bluuebunny/crossref_metadata_2025_split huggingface dataset:
Être « mineur non accompagné » en milieu rural. Trajectoires, discours et représentations de jeunes migrants accompagnés par l’Aide sociale à l’enfance en Ariège
Authors: Touhami Slimane 
Published: December 2021

L’accompagnement des jeunes dits « Mineurs non accompagnés » se pratique aussi en ruralité. Une enquête menée en 2020 auprès de jeunes en Ariège (09) offre l’occasion d’accéder à une subjectivité encore trop souvent ignorée. Des « voix de l’intérieur », restituées ici sous forme de verbatims, dont la reconnaissance participe à la réussite d’un parcours d’intégration.
Innovation sociale transformatrice et gestion de la première vague de la Covid-19 : quelles leçons pour le management de crise et de post-pandémie ?
Authors: Nasho Ah-Pine Elda 
Published: November 2021

Face aux difficultés des pouvoirs publics à relever seuls les nombreux défis sanitaires et socio-économiques liés à la gestion de la Covid-19, des mobilisations exceptionnelles en termes de réactivité, coopération et ressources, se sont multipliées à différents niveaux. Afin de réfléchir à un modèle possible pour le management en situation de crise et de post-pandémie, l’article propose de mobiliser les critères de l’innovation sociale (IS) transformatrice hors crise. Après avoir opérationnalisé ces critères, nous les appliquons de façon comparative à des études de cas exploratoires d’actions émergentes, dans quatre pays réputés pour leur gestion de la première vague de la pandémie : Corée du Sud, Taiwan, Chine, Allemagne. Enfin opérant une comparaison avec le concept voisin de la résilience des individus, nous contribuons à la littérature encore rare sur l’IS en situation de crise, grâce à une réflexion sur le potentiel transformatif d’actions entreprises dans ce type de contexte. Code JEL : O350
La solution du fraternel à l’anorexie mentale chez Hansel & Gretel
Authors: Votadoro Pablo , Kalindjian Nina 
Published: December 2021

Les adolescent(e)s souffrant d’anorexie mentale décrivent régulièrement des relations fraternelles conflictuelles. Le conte des frères Grimm Hansel et Gretel met justement en scène une fratrie, confrontée à des enjeux familiaux proches de ceux que l’on retrouve dans les troubles des conduites alimentaires. Condensé d’expériences humaines accumulé depuis le fond des âges, les contes détiennent un savoir sur la psyché humaine, qui a servi de canevas aux générations d’enfant qui s’y sont reconstitués avant le sommeil. Cette étude vise à mettre à jour les problématiques psychopathologiques fraternelles dans les troubles du comportement alimentaire sous le prisme de ce conte. Il s’avère que cinq grandes problématiques se dégagent : les enjeux de séparation, les angoisses de dévoration, le processus différenciateur, l’angoisse de vide, et enfin la dernière qui paraît être la plus centrale, bien que moins explicite : l’issue grâce au lien adelphique. La discussion sur la solution psychique contenue dans le conte est illustrée par des vignettes cliniques.
De l’auto-agressivité au masochisme moral chez les adolescents présentant des traits de personnalité limite
Authors: Krakhmalnikova Eugénie , Terradas Miguel M. 
Published: December 2021

Le trouble de personnalité limite (TPL) comprend divers symptômes sur le plan nosographique. L’agressivité physique et verbale ainsi que l’auto-agressivité physique et psychique occupent un rôle central au sein du TPL. Bien qu’il soit généralement diagnostiqué à l’âge adulte, il est possible d’observer de tels traits en émergence à l’adolescence. Cet article s’intéresse au sens que l’on peut attribuer à l’auto-agressivité chez les adolescents présentant des traits liés au TPL. Pour ce faire, les auteurs revisitent différentes théories et concepts psychanalytiques entourant le développement psychique et ses trajectoires possibles. Plus précisément, les concepts de la mère suffisamment bonne (Winnicott, 1969a/2006), des relations d’objet (Fairbairn, 1952 ; Kernberg, 1976, 1997 ; Klein, 1935), du self étranger (Fonagy & Target, 2000) et du masochisme moral (Nacht, 1965) sont explorés afin de réfléchir à la complexité des différentes facettes du TPL et de l’auto-agressivité prépondérante au sein de ce trouble.
Assessment of risk of bias in randomized controlled trials published in Indian journals pertaining to pharmacology
Authors: Patil Saurabh R , Bhide Shruti Shripad 
Published: December 2021

Context:
Number of trials in India shows an increasing trend. As these trials will shape clinical practice, their quality is of utmost importance. Among many tools to assess the quality of randomized control trials (RCTs), risk of bias (RoB) is most robust.

Aims:
To understand the quality of trials being carried out in India in terms of RoB.

Settings and Design:
We aimed to assess the RoB in a set of RCTs published in Indian pharmacology of randomized trials from journals pertaining to pharmacology.

Subjects and Methods:
We used published journal articles as source of information for randomized clinical trials and evaluated them using Cochrane RoB tool 2.0.

Statistical Analysis Used:
Descriptive statistics were used.

Results:
158 trials published in seven journals were evaluated in six different domains. Overall evaluation for 97% (153) trials was “high risk,” while 3% (5) were in “some concerns” category, with no trials categorized as “low risk. 74% articles showed a high risk of bias in the domain of 'selection of reported results. Nearly half articles scored “low risk” in domains of “missing data” and “deviations in assignment to intervention.” The study results showed a slowly increasing trend of average RoB over the last 10 years.

Conclusions:
The study shows concerning rise in RoB in various domains RCTs published in Pharmacology journals in India.
Effect of Long-Term Administration of Tadalafil on Arteriosclerosis
Authors: Hayashi Keiichiro , Sasaki Haruaki , Fukagai Takashi , Noguchi Tetsuo , Hirayama Kidai , Ogawa Yu , Igarashi Atsushi , Morita Masashi , Ishikawa Kimiyasu , Ogawa Yoshio 
Published: December 2021

Purpose:
The aim of this study is to prospectively investigate whether the long-term administration of tadalafil, which is commonly used for erectile dysfunction, could reduce arteriosclerosis.

Materials and Methods:
This study included 85 patients who presented to one of the three hospitals with lower urinary tract symptoms. Tadalafil was administered daily (5 mg/d), and pulse wave velocity (PWV) was measured before administration and at weeks 12, 24, 36, and 48. The International Prostate Symptom Score, Overactive Bladder Symptom Score, and Erection Hardness Score were simultaneously assessed at the same time points. Further subanalyses were performed in patients with a high risk of cardiovascular events, those aged 75 years or older, and those younger than 75 years. The Wilcoxon signed-rank test was used for statistical analysis.

Results:
Compared with pretreatment values, the PWV did not show any statistically significant decrease at any time point. The group at high risk of cardiovascular events showed significant improvement at weeks 24 and 36, whereas the 75 years or older group showed significant improvement at only week 24. However, the three aforementioned scores significantly improved in all patients during treatment.

Conclusions:
The long-term administration of tadalafil (5 mg/d) might inhibit the progression of arteriosclerosis or prevent its future development.
The Effect of Treatment Timing and Urinary Drainage on the Outcome of Urinary Tuberculosis
Authors: Lin Tsu-Feng , Lin Wun-Rong , Chen Marcelo , Chang Huang-Kuang , Lin Wen-Chou , Tsai Wei-Kung , Yang Stone , Chiu Allen W. 
Published: December 2021

Background:
Urinary tuberculosis (TB) has a variety of clinical manifestations and is a diagnostic challenge for urologists. Delayed treatment can lead to loss of renal function and structural destruction. In this study, we analyzed the relationship between the timing of treatment and outcomes in patients with urinary TB.

Methods:
We performed a retrospective chart review of all patients with urinary TB from 1978 to 2016 at our hospital and analyzed the patients' symptoms, diagnostic methods, imaging studies, time to diagnosis, treatment methods, and follow-up.

Results:
Twenty-one patients (median age: 49 years) had urinary TB, of whom 18 had hydronephrosis and hydroureter. No bilateral renal involvement was noted. The median duration from symptom onset to anti-TB treatment was 78.5 days. There was no significant relationship between symptom-to-treatment time and posttreatment changes in renal function (Pearson's r = 0.103, P > 0.05); however, the symptom-to-treatment time was linearly associated with pre- and posttreatment hydronephrosis grade (Pearson's r = 0.667, P= 0.03, and r = 0.710, P= 0.007, respectively). In multivariate analysis, the symptom-to-treatment time was found to be an independent predictor of improvements in hydronephrosis but was not associated with renal function change. Of nine patients with upper urinary tract drainage, hydronephrosis improved in three and was stable in five patients. Of 12 patients without drainage, four experienced renal loss.

Conclusion:
Urinary TB has vague clinical manifestations and is prone to a delayed diagnosis. Early diagnosis and prompt internal ureteral stenting may prevent renal loss in certain patients.
Olea europaea subsp. Cuspidata and Juniperus procera Hydroalcoholic Leaves' Extracts Modulate Stress Hormones in Stress-Induced Cystitis in Rats
Authors: Nassir Anmar M. , Aziz Ibrahim Ibrahim Abdel , Afify Mohamed A. , ElSawy Naser A. , Imam Mohammad Tarique , Shaheen Mohammad Hassan , Basyuni Mohammed Adel , Bader Ammar , Azhar Raed A. , Shahzad Naiyer 
Published: December 2021

Objective:
To study the effect of Saudi medicinal plant in stress-induced cystitis in experimental rats.

Materials and Methods:
Seventy-two female Sprague Dawley rats (200–250 g) were divided into eight groups of 9 rats each. Group 1 and 2 are controls assigned nonstressed and stressed, respectively. Other six groups received different treatments for 2 weeks. After the 14 days of treatment, each group was exposed to water-immersion restraint stress (WIRS) for 30 min. Blood samples were collected to measure the corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) levels. The rats were sacrificed, and their urinary bladders were isolated immediately for a histological and immunohistochemical examination.

Results:
Rats exposed to WIRS had lesions in the urinary bladder, with a significant increase in plasma CRH and ACTH levels in comparison to the nonstressed controls. Bladder cut sections in stressed rats showed no gross structural abnormality in smooth muscle and connective tissue ratio. There were noticeable variations in mast cell (MC) infiltration and activity with a loss of more than 20% of cellular staining and a significant increase in the number of red blood cell-filled blood vessels. Our findings showed that supplementation of Olea europaea leaf extract (OEE) or Juniperus procera leaf extract (JPE) reduced the MC infiltration and significantly reduced stress hormones compared to the stressed controls.

Conclusions:
The present study demonstrated that OEE/JPE alone and their combination have a potential protective effect against stress-induced cystitis in rats. The underlying mechanism of the present study also resulted in a decrease in CRH and ACTH stress hormones.
The Impact of Obesity on Serum Testosterone Levels and Semen Quality in a Population of Infertile Men
Authors: Chen Yu-An , Chang Hung-Chiang , Liao Chun-Hou 
Published: December 2021

Introduction:
Multiple factors contribute to male infertility, with hypogonadism and low testosterone levels possibly affecting fertility in different aspects. This study focused on factors for low testosterone in infertile male patients.

Materials and Methods:
We retrospectively collected data of patients who were diagnosed with infertility and visited the National Taiwan University Hospital from January 2015 to October 2017. Patients' weight and height, basic blood test results, sperm analysis, and sex hormone profile were recorded. Patients diagnosed with obstructive azoospermia, particularly absence of bilateral vas deferens, those who received a vasectomy or orchiectomy, and patients diagnosed with cancer undergoing chemotherapy or radiotherapy were excluded. Pearson's correlation test was applied for detecting associating factors for serum testosterone. Multivariate linear regression was used for detecting independent factors predicting serum testosterone. An independent t-test was used to analyze continuous variables, and the Chi-square test was used for categorical variables.

Results:
Two hundred and forty-seven patients had serum sex hormone profile and semen profile recorded. The mean age was 36.48 ± 8.68 years. Pearson's correlation test showed that serum testosterone was correlated with serum triglyceride, total cholesterol, fasting blood sugar, and body mass index (BMI). However, multivariate linear regression showed BMI (P = 0.001) and smoking (P = 0.029) to be independent factors predicting serum testosterone. On comparing sex hormone profile and semen profile between obese (BMI ≥30), overweight patient (BMI ≥25, <30), and nonoverweight patients (BMI <25), (i) serum testosterone was significantly lower in the obese and overweight group comparing to nonoverweight group (nonoverweight: 3.61 ± 1.63 ng/ml vs. overweight: 2.87 ± 1.27, P = 0.001; nonoverweight: 3.61 ± 1.63 vs. obese 2.89 ± 1.59, P = 0.035). Follicle stimulating hormone, luteinizing hormone, and prolactin did not differ significantly between the groups. No significant difference in sperm parameters, namely the total sperm count, sperm concentration, total sperm motility, and morphology, was observed between the groups.

Conclusion:
In the infertile Taiwanese male population, obese patients (BMI ≥ 30) and overweight patients (BMI ≥25) had a significant lower serum testosterone than the nonoverweight patients. Body weight control and treatment of metabolic syndrome, and diabetes could improve serum testosterone levels.
The Role of Body Mass Index Predicting Outcome of Percutaneous Nephrolithotomy
Authors: Chen Tsai-Feng , Chen Chung-Hsin , Lee Yuan-Ju 
Published: December 2021

Objective:
The objective of this study is to evaluate the impact of body mass index (BMI) on clinical outcomes and safety profiles of percutaneous nephrolithotomy (PCNL).

Materials and Methods:
We retrospectively reviewed the patients who received PCNL between January 2015 and December 2016. A total of 182 consecutive patients were enrolled. The patients were categorized into three groups according to BMI (normal: BMI ≤24, overweight: 24 < BMI ≤27, obesity: BMI >27). The stone clearance rate, operation time, duration of hospital stay, postoperative analgesic use, and postoperation complications were compared among groups. The categorical variable was analyzed by Chi-square test, and the continuous variable was analyzed by Kruskal–Wallis test. The possible prognosticators for stone clearance were also analyzed using logistic regression method.

Results:
There were no significant differences among groups in terms of age, gender, stone character, stone size, and laterality. A higher proportion of hypertension was observed in the larger BMI groups and lower hemoglobin level in the smaller BMI group. No significant differences of stone clearance rate (66%, 76%, 70% in normal size, overweight, and obesity groups, respectively), duration of hospital stay, postoperative analgesic use, and complication rate were identified among groups. The most common complication was postoperative fever in overweight and obesity groups. Multivariable analysis showed the stone character was a significant prognosticator for stone clearance.

Conclusion:
BMI did not reveal the impact on the stone clearance, operative time, duration of hospital stay, postoperative analgesic requirement, and postoperative complication in patients undergoing PCNL.
Consensus Report on Controversial Use of 5-Alpha-Reductase Inhibitor in Patients with Benign Prostatic Hyperplasia under Taiwan National Health Insurance Regulations
Authors: Chuang Te-Yen , Wang Chung-Cheng , Chen Po-Cheng , Kao Ming-Hong 
Published: December 2021

Introduction:
Although the National Health Insurance regulations for 5-alpha-reductase inhibitor (5ARI) use is well documented, urologists and medical claims review committee members have sometimes felt confused when determining claims for 5ARI use in certain circumstances. Thus, a consensus meeting was held to discuss how to use 5ARI appropriately in such circumstances.

Materials and Methods:
The expert urologists and medical claim review committee members reviewed seven controversial cases with related clinical evidence and voted for approval of the use of 5ARI after vigorous discussion.

Results:
Among the seven cases, a consensus was achieved in four. First, transrectal ultrasound of the prostate was not necessary if the patient already had other images. Second, prescribing 5ARI was affirmed in patients who had high prostate-specific antigen but who refused biopsy. Third, the normal prostate-specific antigen range was based on the 2003 version of the consensus of prostatic cancer of the National Health Research Institutes. Four, 5ARI could be prescribed in patients with improved clinical data but who were unable to meet the other regulatory criteria. Finally, of the three remaining cases, one case was denied, and in two cases, half of the members approved, and half rejected the claim for 5ARI use.

Conclusion:
This consensus report provided clarification for Taiwanese urologists and medical claims review committee members on reimbursable use of 5ARI in controversial cases.
Smaller Prostate Volume is Associated with Adverse Pathological Features and Biochemical Recurrence after Radical Prostatectomy
Authors: Buie John , De Riese Werner , Sharma Pranav 
Published: December 2021

Introduction:
The relationship between prostate cancer (PCa) and benign prostatic hyperplasia is unclear. Reduction in androgenicity and lower intraprostatic growth factor concentrations in smaller prostates may serve a more ideal environment for the development of aggressive tumors. We determined if prostate volume was associated with adverse pathological features, tumor volume, and biochemical recurrence (BCR) in men undergoing radical prostatectomy (RP) for PCa.

Materials and Methods:
We retrospectively identified 192 men who underwent RP at our institution for PCa from 2010 to 2016 years. Prostate volume was based on RP specimen weight, and cumulative tumor volume was calculated. Means were compared with one-way ANOVA test and proportions with Chi-square analysis. Multivariate logistic regression was performed to determine independent predictors of BCR after RP.

Results:
Patients with prostate volume >60 g were less likely to have high-risk PCa (Gleason grade group >4) (7.1% vs. 13.4%; P = 0.042), node-positive disease (7.1% vs. 13.4%, P = 0.042), and BCR (10.7% vs. 25.0%, P = 0.002) after surgery. Linear regression showed an inverse relationship between prostate and tumor volume (R = 0.267; P < 0.05). On multivariate logistic regression, prostate volume >30 g (odds ratio [OR]: 0.21, 95% confidence interval [CI]: 0.09–0.88; P = 0.015) and >60 g (OR: 0.14, 95% CI: 0.03–0.74; P = 0.002) were independent predictors of reduced BCR at mean follow-up of 24 months.Conclusions: Smaller prostate volume was associated with adverse pathological features, increased tumor volume, higher incidence of pathological node-positive disease, and increased rates of BCR. Prostate volume should be considered as a prognostic feature when counseling patients with both elevated prostate-specific antigen and newly diagnosed PCa.
Comparative Persistence, Switch Rates, and Predictors for Discontinuation of Antimuscarinics for Overactive Bladder
Authors: Chen Hao-Wei , Chen Yu-Chen , Wu Wen-Jeng , Li Ching-Chia , Chang Yu-Han , Geng Jiun-Hung , Shen Jung-Tsung , Jang Mai-Yu , Yang Kai-Fu , Juan Yung-Shun 
Published: December 2021

Objectives:
Although antimuscarinic drugs are considered the gold standard for overactive bladder (OAB), high discontinuation rates have been observed. However, no information is known about this in Taiwan. We investigated the persistence and switch rates among different antimuscarinics prescribed for OAB and evaluated whether different comorbidities impacted the persistence with prescribed antimuscarinics in Taiwan.

Materials and Methods:
We obtained retrospective claims from a Taiwanese health insurance database for patients with OAB; any first claim for the target drugs (tolterodine extended release [ER], tolterodine immediate release [IR], oxybutynin ER, oxybutynin IR, solifenacin, propiverine, and flavoxate) between January 2004 and December 2013 was included. The prescription claims were tracked for 1 year to calculate the time of persistence and switch rates. Comorbidities, including hypertension, diabetes mellitus, and hyperlipidemia, were recorded. Significant factors for discontinuation were investigated by using a Cox proportional hazards model.

Results:
A total of 24,381 patients with OAB were prescribed the target antimuscarinics. The most prescribed drug during the 10-year period was flavoxate (8339 patients). Of the 3481 patients with chronic OAB, the drug with the longest mean persistence was solifenacin (125 days). At 12 months, the persistence rate varied from 7.6% for oxybutynin ER to 4.3% for propiverine. The switch rates varied from 40.3% for propiverine to 25.7% for solifenacin. The Cox proportional hazards model showed that hyperlipidemia was the only comorbidity significantly associated with discontinuation (hazards ratio: 1.12, 95% confidence interval: 1.03–1.21, P = 0.006).

Conclusions:
In this large nationwide Taiwanese study, 12-month persistence was generally low for all antimuscarinics. Solifenacin was associated with the longest mean persistence and the lowest switch rates, oxybutynin ER had the highest 12-month persistence rate, and hyperlipidemia was significantly associated with lower persistence.
Smoking Behavior and Survival Outcomes in Bladder Cancer Patients
Authors: Chu Wei-Chung , Chen Chung-Hsin 
Published: December 2021

Purpose:
The purpose of this study was to compare the survival outcomes of bladder cancer patients with different smoking behaviors.

Materials and Methods:
Between January 2011 and December 2014, a total of 565 bladder cancer patients were included from one institute retrospectively. Regarding smoking behavior, among these patients, 337 were nonsmokers, 52 were “quitters” (patients who had quit smoking ≥10 years ago), 54 were ex-smokers (patients who had quit smoking <10 years ago), and 117 were current smokers. We compared the clinicopathological characteristics and survival outcomes among these four groups.

Results:
In this cohort, the 3-year overall survival (OS) (95% confidence interval [CI]) of the nonsmoker, quitter, ex-smoker, and current smoker groups were 75.6% (95% CI: 72.9%–78.3%), 67.4% (95% CI: 59.8%–75%), 84.1% (95% CI: 78.9%–89.3%), and 83.2% (95% CI: 79.3%–87.1%), respectively. Nonsmoker patients included a higher number of females, and quitters were older than the patients in the other groups. Larger tumors in quitters and higher clinical stages in ex-smokers were observed more frequently than in the patients of the other groups. Compared with nonsmokers, quitters, and ex-smokers, current smokers had no impact on OS (P = 0.541, 0.406, and 0.175, respectively) nor on cancer-specific survival (CSS) (P = 0.631, 0.388, and 0.193, respectively). Higher diagnostic age, being underweight, larger tumor sizes, and higher clinical stages were independent factors predicting OS.

Conclusion:
Smoking behavior seemed to not directly contribute to the deterioration of overall or CSS duration in patients with bladder cancer.