bluuebunny/crossref_metadata_2025_split huggingface dataset:
La CED : point de cristallisation de la politique de Konrad Adenauer
Authors: Casasus Gilbert 
Published: June 2023

Cet article s’inscrit dans une perspective historique et politique pour désacraliser la représentation, souvent caricaturale, des manifestations d’amitié entre Français et Allemands. À l’exemple des divergences qui les ont opposés lors du « Plan Pleven », ce discours ne résiste plus à l’épreuve des faits. Alors que le projet de la Communauté européenne de défense représentait aux yeux du chancelier Konrad Adenauer une chance unique pour mettre la République fédérale d’Allemagne sur un pied d’égalité avec ses partenaires ouest-européens, Pierre Mendès France ne l’aimait pas. À son avis, la CED était en adéquation parfaite avec la vision européenne et étatsunienne de l’Allemagne de l’Ouest. Perçu à Bonn comme le « fossoyeur de la CED », Mendès France n’avait guère apprécié les pressions que son homologue avait exercées pour faire adopter ce texte par l’assemblée nationale. Toutefois, c’est bel et bien l’Allemagne qui se retrouva dès 1957 en position de force face à la France.
Consentement et construction de l’intime
Authors: Vallet-Armellino Marion 
Published: June 2023

Comment être en position de discerner, de savoir à quoi engage son choix ? Comment mesurer, dans une relation, ce qui entrave, empêche, ce qui fera subordination ou emprise, implicite ou explicite ? Cet article interroge le consentement en tant qu’articulation de l’intime et des nouvelles demandes adressées au social, à travers trois dimensions cliniques actuelles : celles des victimes de violences sexuelles, de l’affirmation de genre, notamment des demandes de transition chirurgico-hormonale, et enfin de la pratique d’une psychiatrie de crise qui cherche à éviter des soins sans consentement. Il s’agit, dans chaque champ spécifique, de respecter l’autonomie décisionnelle de la personne, ce qui implique de respecter la temporalité propre au sujet, dans ses dimensions volontaires autant qu’inconscientes.
Mettre en scène le harcèlement dans un théâtre-forum : quand le consentement trouble l’organisation
Authors: Veyrat Émilie 
Published: June 2023

À partir d’une pratique de théâtre-forum en entreprise sur le harcèlement, l’article retrace l’influence de l’évolution sociale (#MeToo) sur le cadre légal, qui impose des changements à l’organisation. Celle-ci cherche à y répondre par une logique d’expertise, mais, dans l’espace clinique ouvert par le théâtre-forum, c’est la notion complexe de consentement qui est débattue. Par des verbatims, l’auteure aborde les conditions de ce dispositif clinique et les difficultés dans sa mise en place. Cette tension entre élaboration et expertise est mise en perspective avec les notions de pouvoir et de résistance, des enjeux latents dans le consentement. Enfin, l’article développe une hypothèse en s’appuyant sur la psychanalyse organisationnelle : celle d’un trouble dans l’organisation, induit par la reconnaissance d’une « nouvelle » forme de subjectivité au travail, non prescrite et inhérente au consentement.
Du consentement libre et éclairé : de l’utopie au sens pratique à l’acte de foi « raisonnable »
Authors: L’Archevêque Alexandre 
Published: June 2023

Au sens strict du terme, consentir de manière « libre et éclairée » implique 1) de pouvoir s’affranchir des déterminants au fondement des conduites humaines et 2) d’être en mesure de prévoir l’ensemble de conséquences possibles des décisions prises. Dans le cadre de cet article, le consentement au sens strict est compris comme une utopie. À partir de l’analyse d’observations issues de la psychologie clinique et de l’intervention psychosociale, de même que d’une revue critique de publications scientifiques, trois formes d’assentiment sont distinguées : l’acte de foi aveugle, l’obéissance volontaire et l’acte de foi « raisonnable ». Pour chacune de ces formes, des enjeux éthiques reliés à la clinique sont présentés et discutés.
Le consentement entre leurre et réalité ?
Authors: Froment Myriam , Ferret-Bosch Célye , Garcia Frédéric 
Published: June 2023

Les institutions publiques posent comme modalités contractuelles la soumission à l’autorité et la sujétion à la hiérarchie. La notion de consentement y est inévitablement ambiguë malgré l’insistance sociétale autour de l’importance de choisir pour soi. Cette notion est ancienne pour certaines prises en charge en santé et en santé mentale : elle est plus rarement formalisée en santé au travail. En utilisant leur expérience de psychologue du travail et psychologue clinicienne au sein de services autonomes en santé au travail dans la fonction publique, les auteurs mettent en évidence les compromis étroits que nécessite la mise en œuvre d’un consentement acceptable. Ces compromis concernent tant les bénéficiaires des dispositifs que les psychologues. Toutefois, pour les bénéficiaires, le psychologue, de par ses modalités d’exercice professionnel proposant un cadre sécure qui repose sur l’étayage et l’accordage, permet d’atténuer ces écueils et soutient un consentement libre et éclairé tant que c’est possible. Quant au psychologue, de moins en moins protégé par les règles conventionnelles qui se sont modifiées, il est davantage exposé et lui faut jouer le mieux possible sa partition tout en se protégeant.
La construction sociale du consentement à la fin de vie. Entre psychologisation de la relationet objectivation de la situation de fin de vie
Authors: Blondel Frédéric 
Published: June 2023

L’article explore la dynamique du consentement dans le contexte spécifique de l’accompagnement à la fin de vie. L’hypothèse développée est que le consentement est perçu comme juste si la posture d’accompagnement des soignants a été en capacité d’articuler avec les aidés deux mouvements : celui de la psychologisation de la relation et celui de l’objectivation de la situation. L’article restitue la manière dont les équipes soignantes accompagnent des aidants familiaux à consentir à la fin de vie de leur proche. Plusieurs configurations de consentement sont restituées en appui sur les travaux de recherche de l’auteur : celui relatif au départ de la personne âgée prise en charge en institution, celui de la personne suivie dans le cadre d’un maintien à domicile, celui de l’enfant victime d’un accident et celui de l’enfant né en situation de polyhandicap.
La prison et ses modules de respect : quel sens du travail chez les surveillants ?
Authors: Hernandez Lucie 
Published: June 2023

L’objectif de l’article est d’analyser le sens du travail chez des surveillants de prison exerçant au sein d’un dispositif appelé « Modules de respect ». L’auteure analyse ce sens à partir de trois facettes : la signification, l’orientation et la cohérence. Pour ce faire, des entretiens ont été menés dans quatre établissements, auprès de 18 surveillants. L’analyse montre notamment que ce dispositif permet aux surveillants de reprendre la main sur la gestion de la détention et apporte davantage de cohérence dans leurs missions. En analysant l’appropriation du dispositif par ces acteurs, l’enjeu est également de cibler les points sur lesquels prend racine la souffrance associée à cette profession et de discuter des dynamiques contradictoires qui continuent malgré tout de le traverser.
De quoi le care est-il le nom ?
Authors: Antoine Agnès 
Published: June 2023

Selon l’auteure, philosophe et psychanalyste, l’émergence contemporaine du courant du care a une signification plus large que l’exigence de revalorisation du « prendre soin » et de l’aide aux personnes, ainsi que des professions qui leur sont liées. En opérant une lecture critique de l’analyse par Freud de la culture et en s’appuyant sur celle du juriste suisse Jacob Bachofen sur le « droit maternel », l’auteure montre que l’appel au care traduit un changement civilisationnel en cours qui balaie les vestiges de la domination patriarcale subsistant dans les démocraties avancées. Elle se demande si la notion de care ne pourrait pas aider la psychanalyse à se dégager elle-même de cette configuration hiérarchique et à dépasser, au plan théorique et pratique, un certain évitement du maternel qui persiste dans son domaine, en dépit des avancées analytiques postfreudiennes.
Sur la structure herméneutique de la raison kantienne
Authors: Guerpillon Louis 
Published: June 2023

Des raisons structurelles conduisent la pensée kantienne à se développer sur le mode d’une herméneutique. On a parfois refusé ce titre à la théorie kantienne de l’interprétation, au motif que le sens y serait systématiquement reconduit à notre destination morale : jamais l’expérience ne serait pour Kant la rencontre d’un sens étranger , le sens y serait d’emblée ramené à soi. Mais, précisément, la moralité n’est pas chez Kant autre chose que l’épreuve d’une distance irréductible à soi-même. Ce fait pratique de la distance à soi commande la nécessité de l’interprétation des œuvres de la culture, voire de la nature même, de manière à y reconnaître ce qui renvoie la personne à son propre effort de se faire soi.
Spinoza avec Vygotski : une psychologie des affects
Authors: Clot Yves 
Published: June 2023

Cette revue critique embrasse trois ouvrages récents permettant une nouvelle approche de la psychologie par la philosphie : celui de Pascal Séverac sur les rapports entre Lev Vygotski et Spinoza et l’édition de traductions de La Science du développement de l’enfant et des Notebooks de Vygotski.
Proposed Hybrid Secured Method to Protect Against DDOS in n Vehicular Adhoc Network (VANET)
Authors: Tuka Kareem Jebur  
Published: June 2023

Security and safety are critical concerns in Vehicular Adhoc Networks. vulnerable to Distributed Denial of Service (DDoS) attacks, which occur when multiple vehicles carry out various tasks. This cause disrupts the normal functioning of legitimate routes. In this work, the Hybrid PSO-BAT Optimization Algorithm (HBPSO) Algorithm based on modified chaos -cellular neural network (Chaos - CNN) approaches has been proposed to overcome DDoS attacks. The suggest approaches consists of three-part which are hybrid optimization search algorithm to enhance the route from source to destination, chaos theory module is used to detect the abnormal nodes, then on Modified Chaotic CNN (MCCN) employed to prevent a malicious node from sending data to the destination by determining node that consumer more resource, packets lose or the victim could reset the path between the attacker and itself. CICIDS dataset has been used to test and evaluate the performance of the proposed approach based on the criteria of accuracy, packet loss, and jitter. The Chaos - CNN approached results to outperform similar models of the related work and the approach protects the VANETs with high accuracy of 0.8736, specificity of 0.9959, TPR of 0.9561, and FPR of 0.78, Detection rate 0.9561.
Cutting Edge: Optimal Formation of Hepatic Tissue-Resident Memory CD4 T Cells Requires T-bet Regulation of CD18
Authors: Depew Claire E , Nguyen Alana T , Franke Marissa C , Calderon Jesica , Sciammas Roger , McSorley Stephen J 
Published: June 2023

Abstract
CD4 tissue-resident memory T cells (TRMs) allow robust protection of barrier surfaces against pathogens. We investigated the role of T-bet in the formation of liver CD4 TRMs using mouse models. T-bet–deficient CD4 T cells did not efficiently form liver TRMs when compared with wild-type (WT). In addition, ectopic expression of T-bet enhanced the formation of liver CD4 TRMs, but only when in competition with WT CD4 T cells. Liver TRMs also expressed higher levels of CD18, which was T-bet dependent. The WT competitive advantage was blocked by Ab neutralization of CD18. Taken together, our data show that activated CD4 T cells compete for entry to liver niches via T-bet–induced expression of CD18, allowing TRM precursors to access subsequent hepatic maturation signals. These findings uncover an essential role for T-bet in liver TRM CD4 formation and suggest targeted enhancement of this pathway could increase the efficacy of vaccines that require hepatic TRMs.
Control of Candida auris Septicemia in Patients of Trauma Intensive Care Unit in a Tertiary Care Hospital
Authors: Sahoo Amiyabala , Malhotra Shalini , Mehta Nirmala Kumari , Sharma Shefali , Kaur Nirmaljit , Kaur Amarjit , Duggal Nandini 
Published: June 2023

Introduction:

Candida auris is associated with nosocomial outbreaks in intensive care settings, and transmission despite the implementation of enhanced infection prevention and control (IPC) measures is a particular concern.

Objective:
Isolation and identification of C. auris from suspected cases of fungal septicemia and its surveillance.

Materials and Methods:
Blood culture samples of all suspected cases of fungal septicemia were taken from the trauma intensive care unit (TICU) of a tertiary care hospital in New Delhi between September 2019 and November 2019 as part of surveillance of device-associated infections. All the samples were obtained by central venous catheter line. Samples were processed in BacT/Alert automated blood culture system. Positive flagged bottles were further subcultured unto blood agar, MacConkey agar, and Sabouraud Dextrose Agar with and without cycloheximide and incubated at 37°C. All suspected Candida isolates were identified by conventional methods and the suspected C. auris isolates were further confirmed by matrix-assisted laser desorption time of flight.

Results:
Out of 24 suspected fungal septicemia cases from TICU, three patients had C. auris septicemia and all three isolates were resistant to fluconazole and voriconazole.

Action Taken:
IPC practices were reinforced as per the Centers for Disease Control and Prevention guidelines by the infection control team.

Conclusion:
This article depicts the emergence of multidrug-resistant C. auris and controlling its spread by appropriate infection control measures.
Prediction of Rise in Alkaline Phosphatase at Different Vitamin D Levels
Authors: Gutch Manish , Mandal Uday Kumar , Kumar Sukriti 
Published: June 2023

Background:
Vitamin D deficiency with a resurgence of rickets and tetany is increasingly being reported in young infants from temperate regions, African Americans, and also from India. The data on Vitamin D status of healthy term breastfed Indian infants and mothers are scant. In fact, the correlation between Vitamin D deficiency and alkaline phosphatase (ALP) is inaccurate in many studies.

Aim and Objective:
The aim and objective of this study are to determine whether serum Vitamin D levels are correlated with serum levels of ALP or not and to study the point, at which ALP surge occurs in Vitamin D deficiency.

Materials and Methods:
Ninety-six participants at birth were enrolled and followed up till 9 months of age. Serum 25 (OH) D along with ALP was estimated in cord blood at birth and 14 ± 1 weeks of life. Seventy-seven participants were followed up at 9 months for estimation of serum 25 (OH) D, parathyroid hormone, ALP, calcium, and phosphorus. Vitamin D deficiency was defined as serum 25 (OH) D <15 ng/mL as per the United States Institute of Medicine guidelines.

Results:
At 9 months out of 96 samples, 16 had mild insufficient (≥15–20 ng/mL) (20.8%), 42 had moderate deficient (<15 ng/mL) (54.5%), and 0 had severe deficient (<5 ng/mL) Vitamin D deficiencies. Serum alkaline phosphate were found to be normal in all the three groups of patients and the receiver operating characteristic curve demonstrated that low Vitamin D level is predicted by a high ALP cutoff of ALP is 190.90 IU/L with reasonable sensitivity and specificity. The correlation coefficient of ALP and serum Vitamin D3 levels was r = 0.501 (P = 0.001).

Conclusion:
Serum Vitamin D3 levels correlated well with increased serum ALP levels but the level, at which the ALP surge occurs was on the lower side.
Role of Initial and Follow-Up Lactate Dehydrogenase Titer in Coronavirus Disease 2019 Pneumonia: A Single-Center Experience
Authors: Patil Shital , Patil Deepak , Khule Shubhangi 
Published: June 2023

Aims:
Robust data of lactate dehydrogenase (LDH) are available as a prognostic marker in hematology, malignancy, and pneumocystis pneumonia, and we have analyzed its usefulness in coronavirus disease 2019 (COVID-19) pneumonia.

Materials and Methods:
A prospective, observational, follow-up study included 1000 COVID-19 cases confirmed with real-time reverse transcription polymerase chain reaction. All cases were assessed with lung involvement documented and categorized on high-resolution computerized tomography (CT) thorax, oxygen saturation, inflammatory marker as LDH at entry point, and follow-up. Age, gender, comorbidity, and use bilevel-positive airway pressure/noninvasive ventilation (BIPAP/NIV) and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis is done by using Chi-square test.

Results:
In a study of 1000 COVID-19 pneumonia cases, age (<50 and >50 years) and gender (male versus female) have a significant association with LDH in predicting severity of COVID-19 pneumonia (P < 0.00001 and P < 0.010, respectively). CT severity score at entry point with LDH level has a significant association (P < 0.00001). LDH level has a significant association with duration of illness (P < 0.00001). Comorbidities such as diabetes mellitus, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, and obesity have a significant association with LDH level (P < 0.00001). LDH level has a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV requirement during course of hospitalization has a significant association with LDH level (P < 0.00001). Timing of BIPAP/NIV requirement in critical care setting has a significant association with LDH level (P < 0.00001). Follow-up LDH titer during hospitalization as compared to entry point abnormal LDH has a significant association in post-COVID lung fibrosis (P < 0.00001). Follow-up LDH titer during hospitalization as compared to entry point normal LDH has a significant association in post-COVID lung fibrosis (P < 0.00001).

Conclusions:
LDH has documented a very crucial role in COVID-19 pneumonia in predicting severity of illness, progression of illness, and sequential LDH titers, which will help assess response to treatment during hospitalization and analyze post-COVID lung fibrosis.
Enhancing the interpretational skills of complete blood count reports by second year medical students using competency based learning method
Authors: Varghese Renu G'Boy , Manickam Niraimathi , Mohanraj Anand 
Published: June 2023

Background:
Competency-based learning can help improve the skills of medical students to interpret lab reports like complete blood counts (CBCs). The objectives of this study were to assess whether “hands-on training” on interpreting the CBC reports is useful and to evaluate the students' and faculty's feedback on their experience based on the Kirkpatrick four-level training model.

Methodology:
Second-year MBBS students were initially assessed on the knowledge they already had regarding the interpretation of CBC reports, which they had learned in Physiology (T1). They were then divided into two groups as study (S) and control (C) groups. Study group students alone were given “hands-on training” to interpret CBC reports. Then, both the groups were assessed using objectively structured practical examination (OSPE) (T2). The control group was given the same training on another day. Then, both the groups were assessed using OSPE 1 month later (T3). Both the pretraining and posttraining scores were analyzed using repeated measures analysis of variance.

Results:
The mean scores differed significantly over time points. In the study group (Group A), the scores from pretraining (T1) to posttraining (T2) (P = 0.001), pretraining (T1) to 1 month later (T3) (P = 0.001), pretraining (T1) to 1 month later (T3) (P = 0.001), and posttraining (T2) to 1 month later (T3) (P = 0.001) were significant. However, in the control group (Group B), the scores from pretraining (T1) to 1 month later (T3) (P = 0.001) and posttraining (T2) to 1 month later (T3) (P = 0.001) were significant, but not from pretraining (T1) to posttraining (T2). Between the study and control groups, the difference in scores at pretraining (P = 0.001) and posttraining (P = 0.001) was significant, but not for the test 1 month later (35.5 ± 11.6 vs. 37.2 ± 10.7).

Conclusion:
Competency-based learning enhanced the student's interpreting skills of CBC reports, which will be useful in their career as doctors.
Loss to follow-up of cervical cancer screening program beneficiaries at Rural Health Training Center in South India – An explanatory mixed method study
Authors: Subramaniyan Subalakshmi , Sindhuri R. , Mohan Reenaa , Ganapathy Kalaiselvan , Manivasakan Jayasree 
Published: June 2023

Background:
In India, routine Pap smear screening is an ongoing process for the detection of cervical cancer, but the follow-up component remains unaddressed. The objectives of the present study were to find out the proportion of abnormal Pap smear results among women aged 30 years screened through the cervical cancer screening program at RHTC, their follow-up status, and explore the reasons and solutions for loss to follow-up (LTFU).

Methodology:
An explanatory mixed-method study (quantitative: A record-based cohort study followed by qualitative: Five in-depth interviews with loss to follow-up patients and 14 key informant interviews with stakeholders who were purposively selected to identify barriers and possible solutions for LTFU using an interview guide) was conducted in RHTC over 3 months. Ethical principles were adhered to.

Results:
The results showed that 307 of the 1328 women screened had abnormal Pap smear results. Of the 31 women with precancerous lesions, 26 (83.9%) were on regular follow-ups, and 5 (16.1%) were on irregular follow-ups. Manual content analysis showed five broad categories as barriers to LTFU, namely: (1) general awareness and practical issues; (2) family-related issues; (3) economic issues; (4) cultural issues; and (5) healthcare-associated issues. Community-level awareness generation for capacity building through health education constantly; displaying creative health information models (information, education, and communication); a positive deviance approach; a family and partner-centered approach; the formation of support groups; proactive intervention; and an incentive-based follow-up approach were possible solutions to mitigate the rate of LTFU.

Conclusion:
Improper knowledge, socio-cultural myths, and a lack of support from partners and family members were the main barriers identified for LTFU. Hence, to strengthen the follow-up component after the initial screening test, periodical sensitization and initiating an incentive-based follow-up approach should be recommended.