bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soins intensifs en hôpital de jour
Authors: Reysset Nadine , Fressoz Muriel 
Published: May 2021

La création d’hôpitaux de jour en psychiatrie Adultes, a été au cœur du Projet Médical d’Etablissement du Centre Hospitalier Alpes-Isère dès 2010, avec la volonté d’accentuer le virage ambulatoire de l’hôpital pour permettre aux patients de rester le plus possible en soins dans leur propre environnement. Soutenu par l’ARS, le CHAI a ainsi mis en place depuis 2012, trois HDJ de psychiatrie adulte correspondant aux pôles géographiques de l’établissement. Il s’est également doté de trois hôpitaux de jour spécialisés, en addictologie, en réhabilitation psycho-sociale, et dans les troubles du spectre de l’Autisme. Les hôpitaux de jour polaires ont dû évoluer pour s’adapter aux besoins. La nouvelle génération dite « de soins intensifs » ou « de crise » représente aujourd’hui un dispositif essentiel dans le parcours thérapeutique individualisé (PTI) des patients, entre l’hospitalisation complète et le suivi en CMP-CATTP. Chacune de ces structures est ici présentée dans sa spécificité à travers une illustration clinique.
Hiatus adolescent, Sublimation ou perversion
Authors: Drossart Francis 
Published: May 2021

Nous proposons le terme de hiatus adolescent pour décrire un phénomène particulier de la clinique, s’exprimant par une discordance (terme emprunté à la phonétique). Ce phénomène met en jeu de manière non dialectisable les couples d’opposés classiques de la psychanalyse : activité/passivité, masculin/féminin, sexualité infantile/sexualité adulte, pulsions de vie/pulsion de mort etc. Ce terme se réfère, sans s’y résumer, aux concepts de : breakdown adolescent, pubertaire, pot-au-noir, fonctionnement psychotique à l’adolescence, changement catastrophique... Le hiatus adolescent infiltre tout particulièrement la relation transférentielle, et à ce titre, il mérite d’être pris en compte dans le travail psychothérapique.
Développer la « pensée critique » avec les jeunes des quartiers populaires urbains en écoutant leur « rapport au monde »
Authors: Bordet Joëlle 
Published: May 2021

Cet article, en résonance au colloque « symbolisation et sublimation à l’adolescence » organisé par l’A2IP, rend compte d’une démarche d’écoute des jeunes des quartiers populaires urbains à propos de leur rapport au monde et à leurs dynamiques identitaires initiées lors des premiers départs de jeunes à Daesch en 2014. En référence aux travaux cliniques sur l’adolescence, nous analysons comment il est important pour les professionnels qui les accompagnent au quotidien de pouvoir accueillir la subjectivité des jeunes et leurs représentations pour penser avec eux. La mise en place « d’ateliers de la pensée critique » permet alors d’expérimenter ensemble une approche de la pensée critique et de développer ces nouvelles pédagogies en France dans le cadre des politiques publiques.
« Adolescent », dites-vous ?
Authors: Bonnellier Roseline 
Published: May 2021

Le vocabulaire dont Freud dispose pour parler de la « personne adolescente » est significatif d’une situation historico-culturelle qui diffère pour la fille / jeune fille par rapport au garçon et « jeune homme », en fonction de la puberté et en continuité avec la théorie de l’Œdipe. Dans une culture freudienne, le topos du Jüngling couplé avec le Knabe du classico-romantisme allemand, s’inscrit dans le mythe du héros observé ici en « retour à Goethe » sur la pierre de touche du héros faustien.
Management of Limbal Dermoids by Simple Excision in Young Children
Authors: Promelle Veronique , Lyons Christopher J. 
Published: May 2021

Purpose:
To report the visual outcomes, refractive results, and complications of simple excision for limbal dermoid in the first 8 years of life.

Methods:
This retrospective chart review included all children aged 8 years or younger who underwent excision of a grade I or II limbal dermoid without involvement of the visual axis between the years 2000 and 2019.

Results:
Nineteen patients met the inclusion criteria. Their mean age was 4.2 ± 2.0 years (age range: 9 months to 8 years). The mean change in visual acuity was +1 ± 2.3 lines. The mean astigmatism was 3.20 ± 1.80 diopters (D) preoperatively and 3.50 ± 2.20 D at the last visit; the mean change in the astigmatism power was +0.20 ± 1.20 D (range: −1.50 to +2.75 D). Epithelial healing occurred in a mean of 8 days. No complications such as perforation were encountered. All patients had a good cosmetic outcome.

Conclusions:
Reepithelialization led to good cosmetic outcomes after this quick, simple, and uncomplicated procedure. There was no significant change in visual acuity or astigmatism, so amblyopia and astigmatism reduction are poor indications for limbal dermoid excision. Families should be counseled preoperatively that correction of the astigmatism and patching will remain essential in the postoperative management of amblyopia.

[
J Pediatr Ophthalmol Strabismus
. 2021;58(3):196–201.]
Dévoiler les « bobards » des médias dominants
Authors: Stephan Gaël , Vauchez Ysé 
Published: May 2021

Le courant de la « réinformation » désigne un groupe d’acteurs militants alliant un ancrage idéologique identitaire et un répertoire d’action fondé sur une pratique informationnelle. Ainsi leur existence se fonde-t-elle sur une prétention à énoncer « la vraie vérité », tout en dénonçant ceux qui, selon eux, trahiraient les exigences professionnelles et éthiques du journalisme : les médias « mainstream ». L’étude ici proposée se concentre sur un moment de sociabilité important pour le mouvement : les Bobards d’Or, une cérémonie annuelle parodique récompensant « [les journalistes] qui n’hésitent pas à mentir délibérément pour servir le politiquement correct », organisée à Paris par la Fondation Polémia. En croisant l’observation ethnographique de plusieurs éditions de la cérémonie, et une analyse statistique des 111 « mensonges » proposés au vote des internautes entre 2012 et 2019, nous analysons les modalités par lesquelles ces acteurs construisent une légitimité hybride, affichant des positions militantes tout en se réclamant de la grammaire du journalisme professionnel. Par un usage stratégique de leur statut d’outsiders, dans leurs discours et dans leurs pratiques, les réinformateurs cherchent à inscrire leurs pratiques comme conformes aux valeurs et standards du journalisme dit « mainstream ». Ce faisant, ils prétendent endosser les normes dont ils sont accusés de dévier.
Pour une théorie critique de la gouvernance algorithmique et de l’intelligence artificielle
Authors: OUELLET Maxime 
Published: May 2021

Dans une perspective dialectique, cet article cherche à saisir les fondements sociohistoriques des catégories centrales qui sont mobilisées dans le domaine de l’intelligence artificielle : la communication, la commande, le contrôle et l’information. L’intention est de poser les bases conceptuelles de l’élaboration d’une théorie critique de la gouvernance algorithmique en montrant comment les développements contemporains de l’intelligence artificielle participent d’une disqualification de la lettre au profit du nombre, c’est-à-dire à la substitution de la langue par le code (informatique). Au plan sociopolitique, cette mutation conduit à la mise en place d’une nouvelle forme algorithmique de régulation de la pratique sociale, la gouvernance algorithmique, qui repose sur un processus d’automatisation de la production de connaissances.
Algorithmes de recommandation et culture technique : penser le dialogue entre éducation et design
Authors: CLAES Arnaud , WIARD Victor , MERCENIER Heidi , PHILIPPETTE Thibault , DUFRASNE Marie , BROWET Arnaud , JUNGERS Raphaël 
Published: May 2021

Pour répondre à la démultiplication de contenus médiatiques accessibles en ligne, de nombreuses plateformes ont aujourd’hui recours à des algorithmes de recommandation pour structurer et hiérarchiser les flux d’information. Ces dispositifs sont critiqués pour l’importance qu’ils accordent à la satisfaction immédiate de l’utilisateur, menaçant la diversité d’opinion accessible au sein d’espaces médiatiques de plus en plus personnalisés. En croisant les résultats de recherches en sciences sociales et en sciences informatiques, cet article examinera la pertinence de la théorie de la « bulle de filtres ». A travers l’analyse de deux cas d’étude portant respectivement sur les modalités d’appropriation de systèmes de recommandation par des jeunes et sur la modélisation de dispositifs alternatifs, nous examinerons en quoi la mise en dialogue de l’éducation aux médias et du design peut contribuer à renégocier nos rapports avec des technologies dites « intelligentes ».
Recruiting and Retaining Racially Minoritized Students into Professional Postbaccalaureate Athletic Training Programs
Authors: White Kimberly Ann , Winkelmann Zachary K. , Edler Nye Jessica R. , Eberman Lindsey E. 
Published: May 2021

Context
Racially diverse individuals are underrepresented in the field of athletic training. Previous research identified multiple factors that may contribute to diversity concerns including a lack of access to higher education, underrepresentation, financial instability, lack of programming, and mentoring for minoritized students through matriculation in health care education programs.

Objective
To identify current recruitment and retention strategies aimed at racially minoritized students in athletic training programs.

Design
Consensual qualitative research.

Setting
Individual interviews.

Patients or Other Participants
A total of 14 professional athletic training program directors (age = 47 ± 7 years; years credentialed = 25 ± 7 years; years in role = 13 ± 7 years).

Main Outcome Measures
This qualitative study used consensual qualitative research methodology with the incorporation of multianalyst triangulation and member checking to establish trustworthiness. The interview protocol consisted of questions regarding current recruitment and retention strategies used by directors of professional master's programs.

Results
Four domains emerged from the study: (1) benefits of diversity, (2) marketing, (3) individualized support, and (4) enrollment management strategies. Participants expressed that diversity could lead to a more inclusive and positive learning environment and could improve patient care through establishing race concordance on the program Web site, social media, and other print materials. Program directors demonstrated a lack of awareness relative to available professional resources and the difference between creating equal versus equitable resources. Participants demonstrated variability in their awareness of enrollment management strategies, specific to admissions resources and professional resources.

Conclusions
Program directors appreciate the benefits of racial diversity and are actively engaged in marketing strategies to recruit minoritized students. They are also working to retain minoritized students but may be providing equal, rather than equitable, resources. Professional athletic training programs must continue to develop and promote effective strategies for admissions, support matriculation, and increase identifiable and equitable resources to better serve minoritized students.
High-Resolution Vessel Wall Imaging in Primary Angiitis of Central Nervous System
Authors: Sundaram Soumya , Kumar P Naveen , Sharma Dev Prakash , Kesavadas Chandrasekharan , Sreedharan Sapna Erat , Prasad B Arun , Sylaja PN 
Published: May 2021

Background:
High-resolution vessel wall imaging (HRVWI) can aid in differentiating the various intracranial vasculopathies, but has been sparingly used in the diagnosis of primary angiitis of central nervous system (PACNS). This study is aimed to describe the vessel wall imaging characteristics of PACNS.

Materials and Methods:
Patients with confirmed diagnosis of PACNS according to the Calabrese and Mallek criteria who had abnormal HRVWI were included in this retrospective descriptive study. Magnetic resonance image of brain, conventional four-vessel cerebral digital subtraction angiogram, and HRVWI were read by a neuroradiologist. The vessel wall parameters assessed were T1W and T2W appearances, pattern of wall thickening and contrast enhancement, and remodeling index.

Results:
HRVWI done in 21 patients with PACNS yielded abnormality in 20 (95.2%) who were included in the analysis. The mean age at presentation was 42.55 ± 9.48 years and 14 (70%) were males. The median number of vessels involved were four (range 2–12). The commonest vessels affected were proximal middle cerebral artery (70%) and internal carotid artery (55%). Vessel wall thickening was concentric, eccentric, and absent in 12 (60%), 1 (5%), and 7 (35%) patients, respectively. Vessel wall enhancement was diffuse in 17 (85%), eccentric in 1 (5%), and absent in 2 (10%) patients. One patient had T2W hyperintense stenotic lesion. Remodeling index was negative in 11 (55%) patients.

Conclusion:
Distinctive vessel wall appearances were observed by HRVWI in PACNS, concentric vessel wall thickening and enhancement being more frequent. Hence, HRVWI can be considered as an additional noninvasive imaging modality in the diagnosis of PACNS.
The Association of Myositis Specific Antibodies in Patients with Inflammatory Myositis
Authors: Negalur Natasha Vijay , Ekbote Gayatri G. , Raval Dhiren N. , Tanna Dhaval V. , Kazi Wasim S. , Bindroo Muzaffar A. , Yadavalli Durgarao J. , Gupta Rajiva 
Published: May 2021

Context:
Autoantibodies have a role in the diagnosis and prognosis in Autoimmune Inflammatory Myositis (AIM).

Aims:
The aim of this work was to study the prevalence and clinical correlation of myositis specific and associated antibodies (MSA and MAA) in AIM.

Setting and Design:
This was a cross-sectional observational study.

Methods and Materials:
Consecutive AIM patents were divided into groups as dermatomyositis (DM), polymyositis (PM), CTD-associated myositis (CTD-M), cancer-associated myositis (CAM) and juvenile myositis (JM). Their data along with serum samples were collected after obtaining informed consent. Sera was analyzed for IgG antibodies against Jo-1, PL-7, PL-12, EJ, SRP, Mi-2, MDA-5, TIF1γ, SAE1, SAE2, NXP2 and SSA/R052kD using the microELISA technique. The institutional ethics committee approved the study.

Statistical Analysis:
SPSS software (version 24.0) was used. P value < 0.05 was considered statistically significant.

Results:
There were 48 patients (DM = 19, PM = 19, CTD-M = 5, CAM = 2, JM = 3) included. MSA were positive in 37.5% patients. Antibodies against Mi-2 were present in 6 (12.5%), Jo-1 in 5 (10.4%), 2 (4.1%) each had PL-7 and SRP antibodies. One patient (2%) each had MDA-5, NXP2 and TIf1g antibodies. Jo-1 antibody was associated with mechanic's hands and ILD. There was a significant association of rash in the Mi-2 group with none of the patients having ILD. Malignancy screening was negative in NXP2 and TIF1g antibody-positive patients. Ro52 was the most common MAA (33.3%) and was associated with mechanic's hand.

Conclusion:
MSA was present in almost 40% of the cohort. Anti Jo-1 antibody was associated with mechanic's hands and ILD. None of the Mi-2 patients had ILD, which may point to a protective role of this antibody for ILD. The association of newer antibodies in Indian patients needs to be further studied in larger cohorts.
Comprehensive Functional Evaluation of the Spectrum of Multi-System Atrophy with 18F-FDG PET/CT and 99mTc TRODAT-1 SPECT
Authors: Seniaray Nikhil , Verma Ritu , Ranjan Rajeev , Belho Ethel , Mahajan Harsh 
Published: May 2021

Aim:
To elucidate the patterns of characteristic hypometabolism on 18F- fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in multisystem atrophy (MSA) and their correlation with the patterns of uptake on dopamine transporter imaging with 99mTc TRODAT-1 SPECT.

Material and Methods:
A retrospective analysis of 67 patients with clinically diagnosed MSA was performed. All the subjects underwent 99mTc TRODAT-1 SPECT and 18F-FDG PET/CT scanning on two separate days. The 99mTc-TRODAT-1 scans were analyzed visually for asymmetry and rostro-caudal gradient. The FDG uptake patterns were recorded, and areas of hypometabolism that were two standard deviations from the mean were considered abnormal.

Results:
All the subjects had an abnormal pattern of FDG uptake on PET scan, both on a visual inspection and semiquantitative analysis. In MSA-P subjects (n = 29), diffuse predominant hypometabolism of the globus pallidus-putamen complex was noted, with relative sparing of the caudate nuclei. In MSA-C subjects (n = 25), characteristic hypometabolism was noted in the cerebellum and brainstem. In mixed subtypes (n = 13), variable involvement of the basal ganglia, cerebellum, and brainstem was noted with frontoparietal hypometabolism. A statistically significant difference between MSA-P and MSA-C for gradient reduction and asymmetry with gradient reduction was observed.

Conclusion:
Dopamine transporter imaging with 99mTc TRODAT-1 SPECT not only helps in confirmation of parkinsonian disorders but also demonstrates varying patterns of distribution in different subtypes of MSA. Characteristic patterns of hypometabolism in 18F-FDG PET may help in the differentiation of the subtypes of MSA in the presence of clinically overlapping symptoms.
Plasmalyte versus normal saline as resuscitation fluid in children
Authors: Arya Vandana , Kavitha M , Mittal Kundan , Gehlawat Virender Kumar 
Published: May 2021

Background:
Plasmalyte A, a balanced solution is reported to be associated with a reduced incidence of hyperchloremia and metabolic acidosis when compared with 0.9% NaCl among adults. Considering the paucity of evidence in the pediatric population, the present study was conducted with an objective to compare the efficacy and safety of plasmalyte and normal saline as intravenous fluid bolus therapy in children with shock in terms of Electrolytes and Acid-base balance at admission and at 6 h.

Subjects and Methods:
This double-blinded, randomized controlled trial was conducted in the pediatric emergency department (ED) of a tertiary care hospital among children aged 1 month to 14 years who presented to the ED with shock. A total of 400 children were randomized to receive either plasmalyte or 0.9% saline solution as intravenous fluid bolus therapy. Changes in laboratory parameters including pH, serum bicarbonate levels, serum lactate level, and serum electrolytes-sodium, potassium, chloride levels from baseline (hour 0) to hour 6 were compared in both groups. Secondary outcomes included the need for vasopressors, duration of hospital stay, and in-hospital mortality.

Results:
The two groups were similar in terms of baseline clinical characteristics. Patients receiving plasmalyte demonstrated significantly greater improvement in the pH (P = 0.001), bicarbonate (P = 0.001) and lactate levels (P = 0.03) compared with patients receiving normal saline. In addition, normal saline group patients had a higher rise in sodium (P = 0.11) and chloride levels (P = 0.02) as compared to the plasmalyte group. The children who received plasmalyte had a significantly lesser need for vasopressors (P = 0.04), shorter mean duration of hospital stay (P = 0.01), and lower mortality (P = 0.03).

Conclusion:
Plasmalyte was superior to Normal saline when used as a resuscitation fluid in children with shock, in terms of better improvement of acid-base balance after fluid bolus therapy, a lower rise in serum chloride level at 6 h from baseline, shorter hospital stay, lesser need for vasoactive drugs and lower mortality.
Validation of the Malayalam version of the parental stressor scale
Authors: Sethuraman Janani , Venkateswaran Chitra 
Published: May 2021

Background:
For any research, it is important to ensure that an establish instrument conforms to the culture of the population in focus. The objectives of this study include translation of the Parental Stressor Scale: Pediatric Intensive Care Unit (PSS: PICU) questionnaire into Malayalam and the analysis of its psychometric properties.

Subjects and Methods:
This was a cross-sectional study of 201 parents of children admitted to the PICU. The PSS: PICU questionnaire was first translated into Malayalam language using the standard “Forward-Backward” procedure. Following consent, parents completed the demographic sheet and the Malayalam version of PSS: PICU scale within 30 min.

Results:
Analysis showed good psychometric properties for the Malayalam PSS: PICU questionnaire when compared to the original English version. The principal component factor analysis with Varimax rotation was used to assess the validity and was found to favor the conceptual dimensions of the original English questionnaire. The Cronbach's alpha coefficient used to assess reliability was 0.865 for the entire scale reflecting good internal consistency.

Conclusion:
The PSS: PICU questionnaire was translated to Malayalam and the psychometric properties of the Malayalam version were found to be adequate, albeit requires further exploration before extensive use.
Neglected Outcomes of Customer Orientation in Urban Public Water Utilities in Uganda and Tanzania
Authors: Mukokoma MMN , Ssemwogere E 
Published: May 2021

We used 30 decision making units (DMUs) of National Water and SewerageCorporation (NWSC) in Uganda and Dar es Salaam Water and Sewerage Corporation [DAWASCO] in Tanzania to collect data from customers and workers/regulators of the two utilities. We also collected secondary data on the performance of the utilities in 2010. We used this data to calculate the Data Envelopment Analysis (DEA) for the DMUs. The results indicate highadoption of customer orientation in NWCS’ DMUs (mean score = 86%) while in DAWASCO’s DMUs the mean score is 44%. The results from DEA analysis show a mean efficiency score of 93% for NWSC and 71% for DAWASCO. Also, the findings indicate a service quality gap of -1.98 forNWSC and -2.81 for DAWASCO. We found that there is a positive correlation between customer orientation and efficiency (0.58 [p<0.01]); a positive correlation between customer orientation and customer satisfaction (0.36 [p>0.01]); and an inverse correlation between customer satisfaction and efficiency (0.043% [p>0.01]). These results imply that increased adoption of customer orientation reforms enhances technical efficiency albeit the resultant improvement in customer satisfaction is statistically insignificant.Keywords · Customer orientation · Service quality · DEA
Práticas integrativas e complementares no empoderamento do cuidar em saúde
Authors: Oliveira Fernanda Pimentel de , Coelho Marcia Gomes Marinheiro , Siqueira Maria Juliana Firmino , Farias Francisca Lucélia Ribeiro De , Amorim Rosendo Freitas de 
Published: May 2021

As Práticas Integrativas e Complementares (PIC) são caracterizadas como um conjunto de práticas e ações terapêuticas que não estão presentes na biomedicina(OMS,2002) e buscam novas perspectivas de mudança do paradigma mecanicista utilizado na atenção à saúde (TELESI, 2016). Este estudo de revisão integrativa teve como objetivo compreender com as Práticas Integrativas e Complementares se inserem no contexto do empoderamento do cuidar em saúde. Trata-se de uma revisão integrativa da literatura, que contempla as seguintes etapas: definição da questão norteadora (problema) e objetivos da pesquisa. As PIC apresentam diferentes abordagens que contemplam a diversidade de cuidados que necessita o ser humano. Por isso, apresentam diferentes abordagens de equilíbrio entre mente, espírito, corpo, ambiente e sua saúde. O restabelecimento da saúde considera a casa, família, amigos, trabalho, a forma de se relacionar, de sentir pertencente e integrado a um grupo social, comunitário e a essa sociedade, além da hereditariedade (MONTEIRO, 2012). As Práticas integrativas e Complementares constituem uma importante aliada na busca de melhorias na saúde por considerar o indivíduo em sua totalidade, priorizando o foco na saúde e não na doença, na busca do equilíbrio entre a mente e o corpo. Tais práticas se opõem à visão medicamentosa, tecnológica com ênfase na medicalização e na doença, para um olhar voltado para o sujeito, singularidade, buscando o resgate do saber popular, no seu uso e aplicabilidade para os problemas de saúde.