bluuebunny/crossref_metadata_2025 huggingface dataset:
Nouvelle grossesse, nouvelle histoire ?
Authors: de Truchis de Lays Anne , Sablayrolles Perrine
Published: December 2021

Le présent article vise à présenter la pratique clinique de ses auteures auprès des parents dont le premier enfant a été placé et qui attendent un second enfant. Des enjeux importants se jouent autour de cette nouvelle grossesse pour les familles ainsi que pour les professionnels qui les entourent. Dans ce contexte, le service de soins en périnatalité de l’hôpital du Vésinet peut être sollicité pour accompagner le lien parents-enfant de façon précoce et offrir un cadre suffisamment étayant au moment de l’arrivée du bébé. En effet, il reçoit des femmes enceintes et des mères en hospitalisation conjointe avec leur(s) bébé(s). L’ouverture de l’hôpital de jour depuis 2019 permet désormais d’accompagner également les pères de façon officielle dans l’instauration du lien avec leur enfant et de leur offrir une réelle place. Le projet est d’accueillir la famille dans la rencontre avec cet enfant, si possible dès le prénatal. Comment travailler avec les parents alors même que la blessure narcissique en lien avec le premier placement est souvent au premier plan ?
Relation entre mères et professionnelles dans les structures d’accueil de petite enfance inclusives
Authors: Koliouli Flora , Pinel-Jacquemin Stéphanie , Zaouche-Gaudron Chantal
Published: December 2021

L’objectif de cet article est d’analyser les relations entre les mères ayant des enfants en situation de handicap ou présentant des difficultés développementales et les professionnelles au sein de crèches collectives dites inclusives. Dans le cadre d’une étude plus vaste, réalisée en France, portant sur le soutien des familles de jeunes enfants porteurs de handicap ou présentant des difficultés développementales, un entretien semi-directif a été réalisé auprès de neuf mères et de dix professionnelles pour analyser leurs relations. L’analyse qualitative de données est réalisée selon l’approche de Braun et Clarke (2006). Les principaux résultats mettent en évidence, pour les mères, l’importance du partage d’informations, le soutien apporté par les professionnelles ainsi que leurs compétences. Les professionnelles, quant à elles, soulignent l’échange d’informations et leur rôle d’accompagnement dans l’acceptation du handicap de l’enfant ou dans le processus de parentalité. Les résultats sont discutés et des pistes d’intervention sont proposées.
L’esthétisation marchande au prisme de la théorie de l’art (et vice versa)
Authors: Buffet Laurent
Published: December 2021

L’article entend confronter la théorie moderne de l’art au phénomène d’esthétisation de la sphère marchande mis en évidence par la sociologie, en prenant pour cadre de référence l’esthétique de la réception de Hans Robert Jauss. Bien que s’appliquant surtout à la littérature, la théorie de Jauss n’est pas sans concerner aussi les arts plastiques. La synthèse qu’elle opère entre, d’un côté, le formalisme russe du début du xx e  siècle, qui, le premier, s’employa à isoler les propriétés internes des œuvres d’art, et, de l’autre, l’historicisme d’inspiration marxiste qui s’attacha pour sa part à rendre compte de leurs évolutions en fonction de l’histoire générale de la société, semble particulièrement propice à l’abord d’un problème qui est à la fois symbolique, esthétique et historique. En effet, dès lors que de nombreux produits et services de consommation tendent à adopter certaines caractéristiques de l’œuvre d’art, l’analyse formelle, qui constitue l’arc-boutant de l’approche esthétique moderne, entre dans un périmètre d’application beaucoup plus large que celui dont participe l’histoire de l’art. Dans ce cas, l’importance accordée à la forme des objets, prise en ce sens esthétique, devient en elle-même une composante de l’histoire sociale, dans la mesure où elle ne concerne plus seulement les évolutions de la production artistique, mais intéresse aussi, en leurs principes, celles plus générale de la production marchande. Moyennant un approfondissement de leur versant social – ceci en se demandant, non pas comment l’expérience artistique transforme le monde vécu, mais comment le monde vécu transforme lui-même le monde artistique – les analyses de Jauss nous permettent ainsi de reformuler, en des termes propres à la théorie de l’art, la question de la convergence catégorielle mise en évidence par la sociologie, et, de là, d’engager une réflexion nouvelle sur les transformations de la sphère artistique à l’heure du capitalisme esthétique.
L’esthétisation et la culture démocratique
Authors: Rebentisch Juliane , Hongler Camille
Published: December 2021

Walter Benjamin a suggéré de voir dans le fascisme une « esthétisation de la politique ». Avant lui, ce même diagnostic était appliqué non pas aux régimes autoritaires, mais, au contraire, aux régimes démocratiques. De Platon à Carl Schmitt, la philosophie a dénoncé la démocratie comme une multitude inconsistante et « bigarrée », qui préfère le jeu à l’ordre. Rebentisch estime que derrière ce jugement dépréciatif, les ennemis de la démocratie ont en fait parfaitement saisi quelques-uns de ses traits distinctifs qu’il s’agit aujourd’hui de défendre dans une culture démocratique. La démocratie ne peut se passer de la mise en scène, car c’est sur scène qu’elle peut figurer le visage qu’elle veut se donner collectivement, consciente de l’écart qui subsiste toujours entre les identités actuelles et les identités possibles.
Mickey Mouse au pays de l’esthétisation
Authors: Kratochvil Sylvia
Published: December 2021

Cet article se penche sur une figure de l’imaginaire collectif, à savoir Mickey Mouse. Cette souris sympathique qui a fait le tour du globe dans les années 1930 est devenue l’animal héraldique du triomphe des économies pulsionnelles et d’une mercantilisation du rêve de bonheur. En partant d’une réflexion sur la contiguïté entre l’activité ludique et l’art de l’animation, l’article tente d’aborder la question de « l’esthétisation de la politique » par le biais du jeu. Une référence constante à la fonction du conte dans le monde enfantin nous permet d’articuler quelques enjeux de ce que W. Benjamin analyse, dans son essai sur L’Œuvre d’art à l’époque de sa reproductibilité technique , sous le terme de « seconde technique ».
Poétique de l’exhumation
Authors: Bertrand Régis , Carol Anne
Published: December 2021

Cette étude se propose d’examiner une pratique liée, dans ses formes les plus banales, à la transition funéraire et aux transformations du cimetière au xix e  siècle en France : l’exhumation. Elle consiste à exhumer un corps enterré dans une tombe temporaire pour le ré-inhumer dans une concession familiale, acquise entre-temps et dotée d’un monument. Cette opération oblige réglementairement à une confrontation a priori pénible entre le cadavre et les proches du défunt, dont la présence est indispensable. Est-il possible de faire de l’exhumation ordinaire une scène touchante, qui s’accorde avec la mélancolie du cimetière mise à la mode par les romantiques, et de transcender sa trivialité ? L’examen de deux types de récits d’exhumation, l’un extrait d’un des nombreux guides pour les visiteurs de cimetières, l’autre des brochures en faveur de l’embaumement, montre que cette mise en récit est possible, à condition de porter en elle une dimension édifiante, ou de nourrir un argumentaire publicitaire construit au plus près des nouvelles sensibilités.
Les cimetières de la conquête. Corps européens, sépultures et pratiques funéraires au Congo colonial (1880-1900)
Authors: Arzel Lancelot
Published: December 2021

À partir de témoignages européens, de photographies prises sur place et de souvenirs des acteurs de l’époque, cet article étudie les « cimetières de la conquête » en Afrique centrale des années 1880 aux années 1900, à savoir tous les sites funéraires mis en place pour recueillir et honorer les dépouilles des militaires européens engagés par l’État indépendant du Congo pour occuper ce vaste territoire colonial. Après avoir décrit les pratiques funéraires précédant l’enterrement, cette étude met en perspective les différentes formes prises par ces cimetières, depuis la tombe individuelle et collective isolée jusqu’aux plus grands espaces funéraires des centres urbains, en passant par tous les signes commémoratifs mis en place. Elle insiste en particulier sur les pratiques funéraires importées d’Europe, en particulier dans la mise en place d’un cimetière clos et hygiéniste. Elle montre également le caractère fondamentalement politique de ces espaces funéraires, sources de tensions et de contestations avec les populations autochtones mais aussi lieux de mémoire essentiels pour les familles, les militaires et l’État colonial.
Heine et la peinture européenne : Allemagne, Italie, Pays-Bas et France
Authors: Calvié Lucien
Published: December 2021

L’approche heinéenne de l’art pictural, moins connue que ses critiques musicales, préfigure l’actuelle histoire culturelle. Heine examine en effet les variantes nationales de la peinture, de l’Allemagne (Nazaréens, paysagistes « nordiques »), avec sa misère historique, à la France (David, Delacroix), terre de la politique et de la liberté, en passant par l’Italie et les Pays-Bas, pays de la beauté et du bonheur de vivre. Mais aussi l’histoire générale de la peinture, en lien avec l’histoire de l’Europe, des Lumières aux années 1830 et 1840, celle de la bourgeoisie financière triomphante, en passant par la phase « héroïque » de la Révolution et de l’Empire. Par-delà ce panorama contrasté, Heine pose la double question d’un « art nouveau », lié au changement politique de 1830, et du « surnaturalisme » comme dépassement de la vieille théorie de l’art comme « imitation de la nature ».
La lisibilité des traces archéologiques dans la fiction littéraire pompéienne du XIX e siècle
Authors: Aude Nicolas
Published: December 2021

Cet article s’intéresse à la représentation des pratiques de lecture qui sous-tendent l’investigation archéologique dans trois fictions narratives du xix e  siècle. En réintégrant l’écriture des choses dans l’espace du livre, la pompéiomanie littéraire semble remettre en cause le primat du vestige matériel sur l’écrit qui fonde l’archéologie comme discipline scientifique. Mais c’est pour mieux confronter la lecture au désir d’étreindre une empreinte. Dans ces fictions, le site de Pompéi s’avère en effet propice à toutes sortes de fantasmes et d’hallucinations, ce qui permet d’articuler la connaissance du passé matériel et le déchiffrement de la psyché humaine autour d’un même objet-vestige. Cette réflexion sur la lisibilité des traces archéologiques vise ainsi à éclairer les antécédents littéraires de la métaphore archéologique chère à Sigmund Freud.
Sign-changing solutions for Schrödinger system with critical growth
Authors: Chu Changmu , Liu Jiaquan , Wang Zhi-Qiang
Published: December 2021

We consider the following Schrödinger system

   \begin{document}$ \begin{equation*} \left\{ \begin{aligned} &-\Delta u_j = \sum\limits_{i = 1}^k \beta_{ij}|u_i|^3|u_j|u_j+\lambda_j|u_j|^{q-2}u_j, \ \ \ \text{in}\, \, \Omega, \\ &u_j = 0\quad\text{on}\, \, \partial\Omega, \, \, j = 1, \cdots, k \end{aligned} \right. \end{equation*} $\end{document}

where $ \Omega\subset\mathbb{R}^3 $ is a bounded domain with smooth boundary. Assume $ 5 < q < 6, \, \lambda_j > 0, \, \beta_{jj} > 0, \, j = 1, \cdots, k $, $ \beta_{ij} = \beta_{ji}, \, i\neq j, i, j = 1, \cdots, k $. Note that the nonlinear coupling terms are of critical Sobolev growth in dimension $ 3 $. We prove that under an additional condition on the coupling matrix the problem has infinitely many sign-changing solutions. The result is obtained by combining the method of invariant sets of descending flow with the approach of using approximation of systems of subcritical growth.
Product innovation, process innovation and advertising-based goodwill: A dynamic analysis in a monopoly
Authors: Guo Genlong , Li Shoude
Published: December 2021

In this paper, we develop a dynamic control model to investigate a monopolist's investment strategies in product innovation, process innovation and advertising-based goodwill. The significant features of our study are: (ⅰ) considering the effect of product quality on goodwill; (ⅱ) considering the instantaneous cost of producing a quality using machinery and/or skilled labour; (ⅲ) the customers' demand function depends on product quality, product price and goodwill in a separable multiplicative way between the state variables and control variables. Our results suggest that (ⅰ) the system admits unique saddle-point steady-state equilibrium under the monopolist optimum and the social optimum; (ⅱ) and the monopolist will have an underinvestment problem as compared with the social planner; and (ⅲ) although the product price is still determined by the monopolist under the social planner optimum, the product price is higher under the monopolist optimum than that under the social planner optimum.
Well-posedness theory for nonlinear scalar conservation laws on networks
Authors: Musch Markus , Fjordholm Ulrik Skre , Risebro Nils Henrik
Published: December 2021

We consider nonlinear scalar conservation laws posed on a network. We define an entropy condition for scalar conservation laws on networks and establish $L^1$ stability, and thus uniqueness, for weak solutions satisfying the entropy condition. We apply standard finite volume methods and show stability and convergence to the unique entropy solution, thus establishing existence of a solution in the process. Both our existence and stability/uniqueness theory is centred around families of stationary states for the equation. In one important case – for monotone fluxes with an upwind difference scheme – we show that the set of (discrete) stationary solutions is indeed sufficiently large to suit our general theory. We demonstrate the method's properties through several numerical experiments.
Impact of an outdoor loose parts intervention on Nova Scotia preschoolers' fundamental movement skills: a multi-methods randomized controlled trial
Authors: Branje Karina ,   School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada, Stevens Daniel , Hobson Heather , Kirk Sara , Stone Michelle ,   Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada,   Interdisciplinary Studies, Dalhousie University, Halifax, Nova Scotia, Canada,   Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
Published: December 2021

Development of fundamental movement skills in early childhood supports lifelong health. The potential for outdoor play with loose parts to enhance fundamental movement skills has not been investigated. A multi-methods randomized controlled design was used to determine the efficacy of integrating outdoor loose parts play into Nova Scotia childcare centers (19 sites: 11 interventions, 8 control). Movement skills (n = 209, age 3–5 years) were assessed over a 6-month period to investigate changes in fundamental movement skills over time and between groups. Qualitative data was also collected on the educators' perceptions of outdoor loose parts play. Quantitative data (fundamental movement skills) revealed a non-intervention effect, however, educators spoke of outdoor loose parts play providing opportunities to combine/ repeat movements and take risks; supporting physical, cognitive and socio-emotional (holistic) development; and increasing awareness of children's physical development and how to support it. Our findings demonstrate value in outdoor loose parts play for the development of fundamental movement skills in childcare settings.
Determinants of Depression in Indonesian Youth: Findings From a Community-based Survey
Authors: Suryaputri Indri Yunita , Mubasyiroh Rofingatul , Idaiani Sri , Indrawati Lely
Published: December 2021

Objectives: This study investigated the determinants of depression in adolescents and young adults.Methods: The present study analyzed data from the 2018 Indonesia Basic Health Survey (Riset Kesehatan Dasar; RISKESDAS). The study subjects were adolescents (15-17 years old) and young adults (18-24 years old). In total, 64 179 subjects were included. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between youths’ characteristics, risky behavior, chronic disease, parents’ health, and youths’ depression.Results: The prevalence of depression was 5.1% in adolescents and 5.6% in young adults. The risk factors for depression in adolescents were being women (adjusted odds ratio [aOR], 3.53; 95% confidence interval [CI], 2.89 to 4.30; p<0.001), an ex-smoker (aOR, 2.99; 95% CI, 2.10 to 4.25; p<0.001), or a current smoker (aOR, 2.60; 95% CI, 1.97 to 3.44; p<0.001); consuming alcohol (aOR, 2.00; 95% CI, 1.33 to 3.01; p=0.001), having a chronic disease (aOR, 2.64; 95% CI, 1.41 to 4.96; p=0.002); maternal depression (aOR, 2.47; 95% CI, 1.97 to 3.09; p<0.001); and paternal depression (aOR, 2.63; 95% CI, 1.98 to 3.50; p<0.001). In young adults, the risk factors were being women (aOR, 2.23; 95% CI, 1.82 to 2.75; p<0.001) or an ex-smoker (aOR, 2.47; 95% CI, 1.67 to 3.67; p<0.001), consuming alcohol (aOR, 2.42; 95% CI, 1.89 to 3.09; p<0.001), maternal depression (aOR, 3.12; 95% CI, 2.54 to 3.84; p<0.001), and paternal depression (aOR, 2.80; 95% CI, 2.17 to 3.63; p<0.001).Conclusions: Being women, smoking, drinking alcohol, having a chronic disease, and having a parent with depression were crucial factors associated with youth depression. Mental health screening, prevention, and treatment should involve collaboration among primary healthcare, schools, universities, professionals, and families.
A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran
Authors: Daniali Zahra Mohammadi , Sepehri Mohammad Mehdi , Sobhani Farzad Movahedi , Heidarzadeh Mohammad
Published: December 2021

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran.Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties.Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider.Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.
CARACTERIZAÇÃO DOS FREQUENTADORES DA ASSOCIAÇÃO NORTE PARANAENSE DE REABILITAÇÃO (ANPR) DE MARINGÁ SUBMETIDOS À AMPUTAÇÃO
Authors:   Universidade Ingá - UNINGÁ, Zenco Rafael Gustavo , Carvalho Júnior Carlos Alberto , Dei Tos Débora ,   Universidade Ingá - UNINGÁ, Fabiano Lilian Catarim ,   Universidade Ingá - UNINGÁ
Published: December 2021

Introdução: Devido à Diabetes Mellitus (DM) e por acidentes automobilísticos, o número de amputados vem crescendo a cada ano, tornando-se um problema de saúde pública. Após o procedimento cirúrgico, o paciente deve ser acompanhado por uma equipe multidisciplinar, sendo o fisioterapeuta essencial nesse processo, permitindo a redução ou prevenção das possíveis complicações que podem surgir além de promover uma melhor independência. Objetivo: Caracterizar os pacientes amputados atendidos na Associação Norte Paranaense de Reabilitação (ANPR) localizada na cidade de Maringá, PR. Metodologia: Foi aplicado a 27 indivíduos, um questionário contendo perguntas referentes à caracterização da amostra, adaptação à prótese, complicações como dor/sensação fantasma e retorno as AVD’s e atividades laborais. Resultado: A amostra foi caracterizada por indivíduos amputados entre 50 - 59 anos, com a prevalência de amputação em um dos membros inferiores, com etiologia maior para as amputações relacionadas a DM. Pouco mais de 50% dos indivíduos conseguiram ter boa adaptação ao uso da prótese e mais de 80% não conseguiram retornar as atividades laborais. Conclusão: Este estudo mostra a necessidade de programas de conscientização e orientação à população, principalmente no que se refere aos pacientes com DM e na prevenção de acidentes automobilísticos. Esses fatores são os que mais expressam a exacerbação de causas de morbidade e mortalidade dos indivíduos, causando sua amputação. Ademais, é possível observar a importância de um bom programa de reabilitação e ações que implementam a acessibilidade no ambiente de trabalho e nova qualificação afim de que esses indivíduos possam retornar as atividades laborais.
CAPACIDADE FUNCIONAL E QUALIDADE DE VIDA DE IDOSOS EM ISOLAMENTO SOCIAL DURANTE O PERÍODO DA PANDEMIA DO COVID-19.
Authors: Paixão Daniele de Souza , Rodrigues Talita Stephani Libanio , Fabiano Lilian Catarim , Fernandes Simone , Dei Tos Débora
Published: December 2021

Um aumento progressivo da população idosa mundial tem sido observado e, muito tem se falado sobre qualidade de vida no processo de envelhecimento. Compreendemos que com o envelhecimento o indivíduo sofre declínio no desempenho físico e funcional, o que interfere nas suas atividades desempenhadas diariamente e nas relações que o mesmo desenvolve no meio em que está inserido. No início do ano de 2020 o mundo foi surpreendido com a disseminação do vírus SARS-CoV-2 que provocou a doença COVID-19. O surto global do COVID-19 afetou significativamente a vida de milhares de pessoas, perturbando suas rotinas social, pessoal e profissional. Como forma de combater a disseminação do vírus, foram adotadas medidas de prevenção, uma delas, o isolamento social. O objetivo deste estudo objetivo investigar possíveis alterações funcionais e da qualidade de vida que afetam os idosos durante o isolamento social na pandemia. Tratou-se de um estudo transversal, realizado com idosos não institucionalizados e que apresentam algum vínculo social com os alunos do último ano do curso de Fisioterapia do Centro Universitário Ingá-UNINGÁ da cidade de Maringá-Paraná. Foram utilizados questionários avaliativos, o Vulnerable Elders Survey-13, o Índice de Vulnerabilidade Clínico-Funcional-20, a Escala de Lawton- Brody, e o Short-Form Health Survey. Pode-se concluir, que mesmo em tempo de pandemia e isolamento social, não houve impacto na qualidade de vida e funcionalidade dos idosos, denota, que a idade dos idosos participantes deste estudo pode ter influenciado, uma vez que a predominância foi de idosos mais novos.
Yield of Rainfed Finger Millet under Selected Agronomic Practices: A Study in Southern Dry Zone
Authors: Liyanage D.  P.  P. , Abeywikrama L. M. , Wanniarachchi S. D.
Published: December 2021

The farmers in Southern dry zone in Sri Lanka are cultivating finger millet mostly under rainfed condition and majority of them practice random broadcasting for crop establishment. The yield obtained by the conventional rainfed farmers is considerably lower. Already there are available a number of improved low cost approaches can enhance the yield in a sustainable manner but such techniques are not used by the farmers in the rainfed farming systems. This study was carried out to enhance the finger millet yield by introducing some agronomic practices with a high yielding variety (Rawana), row seeding in 30 cm spacing, application of half of basal fertilizers recommended by Department of Agriculture (DOA) in Sri Lanka, with compost at the rate of 2 Mg ha-1 and practicing two weeding at third and sixth weeks from planting. Sustainable Agronomic Package of Practices (SAPP) was developed during 2014/2015 and 2015/2016 Maha seasons. Then farmer field demonstrations were conducted during 2016/2017 and 2017/2018 Maha seasons and developed SAPP was compared with traditional farmer practice. Results revealed that the yield can be increased by 165% to 182% by following SAPP with transplanting and sowing at 30 cm spacing compared to the yield to the farmer practice and it was 200% and 220% respectively compared to the estimated average finger millet yield of 1.3 Mg ha-1 in Sri Lanka.
Impact of Rototiller Fertilizer Applicators on Technical Efficiency of Coconut Plantations in North Western Province, Sri Lanka
Authors: Gunathilaka H. A. W. S. , Nuwarapaksha T. D.
Published: December 2021

As a major plantation crop, coconut contributes directly and immensely to the economy of Sri Lanka. With the aim of enhancing the efficiency of the industry, rototillers have been introduced recently as fertilizer applicators. Hence, the purpose of this study was to assess the impact of such application on technical efficiency and productivity of the coconut plantations. Data were collected randomly from 60 growers: 30 rototiller users and 30 non-users. Stochastic frontier production function was used to measure the technical efficiency of production using the maximum likelihood method. The productivity of the estates was used as the output, and inputs were education level, off farm income, farming experience, water availability, availability of irrigation system, cropping system, land extent, labour days, fertilizer cost and other costs. The highest technical efficiency was recorded by increasing land extent. The variables such as land area, labour days, fertilizer cost and other costs were also significant on technical efficiency. The mean efficiency of rototiller users was 71 % and non-users was 62 % owing to a less labour requirement for fertilizer incorporation. Three percent of the rototiller users was smallholders with less than three hectares of land, and their efficiency ranged between 30 -50 %. The results of the study will help coconut growers and policy makers to promote rototillers in coconut cultivations.
Herpes vegetans, an atypical herpes lesion in HIV patient: A case report
Authors: Sirait Sondang P. , Indriatmi Wresti
Published: December 2021

Herpes vegetans is a rare form of Herpes simplex virus (HSV) infection in immunocompromised patients that clinically presents as a verrucous and hypertrophic lesion. In this case, we present a 36-year-old man with exophytic verrucous masses in the genital area that was initially suspected as a malignancy. Difficulty to properly diagnose the patient resulted in a few failed attempts at treating the lesion. After excluding other differential diagnoses, the atypical lesion proved to be caused by vegetative herpes infection due to a good response to HSV therapy. Reevaluation of biopsy also showed signs of HSV etiology. Atypical presentation of herpes simplex in immunocompromised patients still proves to be a challenge to diagnose and treat. Proper clinical identification and workup are needed to diagnose and to choose proper regiments.
VEXAS syndrome with cutaneous nodules
Authors: Argobi Yahya
Published: December 2021

Recently, a rare severe autoinflammatory Vacuoles, E1 enzyme, X-linked, autoinflammatory, Somatic (VEXAS) syndrome caused by somatic variants in the UBA1 gene was discovered. The clinical features of VEXAS syndrome are heterogeneous, including high-grade fever, polychondritis and skin lesions. In 2020, Beck DB et al described an original cohort of 25 patients, of whom 22 (88%) had cutaneous findings, namely, neutrophilic dermatitis, and vasculitis. We report a case of VEXAS syndrome and cutaneous nodules with confirmed UBA1 mutation.
Methotrexate in the therapeutic pathway of patients with psoriasis. Analysis of clinical practice data and comparison with guidelines
Authors: Corazza V. , Cusano F. , De Pità O. , Rossi L. , Virno G.
Published: December 2021

Introduction Psoriasis is an inflammatory skin disease with a chronic-relapsing course. It is estimated that the prevalence in Italy is 3%. An adequate model of taking care of the patient with psoriasis allows the patient to benefit from the most suitable treatment option for his health needs. In this position statement the observations, criticalities and proposals for improvement of the Pso-Path Working Group, composed by health economists, clinicians and patients, on the diagnostic-therapeutic pathway of the patient with psoriasis have been collected. In particular, the deviation of clinical practice from the current Guidelines for the management of patients with psoriasis, which recommend the use of biologic drugs in case of non-response, intolerance or contraindication to Methotrexate or Cyclosporine, was evaluated. Method A Working Group was convened whose participants were asked to express their thoughts on the diagnostic and therapeutic pathway of the patient with psoriasis, bringing out critical elements and proposals for improvement, based on their experiences. Conclusion This position statement summarizes the experiences and consensus between clinicians and patients on actions to optimize the management of patients with psoriasis undergoing biological treatment. Compared to the epidemiological data currently available, it is believed that only a small percentage of patients with psoriasis are treated with systemic drugs. The perception of clinicians, according to their experience, confirms the data emerging from the National Report "National Observatory on the Use of Medicines" (Osmed) compiled by AIFA in 2015, according to which more than 77% of patients with psoriasis are started to treatment with biological drugs without a previous use of Methotrexate or Cyclosporine for at least 3 months. The Pso-Path Working Group came to the conclusion that it would be desirable to incentivize, through the formalization of regional guidelines, the creation of a network system that promotes not only a greater awareness, at the territorial level, of the importance and impact of the disease and the possible paths, but also the collaboration and connection between all the actors involved in the overall care of the patient.
Hybrid true seed production from potato mother plant as influenced by nitrogen splitting and boron
Authors: Chakraborty Rajesh , Islam Shahidul , Roy Tuhin Suvra
Published: December 2021

Experiments were conducted to show the effect of split application of nitrogen (SN) and boron (B) on hybrid True Potato Seed (TPS) production. The TPS-67 (♂) and MF-II (♀) were used as crossing materials. The experiments comprised two factors i.e., factor-A; nitrogen splitting (4 levels): 2 split (SN0-Conventional), 3 split (SN1), 4 split (SN2) and 5 split (SN3) where 50 kg N ha–1 applied as basal from total 300 kg N ha–1 with each split application and the rest 250 kg N ha–1 was splitted as per treatment at 10 days intervals started from 30 DAP (days after planting); and factor- B; boron (4 levels): 0 (B0), 4 (B1), 6 (B2) and 8 (B3) kg B ha–1 under split-plot design with three replications. We found that SN and/or B influenced the hybrid TPS production. The maximum yield (2160.1 mg) of TPS plant–1 was found from SN1B3 and the minimum (1001.8 mg) was in SN0B0. The maximum yield (172.81 kg) of TPS ha–1 was found from SN1B3 and the minimum (80.14 kg) was in SN0B0. The maximum weight (86.87 mg) of 100-TPS was found from SN3B3; whereas, the minimum (53.36 mg) was in SN0B0.
Six minute walk test in Italian children with cystic fibrosis aged 6 and 11
Authors: Innocenti Diletta , Masi Eleonora , Taccetti Giovanni , Genito Marco , Balestri Elena , Berghelli Anna Rita , Ciciretti Maria Antonietta , Collini Francesca , Fanzaghi Patrizia , Fogazzi Annalisa , Leone Paola , Guarise Riccardo
Published: December 2021

Six Minute Walk Test (6MWT) is a field exercise test widely used in clinical practice, both in adults and in pediatric patients. The primary aim of the study is to evaluate the physical performance of the subjects and compare them with the predicted Italian values. The secondary aim is to verify the possible relationship between the 6MWT distance (6MWD) and the clinical variables of the sample. Italian children between 6-11 years affected by CF were recruited from 9 regional centres for CF. Short questionnaire assessments about their health state and physical activity routine was administered. Anthropometric characteristics were measured before the test and, peripheral oxygen saturation (SpO2), heart and respiratory rate were measured before and after a 6-minute walk test. The tests were performed according to the American Thoracic Society (ATS) guidelines. 6MWD was compared with the predicted distance calculated by the reference equation for healthy subjects of the same age.A total of 132 children were recruited (70 male) and completed the assessment. The mean (±SD) for 6MWD was 557.4(±69.9), male = 551.4(±80.0), female = 560.4(±63.3), however the predicted distance mean was 605m. A total of 101(76.5%) subjects practice regular physical activity. A total of 31(23%) had a FEV1 lower than their Lower Limits of Normal (LLN). Functional performance on the 6MWT was poorer among the CF patients than among the predicted distance estimated with Italian values. The correlation with the amount of physical activity and 6MWD has been verified.
Bilateral Lambdoid and Sagittal Craniosynostosis with Hydrocephalus
Authors: Konar Subhas , Shukla Dhaval
Published: December 2021

Background:

Bilateral lambdoid and sagittal craniosynostosis (BLSS), also known as Mercedes Benz pattern craniosynostosis, is a rare form of craniosynostosis. The whole cranial vault remodeling gives the best result.

Objective:

To describe the role of endoscopic third ventriculostomy (ETV) and whole cranial vault remodeling for treatment of BLSS.

Material and Methods:

Surgical technique/procedure: A single-sitting three-step surgery was performed for a 7-month-old child who had BLSS and hydrocephalus. First ETV and anterior cranial vault remodeling were done in the supine position. The posterior cranial vault expansion was done in the prone position.

Results and Conclusions:

The ventricle volume reduced at follow-up and the frontal bossing also reduced. The whole cranial vault remodeling gives the best result for BLSS.
Endoscopic-Assisted Microsurgery for Vestibular Schwannomas
Authors: Shrivastava Adesh , Mishra Rakesh , Nair Anirudh , Nair Suresh
Published: December 2021

Vestibular schwannoma surgery is a challenging operative procedure. Intricate anatomy of vital neurovascular structures demands a meticulous planning and execution. The cerebellopontine angle is an unforgiving area of skull bases surgery which can have grave implications on patient outcome even after a successful tumor removal. As more and more tumors are being detected at early stage, functional preservation of seventh and eighth nerve complex is increasingly being demanded. The key to any minimally invasive approach is to minimize the collateral damage while ensuring complete tumor removal. Binocular microscopy is the workhorse for illumination and dissection via retrosigmoid approach. However, as instrumentation has improved, endoscopic dissections are increasingly being performed. The following video presents the step-by-step nuances for an endoscope-assisted microsurgery for small vestibular schwannomas with stress on endoscopic drilling of the meatal wall to deliver out intracanacular tumor while preserving the labrynthine structures.
Role of Viral Infections in Multiple Sclerosis Pathogenesis among Indian Population
Authors: Pandit Lekha , Malli Chaithra , D'Cunha Anitha , Sudhir Akshatha
Published: December 2021

Background:

The role of viral infections in multiple sclerosis (MS) pathogenesis is unclear.

Objective:

Certain neurotropic viruses previously linked with MS among white population were studied including Epstein–Barr virus, human herpesvirus-6 (HHV-6) and MS-associated retrovirus (MSRV).

Material and Methods:

Sixty-two MS patients (37 had a recent clinical relapse) and 65 controls with other neurological disorders were included. Blood and cerebrospinal fluid (CSF) samples were obtained and processed with the primary objective of determining whether there was intrathecal multiplication of viruses under study (EBV, HHV6 A and B and human endogenous retrovirus) or a breach in blood–brain barrier associated with viral presence in both peripheral blood and CSF.

Results:

Evidence of breach in blood–brain barrier was seen in 86.5% of patients as evidenced by abnormal CSF/serum albumin index and or MRI. EBV nuclear antigen (EBNA1 IgG) was seen in 89% of MS patients and 58% controls (P = <0.001). However, HHV6 IgG was similar in both groups (85% versus 81%; P = 0.45). In affinity immunoblotting reaction intrathecal IgG synthesis against EBNA1 antigen was demonstrable in 26% (16/62) of patients and none against HHV6. A subset of patients showed significant elevation in mean copy number of plasma EBV DNA during relapse and there was a trend for the same among patients harboring HHV-6B. No evidence of isolated intrathecal viral presence or multiplication was seen.

Conclusions:

The results of our study suggest that viruses studied namely EBV and HHV6 have a role in triggering relapses through a peripheral mechanism, rather than a direct role through intrathecal multiplication.
Sporadic Inclusion Body Myositis
Authors: Challa Sundaram , Jakati Saumya , Narla Swethalakshmi , Uppin Megha S , Kannan Meena A , Jagarlapudi M K Murthy
Published: December 2021

Background:

Sporadic inclusion body myositis (s-IBM) is rare in India.

Aim:

The aim of this study was to diagnose s-IBM according to the European Neuromuscular Center (ENMC) IBM research diagnostic criteria 2011.

Materials and Methods:

A retrospective review of patient records diagnosed as s-IBM according to the above criteria during the period from January 2010 to May 2015 was done with an emphasis on pattern of muscle weakness. Serumcreatine kinase (CK) andelectromyography (EMG) were noted. Muscle biopsy was evaluated with basic panel of histochemical stains including Congo red stain. Immunohistochemistry (IHC) with ubiquitin was done in 10 biopsies. IHC for major histocompatibility complex-1 and electron microscopy studies were not performed.

Results:

The diagnosis of s-IBM constituted 5 clinicopathologically defined, 12 clinically defined, and 10 probable IBM in the study period. There was male predominance with median age at 51 and duration of disease varying from 1–5 years. All the patients presented with insidious onset of muscle weakness of quadriceps and/or forearm flexors. CK varied from 57–2939 IU/L. EMG was myopathic in 22, mixed in 2, and neuropathic in 3. Endomysial inflammation was seen in 23 (85.19%) and rimmed vacuoles in 24 (88.89%). Amyloid was demonstrated in only 5 (18.52%) and ubiquitin in 2 biopsies. Mitochondrial abnormalities were seen in 92.59% biopsies.

Conclusions:

Application of the ENMC IBM research diagnostic criteria allowed diagnosis of clinically-defined and probable IBM in the absence of all pathology criteria. Rimmed vacuoles in 88.89% of biopsies indicate presentation at a late stage. Use of ancillary techniques can improve diagnostic yield.
Endoscopic-Assisted C2 Transverse Process Mass Excision
Authors: Bajaj Jitin , Ratre Shailendra , Yadav Yad Ram
Published: December 2021

Background and Introduction:

C2 transverse process exostoses are rare lesions. Due to critical structures surrounding them, their excision is challenging. There are sparse reports of anterior retropharyngeal approach (ARPA) for high-cervical transverse process mass and none for endoscopic ARPA approach.

Objective:

A step-by-step technical report with its video is presented.

Surgical Technique:

A 14-year-old girl presented with chronic right-sided neck pain. The computed tomography scan revealed a 6.5 cm3 mass in the right transverse process extending into the lateral mass of the C2 vertebra. The mass was anterior and in direct contact with the vertebral artery. She underwent a minimally invasive endoscopic ARPA.

Results:

The mass could be excised along with its cartilaginous cap without any complications. The patient's symptoms resolved completely. The biopsy came out as osteochondroma.

Conclusion:

Endoscopic ARPA is a minimally invasive option for high-cervical tumors and was found safe and effective for C2 transverse process osteochondroma.
Cognitive Capacity Assessment
Authors: Bajpai Swati , Nehra Ashima , Pandey R M , Sati Hemchand , Singh Rajesh Kumar , Vishnu Venugopalan Y , Rajan Roopa , Singh Manmohan , Srivastava Achal , Srivastava Padma , Tripathi Manjari
Published: December 2021

Background:

Disability evaluation as per World Health Organization includes assessment of impairments, activity limitations, and participation restriction, which unfortunately is not assessed by the existing guidelines of disability in India.

Aim:

The aim of this study wasto comparea new study criterion with the existing guidelines for assessing cognitive disability for chronic neurological conditions.

Methodology:

A cross-sectional pilot study was conducted on 41 participants. They were assessed on an existing guideline (Gazette India 200,1 assessing physical domain and Intelligence Quotient[IQ]) and study criterion assessing three aspects of cognitive capacity: IQ, neurocognitive functioning, and QOL.

Results:

The existing guideline underestimated 84% of cases for disability. The average percentage of disability measured by the study criterion was 33.2% more as compared to existing guidelines with S.D of 26.6.

Conclusion:

Cognitive capacity assessment is an important element to be measured in chronic neurological disability certification. However, a large sample is required to make an affirmative claim for the same.
Endothelial Nitric Oxide Synthase (Glu298Asp) Polymorphism is Associated Significantly with Ischemic Stroke Presenting with Seizures and Altered Sensorium
Authors: Saluja Alvee , Saraswathy Kallur N , Thakur Sunil , Margekar Shubhalaxmi , Goyal Ankit , Dhamija Rajinder K
Published: December 2021

Background:

Endothelial nitric oxide synthase (eNOS) is an enzymatic marker whose genetic polymorphism might predispose to acute ischemic stroke (AIS) via vascular endothelial dysfunction. It has a potential role in atherosclerosis, making it a plausible risk factor for stroke. Prior studies have failed to prove a conclusive relationship between eNOS polymorphism and AIS.

Objective:

The aim of this study is to find an association between the presence of eNOS polymorphism (Glu298Asp) and the risk of developing AIS.

Materials and Methods:

We recruited 307 subjects including 153 AIS cases and 154 healthy controls. The eNOS (Glu298Asp) polymorphism was identified in EDTA blood by PCR amplification of the target region followed by restriction enzyme digestion, and genotyping on Agarose gel. GG, GT and TT genotypes were obtained. Statistical analysis was done using SPSS software version 20.

Results:

A significant association was found between the presence of TT genotype and the risk of AIS (Odd's ratio (OR): 2.43, P-value = 0.038). There was no significant association between the TT genotype and the traditional stroke risk factors. However, the TT genotype was significantly associated with the presence of altered consciousness (OR: 5.27, 95% CI: 1.59–17.04, P-value = 0.003) and with the occurrence of seizures at presentation (OR: 7.98, 95% CI: 1.99–32.09, P-value = 0.007).

Conclusions:

There is a significant association between the presence of eNOSpolymorphism (Glu298Asp) and the risk of AIS, and the TT genotype may predispose to a more severe initial presentation of ischemic stroke.
Calvarial Lesions
Authors: Attri Gagandeep , Maurya Ved Prakash , Srivastava Arun Kumar , Behari Sanjay , Bhaisora Kamlesh Singh , Sardhara Jayesh , Verma Pawan Kumar , Nazar Aftab Hasan , Jaiswal Sushila
Published: December 2021

Background:

The human calvaria harbors a variety of pathology and majority of them are incidentally noticed as painless swelling. The aim of the present study is to describe the histopathological subtypes of calvarial lesions, their management and factors affecting their surgical outcome at a tertiary care referral center.

Material and Methods:

All patients who underwent excision of the calvarial lesions over the last 15 years (from January 2005 to July 2019) were included in this study. Patients having calvarial pathology of infective origin and recurrent lesions were excluded. Any patient with multiple calvarial lesions who have been operated more than one time for same histopathological diagnosis was counted as one patient. We studied Karnofsky Performance Status (KPS) scores and radiological changes at 3-month follow up.

Results:

Total 65 patients were recruited in this retrospective observational study. The median age of patients in the study was 29 years (range: 8 years to 68 years). Fibrous dysplasia 20 (30.7%) was the commonest lesion while metastatic thyroid carcinoma 3 (4.6%) was the most common malignant pathology. Complete excision was performed in 51 (78.5%) of patients while in 14 (21.5%) cases, subtotal or near total decompression were achieved. After three months of surgery, there was significant improvement in the KPS score (P < 0.00001). Duration of follow up ranges from 6 months to 5 years with 4 mortality in the study.

Conclusions:

Most of the calvarial tumors were benign and surgically addressable. The malignant lesions were scattered with diverse underlying pathology and required individualized holistic approach.
Role of Clinical Neuropsychologists in Awake-Craniotomy
Authors: Hande Vasudha H , Gunasekaran Harini , Hegde Shantala , Shashidhar Abhinith , Arimappamagan Arivazhagan
Published: December 2021

Background:

Awake craniotomy encompasses surgical resection of focal zone of neurological impairment, using intraoperative functional zone mapping. The strength of the procedure is maximum retention of functionally significant zones to ensure better function and quality of life outcomes in patients. A clinical neuropsychologist plays a vital role in profiling the patient's cognitive and psychosocial functioning as well as increasing the efficacy of functional zone mapping procedures.

Objective:

Aim of this article is to summarize the literature on the role of clinical neuropsychologists in awake craniotomy and underscoring the need for establishing standardized operating procedures for neuropsychologists in awake craniotomy highlighting experiential anecdotes from a tertiary care facility.

Materials and Methods:

A review of articles that elucidate the role of clinical neuropsychologists was done and summarized to highlight the role of clinical neuropsychologists. An attempt was made to explain the implementation of this role in regular clinical practice at a tertiary care facility.

Results:

The role of a clinical neuropsychologist is highly crucial at pre-/during and postawake craniotomy, and has a significant bearing on the overall psychological outcome of the individual. The need for a standardized protocol to unify practice and increase the efficacy of the awake-craniotomy procedure is put forth. Recommendations for future directions in research to increase the scope of neuropsychologists in awake craniotomy have also been made.