bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le Japon et Taïwan. Vers un « pivot taïwanais » de Tokyo ?
Authors: Burdy Jean-Paul 
Published: March 2024

Alors que la pression croissante de la Chine dans l’Indo-Pacifique a incité les États-Unis à lancer en 2011 un « pivot asiatique », est-on en train d’assister à un « pivot taïwanais » de la part du Japon ? Sans que soient remis en question le principe d’« une seule Chine » (fixé en 1972) et l’absence de relations officielles avec Taipei, Tokyo lie désormais la sécurité de Taïwan à sa propre sécurité. L’hypothèse d’une opération militaire chinoise contre Taipei n’étant plus à exclure, le Japon révise la doctrine et les budgets de sa politique de défense. Alors que l’histoire continue de peser sur les relations de Tokyo avec ses voisins asiatiques, l’image du Japon est très positive à Taïwan, et réciproquement .
La Corée dans les relations internationales au XX e siècle
Authors: Grosser Pierre 
Published: March 2024

De l’ouverture de l’Asie dans la seconde moitié du XIX e siècle jusqu’à la fin de la guerre froide, la Corée a été un acteur et un enjeu central des relations internationales. Carrefour de l’Asie du Nord-Est, la péninsule a vu tour à tour s’affronter directement ou indirectement sur son territoire quatre grandes puissances rivales : le Japon, la Chine, la Russie puis l’URSS et les États-Unis. Les deux États nés au lendemain de la Seconde Guerre mondiale ont pris depuis des voies économiques et politiques de plus en plus divergentes. Devenus rivaux, ils constituent encore, et très différemment, des acteurs importants de l’ordre stratégique asiatique et mondial contemporain .
Réflexion sur la perspective scientifique du déni et d’acceptation pour comprendre l’expérience de vivre avec une maladie chronique
Authors: Ellefsen Édith , Lafontaine Sarah 
Published: March 2024

Introduction : les concepts de déni et d’acceptation représentent la perspective reconnue scientifiquement pour interpréter les réactions des personnes vivant avec une maladie chronique. Objectif : effectuer une réflexion sur les constructions scientifiques de déni et d’acceptation afin de comprendre les conséquences de leur utilisation par les professionnels de la santé auprès des personnes vivant avec une maladie chronique. Une vision différente de la perspective scientifique du déni et de l’acceptation est proposée. Elle repose sur des modèles théoriques infirmiers issus de recherches qualitatives réalisées auprès de personnes vivant avec une maladie chronique. Ces derniers reconnaissent la complexité et la singularité du parcours de vie emprunté par ces personnes. Ils suggèrent que la perspective scientifique du déni et de l’acceptation a ses limites pour comprendre cette expérience. Conclusion : cette réflexion devrait guider les professionnels de la santé vers une approche de soins centrés sur la personne qui s’avère plus humaniste.
Bébés en colère et bébés philosophes
Authors: Bachler Laurent 
Published: March 2024

D’un point de vue philosophique, la colère pose trois ordres de problèmes. Quand on s’interroge sur l’articulation des manifestations physiques de la colère et les croyances qui agitent l’esprit, on se pose le problème des causes de la colère. Comment le physique et le psychique peuvent-ils se combiner dans l’éclat de la colère ? Quand on tente de faire le tri entre les bonnes et les mauvaises colères, on se confronte aux raisons de la colère. Il est extrêmement difficile de faire la part entre une bonne et une mauvaise raison de se mettre en colère. Enfin, on peut se demander quelle action avoir face à la colère, que ce soit la nôtre ou celle d’autrui. Faut-il la laisser s’exprimer ? Faut-il la condamner ? Pour répondre à ces trois ordres de questions, l’approche des philosophes stoïciens peut-être utile, même pour les enfants très jeunes.
La colère : quelles limites au bouillonnement ?
Authors: Busquet Monique 
Published: March 2024

La colère ébranle autant celui qui en est traversé que celui qui la reçoit. Elle peut alors être contagieuse. Pourtant le jeune enfant a un immense besoin que les adultes, professionnels comme parents, lui servent d’enveloppes, de Moi-peau, de limites psychocorporelles, à la fois protectrices et contenantes, qu’il n’a pas encore lui-même. Il a besoin que l’adulte porte une réelle attention à ses envies, ses besoins, ses ressentis, que celui-ci fasse le travail d’identifier et de nommer ce qui l’agite, qu’il l’aide ainsi à transformer cette colère qui bouillonne à l’intérieur de lui, et progressivement à l’exprimer autrement.
Supervision clinique dans les coulisses du lieu d’accueil enfants-parents
Authors: Chimisanas Gérard , Séguin Gérard , Cherdoud Chérifa , Segu Marie , Minet Marilu 
Published: March 2024

Le lieu d’accueil enfant-parents offre une hospitalité transitionnelle dans le passage de la famille vers le social. Les accueillants sont des dépositaires, témoins, tiers voire des recours, passeurs pour un couple, une famille, se reconstituant autour d’un jeune enfant. La supervision sert de point d’appui aux accueillants pour questionner leur cadre, analyser leur vécu, reconsidérer leurs liens et déposer leurs difficultés, afin de maintenir leur attention et leur disponibilité dans leur présence à l’accueil. Deux vignettes cliniques présenteront des moments d’accueil et l’évolution d’une famille.
La notion juridique de médicament : simple qualification ou véritable définition ?
Authors: Fouassier Éric 
Published: March 2024

La notion juridique de médicament repose formellement sur une juxtaposition de qualifications dont deux seulement sont reconnues dans l’Union européenne : la qualification par présentation et la qualification par fonction. Dans un premier temps, la jurisprudence de la CJUE a prêté les mêmes finalités à ces deux qualifications, tout en les interprétant de façon extensive, pour aboutir à une véritable définition jurisprudentielle du médicament autour de la notion de destination. Puis, à partir des années 2000, pour prendre en compte l’évolution du secteur de la santé et du bien-être ainsi que l’apparition des statuts nouveaux (dispositif médical, complément alimentaire, denrée alimentaire destinée à des fins médicales spéciales), la Cour a adopté une conception beaucoup plus restrictive de la qualification par fonction et ainsi renoncé à son œuvre unificatrice.
Accompagner les parcours selon les limites écologiques en participant à la mise en œuvre du récit alternatif de l’orientation professionnelle
Authors: Tacchini Sabrina , Brazier Caroline Éliane , Rossier Jérôme 
Published: March 2024

De nombreuses activités professionnelles ont des effets dramatiques sur les écosystèmes et contribuent au dépassement des limites planétaires. En parallèle, le modèle économique actuel repose sur l’idée d’une croissance quantitative perpétuelle, qui augmente continuellement les dégradations environnementales. L’AIOSP exhorte la psychologie de l’orientation scolaire et professionnelle à tenir compte des problématiques écologiques et sociales. Le champ pourrait devenir un acteur de la transformation des modes de vie vers davantage de durabilité en proposant des interventions et des perspectives théoriques suggérant que l’activité humaine se situe entre un plafond écologique et un plancher social selon la « théorie du Donut » proposée par Raworth. Cet article propose d’examiner quelques pistes d’interventions compatibles avec cette théorie qui prendraient appui sur le développement de récits, de questionnements et de parcours vocationnels alternatifs. Il présente à titre d’exemple un dispositif groupal d’orientation « Slow ta carrière ! » qui tient compte des limites planétaires.
Relationship between maternal arterial and foetal cord carbon dioxide tension and neonatal outcome in critically ill pregnant women at delivery
Authors: Scharf Katelyn T , Bharadwaj Shobana , Lankford Allison , Wong Michael , Kodali Bhavani S 
Published: March 2024

Background and Aims:
No studies have evaluated the relationship between maternal arterial partial pressure of carbon dioxide (mPaCO2) and umbilical cord venous partial pressure of carbon dioxide (PCO2) in critically ill pregnant women at delivery. Based on the studies in healthy pregnant women, an mPaCO2 target of ≤50 mmHg is a suggested threshold during mechanical ventilation in critically ill parturients. We evaluated the relationship between mPaCO2 and neonatal cord gases in critically ill parturients at delivery as the primary objective. The relationship between mPaCO2 and APGAR scores at delivery was also analysed as a secondary objective.

Methods:
Maternal and neonatal cord gas data at delivery and APGAR scores were obtained by a retrospective chart review of 25 consecutive parturients with severe respiratory compromise who were delivered during mechanical ventilation. Linear regression was used to assess the relationship between mPaCO2 and umbilical artery and vein PCO2 and between mPaCO2 and APGAR scores at 1 and 5 min.

Results:
There was a positive correlation between mPaCO2 and neonatal cord venous PCO2 (P = 0.013). Foetal venous PCO2 exceeded predelivery mPaCO2 by 17.5 (7.5) mmHg. There was an inverse relationship between mPaCO2 and neonatal APGAR scores at 1 and 5 min (P = 0.006 and P = 0.007, respectively).

Conclusion:
Foetal cord venous PCO2 can be predicted if mPaCO2 values are known. Unlike in healthy pregnant women, there was an inverse relationship between rising mPaCO2 levels and neonatal APGAR scores in critically ill pregnant women who had several associated compounding factors.
Cost analysis of different medical oxygen sources for a healthcare facility in India
Authors: Manhas Varun , Rawat Mahipal , Kaurav Yogesh S. , Goyal Sanjay , Dhir Sanjay , Sangineni Kalyani 
Published: March 2024

Background and Aims:
Multiple sources of medical oxygen, namely liquid medical oxygen (LMO) tanks, pressure swing adsorption (PSA) plants, concentrators, and gaseous cylinders, are available at different healthcare facilities. These sources of oxygen have varying installation and operational costs. In low-resource settings, it is imperative to utilise these assets optimally. This study investigated the operational costs of multiple oxygen sources available at a healthcare facility.

Methods:
A Microsoft (MS) Excel-based model was developed to analyse and compare the oxygen manufacturing costs (in ₹/m3) using PSA plants and procurement costs (in ₹/m3) of LMO and third-party vendor-refilled cylinders.

Results:
The oxygen manufacturing costs for PSA plants of different capacities and running times on electricity and diesel generators (DGs) as a power source were calculated. This study highlights the cost-benefit of using PSA plants over LMO and third-party vendor-refilled cylinders as a source of oxygen. PSA plants are most economical when they are of higher capacity and used to their maximum capacity on electricity as the power source. On the contrary, they are most expensive when used on a DG set as a power source. Furthermore, this study provides evidence of PSA plants being more cost-effective for refilling cylinders using a booster compressor unit when compared to third-party vendor-cylinder refilling.

Conclusion:
Given their cost-effectiveness and low third-party dependence, they should be utilised to their maximum capacity as medical oxygen sources at healthcare facilities.
Prevalence and predictors of preoperative cardiac autonomic dysfunction among elective neurosurgical patients: A prospective observational study
Authors: Sangeetha RP , Chakrabarti Dhritiman , Sriganesh Kamath , Mahendranath Musumur , TN Sathyaprabha , Srinivas Dwarakanath 
Published: March 2024

Background and Aims:
The autonomic nervous system (ANS) is cardinal for systemic homeostasis. Autonomic dysfunction is prevalent in as high as 65% of patients presenting for cardiac surgery in the Indian scenario. Pre-existing cardiac autonomic dysfunction (CAD) in surgical patients can accentuate perioperative haemodynamic fluctuations during stressful intraoperative events, predispose to adverse cardiac events, and contribute to morbidity and mortality. The prevalence and predictors of CAD in the elective neurosurgical population are unknown in the Indian scenario. The current study was conducted to bridge this knowledge gap.

Methods:
In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant.

Results:
The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study.

Conclusion:
We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.
Varied presentations of primary cutaneous lymphoma: A case series from a tertiary care center in South India
Authors: Shana Baby , Ambooken Betsy , Balakrishnan Sunitha , Neelakandan Asokan , Ajithkumar Kidangazhiyathmana 
Published: March 2024

Abstract

Background:
Recent studies indicate an upsurge of primary cutaneous lymphoma (PCL) in the Indian population. Of late, we too have come across varied presentations of PCL in relatively younger individuals. Hence, we decided to study the clinical and immunohistological profile of patients with PCL in our department.

Methods:
All cases diagnosed as PCL from October 2016 to October 2019 were included. Clinical details, complete blood count, peripheral smear, imaging, histopathology, and immunohistochemistry of skin specimens were analyzed. Lymph node biopsy and bone marrow studies were done in most cases. Human T lymphotropic virus-1 (HTLV1) serology was done in 10 cases.

Results:
Of the 24 patients with PCL, 12 were below 50 years of age. Twenty-three patients (95.8%) had T-cell lymphoma and only one had B-cell PCL. Mycosis fungoides (MF) (n = 17; 71%) was the most common type of PCL. There were two (8.3%) cases each of adult T-cell lymphoma/leukemia (ATLL) and Sezary syndrome. MF had varied clinical morphology at presentation and variable clinical outcomes. Both cases of ATLL had features of immunosuppression in the form of infective dermatoses.

Conclusion:
We observed an increased proportion of T-cell type of PCL, with the age of onset being relatively early. HTLV-1 positivity was noted in three out of the 10 cases tested. More studies are needed to determine the factors responsible for the younger age of onset of PCL and the role of HTLV-1 infection in the development of PCL.
Spinal lymphangiomas: Case-based review of a chameleonic disease entity
Authors: Sop François Yves Legninda , Benato Alberto , Izoudine Blaise Koumare , Khouri Kifah , Marangon Anna , Fraschetti Flavia , Lonjon Nicolas , Ferraresi Stefano 
Published: March 2024

ABSTRACT

Purpose:
Lymphangiomas are benign hamartomas in the spectrum of lymphatic malformations, exhibiting multifaceted clinical features. Spinal involvement is exceedingly rare, with only 35 cases reported to date. Both due to their rarity and chameleonic radiologic features, spinal lymphangiomas (SLs) are usually misdiagnosed; postoperatively, surgeons are thus confronted with an unexpected histopathological diagnosis with sparse pertinent literature and no treatment guidelines available.

Methods:
Here, we report the case of a 67-year-old female who underwent surgery for a T6-T7 epidural SL with transforaminal extension, manifesting with spastic paraparesis. Then, we present the results of the first systematic review of the literature on this subject, delineating the clinical and imaging features and the therapeutic implications of this rare disease entity.

Results:
Our patient was treated with T6-T7 hemilaminectomy and resection of the epidural mass, with complete recovery of her neurological picture. No recurrence was evident at 18 months. In the literature, 35 cases of SL were reported that can be classified as vertebral SL (n = 18), epidural SL (n = 10), intradural SL (n = 3), or intrathoracic lymphangiomas with secondary spinal involvement (n = 4). Specific treatment strategies (both surgical and nonsurgical) were adopted in relation to each of these categories.

Conclusion:
Gathering knowledge about SL is fundamental to promote both correct preoperative identification and appropriate perioperative management of this rare disease entity. By reviewing the literature and discussing an exemplary case, we delineate a framework that can guide surgeons facing such an unfamiliar diagnosis.
A radiological parametric comparison of low-grade lytic spondylolisthesis to degenerative spondylolisthesis – A retrospective approach to establish its dysplastic origin
Authors: Pratap K. R. , Tandon Vikas , Goparaju Aditya Sunder , Aryal Aayush 
Published: March 2024

ABSTRACT

Objectives:
This study aims to compare low-grade lytic spondylolisthesis (LS) and degenerative spondylolisthesis (DS) radiologically. In addition, it seeks to identify underlying similarities between LS and DS.

Methods:
This study included patients with low-grade single-level spondylolisthesis at L4–L5 or L5–S1. They were categorized into LS and DS. Radiological features, including pedicle height, width, transverse, and sagittal angle, as well as anterior vertebral heights (AVH) and posterior vertebral heights (PVH), were measured using T1-weighted magnetic resonance imaging.

Results:
The study involved 88 patients: 46 in the DS group and 42 in the LS group. In the LS group, the AVH was significantly higher than the posterior height at L4 and L5 (L4 PVH/AVH ratio 0.93 in LS vs. 0.96 in DS; L5 PVH/AVH ratio 0.84 in LS vs. 0.92 in DS), and pedicles were more medially oriented (L4: 19.62° in LS vs. 17.7° in DS; L5: 28.92° in LS vs. 26.47° in DS). In addition, at L5, the pedicle height (10.67 mm in LS vs. 11.48 mm in DS) and width (13.56 mm in LS vs. 14.37 mm in DS) were smaller compared to the DS group.

Conclusions:
Low-grade LS shows distinct radiological vertebral and pedicle anatomy compared to DS. Short and thin pedicles and wedge-shaped vertebrae in LS resemble DS, indicating its dysplastic origin.
En bloc resection followed by gluteal advancement flap for sacral Ewing’s sarcoma: A novel technique
Authors: Joseph Jeena , Prabhu Krishna , Jonathan Edmond , Jesudason Mark Ranjan , Gupta Ashish Kumar 
Published: March 2024

ABSTRACT
Ewing’s sarcoma is a rare and highly aggressive bone tumor primarily affecting children and adolescents. It commonly presents in the pelvic and axial skeleton, with sacral involvement posing unique challenges due to its intricate anatomical location. This report details the case of an 18-year-old male with sacral Ewing’s sarcoma, emphasizing the diagnostic, surgical, and reconstructive aspects of management. The patient presented with lower back pain, lower limb weakness, and urinary incontinence, which prompted an extensive diagnostic evaluation. Magnetic resonance imaging and computed tomography scans revealed a large lytic mass extending from the S2 vertebra to the coccyx invading the presacral space. Biopsy confirmed the diagnosis of Ewing’s sarcoma, characterized by the EWS-FLI1 type 1 translocation. A multidisciplinary team comprising neurosurgeons, colorectal surgeons, and plastic surgeons was formulated. En bloc resection of the tumor, lumbopelvic fixation, and soft-tissue reconstruction using bilateral gluteus maximus advancement flaps were successfully performed. The procedure aimed to address both the oncological and functional aspects of the patient’s condition. Chemotherapy and radiotherapy were administered as adjuvant therapies. At 2-year follow-up, the patient was ambulating independently with no residual tumor on imaging. This case highlights the complex nature of sacral Ewing’s sarcoma and underscores the importance of a multidisciplinary approach. The described surgical technique, including the innovative use of gluteus maximus advancement flaps for soft-tissue reconstruction, contributes to reducing wound complications and promoting successful patient outcomes. The presented approach serves as a valuable addition to the armamentarium of treatment options for this challenging malignancy.
Venous pathology targeted surgical management in Hirayama disease: A comprehensive case series of nine cases exploring this potential etiology
Authors: Sharma Deepak Nandkishore , Yerramneni Vamsi Krishna , Yerragunta Thirumal , Gaikwad Govind B. , Rangan Vasundhara S. , Akurati Sasank 
Published: March 2024

ABSTRACT

Objective:
Hirayama disease is a rare cause of cervical myelopathy predominantly affecting young individuals. The disease is classically characterized by muscle atrophy in the distal upper limbs. While various etiopathogenesis such as dural sac dysplasia, nerve root dysplasia, structural abnormalities of the spinal ligament, and venous dysplasia have been proposed, this study explores the potential role of venous pathology and surgical management on the basis of it.

Methodology:
This is a prospective descriptive case series of nine cases. The diagnosis was made based on the Huashan diagnostic criteria which includes clinical manifestation, imaging, and electrophysiology. In cases where magnetic resonance imaging (MRI) failed to demonstrate engorged veins, a computed tomography (CT) venogram of the cervical spine was used as an imaging tool. All patients underwent cervical laminectomy and coagulation of the posterior epidural venous plexus with or without laminoplasty. All the patients were followed up regularly; clinical improvement and neck disability index were assessed.

Results:
All nine patients were male and exhibited classical clinical features, electrophysiological abnormalities, and MRI findings except, in one patient where a CT venogram helped in establishing the diagnosis as the MRI was inconclusive. Postoperatively, all patients had neurological improvement and stabilization of the disease. All patients who underwent CT venogram and cervical spine X-ray in neutral and dynamic position demonstrated no recurrence of engorged venous plexus or significant instability except one patient developing kyphosis. One patient experiencing symptoms in the other limb underwent a second surgery.

Conclusion:
This comprehensive case series strongly supports venous pathology as a potential etiology of Hirayama disease. Surgical management with laminectomy and venous coagulation with or without expansile laminoplasty has delivered consistent improvement in neurological outcomes and long-term disease stabilization without the restriction of movements and lesser complications. However, further research is warranted to elucidate the mechanism underlying cervical venous dilatation.
Transpedicular Contrast-enhanced CT-guided biopsy of the body and dens of the axis avoiding the trans-oral approach: Technical report and literature review
Authors: Papalexis Nicolas , Ponti Federico , Masi Paola Di , Peta Giuliano , Savarese Leonor Garbin , Miceli Marco , Facchini Giancarlo , Spinnato Paolo 
Published: March 2024

ABSTRACT
This technical report illustrates the technique to perform computed tomography (CT)-guided bone biopsies in the body and dens of the axis (C2 vertebra) through a posterior transpedicular approach with the use of preoperative contrast-enhanced scans to highlight the course of the vertebral artery. The technique is presented through two exemplification cases: a pediatric patient with osteoblastoma and secondary aneurysmal bone cyst and one adult patient with melanoma metastasis. This case highlights the potential of the CT-guided posterolateral/transpedicular approach for performing safe and effective biopsies in the body and dens of C2, even in pediatric patients.