bluuebunny/crossref_metadata_2025 huggingface dataset:
L’autonomie doctrinale des principes de justice : force ou faiblesse de la théorie rawlsienne ?
Authors: Audard Catherine
Published: June 2023

La question de la cohérence de la théorie rawlsienne de la justice et de son tournant politique a été depuis longtemps une source de débats et de malentendus. Pour certains interprètes, l’abandon par le second Rawls d’un fondement kantien des principes de justice au profit d’un libéralisme purement politique serait un prix trop élevé à payer pour obtenir un large consensus sur des principes de justice dans des sociétés démocratiques traversées par des conflits de valeurs insurmontables. « La vérité dérangeante ( inconvenient truth ) que Rawls découvre est qu’il est impossible, écrit Robert Taylor (2011), de parvenir à un consensus par recoupement sur une conception kantienne de la personne ou plus largement sur la justice comme équité », mais qu’en même temps, sans un tel fondement, la force morale de la théorie de la justice serait diluée. Dans cet article, je voudrais répondre à ces critiques et montrer que, bien loin de conduire au relativisme, l’exigence d’autonomie doctrinale et d’indépendance des principes de justice à l’égard de toute conception substantielle du Bien exprimée par Rawls ( Libéralisme politique , p. 133) exprime le sens qu’a pour lui l’idéal démocratique : le respect pour l’autonomie morale des personnes et le rejet de « la pratique séculaire de l’intolérance comme condition nécessaire à l’ordre et à la stabilité de la société » ( Libéralisme politique , p. 14). Mais un tel idéal n’est-il pas irréaliste ? Faire ainsi confiance à l’autonomie des citoyens, à leur capacité à distinguer entre leurs doctrines morales personnelles et des principes publics de justice ( Libéralisme politique , p. 7) ne risque-t‑il pas d’affaiblir les démocraties au lieu de garantir leur stabilité, comme l’espère Rawls ( Libéralisme politique , p. 4) ? Cette ambition d’autonomie doctrinale est-elle une force ou une faiblesse de la théorie rawlsienne ?
Faut-il abandonner la position originelle ?
Authors: Munoz-Dardé Véronique
Published: June 2023

La position originelle a une élégance et un attrait qui vont au-delà de la plupart des figures philosophiques. Il s’agit peut-être de l’aspect de la théorie rawlsienne qui ait le plus fasciné les lecteurs de Théorie de la justice . Bien que très étudiée, réinterprétée et critiquée, la position originelle est souvent présentée de façon erronée. En particulier, la méthode de raisonnement de John Rawls derrière le voile d’ignorance est souvent comprise comme si les conclusions qu’elle induit se situaient dans le seul cadre du choix rationnel. Il y a donc différentes interprétations de la position originelle, correspondant à des perspectives plus ou moins proches d’une perspective éthique dans le cadre du choix rationnel, que ce soit le conséquentialisme ou l’utilitarisme. Mon but dans cet article est de clarifier le but de la position originelle rawlsienne. J’explique la différence entre une interprétation qui part du choix rationnel et des préférences des individus pour définir ce qui est exigé par la justice distributive et une interprétation qui met au contraire l’accent sur la justification raisonnable. Je montre que même si nous renonçons à l’ambition d’arriver à des principes de justice dans la seule perspective du choix rationnel, nous devons retenir plutôt qu’abandonner la position originelle. Je conclus en montrant que la principale différence entre l’utilitarisme et la théorie rawlsienne réside non dans la distribution que ces deux théories recommandent, mais dans la stratégie de justification qu’elles adoptent.
Nucléaire : dialogues croisés depuis le début de la guerre en Ukraine
Authors: Maitre Emmanuelle
Published: June 2023

Depuis 2022, la guerre en Ukraine se déroule sous l’ombre du nucléaire. La Russie utilise cette menace dans le cadre d’une stratégie de coercition. Dès lors, les autres États dotés d’armes nucléaires doivent se positionner pour répondre à la rhétorique russe sans se livrer à une dangereuse escalade. Au niveau bilatéral et multilatéra l’ordre mondial nucléaire est bouleversé par ce conflit et par la réaffirmation de la menace nucléaire.
C2 Multi-milieux multi-champs (M2MC) : imposer la complexité sans la subir
Authors: Besse Jean-Paul
Published: June 2023

Les opérations Multi-milieux multi-champs (M2MC) et le contexte de continuum entre compétition, contestation et affrontement imposent aux forces armées de renforcer l’agilité de leurs systèmes de commandement et de contrôle (C2) dans l’intégration de leurs effecteurs, afin de garantir la liberté d’action et la supériorité décisionnelle sur l’adversaire.
Peut-on être créatif en management ?
Authors: Agogué Marine , Flückiger Johann
Published: June 2023

Le management évolue sans cesse, au gré des besoins des employés qui changent et des crises qui frappent le monde du travail. Les gestionnaires doivent maintenant affiner, voire réimaginer, leurs pratiques en faisant preuve de créativité. Autrement dit, ils doivent agir non seulement comme des praticiens, mais aussi comme des concepteurs du management.
Se déconnecter du travail : un droit en devenir ou une responsabilité collective ?
Authors: Rousseau Alexandre , Bertholet Jean-François
Published: June 2023

Pouvoir commencer à travailler aux premières heures de la journée quand vous êtes en pleine forme pour finir plus tôt : vous ne voyez que des avantages au télétravail ! Or, si votre patron vous appelle un vendredi à 16 h 40 alors qu’il n’y a aucune urgence, vous répondez ou vous ne répondez pas ?
Diagnostic – Relancer les centres-villes canadiens
Authors: Venne Jean-François
Published: June 2023

Pour contrer l’oubli provoqué par la succession ininterrompue de nouvelles quotidiennes, Gestion décortique les enjeux qui se cachent derrière les grands titres.
De la statue à la pierre selon José Saramago
Authors: Levécot Agnès
Published: June 2023

José Saramago a affirmé en 1999, et répété plus d’une fois, que dans la première phase de sa production romanesque, il n’a fait que décrire des statues, restant à la superficie de la pierre. Puis, à partir de L’Aveuglement , explique-t-il, « j’ai perçu le nouveau monde qui se présentait à moi si j’abandonnais la superficie de la pierre pour en pénétrer l’intérieur ». Il s’agit ici de montrer comment se manifeste ce changement de perspective à partir de quelques exemples tirés de son œuvre romanesque et de discuter cette assertion.
Son cœur de pierre
Authors: Weiller Nina
Published: June 2023

Texte inédit.
Hors monde ?
Authors: Barbaras Renaud
Published: June 2023

Le Hors phénomène consiste en ceci que ce n’est pas seulement l’horizon de l’existence qui se trouve bouché mais la possibilité même d’ouvrir un horizon qui est compromise. Il ne renvoie pas à une certaine apparition qui, aussi violente soit-elle, suppose toujours le champ de l’apparaître, mais bien à un ébranlement de la possibilité même d’apparaître : à une phénoménologie de la nuit, qui étend la phénoménalité jusqu’à l’inapparaissant ou au neutre, il faudrait opposer une nuit de la phénoménologie. La question qui se pose alors est la suivante : de cette nuit de la phénoménologie, y a-t-il encore une phénoménologie ou ne signifie-t-elle pas plutôt une sortie pure et simple de la phénoménologie ? En répondant par l’affirmative, en faisant une phénoménologie du Hors phénomène, ne court-on pas le risque d’ouvrir à nouveau l’horizon dont le Hors phénomène est la dénonciation en acte ?
L’extra-phénoménalité à l’épreuve de la solitude
Authors: Audi Paul
Published: June 2023

Hors phénomène prétend à une « philosophie créatrice ». Or c’est bien ce pas, quasi nietzschéen, qu’accomplit Emmanuel Falque en distinguant l’ infra -phénoménal, le supra -phénoménal et l’ extra -phénoménal. Il développe une « philosophie pour temps de crise » et ouvre un champ essentiel pour la pensée aujourd’hui. On se demandera cependant si un tel déport hors de la phénoménalité n’avait pas déjà été au moins aperçu par Martin Heidegger, non pas dans le « retrait », mais dans le « recouvrement » et la « dissimulation » du phénomène. C’est en réalité avec la psychanalyse que l’auteur dialogue ici, quoique sans la citer souvent, y ayant déjà consacré un livre par ailleurs : « Ça » n’a rien à voir (Cerf, 2018). Les notions de « sidération » et de « refoulement » aideraient grandement à éclairer la notion de Hors phénomène. Et c’est surtout à Rousseau et aux Rêveries du promeneur solitaire qu’il faut revenir. Car loin d’être une simple « solitude privative », cette méditation rousseauiste décrit en propre ce que le dernier chapitre de Hors phénomène nomme la « solitude originelle ».
Hors phénomène et l’homme blessé
Authors: Philippart de Foy Olivier
Published: June 2023

En quoi Hors phénomène peut-il nous aider à penser le handicap mental ? On y trouve l’essentiel, à savoir qu’on n’a d’autre choix que de se tenir « devant ce quoi on bute » les uns « à côté ou aux côtés » des autres. Toutefois pour parvenir à « “être-là” pour “vivre avec” », il ne suffit pas de se confronter au trauma du handicap mental car nous sommes aussi convoqués-attendus ailleurs. Si le handicap mental traumatise la personne qui le subit, cette personne à son tour traumatise ses proches. On découvre alors que toute situation traumatique comprend deux scènes traumatiques. Or, comme y insiste Emmanuel Falque, le pire est de ne pas parvenir à constituer « son noyau de solitude ». Comment faire pour rester présent à ceux qui éveillent en nous plus d’inquiétude que de joie et ne pas glisser de la solitude à l’esseulement ?
L’enfantement, un problème non théologique ?
Authors: Picard Clarisse
Published: June 2023

À l’heure où les techniques reproductives sont sur le point de remplacer le corps et la subjectivité des femmes dans l’enfantement, il vaut la peine de s’interroger sur les enjeux anthropologiques, mais aussi téléologiques et théologiques de l’enfantement : en quoi l’enfantement, défini comme l’expérience d’incarnation de soi, d’une mère et de son enfant, serait-il un problème théologique ? La présente réflexion se propose de déployer cette question dans l’horizon du problème du rapport entre incarnation phénoménologique et Incarnation théologique, en empruntant le chemin d’une phénoménologie de l’enfantement, selon « la voie de la monadologie », l’une des voies par lesquelles la phénoménologie husserlienne tâche d’« atteindre Dieu sans Dieu ». Au terme de l’itinéraire, un sujet singulier devenant mère fait apparaître la source originaire constituante, le mouvement et le sens constitué de l’expérience phénoménologique de l’enfantement, ainsi que son rapport à l’ idée de Dieu chez Husserl.
Fixed point results with applications to nonlinear fractional differential equations
Authors: Al-Mezel Saleh Abdullah , Ahmad Jamshaid
Published: June 2023

The aim of this paper is to define a Berinde type ($ \rho $, $ \mu $)-$ \vartheta $ contraction and establish some fixed point results for self mappings in the setting of complete metric spaces. We derive new fixed point results, which extend and improve some results in the literature. We also supply a non trivial example to support the obtained results. Finally, we investigate the existence of solutions for the nonlinear fractional differential equation.
El Centro Interamericano de Vivienda - CINVA y los orígenes de la experimentación con bloques de tierra comprimida (BTC) en la vivienda social (1953-1957)
Authors: Galindo-Díaz Jorge , Escorcia-Oyola Olavo , González-Calderón Alleck J.
Published: June 2023

En este artículo se recoge la génesis de procesos constructivos con bloques de tierra comprimida (BTC) en países en desarrollo y como tema central se describe, valiéndose de fuentes primarias, el proceso experimental llevado a cabo en el Centro Interamericano de Vivienda - CINVA entre 1953 y 1957 que condujo tanto al desarrollo de la máquina Cinva-Ram para la producción de BTC, como al diseño y construcción de viviendas en este material, con el objeto de cualificar las técnicas de la edificación y lograr una vivienda de bajo costo para sectores rurales de América Latina. Las conclusiones están orientadas no solo a rescatar del olvido este ejercicio de naturaleza técnica y social, sino también a poner en evidencia la importancia del trabajo investigativo bajo principios de contextualización en el ámbito de la tecnología de la arquitectura.
Optimización y diseño de colocación de muros de relleno en marcos estructurales de 4 y 8 plantas
Authors: Domínguez-Santos David J.
Published: June 2023

En la construcción, el ladrillo y el hormigón son los materiales más utilizados, ocupando una parte importante del presupuesto de edificación. Su gran versatilidad en la construcción contrasta con la fragilidad de estos elementos. Esta solución es adecuada para edificios de baja altura, pero no está tan clara para edificios de altura media y alta, debido a su baja ductilidad y su peso. La correcta ubicación de estos muros en los edificios podría mejorar su comportamiento resistente y dúctil. En esta investigación se encontrará la solución óptima para la colocación de muros de relleno con ladrillos en pórticos de 4 y 8 pisos, considerando ductilidad y resistencia.
A Systematic Review of the Intelligent Digital Storytelling Process in Disseminating Health Information
Authors: Eambunnapong Kawitsara , Nilsook Prachyanun , Wannapiroon Panita
Published: June 2023

Digital storytelling is a new concept in education that involves creating meaning. It is a tool with great potential, but in Thailand, it is currently not very popular in terms of sharing stories about disease. This review analyzes the components and processes of intelligent digital storytelling to aid the development of an intelligent digital storytelling platform for disseminating health information. Based on the synthesis of relevant documents, the research process involves 9 main steps: 1) identifying the review objectives, 2) reviewing research questions, 3) determining inclusion criteria, 4) finding relevant studies, 5) selecting documents, 6) data extraction, 7) arriving at a conclusion, 8) document synthesis and 9) discussion of the results. A study of articles from the PRISMA Checklist published between 2017 and 2022 revealed that ultimately only 47 articles met the inclusion criteria. From the analysis of the data, it was found that there are four main elements and 16 sub-components of intelligent digital storytelling. There are 12 steps in the process of intelligent digital storytelling with regard to health information dissemination. The optimal length of an intelligent digital narrative video clip relating to health information dissemination is approximately 2-5 minutes when it comes to achieving the best knowledge of health information.
Working with Students with Special Educational Needs and Predictors of Burnout. The Role of ICTs.
Authors: Stathopoulou Agathi , Spinou Despina , Driga Anna Maria
Published: June 2023

The purpose of this study was to examine the burnout dimensions of professionals working with students with special educational needs and the role played by their personal traits in the prevalence of the syndrome. To examine this objective a sample of Greek teachers was selected. The data was collected using the online form of Maslach Burnout Inventory. The results of this research showed that the main prognostic factors of the syndrome in each dimension are the total previous service with students with special educational needs, the specialty, as well as, the age of the sample.
Élaborer le cercle méridien Ertel & Sohn de l’Observatoire de Neuchâtel (1858-1861) : besoins scientifiques, possibilités techniques et contraintes financières
Authors: Gressot Julien , Jeanneret Romain
Published: June 2023

Lors de la fondation d’un observatoire, le choix de l’instrumentation est d’une grande importance pour réaliser des observations scientifiques reconnues et s’insérer ainsi dans le réseau international d’institutions astronomiques. Durant le xixe siècle, le cercle méridien est l’instrument central de l’astronomie de position. Son acquisition par le nouvel Observatoire de Neuchâtel est donc un moment crucial pour une institution qui entend être à la pointe de la mesure du temps. À partir d’une riche correspondance entre un astronome et un fabricant, les enjeux entourant l’élaboration d’un cercle méridien tirant le parti d’innovations électrotechniques se donnent à voir. En considérant l’instrument comme un maillon d’un assemblage spécifique, une chaîne opératoire de la détermination de l’heure, nous allons approfondir la constitution d’un instrument scientifique de haute précision : le cercle méridien Ertel & Sohn de l’Observatoire de Neuchâtel.
Les lanternes publiques, exosquelette de la « machine » policière (Paris, xviiie siècle)
Authors: Bothereau Benjamin
Published: June 2023

Que peut apporter l’histoire des techniques à la compréhension de la police moderne ? Cet article vise à montrer comment la généralisation de l’éclairage public parisien au xviiie siècle participe à la matérialisation de l’action policière dans la cité, en même temps qu’elle alimente la métaphore de la « machine » policière. Les lanternes, en éclairant de façon homogène et synchrone tout le territoire parisien, prennent non seulement part au nouveau style policier mais donnent véritablement « corps » à la jeune lieutenance de police parisienne.
Chronique de l’activité de la Défenseure des droits en matière de lutte contre les discriminations Octobre 2021 – Octobre 2022
Authors: Badré Lalie , Berlemont-Collombel Eric , Mazille Mathilde , Vassetizadeh-Dourandish Mathieu
Published: June 2023

Après la publication, la semaine dernière, de l’activité d’octobre 2021 à octobre 2022 de la Défenseure des droits dans la lutte contre les discriminations liées à l’origine, voici cette semaine un état des lieux de sa dense activité en matière de discriminations liées au genre et à l’orientation sexuelle. Les nombreuses affaires individuelles qu’elle a eu à connaître ont donné principalement lieu à des règlements amiables ou des observations en justice, qu’il s’agisse de transidentité et d’accès aux biens et services (A), de genre et d’emploi (B) ou encore d’adoption et d’orientation sexuelle (C).
Smart Village Infrastructure and Rural Communities
Authors: Praveen Pushkar , Khan Ayoub , Verma Agya Ram , Kumar Manoj , Peoples Cathryn
Published: June 2023

Rural communities around the world face significant challenges in accessing basic services such as healthcare, education, and sanitation, as well as in promoting economic growth and environmental sustainability. In short, smart village infrastructure has emerged as a potential solution to the challenges faced by rural communities around the world. By leveraging technology and innovation, smart village infrastructure has the potential to increase access to basic services, promote economic growth and environmental sustainability, and improve the overall quality of life in rural communities. However, addressing the challenges of funding, skilled labor, and community engagement requires a holistic approach that involves collaboration between multiple stakeholders. The policy recommendations provided in this paper can help promote smart village infrastructure and sustainable rural communities.
Achieving Sustainable Agriculture
Authors: Ali Syed Asif
Published: June 2023

Sustainable agriculture means an integrated agricultural system (IAS), which is a prolonged or long-term support system that fulfils the requirements of agricultural products, improves the environment (by controlling, improving, and monitoring natural biological cycles), and boosts the economy. Crop product quality and quantity have increased significantly over the last half-century, owing in large part to organic chemistry. Organic chemistry, however, remains a key component of crop protection and helps to create techniques to boost crop output. In the modern era of technology, artificial intelligence approaches are used for the analysis of soil nutrients and their optimal management on the basis of supervised learning, depending on behaviour analysis and prior experience. Soil nutrients are an essential component of soil fertility and environmental sustainability. This chapter will cover soil nutrient measurements, water irrigation, and predator control through artificial intelligence techniques such as decision making, artificial neural networks, and machine learning.
Exploring the Frontiers of Microfluidics
Authors: Patel Dhirendra
Published: June 2023

This chapter deals in detail with microfluidics and its fundamental concept. It gives a clear look at what actually is microfluid and lists down the details of the overview and development of the application of microfluidics. It lays down the properties of microfluidics and also describes how these properties help in making microfluidic devices, and how these devices are different from traditional ones. This chapter hereby illustrates the different challenges related to microfluidic device design and the possible solutions associated with it. It also deals in detail with the various types of microfluidic flow and discusses what is open microfluidic flow and continuous flow microfluid. This chapter has all the necessary content about the application of microfluid in different sectors and also inculcates the future scope of microfluidics. This chapter talks about how microfluidics has become an essential component of various devices that are integral to modern-day society. This chapter contains a discussion of a wide range of applications from drug delivery to DNA sequencing.
Microfluidic Technology for Advanced Drug Delivery Systems
Authors: Patil Ankit , Nimdeo Yogesh M.
Published: June 2023

Drug delivery is a procedure to transport drugs to an appropriate site for effective action, achieving the benefits of drugs. In the past few decades, nano-sized drug particles have attracted many researchers to develop an efficient drug delivery system. Microfluidic technology, for its ability to synthesize precise nanoparticles with uniform size, has emerged as a reliable technology for drug delivery. The microreactor has been established as a promising device due to its ability to provide intensive mixing in low-dimension microchannels having a high surface-to-volume ratio. It synthesizes drug particles with higher encapsulation efficiency and uniform particle size. The enhancement in the encapsulation efficiency results in the controlled release of drug particles at the appropriate site for effective medication. In addition, other applications of microreactors to synthesize various organic and inorganic nanoparticles are also discussed in this chapter.
The Impact of Intelligent Systems on Management Accounting
Authors: Marques Sara , Gonçalves Rui , Lopes da Costa Renato , Pereira Leandro Ferreira , Dias Alvaro Lopes
Published: June 2023

In today's competitive and changing business environment, the concern about technologies and intelligent systems has gained more notoriety. However, companies still have many tasks performed by humans; in the medium-term, intelligent systems will become more present in companies and will perform tasks that are currently done by humans much more efficiently. There is a need for companies to adapt and to start thinking about combining human and intelligent systems capabilities. This research was focused specifically in the management accounting profession, as these professionals spend a lot of time collecting and organizing data, doing repetitive tasks that can be easily and quickly accomplished by intelligent systems. This research studied the impact that artificial intelligence, big data, and internet of things can have in this profession.
Design of Graphic Design Assistant System Based on Artificial Intelligence
Authors: Liu Yanqi
Published: June 2023

With the development of technology, graphic design tools are becoming more and more perfect, which allows graphic designers to realize their dream designs, achieve more special effects, and thus expand their conceptual choices. The application of various new technologies in graphic design can promote the development of the graphic design industry. The emergence of artificial intelligence (AI) has broken through the layout design in traditional graphic design. In this article, the author proposes the creation of a graphic design assistant system based on AI drawing on the deep learning (DL) theory. According to the DL theory, the image is segmented by the class variance. The voxelized image matrix of a two-dimensional (2D) model is input into a convolution-automatic encoder (CAE) as input data. The input data first pass through the convolution layer of the CAE, which mainly completes the mapping of features. The research results show that the average aesthetic evaluation of the system design works in this study is higher than that of CAD software and PS software, and the total average score is as high as 8.788, which shows that the system design works in this study are more in line with the requirements of professional understanding.
The Optimization of Global Organizational Communication for Enterprise Supply Organization Management by Using Big Data Text Mining
Authors: Fu Yu , Sun Xiaoxi , Wang Weiwei
Published: June 2023

The purpose is to optimize supply chain management (SCM) programs in global organizations and promote international economic development. This paper first discusses the development of cloud technology and the international organization supply chain under big data, artificial intelligence, the internet of things, mobile internet and cloud computing (BIIMC). Then, the application design concept of cloud technology in the global organization supply chain is discussed. Finally, based on the current international organization supply chain foundation, the management optimization program is designed using cloud technology and evaluated. The results show that the program performs prominently in the SCM of Taobao and Amazon.
Burn reconstruction
Authors: Mehdizade Turan , Özcan Ebru Diana , Sifil Melih Kerem , Durgun Ufuk , Kirazoğlu Ahmet , Çamli Mehmet Fatih , Erbayat Yusuf , Asgerzade Süsen , Ekici Reha Furkan , Koç Can , Evin Nuh , Güneren Ethem
Published: June 2023

Burn injuries are severe traumatic events with a range of local and systemic repercussions. Various complications may occur in the early and late stages of burn injuries depending on the causative agent, duration of contact, degree of burn, and extent of the harm. Long after their burn scars have healed, many patients still struggle with issues related to their burn injuries. Burn scars, hypertrophic scars, keloid, contractures, heterotopic ossifications, chronic ulcerations, and marginal ulcers are late-onset complications that hurt the quality of life and result in lost productivity. Escharotomy, fasciotomy, repeated debridement, and primary wound management can lower mortality and potential complications. Complex burns should ideally be treated in specialized burn centers supervised by plastic surgeons and a multidisciplinary team of experts who treat patients holistically. This case report presents a contracture that occurred following an extensive burn to the neck, arm, and finger joints, which was successfully treated with surgery and healed without complications.
Seven-year microbiological profile and antibiotic sensitivity pattern of burn wound infections in a tertiary care hospital in New Delhi
Authors: Singh Vikas , Grover Naveen , Tandel Kundan , Jena Salil
Published: June 2023

Introduction:

Burn patients are vulnerable for opportunistic colonization by organisms of endogenous and exogenous origin. Hence, it is necessary to evaluate the flora obtained from wounds of burn patients to determine the most effective treatment. The aim of this study was to determine the incidence of various bacteria isolated from burn patients and to determine their antimicrobial susceptibility and resistance pattern spanning 7 years.

Materials and Methods:

The retrospective study included all the culture reports obtained over a period of 7 years (2012–2018).

Results:

Out of the total 1474 positive samples analyzed, the most common sample reported was pus (n = 816), followed by blood culture (n = 314), tissue (n = 188), and urine (n = 156). The most common organism cultured was Pseudomonas aeruginosa (n = 377), followed by Klebsiella pneumoniae (n = 309). Other commonly isolated organisms were Acinetobacter baumannii (n = 206), Escherichia coli (n = 89), coagulase-negative staphylococci (n = 88), Proteus mirabilis (n = 55), Burkholderia cepacia (n = 54),Staphylococcus aureus (n = 42), Candida spp. (n = 39), and Enterococci spp. (n = 36). Pseudomonas was seen to be sensitive to only colistin with resistance to all other major antibiotic classes. Klebsiella was sensitive to colistin, tigecycline, and cefoperazone/sulbactam. A. baumannii was observed to be sensitive only to colistin and tigecycline by the end of 2018 andE. coli was sensitive to amikacin, colistin, meropenem, and tigecycline.

Conclusion:

Antibiotic resistance is rampant, rapidly progressing and devouring down all the antibiotic classes one after other. The high antimicrobial resistance may be ascribed to the inappropriate use of broad-spectrum antibiotics and lack of a definite antibiotic policy in hospitals. Treating surgeons should frequently evaluate the burn patient and run regular tests to localize the most common organisms causing the infections with their antibiotic sensitivity profiles.
Atrial fibrillation - A rare arrhythmia after electrical burns
Authors: Makharia Archita , Tiwari Vineet , Barupal Kishan Gopal , Lakhotia Manoj
Published: June 2023

Electrical injuries are a commonly encountered hazard at both home and the workplace. While most electric-induced arrhythmias are conduction abnormalities or ventricular tachycardia, atrial fibrillation is uncommon. Sparse literature and lack of systematic recommendations on this topic create a challenge in treating such patients. We present a case of a young man who developed atrial fibrillation with fast ventricular rate after an episode of electrical burns, which was reverted successfully with beta-blockers.
Postburn neck contracture reconstruction by interval skin grafting
Authors: Ahmad Imran , Karad Somnath , Khurram Mohammed Fahud , Ali Sheikh Sarfraz , Tripathi Sudhanshu , Chaudhury Gautam
Published: June 2023

Introduction:

Delayed burn wound healing, due to lack of proper initial treatment, especially in deep partial-thickness and full-thickness burns leads to the formation of burn scar contracture. Because of the loose tissue in the anterior neck and also due to habitual and ignorant use of a pillow in burnt patients during the postburn recovery phase, contracture of the neck is a common sequela. Many reconstructive modalities have been described in the literature which include skin grafting, pedicle flap with or without expansion, and free flap. Keeping the esthetic concern in mind, we modified the method of contracture release and skin grafting into two stages.

Materials and Methods:

This is a prospective study conducted on 15 patients with extensive postburn contracture of the neck during the period ranging from January 2020 to August 2021.

Results:

In our study, 80% of the patients were females. The mean age was 25.9 years. The number of type 2 and type 3 neck contractures was 7 and 8, respectively. The mean duration of contracture was 8.26 months. Graft loss was the only complication seen and that too was < 10% in all cases (mean - 4.46). At 6 months, mandibular border and thyroid bulge were distinctly visible, and cervicomental angle was within the normal range (mean - 110.46) giving a youthful and appealing esthetic appearance. The mean of the Patient and Observer Scar Assessment Scale score was 2.06 for the observer component and 3 for the patient component.

Conclusion:

Interval skin grafting can be undertaken following postburn neck contracture release for better functional and esthetic outcomes.
Burn depth assessment in tattooed patients
Authors: Chu Howard , Bechar Janak , Zakaraite Jolita , Dickson John
Published: June 2023

Tattoos are commonly accepted as a lifestyle choice, with an estimated 10-20% of the global population having a tattoo. Burn injuries in tattooed skin can be challenging to assess, and incorrect management can lead to an unnecessary burden on resources. This may lead to preventable patient morbidity. We present a case series of patients presenting to our unit with burn injuries on tattooed skin, and discuss recommendations for assessing and optimising care in this cohort. Four male patients aged 23 to 50 years old are discussed in this study, with burn injuries to limb tattooed skin. One patient underwent surgical management and upon a test shave of the apparent full thickness burn with tattoo pigmentation, showed a bleeding dermis which would indicate a more superficial burn. A second patient had burn depth masked a colour tattoo that mimicked a mid to deep dermal burn. We highlight the difficulties in assessing patients with burn injuries in tattooed skin and the importance of ensuring the correct diagnosis in depth of burn. This is to allow optimal treatment and avoid potential complications that may occur as a result of misdiagnosis.
Epidemiology of severe scald in 0–5–year-old children at the Department of Plastic and Reconstructive Surgery, Gauhati Medical College and Hospital – A 5-year retrospective study
Authors: Baishya Jyotirmay , Nithin M. , Boruah Poresh , Kalita Kabita
Published: June 2023

Background:

The 0–5-year-old age group has the highest incidence of scalds. In assessing a child with scalds, it will be beneficial to look at the interactions between the host, substance, mechanism, and environment. These factors have an effect on the degree, percentage, distribution, and pattern of injury sustained by the child.

Subjects and Methods:

This retrospective study comprised children aged 0–5 years who were admitted to the Burn Unit of the GMCH, Guwahati, with scald wounds between January 1, 2017, and December 31, 2021, for a period of 5 years. After receiving ethical committee approval, the records of the patients were gathered from the medical records department of GMCH, Guwahati, during this time period.

Results:

Majority of the incidences were found in male children aged 9–12 months. Scalds commonly occur in rural areas and indoor at home. The upper lower class had the most scald injuries and parents had a poor educational status. The most common substance was hot water in a vessel. The most common mechanism was for a child to pull a hot water down over themselves. In descending order, children suffered a significantly higher proportion of scalds to the hand, chest, and face.

Conclusions:

Children should be closely supervised by elders or parents, particularly in the kitchen while at home. Parents and caregivers should receive preventive education and training. All kitchen practices, such as floor cooking, low-level shelves, and keeping hot liquids in easily accessible places, should be avoided to prevent childhood scalds.
A Case Study on Jelly Belly
Authors: Khape Nongozonuo
Published: June 2023

Pseudomyxoma peritonei (PMP) is a rare malignant growth characterised by the progressive accumulation of mucus-secreting (mucinous) tumour cells within the abdomen and pelvis. The common manifestations in patients are abdominal distension and appendicitis-like symptoms. Computed tomography scan with contrast of the chest, abdomen and pelvis is currently the imaging modality of choice for the diagnosis of PMP. As per the current guideline, the curative treatment for PMP is complete cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy. The purpose of this article is to highlight the rarity of the disease and the typical presenting symptoms, the trends in diagnosis and treatment, the role of nurses and the challenges faced in taking care of patients with rare malignancies receiving treatment.
Educational Needs of Persons with Epilepsy
Authors: Ghosh Rinki , Arunjyoti Baruah
Published: June 2023

Background:

Epilepsy is a devastating global health concern and can develop at any time in one's life. Inadequate knowledge and awareness about the disease and its causation, discrimination, social stigma are the most prevalent factors which often dissuade persons with epilepsy from seeking treatment.

Methods:

The study used descriptive qualitative research design and semi-structured interview to explore the educational needs of persons with epilepsy. Non-probability purposive sampling technique was used for selection of study sample based on study eligibility criteria. Data saturation was achieved after interviewing 8 samples. Thematic analysis was performed for analysis of the data. Statements were coded and different codes were collated into categories and subsequently into themes. Rigor and quality of the data was ensured using measures of credibility, transferability, dependability and conformability.

Results:

Three major themes namely exiguous knowledge, Deviant epilepsy management and Pragmatic challenges emerged from the analysis. The study finding revealed poor knowledge and awareness and inadequate skill in epilepsy self-management amidst many challenges among majority of the study participants.

Conclusion:

Therefore, there is a need to educate people with epilepsy about the disease and its self-management to manage their epilepsy well and enhance their quality of life.
Effectiveness of Problem-Based Learning versus Traditional Lecture Method in Terms of Knowledge among Nursing Students in a Selected Nursing College of Kashmir
Authors: Amin Ishrat , Tamang Eke Lama , Khan Mikki
Published: June 2023

Introduction:

The rapid advancement in medical technology and science demands nursing education to become hybrid, combining traditional teaching methods with modern methodologies. Problem-based learning (PBL) is one of the new methods, which facilitates student's learning.

Objective:

The study aimed to assess and compare the nursing students' knowledge regarding myocardial infarction taught by PBL and traditional lecture method.

Methods:

A quantitative research approach with post-test-only research design was used. All 50 B.Sc. 2nd-year nursing students were included in the study. A structured knowledge questionnaire was used to assess the knowledge.

Results:

The findings revealed that the mean knowledge score of nursing students in the PBL group was 24.28 and in the traditional lecture group was 19.36. The obtained mean difference between PBL group and traditional lecture group was found to be statistically significant as evident from 't' = 2.71 at 0.05 level of significance. The study findings also revealed that in the PBL group, 16% of nursing students had acquired poor knowledge, 68% had acquired average knowledge and 16% had acquired good knowledge, whereas in the traditional lecture group, 40% of students had acquired poor knowledge, 52% had acquired average knowledge and 8% had acquired good knowledge.

Conclusion:

The study revealed that the mean knowledge score after post-test of nursing students in the PBL group was higher than mean knowledge score after post-test of nursing students in the traditional lecture group; hence, PBL method was more effective than traditional lecture method.
Development and Initial Evaluation of Informal Caregiver Burnout Scale
Authors: Tamarana Rameshbabu , Jain Esha , Sinha Snigdha , Manjunatha Surabhi , Amissah Awurakua Amaki , Balaji Bhavna
Published: June 2023

Background:

Individuals in service-oriented professions, such as caregivers, often face burnout. Informal caregivers, in particular, are individuals who care for another individual/s for no monetary benefit and do not necessarily require professional training for the same.

Objectives:

The study aimed to quantify informal caregiver burnout in the form of a scale, for which the domains of three main variables concerning the tridimensional characterization of the burnout syndrome included emotional exhaustion, cynicism and professional efficacy. In addition, the scale focused mainly in primary appraisal (how the caregiver evaluates their condition) rather than secondary appraisal (coping with stressful situations). The current study evaluated the psychometric properties of the informal caregiver burnout scale (ICBS) to assess burnout levels amongst informal caregivers.

Results:

Results from exploratory factor analysis provide preliminary psychometric support for dimensionality and reliability and suggest further revisions to future versions of the scale. Importantly, dimensionality findings from the current study found two dimensions.

Conclusion:

Further, replications using a more targeted sample of participants should improve dimensionality findings.
Lack of Adequate Equipment for Healthcare – The Agony of Patients and Nurses
Authors: Akpor Oluwaseyi Abiodun , Akingbade Timothy Oluwaodojutimi , Olorunfemi Olaolorunpo
Published: June 2023

The health sector is crucial to the growth and development of a nation. Despite sound policies and interventions to develop the Nigerian health sector, there are challenges that continue to reduce the progress and achievement of universal access to healthcare. The major factors that affect the overall performance of the health system include inadequate health facilities/structure, poor human resources and management, poor remuneration and motivation, lack of fair and sustainable healthcare financing, unequal economic and political relations. Other factors inlucde neo-liberal economic policies of the Nigerian state, corruption, illiteracy, very low government spending on health, high out-of-pocket expenditure in health, and the absence of an integrated system for disease prevention, surveillance and treatment, inadequate mechanisms for families to access healthcare, and the most persistent problem, the shortage of basic and essential equipment in most public health facilities in Nigeria. The agony which patients and nurses are passing through due to the non-availability of equipment needed to render the required services causes inefficient service delivery and increases job stress. This review paper describes the enormity of the problems and recommends options vital to addressing the problem to attain equilibrium in demand, quality and efficiency in healthcare delivery.
Indole curcumin combats metastatic HBV-positive hepatocellular carcinoma by inhibiting cell proliferation, migration, and matrix metalloproteinase-9 activity
Authors: Subramanian Srividya , Pajaniradje Sankar , Tumdam Roshan , Hoda Mudassarul , Dasgupta Asmita , Rajagopalan Rukkumani
Published: June 2023

Background:

Chemical modification of the natural products and molecules can lead us toward drugs with lesser off-target effects for chemotherapeutic use against cancers. In this study, we explored the effect of an indole analog of the molecule curcumin, for the first time against HBV-positive hepatocellular carcinoma (HCC) cells in vitro.

Materials and Methods:

3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase assays were used to measure the cytotoxic effects of indole curcumin against Hep3B cells. The mode of cell death was established through acridine orange/ethidium bromide fluorescence staining, propidium iodide fluorescence staining, and the comet assay. The effect of the compound on cell migration behavior was studied through wound healing assay, whereas the effect on matrix metalloproteinase (MMP) activity was evaluated using gelatin zymography. In silico molecular docking was performed to predict the affinity of indole curcumin toward probable intracellular interacting partners.

Results and Discussion:

Indole curcumin had an antiproliferative effect on Hep3B cells, induced apoptotic mode of cell death, inhibited cell migration in time- and dose-dependent assays, and decreased MMP-9 activity levels. Molecular docking results suggest that the interaction of PI3K with indole curcumin may have led to downregulation of MMP-9 expression, thereby contributing to the overall reduction in MMP-9 activity.

Conclusion:

Our study establishes that indole curcumin is an effective cytotoxic and antimetastatic agent against hepatitis virus-B positive HCC cells. Hence, it can be a possible candidate for the treatment of hepatocarcinoma induced/promoted by the presence of chronic hepatitis B infection.
Recurrent dermatofibrosarcoma protuberans: A report of two cases involving the trunk and abdominal wall
Authors: Vindal Anubhav , Lal Tusharindra , Gupta Yashika , Kale Ashish Rasik , Lal Pawanindra
Published: June 2023

In this paper, we report two cases of dermatofibrosarcoma protuberans (DFSP) who were treated with distinct surgical approaches. In the first case, a 50-year-old woman presented with a mass on her right shoulder and underwent local excision with subsequent reconstruction using a deltopectoral flap. The second case was of a young female who presented with a giant protuberant DFSP on the anterior abdominal wall who was treated with wide local excision along with inlay mesh repair of the defect. Early excision and adjuvant radiotherapy facilitates a low recurrence rate while also improving the prognosis of the patients.
Is FGFR4 Gly388Arg missense variant a suitable prognostic marker in neuroblastoma?
Authors: Katarzyna Szewczyk
Published: June 2023

Context:

Evidence suggested that FGFR4-Arg388 allele is frequently detected in multiple cancers with rapid progression and unfavorable clinical implications.

Aims:

It was investigated whether the FGFR4 missense variant (Gly388Arg) could serve as a prognostic biomarker and therapeutic target in neuroblastoma (NB).

Materials and Methods:

FGFR4 genotypes were determined by DNA sequencing in 34 NB tumors. The results were correlated with patient outcomes and prognostic features.

Results:

The frequency of the pathogenic allele in NB tumor tissue was 47% (35.3% Gly388Arg and 23.5% Arg388Arg), which was higher than that reported in a previous study from peripheral blood. Missense variant FGFR4-Arg388 was more popular in localized tumors withouth MYCN gene amplification.

Conclusions:

We investigated, for the first time, the frequency of the FGFR4-Arg388 missense variant in NB tumors. The different distribution of the pathogenic allele was presented in different biological groups, especially with and without MYCN copy number enhancing, as well as in patients with various clinical features.
Genetic analysis of polymorphism rs10937405 of TP63 gene in breast and ovarian cancer patients of North Indian Cohort
Authors: Verma Sonali , Bakshi Divya , Bhat Gh. Rasool , Bhat Amrita , Shah Ruchi , Sharma Bhanu , Wakhloo Ajay , Heer Vikas , Chander Gresh , Kumar Rakesh
Published: June 2023

Introduction:

Ovarian and breast cancers are highly prevalent in the population of Jammu and Kashmir (J&K). However, case–control association studies on breast and ovarian cancers are lacking in this population. Moreover, no case–control study is available on variant rs10937405 of TP63 in breast and ovarian cancers. Thus, we designed to replicate the cancer susceptible variant rs10937405 of TP63 in ovarian and breast cancers in the population of J&K because the TP63 gene act as a tumor suppressor gene and was previously associated with various cancers.

Materials and Methods:

This case–control association study conducted at the Shri Mata Vaishno Devi University, includes 150 breast, 150 ovarian cancer cases, and 210 healthy controls (age and sex-matched). Variant rs10937405 of the TP63 gene was determined by the TaqMan assay. Hardy–Weinberg equilibrium for the variant was assessed using the Chi-square test. The allele and genotype-specific risks were estimated by odds ratios (ORs) with 95% confidence intervals (CI).

Results:

In this study, variant rs10937405 of TP63 gene did not show any risk with ovarian and breast cancer with (P-value = 0.70) having OR 0.94, (0.69–1.28 at 95% CI) and (P-value = 0.16) having OR 0.80, (0.59–1.10).

Discussion:

Our results indicate that the variant rs10937405 of the TP63 gene did not impart any risk of breast and ovarian cancer in the population of J&K. Our results indicate that a larger sample size is needed for further statistical validation. As the study was for a particular variant, it warrants the analysis of other variants of this gene.