bluuebunny/crossref_metadata_2025 huggingface dataset:
L’urgence de la justice climatique
Authors: Boyce James K. , Carenini Emma
Published: April 2023

La proposition phare de la justice climatique consiste à dire que la transition historique des énergies fossiles à l’énergie propre doit s’accompagner d’une transition vers un ordre social plus égalitaire. Une taxe carbone associée à un dividende carbone versé directement aux citoyens permettrait de réduire nettement nos émissions de carbone au travers d’une véritable politique sociale.
La garantie à l’emploi vert
Authors: Madec Adrien , Ouizille Alexandre , Bourdier Antoine
Published: April 2023

La garantie à l’emploi vert constitue une pièce maîtresse de la reconstruction écologique. À rebours du récit libéral de la fin du travail, elle propose une vision de la société qui garantit à chacun une place d’utile au monde, à soi et aux autres, conformément à la promesse républicaine.
Paroles d’agriculteurs
Authors: Bet Marion , Carenini Emma , Canella Théo
Published: April 2023

Des agriculteurs et des éleveurs témoignent de l’évolution de leur métier ces dernières années et de leur rapport à la question écologique.
« On ne peut réaliser la transition écologique contre une partie de la population »
Authors: Imer Mathilde , Bet Marion , Grandin Aurore
Published: April 2023

Membre de la Convention citoyenne pour le climat, Mathilde Imbert revient sur les conséquences et les limites de cette consultation inédite.
Les limites de la victimisation
Authors: Lemieux Cyril
Published: April 2023

La compréhension de la situation actuelle des classes populaires est souvent envisagée selon deux perspectives apparemment contraires : pour les uns les polarités de classe auraient aujourd’hui disparu au profit d’une moyennisation de la société, pour les autres la dislocation de la classe ouvrière aurait renforcé les effets de domination sur les classes populaires qui souffriraient des dynamiques d’individualisation. La prise en considération de l’accroissement de la division du travail social, contemporain de la mondialisation, invite cependant à une autre compréhension des classes populaires contemporaines et nous permet de penser, à partir d’elles, un individualisme concret et émancipateur.
ROH2F, ou la synecdoque d’une dynamique d’intégration
Authors: Lévy-Bruhl Milo
Published: April 2023

La carrière du rappeur Rohff est révélatrice d’une tension entre la réussite musicale et sociale (le monde de son personnage ROH2F) et l’attachement aux codes de la rue (le monde d’Housni, son prénom), qui offre un condensé de ce que le rap signifie pour la société française.
Pour les classes populaires, Le syndicalisme est-il encore un vecteur efficace de politisation à gauche ?
Authors: Pélisse Jérôme
Published: April 2023

Si les syndicats constituent toujours d’importants vecteurs de socialisation et de politisation des classes populaires, qui en demeurent les principaux adhérents, les syndicats français s’avèrent fragilisés par une culture syndicale militante qui peine à faire face aux évolutions du monde du travail, qu’il s’agisse de la précarisation ou du déclin du secteur industriel.
Comment réduire la ségrégation scolaire ?
Authors: Merle Pierre
Published: April 2023

Si la ségrégation scolaire est un phénomène relativement bien identifié, les politiques pour y remédier demeurent le plus souvent inefficaces. C’est que nous avons oublié qu’un problème aussi considérable doit recevoir une réponse systématique et globale, et non seulement ponctuelle et locale : pour réduire la ségrégation sociale et la ségrégation académique, il faut lutter contre les effets néfastes de politiques urbaines et scolaires restées trop longtemps indifférentes à la mixité sociale.
Comment raccrocher les classes populaires au projet européen ?
Authors: Leron Nicolas
Published: April 2023

Les classes populaires se sont progressivement détachées d’un projet européen qui réduit la capacité des États à les protéger. Pour que l’Europe sociale ne soit pas qu’un slogan creux, il importe d’abord que l’Europe devienne une puissance politique.
« Les institutions européennes où se bâtit une expertise n’évacuent pas le politique, mais le mettent à sa place. »
Authors: Guéhenno Jean-Marie , Leron Nicolas , Moreno Alexis
Published: April 2023

Le triptyque paix-prospérité-démocratie est remis en cause par l’émergence de la Chine et l’aff aiblissement interne des démocraties occidentales. Mais l’Europe dispose des ressources humaines pour articuler de manière équilibrée le niveau de l’expertise et celui de la politique.
Pourquoi la gauche devrait prendre au sérieux le déficit commercial
Authors: Brice Benjamin
Published: April 2023

La gauche abandonne généralement le thème du déficit commercial aux représentants du centre et de la droite. C’est probablement une erreur, car cette question touche à des problèmes décisifs : la surconsommation de produits industriels, le manque de crédibilité de la France au sein de l’Europe, les déséquilibres entre classes sociales ainsi qu’entre territoires, et le manque de moyens pour financer les services publics et l’investissement.
Puissance
Authors: de Chalendar Pierre-André , Gallois Louis , Leberquier Olivier , Murciano Charles
Published: April 2023

Ce texte retrace trois entretiens conduits séparément, en janvier 2022, avec M. Pierre-André de Chalendar, président du groupe Saint-Gobain et co-président de La Fabrique de l’industrie, M. Louis Gallois, ancien président de PSA et co-président de La Fabrique de l’industrie ainsi que M. Olivier Leberquier, président de la Société coopérative ouvrière provençale des thés et infusions (Scop-TI).
Une « grande stratégie » de gauche est-elle possible ?
Authors: Escudier Alexandre
Published: April 2023

Les équilibres politiques internes ne sont jamais déliés des contraintes géostratégiques ni des interdépendances géoéconomiques externes. L’histoire de la gauche est pourtant traversée de cet impensé politique de l’externe. Face aux nouvelles demandes de protection, la doctrine du socialisme démocratique doit être refondée – sauf à sortir de l’histoire – à partir des trois socles fondamentaux des biens politiques premiers que sont les sécurités, le bien-être social et les libertés.
La mondialisation sans « capitalisme »
Authors: Phatthanasinh Emmanuel
Published: April 2023

Les notions d’« économie-monde » et de « capitalisme » développées par Fernand Braudel permettent d’analyser la mondialisation comme la domination d’une classe capitaliste sur les flux financiers. Dans ce jeu, la France et l’Europe occupent une position subordonnée.
Évolution du niveau et comparaisons internationales
Authors: Charbonnier Éric , Bet Marion
Published: April 2023

Éric Charbonnier, membre de l’OCDE à la Direction de l’éducation, revient sur les classements PISA, leur utilité et ce qu’ils révèlent à propos de la France – pays où le milieu socio-économique influe de manière particulièrement forte sur les performances scolaires. Il montre dans quelle mesure les classements internationaux peuvent orienter vertueusement les réformes politiques et rappelle les préconisations de l’OCDE en matière d’éducation.
Retour sur le projet de refondation de l’école de 2013
Authors: Peillon Vincent , Bet Marion , Cazeneuve Nathan
Published: April 2023

Vincent Peillon, ancien ministre de l’Éducation nationale, évoque les ambitions et les difficultés qu’a rencontré la loi de 2013, dite de « Refondation de l’école ». Il expose en quoi l’école primaire est une clef de l’amélioration de notre système scolaire, et ce que peut apporter une réforme des rythmes scolaires. Il développe enfin sa vision de la laïcité et d’une conception socialiste de l’école.
La gauche et l’école : tentative de clarification idéologique
Authors: Lemieux Cyril
Published: April 2023

Pour relancer une réflexion authentiquement de gauche sur l’enseignement, il importe d’effectuer une analyse idéologique des différentes politiques éducatives – libérale, réactionnaire et socialiste. Cette analyse doit s’intéresser non seulement aux discours sur l’école, qu’elle décrypte, mais également aux pratiques empiriques des acteurs de l’éducation. Ainsi pourra-t-on dégager toute la spécificité du socialisme dans son rapport aux connaissances, et ouvrir la voie à une pensée sociologique de l’autorité enseignante.
Multiples facettes diagnostiques du mensonge, illustration par un cas clinique en unité d’addictologie
Authors: Ulmann Sophie , Kajosch Hendrik , Kornreich Charles
Published: April 2023

Introduit par Dupré en 1905, le terme mythomanie a aujourd’hui disparu du manuel diagnostique et statistique des troubles mentaux (DSM) et seul le terme « mensonge » demeure en tant que symptôme illustrant la personnalité antisociale ou des troubles de conduites (American Psychiatric Association, 2015; Haustgen, 2007; Dupré, 1905). La mythomanie est seulement citée dans la CIM-11 dans la catégorie « autres troubles de la personnalité », sans description associée. Pourtant, la clinique décrite liée au mensonge est loin d’être suffisante et pose des difficultés considérables de diagnostic, de prise en charge et d’alliance thérapeutique. Elles seront étudiées à travers un cas clinique rencontré en unité d’addictologie.
Addictions et milieu carcéral : quels intérêts de l’hypnose dans ces prises en charge ?
Authors: Chevance Justine , Bioy Antoine
Published: April 2023

Les personnes incarcérées apparaissent comme présentant une situation sanitaire plus fragile que la population générale. Plusieurs événements majeurs ont permis des avancées dans la prise en charge sanitaire des détenus et plus particulièrement des problématiques addictives. Pourtant, la prise en charge des addictions en milieu carcéral reste un sujet tabou qui évolue difficilement. Alors, face à ces patients en demande de soin, comment envisager une prise en charge ? Nous exposerons le contexte sanitaire carcéral et son évolution puis les difficultés cliniques que rencontrent les psychologues dans cette clinique auprès des consommateurs de substances psychoactives en détention. Nous expliciterons la pertinence d’une prise en charge par l’hypnose pour construire une relation thérapeutique, explorer le corps enfermé dans l’addiction mais aussi dans ce milieu clos et enfin, nous ouvrirons la réflexion sur la fonction de substitution de la transe hypnotique. Nous illustrerons nos propos avec un cas clinique tiré de notre expérience en détention.
L’échappée belle
Authors: Monzani Stefano
Published: April 2023

Sous l’effet de la mondialisation, de ses métissages, de la révolution numérique liée à l’utilisation des avatars et la manipulation de soi en ligne et bien d’autres facteurs, l’image contemporaine du Soi a été bouleversée. Celui-ci est désormais conçu comme pluriel, protéiforme et décentré, ainsi que comme un objet d’expérimentations virtuelles, notamment sous l’injonction de la recherche d’authenticité. Cette perspective n’a pas non plus été sans conséquences sur la théorie et la pratique analytiques. Mais si nous sommes potentiellement plusieurs personnalités, comment trouver un équilibre identitaire et une continuité de soi ? Le cas de l’écrivain Maurice Sachs va illustrer les limites de la capacité intégratrice des soi multiples.
A possible interpretation of financial markets affected by dark volatility
Authors: Pinčák Richard , Pigazzini Alexander , Jafari Saeid , Korkmaz Özge , Özel Cenap , Bartoš Erik
Published: April 2023

The aim of this paper is to use a special type of Einstein warped product manifolds recently introduced, the so-called PNDP-manifolds, for the differential geometric study, by focusing on some aspects related to dark field in financial market such as the concept of dark volatility. This volatility is not fixed in any relevant economic parameter, a sort of negative dimension, a ghost field, that greatly influences the behavior of real market. Since the PNDP-manifold has a "virtual" dimension, we want to use it in order to show how the Global Market is influenced by dark volatility, and in this regard we also provide an example, by considering the classical exponential models as possible solutions to our approach. We show how dark volatility, combined with specific conditions, leads to the collapse of a forward price.
The connection between ordinary and soft $ \sigma $-algebras with applications to information structures
Authors: Al-shami Tareq M. , Ameen Zanyar A. , Mhemdi Abdelwaheb
Published: April 2023

The paper presents a novel analysis of interrelations between ordinary (crisp) $ \sigma $-algebras and soft $ \sigma $-algebras. It is known that each soft $ \sigma $-algebra produces a system of crisp (parameterized) $ \sigma $-algebras. The other way round is also possible. That is to say, one can generate a soft $ \sigma $-algebra from a system of crisp $ \sigma $-algebras. Different methods of producing soft $ \sigma $-algebras are discussed by implementing two formulas. It is demonstrated how these formulas can be used in practice with the aid of some examples. Furthermore, we study the fundamental properties of soft $ \sigma $-algebras. Lastly, we show that elements of a soft $ \sigma $-algebra contain information about a specific event.
Isoperimetric planar clusters with infinitely many regions
Authors: Novaga Matteo , Paolini Emanuele , Stepanov Eugene , Tortorelli Vincenzo Maria
Published: April 2023

In this paper we study infinite isoperimetric clusters. An infinite cluster $ {\bf{E}} $ in $ \mathbb R^d $ is a sequence of disjoint measurable sets $ E_k\subset \mathbb R^d $, called regions of the cluster, $ k = 1, 2, 3, \dots $ A natural question is the existence of a cluster $ {\bf{E}} $ with given volumes $ a_k\ge 0 $ of the regions $ E_k $, having finite perimeter $ P({\bf{E}}) $, which is minimal among all the clusters with regions having the same volumes. We prove that such a cluster exists in the planar case $ d = 2 $, for any choice of the areas $ a_k $ with $ \sum \sqrt a_k < \infty $. We also show the existence of a bounded minimizer with the property $ P({\bf{E}}) = \mathcal H^1({\tilde\partial} {\bf{E}}) $, where $ {\tilde\partial} {\bf{E}} $ denotes the measure theoretic boundary of the cluster. Finally, we provide several examples of infinite isoperimetric clusters for anisotropic and fractional perimeters.
Data Quality in Social Survey Research
Authors: Palmieri Marco , Aprile Rosario
Published: April 2023

Social survey researchers need to share criteria for assessing the quality of data. In the tradition of data quality debate, two antithetical positions emerge. One comes from the behaviourist paradigm: the quality of survey data is defined as the absence of distortions in the measurement process. The other was born within the pragmatic paradigm: data quality is the satisfaction of the logical and methodological conditions necessary to achieve the cognitive objectives of the research. The first position largely prevails, but the pragmatic one is more adequate because it looks at the actual research conditions that move the social survey research. This approach rejects the concept of true value; the data of survey research is constructed by the researcher's choices. This article explores the survey data quality in its pragmatic perspective, offering definitions of conceptual map, conversational interview, data fidelity, data quality, formal standardization, semantic standardization, social desirability, response accuracy, pretest, and validity.
Intergenerational Attitudes Towards Digital Banking Applications
Authors: Tsourgiannis Lambros , Zoumpoulidis Vassilios , Kontogiannis Sotirios , Valsamidis Stavros Ioannis
Published: April 2023

The digitization of banking transactions is now a reality. As the most economically active generations are Generation X and Y, it is interesting to explore customers' attitudes of those two generations towards the digital marketing applications launched by the banking sector and financial institutions. This study identifies the factors that affect customers' attitudes of Generation X and Y towards those applications, classifies the customers of both generations into groups according to their similar behaviour patterns, and profiles each group of customers according to their demographic characteristics and other factors. Principal component analysis was conducted to identify the main factors that affect customers' attitudes of Generation X and Y towards the use of digital services and applications in the banking sector. Cluster analysis was performed to classify them into groups with similar behaviour whilst discriminant analysis was conducted to check cluster predictability. Nonparametric tests were performed to profile each group of customers according to their demographic characteristics and other factors.
Achievement Emotions in Paper-Based Exams vs. Computer-Based Exams
Authors: AlSufayan Reem , El-Dakhs Dina Abdel Salam
Published: April 2023

This study investigates the emotional experiences of undergraduate students when taking computer-based compared to traditional paper-based exams. The authors surveyed 144 students and conducted in-depth written interviews with 44 of them to gain a comprehensive understanding of their emotions and experiences. The findings revealed that students generally feel more positive emotions, such as enjoyment, hope, and pride during computer-based exams. Conversely, they experienced less anger, anxiety, and hopelessness compared to paper-based exams. However, they observed no significant differences in feelings of relief and shame between the two exam modes. The interview responses provided valuable insights into the reasons behind these emotions. Students found computer-based testing to be more efficient, user-friendly for language editing, and appreciated the auto-grading features. However, technical concerns were identified as a major challenge in this format. On the other hand, paper-based exams allowed students to avoid technical problems, draft their answers, and express ideas more effectively. Despite these advantages, students reported disliking the lengthiness of the written responses, the difficulty of editing, and the pressure of maintaining legible handwriting. Overall, this study sheds light on the emotional experiences of students in different exam formats, helping educators make informed decisions to optimize testing environments.
Modeling and Optimization of Multi-Model Waste Vehicle Routing Problem Based on the Time Window
Authors: Wan Hongjie , Ma Junchen , Yu Qiumei , Sun Guozi , He Hansen , Li Huakang
Published: April 2023

With the development of China's economy, the urban floating population is also increasing, resulting in a sharp increase in the amount of urban waste. How to recycle and dispose of municipal waste more efficiently has become the top concern of municipalities and other relevant departments. In this article, the above problem is transformed into the municipal waste collection vehicle routing problem (MWCVRP) to solve the problem with the minimum total waste transportation cost. Because the carrying capacity of different models is different, this article introduces a cost calculation criterion that combines the total mileage of different models of transport vehicles and the number of station services. A multi-model garbage truck path optimization model is established, and then a heuristic-based task dynamic assignment algorithm is designed to solve the problem. The Solomon dataset is used to verify the feasibility and effectiveness of the model and algorithm through experiments.
Text Detection Model for Historical Documents Using CNN and MSER
Authors: Li Rankang , Chen Shanxiong , Zhao Fujia , Qiu Xiaogang
Published: April 2023

This article introduces a text detection model for historical documents images. The handwritten characters in historical documents are always difficult to detect because they contain fuzzy or missing ink, or weathering features and stains; these features will seriously affect the detection accuracy. In order to reduce the influence mentioned above, an effective ATD model is proposed to detect the textbox of characters in historical documents image, and ATD model includes a CNN-based text-box generation network and an NMS-based MSER text-box generation model. As a post-processing method, a text merging algorithm is proposed to achieve higher detection accuracy. The test results on historical document datasets such as Yi, English, Latin, and Italian datasets show that the method in this paper has good accuracy, and it has taken a solid step for the detection of historical documents.
Wind Tunnel Test of Optimal Rotor Blade Tip for a Winged Compound Helicopter at High Advance Ratio
Authors:   Japan Aerospace Exploration Agency, Sugiura Masahiko ,   Kawaju Gifu Engineering Co. Ltd., Yoshida Akira ,   Kawasaki Heavy Industries Ltd., Furumoto Takuya ,   Ryoyu Systems, Takekawa Kuniyuki , Kimura Keita , Kobiki Noboru , Sugawara Hideaki , Tanabe Yasutada , Iwasaki Yoshiki , Noda Takahiro , Shibata Yoshiyuki , Tsujiuchi Tomoka , Ueda Kentaro , Yasuda Hidemasa
Published: April 2023

Aerodynamic characteristics of optimized blade tip geometries for flight at high advance ratio are identified by wind tunnel tests conducted in October 2020. Several types of high-speed compound helicopters are in the development process today after the successful technology demonstrations. JAXA has been studying a high-speed compound helicopter for emergency medical service since it is expected to help save lives significantly in Japan. In this study, optimized blade shapes are invented, whose high-speed performance is twice as high as a conventional blade shape while maintaining hovering performance. In this paper, an optimized rotor blade with a swept-back angle is evaluated highest among optimized rotors and UH-60A rotor in the items of hover performance, high-speed performance, reduction effect of rotor drive power, control hydraulic system output reduction effect, and static aerodynamic stability. Thus, it is concluded that an optimized rotor blade with a swept-back angle is the most practical from the viewpoint of the aerodynamic characteristics of the rotor blade tips.
Blade Flapping Measurement System for Small Scale Rotorcraft
Authors:   Universite de Sherbrooke, Perron Etienne ,   Laflamme Aero Inc., Ratelle Charles ,   NGC Aerospace Ltd., Sobiesiak Ludwik ,   Université de Sherbrooke, Rancourt David
Published: April 2023

Flight data are often required to improve rotorcraft dynamic inflow models, especially for multi-rotor configurations. However, traditional full-scale wind-tunnel experiments are not suitable for hundred-pound-sized rotorcraft. Therefore, methods to capture flapping motion directly in flight are a good substitute. The teetering blade angle is measured using a hall effect sensor, and another hall effect is used to synchronize its azimuth. This work presents a design and prototype of an acquisition system and demonstrates its functionality on a rotor mock-up. Post-processing takes the raw flapping angle measured in the rotating frame and estimates the rotor tip path plane angles in the non-rotating frame. The results show the acquisition capacities to sense flapping motion and synchronize its data to UTC under one millisecond of error. Therefore, data can be matched to airframe inertial and navigation data or another acquisition system. Data generated can be used to validate/calibrate trim models and dynamic inflow models.
Computational Characterization of Unsteady Rotor Hub Wakes
Authors:   University of Tennessee, Mobley Forrest , Coder James , Wall Tristan
Published: April 2023

Reynolds stresses and turbulent kinetic energy are studied in the wakes for several helicopter rotor hub geometries in forward flight. Computational Fluid Dynamics (CFD) simulations are performed using NASA's OVERFLOW 2.2n Reynolds-averaged Navier Stokes solver. The simulations impose flow conditions based on previous and current experimental and numerical studies. Discrete Fourier Transforms (DFT) are used to examine velocity harmonics for several frequencies and compared against experimental data. Components of the Reynolds stress tensor are computed and examined. Production, transport, and flux of the turbulent kinetic energy are examined through the rotor hub wakes at six streamwise coordinates. Proper orthogonal decomposition is also used to examine a dominant component of the Reynolds stress tensor. It was found that the scissor arms, previously found to have a significant effect on rotor hub force harmonics, also had a significant effect on the magnitudes of Reynolds stresses and turbulent kinetic energy. Integrated values of turbulent kinetic energy flux and transport indicate that a relation between geometry and turbulent kinetic energy levels exists.
Lessons Learned For Application to Rotorcraft Structural Integrity Programs
Authors:   Mercer Engineering Research Center, DeMontfort Chad , Forgerson Sam , Harper Brian
Published: April 2023

Airworthiness for the Future Vertical Lift (FVL) programs will be guided by the Rotorcraft Structural Integrity Program (RSIP) standard, published as MIL-STD-3063. The United States Air Force (USAF) standard that helped to guide RSIP, the Aircraft Structural Integrity Program (ASIP), MIL-STD-1530, has been used by the USAF to guide airworthiness for their helicopter fleets for decades. Mercer Engineering Research Center (MERC) has been supporting these USAF helicopter ASIP programs for several years, often instantiating ASIP requirements on fleets not originally designed to those requirements. MERC believes vital opportunities exist in the early stages of new platforms to inject important lessons learned during the course of this support. For the purposes of this paper, these lessons learned will focus on three primary areas. These areas are 1) identifying and accessing data required for sustainment activities, 2) understanding failure modes of the data and how to handle them appropriately, and 3) efficiently storing and processing of ever-increasing amounts of data. Ultimately, continuous and purposeful communication between development and force management communities is vital to positioning these new fleets as early as possible for the longest phase in their life cycles.
Burnout phenomenon in Saudi dermatology residents: a national assessment of prevalence and contributing factors
Authors: Shadid Asem M. , Aldosari Batal M. , Dawari Sakhr , Baabdullah Ahmed , AlKheraiji Asma , AlBassam Abdulatif , Altalhab Saad , Alharithy Ruaa
Published: April 2023

Background: Burnout is a multidimensional syndrome declared recently as an occupational phenomenon in the International Classification of Diseases, recognizing burnout as a serious public health issue of national proportions. Objective: To determine burnout prevalence in Saudi dermatology residency and identify contributing factors. Methods: Validated measure of burnout (Maslach Burnout Inventory-human services survey), alongside the possible risk factors of burnout, was distributed to all dermatology board training programs in all centers with Saudi Board Dermatology Training Program in the Western, Eastern, and Southern Region in Saudi Arabia. Results: A total of 70 respondents completed the questionnaire. High Emotional Exhaustion (EE) was present in (47.1%) , low personal accomplishment (PA) was present in (65.7%) , and high depersonalization (DP) was the least prevalent across all burnout dimensions (24.3%) of dermatology residents. Overall burnout was present in (21.4%) of the dermatology residents. Multivariate analysis showed that the odds of EE were significantly lower in males than females (OR = 0.2, P = 0.016) and the higher number of patients seen per clinic (OR = 1.09, P = 0.032) was associated with higher odds of having high risk of EE while higher satisfaction with work life balance was associated with lower odds of high risk of EE (OR = 0.47, P = 0.005). Higher number of study hours/week was associated with lower odds of low PA (OR = 0.95, P = 0.02). Similarly, higher satisfaction with career was associated with lower odds of low PA (OR = 0.35, P = 0.042). Multivariate analysis showed that only exercise (OR = 0.21, P = 0.05) and satisfaction with work/life balance (OR = 0.42, P = 0.008) were associated with lower risk of burnout. Conclusion: Our study adds to the literature the burnout rates in dermatology residents in Saudi Arabia, in addition to possible risk factors that can predict burnout. These findings can be applied in the improvement of training programs to reduce the burnout rate among residents.
Generalized keratosis pilaris induced by testosterone injections in patient with CHARGE syndrome
Authors: Alkhayal Fares A. , Bin Fadliah Rima , Alasgah Sarah , Almutiri Raed , Alqubaisy Yasser
Published: April 2023

Keratosis pilaris (KP) is a common disorder of follicular keratinization characterized by keratotic follicular papules with varying degrees of perifollicular erythema. Keratosis pilaris affects up to half of normal children and up to three-quarters of children with atopic dermatitis. KP is prominent during teenage years, and least common in older people, but it may occur in children and adults of all ages. Here in this report, we describe a 13-year-old boy known to have CHARGE syndrome who developed generalized keratosis pilaris after injection of testosterone. To the best of our knowledge, this is the first reported case of Generalized keratosis pilaris induced by testosterone injection.
Hospital-Acquired Pneumonia Pattern in the Intensive Care Units of a Governmental Hospital
Authors: Yakoub Mina , Elkhwsky Fayek , El Tayar Ayman , El Sayed Iman
Published: April 2023

Background:

Epidemiological data on Hospital-Acquired Pneumonia (HAP) are scarce inside Intensive Care Units (ICUs).

Aim:

This study aims to quantify the incidence of HAP, determine the predictors of HAP, calculate HAP-related mortality risk ratio as well as pinpoint the different risk factors contributing to mortality.

Subjects and Methods:

A prospective longitudinal study was conducted at a governmental hospital's general ICUs over 12 months. We included adult patients admitted for at least 72 h before signs appear. We utilized a logistic regression model for fatality outcome and cox proportional hazard model for HAP outcome.

Results:

Of 356 patients, 133 patients developed Ventilated-Acquired Pneumonia (VAP), 76 patients with Non-Ventilated HAP (NV-HAP), as well as 147 patients did not acquire HAP. The incidence of HAP was 28 cases of HAP per 1000 person-days, as well as the mortality rate was 74 per 100 days, while the Attributable Risk Percentage (ARP) was 85%. This high fatality rate was clarified by independent predictors as reintubation (odds ratio [OR] = 8.99, P < 0.001), ICU duration ≥5 days (OR = 7.29, P = 0.02), HAP outcome (OR = 6.49, P = 0.001), diabetes mellitus (DM) (OR = 2.98, P = 0.004), APACHE II ≥17 (OR = 2.76, P = 0.004), as well as neurological diseases (OR = 2.20, P = 0.03). The most common independent HAP predictors were Pseudomonas aeruginosa (Hazard Ratio [HR] = 2.27, P < 0.001), Klebsiella pneumoniae (HR = 1.81, P = 0.003), tracheostomy (HR = 1.72, P = 0.04), and APACHE II ≥17 (HR = 1.54, P = 0.04).

Conclusion:

High incidence rate of HAP was linked with P. aeruginosa, K. pneumoniae, tracheostomy, and APACHE II ≥17. Furthermore, a high mortality rate was strongly correlated with reintubation, duration in ICU ≥5 days, HAP outcome, DM, APACHE II ≥17, and neurological diseases.
CO RADS Grade of HRCT Thorax and RT PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID 19)
Authors: Ghosh Kaushik , Ghosh Susmita , Acharyya Amitava , Sarkar Kalyan , Bhattacharya Ambarish , Hassan Muhammad Sohail , Ghosh Uday Shankar
Published: April 2023

Background:

The coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) grade of high-resolution computed tomography (HRCT)–thorax scan investigation is an innovative tool for the diagnosis of COVID-19 patients. By this tool, majority of moderate-to-severe COVID-19 patients are screened to detect lung pathologies. Hardly any study has explored its use vis-a-vis reverse transcriptase-polymerase chain reaction (RT-PCR) in asymptomatic patients.

Objectives:

(1) The objective of the study is to assess the frequency COVID-19 patients among asymptomatic subjects who were admitted in the hospital for planned surgery, (2) estimate the sensitivity and specificity of CO-RADS grade of HRCT-thorax investigation for the diagnosis of COVID-19 patients where RT-PCR test was considered as “Gold Standard” test.

Methodology:

A descriptive retrospective study was conducted by studying the records in the case files of 150 patients who were admitted in the Department of General Surgery, Man Mohini Health Clinic, Murshidabad, West Bengal for minor surgical procedures between September 1 and December 31, 2020. Data were collected from hospital records. The CO-RADS grade of HRCT-thorax investigation and RT-PCR test were performed for the diagnosis of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) virus. The MS-excel application was applied for data analysis.

Results:

The mean age of the participants was 42.58 ± 14.29 years. A total of 17 (11%) and 39 (26%) of the patients were diagnosed with COVID-19 by HRCT-thorax and RT-PCR test, respectively. The sensitivity and specificity of CO-RADS grade of HRCT-thorax investigation for diagnosis of COVID-19 patients were 43.58% and 100%, respectively. The positive and negative predictive values of CO-RADS grade of HRCT-thorax investigation were 100% and 83.45%, respectively.

Conclusions:

The frequency of asymptomatic patients with COVID-19 that was missed by HRCT thorax was high, compared to the gold standard RT-PCR, reflecting its low sensitivity and low negative predictive value in the diagnosis of SARS-CoV-2 virus infection. Hence, it is difficult to conclude in favor of HRCT thorax as first-line screening modality in all individuals.
Assessment of Common Errors and Subjective Quality of Digital Panoramic Radiographs in Dental Institution, Riyadh
Authors: Lingam Amara Swapna , Koppolu Pradeep , Abdulsalam Rasheed , Reddy Reddy Lavanya , Anwarullah Anupreeta , Koppolu Deepak
Published: April 2023

Aim:

The study aims to determine the frequency of positioning errors, record the number of diagnostically inappropriate images, and assess the quality of panoramic radiographs.

Materials and Methods:

In this study, a total of 2629 patients for whom orthopantomogram were selected out of 3900 new patients between August 2020 and June 2021. The positioning errors of the radiographs were evaluated and categorized into ten groups. The quality of the radiographs is further assessed as “Excellent,” “Diagnostically Acceptable,” and “Diagnostically Unacceptable.”

Results:

Out of the total radiographs, 32.8% had no errors, and 77.2% of the radiographs had one or more positioning errors. The radiographs were analyzed in detail, and the errors found in the panoramic radiographs were recorded. The most common positioning error observed in the radiograph was error 8, failure to place the tongue close to the palate.

Conclusion:

The results and evaluation inferred that attention to patient positioning and focusing on reducing diagnostically indecent images could improve the quality of panoramic radiographs. Proper instructions to the patient, patient preparation, appropriate positioning of the patient, and the technician's skill plays a vital role in reducing diagnostic errors in Panoramic Radiography.
Association of Vitamin D with the Severity of Disease and Mortality in COVID-19
Authors: Rathod Bharatsing Deorao , Ahirwar Ashok Kumar , Banerjee Sitikantha , Joshi Prashant P. , Khot Rajashree Sanjay , Dube Amol H. , Kumbhalkar Sunita D. , Dabhekar Sandeep B.
Published: April 2023

Background:

Many factors have been proposed to be associated with the severity of disease and mortality in COVID-19. Vitamin D had recently been reviewed as one of these factors.

Aim and Objectives:

To evaluate the association between Vitamin D and the disease severity and mortality in COVID-19.

Materials and Methods:

After approval from Institutional Ethics Committee, this prospective cohort study was carried out in selected tertiary care teaching medical institutes of Central India. Participants were COVID-19 patients of the age group of 18 years and above admitted during the study period. They were categorized into four groups as asymptomatic (Group A), mild (Group B), moderate (Group C), and severe (Group D) based on clinical symptoms, respiratory rate, oxygen saturation, and chest imaging. Serum level of Vitamin 25(OH) D was measured using chemiluminescent immunoassay. The outcome of the disease was classified as recovery and death during hospitalization. The association of sociodemographic and medical characteristics with treatment outcome was studied using an appropriate statistical test. A full logistic regression model was built for the assessment of the relationship between treatment outcomes with Vitamin D level. Further, one receiver operating characteristic curve was developed to examine the prognostic significance of Vitamin D levels in COVID-19 patients.

Results:

Out of 748 enrolled patients, 44 (5.88%), had severe disease (Group D). A total of 721 cases (96.39%) recovered and were discharged, whereas 27 (3.61%) died during hospitalization. Mean Vitamin D level was found to be significantly different in discharged patients compared to those who were deceased. Increasing age-adjusted odds ratio (AOR) (95% confidence interval [CI]=1.07 [1.02–1.12]), known hypertension AOR (95%CI) = 3.38 (1.13–10.08), and diabetes mellitus AOR (95%CI) =28.5 (6.04–134.13) were found to be significant predictors of death among COVID-19 patients. Increasing Vitamin D level was found to be protective against COVID-19-related death (AOR (95% CI = 0.87 [0.80–0.94]).

Conclusion:

Vitamin D was significantly associated with the disease severity and mortality in COVID-19.
Quality of Sleep and Disability Associated with Headache
Authors: Singh Angad Harshbir , Bathla Manish , Gupta Parul , Bhusri Leezu
Published: April 2023

Background:

One of the commonest and most frequently said, quoted and understood by even the least educated elements of our society is the neurological symptom of headache. The commonly diagnosed and studied headaches are Migraine and Tension type headache [TTH]. Headache has the power to reduce the very essence of a peaceful life and produce a disability in a person.

Aims and Objectives:

The aim of our study is to approach the subject with view of correlation of quality of sleep with the disability associated with migraine and compare it to TTH.

Materials and Methods:

For the same a cross-sectional study design was adopted and a consecutive sampling procedure was adopted. The sample was subjected to basic socio-demography, VAS, PSQI and HDI. Statistical analysis was done on the collected data.

Results:

Based on scales the results were evaluated using appropriate statistical methods. It was observed that there was a higher female preponderance in both migraine and TTH, there was severe disability associated and both headaches cause poor sleep quality.

Conclusion:

The current study concludes that headache is a debilitating illness which causes significant disability to a person.
Comparison between Intermittent Epidural Bolus of Levobupivacaine 0.125% and Ropivacaine 0.2% with Fentanyl as Adjuvant for Combined Spinal Epidural Technique in Labor Analgesia
Authors: Thammaiah Srinivas Hebbal , Sreenath Rashmi Hosahalli , Swamy Akshay Hiryur Manjunatha , Kumararadhya Girish Bandigowdanahalli , Priya Sushant Satya
Published: April 2023

Objective:

This study aims to compare levobupivacaine 0.125% and ropivacaine 0.2% with fentanyl as epidural drugs for labor analgesia using combined spinal epidural (CSE) technique regarding time for onset, duration of analgesia achieved by first epidural bolus dose and to compare the quality of labor analgesia. In addition, the study is also designed to assess the maternal and fetal outcome, incidence of instrumental delivery, degree of motor blockade, and maternal satisfaction.

Materials and Methods:

Following approval from Institutional Ethical Committee, 50 American Society of Anesthesiologists Physical Status II pregnant women requesting labor analgesia, satisfying the inclusion criteria were randomly divided equally into Groups L and R. CSE performed, 0.5 ml hyperbaric bupivacaine 0.5% with fentanyl 25 mcg administered intrathecally. IEBs 10 ml of study drugs given through epidural catheter as demand dose.

Results:

The mean onset of analgesia with Group R and group L were 16.280 ± 1.59 min and 21.480 ± 1.32 min(P = 0.000) respectively. The total duration of analgesia in Group R = 72.08 ± 1.97 min, whereas Group L = 82.160 ± 2.07 min (P = 0.000). There was no difference between the groups in terms of maternal demographic traits, mode of delivery, maternal and fetal outcome, and maternal satisfaction. Both 0.125% levobupivacaine and 0.2% ropivacaine produce excellent-quality of analgesia.

Conclusion:

Ropivacaine produces an early onset of analgesia than levobupivacaine but levobupivacaine had significantly prolonged analgesia compared to ropivacaine. Both drugs were found to be safe for labor analgesia. Maternal satisfaction and fetal outcome were similar with both the drugs.
Ethnicity Based Comprehensive Evaluation of Polymorphism in Interferon-Gamma Gene and Its Association with Pulmonary and Extra-Pulmonary Tuberculosis Risk
Authors: Priyanka  , Sharma Monika , Sharma Sadhna
Published: April 2023

Background:

Host genetic background plays an important role in susceptibility to intracellular infectious pathogens like Mycobacterium tuberculosis (Mtb). Cellular immune response activation is vital for protection to these pathogens. Interferon-gamma (IFN-γ) plays a crucial role in this activation and preventing the intracellular growth of Mtb. A mutation in the IFN-γ gene, therefore, may lead to increased susceptibility to tuberculosis (TB) that may vary in different ethnic groups and its consequence also varies in pulmonary and extra-pulmonary TB (EPTB). Several IFN-γ gene polymorphisms are investigated for susceptibility to TB, but their associations are not always consistent as its impact may vary from one ethnicity to the other as well as with the type of TB. Hence, we performed a meta-analysis to overcome this problem. The present study involves comprehensive meta-analysis of + 874T/A polymorphism in the IFN-γ gene based on type of TB within five different ethnic groups to show its association with increased susceptibility to TB.

Methods:

Using PubMed and Google Scholar databases, a total of 50 case-control studies were retrieved having 8152 cases and 9755 controls in this meta-analysis. Thirty-eight studies of + 874T/A polymorphism of IFN-γ gene were correlated for Pooled odds ratios with 95% confidence intervals. The polymorphism was analyzed for six genetic models for five major ethnic groups accounting for heterogeneity among studies. Moreover, the sub-group analysis was based on the type of TB within each ethnic group. Trial sequential analysis was also performed for all the sub-groups to estimate the statistical consistency.

Results:

IFN-γ +874 T/A polymorphism analysis clearly confirmed the increased association of + 874AA genotype with increased TB risk. This polymorphism also showed significant association in East Asian, European, American, and African ethnic groups whereas no such association was found in Asians. Patients with pulmonary TB (PTB) confirmed the association in East Asians, Africans, and Americans, whereas patients with EPTB showed association in Asian and East Asian populations only.

Conclusions:

This study reaffirms the association of IFN-γ+874 T/A polymorphism with TB risk. It specifically confirms that IFN-γ+874 T/A polymorphism increases the susceptibility of pulmonary infection in Africans and Americans, while the East Asian population is more susceptible to both, pulmonary and EPTB.
Safety and Efficacy of High-Dose Rifampicin in the Management of Tuberculosis Meningitis
Authors: Charlie Loveness , Abay Solomon Mequante , Tesfaye Abraham , Mlera Ronald Nachipo , Mwango Samuel , Goretti Mary
Published: April 2023

Background:

Mycobacterium tuberculosis (TB) practically affects any part of the body, but when the brain is involved, the consequences are devastating. Tuberculous meningitis (TBM) is the most severe form of drug-susceptible TB, with an estimation of more than 100,000 new cases occurring every year and a high mortality rate globally. The treatment strategy is based on pulmonary TB (PTB) management regimens which consider rifampicin as the backbone. Optimal treatment regimens for PTB may not be the most effective option for TBM due to difference in TB drug penetration across the blood–cerebrospinal fluid barrier, hence the need for other treatment options. This study aims to review the efficacy and safety of higher doses of rifampicin (>10 mg/kg) compared to 10 mg/kg rifampicin as part of standard therapy for the treatment of TBM.

Methods:

A systematic review and meta-analysis was conducted to assess the efficacy and safety of high-dose rifampicin for TBM. A search was done on PubMed, Google Scholar, and Cochrane library databases without publication date limit to identify studies providing data on the use of high-dose rifampicin for the treatment of TBM. Titles and abstracts were screened for relevance by three reviewers. Two reviewers used a predefined checklist on the inclusion criteria to assess full text for their eligibility in the review. A heterogeneity test was conducted to assess the variations among study outcomes. The risk ratio (RR) with a 95% confidence interval (CI) was calculated as a measure of intervention effect. The study is registered on PROSPERO and the registration number is CRD42020212737.

Results:

Five Phase 2 trials with a total of 1028 participants were included in this meta-analysis. All the five trials were used to analyze safety data, which found that there was no significant increase in the risk of Grade 3–5 adverse events in high-dose rifampicin (RR = 1.05; 95% CI = 0.95–1.18). Only four of them were included for the analysis of efficacy. The findings indicated that exposure to high-dose rifampicin is not associated with a reduced risk of mortality (RR = 0.95; 95% CI = 0.78–1.16).

Conclusions:

It can be concluded from this meta-analysis that there is no significant relation of high-dose rifampicin with adverse events and the reduction of mortality in TBM patients. Whether in future optimized TBM treatment regimen will include high-dose rifampicin or not should be determined by a large-scale clinical trial.
Assessment of Multidrug-Resistant Tuberculosis Patient'S Skin Drug Reaction in Zanzibar
Authors: Mohamed Saida Abuubakar , Mshana Julius O. , Abubakar Khamis , Juma Ali Hamid , Mussa Issa A. , Hamad Mohd Foum , Juma Juma Khamis , Khalid Farhat Jowhar , Lyakurwa Dennis Modestus
Published: April 2023

Drug-resistant tuberculosis (DR-TB) is a serious public health of concern. We present the management of multidrug-resistant (MDR)-TB with skin reaction in Zanzibar in a patient who had prior exposure to anti-TB drugs. The reaction developed 4 months later, following MDR-TB treatment, stopped when the drug was withdrawn, and reappeared when reintroduced. Close monitoring is important in managing DR-TB cases, and an active DR-TB safety, monitoring, and management is required to detect, monitor, and manage adverse events timely.