bluuebunny/crossref_metadata_2025_split huggingface dataset:
Les polytechniciens et l’État
Authors: Delespierre Adrien , Dudouet François-Xavier , Joly Hervé 
Published: October 2022

Longtemps l’École polytechnique a eu pour vocation première de former des ingénieurs appelés à alimenter les corps techniques de l’État. La proportion de polytechniciens démissionnaires n’a, cependant, cessé d’augmenter, au cours du xx e siècle, pour devenir systématiquement majoritaire à compter du milieu des années 1980. L’article montre que cette transformation s’explique par un double phénomène : d’une part, l’État a de moins en moins recours aux polytechniciens pour pourvoir à ses postes d’encadrement supérieurs et, d’autre part, les polytechniciens eux-mêmes se détournent de plus en plus des corps de l’État au profit d’une internationalisation de plus en plus précoce.
Sport et développement territorial en Guyane. Une approche par la théorie de la base
Authors: Bastien Jérémie , Gouguet Jean-Jacques , Rougier Cyrille 
Published: October 2022

Le sport peut constituer un investissement très rentable tant d’un point de vue économique que social, et cette rentabilité est d’autant plus élevée qu’on se trouve dans des territoires défavorisés où le sport est une des rares options envisageables pour générer du développement économique et de l’insertion sociale à moindre coût. C’est le cas de la Guyane. Cette région va devoir relever plusieurs défis majeurs dans les prochaines années : une démographie galopante ; des déséquilibres territoriaux considérables ; une société multiculturelle en quête d’identité ; un mal développement économique profond. Cet article montre que le sport peut contribuer à relever de tels défis à la condition que certaines contraintes soient levées. En particulier, la politique sportive de la Guyane devrait être pensée en synergie avec les autres politiques publiques (éducation, santé, transports, social…). Il est indispensable d’intégrer le projet sportif dans un projet territorial global.
Crimes de masse, justice et réparations
Authors: Plas Pascal 
Published: October 2022

À l’issue des conflits violents inter ou intra étatiques, caractéristiques du xx e siècle et, sous de nouvelles formes – terrorisme – du premier xxi e siècle, le concept de réparations a singulièrement évolué. La justice, quelle que soit sa forme y joue un rôle de plus en plus important ; elle permet même un dépassement de la définition « classique » des réparations, celle qui portait essentiellement sur les indemnités de guerre.
Manifester, se manifester
Authors: Jobard Fabien , Taïbi Nadia 
Published: October 2022

L’entretien revient pour l’essentiel sur l’ouvrage co-écrit avec Olivier Fillieule (professeur de sociologie politique à l’Institut d’études politiques (IEP) de l’université de Lausanne) et publié aux éditions du Seuil en novembre 2020 : Politiques du désordre. La police des manifestations en France .
Le désir de réparation, sens et limites
Authors: L’Heuillet Hélène 
Published: October 2022

Réparer est un maître mot de notre époque. Tout doit désormais pouvoir être réparé, non seulement les choses mais aussi les sujets humains et leur histoire. Il faut réparer aussi bien la dégradation du corps que le trauma, l’offense que l’injustice, le paraître que l’être, le personnel et le collectif. La réparation devient un but de la justice, de la politique, de médecine et de la thérapeutique, et même des relations interpersonnelles qui engendrent leur part de heurts et de dommages. La réparation est forcément incomplète et bute contre un impossible. L’irréversibilité du temps condamne l’entreprise réparatrice. Il est impossible de revenir à l’« avant » endommagé. Mais alors pourquoi souhaitons-nous réparer ?
Résister aux sirènes du djihadisme : qu’est-ce que l’esprit républicain ?
Authors: Vallat David , Taïbi Nadia 
Published: October 2022

Converti à l’islam dans sa jeunesse : David Vallat tente de rejoindre les rangs des moudjahidines étrangers partis soutenir les musulmans de Bosnie pendant la guerre de Bosnie-Herzégovine, puis il part s’entraîner dans un camp de djihadistes en Afghanistan. À son retour, il a formé la cellule islamiste de Chasse-sur-Rhône qui a été démantelée dans le contexte des attentats de 1995. En 1998, David Vallat est condamné à six ans de prison. Au cours de ses années de détention, il rompt avec l’idéologie islamiste… Nous interrogeons ici les mécanismes de cette rupture.
Participative Adult Business Teaching
Authors: Van der Merwe André 
Published: October 2022

Dit is waaroor hierdie artikel handel: androgogie - leiding aan die volwassene om te leer. Die skrywer toon aan dat, hoewel daar 'n sterk ooreenkoms is tussen pedagogie en androgogie, juis vanweë die gemeenskaplike basis van die mens se leerproses, daar ook verskille tussen hulle is.
Management of Bronchomalacia in Infants Post-Cardiac Surgery Using Synchronized Nasal DuoPAP
Authors: Kumar Alok , Praveen M , Tiwari Nikhil , Ramamoorthy H. Ravi , Joshi Ankur , Parikh Badal 
Published: October 2022

ABSTRACT

Background:
Tracheo-bronchomalacia (TBM) is the weakness in the structural integrity of the cartilaginous ring and arch. It may occur in isolation with prematurity or secondarily in association with various congenital anomalies. Bronchomalacia is more commonly associated with congenital heart diseases. The conventional treatment options include positive pressure ventilation with or without tracheostomy, surgical correction of external compression and airway stenting.

Aim:
To use “synchronized” nasal Dual positive airway pressure (DuoPAP), a non-invasive mode of ventilation as an alternative treatment option for bronchomalacia to avoid complications associated with conventional treatment modalities.

Study Design:
Prospective observational study conducted in Army Hospital Research and Referral from Jul 2019 to Dec 2020.

Material and Methods:
We diagnosed seven cases of TBM post-cardiac surgery at our institute, incidence of 4.2%. Four infants were diagnosed with left sided bronchomalacia, 2 were diagnosed with right sided bronchomalacia and one with tracheomalacia. Those infants were managed by “synchronized” nasal DuoPAP, a first in ventilation technology by Fabian Therapy Evolution ventilator (Acutronic, Switzerland).

Results:
All seven infants showed significant improvement with synchronized nasal DuoPAP both clinically as well as radiologically. None of the infant required tracheostomy and discharged to home successfully.

Conclusion:
The synchronized nasal DuoPAP is a low cost and effective treatment option for infants with TBM. It could be attributed to synchronization of the breaths leading to better tolerance and compliance in paediatric age group.
C–Reactive Protein Kinetics after Cardiac Surgery
Authors: Santonocito Cristina , Sanfilippo Filippo , De Locker Isabelle , Chiarenza Federica , Giacomo Cucuzza , Njimi Hassane , George Shane , Astuto Marinella , Vincent Jean-Louis 
Published: October 2022

ABSTRACT

Background:
Recognition of postoperative infection after cardiac surgery is challenging. Biomarkers may be very useful to recognize infection at early stage, but the literature is controversial.

Methods:
We conducted a retrospective study at two large University Hospitals, including adult patients undergoing cardiac surgery (excluding those with preoperative infections, cirrhotic or immunocompromised). We evaluated the kinetics of C-Reactive Protein (CRP) and White Cell Count (WCC) during the first postoperative week. Primary outcomes were CRP and WCC changes according to the development of postoperative infection. In order to evaluate the influence of cardiopulmonary bypass on biomarker kinetics, we also studied CRP and WCC changes in patients without postoperative infection and undergoing on- vs off-pump coronary-artery bypass grafting.

Results:
Among 429 included, 45 patients (10.5%) had evidence of postoperative infection. Patients with postoperative infection had higher CRP and WCC values than those without infection, with between-groups difference becoming significant from postoperative day 2 for CRP (120.6 ± 3.6 vs. 134.6 ± 7.9, P < 0.01), and from postoperative day 3 for WCC (10.5 ± 0.5 vs. 9.9 ± 0.2, P = 0.02). Over the postoperative period, CRP and WCC showed significant within-group changes regardless of development of postoperative infection (P < 0.001 for both). We found no differences in CRP and WCC kinetics between patients undergoing on- vs off-pump procedure.

Conclusions:
During the first week after cardiac surgery, CRP increases one day earlier than WCC in patients developing postoperative infections, with such difference becoming significant on the second postoperative day. In not infected patients, use of cardiopulmonary bypass does not influence CRP and WCC kinetics.
The Use of Cerebral Oximetry in Cardiac Surgery
Authors: Chiong Xin Hui , Wong Zhen Zhe , Lim Siu Min , Ng Tyng Yan , Ng Ka Ting 
Published: October 2022

ABSTRACT
High prevalence of cerebral desaturation is associated with postoperative neurological complications in cardiac surgery. However, the evidence use of cerebral oximetry by correcting cerebral desaturation in the reduction of postoperative complications remains uncertain in the literature. This systematic review and meta-analysis aimed to examine the effect of cerebral oximetry on the incidence of postoperative cognitive dysfunction in cardiac surgery. Databases of MEDLINE, EMBASE, and CENTRAL were searched from their inception until April 2021. All randomized controlled trials comparing cerebral oximetry and blinded/no cerebral oximetry in adult patients undergoing cardiac surgery were included. Observational studies, case series, and case reports were excluded. A total of 14 trials (n = 2,033) were included in this review. Our pooled data demonstrated that patients with cerebral oximetry were associated with a lower incidence of postoperative cognitive dysfunction than the control group (studies = 4, n = 609, odds ratio [OR]: 0.15, 95% confidence interval [CI]: 0.04 to 0.54, P = 0.003, I
2 = 88%; certainty of evidence = very low). In terms of postoperative delirium (OR: 0.75, 95%CI: 0.50–1.14, P = 0.18, I
2 = 0%; certainty of evidence = low) and postoperative stroke (OR: 0.81 95%CI: 0.37–1.80, P = 0.61, I
2 = 0%; certainty of evidence = high), no significant differences (P > 0.05) were reported between the cerebral oximetry and control groups. In this meta-analysis, the use of cerebral oximetry monitoring in cardiac surgery demonstrated a lower incidence of postoperative cognitive dysfunction. However, this finding must be interpreted with caution due to the low level of evidence, high degree of heterogeneity, lack of standardized cognitive assessments, and cerebral desaturation interventions.
The Use of Ketamine as an Induction Agent for Anesthesia in Pulmonary Thromboendarterectomy Surgery
Authors: Salaunkey Kiran , Jenkins David , Roscoe Andrew 
Published: October 2022

ABSTRACT
Pulmonary thromboendarterectomy (PTE) surgery is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The induction of anesthesia in patients with severe pulmonary hypertension (PHT) can be challenging, with a risk of cardiovascular collapse. The administration of ketamine in patients with PHT is controversial, with some recommendations contraindicating its use. However, ketamine has been used safely in children with severe PHT. We present a retrospective case series of adult patients with severe PHT presenting for PTE surgery, using intravenous ketamine as a co-induction anesthetic agent.
Combination of Low-Dose Spinal Anesthesia and Epidural Anesthesia as Anesthetic Management in Patient with Uncorrected Double Outlet Right Ventricle (DORV) Underwent Cesarean Section
Authors: Hartono Ruddi , Ramadhani Dendy D. , Isngadi Isngadi 
Published: October 2022

ABSTRACT
Pregnant patients with uncorrected Double Outlet Right Ventricle (DORV) undergoing cesarean section are challenging for anesthesiologists. We present a case of a 24-year-old woman with a gestational age of 30–32 weeks with DORV, ventricular septal defect, pulmonary hypertension, and stage C functional class III heart failure who was successfully managed using a combination of low-dose spinal anesthesia bupivacaine 0.5% 7.5 mg with adjuvant fentanyl 50 mcg and epidural ropivacaine 0.2%, and fentanyl 50 mcg TV 10 cc given 30 minutes after the birth of her baby. Hemodynamics was stable after low-dose spinal anesthesia and until the end of the operation.
VASOplegia is Predicted by Preoperative Platelet-LEucocyte conGlomerate Indices in Cardiac Surgery (VASOPLEGICS)
Authors: Magoon Rohan , Kashav Ramesh C. , Shri Iti , Dey Souvik , Walian Ashish , Kohli Jasvinder K. 
Published: October 2022

ABSTRACT

Background:
Post-cardiotomy vasoplegia syndrome (VS) is often linked to an exaggerated inflammatory response to cardiopulmonary bypass (CPB). At the same time, the prognostic role of platelet-leucocyte indices (PLIs) and leucocyte indices (LIs), (platelet-lymphocyte ratio [PLR], systemic immune-inflammation index [SII = platelet × neutrophil/lymphocyte], aggregate index of systemic inflammation [AISI = platelet × monocyte × neutrophil/lymphocyte], and neutrophil-lymphocyte ratio [NLR], systemic inflammation response index [SIRI = monocyte × neutrophil/lymphocyte), respectively] has been recently described in diverse inflammatory settings.

Methods:
The retrospective study was conducted to evaluate the VS predictive performance of PLIs and LIs in 1,045 adult patients undergoing elective cardiac surgery at a tertiary care center. VS was defined by mean blood pressure <60 mmHg, low systemic vascular resistance (SVRI <1,500 dynes.s/cm 5/m2), a normal or high CI (>2.5 L/min/m2), and a normal or reduced central filling pressure despite high-dose vasopressors.

Results:
About 205 (19.61%) patients developed VS postoperatively. On univariate analysis, age, diabetes, dialysis-dependent renal failure, preoperative congestive heart failure (CHF), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, ejection fraction, NLR, PLR, SII, SIRI, AISI, CPB, and aortic cross clamp (ACC) duration, packed red blood cell (PRBC) transfusion, and time-weighted average blood glucose predicted VS. Subsequent to the multivariate analysis, the predictive performance of EuroSCORE II (OR: 3.236; 95% CI: 2.345–4.468; P < 0.001), CHF (OR: 1.04; 95% CI: 1.02–1.06; P = 0.011), SII (OR: 1.09; 95% CI: 1.02–1.18; P = 0.001), AISI (OR: 1.11; 95% CI: 1.05–1.17; P < 0.001), PRBC (OR: 4.747; 95% CI: 2.443–9.223; P < 0.001), ACC time (OR: 1.003; 95% CI: 1.001–1.005; P = 0.004), and CPB time (OR: 1.016; 95% CI: 1.004–1.028; P = 0.001) remained significant. VS predictive cut-offs of SII and AISI were 1,045 1045×109/mm3 and 137532×109/mm3, respectively. AISI positively correlated with the postoperative vasoactive-inotropic score (R = 0.718), lactate (R = 0.655), mechanical ventilation duration (R = 0.837), and ICU stay (R = 0.757).

Conclusions:
Preoperative elevated SII and AISI emerged as independent predictors of post-cardiotomy VS.
Serum Gamma Glutamyltransferase (GGT) in Coronary Artery Disease
Authors: Singh Kunal K. , Kapoor Aditya , Khanna Roopali , Sahu Ankit , Kapoor Vishwas , Kumar Sudeep , Garg Naveen , Tewari Satyendra , Goel Pravin 
Published: October 2022

ABSTRACT

Background:
There is a need to identify novel markers for CAD, independent of traditional CV risk factors. One of these is gamma-glutamyl transferase (GGT), a marker of increased oxidative stress. Given the high prevalence of CAD in Asian Indians, the link of GGT and CAD in them needs to be studied.

Aim:
To assess GGT in patients with angiographically documented CAD.

Methods and Results:
Two hundred patients aged 58.1 ± 9.95 years, 73% males, hypertension 56%, diabetes 40% were included. Mean GGT was 63.6 ± 44.33 (10–269 U/L). The levels of GGT progressively increased in those with single/double or triple-vessel CAD (36.5, 61.5, and 87 U/L, respectively, P < 0.001). Using objective criteria of CAD burden (SYNTAX and Gensini scores), we reaffirmed these findings. GGT in patients with SYNTAX tertiles 0–22, 23–32, and ≥ 33 was 33, 62, and 97 U/L, respectively and in Gensini tertiles 0–17.65, 17.66–56.65, ≥56.66 was 32, 52, and 88 U/L, respectively, all P < 0.001. SYNTAX score ≥ 23 was present in only 23% patients in GGT tertile 1 (<41 U/L), whereas60% and 94% in GGT tertiles 2 and 3 had SYNTAX ≥ 23. Significant positive correlation was seen between GGT and SYNTAX (r = 0.634) and Gensini score (r = 0.772).

Conclusions:
In this study, GGT had an independent correlation with angiographic severity of CAD and SYNTAX and Gensini scores. Although the existing evidence seems biologically plausible, more studies are needed to explore the potential role of this inexpensive marker for predicting disease burden in patients with CAD.
A comparison of the success rate of radial artery cannulation between the ultrasound-guided and conventional palpation techniques in elderly patients undergoing cardiothoracic surgery
Authors: Chanthawong Sarinya , Tribuddharat Sirirat , Sathitkarnmanee Thepakorn , Suwongkrua Thanaporn , Silarat Suparit , Plengpanich Pathawat 
Published: October 2022

ABSTRACT

Background:
Ultrasound-guided (USG) radial artery cannulation against the standard palpation technique increases the first attempt rate in both pediatric and adult patients. The objective of this study was to evaluate the benefits of USG versus the palpation technique in improving the first attempt rate in elderly patients.

Methods:
The patients over 65 years of age were randomized to the USG or Palpation group. The radial artery identification in the USG group was performed with the aid of the Sonimage HS 1. In the Palpation group, the radial artery was identified by manual palpation. The operators were cardiothoracic anesthesiologists. Overall success was defined as cannulation completed within 10 min.

Results:
Eighty patients (40 in each group) were recruited. The respective first attempt and overall success rate for the USG group were similar to the Palpation group (P > 0.999 and P = 0.732). The time to the first attempt and overall success were also similar (P = 0.075 and P = 0.636). The number of attempts, number of catheters used, and failure rates were similar between the groups (P = 0.935, P = 0.938, and P = 0.723). The number of successful cannulations within 10 min was similar for both the groups as categorized by the radial artery diameter (P = 0.169).

Conclusions:
The USG did not increase the first attempt or overall success rate of radial artery cannulation in the elderly patients undergoing cardiothoracic surgery. The time to first attempt and overall success were similar between both the groups. The number of attempts and number of catheters used were similar between both groups.
Randomized Control Study of Nebulized Colistin as an Adjunctive Therapy in Ventilator-Associated Pneumonia in Pediatric Postoperative Cardiac Surgical Population
Authors: Bharathi K. S. , Bhat Ananda , Pruthi Gegal , Simha Parimala P. 
Published: October 2022

ABSTRACT

Background:
Ventilator-associated pneumonia (VAP) with multidrug-resistant (MDR) gram negative organisms is a common problem in intensive care unit (ICU). Aerosolized antibiotics enhance the efficacy of systemic antibiotics when added as adjuvants.

Aim:
The primary objective of the study was to compare the clinical and bacteriological outcome of patients with VAP who were administered intravenous (IV) antibiotics alone with those patients who were treated with adjunctive nebulized colistin (NC) along with IV antibiotics. The secondary objective was to study the occurrence of any adverse events during colistin nebulization.

Settings and Design:
The study was a prospective, randomized, double-blinded controlled study conducted at a tertiary-care teaching institution.

Materials and Methods:
Ninety-eight children from surgical ICU aged less than 12 years who were diagnosed with VAP due to gram negative bacteria following cardiac surgery were chosen and divided randomly into two groups. The experimental group (NC group) was treated with systemic antibiotics along with NC, whereas the control group (NS group) was administered systemic antibiotics with nebulized normal saline (NS). Clinical and bacteriological outcomes were noted. Statistical analysis was done using SPSS Version 20.0 software. The patient characteristics were compared using independent Student's t test and Chi-square test.

Results:
There was a statistically significant reduction in the duration of mechanical ventilation, postoperative ICU and hospital stay (P < 0.05) in the NC group compared with the NS group.

Conclusion:
Aerosolized colistin may be considered as an adjunct to systemic IV antibiotics in pediatric patients with VAP due to gram negative bacteria susceptible to colistin.
Medical students' knowledge and attitudes in relation to COVID-19 pandemic in Saudi Arabia
Authors: Alsheikh Sultan , Alorainy Walid , Alkahthlan Husam , Alamri Khalid , Neel Lina , Alrumaihi Nouf , Alshahrani Fatma , Soliman Mona 
Published: October 2022

Background:
Medical students have an important role to provide training to other medical students and health workers, and to volunteer when there is a shortage in health care personnel. The aim of the study was to evaluate the knowledge of medical students in six medical colleges in Riyadh, Saudi Arabia, about the coronavirus-19 (COVID-19) pandemic.

Materials and Methods:
An online survey was distributed to undergraduate medical students from August to October 2021. A total of 261 medical students participated in the study. The survey composed of 26 questions that evaluated students' knowledge about the COVID-19 pandemic in terms of symptoms, modes of transmission, diagnosis, management, and prevention.

Results:
Two hundred and sixty-one medical students participated in the study with an overall response rate of 31.37%. Around half of the respondents (54%) being from 1st to 4rd medical years 81 (31.03%) and 60 (22.99%), respectively. The students' knowledge regarding COVID-19 was investigated in different domains. The mean knowledge score of the protection and prevention of the disease was the highest with a (mean = 79.85%) followed by the knowledge of the ways of the disease transmission (mean 71.31%). 140 (53.64%) of the participants knew how to properly diagnose COVID-19, while (48.35%) were able to identify the different possible symptoms that can be seen in COVID-19-positive individuals (47.32%) knew the different lines of treatment according to the case severity.

Conclusions:
The results of the present study can be utilized to develop undergraduate medical curricula with the sufficient amount of knowledge about the COVID-19 pandemic.