grand nombre en entretenant un dialogue actif avec les personnes exilées.
Demander l’asile dans sa langue
Authors: Mahroug Naoual , Bouagga Yasmine
Published: March 2020

Longtemps négligée dans la procédure d’asile 1 , la question linguistique fait désormais l’objet d’une plus grande attention. Les mobilisations en faveur du droit des étrangers ont conduit à renforcer le droit des personnes, au titre d’usagères de l’administration, à être informées des décisions les concernant dans une langue qu’elles comprennent et des mesures ont été prises pour développer l’accès à l’interprétariat en préfecture. Pourtant, il demeure difficile et incertain, pour les personnes étrangères arrivant en France, d’accéder à l’information sur leurs droits : les difficultés de compréhension participent ainsi à leur mise à l’épreuve face aux institutions.
Dieux, amours et serpents dans la peinture de Nicolas Poussin. L’autre XVII e siècle d’Hélène Bouchilloux
Authors: Touboul Patricia
Published: March 2020

Le Paysage avec un homme tué par un serpent , peint par Nicolas Poussin en 1648, a donné lieu, depuis celles de Félibien, Fénelon ou Diderot, à de multiples lectures, suggérant telle source poétique ou telle gravure pour rendre compte de l’identité du personnage mort ou de celle du serpent, sans qu’aucune de ces hypothèses paraisse décisive. Celle que propose Hélène Bouchilloux désigne Narcisse pour le personnage mort et Python pour le serpent : Poussin aurait mis en scène la « destitution » de l’amour stérile en même temps que celle de l’idée erronée de la peinture incarnée par le Caravage. Cette hypothèse séduisante présente toutefois des difficultés méthodologiques, tant dans l’interprétation du texte d’Ovide que dans l’approche comparative de plusieurs toiles de Poussin, n’évitant pas le risque d’une surinterprétation.
L’errance et l’impasse diagnostiques dans les maladies rares d’origine génétique
Authors: Faivre Laurence , Vitobello Antonio , Padre Magali , Odent Sylvie , Domenighetti Laetitia , Giot Gwendoline , Thauvin Christel
Published: March 2020

Plus de 8 000 maladies rares sont répertoriées à ce jour et l’on en découvre de nouvelles chaque mois. 80 % d’entre elles sont d’origine génétique. On considère qu’environ la moitié des patients atteints de maladies rares n’ont pas de diagnostic étiologique précis. Vivre sans diagnostic peut entraîner un parcours médical difficile avec une prise en charge retardée ou non optimisée des personnes touchées, et un risque d’isolement. Un diagnostic peut être la clé qui va débloquer l’accès à des soins médicaux et à des services sociaux efficaces, peut permettre de connaître les risques de transmission, ainsi que plus rarement d’accéder à des possibilités thérapeutiques. En l’absence de diagnostic clinique, l’accès à un diagnostic causal est fortement conditionné par l’accès aux technologies de séquençage haut débit, et en particulier au séquençage de l’exome pour certaines pathologies comme les maladies du développement et la déficience intellectuelle. Le séquençage de l’exome n’est cependant proposé à titre diagnostique que dans quelques centres en France. La mise en place de cette offre diagnostique, pourtant très efficace et inégalable sur le plan du rendement et du délai, a été essentiellement freinée en raison de considérations économiques et éthiques. Plusieurs études emblématiques nationales sont en cours pour répondre aux questions posées. Les Plans nationaux maladies rares (PNMR) 1 et 2 ont mis en place des réseaux de soins pour lutter contre l’errance diagnostique et permettre d’orienter les malades vers des centres experts pouvant porter un diagnostic. Le PNMR3 s’attaque maintenant aux situations d’impasse diagnostique et le Plan France médecine génomique 2025 vise à permettre le séquençage du génome à tout patient concerné.