bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’état de grâce du premier mois de cours de l’année scolaire : une incidence du rapport au savoir ?
Authors: Renauld Dominique 
Published: April 2023

Cet article se propose d’examiner l’incidence du rapport au savoir d’une professeure de philosophie sur l’évocation de sa pratique professionnelle. Il est constitué de l’analyse d’un entretien clinique à visée de recherche issu d’une thèse de doctorat en sciences de l’éducation d’orientation psychanalytique consacrée à l’enseignement de la philosophie au lycée. Si, depuis la récente réforme du baccalauréat, la philosophie peut être désormais abordée en partie en classe de première, à travers un enseignement optionnel d’humanités, toutefois, à la différence de nombreuses disciplines dont l’apprentissage débute très tôt dans une scolarité, c’est en terminale que les élèves des lycées en découvrent les rudiments. Que peut donc ressentir un enseignant de cette discipline lors de ce premier mois de cours de l’année scolaire et quelle part psychique inconsciente son rapport au savoir peut-il prendre dans l’évocation de cette période ?
Rapport au savoir : ratage du processus de subjectivation en formation soins infirmiers
Authors: Merniz Nora 
Published: April 2023

Depuis la mise en œuvre d’une gestion libérale associée à un néo management des systèmes de soins, les pratiques soignantes s’éloignent sensiblement des conceptions de soins fondées sur le care. Sa pratique enseignante en IFSI a conduit l’auteure à rencontrer un fait de « plagiat » auquel se sont livrés deux étudiants. C’est de sa place de chercheuse en immersion au sein de cet institut qu’elle s’est sentie interpellée : cet acte serait-il un des effets de l’alternance de la formation ? Dans cet article, lequel met en question le rapport des étudiants au savoir, l’auteure propose deux interprétations de cet acte transgressif en prenant appui sur les concepts psychanalytiques d’identification et de Verleugnung. La discussion permet de mettre particulièrement en exergue comment le rapport au savoir de chaque étudiant est indissociablement lié au malentendu nodal de la culture hospitalière et de la formation, et comment leurs rapports au savoir interrogent leurs désirs professionnels et leurs identités de soignants.
Proposition de points de repères méthodologiques pour un entretien clinique de recherche d’orientation psychanalytique
Authors: Chaussecourte Philippe 
Published: April 2023

Il s’agit dans ce texte d’expliciter très concrètement la réalisation d’un entretien clinique de recherche dans le cadre d’une approche clinique d’orientation psychanalytique en Éducation et Formation. Il est organisé chronologiquement par rapport à l’exécution d’un tel entretien : ce à quoi il faut penser en amont de l’entretien, puis au moment de la conduite de l’entretien lui-même et enfin, comment on peut organiser le matériel récolté et comment il peut être analysé.
Handicap psychique et fracture numérique. Quelles solutions pour favoriser l’inclusion sociale ?
Authors: Soto Stéphanie , col  
Published: April 2023

Portés par une réflexion collective du Comité Local de Santé Mentale (CLSM), les professionnel(le)s de l’antenne de Pézenas du SAVS de l’Association AVH, ont réfléchi à l’impact de la fracture numérique sur le public accompagné 1 . Ils proposent quelques pistes d’actions concrètes afin d’améliorer l’accès des usagers à ces pratiques et, partant, de leur permettre un meilleur pouvoir d’agir en vue de construire leur propre vie en diminuant leur dépendance vis-à-vis de leurs aidants.
La fonction thérapeutique du numérique dans les soins pour les personnes âgées
Authors: Asvazadourian Renald 
Published: April 2023

L’hôpital de jour « Espace Phare » de l’Association Les Ailes Déployées accueille des personnes âgées souffrant de troubles psychiatriques. Ces patients sont doublement pénalisés, par leur âge et par leur handicap psychique. L’utilisation du numérique dans la vie quotidienne et dans différents ateliers, en réduisant la fracture numérique, contribue à une meilleure insertion dans leur environnement amical et social, et renouvelle et renforce les échanges intra familiaux, particulièrement trans-générationnels. D’autre part, certains dispositifs (ex : « Discord ») permettent à des patients qui ne peuvent pas se déplacer de rester dans un lien actif avec ce centre d’échange et de communication qu’est l’Espace Phare, que leur mobilité soit affectée par des problèmes physiques ou liée à leur pathologie psychique.
Standard Technique versus Rotational Technique of Insertion of Baska Mask®
Authors: Sheetal  , Jindal Seema , Sidhu Gurkaran Kaur , Jindal Swati , Kaur Sandeep 
Published: April 2023

Background and Aims:
Baska Mask® is a new third-generation supraglottic airway device (SGAD). The placement of Baska Mask® using the standard technique causes posterior displacement of the tongue, leading to incorrect positioning and insertion failure. The rotation technique may alleviate this obstacle during insertion by decreasing resistance between the airway and tongue. The primary objective of this study was to compare the insertion time between the standard versus rotational technique of Baska Mask®, and the secondary outcome measures were ease of insertion, number of attempts and postoperative airway morbidity with both techniques.

Methods:
One hundred consenting adults of the American Society of Anaesthesiologists I-II, aged 20–65 years of either gender scheduled for a variety of surgical procedures under general anaesthesia in a tertiary care hospital (May 2019 to November 2020), were included in the study. The patients were randomly allocated to Group S and Group R using the standard and rotation techniques, respectively. All statistical analyses were done using the SPSS (Statistical Package for the Social Sciences) software. The comparison of quantitative variables between the study groups was done using the Student's t-test and Mann–Whitney test. For comparing categorical data, the Chi-square χ
2 test was performed.

Results:
The mean insertion time was significantly higher with the standard compared to the rotation technique of Baska Mask (20.90 ± 3.13 vs. 14.84 ± 1.11 s, P = 0.000). Device insertion was easy in rotation compared to the standard technique (P = 0.031). The number of attempts required for insertion was more with the standard technique than with the rotation technique (P = 0.011).

Conclusion:
Although the standard technique of Baska Mask® remains the first choice, the rotational technique of Baska Mask® has a higher success of insertion with fewer complications than the standard technique; hence, it can be accepted as an alternative.
Comparison between Dexmedetomidine and Fentanyl on Intubating Condition to Facilitate Awake Oral Fibreoptic Intubation under Topical Anaesthesia – A Randomised Controlled Trial
Authors: Panwar Vishnu , Krishnan Sushil , Sharma Anil Kumar 
Published: April 2023

Background and Aims:
Awake fibreoptic intubation (AFOI) is the standard method of airway management in the anticipated difficult airway. While many drugs have been employed for sedation, there is no single drug that can be recommended as the drug of choice. Dexmedetomidine is characterised by effects of sedation, analgesia, amnesia and lack of respiratory depression. Hence, we hypothesised that dexmedetomidine should be suitable for AFOI and compared it to the control drug fentanyl. This study assesses the level of sedation and intubating conditions using dexmedetomidine or fentanyl during awake fibreoptic orotracheal intubation.

Methods:
Sixty adult patients, American Society of Anaesthesiology class I and II, who required orotracheal intubation during general anaesthesia with the normal airway were randomised to receive dexmedetomidine 0.6 μg/kg (Group A) or fentanyl 1.0 μg/kg (Group B) intravenous infusion for 10 min, after topical anaesthesia to the airway. A total of 60 patients were allocated, 30 patients in each group. The primary objective was to assess the intubating conditions with dexmedetomidine compared to fentanyl.

Results:
The intubation score for vocal cord movement (1.57 ± 0.68 in Group A vs 1.93 ± 0.75 in Group B) and cough (1.50 ± 0.78 in Group A vs 1.90 ± 0.72 in Group B), endoscopy score (2.17 ± 0.59 in Group A vs 2.47 ± 0.69 in Group B), sedation score (4.73 ± 0.5 in Group A vs 4.47 ± 0.57 in Group B) and patient satisfaction score (1.20 ± 0.41 in Group A vs 1.47 ± 0.68 in Group B) were statistically significant in patients receiving dexmedetomidine. During the procedure, there was a statistically and clinically significant increase in heart rate of 1.5% in Group A versus 22% in Group B, and an increase in mean arterial pressure of 1.95% in Group A versus and 10.27% in the Group B.

Conclusion:
Dexmedetomidine provided better intubation conditions than fentanyl, with greater haemodynamic stability, better sedation and greater patient satisfaction score compared to fentanyl during awake fibreoptic oral intubation.
Classification of Rajayoga Meditators Based on the Duration of Practice Using Graph Theoretical Measures of Functional Connectivity from Task-Based Functional Magnetic Resonance Imaging
Authors: Savanth Ashwini S. , Vijaya P. A. , Nair Ajay Kumar , Kutty Bindu M. 
Published: April 2023

Context:
Functional magnetic resonance imaging (fMRI) studies on mental training techniques such as meditation have reported benefits like increased attention and concentration, better emotional regulation, as well as reduced stress and anxiety. Although several studies have examined functional activation and connectivity in long-term as well as short-term meditators from different meditation traditions, it is unclear if long-term meditation practice brings about distinct changes in network properties of brain functional connectivity that persist during task performance. Indeed, task-based functional connectivity studies of meditators are rare.

Aims:
This study aimed to differentiate between long-term and short-term Rajayoga meditators based on functional connectivity between regions of interest in the brain. Task-based fMRI was captured as the meditators performed an engaging task. The graph theoretical-based functional connectivity measures of task-based fMRI were calculated using CONN toolbox and were used as features to classify the two groups using Machine Learning models.

Subjects and Methods:
In this study, we recruited two age and sex-matched groups of Rajayoga meditators from the Brahma Kumaris tradition that differed in the duration of their meditation experience: Long-term practitioners (n = 12, mean 13,596 h) and short-term practitioners (n = 10, mean 1095 h). fMRI data were acquired as they performed an engaging task and functional connectivity metrics were calculated from this data. These metrics were used as features in training machine learning algorithms. Specifically, we used adjacency matrices generated from graph measures, global efficiency, and local efficiency, as features. We computed functional connectivity with 132 ROIs as well as 32 network ROIs.

Statistical Analysis Used:
Five machine learning models, such as logistic regression, SVM, decision tree, random forest, and gradient boosted tree, were trained to classify the two groups. Accuracy, precision, sensitivity, selectivity, area under the curve receiver operating characteristics curve were used as performance measures.

Results:
The graph measures were effective features, and tree-based algorithms such as decision tree, random forest, and gradient boosted tree yielded the best performance (test accuracy >84% with 132 ROIs) in classifying the two groups of meditators.

Conclusions:
Our results support the hypothesis that long-term meditative practices alter brain functional connectivity networks even in nonmeditative contexts. Further, the use of adjacency matrices from graph theoretical measures of high-dimensional fMRI data yields a promising feature set for machine learning classifiers.
Yoga and Integrative Healthcare
Authors: Bhargav Hemant , Holla Bharath , Ramakrishna Kishore Kumar , Shivakumar Venkataram , Gokulakrishnan K. , Varambally Shivarama , Gangadhar B. N. 
Published: April 2023

Background:
There is growing evidence and increasing interest for systemic integration of medicine (synergistic and evidence-based combination of different systems along with conventional biomedicine). The National Institute of Mental Health and Neurosciences (NIMHANS), an Institute of National Importance and a tertiary mental and neurological healthcare hospital situated in Bengaluru, India, has established one such integrative model. The present manuscript traces the history and describes the important steps followed in this integrative approach.

Methodology:
The NIMHANS model followed a stage-wise two-step approach: (1) First stage – Starting with Integration of Yoga: The process began more than a decade ago, with integrating yoga into a clinical department (rather than an exclusive research-based approach) of the institute which had relatively high clinical service load (For example, Department of Psychiatry in NIMHANS). Yoga was gradually formalized into academic and clinical activities (outpatient and inpatient services) by appointing a Yoga faculty with a medical background with an MD/PhD in Yoga. The research was primarily directed by the clinical observations of patients receiving yoga therapy. (2) Second stage: Adding an appropriate and compatible discipline from Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) system (Ayurveda in this case): The center for yoga gradually evolved into the Department of Integrative Medicine with the appointment of faculty from the Ayurveda stream. In this model, specialists from each discipline provide clinical inputs after simultaneous consultation with the patient through systemic integration in clinical, academic, and research domains rather than mere co-location of AYUSH services with mainstream medicine.

Conclusion:
The NIMHANS model of integration suggests the application of yoga into mainstream clinical service as the first step toward integration. Yoga should be added as a formalized clinical discipline with systemic integration. Gradually, other feasible systems of traditional medicine from AYUSH can be integrated at a later stage in a step-by-step manner based on clinical practice and evidence.
Slivers of Hair – A Clue to Uncover Silver Hair Syndromes
Authors: Ganeshan Nivetha , Rajaram Muthukumaran , Ramamoorthy Madhavan , Sukumar Bharathi 
Published: April 2023

ABSTRACT
Silver hair syndromes (SHS) consist of rare autosomal recessive disorders, Chediak–Higashi syndrome (CHS), Griscelli syndrome (GS), and Elejalde disease. CHS is a disorder of vesicle trafficking; characterized by silvery hair, diffuse pigment dilution, immunodeficiency, bleeding diathesis, neurological manifestations, and an accelerated phase due to lymphohistiocytic infiltration. GS is characterized by hypopigmentation of skin and hair, with large clumps of pigment in the hair shaft. There are three types of GS. GS1 and GS2 show neurologic and hematologic impairments; GS3 is restricted to the skin. Some authors suggest that Elejalde syndrome is synonymous with GS Type 1. Here, we report two cases who presented with silver-gray hair but with varied clinical manifestations. With a light microscopic examination of the hair and peripheral smear, a diagnosis has been made. This report highlights the importance of hair shaft microscopy, an inexpensive, noninvasive, and simple tool in the diagnosis of SHS.
Study on Results of Laminectomy with Short-Segment Pedicle Screw Fixation in Dorsolumbar Fractures with Respect to Anatomical Reduction, Functional Recovery and Pain
Authors: Maheshwari Deepanshu , Tonk Gyaneshwar , Agarwal Sumit 
Published: April 2023

Background:
The aim of this study was to report the results of laminectomy with short-segment pedicle screw fixation in thoracolumbar fracture.

Materials and Methods:
Forty-two patients were analyzed prospectively, followed up in the outpatient department for the period of 24 months.

Results:
Most of the patients in the study had reasonable to good neurological recovery in the postoperative period assessed in the form of American Spinal Cord Injury Association (ASIA) score. There was also an excellent improvement in the components of anatomical reduction such as vertebral height, Cobb’s angle, and anterior wedge angle, which was directly related to functional recovery of the patient. Patients postoperatively also got relieved in pain in the dorsolumbar region assessed based on Denis pain scale.

Conclusion:
Laminectomy with pedicle screw fixation is an excellent option for patients with thoracolumbar fracture; it not only decompresses the spine but also provides stability with minimal manageable complications.
Autonomic Functions in Hypothyroidism
Authors: Jose Antony , Maroli Roshan , George Peter 
Published: April 2023

Background:
Hypothyroidism is a common endocrine disorder in the general population. Most of the cardiovascular and neurological manifestations of hypothyroidism are due to autonomic dysfunction. The American Academy of Neurology has recommended simple bedside autonomic function tests for the diagnosis and follow-up of autonomic functions. Recognition of autonomic dysfunction and treatment of hypothyroidism may improve cardiovascular outcomes. This study aims to assess autonomic dysfunction in hypothyroidism and correlate it with serum thyroid-stimulating hormone (TSH) levels.

Materials and Methods:
This cross-sectional study was conducted on 60 patients diagnosed with hypothyroidism for 12 months at a tertiary care center in Southern India. Patients with a Zulewski clinical score over 5 and fulfilling the selection criteria were included in the study after obtaining written informed consent. Details of history, treatment, examination, and thyroid function tests data were collected and bedside tests for autonomic functions were performed.

Results:
Ninety percent of individuals were female, and the average age of the included study population was 40.38 ± 11.78 years. Based on TSH and FT4 values, the patients were subgrouped into currently euthyroid and overt hypothyroid individuals. The majority of the individuals (81.67%) included in the study had autonomic dysfunction. Based on the autonomic dysfunction score, there was a significantly higher proportion of overt hypothyroid individuals (n = 18) with severe autonomic dysfunction compared to euthyroid individuals (n = 4). About 75% of the study individuals had sympathetic dysfunction and 66.7% of individuals had parasympathetic dysfunction. There was no statistically significant association between autonomic dysfunction and the duration of hypothyroidism.

Conclusion:
Autonomic dysfunction in hypothyroidism is common; sympathetic dysfunction was observed more as compared to parasympathetic dysfunction.
Impact of Percutaneous Coronary Intervention in the Right Coronary Artery on Right Ventricular Function in Patients with Acute Myocardial Infarction
Authors: Kiran Ganthala Paul , Santosh T. , John Grace Madhuri , Rao M. Srinivasa 
Published: April 2023

Background:
Right ventricular (RV) dysfunction is a potent predictor of mortality and morbidity after acute myocardial infarction (MI). Even though elective percutaneous coronary intervention (PCI) has significantly decreased myocardial damage of the left ventricle; in literature, there has been a lack of information regarding the effect of PCI on RV function.

Objective:
The objective of this study is to examine the effect of the right coronary artery (RCA) revascularization on systolic and diastolic functions of the right ventricle following acute inferior wall MI (IWMI).

Subjects and Methods:
Fifty-nine patients diagnosed with acute IWMI following RCA revascularization were prospectively investigated between April 2018 and January 2020. Patients were subjected to two-dimensional echocardiography. RV systolic and diastolic functions were reported before and after the PCI procedure and compared using different echocardiographic RV systolic and diastolic parameters.

Results:
After PCI, echocardiographic RV systolic and diastolic functions were significantly improved in proximal and mid RCA in terms of tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and early RV filling velocity/late RV filling velocity (E/A). Significant improvement was found in mid RCA in terms of peak systolic (S’) velocity (P = 0.008) and proximal RCA in terms of early RV filling velocity/early diastolic tricuspid annulus velocity (E/e’) (P = 0.021). Overall echocardiographic systolic and diastolic parameters in patients with RV dysfunction following PCI were improved (TAPSE [37.29% vs. 81.82%], S’ velocity [37.29% vs. 68.18%], RVFAC [33.90% vs. 90.00%], and E/A [33.90% vs. 75.00%]).

Conclusions:
Patients with RV dysfunction were remarkably improved after RCA revascularization. Hence, RCA revascularization can become an appropriate treatment alternative for the recovery of patients who suffer from RV dysfunction.
How Accurately FNAC Reflects the Breast Papillary Lesions?
Authors: Gümrükçü Gülistan , Doğan Meryem , Gürsan Nilüfer , Boylu Barış , Ekren Erhan , Aker Fügen Vardar 
Published: April 2023

Context:
Diagnosis of papillary lesions of the breast by fine needle aspiration cytology (FNAC) is problematic. For this reason, it is situated in the indeterminate zone in classification systems.

Aims:
To ascertain the accuracy of cytological diagnosis of papillary lesions in distinguishing papillary lesions from non-papillary lesions and to determine whether papillomas can be reliably distinguished from malignant papillary lesions by FNAC.

Material and Methods:
A total of 346 cases with the diagnoses of breast papillary lesions were selected among 5112 breast FNAC procedures performed in our center. One hundred and thirty-nine cases with excised lesions were included in this study, and their corresponding histology was reviewed.

Results:
Papillary lesion diagnosis was confirmed by histopathology in 103 (74.1%) of 139 patients. Cytology and histopathology results were not found to be compatible in 35 (25.2%) cases. The diagnostic accuracy of distinguishing papillary breast lesions as malignant or benign was assessed statistically. According to the cytology–histology comparison, one case was evaluated as false negative (FN) and twelve cases as false positive (FP). Overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in distinguishing papillary lesions as benign or malignant were calculated as 87%, 97%, 83%, 72%, and 98%, respectively.

Conclusions:
The diagnostic accuracy of papillary breast lesions classified by FNAC might be improved by careful evaluation together with cytological, radiological, and clinical findings (triple test). Cell block may allow more accurate evaluation of the papillary lesion and can be applied to immunohistochemical examination. It may also facilitate the differentiation of benign/malignant papillary lesions.