bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Influenza Vaccination During Orthopaedic Surgery Hospitalizations
Authors: Navarro Ronald A. , Lin Charles C. , Colli Bailey , Qian Lei , Liu In-Lu Amy , Sy Lina S. , Jacobsen Steven J. , Tartof Sara Y. 
Published: November 2021

Background:
Despite national recommendations, influenza vaccination rates during hospitalizations remain low. Inpatient hospitalization for orthopaedic surgery remains a largely missed opportunity for vaccination. To address potential concerns regarding safety, we evaluated whether influenza vaccination during hospitalization for orthopaedic surgery increases evaluations for infection postdischarge because patients and clinicians often cite fear of this potential outcome.

Methods:
This was a retrospective cohort study that was conducted among patients of a large integrated healthcare organization aged ≥6 months who were hospitalized for an orthopaedic surgery (defined by International Classification of Diseases, Ninth Revision procedure codes) between September 1 and March 31 from 2011 to 2014. Using propensity score matching (1:1) to adjust for confounding, we assessed the association between influenza vaccination during an inpatient stay for orthopaedic surgery and rates of readmission, emergency department visits, outpatient visits, fever (temperature ≥38.0°C), and evaluations for infections less than 7 days postdischarge.

Results:
Overall, 2,395 hospitalizations with inpatient vaccination and 21,708 hospitalizations without inpatient vaccination were identified. Following successful balance of covariates (standardized difference <0.1 for all covariates) through 1:1 propensity score matching, we included 2,376 exposed patients and 2,376 unexposed patients in the matched analysis. In adjusted analyses, compared with those who were not vaccinated during hospitalization, those vaccinated during an inpatient stay for orthopaedic surgery had no statistically significant increase in readmission (relative risk [RR] = 1.00, 95% confidence interval [CI]: 0.75 to 1.34), emergency department visits (RR = 1.14, 95% CI: 0.93 to 1.41), fever (RR = 1.31, 95% CI: 0.81 to 2.12), or clinical workups for infection (RR = 1.08, 95% CI: 0.98 to 1.18). A marginally increased risk of outpatient visits in the 7 days postdischarge was detected (RR = 1.13, 95% CI: 1.02 to 1.26).

Discussion:
There was no evidence of a substantial increased risk of infection-related outcomes associated with influenza vaccination during hospitalization for orthopaedic surgery. Our data support the recommendation of vaccinating orthopaedic surgery patients against influenza perioperatively.
Reverse Shoulder Arthroplasty After Prior Rotator Cuff Repair: A Matched Cohort Analysis
Authors: Marigi Erick M. , Tams Carl , King Joseph J. , Crowe Matthew M. , Werthel Jean-David , Eichinger Josef , Wright Thomas , Friedman Richard J. , Schoch Bradley S. 
Published: November 2021

Introduction:
Rotator cuff repair (RCR) is commonly performed before reverse shoulder arthroplasty (RSA) with conflicting evidence on the effect on arthroplasty outcomes. The purpose of this investigation was to evaluate the effect of a prior RCR on the outcomes and complications of primary RSA.

Methods:
Between 2007 and 2017, 438 RSAs performed in patients with a prior RCR and 876 case-matched controls were identified from a multicenter database. Patients were grouped based on a preoperative diagnosis of glenohumeral osteoarthritis (GHOA) and rotator cuff tear arthropathy (CTA). Data collected included range of motion, strength, complications, and revisions. Additional clinical metrics included American Shoulder and Elbow Society score, Constant score, Shoulder Pain and Disability Index, Simple Shoulder Test, and the University of California Los Angeles shoulder score.

Results:
Compared with controls, both GHOA and CTA study groups demonstrated lower postoperative forward elevation (FE) (133° versus 147°, P < 0.001; 133° versus 139°, P = 0.048) and FE trength (6.5 versus 8.2, P = 0.004; 6.1 versus 7.3, P = 0.014). In addition, inferior improvements were observed in the GHOA and CTA study groups with respect to abduction (38° versus 52°, P = 0.001; 36° versus 49°, P = 0.001), FE (41° versus 60°, P < 0.001; 38° versus 52°, P = 0.001), ER (16° versus 25°, P < 0.001; 10° versus 17°, P = 0.001), and Constant score (28.4 versus 37.1, P < 0.001; 26.2 versus 30.9, P = 0.016). Compared with controls, no differences were observed in the GHOA and CTA study groups with respect to notching (11.2% versus 5.6%, P = 0.115; 5.8% versus 7.9%, P = 0.967), complications (4.3% versus 1.6%, P = 0.073; 2.5% versus 2.7%, P = 0.878), and revision surgery (3.1% versus 0.9%, P = 0.089; 1.1% versus 1.3%, P = 0.822).

Conclusion:
RSA after a prior RCR improves both pain and function, without increasing scapular notching, complications, or revision surgery. However, compared with patients without a prior RCR, postoperative shoulder function may be slightly decreased.

Level of Evidence:
III; Retrospective Cohort Study.
Regional or Neuraxial Anesthesia May Help Mitigate the Effects of Bone Cement Implantation Syndrome in Patients Undergoing Cemented Hip and Knee Arthroplasty for Oncologic Indications
Authors: Rao Sandesh S. , Suresh Krishna V. , Margalit Adam , Morris Carol D. , Levin Adam S. 
Published: November 2021

Introduction:
Bone cement implantation syndrome (BCIS) occurs during and after cementation of implants and is associated with hypotension, hypoxia, and cardiovascular collapse. In this study, we aimed to identify risk factors and potential mitigating factors of BCIS in the oncologic adult cohort undergoing cemented arthroplasty.

Methods:
We retrospectively reviewed oncologic patients aged 18 years or older who underwent cemented arthroplasty of either the hip or knee from 2015 to 2020. All implants were stemmed. We classified BCIS into three separate categories: (1) grade 1: intraoperative moderate hypoxia (<94%) or drop in systolic blood pressure >20%; (2) grade 2: intraoperative severe hypoxia or drop in systolic blood pressure >40%; and (3) grade 3: cardiovascular collapse requiring cardiopulmonary resuscitation. Demographics, primary malignancy diagnosis, intraoperative factors including cement timing, development of BCIS, 30-day postoperative outcomes, and mortality up to 2 years postoperatively were evaluated. Bivariate analyses and multivariate logistic regression were performed.

Results:
Sixty-seven patients met inclusion criteria. Of these, 31 patients (46%) developed BCIS. No difference was found in age (65.5 versus 60.9 years; P = 0.15) or body mass index (28.8 kg/m2 versus 29.3 kg/m2; P = 0.76), comorbidities, intraoperative factors, or postoperative surgical outcomes between those who developed BCIS and those who did not (all; P > 0.05). An association with the type of anesthesia administered and development of BCIS in patients receiving general anesthesia alone (17/24 patients, 71%), neuraxial and general (4/15 patients, 27%), and regional and general anesthesia (10/28 patients 36%, P = 0.01) was found. Compared With neuraxial and regional anesthesia, general anesthesia alone had 5.8 (P = 0.007) and 4.5 times (P = 0.006) greater odds of developing BCIS, respectively. No differences were noted in rates of BCIS between regional and neuraxial anesthesia (P = 0.81).

Discussion:
Addition of regional or neuraxial anesthesia may be protective in reducing development of BCIS in the orthopaedic oncologic cohort undergoing hip and knee arthroplasty.

Level of Evidence:
III
Orthopaedic Urgent Care Versus the Emergency Department: Cost Implications for Low-energy Fracture Care
Authors: Pean Christian A. , Bird Mackenzie L. , Buchalter Daniel B. , Yang S. Steven , Egol Kenneth A. 
Published: November 2021

Introduction:
This study compared costs, length of visit, and utilization trends for patients with fractures seen in an immediate care orthopaedic center (I-Care) versus the emergency department (ED) in a major metropolitan area.

Methods:
A retrospective chart review of consecutive patients seen on an outpatient basis in the ED and I-Care over a 6-month period was conducted. Patient demographics, procedures done, care category, estimated costs, and disposition information were included for statistical analysis. Within the low-acuity fracture care group, a cost-comparison analysis was conducted.

Results:
A total of 610 patients met inclusion criteria with 311 seen in I-Care and 299 in the ER. I-Care patients were more likely to have low-acuity injuries compared with ED patients (60.1% versus 18.1%, P < 0.001). The length of visit was longer for patients seen in the ED compared with I-Care (6.1 versus 1.43 hours, P value < 0.001). A cost analysis of low-acuity patients revealed that an estimated $62,150 USD could have been saved in healthcare costs by the initial diversion of low-acuity patients seen in the ER to I-Care during the study period.

Discussion:
These results suggest that the I-Care orthopaedic urgent care model is a more cost-effective and more efficient alternative to the ED for patients with fractures requiring procedural treatment and low-acuity patients managed on an outpatient basis.
Discharge Opioid Prescribing Patterns in an Academic Orthopaedic Setting: Level of Training and Subspecialty Patterns
Authors: Fang Francia Y. , Weir Tristan B. , Codd Casey M. , May Catherine C. , Abzug Joshua M. 
Published: November 2021

Introduction:
Despite increased research on opioids in the orthopaedic literature, little is known of the prescribing practices of orthopaedic providers based on their level of training. The purpose of this study was to describe the discharge opioid prescribing patterns of orthopaedic providers, stratifying by level of training and orthopaedic subspecialty, within a single medical system.

Methods:
A retrospective review of orthopaedic surgical encounters was performed over a 1-year period for adults who received a discharge opioid prescription. Patient demographics and prescriber characteristics were collected, including the provider's level of training (attending, fellow, resident, physician assistant [PA], and nurse practitioner [NP]) and surgical subspecialty. Junior residents were postgraduate year 1 to 3, whereas senior residents/fellows were postgraduate year 4 to 6. Discharge opioids were converted to milligram morphine equivalents (MMEs). Overprescribing was defined as a prescribing more than a seven-day supply or >45 MMEs per day. Multivariable linear regression analysis determined the factors associated with discharge MMEs, whereas logistic regression determined the factors associated with overprescribing opioids.

Results:
Of the 3,786 patients reviewed, 1,500 met the criteria for inclusion in the study. The greatest proportion of opioid prescriptions was written by junior residents (33.9%), followed by NPs (30.1%), PAs (24.1%), senior residents/fellows (10.6%), and attendings (1.2%). Compared with junior residents, senior residents prescribed −59.4 MMEs, NPs prescribed +104 MMEs, and attendings prescribed +168 MMEs (P < 0.05), whereas PAs prescribed similar amounts (P > 0.05). Orthopaedic subspecialty was also predictive of discharge MMEs (P < 0.05). Senior residents and attendings were more likely to prescribe more than seven days of opioids (P < 0.05), whereas NPs and PAs were more likely to prescribe >45 MMEs per day (P < 0.05).

Discussion:
This study demonstrates significant variability in opioid prescribing practices according to provider level of training and subspecialty. National guidelines for opioid prescribing practices and educational programs may help reduce such variability.

Level of Evidence:
Level III, retrospective cohort study
Investigation of the liquefaction possibility of Ermenek lignite as an alternative clean energy source
Authors: AKSOĞAN KORKMAZ Aydan 
Published: November 2021

Coal liquefaction; can be defined as the transformation of coal into products that have a high energy density, can be easily stored and transported and do not create environmental pollution, to meet both fuel and chemical raw material requirements.
This study was carried out to determine the yields of the products formed as a result of the liquefaction of Konya-Ermenek lignite in the N2 atmosphere and under non-catalytic conditions. Proximate and ultimate analysis of the obtained solid and liquid products was made. The composition of the oil product was determined by GC-MS. As a result of liquefaction, the char yield was 71.37%, the preasphaltene yield was 12.24%, the asphaltene yield was 2.23% and the oil + gas yield was 14.16%. It was determined that the higher heating value of 4199 kcal/kg in raw lignite is twice as high in liquefaction products. It was determined that the sulfur content of 3.94% in raw lignite decreased to 1.54%, 0.85% and 0.44% in char, preasphaltene and oil, respectively.
Melatonin serum level, sleep functions, and depression level after bilateral anodal transcranial direct current stimulation in patients with Parkinson’s disease: a feasibility study
Authors: Hadoush Hikmat , Alqudah Ansam , Banihani Saleem A. , Al-Jarrah Muhammed , Amro Akram , Aldajah Salameh 
Published: November 2021

ABSTRACT
Objective: Parkinson’s disease (PD) is associated with non-motor complications such as sleep disturbance and depression. Transcranial direct current stimulation (tDCS) showed therapeutic effects on the motor dysfunctions. However, the potential effects of tDCS therapy on melatonin hormone, sleep dysfunctions, and depression in patients with PD still unclear. This feasibility study aimed to identify any potential changes in melatonin serum level, sleep functions and depression after the bilateral anodal tDCS in patients with PD.
Material and Methods: Tensessions of bilateral anodal tDCS stimulation applied over left and right prefrontal and motor areas were given to twenty-five patients with PD. Melatonin serum level, Pittsburgh sleep quality index, and geriatric depression scale examined before and after tDCS stimulation.
Results: After bilateral anodal tDCS, there was a significant reduction in melatonin serum level, improvement in depression, improvements in overall sleep quality, and sleep latency. Correlations test showed significant associations between melatonin serum level reduction and changes in subjective sleep quality, and sleep duration, as well as between improvements in depression and overall sleep quality, sleep latency, and sleep disturbance.
Conclusion: Bilateral anodal tDCS therapy was a feasible and safe tool that showed potential therapeutic effects on melatonin serum level, sleep quality, and depression level in patients with PD. Although the further large scale and randomized-control trial studies are crucially needed, there is still a need for such a feasibility study to be established before such trials can be implemented as is recommended in the new medical research council guidelines.
Expériences du mourir et de la mort
Authors: Le Gall Josiane , Samson Marie-Ève , Fortin Sylvie 
Published: November 2021

Les études sur les expériences de fin de vie et de mort du point de vue des familles et des proches sont parcellaires, davantage encore dans un contexte de diversité religieuse, ethnique et socioculturelle tel que Montréal. Les quelques travaux qui en tiennent compte soulignent une différence de perspectives entre patients, familles et intervenants, notamment en regard de ce qui est entendu par une « bonne mort ». Cet article se base sur les résultats d’une recherche sur les expériences de fin de vie et de mort à domicile et en institution de soins auprès de familles et proches de groupes minoritaires à Montréal. S’appuyant sur des entretiens approfondis menés auprès de 23 proches ayant accompagné un aîné immigrant âgé de 80 ans et plus en fin de vie, l’article aborde spécifiquement les attentes des familles en ce qui a trait à une fin de vie de qualité et les enjeux soulevés par la rencontre avec les services de santé. Les résultats révèlent une diversité des expériences (des bonnes et des moins bonnes) et montrent que le regard porté par les familles sur la fin de vie et la mort est influencé par l’écart possible entre ce qui est souhaité pour l’aîné et leur appréciation des soins professionnels reçus.
Concevoir une linguistique de la mort (note de recherche)
Authors: Erard Michael , Kerbiriou Anne-Hélène 
Published: November 2021

Bien que la mort et le mourir constituent un élément central de l’expérience humaine, les linguistes n’ont jamais mis leur science au service de l’explication des phénomènes linguistiques et communicationnels qui se produisent au chevet des mourants ou à proximité. Une série d’entretiens informels effectués avec des linguistes permet de comprendre pourquoi les linguistes ont ignoré cette question : la difficulté de recueillir des données, les problèmes de financement pour ce faire, et d’autres problèmes de navigation dans la recherche moderne ; les tabous entourant la mort et le mourir en tant que sujet d’étude ; et le manque d’expérience en matière de mourir. Une esquisse de l’histoire de la linguistique permet d’avancer une raison supplémentaire : ce champ d’études est fondamentalement orienté vers les origines et les commencements, et dans la linguistique contemporaine les controverses théoriques les plus accentuées portent sur l’acquisition du langage.
Architectes de leur mort
Authors: Giampaoli Michelangelo 
Published: November 2021

Si, comme le disait Edmond Haraucourt dansRondel de l’adieu(1890), « [p]artir, c’est mourir un peu », il est vrai aussi que mourir signifie quitter ce monde et, également, commencer à s’organiser en vue de ce que (peut-être) il y aura juste après le dernier souffle. Pour un nombre surprenant de personnes, cela signifie se préparer à sa propre mort en se consacrant à l’achat d’une concession funéraire et à la création de sa dernière demeure : on choisit le cimetière, le monument, les matériaux, les symboles, l’épitaphe… On construit, en fait, un dernier foyer pour soi-même et, souvent, pour sa propre famille. Dans le cadre d’une plus vaste recherche anthropologique conduite dans des cimetières en Italie, aux États-Unis et au Brésil, on a pu se confronter à des individus qui ont décidé de passer leurs derniers mois ou années de vie à choisir, acheter, décorer et personnaliser leur propre tombe. Qu’ils fassent cela pour réaliser leurs derniers rêves et volontés — avant qu’il ne soit trop tard et en ne se fiant pas trop au fait que les autres le fassent pour eux — ou, tout « simplement », pour ne pas penser à la maladie et à la destruction du corps, le résultat est souvent le même : sous forme d’une chapelle, d’un buste, d’un petit jardin ou d’une photographie funéraire, et dans des espaces — les cimetières — qu’on apprend à aimer chaque jour davantage, des individus pensent à la mort de façon constructive et, souvent, artistique. C’est surtout une manière de ne pas la subir, la mort ; au contraire, on apprend à la connaître et à la maîtriser, jusqu’à en faire une oeuvre d’art ou juste un agréable espace de mémoire.
Fins de vie, controverses et conceptions de la personne
Authors: Schepens Florent 
Published: November 2021

L’univers de la fin de vie est traversé par deux entreprises morales en France. L’une est le fait des soignants des soins palliatifs qui s’appuient sur la légitimité de la science et de la médecine pour fonder leur approche ; l’autre est celle des tenants d’une aide active à mourir qui mettent en oeuvre une rhétorique émotionnelle pour produire de l’intolérable et obliger le législateur à intervenir et à prendre en considération leurs revendications. Derrière les discours portés par les différents acteurs apparaissent deux figures de la personne malade : l’une isolée, l’autre prise dans un collectif ; l’une référée principalement à sa corporalité biologique, l’autre à son psychisme. In fine, ce sont deux conceptions de la personne aux propriétés différentes qui s’affrontent ici.
La formation des psychoéducateurs et des psycho-éducatrices au Québec : rétrospective et prospective
Authors: Caouette Martin , Bégin Jean-Yves , Trudel Dominique 
Published: November 2021

Les psychoéducateurs constituent un groupe de plus de 5000 professionnels québécois qui interviennent auprès de personnes aux prises avec des difficultés d’adaptation se manifestant sur le plan comportemental dans leurs différents milieux de vie. Cette expertise s’appuie notamment sur une formation initiale universitaire de 1eret de 2e cycle. Dans une visée rétrospective et prospective, cet article retrace d’abord l’évolution de la formation des psychoéducateurs au cours des soixante dernières années, de ses origines dans les internats pour jeunes en difficulté d’adaptation jusqu’au développement de programmes doctoraux en psychoéducation. L’arrivée de l’ordre professionnel, en 2000, est ensuite présentée comme un jalon important de cette histoire avec l’encadrement des programmes donnant accès au permis d’exercice. Enfin, un regard est posé sur les défis que cette formation devra relever au cours de la prochaine décennie.
La psychoéducation classique est-elle une discipline en dissipation? Le parcours de l’École de psychoéducation de l’Université de Montréal en parallèle de quatre périodes doctrinaires : de la réforme à la rééducation vers l’hétérogisme et le contrôle
Authors: Le Blanc Marc , Morizot Julien 
Published: November 2021

Cet article présente l’évolution de la psychoéducation au Québec en la situant dans le contexte de quatre périodes historiques qui correspondent chacune à des doctrines successives de la prise en charge des jeunes en difficulté par l’État québécois. Les racines de l’École de psychoéducation (ÉPÉ), créée à l’Université de Montréal au début des années 1970, sont déterrées jusqu’au dernier quart du 19e siècle lorsque la doctrine dominante était la réforme. Par ailleurs, une formation sur la jeunesse inadaptée avait pris forme dans des internats pour enfants et adolescents avant la création de l’ÉPÉ dans les années 1950-1960. La doctrine de la rééducation commençait alors à remplacer celle de la réforme. Cette rééducation scientifique se construisait déjà en raison de son assise théorique, d’activités diverses de recherche et de stages. Le Boscoville classique atteignait alors son apogée. L’ÉPÉ a repris ce modèle avec des cours sur les théories du développement psychologique et les connaissances sur l’organisation et le fonctionnement d’un internat et des stages pratiques. Par la suite l’ÉPÉ s’est adaptée, à partir du milieu des années 1970, à la doctrine de l’hétérogisme qui prônait, entre autre, la désinstitutionalisation et la diversification des services et des approches cliniques. Elle a alors pris la direction des recherches longitudinales, soit expérimentale ou évaluative. Surtout, elle a accepté progressivement un large éventail de types de difficultés d’adaptation et une diversité de milieux pour la pratique de la psychoéducation. Elle a aussi remplacé, au cours des années 1990, l’approche psychodynamique par celle dite cognitivo-comportementale et elle a fait un clin d’oeil à la psychopathologie. La dernière période, depuis 2000, a été celle du contrôle légal, organisationnel, professionnel et scientifique, c’est-à-dire l’imposition de processus, règles et procédures qui limitent les initiatives créatrices. Tous ces changements et contraintes successives amènent à conclure que la psychoéducation est devenue une discipline en dissipation.