bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exit, Pursued by a Bear: Dushu sheng and the Limits of Community in the Early Qing
Authors: Fox Ariel 
Published: June 2020

Abstract
This article explores the late imperial imagination of the nonhuman other by way of a curious creature that appears in the southern drama Dushu sheng. Midway through the play, set in the early years of the Yuan dynasty, the young literatus protagonist is abandoned on a remote island, where he is rescued by a renxiong, a fierce yet empathetic bear-like creature that takes him as its mate. Though short-lived, their union is one of several in the play in which marginal characters are brought into the (narrative and imperial) center through marriage: by the end of the play, the protagonist is wed to both the daughter of a boatman and the daughter of a Mongol official. But while this double marriage offers the possibility of a productive overcoming of the distinctions between scholar and merchant and between Chinese and barbarian, the tragic fate of the renxiong forecloses any possibility of overcoming that which divides man and beast. Rather, as the human community is expanded to include merchant and Mongol, the renxiong serves as the necessary limit, allowing the play to rescue these social and ethnic others from baseness and barbarity. At the same time, the exclusion of the renxiong from this new community is not untroubled; in resisting the genre's compulsive imposition of wholeness, Dushu sheng dramatizes the fractures and exclusions that made possible the restoration of order in the early Qing.
Cannibalism as Method
Authors: Wong Lorraine 
Published: June 2020

Abstract
Tian yu di 天與地 (When Heaven Burns, 2011), a primetime television series that was screened in Hong Kong from November 2011 to January 2012, tells the story of a young rock band struggling with the memory of having eaten a fellow bandmate in order to survive a mountaineering accident. Cannibalism not only bewildered the mainstream TV audience, but it was also viewed as an allusion to the June Fourth crackdown on the Tiananmen student movement. This essay explores cannibalism as a method that questions the assimilation of Hong Kong into the national body politic of China. Its argument is twofold. First, cannibalism in this drama disrupts the bourgeois consciousness of a healthy subject, exploring a shattered but renewed life that questions the dissolution of food in the making of a healthy subject. Second, by challenging the bourgeois model of a reconciled body, this drama series throws critical light on Hong Kong's coerced “swallowing” of a China excessive in its material aggrandizement, restoring the power of imagination of possible futures not dictated by Hong Kong's increasing integration with China. Finally, this essay suggests that cannibalism, viewed through the Tiananmen legacy, may function as a method to explore modes of relationality between Hong Kong and Mainland China.
Producción de aceite de palma en Colombia: ¿trabajo decente y saludable?
Authors: Gallo Óscar , Hawkins Daniel , Luna-García Jairo Ernesto , Torres-Tovar Mauricio 
Published: June 2020

Introducción: este artículo analiza la relación entre el proceso productivo del aceite de palma en Colombia y sus efectos en la salud de los trabajadores del sector. Método: entre marzo y septiembre de 2017, se llevaron a cabo un taller piloto con directivos sindicales y ocho grupos focales en los que participaron 165 trabajadores de diversas áreas y empresas del sector y un taller de revisión y retroalimentación con la participación de diez dirigentes sindicales. Igualmente, se efectuaron visitas a algunas empresas para observar los procesos productivos, tanto en las plantaciones como en las plantas extractoras. La Encuesta de Morbilidad Sentida, sobre la información suministrada por los trabajadores (percepciones e interpretaciones acerca de su estado de salud en vínculo con su trabajo), fue la base para identificar los factores de riesgo del sector, el desgaste, la fatiga y las condiciones de salud-enfermedad asociadas a los oficios del cultivo de la palma en campo y al proceso industrial en la planta de extracción del aceite. Conclusión: la morbilidad sentida sugiere que las cargas laborales, los patrones de desgaste asociados a la producción, la exposición a altas temperaturas y agrotóxicos, además de la intensificación productiva derivada de la forma de organización del trabajo afectan significativamente la salud de los trabajadores de la agroindustria de palma. Basados en estos resultados, sugerimos que los trabajadores del sector deberían ser cobijados por un régimen especial de pensión conjugado con políticas de prevención en salud y seguridad en el trabajo y cobertura de protección social.
Talleres y evaluaciones de proceso: una herramienta que mejora el rendimiento en asignaturas integradas
Authors: Urrejola Contreras Gabriela , Tenore Venegas Paulina , Elgueta Perinni Sebastián , Pérez Lizama Miguel , Araya Herrera Paula , Campos Reinoso Pía Daniela 
Published: June 2020

Introducción: una tendencia actual en la educación superior es fusionar materias y articular las asignaturas integradas; sin embargo, hay menor rendimiento y un incremento de la reprobación. Se ha descrito como favorable la aplicación de evaluaciones de procesos como instrumentos de enseñanza y aprendizaje en ciencias de la salud, criterio pertinente de considerar en asignaturas de gran volumen de contenidos. El objetivo de este trabajo fue valorar el efecto de la evaluación del proceso sobre una asignatura integrada de anatomía y fisiología en estudiantes de ciencias de la salud y su relación con el rendimiento. Materiales y métodos: estudio experimental con 144 estudiantes de la Escuela de Ciencias de la Salud en la asignatura de Estructura y Función, distribuidos en dos grupos: control y experimental. Se diseñó e implementó una intervención metodológica para evaluar su efecto en el rendimiento académico. Resultados: la intervención del proceso en el grupo control experimental mejoró el rendimiento comparado con el grupo control tanto en el promedio como en las evaluaciones parciales de cada unidad (t-test < 0.05). En el grupo experimental se registró un incremento del rendimiento entre el 59 % y el 83 % de los estudiantes. Adicionalmente, la mejora progresiva modificó la condición de reprobación a aprobación en un 27% de los estudiantes tras la intervención (Anova: p < 0.05). Conclusión: la incorporación de evaluaciones de proceso parece ser una favorable herramienta para descomprimir las materias, aplicar lo aprendido, realizar seguimiento a las metodologías de estudio y mejorar el rendimiento de los estudiantes.
The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty
Authors: Dakin H. , Eibich P. , Beard D. , Gray A. , Price A. 
Published: June 2020

Aims To assess how the cost-effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) varies with age, sex, and preoperative Oxford Hip or Knee Score (OHS/OKS); and to identify the patient groups for whom THA/TKA is cost-effective. Methods We conducted a cost-effectiveness analysis using a Markov model from a United Kingdom NHS perspective, informed by published analyses of patient-level data. We assessed the cost-effectiveness of THA and TKA in adults with hip or knee osteoarthritis compared with having no arthroplasty surgery during the ten-year time horizon. Results THA and TKA cost < £7,000 per quality-adjusted life-year (QALY) gained at all preoperative scores below the absolute referral thresholds calculated previously (40 for OHS and 41 for OKS). Furthermore, THA cost < £20,000/QALY for patients with OHS of ≤ 45, while TKA was cost-effective for patients with OKS of ≤ 43, since the small improvements in quality of life outweighed the cost of surgery and any subsequent revisions. Probabilistic and one-way sensitivity analyses demonstrated that there is little uncertainty around the conclusions. Conclusion If society is willing to pay £20,000 per QALY gained, THA and TKA are cost-effective for nearly all patients who currently undergo surgery, including all patients at and above our calculated absolute referral thresholds. Cite this article: Bone Joint J 2020;102-B(7):950–958.
Safety of a ‘swing room’ surgery model at a high-volume hip and knee arthroplasty centre
Authors: Waly Feras J. , Garbuz Donald S. , Greidanus Nelson V. , Duncan Clive P. , Masri Bassam A. 
Published: June 2020

Aims The practice of overlapping surgery has been increasing in the delivery of orthopaedic surgery, aiming to provide efficient, high-quality care. However, there are concerns about the safety of this practice. The purpose of this study was to examine the safety and efficacy of a model of partially overlapping surgery that we termed ‘swing room’ in the practice of primary total hip (THA) and knee arthroplasty (TKA). Methods A retrospective review of prospectively collected data was carried out on patients who underwent primary THA and TKA between 2006 and 2017 in two academic centres. Cases were stratified as partially overlapping (swing room), in which the surgeon is in one operating room (OR) while the next patient is being prepared in another, or nonoverlapping surgery. The demographic details of the patients which were collected included operating time, length of stay (LOS), postoperative complications within six weeks of the procedure, unplanned hospital readmissions, and unplanned reoperations. Fisher's exact, Wilcoxon rank-sum tests, chi-squared tests, and logistic regression analysis were used for statistical analysis. Results A total of 12,225 cases performed at our institution were included in the study, of which 10,596 (86.6%) were partially overlapping (swing room) and 1,629 (13.3%) were nonoverlapping. There was no significant difference in the mean age, sex, body mass index (BMI), side, and LOS between the two groups. The mean operating time was significantly shorter in the swing room group (58.2 minutes) compared with the nonoverlapping group (62.8 minutes; p < 0.001). There was no significant difference in the rates of complications, readmission and reoperations (p = 0.801 and p = 0.300, respectively) after adjusting for baseline American Society of Anesthesiologists scores. Conclusion The new ‘swing room’ model yields similar short-term outcomes without an increase in complication rates compared with routine single OR surgery in patients undergoing primary THA or TKA. Cite this article: Bone Joint J 2020;102-B(7 Supple B):112–115.
Data for registry and quality review can be retrospectively collected using natural language processing from unstructured charts of arthroplasty patients
Authors: Shah Romil F. , Bini Stefano , Vail Thomas 
Published: June 2020

Aims Natural Language Processing (NLP) offers an automated method to extract data from unstructured free text fields for arthroplasty registry participation. Our objective was to investigate how accurately NLP can be used to extract structured clinical data from unstructured clinical notes when compared with manual data extraction. Methods A group of 1,000 randomly selected clinical and hospital notes from eight different surgeons were collected for patients undergoing primary arthroplasty between 2012 and 2018. In all, 19 preoperative, 17 operative, and two postoperative variables of interest were manually extracted from these notes. A NLP algorithm was created to automatically extract these variables from a training sample of these notes, and the algorithm was tested on a random test sample of notes. Performance of the NLP algorithm was measured in Statistical Analysis System (SAS) by calculating the accuracy of the variables collected, the ability of the algorithm to collect the correct information when it was indeed in the note (sensitivity), and the ability of the algorithm to not collect a certain data element when it was not in the note (specificity). Results The NLP algorithm performed well at extracting variables from unstructured data in our random test dataset (accuracy = 96.3%, sensitivity = 95.2%, and specificity = 97.4%). It performed better at extracting data that were in a structured, templated format such as range of movement (ROM) (accuracy = 98%) and implant brand (accuracy = 98%) than data that were entered with variation depending on the author of the note such as the presence of deep-vein thrombosis (DVT) (accuracy = 90%). Conclusion The NLP algorithm used in this study was able to identify a subset of variables from randomly selected unstructured notes in arthroplasty with an accuracy above 90%. For some variables, such as objective exam data, the accuracy was very high. Our findings suggest that automated algorithms using NLP can help orthopaedic practices retrospectively collect information for registries and quality improvement (QI) efforts. Cite this article: Bone Joint J 2020;102-B(7 Supple B):99–104.
Cutibacterium colonization of the anterior and lateral thigh
Authors: Elkins Jacob M. , Dennis Douglas A. , Kleeman-Forsthuber Lindsay , Yang Charlie C. , Miner Todd M. , Jennings Jason M. 
Published: June 2020

Aims Of growing concern in arthroplasty is the emergence of atypical infections, particularly Cutibacterium (formerly Propionibacterium) sp. infections. Currently, the dermal colonization rate of Cutibacterium about the hip is unknown. Therefore, the aim of this study was to investigate colonization rates of Cutibacterium sp. at locations approximating anterior and posterolateral approaches to the hip joint. Methods For this non-randomized non-blinded study, 101 adult patients scheduled for hip or knee surgery were recruited. For each, four 3 mm dermal punch biopsies were collected after administration of anaesthesia, but prior to antibiotics. Prebiopsy skin preparation consisted of a standardized preoperative 2% chlorhexidine skin cleansing protocol and an additional 70% isopropyl alcohol mechanical skin scrub immediately prior to biopsy collection. Two skin samples 10 cm apart were collected from a location approximating a standard direct anterior skin incision, and two samples 10 cm apart were collected from a lateral skin incision (suitable for posterior, direct-lateral, or anterolateral approaches). Samples were cultured for two weeks using a protocol optimized for Cutibacterium. Results A total of 23 out of 404 cultures (collected from 101 patients) were positive for a microorganism, with a total of 22 patients having a positive culture (22%). Overall, 15 of the cultures in 14 patients were positive for Cutibacterium sp. (65%), of which Cutibacterium acnes comprised the majority (n = 13; 87%). Other isolated microorganisms include coagulase-negative Staphylococcus (n = 6), Clostridium (n = 1), and Corynebacterium (n = 1). Of all positive cultures, 15 were obtained from the anterior location (65%), of which seven (60%) were from the most proximal biopsy location. However, these findings were not statistically significant (anterior vs lateral, p = 0.076; proximal vs distal, p =0.238). Conclusion Approximately 14% (14/101) of the patients demonstrated a positive Cutibacterium colonization about the hip, the majority anteriorly. Given the high colonization rate of Cutibacterium, alternative skin preparations for total hip arthroplasty should be considered. Cite this article: Bone Joint J 2020;102-B(7 Supple B):52–56.
Management of osteonecrosis of the femoral head
Authors: Sodhi Nipun , Acuna Alexander , Etcheson Jennifer , Mohamed Nequesha , Davila Iciar , Ehiorobo Joseph O. , Jones Lynne C. , Delanois Ronald E. , Mont Michael A. 
Published: June 2020

AimsEarlier studies dealing with trends in the management of osteonecrosis of the femoral head (ONFH) identified an increasing rate of total hip arthroplasties (THAs) and a decreasing rate of joint-preserving procedures between 1992 and 2008. In an effort to assess new trends in the management of this condition, this study evaluated the annual trends of joint-preserving versus arthroplasties for patients aged < or > 50 years old, and the incidence of specific operative management techniques.MethodsA total of 219,371 patients with ONFH were identified from a nationwide database between 1 January 2009 and 31 December 2015. The mean age was 54 years (18 to 90) and 105,298 (48%) were female. The diagnosis was made using International Classification of Disease, Ninth revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) procedure codes. The percentage of patients managed using each procedure during each year was calculated and compared between years. The trends in the use of the types of procedure were also evaluated.ResultsThe rate of joint-preserving procedures was significantly higher in patients aged < 50 years compared with those aged > 50 years (4.93% vs 1.52%; p < 0.001). For the overall cohort, rates of arthroplasty were far greater than those for joint-preserving procedures. THA was the most commonly performed procedure (291,114; 94.03%), while osteotomy (3,598; 1.16%), partial arthroplasty (9,171; 2.96%), core decompression (1,200; 0.39%), and bone graft (3,026; 0.98%) were performed markedly less frequently. The annual percentage of patients managed using a THA (93.56% to 89.52%; p < 0.001), resurfacing (1.22% to 0.19%; p < 0.001), and osteotomy (1.31% to 1.05%; p < 0.001) also decreased during the study period.ConclusionWe found that patients with ONFH have been most commonly managed with non-joint-preserving procedures. Our findings provide valuable insight into the current management of this condition and should increase efforts being made to save the hip joint. Cite this article: Bone Joint J 2020;102-B(7 Supple B):122–128.
Pelvic rotation after total hip arthroplasty is dynamic and variable
Authors: Kazarian Gregory S. , Schloemann Derek T. , Barrack Toby N. , Lawrie Charles M. , Barrack Robert L. 
Published: June 2020

Aims The aims of this study were to determine the change in the sagittal alignment of the pelvis and the associated impact on acetabular component position at one-year follow-up after total hip arthroplasty (THA). Methods This study represents the one-year follow-up of a previous short-term study at our institution. Using the patient population from our prior study, the radiological pelvic ratio was assessed in 91 patients undergoing THA, of whom 50 were available for follow-up of at least one year (median 1.5; interquartile range (IQR) 1.1 to 2.0). Anteroposterior radiographs of the pelvis were obtained in the standing position preoperatively and at one year postoperatively. Pelvic ratio was defined as the ratio between the vertical distance from the inferior sacroiliac (SI) joints to the superior pubic symphysis and the horizontal distance between the inferior SI joints. Apparent acetabular component position changes were determined from the change in pelvic ratio. A change of at least 5° was considered clinically meaningful. Results Pelvic ratio decreased (posterior tilt) in 54.0% (27) of cases, did not change significantly in 34.0% (17) of cases, and increased (anterior tilt) in 12.0% (6) of cases when comparing preoperative to one-year postoperative radiographs. This would correspond with 5° to 10° of abduction error in 22.0% of cases and > 10° of error in 6.0%. Likewise, this would correspond with 5° to 10° of version error in 22.0% of cases and > 10° of error in 44.0%. Conclusion Pelvic sagittal alignment is dynamic and variable after THA, and these changes persist to the one-year postoperative period, altering the orientation of the acetabular component. Surgeons who individualize the acetabular component placement based on preoperative functional radiographs should consider that the rotation of the pelvis (and thus the component version and inclination) changes one year postoperatively. Cite this article: Bone Joint J 2020;102-B(7 Supple B):47–51.
Comparative study of the use of Paediatric Quality Of Life Inventory 4.0 generic core scales in paediatric patients with spine and limb pathologies
Authors: Cheung Prudence W. H. , Wong Carlos K. H. , Cheung Jason P. Y. 
Published: June 2020

Aims The health-related quality of life (HRQoL) of paediatric patients with orthopaedic conditions and spinal deformity is important, but existing generic tools have their shortcomings. We aim to evaluate the use of Paediatric Quality of Life Inventory (PedsQL) 4.0 generic core scales in the paediatric population with specific comparisons between those with spinal and limb pathologies, and to explore the feasibility of using PedsQL for studying scoliosis patients’ HRQoL. Methods Paediatric patients attending a speciality outpatient clinic were recruited through consecutive sampling. Two groups of patients were included: idiopathic scoliosis, and paediatric orthopaedic upper and lower limb condition without scoliosis. Patients were asked to complete PedsQL 4.0 generic core scales, Youth version of 5-level EuroQol-5-dimension questionnaire, and Refined Scoliosis Research Society 22-item (SRS-22r) questionnaire. Statistical analyses included scores comparison between scoliosis and limb pathology patients using independent-samples t-test, and correlation tests of PedsQL and SRS-22r. Results A total of 566 paediatric patients were recruited: 357 (63.0%) having idiopathic scoliosis, and 209 (37.0%) with limb conditions. Patients with limb pathology had lower functioning scale, summary, and total scores of PedsQL than scoliosis patients (p < 0.05 to p < 0.001). No floor or ceiling effects (< 15%) were detected for PedsQL Psychosocial Health Summary and total scores in both groups. PedsQL was sensitive in differentiating patients with/without problems in their daily lives (p < 0.05 to p < 0.01). PedsQL summary and total scores correlated with SRS-22r total score. Conclusion PedsQL is an effective HRQoL measure for both paediatric orthopaedic groups with minimal ceiling and floor effects, and is capable of detecting worse HRQoL in patients with limb pathology. The multidimensional PedsQL is sensitive in differentiating among those with daily life problems, especially for scoliosis patients. Cite this article: Bone Joint J 2020;102-B(7):890–898.
High-sensitivity SPR sensor based on the eightfold eccentric core PQF with locally coated indium tin oxide
Authors: Liu Qiang , Sun Jiudi , Sun Yudan , Liu Wei , Lv Jingwei , Liu Chao , Li Xianli , Ren Zonghuan , Wang Famei , Lu Wenshu , Jiang Yu , Sun Tao , Chu Paul K. 
Published: June 2020

A highly sensitive surface plasmon resonance (SPR) sensor comprising an eccentric core photonic quasi-crystal fiber (PQF) coated with indium tin oxide is designed and numerically analyzed. The novel, to the best of our knowledge, structure with an eccentric core layout and local coating not only strengthens coupling between the core mode and surface plasmon polariton mode but also provides higher refractive index sensitivity in the near-infrared region. Analysis based on the finite element method to assess the performance of the sensor and optimize the structural parameters reveals that the maximum wavelength sensitivity and resolution are 96667 nm/RIU and

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in the sensing range between 1.380 and 1.413, respectively. Meanwhile, the average sensitivity is enhanced to 25458 nm/RIU. The sensor is expected to have broad applications in environmental monitoring, biochemical sensing, food safety testing, and related applications due to the ultrahigh sensitivity and resolution.