bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aménagements des espaces, lieux pratiqués et qualité des soins aux nouveau-nés au Cameroun
Authors: Legrand Fosso Albert , Kane Hélène 
Published: February 2020

Introduction : Afin de fournir des soins néonatals de qualité, il est indispensable de disposer d’infrastructures et de matériel adéquats. Dépassant l’apparente simplicité de cette condition, nous proposons d’analyser finement le rapport entre l’aménagement des espaces de soins en maternité, leurs usages et la qualité des soins délivrés aux nouveau-nés. Méthode : Une enquête ethnographique dans dix hôpitaux du Cameroun, dont un par région choisi parmi les différents niveaux de la pyramide sanitaire, nous a permis d’examiner comment l’aménagement des espaces sanitaires et la disposition du matériel peuvent contribuer à la vulnérabilité des nouveau-nés en maternité. Deux cents observations des soins à la naissance ont été retranscrites, puis utilisées en support d’entretiens visant l’explicitation des actions par les professionnels de santé. Résultats : Les espaces sanitaires, habités par des usages et des modes d’organisation, n’optimisent pas la qualité des soins aux nouveau-nés. La fragmentation des lieux utilisés dans la prise en charge des nouveau-nés engendre des délais de prise en charge en cas de complication à la naissance. L’occupation des espaces et les usages matériels révèlent un manque d’anticipation et de coordination des soins. Les appropriations des lieux et la disposition des équipements ne sont pas favorables aux pratiques de soins néonatals recommandées, notamment concernant la lutte contre l’hypothermie et la promotion de l’allaitement maternel précoce. Au demeurant, l’organisation spatiale des maternités s’avère davantage axée sur les soins obstétriques. Discussion : La réflexion sur les espaces de soins peut être la base de processus collectifs locaux d’amélioration des pratiques de soins aux nouveau-nés. Elle permet de requestionner la culture professionnelle biomédicale, la segmentation des tâches et les techniques, afin d’ancrer durablement des évolutions favorables à la survie néonatale.
L’« oubli » du nouveau-né en maternité : analyse anthropologique en Mauritanie
Authors: Kane Hélène 
Published: February 2020

Introduction : En Mauritanie comme dans les autres pays ouest-africains, un ensemble d’actions ont été menées afin de lutter contre la mortalité néonatale. Considérant le succès mitigé de ces programmes, nous nous sommes interrogés sur la manière dont les agents de santé investissent les soins néonataux. Méthode : Une étude anthropologique a été réalisée dans une localité de la vallée du fleuve Sénégal. Les enquêtes ont consisté en une ethnographie d’un centre de santé, qui a donné lieu à des observations détaillées des soins et à des entretiens avec les agents de santé. Résultats : Nos observations révèlent que dans les minutes et les heures cruciales qui suivent une naissance normale, l’attention des soignantes tend à se détourner du nouveau-né. Les soins recommandés tels que le maintien au chaud, l’examen et la surveillance du nouveau-né ne sont pas dispensés, tandis que la mise au sein précoce intervient de manière fluctuante. Le nouveau-né est rapidement remis à la famille. Les soins aux nouveau-nés sont ainsi « oubliés », à la fois dans l’enchaînement des gestes autour de l’accouchement et dans la répartition collective des responsabilités professionnelles. Discussion : Les soins du nouveau-né à la naissance demeurent peu médicalisés. Nous analysons la moindre implication des agents de santé vis-à-vis des nouveau-nés selon deux aspects : la perception de l’incertitude de la survie néonatale, et la prédominance des modes de maternages locaux. Nous formulons des propositions visant à replacer l’attention sur le nouveau-né, afin de promouvoir une meilleure qualité des soins néonatals.
Chute du nœud ombilical et soins du corps du nouveau-né privilégiés par les savoirs populaires au Bénin
Authors: Ahouangonou Dossi Salomé 
Published: February 2020

Introduction : Au Bénin, en dépit des efforts appréciables menés en matière de soins prénataux et de la proportion d’accouchements assistés par un prestataire qualifié (84 %), la mortalité néonatale reste encore élevée : 38 décès de nouveau-nés pour 1 000 naissances vivantes. L’objectif de cette étude est d’identifier les situations supposées « poser problème » dans la prise en charge des nouveau-nés. Méthode : Il s’agit d’une étude qualitative fondée, dans un premier temps, sur l’observation des gestes médicaux et socio-affectifs qui s’adressent aux nouveau-nés, de la maternité au domicile. Un second moment a reposé sur des entrevues auprès de 40 acteurs, dont 10 personnels de santé et 30 personnes de la famille et de l’entourage du nouveau-né. Sur une période de deux mois, 18 observations d’accouchements et de soins au nouveau-né ont été réalisées en maternité. Des observations des soins ont été poursuivies pour 14 nouveau-nés à domicile. Résultats : Les premiers jours, le nouveau-né vivant bénéficie très souvent des premiers soins usuels, mais plus souvent encore échappe à la surveillance du personnel de santé. Du sel au remède savamment concocté, des produits et substances inappropriés sont utilisés pour les soins du cordon. En particulier, l’usage du dentifrice s’intègre de plus en plus dans les pratiques de soins du corps pour une chute rapide du nœud ombilical. Dans le cas de cette étude, des substances inappropriées ont été appliquées sur le nœud ombilical de 13 parmi les 14 nouveau-nés suivis à domicile. Conclusion : Face aux logiques des différents acteurs, on peut conclure que les savoirs privilégiés dans les pratiques familiales de soins du cordon ombilical interfèrent avec les recommandations, maintenant le nouveau-né dans une certaine vulnérabilité.
Calculation of radium-223 and actinium-225 α-emitter radiopharmaceuticals dose rates in treatment of metastatic castration-resistant prostate cancer
Authors: Abbasi Akbar , Dadashpour Mehdi , Alipourfard Iraj 
Published: February 2020

Aim of Study:
There is limited information regarding the α-emitter radiopharmaceuticals dose calculation used in the setting of men with prostate cancer (PCa). The present study investigates the α-emitter radiopharmaceuticals absorbed dose distribution in the body organs.

Materials and Methods:
The α-emitter radiopharmaceuticals dose coefficient and absorbed doses biokinetics distribution, which are used for the treatment of PCa in all over the world, were performed using the “Internal Dose Assessed by Computer” (IDAC-Dose 2.1) program. The results of absorbed dose distribution in any organ of the body, were compared in studied α-emitter radiopharmaceuticals.

Results:
The absorbed dose value of 223Ra radiopharmaceutical in the prostate organ was evaluated 9.47E-9 Gy/Bq. The maximum and minimum absorbed doses due to biokinetics distribution of 223Ra were found in the thymus (9.53E-8 Gy/Bq) and eye lenses (1.30E-10 Gy/Bq) organs, respectively. Furthermore, the 225Ac absorbed dose in the prostate organ was obtained 1.91E-9 Gy/Bq, where this value is 1% of total body dose. While the absorbed dose distribution of 225Ac in body organs shows the highest concentration in the spleen (1.47E-8 Gy/Bq) and lowest in the eye lenses (7.93E-12 Gy/Bq).

Conclusion:
The absorbed dose in the body organs due to 223Ra and 225Ac α-emitter radiopharmaceuticals which are used in metastasized castration-resistant prostate cancer (mCRPC), calculated in this study. The results of this study will assist in evaluating and analyzing human body organ doses from application of 223Ra and 225Ac that used in mCRPC patients.
Integrated Report System in Italian Law
Authors: Cantino Valter , Cortese Damiano 
Published: February 2020

The recent (2016) implementation in the Italian judicial system of the European Directive (2014/95/EU) about the disclosure of non-financial and diversity information by large companies and groups is crucial for understanding the need to manage in a fair approach the transition to a global and sustainable economy oriented to social and environmental principles. The Directive calls for a more concrete proof of social, environmental and ethical concerns that can be guaranteed by integrated tools. Integrated reporting generates impacts at governance level and new set of transparent and intelligible information shared with stakeholders favor their engagement and allow understanding of the social role that the company was always asked to play but not always has properly communicated. Implementing integrated reporting, a company might enhance its performances, increase market rating, build more effective bank-firm relationships, and generate growing value, both in perception and financial.
Cathodic Activity on Passive Materials in Deep Seawater
Authors: Diler Erwan , Larché Nicolas , Thierry Dominique 
Published: February 2020

In this study, the cathodic activity of biofilmed stainless steel surfaces was investigated at two exposure depths at the same location at 1,020 m and 2,020 m depth. For this purpose, a set of passive materials and sensors were exposed for 11 months in Azores, in the Atlantic Ocean. Characteristic cathodic depolarizations due to biological activity were observed in intermediary and deep water. However, a strong cathodic activity was only measured in deep water. Potential ennoblement appeared between 80 d and 200 d, depending on the exposure depth and the experimental setup used. In a given environment, the biological cathodic activity appears to be strongly related to the limiting parameter of the reaction, which can be anodic or cathodic. The biofilm sensors exposed for the first time in open, deep water appear relevant to discriminate cathodically “strongly-active” and “weakly-active” biological activity. Under cathodic control, a high current density was measured on stainless steel in deep seawater. The experimental setup used is particularly relevant as it allows determination in situ of the maximal cathodic current density.
Observing geometry effects on a Global Navigation Satellite System (GNSS)-based water vapor tomography solved by least squares and by compressive sensing
Authors: Heublein Marion , Bradley Patrick Erik , Hinz Stefan 
Published: February 2020

Abstract. In this work, the effect of the observing geometry on the tomographic reconstruction quality of both a regularized least squares (LSQ) approach and a compressive sensing (CS) approach for water vapor tomography is compared based on synthetic Global Navigation Satellite System (GNSS) slant wet delay (SWD) estimates. In this context, the term “observing geometry” mainly refers to the number of GNSS sites situated within a specific study area subdivided into a certain number of volumetric pixels (voxels) and to the number of signal directions available at each GNSS site.
The novelties of this research are (1) the comparison of the observing geometry's effects on the tomographic reconstruction accuracy when using LSQ or CS for the solution of the tomographic system and (2) the investigation of the effect of the signal directions' variability on the tomographic reconstruction.
The tomographic reconstruction is performed based on synthetic SWD data sets generated, for many samples of various observing geometry settings, based on wet refractivity information from the Weather Research and Forecasting (WRF) model. The validation of the achieved results focuses on a comparison of the refractivity estimates with the input WRF refractivities.
The results show that the recommendation of Champollion et al. (2004) to discretize the analyzed study area into voxels with horizontal sizes comparable to the mean GNSS intersite distance represents a good rule of thumb for both LSQ- and CS-based tomography solutions. In addition, this research shows that CS needs a variety of at least 15 signal directions per site in order to estimate the refractivity field more accurately and more precisely than LSQ. Therefore, the use of CS is particularly recommended for water vapor tomography applications for which a high number of multi-GNSS SWD estimates are available.
Educating Engineering Students in Egypt: Recommendations for Improvement
Authors: Elsafty Ashraf , Elsayad Hanaa Ibrahim , Shaaban Ibrahim G. 
Published: February 2020

Egyptian schools of engineering (government faculties, private faculties and private higher engineering institutes) award degrees to 35000 graduates annually. There have been concerns from the Egyptian Engineers Syndicate, experienced engineers, local & international employers, parents and other society stakeholders about the knowledge and skills gained by engineering graduates. In this article, first the institutions were analyzed from a fresh business perspective. The analysis highlighted several constraints that hinder radical reforms. In part two of this article the aspirations of stakeholders were collected and identified. In part three, recommendations were made based on the experiences of engineering education providers worldwide.
Radiographic Evaluation of the Tibial Intramedullary Nail Entry Point
Authors: Maslow Jed I. , Joseph Hayden L. , Hong Daniel Y. , Henry Abigail L. , Mitchell Phillip M. , Collinge Cory A. 
Published: February 2020

Introduction:
Tibia fractures are common injuries that can often be effectively treated with intramedullary nail (IMN) fixation. The ideal starting point for IMN reaming and nail placement is well described and regarded as a crucial aspect in the technique. The purpose of this study is to determine the accuracy and precision with which the starting point is established and if this is maintained after nail insertion during fracture fixation.

Methods:
Fifty consecutive tibia fractures treated by IMN fixation sized 9 to 13 mm through an infrapatellar or medial parapatellar approach and 50 treated with a suprapatellar approach were evaluated. The starting point for reaming and IMN placement was measured using intraoperative fluoroscopy. Postoperative radiographs were used to determine the center of the IMN after placement. The distance between the measured points and the ideal starting point was measured.

Results:
Deviation from the ideal entry point on intraoperative fluoroscopy averaged 4.6 ± 4.0 mm medially, 2.9 ± 3.7 mm anteriorly, and 2.7 ± 3.3 mm distally. In 30% of cases, the final IMN position varied from the entry point by greater than one SD in the coronal or sagittal plane. No difference between approaches was appreciated.

Discussion:
Although the ideal starting point for tibial IMN fixation is known, this is frequently not the starting point accepted in practice. Final position of the IMN is independent of IMN size or approach and is not markedly different than the obtained starting point.

Level of Evidence:
Therapeutic level III
Assessing Preoperative Risk Factors With Sex Disparities in Total Joint Arthroplasty Patients and Financial Outcomes From the National Inpatient Sample Database
Authors: Cheah Cheryl , Hussein Inaya Hajj , El Othmani Amjad , Rizvi Syed A. , Sayeed Zain , El-Othmani Mouhanad M. 
Published: February 2020

Introduction:
Disparities in the healthcare system imply potential risks for vulnerable groups whose needs are not appropriately met. Total joint arthroplasty (TJA) is successful in treating end-stage arthritis, resulting in increased demand for the procedure, however remains underused in both sexes, especially in women. Although multiple studies assessed the differences in postoperative morbidities between sexes, there remains a lack in understanding patients' preoperative clinical profile and nonclinical demographics. The aim of this study is to provide a population-based epidemiologic assessment of preoperative risk factors and sex disparities and assess differences in outcomes following TJA.

Methods:
The National Inpatient Sample database from 2006 to 2011 was analyzed. Patients who underwent primary total knee and hip arthroplasty were identified and stratified into two cohorts of male and female, and demographic data and comorbidities were collected. Postoperative complications, length of stay, total charges, and discharge destination were measured for matched cohorts.

Results:
Female patients present for TJAs at an older average age, are less likely to present with AIDS, alcohol abuse, coagulopathy, congestive heart failure, drug abuse, liver disease, peripheral vascular disease, and renal failure, and are more likely to present with anemia, autoimmune disorders, chronic obstructive pulmonary disease, depression, obesity, and valvular disease. Postoperatively, the average length of stay for female patients was markedly higher (3.52 versus 3.39) and a lower percentage went home (59% versus 73%). Overall, female patients experience greater odds of any complication while in-patient.

Discussion:
This study highlighted sex differences in areas that could account for the underuse of the procedure in both sexes, with women affected to a greater extent. Understanding these factors will help address the unmet needs of both sexes after TJA by encouraging future studies and provider education to ensure that all patients are able to access the necessary procedures for pain relief and functional improvement.
Where Will Pathologic Hip Fractures Go in a Value-based Hip Fracture Bundle?
Authors: Malik Azeem Tariq , Alexander John H. , Khan Safdar N. , Scharschmidt Thomas J. 
Published: February 2020

Introduction:
There has been a burgeoning interest for implementing bundled payments for hip fractures being treated with hemiarthroplasty, percutaneous pinning, and/or open reduction and internal fixation. Concerns exist about how hip fracture bundles may impede access to care for patients who require more resources, such as those with pathologic/neoplastic fractures.

Methods:
The 2011 to 2017 American College of Surgeons—National Surgical Quality Improvement Program database was queried to identify patients undergoing percutaneous pinning, hemiarthroplasty, plate/screw, and intramedullary nail for hip fractures. Multivariate regression analyses were used to identify notable differences in 30-day complications, readmissions, reoperations, mortality, length of stay, and nonhome discharges between native and pathologic/neoplastic hip fractures.

Results:
A total of 67,548 patients were included—of which 378 (0.6%) had a pathologic/neoplastic hip fracture. Pathologic fractures (versus native hip fractures) had significantly higher odds of experiencing a prolonged length of stay >5 days (odds ratio [OR] 1.57), pulmonary embolism (OR 3.67), deep vein thrombosis (OR 2.03), 30-day readmissions (OR 1.43), and 30-day mortality (OR 2.66).

Discussion:
Patients sustaining a pathologic/neoplastic hip fracture have a worse adverse event profile. Risk adjustment based on facture etiology will be necessary to ensure that providers taking care of pathologic/neoplastic fractures are appropriately reimbursed to minimize barriers to access of care for this vulnerable cohort.
Safely Implementing the Direct Anterior Total Hip Arthroplasty: A Methodological Approach to Minimizing the Learning Curve
Authors: Pirruccio Kevin , Evangelista Perry J. , Haw Jonathan , Goldberg Tyler , Sheth Neil P. 
Published: February 2020

Introduction:
Orthopaedic surgeons often cite concern for a learning curve as a barrier to adopting the direct anterior approach (DAA) for total hip arthroplasty (THA) while transitioning from other approaches. Studies both assessing and describing a practical approach and strategy to safely accomplish this transition, as well as the effect on clinical outcomes, are not well described.

Methods:
This prospective study compares a single surgeon's operative results and complications for the first consecutive 100 direct anterior THA to the last 100 consecutive posterior THA after 7 years in practice. The regimented and disciplined learning strategy used to implement the DAA is detailed in this study. The data were analyzed using univariate and multivariate regression models.

Results:
Univariate analyses identified significant differences in sex, age, Asian race, and diagnostic cause for THA between the two cohorts. Multivariate analyses controlled for these differences and showed that relative to posterior THA, direct anterior THA cases were associated with 7-minute longer procedures (P = 0.002) and lengths of stay that were 0.7 days fewer (P = 0.013). No significant differences were present in the estimated blood loss, and importantly, no significant differences in death or surgical complication rates between cohorts.

Discussion:
This study suggests that the DAA for THA can be safely implemented without the increased and adverse risk to the patient when a structured learning process is maintained and meticulously performed.
Veterans Undergoing Total Hip and Knee Arthroplasty: 30-day Outcomes as Compared to the General Population
Authors: Frisch Nicholas B. , Courtney P. Maxwell , Darrith Brian , Copeland Laurel A. , Gerlinger Tad L. 
Published: February 2020

Introduction:
The Veterans Affairs (VA) health system is vital to providing joint replacement care to our retired service members but has come under recent scrutiny. The purpose of this study was to compare the short-term outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA) between the VA cohort and the general cohort.

Methods:
We retrospectively reviewed 10.460 patients with primary THA and TKA from the Veterans Affairs Corporate Data Warehouse. As a control group, we queried the American College of Surgeons—National Surgical Quality Improvement Program database and identified 58,820 patients with primary THA and TKA over the same time period. We compared length of stay, mortality rates, 30-day complication rates, and 30-day readmissions. We performed a multivariate logistic regression analysis to identify the independent effect of the VA system on adverse outcomes.

Results:
Veterans are more likely to be men (93% versus 41%, P < 0.001) and have increased rates of medical comorbidities (all P < 0.001). The rate of short-term complications (all P < 0.001) were all higher in the VA cohort. When controlling for demographics and medical comorbidities, VA patients were more likely to have a readmission (P < 0.001), prolonged length of stay > 4 days (P < 0.001), and experience a complication within 30 days (P < 0.001).

Discussion:
Despite controlling for higher rates of medical comorbidities, VA patients undergoing primary THA and TKA had poorer short-term outcomes than the civilian cohort. Additional research is needed to ensure our veteran cohort is appropriately optimized and address the discrepancy with the outcomes of the civilian.