bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient and Physician Perspectives of Systemic Lupus Erythematosus Flare: A Qualitative Study
Authors: Rogers Jennifer L. , Clowse Megan E.B. , McKenna Kevin , Starling Summer , Swezey Teresa , Molokwu Nneka , Corneli Amy , Pisetsky David S. , Sun Kai , Criscione-Schreiber Lisa G. , Sadun Rebecca E. , Maheswaranathan Mithu , Burshell Dana , Doss Jayanth , Eudy Amanda M. 
Published: December 2023

ObjectiveSystemic lupus erythematosus (SLE) flares are associated with increased damage and decreased health-related quality of life. We hypothesized that there is discordance between physicians’ and patients’ views of SLE flare. In this study, we aimed to explore patient and physician descriptions of SLE flares.MethodsWe conducted a qualitative descriptive study using in-depth interviews with a purposeful sample of patients with SLE (who met 1997 American College of Rheumatology or Systemic Lupus International Collaborating Clinics criteria) and practicing rheumatologists. Interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis.ResultsForty-two patient participants with SLE, representing a range of SLE activity, completed interviews. The majority described flare symptoms as joint pain, fatigue, and skin issues lasting several days. Few included objective signs or laboratory measures, when available, as features of flare. We interviewed 13 rheumatologists from 10 academic and 3 community settings. The majority defined flare as increased or worsening SLE disease activity, with slightly more than half requiring objective findings. Around half of the rheumatologists included fatigue, pain, or other patient-reported symptoms.ConclusionPatients and physicians described flare differently. Participants with SLE perceived flares as several days of fatigue, pain, and skin issues. Providers defined flares as periods of increased clinical SLE activity. Our findings suggest the current definition of flare may be insufficient to integrate both perceptions. Further study is needed to understand the pathophysiology of patient flares and the best way to incorporate patients’ perspectives into clinical assessments.
Sous les décombres de Gaza
Authors: Bahout Joseph 
Published: December 2023

L’opération « Déluge d’al-Aqsa » lancée par le Hamas remet la question palestinienne au centre de la scène moyen-orientale, forçant les pays arabes, les États-Unis et l’Europe à se remobiliser. Mais il faut éviter la rhétorique du choc des civilisations pour créer un État palestinien.
Diplômés, trentenaires, déclassés
Authors: Boëton Marie 
Published: December 2023

Résumé Mobilité sociale et ascension sociale ne riment plus. Les Trente Glorieuses sont loin et les choses ont changé. La génération des baby-boomers profite à plein de la croissance, mais voit les obstacles s’accumuler pour ses enfants. Nombre de trentenaires subissent le phénomène du « déclassement », avec son lot d’aspirations déçues.
Mafias
Authors: Cretin Thierry 
Published: December 2023

Résumé Les mafias sont territoriales, mais l’essentiel de leurs activités est à échelle internationale, d’où la difficulté à les combattre : les juges butent sur les frontières, tandis que les criminels sont protégés par elles. Les efforts de concertation transnationaux sont encore loin de l’efficacité voulue.
La France en mouvement ?
Authors: Le Gall Jean-Marc 
Published: December 2023

Résumé La réussite du nouvel exécutif repose sur sa capacité à obtenir des résultats crédibles sur les deux sujets qui minent la confiance des Français en l’avenir : le dynamisme de l’emploi et la pérennité de la protection sociale ; faute de quoi les citoyens ne retiendraient de la politique menée que ses aspects les plus conservateurs et inégalitaires.
Gordon Brown et Tony Blair
Authors: Le Galès Patrick 
Published: December 2023

Résumé 2007 : après dix années de gouvernement, Tony Blair laisse le champ libre à son associé rival de toujours, Gordon Brown. L’expérience du New Labour se poursuit. Hybride de libéralisme économique hérité de M rs Thatcher ou inspiré par le projet démocrate de Clinton, New Labour n’est ni un parti socialiste, ni un parti démocrate classique.
L'Eglise catholique aux Etats-Unis
Authors: Decherf Dominique 
Published: December 2023

Résumé « Qu’est-ce qui se passe en Amérique ? » s’était directement enquis Jean Paul II au début de la crise sur les abus sexuels. La question revêtait une portée dont on s’aperçoit aujourd’hui qu’elle était beaucoup plus générale.
Quelle place pour le « ménage » dans le travail d’accompagnement des personnes âgées ?
Authors: Devetter François-Xavier 
Published: December 2023

L’activité des aides à domicile et des agentes de service du secteur médico-social comporte une part de tâches liées à l’entretien et au nettoyage. Mais quelle place celles-ci occupent-elles dans la définition de ces métiers ? La question demeure, y compris pour les salariées concernées, conflictuelle. La réponse apportée est d’autant plus importante qu’elle se répercute sur la qualité des emplois, la valeur perçue du service et les modes de régulation des services et des établissements en charge d’accompagner les personnes en perte d’autonomie.
Excès savant, excès populaire : le saturationnisme à l’écoute du rock ?
Authors: Arnoux Pierre 
Published: December 2023

« L’article se propose d’analyser l’exploitation musicale et théorique d’une figure sonore empruntée au rock et à certaines de ces sonorités, celle de l’« excès », par les compositeurs saturationnistes. Il montre l’ambiguïté de cette référence, l’emprunt d’une notion issue de la musique populaire phonographique conduisant, non à une remise en question de la séparation savant / populaire, comme on aurait pu le penser, mais au contraire au renforcement de cette séparation. Après être revenu sur les caractéristiques de la musique saturationniste telles qu’elles sont définies par les compositeurs qui s’en sont réclamés dans les années 2000-2010 (Franck Bedrossian, Raphaël Cendo, Yann Robin), l’auteur montre qu’elles ont surtout pour fonction de mettre à distance toute référence au rock au profit d’un travail sur le timbre, s’inscrivant dans une histoire du bruit et plus largement dans la tradition savante. Ce faisant, est ignorée la manière spécifique dont l’excès est mis en œuvre dans le rock, dont sont donnés quelques traits fondamentaux, concernant aussi bien les sonorités de son instrumentarium que son fonctionnement par plateaux d’intensité. En dernière analyse, l’auteur montre comment la notion d’« excès », en tant qu’elle constitue chez les saturationnistes un principe d’écriture musicale, ne permet pas, comme on pourrait le croire au premier abord, une remise en question des normes esthético-historiques définissant le savant, mais travaille au maintien de la hiérarchie savant / populaire, interdisant de ce fait de comprendre le savoir tacite qui se déploie dans le populaire, ici plus précisément la musique rock. »
L’espace domestique des migrants marocains : les extensions transnationales de l’intimité familiale
Authors: Pinel Jordan , Lacroix Thomas 
Published: December 2023

Le vieillissement des migrants maghrébins a suscité un renouvellement de la recherche sur leurs pratiques résidentielles. En effet, nombreux sont les retraités qui ont choisi de partager leur existence entre leur logement en France et celui qu’ils ont acquis au Maroc. La retraite serait donc l’âge des allers-retours plutôt que celui du retour. En étudiant l’aménagement intérieur de leurs logements, cet article remet en question l’idée d’un surinvestissement dans la maison construite au pays afin de s’y afficher comme « notable ». Ce qui ressort de l’analyse est bien plutôt celui d’une mise en continuité des espaces résidentiels par la mise en résonnance des aménagements. Ils démontrent la volonté de construire un espace de l’intimité familiale par-delà les ruptures légales et culturelles.
Touaregs en ZAD
Authors: Sauvineau Jérémy 
Published: December 2023

Face au sous-dimensionnement chronique du parc d’hébergement des demandeurs d’asile en France, les militants de la cause des étrangers se sont mobilisés en expérimentant divers types d’habitats alternatifs. Cet article souhaite documenter une de ces formes particulières d’accueil : celle de migrants en Zone à Défendre [ZAD] dans une métropole française. En privilégiant les manifestations du mode d’existence des Touaregs accueillis, je me propose de rendre compte de la manière dont les Touaregs élaborent des ambiances alternatives au sein de la ZAD, dont le concert de blues touareg est l’exemple caractéristique.
Le rôle de la réglementation dans la protection des milieux aquatiques. Le cas de l’autosurveillance des réseaux d’assainissement urbain en France
Authors: Baati Selma , Vareilles Sophie , Toussaint Jean-Yves 
Published: December 2023

Cet article s’intéresse aux changements sociotechniques dans le contexte actuel de changements climatiques : il interroge en particulier le rôle de la réglementation dans la réalisation de ces changements. Pour cela, il porte sur la réglementation mise en œuvre pour protéger les milieux aquatiques en France à travers l’analyse de la procédure d’autosurveillance des réseaux d’assainissement. Il s’appuie sur une étude des textes législatifs et réglementaires instituant cette procédure et deux études de cas sur la Métropole de Lyon et Nantes Métropole. Ces études de cas impliquent des observations in situ et des entretiens avec des acteurs engagés dans l’autosurveillance des réseaux. Elles montrent les effets de la réglementation sur les organisations et la mise en œuvre par les collectivités territoriales d’une surveillance des rejets des réseaux vers les milieux aquatiques. Néanmoins, cette surveillance reste limitée en raison de moyens restreints (notamment en personnels) dans les collectivités territoriales et les autres organismes impliqués ; sa pérennisation apparaît même fragile dans l’agglomération nantaise. Dans ces conditions, la surveillance permet de répondre dans l’ensemble aux exigences a minima de la réglementation (produire des données sur les rejets des réseaux dans les milieux aquatiques), mais pas de relever les objectifs environnementaux à l’origine de la procédure (protéger l’environnement, restaurer la qualité des milieux aquatiques).
Preoperative maltodextrin in minimally invasive colorectal surgery: Is it safe for diabetics? A randomised controlled trial
Authors: Kumar Lakshmi , Ashok Amaldev , Sudhakar Abish , Sreekumar Gayathri 
Published: December 2023

Background and Aims:
Preoperative fasting can result in thirst and fatigue. We evaluated the blood glucose levels during and after surgery following the administration of maltodextrin among patients including diabetics, undergoing minimally invasive colorectal surgery.

Methods:
One hundred and fifty patients undergoing colorectal surgery were randomised into group CL (received 50 g of 12.5% maltodextrin dissolved in 400 ml of water 2 h before surgery) and group W (received 400 ml of plain water 2 h before surgery). Blood glucose was checked at T0 (induction of anaesthesia), T2 (2 h), T4 (4 h), T6 (6 h) of surgery and eight hourly postoperatively in the intensive care unit (ICU) for 24 h. Thirst or discomfort before induction, gastric aspirate after intubation, incidence of hyperglycaemia and need for insulin intervention intra- and postoperatively were also assessed.

Results:
Mean (standard deviation [SD]) blood glucose levels were lower at T2 in group CL (136.2 [28.4] mg/dl) than in group W (157.8 [37.8] mg/dl) (P < 0.001). It remained lower in group CL at T4 (P = 0.008), T6 (P = 0.009), T8 ICU (P = 0.012), T16 ICU (P = 0.001) and T24 ICU (P = 0.001). The thirst scores were superior in group CL (P < 0.001). Among diabetic patients, blood glucose levels remained significantly lower at T2 (P < 0.001), T4 (P = 0.002), T6 (P = 0.002), T8 ICU, T16 ICU and T24 ICU (P = 0.016, 0.025 and 0.003, respectively). Lesser number of insulin interventions at T4 (P = 0.006), T6 (P = 0.002), T8 ICU (P = 0.025) and T16 ICU (P = 0.012) was needed in group CL in the diabetic subgroup.

Conclusion:
Preoperative administration of oral maltodextrin lowers the blood glucose levels from 2 h into surgery until 24 h postoperatively, even among controlled diabetic patients, and improves preoperative thirst scores in patients undergoing minimally invasive colorectal surgery.
Impact of general or regional anaesthesia on recurrence of colorectal cancer after surgery: Systematic review
Authors: Chachra Alisha , Gunashekar Satheesh , Kumar Ajit , Thakur Nitish , Jagath Arun 
Published: December 2023

Background and Aims:
Studies have suggested that anaesthetic agents have modulatory effects on the immune system, leading to cancer recurrence. The association between colorectal cancer (CRC) recurrence and anaesthesia is still unclear. Therefore, this systematic review aimed to determine the association between the recurrence of CRC after surgery and anaesthesia.

Methods:
A database search of PubMed, Cochrane, Embase, and Scopus was performed for articles on the recurrence of CRC after surgeries under general anaesthesia (GA) and regional anaesthesia (RA), published between January 2002 and January 2023. Qualitative and risk-of-bias assessment of retrospective studies was performed using the Newcastle–Ottawa scale (NOS). Synthesis Without Meta-analysis guidelines were used to report data synthesis. The primary outcome was cancer recurrence, and the secondary outcomes were disease-free survival (DFS) and overall survival. The standardised metric to represent data synthesis was the median hazard ratio (HR). Evidence quality was rated as per GRADE pro-GDT.

Results:
A total of six retrospective cohorts were identified through the literature search for inclusion. The risk of bias was low in all studies and was rated good quality as per the NOS. The pooled risk ratio for cancer recurrence in the two studies was 1.04, 95% confidence interval 0.98–1.10 (P = 0.20). The median HR for cancer recurrence was 0.895. DFS was not statistically significant with GA or RA, with a median HR of 1.06.

Conclusion:
No conclusive association was found between regional anaesthesia and colorectal cancer recurrence. However, due to a lack of studies reporting cancer recurrence and less data for comparison and different intervention groups, a conclusive association cannot be made.
Role of Mycobacterium indicus pranii in clinical outcomes in patients with sepsis: A systematic review and meta-analysis of randomised controlled trials
Authors: Saran Khushboo , Iyengar Swathy S. , Sinha Nitesh , Abhishek Kumar , Kumar Amit , Prakash Jay 
Published: December 2023

Background and Aims:
Sepsis-induced immunosuppression appears to be reversible with immunomodulatory drugs. Mycobacterium indicus pranii (MIP) stimulates the Th1 type of immune response. This systematic review and meta-analysis of randomised controlled trials (RCTs) was aimed to find out if MIP is effective at improving clinical outcomes in sepsis patients.

Methods:
The databases (PubMed, Google Scholar, Web of Science, and Cochrane Library), along with preprint servers until June 2023, were searched. The methodology was evaluated using the ‘Cochrane Collaboration risk of bias-2 tool’ for RCT. The study included patients more than 18 years of age with sepsis within 48 h of first organ dysfunction. The primary outcome was 28-day mortality, and secondary outcomes were the length of stay in the intensive care unit (ICU), days on vasopressor support, ventilator-associated pneumonia (VAP), secondary infections, catheter-related bloodstream infections (CRBSI), and the delta sequential organ failure assessment (SOFA) score.

Results:
The meta-analysis included two studies with 252 participants. In a pooled analysis, mortality in the MIP group was 43% lower than in the control (RR: 0.57, 95%CI: 0.33–1); however, this difference was statistically not significant. We observed the days on a vasopressor day (standardised mean difference [SMD]: 0.38; 95%CI: −1.20 to 0.44), length of ICU stay (SMD: 0.46; 95%CI: −1.44 to 0.51), secondary infection (RR: 0.75; 95%CI: 0.19–3.01), VAP (RR: 0.6; 95%CI: 0.28–1.56), CRBSI (RR: 0.97, 95%CI: 0.14–6.98), delta SOFA score (SMD: 0.88, 95%CI: −1.66 to − 0.10) between the two groups.

Conclusions:
Our findings observed preliminary evidence in the trends for a positive association of MIP with better outcomes in sepsis patients.
Vision impairment and access to eye care in an integrated network of eye care system in Southern and Eastern India
Authors: Chadalavada Harithaa P , Marmamula Srinivas , Khanna Rohit C 
Published: December 2023

Purpose:
The World Report on Vision highlights that health information systems (HIS) should collect information on the determinants of eye conditions and vision impairment (VI) as a step toward integrated people-centered eye care (IPEC). Thus, this retrospective study aims to elucidate VI trends across age and gender of the patients who visited our centres in southern and eastern India.

Methods:
Electronic medical records of all new patients who visited the network were included. VI was defined as visual acuity less than 6/12; unilateral VI was based on the worse presenting eye (the other eye being normal), and bilateral VI was based on the better eye. “Total VI” includes both unilateral and bilateral VI.

Results:
The records of 7,31,307 patients from January to December 2019 were extracted. Males were 54%. The mean age was 40 years (SD: 19.16 years). The majority of patients (46.54%) visited a primary care centre. Centres in Andhra Pradesh saw the largest number of patients (46%). Approximately 65% of all patients presented had no VI in either eye. Total VI was 23.5% at the primary-centre level and approximately 45% at other levels, the highest being in Odisha. More females accessed care at primary and secondary centres (46.6%) than at higher levels of care (44%). Odisha had the lowest number of females accessing care (43.01%).

Conclusion:
Non-visually impairing conditions form an important reason for patients visiting our eye care facilities. Strategies focusing on improving access to eye care for females should be planned at all levels, especially in Odisha.
Histopathologic correlates of trabecular meshwork in microincisional trabeculectomy
Authors: Rao Aparna 
Published: December 2023

Purpose:
To report the histopathologic correlates of trabecular meshwork (TM) specimens procured by microincisional trabeculectomy (MIT) for different severities of glaucoma (early glaucoma: visual field mean deviation [MD] <−6 dB, moderate glaucoma: MD from − 6 to − 12 dB, and advanced glaucoma: MD <−12 dB).

Methods:
TM specimens from four patients undergoing MIT with or without cataract surgery were analyzed by routine histopathology for structural changes. The number of cells, the number of cells with spindle-shaped nuclei suggestive of epithelial–mesenchymal transformation (EMT), and the distance between the trabecular beams were calculated using different tools on freely available ImageJ software using the line or pint/count tool.

Results:
The TM specimens procured from two early and two advanced glaucoma cases showed decreasing cellularity and decreased compact arrangement of the trabecular beams in severe disease stages. The number of cells and preserved architecture in all four specimens were evident, with > 50 cells being present per section in all four cases despite the glaucoma being of advanced disease stage in two patients.

Conclusion:
The TM specimens obtained from MIT can be utilized for downstream analysis using different molecular methods for studying the molecular events in the tissue from early to severe glaucoma.
Association of primary chronic dacryocystitis and meibomian gland dysfunction
Authors: Goel Ruchi , Saini Swati , Golhait Priyanka , Shah Shalin 
Published: December 2023

Purpose:
To evaluate the association between meibomian gland dysfunction (MGD) and primary chronic dacryocystitis (PCD) and the effect of dacryocystorhinostomy (DCR) on tear film stability and MGD.

Methods:
This prospective, interventional, non-randomized study involved 50 unilateral acquired PCD cases and 50 age-matched healthy controls. Patients with lid abnormalities, ocular trauma, previous ocular surgery, contact lens wearers, and chronic topical or systemic drug users were excluded from the study. After a detailed history, the ocular surface disease index (OSDI) was calculated. The ocular assessment included visual acuity, tear meniscus height (TMH), tear break-up time (TBUT), tear well diameter (TWD), Schirmer 1 test, meibomian gland (MG) expressibility, and meibography. PCD eyes underwent external DCR, and the tests were repeated after 8 weeks.

Results:
The mean age of PCD cases was 42.58 ± 12.74 years, the male: female ratio was 7:19, and the mean duration of epiphora was 2.2 ± 1 years. The MG expressibility grade of ≥2 was seen in 98% (49/50) PCD eyes, which was strongly associated with PCD as compared to controls (OR = 563, P = 0.00, 95% CI = 60.71–5229.70). MG loss ≥50% was seen in 62% (31/50) of PCD eyes and none of the control eyes. Following DCR, MG loss remained unchanged, and a significant decrease occurred in OSDI scores, TWD and Schirmer 1 values, and MG expressibility grade (Z = −6.85). The mean TMH decreased from 767.60 ± 331.60 µm to 384 ± 204.29 µm (P = 0.004) post DCR.

Conclusions:
PCD is strongly associated with MGD. DCR reverses the functional MG changes with improvement in the tear film stability but no effect on MG loss.
A study to determine the effect of hydroxychloroquine (HCQ) on central corneal thickness (CCT) in patients with rheumatoid arthritis (RA)
Authors: Jaichander Roshan Christina , Thomas Reji Koshy , Shobha Vineeta 
Published: December 2023

Purpose:
Corneal thinning is common in rheumatoid arthritis (RA), thereby affecting the central corneal thickness (CCT). Effect of hydroxychloroquine (HCQ) in RA has abounding literature on retinal toxicity, but there is lack of data on its corneal effects.

Methods:
A cross-sectional study was carried out to compare CCT in RA patients before treatment initiation (Group 1) with CCT in those on HCQ for ≥3 months (Group 2).

Results:
Fifty patients were enrolled in each group. The mean age was 44.36 years with similar age, gender distribution and visual acuity in both groups. The mean CCT of patients in the cohort was 521.80 µm ± 32.57 µm and 523.94 µm ± 33.40 µm in the right eye (RE) and left eye (LE), respectively. Mean CCT in Group 1 was (RE) 522.80 µm/(LE) 524.26 µm and in Group 2 was (RE) 520.80 µm/(LE) 523.62 µm, and there was no significant difference in CCT between both the groups. Median duration of HCQ usage in Group 2 was 24 months, with the median cumulative dosage being 171 g and a majority having a dosage of 200 mg/day. There was no significant correlation between the duration/cumulative dosage of HCQ intake and CCT. No corneal deposits were identified in any patient.

Conclusion:
CCT of RA patients was similar to those reported in the Indian literature. However, there was no significant change in CCT or corneal deposits identified with an HCQ dosage of 200–400 mg/day. Longer follow-up would provide clarity on the impact of duration and cumulative dosage of HCQ on corneal changes and CCT.