bluuebunny/crossref_metadata_2025_split huggingface dataset:
De la ville touristique vers la ville cité-loisirs : Évreux, une ville pionnière
Authors: Houllier-Guibert Charles-Edouard , Sohier Alice 
Published: July 2022

Le tourisme de proximité s’est développé ces dernières années, notamment en tant que stratégie de repositionnement marketing à Évreux, ce, bien avant la crise sanitaire de la Covid-19. Cette ville rurale normande, pionnière en la matière, a repensé son office de tourisme en ne ciblant plus de manière prioritaire les touristes. La transformation de l’office de tourisme d’Évreux en « Comptoir des Loisirs », à destination des habitants, est étudiée dans cet article. Les éléments théoriques mobilisés (développement et innovations dans les offices de tourisme ; théorie du marketing territorial), ainsi que l’étude qualitative menée (entretiens d’experts) rendent compte des prises de décision des acteurs locaux et des étapes du repositionnement de l’office de tourisme d’Évreux.
Acute-Onset Visual Snow Syndrome After LASIK
Authors: Keppel Kevin , Randleman J. Bradley 
Published: July 2022

PURPOSE:
To describe a case of acute-onset visual snow syndrome occurring after bilateral myopic laser in situ keratomileusis (LASIK).

METHODS:
Case report.

RESULTS:
A 38-year-old man presented with a 7-month history of constant positive visual disturbances involving his entire binocular visual field after bilateral LASIK. The patient described his symptoms as a “moving texture” present at all times in all lighting conditions that he noticed beginning the evening of the same day he had LASIK. The phenomenon was worse in low lighting and was in fact present in complete darkness, even when his eyes were closed. The patient also endorsed large halos, nyctalopia, and enhanced entoptic phenomena in both eyes, all of which had subjectively worsened after LASIK. Topography-guided customized ablation treatment enhancement had been performed to reduce the patient's symptoms without success. On presentation, uncorrected distance visual acuity was 20/16 in both eyes. Results of slit-lamp examination and corneal imaging were unremarkable in both eyes. The patient was eventually fit with scleral contact lenses, which reduced his halos at night but did not improve his visual snow symptoms.

CONCLUSIONS:
Although visual snow and visual snow syndrome have been known to present suddenly in a subset of cases, this is the first published case report of acute-onset visual snow syndrome immediately after refractive surgery. Visual snow syndrome has reportedly been preceded by specific events, including migraine attacks, medications, and trauma. Because the symptoms are non-ocular in origin, further refractive surgery enhancement is not indicated.

[
Journal of Refractive Surgery Case Reports.
2022;2(3):e51–e54.]
Orígenes y relaciones familiares de Raimundo de Borgoña y Hugo de Champaña, promotor del Temple
Authors: Torres Sevilla-Quiñones de León Margarita C. 
Published: July 2022

Si hay una orden militar capaz de generar interés pasados siete siglos de su disolución por orden papal, ésta es, sin duda, la del Temple. Sin embargo, sobre sus fundadores todavía existen aspectos que aún deben abordarse. Por ello, con este trabajo se busca trazar una semblanza genealógica de quien es el soporte verdadero de la orden desde sus comienzos, el conde Hugo de Champaña, y sus lazos de parentesco con la familia real de León a través de sus cercanos vínculos de sangre con el conde de Galicia Raimundo de Borgoña, y también con el conde Enrique de Portugal, lo que explicaría la temprana implantación de la orden en el noroeste de Hispania y el apoyo decidido de la corona.

[gl]
Se hai unha orde militar capaz de xerar interese pasados sete séculos da súa disolución por orde papal, esta é, sen dúbida, a do Temple. Con todo, sobre os seus fundadores aínda existen aspectos que deben abordarse. Por iso, con este traballo búscase trazar unha descrición xenealóxica de quen é o soporte verdadeiro da orde desde os seus comezos, o conde Hugo de Champaña, e os seus lazos de parentesco coa familia real de León a través dos seus próximos vínculos de sangue co conde de Galicia Raimundo de Borgoña, e tamén co conde Henrique de Portugal, o que explicaría a temperá implantación da orde no noroeste de Hispania e o apoio decidido da coroa.
La socialización de los notarios compostelanos en los siglos XIV-XVI a través de la cofradía de cambiadores de Santiago
Authors: Ares Legaspi Adrián 
Published: July 2022

El objetivo de esta investigación es el análisis de las redes y prácticas sociales de los notarios compostelanos en los siglos XIV-XVI a través de su pertenencia a la cofradía de cambiadores de Santiago y del ejercicio de su profesión. Mediante una aproximación desde la diplomática a los Libros dos Cambeadores, a los protocolos notariales, a la legislación y a otros casos peninsulares, comprobaremos que la cofradía de cambiadores se convirtió en punto de encuentro de los distintos tipos de notarios, donde crear y asentar los vínculos familiares y profesionales con el resto de la oligarquía urbana. Una realidad marcada por la endogamia del notariado, su política matrimonial, la patrimonialización de los oficios, la diversificación de sus actividades económicas y, finalmente, la movilidad social de estos profesionales. En suma, los notarios compostelanos se convirtieron en intermediarios imprescindibles dentro de la comunidad en el plano administrativo, social, económico y cultural, gracias a su posición socioeconómica elevada y a su trabajo en el ámbito de la cultura escrita.

[gl] Nesta investigación analízanse as redes e prácticas sociais dos notarios composteláns nos séculos XIV-XVI a través da súa pertenza á confraría de cambiadores de Santiago e do exercicio da súa profesión. Mediante un achegamento dende a diplomática aos Libros dos Cambeadores, aos protocolos notariais, á lexislación e a outras casuísticas peninsulares, comprobaremos que a confraría de cambiadores se converteu nun punto de encontro dos distintos tipos de notarios, onde crear e asentar os vínculos familiares e profesionais co resto da oligarquía urbana. Unha realidade marcada pola endogamia do notariado, a súa política matrimonial, a patrimonialización dos oficios, a diversificación das súas actividades económicas e, finalmente, a mobilidade social destes profesionais. En suma, os notarios composteláns convertéronse en intermediarios imprescindibles dentro da comunidade no plano administrativo, social, económico e cultural, grazas á súa posición socioeconómica elevada e ao seu traballo no eido da cultura escrita.
Nutrition knowledge of caregivers working in health and education centers for children with special healthcare needs
Authors: Cheikh Ismail Leila , Abu Qiyas Salma , Mohamad Maysm N. , Osaili Tareq Mohammed Ibrahim , Obaid Reyad Rashid Shaker , Saleh Sheima T. , Kassem Hanin , Al Dhaheri Ayesha S. , Al Daour Rameez , Al Rajaby Radhiya , Hasan Hayder Abbas , Hashim Mona Sharef 
Published: July 2022

Background:
Children with special healthcare needs are recognized as a high-risk group for malnutrition. Caregivers have a strong influence on the dietary habits of their students, therefore, adequate nutrition knowledge among caregivers and educators has a great potential in improving the health of children. The purpose of this study is to assess the level of nutrition knowledge and demographic influences of knowledge among caregivers working in health and education centers.

Methods:
a cross-sectional, web-based survey was conducted among educators and caregivers working at Sharjah City for Humanitarian Services to assess their nutritional knowledge using a modified validated general nutrition knowledge questionnaire.

Results:
233 participants completed the survey. The basic recommendations about reducing the intake of sugary, salty, and fatty foods and consuming more water and vegetables were best acknowledged. However, an inadequate level of knowledge was identified regarding specified number portion. For instance, more than half of the participants were aware of the need to consume more vegetables and fruits while only 10% knew the minimum number of servings to consume in a day. The overall nutrition knowledge score was adequate at 46.30 (55.1%). Caregivers with nutrition qualifications and who have four children had a significantly higher knowledge score. Older age was associated with better diet-disease relationship knowledge.

Conclusions:
The level of nutrition knowledge among caregivers and health workers was insufficient. However, periodic nutrition education reinforcement among health caregivers should be considered.
The Use of Blood and Crystalloid Cardioplegia in Adult Open-Heart Surgery on Postsurgical Outcomes
Authors: Putro Bambang Novianto , Hidayat Jefferson K. , Soenarto Ratna Farida 
Published: July 2022

Abstract

Background:
Myocardial ischemia can occur due to hypotension, shock, coronary heart disease, and aortic cross-clamping during open-heart surgery using a cardiopulmonary bypass machine. As the cardioprotective method, cardioplegia is classified into blood or crystalloid base. This systematic review is aimed to describe the effectiveness of blood and crystalloid cardioplegic solutions in adult open-heart surgery procedures by focusing on their effects on cardiac enzymes.

Materials and Methods:
This study investigated the effect of blood and crystalloid cardioplegia on troponin (cTn) and creatinine kinase myocardial bound. The literature search was carried out on several Cochrane, PubMed, PMC, and Google Scholar databases from January 2014 to August 2020 using the MeSH keywords and Boolean operator.

Results:
We obtained 346 articles and identified six prospective randomized studies from four countries. The majority discussed the comparison of blood cardioplegia and crystalloids in coronary revascularization cardiac surgery (coronary artery bypass grafting). Overall, the articles used have a low risk of bias despite their high level of homogenicity.

Conclusions:
The current literatures on cardioplegia in adults do not provide adequate advanced-phase trials. Both types of cardioplegia provide a reasonable protection for myocardium. However, several studies reveal that crystalloid cardioplegia increases cardiac enzymes more significantly than blood cardioplegia. This research has been registered with PROSPERO with the number CRD42022312548.
Anesthcalc™ is Associated with Superior Accuracy and Faster Accomplishment in Simulation-based Anesthesia Drugs Dosage Calculation
Authors: Lestari Mayang Indah , Zulkifli  , Zainal Rizal , Mulia Muhammad Imam 
Published: July 2022

Abstract

Background:
Medication error is one of the barriers to achieving sustainable patient safety. We aim to determine the efficacy and reliability of a smartphone dosage calculator application (AnesthCalc™) when compared with the manual calculation of various anesthetic drugs to prevent medication error.

Materials and Methods:
This is a pre-test–post-test intervention study. There are 52 participants who included residents in anesthesiology, which is divided into two groups. Each group performed two simulation cases in which they had to calculate drugs dosage in anesthesia settings. One set of cases was performed with the app and the other set was performed manually. The order of drugs and simulation patients was randomized. The accuracy and the deviation of administered drug doses were recorded. Accuracy of dosage was categorized as either accurate (80–100% of target dose) or inaccurate (less than 80%), whereas the deviation of dosage was categorized as either deviant (<50% or >200% of target dose) or safe (between the range).

Results:
There is a significant increase in the accuracy of calculation between the manual group and that using the app group (from 46% to 92%, a mean increase of 18.29%, P < 0.005). There is a significant decrease in the duration of calculation between without using the app group and with using the app group (from 32.92 to 18.79 s, a mean decrease of 30.55 s, P = 0.001).

Conclusion:
AnesthCalc™ is a valid and reliable instrument as it increases users’ accuracy and shortens calculating time. AnesthCalc™ may be the potential to reduce calculation errors and may increase patients’ safety.
Factors Influencing Substance use Among Transgender Individuals in India
Authors: Subramanian Karthick , Kavya Muthuraman 
Published: July 2022

Background:
Due to various psychological and psychosocial factors, transgender (TG) individuals suffer from psychiatric disorders including substance use disorders (SUDs). Although factors influencing mental illness and stigma in TG persons have been identified, the literature is scarce regarding the factors influencing substance abuse among the TG population. The present review identifies the burden and risk factors for substance use among TG individuals in India.

Methods:
An electronic search of databases such as MEDLINE, ProQuest, and Google Scholar yielded 11 relevant Indian research articles. The factors moderating substance abuse among TG persons were reviewed.

Results:
Studies reveal that alcohol and tobacco use disorders are the most common SUDs among TG persons in India, apart from illicit drug use. Depressive symptoms, anxiety, unemployment, and discrimination in various spheres of life were associated with elevated substance use among TG individuals. Not being married, higher income, often out with family and friends, having more sexual partners, and interpersonal violence with partner predicted harmful and illicit patterns of substance use.

Conclusion:
Various demographics, sexual relationship characteristics, and psychosocial factors tend to influence substance abuse patterns. Future studies are needed to explore the influence of various physical, psychosexual, psychological, and psychosocial factors on the substance use patterns among TG persons in India.
Superior laryngeal nerve block with in-line lignocaine nebulization for awake extubation response
Authors: Jadhav Kashinath K. , Karnalkar Asmita P. , Patil Shailendra B. 
Published: July 2022

Background and Aims:
Tracheal extubation is associated with various undesirable hemodynamic and airway responses. Various drugs are used effectively to curb these responses. But these drugs have limitations and produce side effects. Hence, the study was planned to assess the effects of superior laryngeal nerve block with inline lignocaine nebulization on awake extubation responses to suggest an alternative. The aim of this study was to assess the effect of bilateral superior laryngeal nerve block with inline lignocaine nebulization on awake extubation responses.

Material and Methods:
A study was conducted in 35 patients aged 18-60 years, posted for surgery less than 3 h under general anesthesia. The hemodynamic responses like heart rate, arterial blood pressure, and mean arterial pressure were recorded preoperatively and at 1, 5, and 10 min postextubation. Undesirable respiratory responses like bucking, severity of sore throat, and cough response were also assessed. Repeated measures analysis of variance followed by the Tukey HSD test was used to find the significance of hemodynamic parameters. Qualitative data were expressed as percentages.

Results:
Decrease in Systolic Blood Pressure, Diastolic Blood Pressure and Mean Arterial Pressure was statistically significant at 5 mins (T2) and 10 mins (T3) postextubation as compared to baseline (T0). No cough was observed postextubation in 80% patients while 20% had mild Grade 1 cough.

Conclusion:
Superior laryngeal nerve block with in-line lignocaine nebulization for awake extubation is effective in curbing the haemodynamic and respiratory responses of extubation.
Comparative study of Baska mask with proseal LMA in adult patients undergoing elective surgery under general anesthesia with controlled ventilation
Authors: Agrawal Nidhi , Singh Anuradha , Gupta Anju 
Published: July 2022

Background and Aims:
Several supraglottic airway devices (SGD) are available nowadays. But none has been found to be better than Proseal laryngeal mask (PLMA) in terms of oropharyngeal leak pressure (OLP). We aimed to compare OLP of newly introduced Baska® Mask with PLMA in patients undergoing elective surgical procedures under general anesthesia.

Material and Methods:
Totally, 80 consecutive adult patients of either sex requiring general anesthesia were randomized into two groups Group B (Baska mask, n = 40) or Group P (PLMA. n = 40). After standardized induction with propofol 2 − 2.5 mg/kg-1 and fentanyl 2 mgkg-1, and muscle relaxation with vecuronium 0.1 mgkg-1 one of the two devices was placed. OLP (primary outcome) was measured 5 minutes and 30 minutes post induction. The time needed to achieve effective airway, anatomical alignment of the device, number of attempts, leak fraction, and postoperative laryngopharyngeal morbidity were noted.

Results:
Both the devices could be inserted in first attempt in all the patients, but the time needed to achieve effective airway was significantly less in Group B (12.58 ± 1.81 sec vs 17.92 ± 2.45 sec, P < 0.001). The mean OLP was better in Group B at 5 min (37.6 ± 2.43 cm H2O vs 30.82 ± 3.96 cm H2O) and at 30 min (38.83 ± 1.72 cm H2O vs 30.82 ± 3.96 cm H2O; P < 0.001). Anatomical alignment of SGD with glottis (FOB grade 3 or 4 view) was significantly better in group B (34/40) as compared to group P (25/40) (p = 0.009). There was no difference in laryngopharyngeal morbidity in the two groups.

Conclusion:
Baska mask provided higher OLP, better alignment to the glottis and faster placement time as compared to PLMA.
Resilience of healthcare professionals involved in anesthesia practice: A cross-sectional questionnaire based pilot study
Authors: Patil Narendra , Manwani Roshani , Vyas Varsha , Vardhan Vikram , Gehdoo R.P. , Patil Surekha 
Published: July 2022

Background and Aims:
Resilience of healthcare professionals involved in Anesthesia practice is relatively a new area of research. Improvement of resilience is important for the sustainability of the healthcare workforce. The aim of this study was to evaluate resilience of the health care providers towards intra-operative emergency situation and intensive care unit.

Material and Methods:
In this cross-sectional pilot study, healthcare providers working involved in anesthesia practice responded to a questionnaire consisting of 20 questions related to their regular work profile. Answers were graded as- ”Yes”, “Not often” and “No”. Scores of “Three”, “Two” and “One” were assigned to these responses and total score was calculated. Frequency and percentage of each response were compared based on place of work and roles. Scores were compared based on the designation.

Results:
Out of 103 healthcare workers 56 (54.4%) were from government or charity hospital. Thirty-one (30.1%) were Junior Residents. Comparison of responses based on the role/designation, significant differences were observed for questions- I reach to operation theatre well before the proposed time for the case (0.02994), I personally check operation theatre preparation (p = 0.01966), I check for the consent form every time (p = 0.02018), I can recognize different electrocardiogram (ECG) patterns (p = 0.00231) and I always try to learn from everything (p = 0.01989). Based on the place of work of study participants, there was a significant difference (p = 0.002095) for question, i.e., “I personally check operation theatre preparation.”

Conclusion:
The study results suggested good resilience of healthcare professionals involved in anesthesia and intensive care. Some pointers towards burnout are seen among study population. Early interventions may be useful to improve resilience and reduce risk of burnout.
Effect of caudally administered clonidine on sevoflurane induced emergence agitation—A randomized trial
Authors: Archana K N , Vyshnavi S , Ganesh Vinutha 
Published: July 2022

Background and Aims:
Emergence agitation (EA) is an unpleasant problem encountered in children following anesthesia with Sevoflurane. We studied the effectiveness of caudal epidural block (CEB) with ropivacaine 0.2% and clonidine two microgram per kilogram (mcg/kg) on the incidence of EA, with respiratory depression and hemodynamic variables as secondary end points.

Material and Methods:
Ninety children aged one to eight years undergoing infra umbilical surgeries were randomly allocated into two groups. Group RS: Ropivacaine 0.2% one ml/kg + . Saline one ml and Group RC: Ropivacaine 0.2% one ml/kg + Clonidine two mcg/kg made to one ml. They were then administered general anesthesia with endotracheal intubation followed by CEB using test drugs. Post surgery, EA was evaluated by Modified Richmond Agitation Scale at 15-minute intervals for one hour. The results were then analyzed using mean and standard deviation (SD), Chi square test, and Independent t test.

Results:
EA was significantly lower in group RC when compared to group RS (P < 0.0001).Group RC had 12 (28.5%) children with EA at 15 minutes compared to 35 (83.3%) children in Group RS. At 30 minutes, it was seen in five (11.3%) and 27 (64.2%) children in group RC and RS, respectively. No significant respiratory depression was noted in both groups. A significant decrease in heart rate was seen in Group RC (P < 0.001) but was not significant clinically. No adverse events were recorded in both the groups.

Conclusion:
Addition of clonidine (2mcg/kg) to ropivacaine 0.2% offers an advantage over 0.2% ropivacaine alone in decreasing the incidence of sevoflurane induced EA in children undergoing lower abdominal surgery without any adverse effects.
Comparison of haemodynamic changes between propofol and ketofol as induction agents in patients undergoing laparoscopic surgeries under general anaesthesia
Authors: Raman Vikasini , Segaran Sivakumar , Ramyavel T. , George Sagiev Koshy , Zachariah Mamie 
Published: July 2022

Background and Aims:
Laparoscopic surgeries are more commonly performed procedure nowadays because of its advantages however generation of pneumoperitoneum causes significant physiological changes. Propofol is the most commonly used induction agent but its use is limited by its side effects like dose-dependent hypotension and myocardial depression. So by combining propofol with ketamine to form ketofol may result in better hemodynamic stability. The aim of this study was to compare the haemodynamic changes in patients undergoing laparoscopic surgery under general anesthesia using propofol and ketofol as induction agents.

Material and Methods:
In this prospective randomized double blind study, 80 patients of ASA I/II undergoing elective laparoscopic surgery were randomized into two Groups. Group A received 1 mg/kg of propofol + 1 mg/kg ketamine made up to a total volume of 20 ml with normal saline and Group B received 2 mg/kg propofol + normal saline to make up to an equal volume. Hemodynamic profiles like HR, SBP, DBP, and MAP were recorded at different time intervals until pneumoperitoneum. Postoperative recovery profile and complications were recorded. All data were entered in MS excel and analyzed using SPSS Version 20.0. Repeated measures ANOVA and Chi-square test were used to test the level of significance.

Results:
Demographic character and duration of surgery were comparable. SBP, DBP, MAP and HR showed statistically significant difference in both groups in various time intervals with P < 0.05 with Group A (ketofol ) having a better hemodynamic stability. Recovery profile in ketofol group took longer duration (4.95 min) compared to propofol group B (1.8 min). Postoperative nausea and vomiting were significant (P = 0.004) in ketofol group.

Conclusion:
We concluded that ketofol had a better hemodynamic stability compared to propofol as an induction agent, however time for recovery in ketofol group took a longer period compared to propofol group, with no complication in either groups.