bluuebunny/crossref_metadata_2025_split huggingface dataset:
La couverture des aditus et les origines du « théâtre latin »
Authors: Letellier-Taillefer Éloïse 
Published: May 2024

Cet article propose une réflexion synthétique sur l’apparition et le développement de la couverture des accès latéraux à l’orchestra (aditus) dans les premiers théâtres permanents bâtis dans l’Italie centrale et méridionale sous domination romaine. Il s’appuie sur l’état actuel des connaissances archéologiques à propos d’édifices théâtraux intégrés dans des sanctuaires ou bâtis en contexte urbain, dans le Latium, en Campanie ou dans le Samnium, entre le iie s. et le ier s. av. J.‑C. Une approche typo-chronologique reste impossible en raison des lacunes et des incertitudes encore importantes concernant la datation de la plupart des monuments concernés. Leur mise en série permet cependant de restituer les enjeux à la fois statiques, fonctionnels et de représentation qui ont pu favoriser le développement de la formule « latine » de l’architecture théâtrale, dotée d’accès latéraux à l’orchestra couverts par des voûtes et bientôt surmontés de gradins ou de tribunes destinées à mettre en valeur des spectateurs privilégiés.
La communication au temps du covid-19 : analyse discursive du discours d’Emmanuel Macron du 25 mars 2020
Authors: Bouzidi Attef 
Published: May 2024

« On ne peut pas ne pas communiquer » (1967) constatait Watzlawick. C’est certainement capital pour les civilisations. Et ce qui est aussi important, c’est ce que cette communication produit sur l’Autre. La réaction, le sentiment ou le comportement qu’elle engendre. La persuasion est alors l’objectif de n’importe quelle communication. A l’ère du numérique, ce besoin et cet objectif semblent se complexifier et se ramifier. L’analyse discursive que le présent article se propose de faire vise à revenir sur le discours du président français Emmanuel Macron du 25 mars 2020. Une communication qui devait se construire entre restrictions sanitaires et libertés individuelles et collectives.
La théorie du rêve d’Aaron T. Beck dans son contexte
Authors: Rosner Rachael I. 
Published: May 2024

Durant les premières années de la thérapie cognitive (1969-1971), son fondateur, Aaron T. Beck (1921-2021), a développé les rudiments d’une théorie des rêves, qu’il a présentée à la fois aux psychanalystes et aux thérapeutes comportementalistes. Cet article examine les conditions historiques qui ont favorisé l’élaboration de cette théorie cognitive des rêves. Les recherches psychanalytiques que Beck a menées sur ce sujet au début de sa carrière lui ont enseigné les vertus de la recherche en sciences sociales et ont catalysé sa transition vers le modèle cognitif. Une fois ce modèle en place, il a rouvert le dossier des rêves pour se positionner politiquement sur la scène thérapeutique nationale. L’article de 1971 témoigne de ses efforts pour atteindre les psychanalystes avec son nouveau modèle ; or le travail de Beck sur les rêves est tombé dans l’oubli, dès lors qu’il s’est allié aux thérapeutes comportementaux. L’intérêt actuel pour les psychothérapies intégratives a toutefois ramené l’attention sur les rêves dans le milieu de la thérapie cognitive.
Cardiovascular sequelae in post-COVID-19 patients with moderate to severe CT severity score: A follow-up study
Authors: Agarwal Niharika , Goyal Anamika , Pursnani Nikhil , Kanaujia Garima , Semwal Akanksha , Agrawal Prabhat , Raj Abhishek 
Published: May 2024

Objective:
To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography (CT) severity score.

Methods:
A prospective, non-randomized, observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021. Fifty- nine were male [mean age (54.1±12.2) years] and 41 were female [mean age (46.9±15.1) years]. Patients with previous cardiovascular disease, previous chronic lung disease, and pre-existing primary or secondary pulmonary hypertension were excluded. Patients were examined, and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality.

Results:
Post-COVID-19 patients had persistent symptoms, the most common being fatigue (59%). Most of these symptoms were relieved on follow-up. A rise in systolic, diastolic blood pressure, and pulse rate was observed. The electrocardiographic evaluation revealed ST-T segment changes, sinus tachycardia, ventricular hypertrophy, and arrhythmias among a considerable number of patients. On echocardiography, left ventricular diastolic dysfunction was most common (43%). Pulmonary hypertension, as evidenced by elevated pulmonary artery systolic pressure, was seen in 15% of patients.

Conclusions:
The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.
Complex Pediatric “Spin Dryer” Injuries – An Uncommon Mechanism and Pattern of Synchronous Upper Limb Fractures
Authors: Mencia Marlon M. , Goalan Raakesh 
Published: May 2024

Ipsilateral humerus and forearm fractures, or ‘floating elbow,’ are high-energy injuries, uncommon in children and usually due to falls or motor vehicle accidents. Early models of washing machines were associated with various reports of upper extremity injuries in children, mostly occurring when the child attempted to remove clothes from a spinning machine. Some of these accidents resulted in serious injuries, including amputation, but have become considerably less common with the introduction of improved safety features in modern appliances.
We describe the successful management of a child with multiple complex upper limb fractures caused by a modern washing machine.
Challenges for Technology Adoption Towards Primary Geriatrics Services
Authors: Kumar B. S. , Shalini Shivananjiah P. , Rao Y. Medha , Hedberg Pia , Liljegren Per-Daniel , Edin-Liljegren Anette 
Published: May 2024

Background:
The telemedicine-based approach facilitates remote health and social care for maintaining autonomy, thereby improving quality of life for geriatric patients with associated morbidities. Thus, the present study focusses on various challenges encountered during the use of technology-based model for geriatric care in urban as well as rural settings.

Materials and Methods:
The present operational research-based study was conducted on 2531 elderly individuals from rural and urban settings. The HUB and spoke model have been developed using cloud-based teleconsulting as well as mobile-based teleconsulting approaches which were setup up in rural and urban areas in India and Sweden for teleconsulting of elderly population. The rural and urban elderly population were screened using the telemedicine-based model. Feedbacks were taken from elderly subjects in both rural and urban settings to assess various challenges encountered during the use of technology-based model for geriatric care

Results:
Of 2531 elderly individuals, 701 (27.7%) individuals belonged to the urban population, while 1830 (72.3%) individuals belonged to the rural population who were examined with the help of model developed using telemedicine technology. Majority of persons screened were in the age group of 60–69 years with mean age 69.7 ± 7.90 years. Some of the challenges faced implementation of this tele-geriatrics model includes non-availability of accurate patient history, limitations over clinical examination, etc. have been highlighted working upon which would further improve this model.

Conclusion:
This teleconsultation-based model developed through this study provides practical evidence for its use in treating elderly population and associated challenges thereby improving their quality of life.
Attitudinal Change toward Yoga after Its Introduction in the New Curriculum
Authors: Mishra Aparajita , Mohapatra Ipsa , Burma Amrita , Sarkar Bidisa 
Published: May 2024

Introduction:
Benefits of yoga for a healthy life and stress management are proven; yoga was introduced into the new medical curriculum (competency-based medical education) from 2019 batch. This study was conducted to compare the attitudinal change of medical students and to identify the barriers of yoga practice among those with yoga in curriculum to those without.

Materials and Methods:
Using a cross-sectional study design, a total of 300 students (150 each from sixth [traditional] and fourth semesters [new curriculum]) were contacted. A self-administered researcher-made questionnaire (Google form) was sent to those who consented. Data were analyzed using SPSS version 20.0.

Results:
In this comparative study, among fourth and sixth semester students, it was found that 43.4% of the fourth, whereas 53.7% of the sixth semester students, knew about the benefits of yoga (P = 0.040). On comparing their attitude, “it was considered to be purely a weight loss program” by 17.9% of the fourth and 8.8% of the sixth semester students, respectively (P = 0.017). 94.5% students of the fourth semester, whereas 87.1% of the sixth semester, believed that yoga helped in improving immunity (P = 0.023). The barriers for practicing yoga cited were a lack of interest (37.1% by fourth semester, whereas 40% by sixth semester) and a lack of time (33% in fourth semester and 30.5% in sixth semester).

Conclusion:
The study helped reveal that the integration of yoga into the medical curriculum had brought an attitudinal change in them, but had not influenced their practices. The identified barriers will help implementing yogic lifestyle education programs, increasing its acceptance among medical students.
A Comparative Study of Nalbuphine and Fentanyl as Adjuvants to Bupivacaine in Spinal Anesthesia in Lower Limb Orthopedic Surgeries
Authors: Parekh Khushbu M. , Gupta Namita , Sachdeva Sudhir , Jethava Durga 
Published: May 2024

Background:
Subarachnoid block is the most common technique employed for lower limb orthopedic surgeries. Adjuvants such as fentanyl and nalbuphine are added to increase the duration of post-operative analgesia. This study aimed to compare the efficacy of nalbuphine and fentanyl as adjuvants to bupivacaine in providing intra-operative anesthesia and post-operative analgesia in lower limb orthopedic surgeries.

Objectives:
The aim of this article is to compare the characteristics of sensory and motor block, hemodynamic parameter, time of first rescue analgesia, and adverse effects between the two groups.

Materials and Methods:
In this clinical trial, 80 patients undergoing elective lower limb orthopedic surgeries under spinal anesthesia were randomly allocated into two groups. In group BN, the patients received 0.5% 3 mL (H) bupivacaine + 800 mcg nalbuphine. In group BF, the patients received 0.5% 3 mL (H) bupivacaine + 25 mcg fentanyl. In both the groups, characteristics of sensory and motor block and time for first rescue analgesia were compared.

Results:
The onset of motor block, the maximum level of the block, and time to reach the peak level of the block were significantly faster in the BF group. Duration of motor block and time for first rescue analgesia were significantly prolonged in the BN group. However, there was no significant difference in time for two-segment regression [P = 0.157 (NS)] and hemodynamic changes.

Conclusion:
We conclude that combination of fentanyl as adjuvant to bupivacaine provides higher segmental level sensory blockage and faster sensory and motor blockage than nalbuphine. But nalbuphine gives longer time of post-operative analgesia than fentanyl did.
Impact of Nutritional Status of Children Admitted in PICU on Mortality and Morbidity
Authors: Samanta Moumita , Das Sanjay , Mahato Saikat , Rai Akash , Sinhamahapatra Tapan K. 
Published: May 2024

Objectives:
Anthropometry is a routine and simple procedure to assess the nutritional status of a child. We aimed to study the impact nutritional status has on the mortality and morbidity of children admitted in the pediatric intensive care unit (PICU) in a tertiary care hospital in Eastern India.

Materials and Methods:
We performed a prospective observational study to assess the relation between anthropometric measurements of children on admission in PICU and their outcomes in terms of mortality and morbidities (total stay in PICU, duration of mechanical ventilation, requirement of inotrope, delay in enteral nutrition, and total duration of enteral feeding).

Results:
Sixty children were included out of which 45 were under 5 years of age and 15 were more than 5 years of age. Children under 5 years with normal weight for age, weight for height, and mid-upper arm circumference had higher chances of survival. Similarly, in children >5 years of age, those with weight for age and body mass index for age in 25th–50th percentile had higher chances of survival. All these associations were statistically significant. On further analysis, these anthropometric measurements that affected mortality also influenced morbidities significantly.

Conclusion:
Children with inadequate nutritional status as assessed by anthropometry had statistically significant higher mortality and morbidity in the PICU. Thus nutritional status of a child on admission is an important factor to prognosticate the outcome of a child in PICU.
Role of Laparoscopy in Complicated Appendicitis in Children
Authors: S Pramod , K Tejashwini 
Published: May 2024

Background:
Appendicitis is one of the most common surgical emergencies among children. Approximately 30% of children present to the hospital with complicated appendicitis, which is associated with higher morbidity than simple appendicitis. Controversy exists in the treatment of complicated appendicitis in the pediatric age group. The goal of this study was to review the results of laparoscopic surgery in complicated appendicitis in terms of safety, efficacy, and complicationsMaterials and Methods: A retrospective observational study was conducted in a tertiary care hospital in Bangalore from 2015 to 2020 over a period of 5 years. All children who underwent laparoscopic surgery for complicated appendicitis (perforated, gangrenous, and mass) were included in the study. Thorough history with respect to symptoms and their duration were recorded followed by general and abdominal examination. Routine blood investigation and imaging were done before surgery. Intraoperative data regarding the type of complication, presence or absence of fecolith, and position of appendix were documented. Postoperatively duration of stay and complications were analyzed.

Results:
Sixty cases were included in the study. The mean age of presentation was 10.11 ± 0.855 years. Of 60 children, 53 were males and 7 were females. The mean operative time was 55.8333 ± 4.806 min. The rate of conversion from the laparoscopy to open surgery was 11.5%. The mean time of duration of intravenous antibiotics was 4.2778 ± 0.446 days. The mean time for starting of oral feeding was 2.8333 ± 0.307 days. The mean duration of hospital stay was 5.11 ± 0.545 days. Wound infection in the immediate postoperative period was seen in 6.6% of the children. No long-term complications were noted.

Conclusion:
Laparoscopic appendectomy (LA) for complicated appendicitis is safe and effective. Therefore, it should be the first choice for cases of complicated appendicitis in children.
Indications for Percutaneous Ultrasound-guided Renal Biopsy and Complications Associated with It
Authors: Bhat Mohammad Ashraf , Sulayman Shahid , Parry Manzoor Ahmad , Wani Muzaffar Maqsood , Wani Imtiyaz Ahmad 
Published: May 2024

Introduction:
Renal biopsy is performed for various reasons depending on the signs and symptoms presented. Although percutaneous kidney biopsy is a safe procedure, major or minor complications may occur. Our study aimed to assess the indications for percutaneous renal biopsy and complications associated with the procedure.

Materials and Methods:
This was a prospective observational study conducted in the Department of Nephrology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar. Patients who underwent percutaneous ultrasound-guided renal biopsy at the Institute between October 2017 and June 2019 were enrolled in the study. Data regarding indications for performing a percutaneous renal biopsy and incidence of minor and major post-biopsy complications were collected.

Results:
A total of 229 patients who underwent ultrasound-guided percutaneous renal biopsy under ultrasound guidance were enrolled in the study. The most common indications for ultrasound-guided percutaneous renal biopsy were nephrotic syndrome (33.3%), subnephrotic proteinuria with azotemia (14%), and unexplained azotemia with proteinuria and hematuria (13.5%). Post-biopsy complications were observed in 89 (37.55%) patients. Minor complications developed in 83 (36.22%) patients and major complications in 6 (2.62%) patients. Among patients with major complications, two (0.87%) patients underwent invasive procedures (embolization and cystoscopic removal of bladder clot) and four patients developed hemodynamic instability. There was no procedure-related mortality reported in the study.

Conclusions:
The most common indications for renal biopsy were nephrotic syndrome, subnephrotic proteinuria with azotemia, unexplained azotemia with proteinuria, and hematuria. The incidence of major complications was low.
Tomato flu outbreak in India: Evolution, epidemiology, preventive strategies, and way ahead
Authors: Kapoor Suraj , Sirohi Manraj , Varadharajan Ashvin , Kandukuri Gayatri 
Published: May 2024

Abstract

Introduction:
Just as the world recovers from the throes of the COVID-19 pandemic, there are reports of monkeypox virus infections in previously unaffected regions. To add another communicable and contagious outbreak to the list, India is witnessing many Pediatric cases of Hand Foot, and mouth disease (HFMD)

Aim:
To explore the key Epidemiological aspects of Tomato flu, including the difference between the current outbreak and classical HFMD.

Materials and Methods:
Secondary data from official government sites, press information, latest articles, newspapers, and the WHO website was extracted and discussed in the article. The current Epidemiology of the Tomato flu with a difference from the typical hand foot and mouth disease is highlighted in the study. The most probable factors for the starting point of the emergence of communicable diseases like COVID-19, Monkeypox, and the current tomato flu epidemic in Kerala across the country are also highlighted.

Results:
Total number of thirty-two articles/government/international websites were assessed. The current study highlights the current epidemiology of Tomato flu, including difference from classical HFMD. The most probable reasons for Kerala being starting point of emerging diseases like COVID-19, Monkey pox and Tomato flu are highlighted. Preventive strategies including steps taken by government and way ahead are also discussed.

Conclusion:
The study highlights that Current Tomato flu presentation is quite different from classical HFMD. Surveillance, Screening, Personal hand hygiene, and isolation of cases are preventive measures that can be adopted. It is imperative to raise awareness and promote personal hygiene among children, parents, and schools with immediate effect.
Effect of cloth mask versus N95 mask on hemodynamic parameters, oxygenation, and peak expiratory flow rate at rest and during physical activity in health-care providers: A cross-over design
Authors: BR Ganesh , Jobanputra Devanshi Prerit , Naik Varun 
Published: May 2024

Abstract

Background:
This study aimed to evaluate the effect of cloth mask vs. N95 mask on cardiovascular and pulmonary parameters at rest and during physical activity in health-care providers.

Materials and Methods:
Hundred health-care providers (45 men and 55 women) were included in the study. The procedure comprised of pre-test and post-test outcome measures like hemodynamic parameters comprising of heart rate,[15] respiratory rate,[16] peak expiratory flow rate[7] and oxygen saturation[7] taken on first day with cloth mask and second day with an N95 mask consecutively. Outcome measures were measured during quite sitting and brisk walking on treadmill, which was a self-paced test. Subjects manually selected their comfortable speed while walking on the treadmill, when exhausted the test was terminated. Comparing values of the outcome measures we found the effect of N95 masks and cloth masks on hemodynamic parameters, oxygenation and peak expiratory flow rate during rest and physical activity.

Results:
This study resulted in favor of N95 masks (P < 0.05). The difference was significant, concluding a slight increase in the respiratory rate (P = 0.0009) and heart rate (P = 0.0001) while wearing a cloth mask in comparison with an N95 mask. Oxygen saturation and peak expiratory flow rate were significantly maintained during physical activity while wearing an N95 mask, compared to a cloth mask (P = 0.0001).

Conclusion:
N95 masks should be utilized by health-care providers as, they did not impair respiratory rate, heart rate, oxygenation, and peak expiratory flow rate at rest and during physical activity. In comparison with cloth masks, N95 masks were better in maintaining oxygen saturation and peak expiratory flow rate during physical activity.
Clinical, Biochemical, Genetic, and Therapeutic Profile of Patients with Epidermal Necrolysis
Authors: Sangwan Sushil K. , Khanna Neena , Sharma Namrata , Agarwal Tushar , Sharma Arundhati , Vajpayee Rasik B. 
Published: May 2024

Background:
Epidermal necrolysis (SJS/TEN) is a rare but acute severe drug reaction associated with high morbidity and mortality rates.

Aims:
To describe the clinical, molecular, biochemical, and therapeutic profile of these patients.

Methods:
A total of 24 acute SJS/TEN patients were recruited during their hospital stay and detailed clinical history and treatment course recorded. Blood samples collected were subjected to DNA and serum separation for molecular and biochemical analysis.

Results:
Of 24 patients, 18 (75%) were females and six (25%) were males with six SJS, six SJS–TEN overlap, and 12 TEN cases. The inciting drugs were non-steroidal anti-inflammatory (87.50%; n = 21) followed by antibiotics (66.67%; n = 16), antiepileptics (37.50%; n = 9), and others (37.50%; n = 9). Seventeen patients (77.2%) showed skin eruptions within 7 days after drug intake. Different co-morbidities were observed in 22 (91.6%) and 20 (83.3%) patients showed ocular manifestations. Length of hospital stay ranged from 8 to 55 days, 20 (83.3%) patients were treated with corticosteroids, and four (16.6%) received antimicrobial therapy. Interleukin polymorphisms revealed significantly low frequency of IL-4 in the patients, HLA-A locus typing revealed higher frequency of HLA-A*3301 (20.8%), HLA-A*02 (25%), HLA-A*2402 (14.6%), and sera showed raised levels of granulysin and sFas L in the patients compared to controls.

Conclusions:
The preliminary study illustrates the clinical, molecular, and biochemical features of acute SJS/TEN and provides a better understanding that helps to improve patient care at an earlier stage. It also highlights the use of corticosteroids and antimicrobial therapy for effective treatment of patients.