bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soins primaires et COVID-19 en France : apports d’un réseau de recherche associant praticiens et chercheurs
Authors: Gautier Sylvain , Ray Marine , Rousseau Anne , Seixas Clarissa , Baumann Sophie , Gaucher Laurent , Le Breton Julien , Bouchez Tiphanie , Saint-Lary Olivier , Ramond-Roquin Aline , Bourgueil Yann 
Published: March 2022

Introduction : L’épidémie de COVID a présenté un défi majeur pour les acteurs et les organisations des soins primaires en France. L’objectif de ce travail réalisé par le réseau de recherche ACCORD, associant praticiens et chercheurs, est de décrire et d’analyser en interprofessionnalité les adaptations et organisations précoces des acteurs des soins primaires durant le premier confinement. Méthodes : Ce travail confronte du matériel quantitatif et qualitatif. Les données quantitatives résultent d’une exploitation croisée des six enquêtes en ligne réalisées par le réseau ACCORD, entre mars et mai 2020, auprès des médecins généralistes, sages-femmes et structures pluriprofessionnelles en France. Ces données ont été enrichies d’échanges collectifs pluriprofessionnels et pluridisciplinaires, conduits en groupes focaux lors d’un séminaire dématérialisé. Résultats : Durant la période considérée, une baisse importante de l’activité en soins primaires a été constatée. Les acteurs ont été nombreux à adapter leurs organisations pour concilier risque épidémique et maintien de l’accès et de la continuité des soins. Les sources d’information utilisées par les professionnels se sont avérées très variables. La crise a révélé des réseaux d’échange et de collaboration importants au niveau des territoires. Conclusion : Face à la crise sanitaire, les acteurs des soins primaires ont adapté leurs organisations et leurs pratiques de façon précoce et diversifiée, soulignant l’importance des organisations préexistantes et des collaborations à l’échelon territorial.
Mise en œuvre de la capacité de réponse à la COVID-19 dans un hôpital au Brésil
Authors: De Araujo Oliveira Sydia Rosana , Soares Sampaio Aletheia , Vasconcelos Ana Lucia , Cazarin Gisele , Zacarias Amanda , Furtado Betise , Andrade Andréa Carla , Paz de Sousa Karla Myrelle , Ridde Valéry 
Published: March 2022

Après la déclaration d’urgence de santé publique d’importance internationale, les hôpitaux sont devenus une référence dans la réponse à la pandémie. Il est donc important d’évaluer la capacité à répondre à la pandémie de COVID-19 parmi les professionnels de la santé d’un hôpital de référence à Pernambuco, dans le nord-est du Brésil. Cette étude traite d’un recherche évaluative qualitative, de type étude de cas. Trois méthodes ont été utilisées pour identifier les événements critiques : entretien avec 18 professionnels de la santé qui avaient travaillé en « première ligne » de soins pour les personnes atteintes de la COVID-19, observation directe dans les secteurs de cet hôpital et analyse documentaire. Les entretiens ont été transcrits et analysés à l’aide du logiciel MaxQDA Analytics pro 2020 ® , en utilisant la Théorie Acteur-Réseau et pour interpréter les événements critiques, les catégories de résilience : absorption, adaptation et transformation. Il a été constaté que la capacité de réponse des professionnels était influencée par cinq événements critiques : l’arrivée des cas, de nouvelles façons de mettre le patient en relation avec son réseau de soutien social, l’impact social et personnel sur la vie quotidienne des professionnels, le manque d’équipement essentiel et tests de confirmation, enfin la pénurie et la maladie des professionnels. L’étude montre que dans les expériences quotidiennes, la capacité de réponse des professionnels a conduit à un processus d’adaptation prioritaire qui peut accélérer des changements importants dans le système de santé.
Gérer la crise de la première vague de COVID-19 : retour d’expérience d’une agence régionale de santé
Authors: Ramel Viviane , Autès-Tréand Erwan 
Published: March 2022

La crise de la COVID-19 a bouleversé l’organisation sanitaire en France, particulièrement dans son administration. Or, la gestion de crise par les agences régionales de santé (ARS) est insuffisamment étudiée. Basée sur un exercice de retour d’expérience (Retex) interne via une méthode qualitative de croisement de sources documentaires et d’entretiens semi-dirigés, cette étude rend compte de la gestion régionale de la crise COVID-19 depuis une organisation administrative : ses dynamiques temporelle et organisationnelle, le rôle exercé par cette autorité publique et les stratégies mobilisées, en interaction avec les acteurs à différentes échelles. Entre janvier et juin 2020, la gestion de la COVID-19 a été marquée par la perturbation subite des repères, de l’agenda habituel des priorités et par une installation inhabituelle dans la durée. En situation d’adaptation permanente, l’ARS étudiée (Nouvelle-Aquitaine) a mis en place une organisation ad hoc de gestion de crise. Elle s’est positionnée, tel un maillon majeur du dispositif national de gestion de crise, en interaction avec divers acteurs, avec un éventail d’instruments d’action publique. Cette étude met en discussion les données recueillies sur une gestion de crise sanitaire par une ARS, démontrant l’intérêt de Retex de crise, à visées interne pour l’administration et heuristiques, et questionne savoirs et maîtrises habituels.
Rôle d’un centre ressources en prévention, promotion et éducation pour la santé dans le cadre d’une crise sanitaire
Authors: Rondon Julia , Benkhoucha Cynthia , Cornec Nathalie , Fleur Lisbeth , Lhours Gaëlle , Marchais Stéphanie , Saugeron Benoit , Sonnier Pierre , Sylvain Marion 
Published: March 2022

L’irruption de la pandémie liée à la COVID-19 s’est traduite par des retombées majeures sur les systèmes de soins. En parallèle, la crise sanitaire a occasionné une surabondance d’information. L’accès à une information vérifiée et actualisée revêt un caractère crucial pour la compréhension de l’épidémie et des mesures de prévention par les professionnels et la population. Dans ce contexte, le Comité régional d’éducation pour la santé (CRES) Provence-Alpes-Côte d’Azur, centre de ressources en promotion et éducation pour la santé, a pleinement joué son rôle d’acteur de santé publique en s’engageant dans une démarche de transfert de connaissances avec la création de trois outils : une lettre de veille, une série d’enregistrements audio et une formation. Il a aussi transformé ses activités habituelles par le recours au numérique. Cet article décrit la nécessaire adaptation à une situation inédite, tant par la création rapide d’activités nouvelles que l’adaptation d’activités traditionnelles à un contexte complexe. Il montre, également, en quoi ces activités sont pertinentes et ont répondu à une demande des professionnels. Les résultats des évaluations témoignent de la pertinence des outils mis à la disposition des professionnels : leur besoin d’accéder à une information claire et validée scientifiquement a été assouvi. Le CRES s’est positionné comme un acteur essentiel, depuis le début de la crise, en facilitant l’accès à la connaissance. De nouveaux besoins liés à l’épidémie sont aujourd’hui identifiés et constituent des perspectives concrètes pour le CRES.
Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation
Authors: Mathew Gincy , Manjuladevi M. , Joachim Nayanthara , Kothari Apoorwa N. 
Published: March 2022

Background and Aims:
Preoxygenation is supplementation of 100% oxygen prior to induction of general anaesthesia to increase the body’s oxygen stores. Efficacy of preoxygenation can be increased by optimising fresh gas flow (FGF) rate and pattern of breathing.

Methods:
Based on pattern of breathing—Tidal Volume Breathing (TVB) or Deep Breathing (DB) and FGF-10 L/min or 15 L/min—100 subjects of the American Society of Anesthesiologists physical status I/II posted for elective surgery were recruited and randomised into four groups: T10 - TVB with 10 L/min; D10 - DB with 10 L/min; T15 - TVB with 15 L/min; and D15 - DB with 15 L/min. A tight-fitting anaesthesia mask along with continuous positive airway pressure of 5 cm of H2O with 20° head-up was used for preoxygenation. The total time taken and the total number of breaths required to achieve end tidal oxygen concentration (EtO2) of 90% were noted. Exhaled tidal volume (Vte), end tidal carbon dioxide, fraction of inspired oxygen, and EtO2 were recorded at each breath. Analysis of variance (ANOVA) was used for inferential statistics and Tukey’s honestly significant difference (HSD) test was used to calculate mean difference in total time and number of breaths amongst the groups.

Results:
Total time taken was significantly low (P < 0.001) in DB compared to TVB (D10: 70.2 ± 19.91, D15: 68.4 ± 20.27 vs T10: 112.28 ± 47.96, T15: 113.6 ± 48.57 seconds). Number of breaths was significantly high (P < 0.001) in TVB with 22.84 ± 8.73, 23.76 ± 11.64, 10.56 ± 3.69, and 8.32 ± 1.8 in T10, T15, D10 and D15, respectively. Vte was significantly low in TVB (P < 0.001).

Conclusion:
Rapid preoxygenation can be achieved by DB at high FGF of a minimum of 10 L/min.
Anesthesia-related perioperative patient safety services in Indian public and private hospitals with or without teaching programs
Authors: Karim Habib Reazaul , Kumar Mayank , Sinha Mamta 
Published: March 2022

Introduction:
The World Health Organization is emphasizing global patient safety for more than a decade. However, very less is known about the patient safety environment in the perioperative settings in developing countries. The present secondary analysis aimed to compare the anesthesia-related patient safety measures and services in Indian public versus private and teaching versus nonteaching hospitals.

Materials and Methods:
The present study is a post hoc, subgroup analysis of a previously conducted cross-sectional, questionnaire-based, online survey during February–May 2019. Responses from the postgraduate trainee and consultant/qualified practitioners were included. Data related to the practice pattern and availability of standard, advanced monitoring, and equipment were then categorized based on the hospital funding source and availability of teaching program; compared using the Fisher's exact test, and P < 0.05 was considered statistically significant.

Results:
Six hundred responses were included. The majority (60.7%) were from the private sector; 57.3% worked in teaching hospitals. Overall, anesthesia-related patient safety and equipment were deficient across the entire range of hospitals. However, there was no difference between matched public and private hospitals (P > 0.05 for most), except the anonymous incident reporting, which was significantly higher in the corporate teaching hospitals (P < 0.0001). Teaching hospitals had significantly better safety measures (P < 0.0001 for most parameters) than nonteaching hospitals.

Conclusion:
Public sector hospitals in India are not having significantly different anesthesia services related to patient safety monitoring and equipment than private sector hospitals. However, the safety measures are relatively low in many aspects across all sectors, which need attention.

The following core competencies are addressed in this article:
Patient care, Systems-based practice.
Impacting pediatric cardiologist burnout
Authors: Parsons Chelsea , Dasgupta Soham , Mohl Larry , Sachdeva Ritu , Border William 
Published: March 2022

Introduction:
Burnout among physicians may impact productivity and result in suboptimal patient care. Studies looking at burnout in a specific pediatric subspecialty are extremely limited. In a previous study, the authors evaluated the work–life balance and burnout among pediatric cardiology attending at our institution. This demonstrated early signs of reduced work engagement and possible burnout in the near future. To address this, the authors implemented a number of targeted interventions and conducted a follow-up survey to assess the effects of such changes. The objective of this study was to evaluate the current status of work–life balance and burnout among pediatric cardiologists at the author's institution compared to the general population and to the prior survey.

Materials and Methods:
Pediatric cardiology attending physicians were surveyed at the author's institution to assess their perception of burnout and work–life balance using the Maslach burnout inventory and the areas of work–life survey.

Results:
Forty-seven of the 52 pediatric cardiologists responded to the survey. They were divided into groups by their respective subspecialty: interventional/electrophysiology (n = 2), cardiac intensive care unit/inpatient (n = 9), noninvasive imaging (n = 6), outpatient (n = 22), and other (n = 8). When compared to the previous survey, the Maslach burnout inventory scores were significantly lower in the area of emotional exhaustion. However, most scores in the areas of work–life survey were lower than the prior survey.

Conclusion:
This follow-up study focusing on pediatric cardiology attending physicians demonstrated worsening burnout and signs of reduced work engagement compared to the previous survey 4 years ago. Interventions did not include bolstering our physician support systems and developing resiliency training for our physicians, which is an area the authors are going to focus on going forward.

The following core competencies are addressed in this article:
Medical knowledge, Practice-based learning, Systems-based practice.
Efficacy of supplemental Occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia
Authors: Jethani Jitendra , Kamat Anisha , Shah Kalpit , Thakkar Hansa , Sharma Sumedha 
Published: March 2022

Purpose:
To study the efficacy of supplemental occlu-pad therapy with partial occlusion in children with refractive anisometropic amblyopia.

Methods:
Thirty-one children who did not improve after partial occlusion of 6 h for 6 months were supplemented with the use of occlu-pad for 1 h per day and three such sessions in a week.

Results:
The mean age was 6.8+/-1.4 years (range 5–9 years). A significant improvement of 3.2+/-1.3 lines in visual acuity was noticed at the end of 3 months of starting this supplemental therapy in children. Out of 31 children, 26 children improved at least 2 lines or more at the end of 3 months. All children (n = 9) having anisohyperopic amblyopia improved at the end of 3 months

Conclusion:
Occlu-pad is useful in supplementing occlusion therapy in cases of refractive amblyopia and is more effective in anisohyperopic amblyopia.
Eye screening can be used to perform anemia screening and treatment in adolescent girls using ToucHb
Authors: Gogate Bageshri , Phadke Supriya , Gogate Parikshit M 
Published: March 2022

Purpose:
Anemia is common in adolescent girls. Apprehension while drawing blood to estimate hemoglobin concentration is a barrier for confirming anemia. ToucHb, a noninvasive instrument that estimates the hemoglobin by taking an image of the exposed conjunctiva, was used during eye screening to help diagnose and treat anemia.

Methods:
ToucHb was used during secondary school eye screening and during house-to-house eye screening to estimate the hemoglobin concentration in the body. Each of the girls was distributed a packet of 60 tablets of ferrous and folate and a tablet of albendazole. They were followed up after 3 months.

Results:
Exactly 1511 municipal school girls aged 10-19 years (mean 12.9; standard deviation [SD] 1.64) were examined. Of them, 949 (62.8%) had hemoglobin of ≤9 mg%. Among those girls with hemoglobin ≤9 mg%, the mean (SD) during the initial and follow-up examinations was 6.1 (1.4) and 9.6 (1.03), respectively, by paired t-test (P < 0.001). Another 588 girls (average age 14.4 years, SD 1.2) had their eyes examined and hemoglobin estimated during a house-to-house eye screening. Of them, 116 (19.7%) had hemoglobin level of ≤9 mg%. Their pre-Hb was 7.9 (SD 1.05) on average and after 3 months, it was 9.6 (SD 1.02). Among those girls with hemoglobin ≤9 mg%, the mean (SD) during the initial and follow-up examinations was 6.2 (1.4) and 7.9 (1.1), respectively, by paired t-test (P < 0.001)

Conclusion:
ToucHb was useful to diagnose anemia while doing eye screening and to ensure its treatment. Anemia diagnosis and management would enhance the health of adolescent girls.
Incidence and risk factors for post-penetrating keratoplasty glaucoma
Authors: Shree Neha , Gandhi Monica , Dave Abhishek , Mathur Umang 
Published: March 2022

Purpose:
To carry out a prospective study to analyze the incidence and various preoperative, intraoperative, and postoperative risk factors for the development of PPKG.

Methods:
A total of 207 patients were analyzed prospectively, who were operated for penetrating keratoplasty (PK) in a tertiary eye care hospital between the time period of August 1, 2017 and February 28, 2018 and were followed up till the sixth month. Each patient was analyzed at every visit to determine the factors responsible for post-keratoplasty glaucoma.

Results:
Out of 207 eyes, post-PK glaucoma developed in 84 cases, which yielded an incidence of 41%. Incidence of PPKG (Post PK glaucoma) in various conditions was as follows: in repeat PK 62%, in perforated corneal ulcer 33%, in nonperforated corneal ulcer 29%, in corneal scar including adherent leukoma 37.2%, and in pseudophakic bullous keratopathy and aphakic bullous keratopathy, 14% and 80%, respectively. In age- and sex-adjusted multivariate analysis, the significant risk factors were age (P-value- 0.006), presence of PAS (P-value 0.001), and fellow eye glaucoma (P-value 0.04). Aphakia and combined surgery were not found to be significant

Conclusion:
Our study recommends a meticulous examination of the fellow eye to assess the presence of glaucoma as it can increase the suspicion of glaucoma in the eye to be operated. The presence of PAS and age are important risk factors for developing PPKG. The risk of developing PPKG increases exponentially as the number of risk factors increases, but the presence of more than three risk factors does not add to the development of PPKG.
Safety and efficacy of suprachoroidal triamcinolone acetonide for the management of serous choroidal detachment prior to rhegmatogenous retinal detachment surgery: A Pilot study
Authors: Kohli Gaurav Mohan , Shenoy Pratik , Halim Danish , Nigam Saurabh , Shetty Sachin , Talwar Dinesh , Sen Alok 
Published: March 2022

Purpose:
To study the safety and efficacy of pre-operative suprachoroidal triamcinolone acetonide (SCTA) for achieving reduction/resolution of serous choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD).

Methods:
This was a prospective, noncomparative, interventional pilot study. All consecutive patients presenting with RD and coexisting CD underwent transconjunctival injection of SCTA before proceeding with vitrectomy/scleral buckle surgery. Sequential ultrasound B scans were performed for assessing the change in height of the CD.

Results:
The mean age of the cohort was 53.8 ± 10.8 years (range: 39–72 years). The CD was present in a median of 3 quadrants; the cumulative mean CD height was 5.59 mm (range: 2.02–9.42 mm). Following SCTA, a successful response (>50% reduction) was seen in five eyes by day 3 and in two eyes by day 5. Three eyes failed to respond to SCTA and required surgical drainage before proceeding with vitrectomy. No intraprocedural injection-related complications were noted. A transient rise in the intraocular pressure (30 mmHg) was seen in one eye following vitrectomy and was managed successfully with topical antiglaucoma medications

Conclusion:
Suprachoroidal administration of triamcinolone appears to be a safe and effective technique to achieve CD resolution in eyes with RRD.
Combined treatment modality including topical 20% fluorescein dye in the management of phthiriasis palpebrarum – A case series
Authors: Mishra Chitaranjan , Kim Usha , Dheera Mulasthanam S , Krishnakumar Krishin 
Published: March 2022

Purpose:
To study the clinical presentations and outcomes of phthiriasis palpebrarum (PP) managed with combined treatment modality comprising of 20% fluorescein dye, mechanical removal of the ectoparasites, and topical application of antibiotic eye ointment with paraffin base.

Methods:
This is a prospective interventional noncomparative hospital-based series of 13 patients of PP. All the patients underwent local application of 20% fluorescein dye over the eyelashes and eyebrows of both the eyes followed by the mechanical removal of all the ectoparasites and trimming of the eyelashes from the base followed by application of ophthalmic ointment.

Results:
Mean age of the patients was 28 ± 22 years (range 3–60 Years). Out of the total of 13 patients, 11 patients (85%) were having bilateral involvement. The mean duration of symptoms in 11 patients (rest 2 were accidental findings) was 4 ± 3 weeks (range 1–10 weeks). Three patients (23%) had a history of sexual contact with possible parasite-infested partners. Four patients (31%) had additional parasites in the pubic area or torso. All the patients were completely parasite free at the end of 1 month. There was no infestation of the treating medical personnel from the patient. The average follow-up was 8 ± 5 months (range 3–21 months)

Conclusion:
Itching and irritation of the eyes were the most common presentations of PP. Combined treatment modality comprising of 20% fluorescein dye, mechanical removal of ectoparasites, and topical application of antibiotic eye ointment with paraffin base is effective in the management of PP.
Diagnostic accuracy and clinical utility of bed side tests versus laboratory tests in the diagnosis of ocular myasthenia
Authors: Sivakumar Priya , Tagare Shivraj , Kumar Mahesh 
Published: March 2022

Purpose:
To assess the diagnostic accuracy of forced eyelid closure test (FECT), ice pack test (IPT), repetitive nerve stimulation test (RNS), and acetylcholine receptor (AchR) antibody test in patients with suspected ocular myasthenia. To assess the clinical utility of AchR antibody test in predicting disease progression.

Methods:
Retrospective cohort study of patients diagnosed with ocular myasthenia at a South-Indian neuro-ophthalmology tertiary eye clinic. Baseline characteristics; ocular myasthenia symptoms; results of FECT, IPT, RNS, and AchR antibody test; and progression time to generalized myasthenia (GM) over 36 months from the time of diagnosis were recorded and analyzed using receiver operator curve analysis, multiple logistic regression, and Kaplan–Meier survival analysis.

Results:
FECT had a sensitivity of 96.7% (95% CI: 88.5–99.6) and a specificity of 75% (95% CI: 34.9–96.8). Combination of FECT and IPT, using the positivity of at least one test, increased the sensitivity to 98.3% (95% CI: 91–100), reducing the specificity to 50% (95% CI: 15.7–84.3), whereas using the positivity of both tests, we obtained a sensitivity of 71.7% (95% CI: 58.6–82.5) and a specificity of 100% (95% CI: 63.1–100). In the subset of patients with double negative RNS and AchR antibodies, the positive predictive value of combined FECT and IPT (double positive) was 100%. Patients who developed GM were more likely to have a positive AchR antibody test result (P = 0.001)

Conclusion:
Combined FECT and IPT (double positive) has high diagnostic accuracy even among patients with normal RNS and negative AchR antibodies. Despite low sensitivity, AchR-antibody test has a significant predictive value in disease progression.