bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introduction de la morphine pré-diluée dans un établissement de santé :
Authors: Girard Sophie , Stamm Catherine , Verne Karine , Pivot Christine , Paillet Carole 
Published: February 2025

Contexte. Suite à une concertation multidisciplinaire sur l’utilisation de la morphine injectable au sein des services de soins critiques, des blocs opératoires et des salles de réveil, il a été décidé de retirer la forme de concentration de 10 mg/ml par ampoule d’1 ml et de la remplacer par une présentation pré-diluée de concentration 1 mg/ml, par ampoule de 10 ml. Objectif. Afin de limiter la survenue d’erreurs médicamenteuses lors de ce changement, la conduite d’une analyse de risques a priori de type Amdec (analyse des modes de défaillance, de leurs effets et de leur criticité) associant les professionnels concernés a été proposée. Matériel et méthode. Deux réunions pluridisciplinaires à 15 jours d’intervalle, animées par un binôme pharmaceutique en visioconférence, ont permis de conduire l’analyse. Résultats. Après étude de l’ensemble du processus qui a permis d’identifier 6 étapes découpées en 24 tâches, l’analyse de risque a décelé 50 défaillances possibles. La criticité des tâches a été évaluée de 2 à 18 (moyenne à 8). Les actions préventives identifiées ont été regroupées en 6 axes : rétroplanning des étapes, check-list pharmacie, identification optimale et conforme du stock de médicaments dans le coffre à stupéfiants, définition des missions et désignation du référent soignant pour le déploiement dans chaque unité de soins, création des supports de communication, et contact avec les services utilisant de la morphine par voie sous-cutanée afin de s’assurer de ne pas introduire un nouveau risque d’erreurs. Conclusion. Grâce à la pluridisciplinarité des participants, l’Amdec permet une identification détaillée des risques et d’introduire cette nouvelle présentation de manière maîtrisée.
Validation de six indicateurs de réhospitalisations après chirurgie ambulatoire
Authors: Banaei-Bouchareb Linda , Prunet Caroline , Morin Sandrine , May-Michelangeli Laetitia 
Published: February 2025

Depuis 2015, la Haute Autorité de santé (HAS) développe des indicateurs de qualité et de sécurité des soins (IQSS) de type résultats mesurés à partir des bases médico-administratives. Ils sont élaborés en lien avec les professionnels de santé, les médecins codeurs de l’information médicale et les patients. La HAS utilise une méthode robuste pour la construction d’indicateurs susceptibles de contribuer à l’amélioration de la qualité et de la sécurité des soins de différentes manières : actions d’amélioration de la qualité, gestion des risques, certification des établissements, diffusion publique, financement… Le développement et la méthode de validation des indicateurs HAS sur les réhospitalisations en chirurgie ambulatoire calculés à partir du Programme de médicalisation des systèmes d’information (PMSI) sont décrits dans cet article : ils mesurent le nombre de réhospitalisations entre 1 et 3 jours suite à six interventions chirurgicales réalisées en ambulatoire présentant un potentiel d’amélioration.
Garçonnité : une catégorie utile d’analyse historique
Authors: Jablonka Ivan 
Published: February 2025

Outil essentiel en sciences sociales, le genre peut être croisé avec la génération au sens démographique. Car l’âge est toujours sexué : les périodes de la vie sont différentes selon qu’elles se déroulent à l’ombre du féminin ou du masculin. Ce numéro spécial est consacré à la « garçonnité », c’est-à-dire à l’apprentissage du masculin au cours de l’enfance. Qu’ils aient grandi dans la Rome antique, les cités grecques, les villes du Moyen Âge, l’espace germanique à l’époque moderne ou la France de la Troisième République, des millions de garçons ont été éduqués et socialisés dans les codes de la masculinité, qu’ils ont acquis – ou pas.
« Ay ixf-iw rfed asefru », lorsque les mots surmontent les maux
Authors: Sadoudi Oumelaz 
Published: February 2025

Cet article décortiquera, d’une part, le mot amazigh asefru qui est d’une richesse inestimable qui dépasse largement ses équivalents du latin et/ou du grec desquels est issu le mot français poème. D’autre part, il abordera l’expression amazighe « ay ixf-iw rfed asefru » : sa structure morphosyntaxique, ses différentes significations, ses différents contextes d’usage et ses variantes. Nous allons expliquer pourquoi elle constitue un phraséologisme pragmatique d’expression savante, car, lorsque l’homme interpelle son esprit et son âme et se relie à son être par la force nuptiale du verbe, accouchant des vers, il devient ainsi poète, il devient sage ! Il est qualifié, chez les Amazighs, même de devin et de clairvoyant. Pour eux, selon leur imaginaire et leurs croyances, la capacité de produire isefra ou de s’exprimer en vers/poèmes est même un don attribué par le Divin à des êtres élus ou choisis. Si l’art poétique est pratiqué depuis la nuit des temps par tous les peuples du monde, il y a dans le patrimoine immatériel amazigh, tel qu’enregistré dans le mot asefru et l’expression « ay ixf-iw rfed asefru », à part l’idée d’un savoir-faire poétique, celle d’un savoir-être : attitude résiliente. Autrement dit, face à l’absurdité de l’existence et aux souffrances, la culture et la sagesse amazighes invitent l’homme à devenir poète, à surmonter ses maux par les mots, à s’élever aux rangs des sages, porteurs de messages lucides, perçant les secrets impénétrables des Hommes et du Monde.
En deçà de la racine. Esquisse d’application de la TME au domaine amazigh
Authors: Haddad Mohand 
Published: February 2025

La Théorie des Matrices et des Etymons (TME) fait partie d’un champ disciplinaire récent qui a comme objectif la compréhension de l’organisation du lexique en tentant « d’identifier et d’étudier toute manifestation dans le lexique d’éléments plus petits que le morphème conçus comme jouant un rôle dans la construction du ‘sens’. ». Cette approche se fonde sur l’idée d’un lien naturel entre son et sens qu’elle pose comme élément essentiel dans l’organisation du lexique. Mais des réticences à ce genre de problématiques ont de tout temps traversé la linguistique. Des auteurs à l’image de M. Cohen affirme que ce genre d’études, qu’il qualifie de « mirage étymologique », est à redouter. Mais, tel que relevé par Lionel Galand : « lorsque le nombre des exemples est si grand qu’il exclut l’intervention du hasard, il parait difficile de nier les corrélations observées entre forme et sens. ». Cette théorie a donné ses preuves relativement au lexique de l’arabe. Que donnera une application de celle-ci au lexique amazigh? Cet article tente de saisir les procédés dégagés par les premiers auteurs dans le cadre de cette théorie pour voir s’ils peuvent être appliqués au domaine amazigh. Nous postulons que cela pourrait être possible mais, peut-être, y aurait-il nécessité de remanier ou d’ajuster certains de ces procédés en tenant compte des spécificités du lexique de l’amazigh.
Household Food Security, Feeding Practices, and Anthropometric Failure Among Children Aged 6–23 Months: A Hospital-Based Study
Authors: Chatterjee Rohan , Ray Soumalya , Mukhopadhyay Dipta Kanti 
Published: February 2025

Abstract

Background:
Household food security (HHFS) and age-appropriate complementary feeding (CF) conceptually play an important role in growth of a child. This study aims to assess the status of HHFS, age-appropriate CF, and undernutrition among children of 6–23 months and their association (if any).

Materials and Methods:
This institution-based cross-sectional study was conducted among children attending Pediatric OPD of College of Medicine and Sagore Dutta Hospital. Children were assessed regarding age-appropriate complementary feeding using infant and young child feeding (IYCF) practices indicator, nutritional status using composite index of anthropometric failure indicators, and HHFS using standardized and validated HHFS short Bengali version questionnaire. Mothers/primary caregivers were the respondents. Categorical variables were expressed in frequency and percentages. Statistical analysis was done in Jamovi (v2.2.5).

Results:
430 mother-child dyads participated in the study with 83.26% of them having low or very low food security. Minimum acceptable diet (MAD) was absent in 74.65% of children and 42.09% of children had single/multiple anthropometric failure(s). Children aged 6–8 months had higher odds of not having MAD (AOR = 3.6, 1.5–8.3). Male gender (AOR = 2.7, 1.7–4.2) and lack of MAD (AOR = 2.7, 1.6–4.7) were associated with anthropometric failure. However, HHFS was not found to be associated with either lack of MAD or anthropometric failure in this study population.

Conclusion:
Improper transition from exclusive breast feeding to CF may be responsible for higher odds of having lack of MAD in 6–8 months age group, which require strengthening of IEC activity related to IYCF practices on or before initiation of complementary feeding.
Access to Disability-related Healthcare among People with Visual Disability in India: Evidence from a National Sample Survey
Authors: Kumar Ashok , Tandon Praveena , Meratwal Gaurav 
Published: February 2025

Abstract

Background:
Despite progress, there are still gaps and inequalities in achieving universal health coverage (UHC), particularly among marginalized populations such as people with visual disability (VD). This study aimed to evaluate access to disability-related healthcare among people with VD in India.

Methods:
Data from the Survey of Persons with Disabilities in India, the 76th round of the National Sample Survey (NSS), which was conducted between July 2018 and December 2018, were used in this study. Binomial logistic regression was used to find the association between access to disability-related healthcare and sociodemographic characteristics.

Results:
The prevalence of VD in the general population was 0.23%. About 15% of people with VD did not have access to healthcare for disability. Access was lower in the older age group (Adjusted Odds Ratio (AOR) =0.68) than in the younger age group, females (AOR = 0.89), persons with low literacy (AOR = 0.72), low consumption expenditure (AOR = 0.60), and people belonging to the scheduled tribes (STs) (AOR = 0.57). Affordability was the leading reason for poor accessibility. About 55% of people with VD had zero out-of-pocket expenditure (OOPE), 35.8% had monthly OOPE below INR 1000, and 1.3% had monthly OOPE INR >5000.

Conclusion:
The study found gaps in access to healthcare in people with VD in India. This population is falling behind in the core elements of UHC, i.e. affordability and inequality. India should adopt a comprehensive strategy that includes age-specific interventions, improved rural access, measures for socioeconomic equity, gender sensitivity, and expanded public health insurance coverage and social security schemes for people with VD.
Prevalence and Determinants of Undernutrition in Under-Five Children in Urban Slums of Tripura, India
Authors: Chakraborty Manali , Basu Saurav , Jerath Suparna G. 
Published: February 2025

Abstract

Background:
We conducted this study to ascertain the prevalence of undernutrition in terms of stunting, wasting, and underweight for age and their determinants among under-five slum children in urban poor settlements in Tripura, India.

Methods:
This community-based cross-sectional study was conducted in a selected ward in the West District of Tripura from Jan to June 2023, including 353 children. The mothers of the respective children were interviewed regarding their sociodemographic status, household conditions, and child feeding practices.

Results:
The prevalence of stunting, underweight, and wasting was found to be 23.23% (95% confidence interval [CI]: 18.82%–27.63%), 23.23% (95% CI: 18.82%–27.63%), and 22.95 (95% CI: 18.56%–27.33%), respectively. The increasing age of the child and the lower maternal education were associated with increased odds of both wasting and being underweight. Children living in households using unclean fuel had nearly five times higher odds of stunting, 1.49 times higher odds of wasting, and 1.9 times higher odds of being underweight.

Conclusion:
The burden of undernutrition in under-five children in urban poor settlements was comparable to that in the general population of Tripura. Higher educational status of the mother and use of clean fuel (liquefied petroleum gas) were protective against adverse nutritional status (wasting and underweight) in the children.
Temporal Trends of Dog Bite Cases and their Correlation with Meteorological Factors in a Metropolitan City
Authors: Asokan Dinesh , Mall Anjali , Sankhe Lalit , Jaganathasamy Nagaraj , Pardeshi Geeta 
Published: February 2025

Abstract

Background:
Dog bites are a major public health concern in India. Understanding the temporal trends of dog bites and their correlation with meteorological data will help develop effective strategies for prevention under one health program. Assessment of temporal trends of dog bite cases and their correlation with meteorological factors.

Methodology:
A retrospective secondary data analysis was conducted using the data of 2022 dog bite cases reported at a tertiary care hospital in Mumbai. The month-wise temporal trend was described, and its correlation was assessed with meteorological data retrieved from the regional meteorological center by using Spearman’s correlation coefficient.

Conclusion:
Of the 3350 dog bite cases that attended the outpatient department, 2368 (70.7%) were below 40 years of age, 2733 (81.6%) were males, and 2621 (78.18%) had category III bites. We found a positive correlation between the number of dog bites and temperature (ρ = 0.650, P = 0.022) and average sun hours (ρ =0.804, P = 0.002). A negative correlation was found between rainfall (ρ = −0.845, P = 0.001), humidity (ρ = −0.730, P = 0.007), and rainy days (ρ = −0.804, P = 0.002). A similar correlation pattern was found for category III bites.
Determinants of Quality Antenatal Care in Pregnant Women Using NFHS-4 Data: A Path Analysis Approach
Authors: Ganapathy Sachit , Soni Bhanushree , Mishra Akash 
Published: February 2025

Abstract

Introduction:
Quality antenatal care (QANC) is an important health care indicator of the public health structure of the country. Causal mediation analysis is a statistical model that can model the complex path that determines the QANC received by women. The objective of the study was to assess the proportion of women receiving QANC in India and to ascertain its determinants using causal mediation analysis.

Methodology:
The dataset for study was obtained from the NFHS-4 survey. The outcome variable QANC was formulated based on a set working definition. The potential determinants of QANC at individual and population levels were identified by literature search, expert opinion, and availability in the NFHS dataset. The effect estimates of the determinants were estimated by multiple logistic regression. The potential determinant variables were categorized as independent and mediating variables. A schematic path analysis model was conceptualized by plausibility and expert opinion. The direct, indirect, and total effects of independent and mediating variables were estimated by generalized causal path analysis.

Results:
We found that region, education, wealth, religion, working status, husband’s education, and age were significant independent factors influencing QANC. Additionally, we found that husband’s alcohol status, pregnancy awareness month, presence of husband during antenatal care (ANC) visit, pregnancy registration month, emotional violence, and timing of the first ANC visit were significant mediating variables.

Conclusion:
Understanding the factors associated with QANC is statistically more robust using causal path analysis, which would help us better shape policies for improved maternal health care in India.
A Study on Description of Collateral Pathway Patterns in Patients with Aortoiliac Occlusive Disease and Its Prospective Implication in Clinical Practice
Authors: Praveena Madavan , Singh Devender , Kalagani Bhavani Prasad 
Published: February 2025

Objectives:
Collateral pathways in aortoiliac occlusive disease are essential for arterial blood flow to the lower abdomen and limbs. These different pathways further indicates the severity of disease and need of an appropriate treatment. The present study attempts in describing the various collateral pathways and its implication in the clinical practice.

Materials:
This is a retrospective study from January 2023 to June 2024 and reviewed all the records. Twelve patients (10 males, 2 females) with a mean age of 60 years were included in this study. All the patients were evaluated with three dimensional volume rendered rotational CT angiography and non invasive segmental blood pressure, pulse volume recording with ankle brachial index.

Results:
Nine patients had diabetes mellitus, 8 hypertension, and 6 dyslipidemia. Ten were active smokers. Five patients presented with intermittent claudication and 7 presented with critical limb ischemia. Two dominant collateral pathways were observed. Systemic collateral pathways were dominant in 7 patients, whereas visceral collaterals pathways were prominent in 5 patients. It is noted that complete occlusion of infrarenal aorta tends to have visceral collaterals pathways, whereas distal aortic occlusions had systemic collaterals pathways. Patients with visceral pathways had lower ABI and required early revascularisation. Knowledge of these pathways, demands careful surgical dissection; however we did not find any difference in the post operative outcome after successful revascularisation.

Conclusions:
Collateral pathways are defined mainly by the location of the lesion and helps in deciding the appropriate treatment. Patients with visceral collaterals pathways are more symptomatic and needs early revascularisation. Failure to recognize these pathways particularly during non vascular surgeries could lead to limb threatening situations.
Predictors of Perioperative Outcomes in Chronic Limb-threatening Ischemia Patients
Authors: Lekshmi G Gouri , Sebastian Jithin Jagan , Michael Robin , Subramanian Sairam 
Published: February 2025

Background:
Revascularization in chronic limb-threatening ischemia (CLTI) patients carries a risk of perioperative events. Scoring systems such as the Society for Vascular Surgery vascular quality initiative mortality prediction score (VQI MPS) for 30 days and 2-year mortality and revised cardiac risk index (RCRI) for perioperative major adverse cardiac events (MACE) have been validated to risk stratify patients. Both scoring systems had not been previously validated in an Indian cohort.

Aims and Objectives:
This study was conducted to validate both scoring systems and to identify predictors of perioperative adverse events. The primary objective was the validation of scoring systems based on observed peri-operative 30-day mortality and MACE. The secondary objective was to identify risk factors that affected these outcomes.

Materials and Methods:
Data of subsequent CLTI patients who underwent open or endovascular revascularization in a single centre between 2018 and 2024 were retrieved from a prospectively maintained database and retrospectively analysed. Patients who were lost to follow-up or had incomplete data were excluded from the study. MACE was defined as any acute coronary syndrome, pulmonary oedema, or cardiac-related death. Validity of VQI MPS and RCRI was calculated using receiver-operating curves. Predictors of outcome were analysed by univariate analysis and logistic regression.

Results:
One hundred forty-six patients were analysed and risk-stratified based on VQI MPS and RCRI. The mean age was 68 ± 9 years with 31.5% females. About 88.4% (n = 129/146), 9.6% (n = 14/146), and 2% (n = 3/146) were categorized into low, medium, and high risk as per VQI MPS and 19 (13.05%), 59 (40.4%), 49 (33.5%), and 19 (13.05%) patients were categorized into Class 1, II, III, IV and above according to RCRI, respectively. Both scoring systems accurately risk-stratified procedures into different strata. Seven (4.79%) patients died within 30 day of procedure and 10 (6.84%) patients had MACE. There was a statistical difference between the predicted versus observed 30-day mortality and MACE. The discriminatory power of VQI MPS and RCRI were poor with c statistic of 0.664 for VQI MPS and 0.518 for RCRI. Univariate analysis showed that congestive heart failure (CHF) was the only factor that affected 30-day mortality and perioperative MACE.

Conclusion:
VQI MPS and RCRI did not accurately predict perioperative outcomes in CLTI patient undergoing revascularization in an Indian population. CHF was found to be the only predictor of perioperative mortality and MACE.
Clopidogrel and Aspirin Resistance and Its Interaction with Peripheral Arterial Disease Outcomes in the Indian Population
Authors: Patra Vikram , Mehra Rohit , Dattatraya C V N M , Dhillan Rishi , Sharma Anuka , Sharma Varun , Biswas Brijesh , Dabas Ajay Kumar , Merkhed Rahul 
Published: February 2025

Objectives:
The objective of the study was to ascertain adverse events (major adverse cardiac and limb events) events in patients of established peripheral arterial disease (PAD), on clopidogrel and aspirin antiplatelet therapy.

Patients and Methods:
Patients aged 18 years or over, with PAD were screened for participation in the study. Patients were considered to have symptomatic PAD if they met either of two criteria: a history of intermittent claudication, rest pain, or tissue loss of presumed atherosclerotic origin, with either ankle–brachial index <0.85, previous leg amputation, peripheral vascular surgery, or percutaneous intervention; or angiographic or computed tomographic imaging of significant lower-extremity occlusive atherosclerotic disease. The patients took clopidogrel and aspirin at a dose ≥75 mg/day for at least 4 weeks before enrolment. Those with contraindications to antiplatelet usage were excluded from the study. Blood was used as genotyping material. Patient samples were genotyped for clopidogrel resistance (CR)-associated single-nucleotide polymorphism (SNPs) using Illumina Global Screening Array Ver 3 Bead Chip. Illumina Infinium Genotyping Assay protocol was implemented. Intensities of the beads’ fluorescence were detected using iScan Reader (Illumina Inc). Aspirin resistance (AR) was determined with the whole blood, point of care, turbidimetric cartridge-based method, platelet aggregation, and VerifyNow P2Y12 assay, and results were reported in platelet reactivity units (PRU), at a cutoff of 550 PRU.

Results:
The mean age was 58.4 (12.6) years with 90% males. The mean body mass index was 22.57 (3.54) kg/m2. The cohort comprised 58.9% smokers, 42% alcoholics, 33.5% diabetics, and 63% hypertensives. Limited efficacy of clopidogrel was observed in 52.38% of patients with loss of function (LOF) variations in the CYP2C19 gene. The mean duration of follow-up was 13.4 (4.7) months. Subjects with CYP2C19 LOF alleles showed more complications (39%) and the relationship between the LOF variation in the CYP2C19 gene and the adverse clinical outcomes (major adverse cardiac events [MACE] and major adverse limb events [MALE]) was found to be statistically significant (P = 0.11). CR and AR were found in 147 (50.3%) and 69 (23%) patients, respectively. Resistance to both the antiplatelets was found in 41 (14%) patients.

Conclusion:
In this largest observational study, the use of dual antiplatelet therapy in the Indian population with PAD on the MACE and MALE events was higher in the patients with CYP2C19 LOF alleles. The study found a statistically significant relationship between genetic testing results and clinical outcomes.