bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ketoacid Supplementation Partially Improves Metabolic Parameters in Patients on Peritoneal Dialysis
Authors: Dong Jie , Li Yan-Jun , Xu Rong , Ikizler Talat Alp , Wang Hai-Yan 
Published: September 2015

Background A low protein diet supplemented with ketoacids has been shown to improve the metabolic profile, including insulin resistance, in patients with chronic kidney disease (CKD), but whether ketoacids alone exert similar effects is unknown. In this prospective randomized controlled trial, we aimed to evaluate the effects of ketoacid supplementation on insulin resistance, systemic inflammation, oxidative stress and endothelial dysfunction among 100 CKD patients undergoing peritoneal dialysis (PD). Methods Patients from one Chinese PD center were randomly assigned to take ketoacids (12 tablets per day) ( n = 50) versus a control group ( n = 50) for 6 months in an open-label parallel-arm design. Daily protein intake of 0.8 – 1.2 g/kg/d and daily energy intake of 25 – 35 kcal/kg/d was prescribed to both groups. Insulin resistance was evaluated using homeostatic model assessment (HOMA-IR) index as the primary outcome. We assessed systemic inflammation using high-sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6), oxidative stress using plasma oxidized low density lipoprotein (oxLDL), adipokines using leptin and adiponectin and endothelial dysfunction using serum soluble intercellular adhesion molecule-1 (sICAM) and soluble vascular adhesion molecule-1 (sVCAM) as secondary outcomes. Results There were no significant differences in baseline characteristics between the 2 groups except a slightly higher age in patients assigned to the intervention. A total of 89% of participants completed the 6-month intervention. There was no significant difference in the change of HOMA-IR values from baseline between groups after adjusting for baseline age, gender, body mass index and HOMA-IR. For secondary outcomes, hs-CRP varied significantly between groups ( p = 0.02), increasing over time for the control group while remaining stable for the ketoacid group. Similarly, the leptin/adiponectin ratio (LAR) differed between groups ( p < 0.001), remaining stable in the ketoacid group but increasing in the control group. Conclusion Ketoacid therapy administered for 6 months had no effect on HOMA-IR but resulted in improvements in hs-CRP and LAR, suggesting metabolic benefit. Future studies are needed to confirm these results and any potential benefit in vascular health of PD patients.
Exit-Site Dressing and Infection in Peritoneal Dialysis: A Randomized Controlled Pilot Trial
Authors: Mushahar Lily , Mei Lim Wei , Yusuf Wan Shaariah , Sivathasan Sudhaharan , Kamaruddin Norilah , Idzham Nor Juliana Mohd 
Published: September 2015

Objective Peritoneal dialysis (PD)-related infection is a common cause of catheter loss and the main reason for PD drop-out. Exit-site infection (ESI) is a pathway to developing tunnel infection and peritonitis, hence rigorous exit-site care has always been emphasized in PD therapy. The aim of this study was to evaluate the effect of exit-site dressing vs non-dressing on the rate of PD-related infection. Methods A prospective randomized controlled study was conducted in prevalent PD patients at the Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia, from April 2011 until April 2013. All patients were required to perform daily washing of the exit site with antibacterial soap during a shower. In the dressing group ( n = 54), patients were required to clean their exit site using povidone-iodine after drying, followed by topical mupirocin antibiotic application to the exit site. The exit site was then covered with a sterile gauze dressing and the catheter immobilized with tape. In the non-dressing group ( n = 54), patients were not required to do any further dressing after drying. They were only required to apply mupirocin cream to the exit site and then left the exit site uncovered. The catheter was immobilized with tape. The primary outcome was ESI. The secondary outcomes were evidence of tunnel infection or peritonitis. Results A total of 97 patients completed the study. There were a total of 12 ESI episodes: 4 episodes in 4 patients in the dressing group vs 8 episodes in 4 patients in the non-dressing group. This corresponds to 1 episode per 241.3 patient-months vs 1 episode per 111.1 patient-months in the dressing and non-dressing groups respectively. Median time to first ESI episode was shorter in the non-dressing than in the dressing group, but not significant ( p = 0.25). The incidence of gram-positive ESI in both groups was similar. There were no gram-negative ESI in the non-dressing group compared with 2 in the dressing group. The peritonitis rate was 1 per 37.1 patient-month in the dressing group and 1 per 44.4 patient-months in the non-dressing group. Median time to first peritonitis episode was significantly shorter in the dressing group compared to non-dressing ( p = 0.03). There was no impact of dressing disruptions in the occurrence of major PD catheter-related infection. Conclusion Use of a non-dressing technique with only prophylactic topical mupirocin cream application is effective in preventing PD-related infection. The non-dressing technique is more cost-effective and convenient for PD patients, with fewer disposables.
Evaluating Hyponatremia in Non-Diabetic Uremic Patients on Peritoneal Dialysis
Authors: Yan Ming-Tso , Cheng Chih-Jen , Wang Hsiu-Yuan , Yang Chwei-Shiun , Peng Sheng-Jeng , Lin Shih-Hua 
Published: September 2015

Background An approach to hyponatremia in uremic patients on peritoneal dialysis (PD) necessitates the assessment of intra-cellular fluid volume (ICV) and extracellular volume (ECV). The aim of the study was to evaluate the association of plasma sodium (Na+) concentration and body fluid composition and identify the causes of hyponatremia in non-diabetic PD patients. Methods Sixty non-diabetic uremic patients on PD were enrolled. Baseline body fluid composition, biochemistry, hand-grip test, peritoneal membrane characteristics, dialysis adequacy, Na+ and water balance, and residual renal function (RRF) were measured. These parameters were reevaluated for those who developed hyponatremia, defined as serum Na+ concentration < 132 mmol/L and a decline in serum Na+ > 7 mmol/L, during monthly visits for 1 year. Body fluid composition was determined by multi-frequency bioelectrical impedance (BIA). Results There was no significant correlation between serum Na+ concentrations and any other parameters except a negative correction with overnight ultrafiltration (UF) amount ( p = 0.02). The ICV/ECV ratio was positively correlated with serum albumin ( p < 0.005) and hand grip strength ( p < 0.05). Over 1 year, 9 patients (M:F = 3:6, aged 35 – 77) with 4 different etiologies of hyponatremia were identified. Hyponatremic patients with a body weight (BW) loss had either an increased ICV/ECV ratio associated with primarily a negative Na+ balance ( n = 2) or a reduced ratio of ICV/ECV associated with malnutrition ( n = 2). In contrast, hyponatremic patients with a BW gain had either a reduced ICV/ECV ratio associated with a rapid loss of RRF and a higher peritoneal permeability ( n = 2) or a normal to increased ICV/ECV ratio associated with high water intake ( n = 3). Conclusion Besides BW change and ultrafiltration rate, the assessment of ICV/ECV ratio is valuable in identifying the etiologies of hyponatremia in PD and provides a guide for optimal therapy.
Peritoneal Dialysis University for Surgeons: A Peritoneal Access Training Program
Authors: Crabtree John H. , Penner Todd , Armstrong Sean W. , Burkart John 
Published: September 2015

Background A functioning catheter is vital to the success of peritoneal dialysis (PD). Catheter complications related to the insertion procedure remain a major hindrance to PD utilization. Most catheters are placed by surgeons. Suboptimal catheter outcomes appear to be related to inadequate training and experience during surgical residency and the absence of educational opportunities to remedy this deficit once the surgeon is in practice. Objective The aim of this report is to describe a 1-day comprehensive surgeon training program in PD access surgery and to convey the results of the first 7 courses. Methods Needs assessment data served as the foundation for formulating course objectives and content. A disease-based approach to PD was taken to provide both didactic instruction and laboratory exercises. Surgical simulators permitted skills development for each key task in catheter placement. Educational outcomes were measured with pre- and post-tests, course evaluation, and follow-up survey. Results Seven courses were attended by 134 surgeons with an average faculty to participant ratio of 1:4 during hands-on laboratory sessions. Pre- and post-testing demonstrated a class-average normalized educational gain of 50%. On a 5-point Likert scale, the course was scored highly on 14 areas of evaluation with average responses ranging from 4.4 to 4.9. A follow-up survey conducted a mean of 28 months after the programs revealed significantly increased utilization of all 10 course-targeted PD access skills. Participants gave mean scores of 4.6 for improved confidence in case management and 4.4 for better catheter outcomes. Conclusions A comprehensive 1-day peritoneal access training course can produce long-term self-assessed improvement in surgical management and PD catheter outcomes.
Pharmacokinetic Drug–drug Interaction Study between Raltegravir and Citalopram
Authors: Blonk Maren I , Langemeijer Charlotte CA , Colbers Angela PH , Hoogtanders Karin EJ , van Schaik Ron HN , Schouwenberg Bas JJW , Burger David M 
Published: September 2015

Background Depression is the most common mental health disorder among HIV-infected patients. When treating HIV-infected patients with a selective serotonin reuptake inhibitor (SSRI), potential drug–drug interactions with antiretroviral agents have to be taken into account. We investigated the two-way pharmacokinetic drug–drug interaction and tolerability of concomitant administration of the SSRI citalopram and the HIV-1 integrase inhibitor raltegravir in healthy volunteers. Methods An open-label, crossover, two-period trial was conducted in 24 healthy volunteers. Subjects received the following treatments: citalopram 20 mg once daily for 2 weeks followed by the combination with raltegravir 400 mg twice daily for 5 days and after a washout period raltegravir 400 mg twice daily for 5 days. Intensive steady-state pharmacokinetic blood sampling was performed. Geometric mean ratios (GMRs) of the combination versus the reference treatment and 90% CIs were calculated for the area under the plasma concentration–time curve (AUC). CYP2C19 genotyping was performed because it influences N-demethylation of citalopram to desmethylcitalopram. Results A total of 22 healthy volunteers completed the trial. GMRs (90% CI) were 1.00 (0.98, 1.03) for citalopram AUC0–24h, 0.99 (0.88, 1.12) for desmethylcitalopram AUC0–24h and 0.77 (0.50, 1.19) for raltegravir AUC0–12h. Raltegravir plasma concentration 12 h after intake (C12h) did not change with concomitant use of citalopram. Within each CYP2C19 phenotype subgroup the citalopram metabolite-to-parent ratio, which is a measure for metabolic enzyme activity, was not influenced by concomitant raltegravir use. Conclusions Raltegravir does not influence the pharmacokinetics of citalopram and desmethylcitalopram. Citalopram did not change the pharmacokinetics of raltegravir in a clinically meaningful way. The combination was well tolerated and can be administered without dose adjustments. ClinicalTrials.gov NCT01978782.
Habiter, concept novateur dans la géographie scolaire ?
Authors: Biaggi Catherine 
Published: September 2015

L’article vise à caractériser la place de l’habiter dans la géographie scolaire, à identifier le moment et la manière dont la notion a été intégrée dans les programmes de collège, dans une sorte de « making of » du processus de leur élaboration, à travers un récit de l’auteur, membre du groupe d’experts ayant fabriqué les programmes. Mais le propos cherche également à travers cette expérience à rendre compte du travail de transposition du concept d’habiter, opéré entre champ académique et champ scolaire. Ce récit tente, dans sa partie finale une sorte d’état des lieux de la prise en compte de l’habiter dans la géographie enseignée, à travers l’examen des démarches et des pratiques actuelles.
Pièges-à-jeunes
Authors: Morel Geneviève 
Published: September 2015

Il existe bien des façons de passer d’une rêverie « normale » à une attitude hors-la-loi ou à un comportement qui vous sera préjudiciable. Nous en examinons trois modalités à partir d’exemples : la fascination par l’image, lorsqu’elle est désormais multipliée de façon exponentielle par les réseaux sociaux (cf. The Bling Ring , Sofia Coppola, 2013) ; la croyance naïve au mythe néolibéral du plaisir pur (cf. The Spring Breakers , Harmony Korine, 2012) ; et enfin les bons vieux fantasmes freudiens. Trois façons de se faire piéger efficacement .
Jeunes psychotiques : entre l’errance et la contrainte
Authors: Ouldamar Kada 
Published: September 2015

Après le déclenchement de leur psychose, certains jeunes patients ont du mal à l’accepter et à s’inscrire dans un projet de soins. À travers l’histoire marquée par l’errance et l’incurie de trois jeunes patients psychotiques « rebelles » à toute prise en charge psychiatrique, nous posons la question en forme de dilemme de la légitimité en dernier recours de la contrainte aux soins et de l’hospitalisation prolongée.
« Je l’aime, lui, un punk »
Authors: Boudailliez Sylvie 
Published: September 2015

Une jeune fille, brillante dans ses études, s’extrait de son milieu pour fréquenter un sdf avec qui elle a des rapports sexuels non protégés et s’alcoolise régulièrement. Comment a-t-elle pu en arriver à une telle dérive ? Nous tentons de situer les points de bascule aux confluents des conflits familiaux et sociaux auxquels elle s’est confrontée, et nous démontrons comment, à certains égards, ces éléments résonnent avec L’éveil du printemps de Frank Wedekind (1864-1918) ; un auteur qui, dans son attention aux conséquences de la répression de la sexualité, fut considéré par Bertolt Brecht comme l’un des plus grands éducateurs de l’Allemagne moderne.
Exploitation, aliénation et émancipation : Marx et l’expérience moderne du travail
Authors: Sobel Richard 
Published: September 2015

L’article propose une analyse de l’expérience moderne du travail à partir d’une interprétation de la philosophie du travail de Marx qui articule trois dimensions : travail-production, travail-subjectivation et travail-intégration. Si Marx nous permet de jeter un éclairage radical sur l’exploitation et l’aliénation, en particulier dans le capitalisme, force est de constater qu’il manque en partie la compréhension des tenants et aboutissants de l’émancipation telle qu’elle se déploie effectivement dans nos sociétés salariales, loin de la radicalité de son utopie communiste.
Les Soprano et la psychanalyse : plaisir de fiction et transgression
Authors: Bergami G. Barbosa Pablo 
Published: September 2015

Le présent article explore la représentation de la psychanalyse dans Les Soprano , série télévisée pionnière de l’« âge d’or des séries ». L’auteur explore la précision, inédite dans la production audiovisuelle, de la représentation de la psychanalyse au centre de la série, mais l’accent est mis sur une influence plus profonde de la psychanalyse sur celle-ci. Ainsi, Les Soprano pourrait être caractérisée comme une série « psychanalytique » en ce qu’elle va à la fois entretenir le « plaisir de fiction » typique des films de gangsters, tout en frustrant plusieurs des attentes de satisfaction des spectateurs, mettant au jour les scénarios fantasmatiques sous-jacents typiques de ce genre.
Le lien entre le patient et l’analyste : l’exemple de Jimmy P.
Authors: Rubiliani-Lenne Sylvie 
Published: September 2015

Poussera-t-on plus facilement la porte d’un cabinet de psychanalyste après avoir vu le film Jimmy P. d’Arnaud Desplechin ? L’accueil très majoritairement favorable des critiques et le nombre élevé d’entrées pourraient en effet le laisser supposer. En analysant le scénario qui met en images une cure psychanalytique hors normes et un psychanalyste d’abord ethnologue, Georges Devereux, nous tentons de démontrer que ces choix d’un réalisateur passionné par les tourments de l’esprit réussissent à donner une image convaincante et incitative de la psychanalyse. Le film s’inscrit de ce fait à l’opposé des inépuisables productions de ces soixante dernières années ayant pris la psychanalyse pour objet et le plus souvent pour cible. S’inspirant du pari hitchcockien des années cinquante, le réalisateur d’aujourd’hui dirige le projecteur sur le lien entre l’analyste et le patient, lien dont la qualité constitue d’après lui la seule condition à la guérison de ce dernier. Le caractère peu académique de cette relation entre analysant et analysé est déjà clairement affirmé dans l’affiche du film. Dans Jimmy P. l’image de la psychanalyse est renvoyée au spectateur par le prisme du psychanalyste, de son histoire, de sa posture et de son empathie. On peut donc avancer l’hypothèse que c’est à lui que revient la responsabilité du statut et de l’image de sa pratique dans la société. C’est en tout cas l’option que cet article propose.
Analyse filmique et psychanalyse, une histoire de rencontre
Authors: Weyl Dimitri 
Published: September 2015

Depuis le regard psychanalytique l’art cinématographique est appréhendé — la plupart du temps — soit dans une logique de psychanalyse appliquée, soit en termes « isomorphiques ». Cela limite l’apport que la rencontre entre cinéma et psychanalyse peut générer lorsque ces deux champs sont reconnus dans leur puissance et singularité respectives. Cet article se propose d’identifier, synthétiquement, ce qui apparaît essentiel dans une démarche de recherche pour que l’analyse filmique puisse être le plus fructueuse possible. Walter Benjamin avait vu très tôt que psychanalyse et cinéma ont ouvert des champs de regard et d’écoute de ce qui ne pouvait être vu et entendu jusqu’alors. Et que ces champs pouvaient être puissamment complémentaires. Le langage cinématographique — lorsqu’il est reconnu dans sa pleine puissance — permet de cerner des effets de réel tels qu’aucun autre matériel ne le permet. Partant, notre hypothèse sera de considérer que lier harmonieusement le regard cinématographique au regard psychanalytique c’est ouvrir une « double focale ». Deux focales qui lorsqu’elles se rencontrent tendent à lier l’invisible au visible . L’invisible des enjeux inconscients au visible qu’ouvre l’image-mouvement.
Flow of magnetic repelling grains in a two-dimensional silo
Authors: Lumay Geoffroy , Schockmel J. , Henández-Enríquez D. , Dorbolo S. , Vandewalle N. , Pacheco-Vázquez F. 
Published: September 2015

During a typical silo discharge, the material flow rate is determined by the contact forces between the grains. Here, we report an original study concerning the discharge of a two-dimensional silo filled with repelling magnetic grains. This non-contact interaction leads to a different dynamics from the one observed with conventional granular materials. We found that, although the flow rate dependence on the aperture size follows roughly the power-law with an exponent 3/2 found in non-repulsive systems, the density and velocity profiles during the discharge are totally different. New phenomena must be taken into account. Despite the absence of contacts, clogging and intermittence were also observed for apertures smaller than a critical size determined by the effective radius of the repulsive grains. Received: 10 July 2015, Accepted: 7 August 2015; Edited by: L. A. Pugnaloni; Reviewed by: J. R. Darias, Universidad Simón o Bolívar, Caracas, Venezuela; DOI: http://dx.doi.org/10.4279/PIP.070013Cite as: G Lumay, J Schockmel, D Henández-Enríquez, S Dorbolo, N Vandewalle, F Pacheco-Vázquez, Papers in Physics 7, 070013 (2015)This paper, by G Lumay, J Schockmel, D Henández-Enríquez, S Dorbolo, N Vandewalle, F Pacheco-Vázquez, is licensed under the Creative Commons Attribution License 3.0.
Physician Perceptions and Beliefs about Generating and Providing a Clinical Summary of the Office Visit
Authors: Ting D.Y. , Healey M. , Lipsitz S.R. , Ramelson H. , Suric V. , Bates D.W. , Emani S. 
Published: September 2015

Summary
Background: A core measure of the meaningful use of EHR incentive program is the generation and provision of the clinical summary of the office visit, or the after visit summary (AVS), to patients. However, little research has been conducted on physician perceptions and beliefs about the AVS.
Objective: Evaluate physician perceptions and beliefs about the AVS and the effect of the AVS on workload, patient outcomes, and the care the physician delivers.
Methods: A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who are participating in the meaningful use EHR incentive program.
Results: Of the 1 795 physicians at both AMCs participating in the incentive program, 853 completed the survey for a response rate of 47.5%. Eighty percent of the respondents reported that the AVS was easy (very easy or quite easy or somewhat easy) to generate and provide to patients. Nonetheless, more than three-fourths of the respondents reported a negative effect of generating and providing the AVS on workload of office staff (78%) and workload of physicians (76%).Primary care physicians had more positive beliefs about the effect of the AVS on patient outcomes than specialists (p<0.001) and also had more positive beliefs about the effect of the AVS on the care they delivered than specialists (p<0.001).
Conclusions: Achieving the core meaningful use measure of generating and providing the AVS was easy for physicians but it did not necessarily translate into positive beliefs about the effect of the AVS on patient outcomes or the care the physician delivered. Physicians also had negative beliefs about the effect of the AVS on workload. To promote positive beliefs among physicians around the AVS, organizations should obtain physician input into the design and implementation of the AVS and develop strategies to mitigate its negative impacts on workload.
Citation: Emani S, , Ting DY, Healey M, Lipsitz SR, Ramelson H, Suric V, Bates DW. Physician perceptions and beliefs about generating and providing a clinical summary of the office visit. Appl Clin Inform 2015; 6: 577–590http://dx.doi.org/10.4338/ACI-2015-04-RA-0043
Pas op! Over beheerst risico’s beheersen in het governancetijdperk
Authors: de Bruijne Mark , Steenhuisen Bauke , van der Voort Haiko 
Published: September 2015

Be careful! About managing risk management in the era of governance
Risks taken by some organizations may have considerable impact on society. In this contribution the assessment and management of risk are perceived to take place in a multi-actor setting. Within an organization operators, risk managers, and top managers interact about risk assessments and risk mitigation strategies. Public regulators and inspectorates increasingly focus on risk management systems instead of the operational activities or organizational outputs. Are organizations systematically assessing their risks? This contribution identifies two contrasting perspectives on risk assessment and risk mitigation in literature: risk management and risk governance. An empirical study in three sectors reveals evidence of both perspectives in practice. Companies adopt hybrid approaches, which are essential for the quality of risk assessment and mitigation. Indeed, adopting just one perspective seems dangerous. We conclude that public regulators and inspectorates might provide incentives to focus on just one perspective and suggest two heuristics for public inspectorates that respect hybrid approaches of risk assessment and mitigation.