bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Academic Detailing to Impact Pharmacists’ Compliance with an Outpatient Pharmacy Partial Fill Policy
Authors: Wynn Rebecca E. , Kirk Cain Eric
Published: December 2020

Background

Pharmacists’ compliance with a medication partial fill policy at a Veterans Affairs healthcare system has been underwhelming. Academic detailing, an educational outreach approach conducted by trained health care professionals to improve patient care, is an attractive method for improving pharmacists’ compliance with the policy.

Objective

To evaluate the impact of academic detailing on pharmacists’ compliance with the partial fill policy.

Methods

A pre-post analysis was performed to evaluate the impact of academic detailing outreach visits on pharmacists’ compliance with the partial fill policy. Data collection included all partial fill medication orders verified during the study duration. Student’s t-test was used to analyze the change in the day supply of partial fills following the academic detailing intervention. Total partial fill drug expense during the pre- and post-intervention phases was calculated as drug cost plus material cost for each partial fill.

Results

A total of 36 (97.3%) pharmacists received an academic detailing outreach visit. Total percentage of partial fills limited to a 7-day supply was significantly increased following academic detailing outreach visits (49.2% pre-intervention vs. 84.2% post-intervention, p-value <0.001). Total partial fill drug expense decreased from $12,144.42 to $9,713.50. Percentage of partial fills limited to a 7-day supply remained significant during the 6-month follow-up period (p-value = 0.03).

Conclusions

Academic detailing is an effective method for improving pharmacists’ compliance with an outpatient pharmacy partial fill policy and decreasing total partial fill drug expense for the pharmacy department.
The Experience of Working With a Faith Community Nurse Liaison of Care in a Primary Care Practice Among Older Adult Clients and Their Informal Caregiver
Authors: Sessanna Loralee , Pomeroy Sherry H. , Askew Yvonne , McDonald-Shanahan Kathleen , Couche Maureen
Published: December 2020

Informal caregivers of older adults aging in place are at risk for adverse health and financial consequences. This descriptive qualitative study explored the experience of working with a faith community nurse (FCN) liaison of care in a Catholic health care system affiliated primary care practice among older adult clients and their informal caregiver. Semistructured face-to-face interviews were conducted with nine older adult client–informal caregiver dyads, three clients, and one caregiver ( n = 22). Interviews were audio recorded, transcribed, and analyzed using Braun and Clarke’s reflexive thematic analysis method. The analysis generated one overarching theme, I’m Sorry the Study and FCN Visits Are Coming to an End, and two key themes, The FCN Was Always There to Help Us (older adult clients) and The FCN Took the Pressure Off of Caregiving for Awhile (informal caregivers). Participants viewed the FCN as an instrumental member of their health care team and considered prayer and spiritual support offered by the FCN an essential element of care.
Legislating Islamophobia: The factors for the existence of anti-sharia laws in the United States
Authors: Hummel Daniel
Published: December 2020

In 2010 a number of states began introducing a law that prohibited the application of sharia in U.S. courtrooms. Sharia, translated as the ‘clear path’, is essentially the law of Islam. These laws are an outgrowth of the angst and prejudice toward Muslim Americans known as Islamophobia. This study attempts to understand these laws, their origin and the population, legislative and political/cultural factors most closely related to their introduction and existence. This is a very salient topic given the targeting of Islam by some politicians most prominently in the 2016 presidential election. Their introduction and passage in some states have alienated the small, but growing population of Muslims. It was found in this study that religious salience, traditionalism and the size of the presence of anti-Muslim groups predicted the existence of an anti-sharia law, while Democratic dominance predicted no law. These results indicate that Islam is part of the ‘culture war’ in the United States.
Modification of traditional benzoxazine by blending with polyfunctional benzoxazines containing aromatic group and fluorene group
Authors: Wang Ting , Guo Zhi-yi , Wang Jun-yi , Dayo Abdul Qadeer , Liu Wen-bin , Wang Jun
Published: December 2020

A series of polyfunctional benzoxazine monomers containing aromatic and fluorene group (AMFB) were used as modified agents to improve the performance of typical bifunctional bisphenol-A-aniline-based (BA-a) benzoxazine resins. The polymerization behaviors of BA-a/AMFB blends were investigated by using the differential scanning calorimetry (DSC), while the dynamic mechanical analysis (DMA) and thermogravimetric analysis (TGA) were used to analyze the thermomechanical and thermal properties of BA-a/AMFB copolymers [poly(BA-a/AMFB)]. Moreover, the cross-section morphologies of poly(BA-a/AMFB) were observed by scanning electron microscope (SEM). The experimental results showed that BA-a monomer has good catalytic activity for AMFB monomers during the curing process. Compared with BA-a polymer [poly(BA-a)], due to the introduction of heat-resistant fluorene ring and the increase of the crosslinking degree of copolymers, the copolymers showed higher glass transition temperature and better thermal properties. For poly(BA-a/AMFB), the T5, T10, and Yc were higher than those of poly(BA-a). With the increase of the alkyl chain length of AMFB monomers, the cross-section creases gradually changed from linear to dendritic, and the number of creases increased significantly, which indicated that the toughness of the copolymers was significantly improved.
Accuracy Analysis of Machining Trajectory Contemplating Workpiece Dislocation on a Six Degree of Freedom Machining Bed
Authors: Shah Muhammad Faizan , Kausar Zareena , Farooq Muhammad Umer , Khan Liaquat Ali , Farooq Syed Saad
Published: December 2020

Machining is material removal from a workpiece. Current spindle technologies allow the material to be removed very quickly but unfortunately this compromises the accuracy of the desired machined trajectory on the workpiece. Proposed solution to the problem is restricting motion of the tool and giving rotation to the workpiece. This paper presents analysis of the accuracy of trajectory of material removal from a workpiece, such that the workpiece rotates with six degrees of freedom, in the presence of error generated due to an offset of the workpiece from centre of the moving platform of the machining bed. The kinematics of the machining bed is, therefore, modeled using as inverse kinematic formulation applying geometric and vector addition method. The mechanism outputs three rotational and three translational motions. The leg length for each of six legs of the bed is computed individually. Moreover, workpiece position offset error is modelled to find actual leg lengths of the bed. Finally accuracy computation model is proposed to analyse the accuracy of the final trajectory of the motion of the workpiece. The models are verified in simulation for a trajectory and validated experimentally on a six degree of freedom (6DOF) machining bed. The results reveal maximum inaccuracy in machining trajectory to be 1% in experiments while less than 1% in simulation. This verifies quality of the mechanism and efficacy of the proposed 6DOF machining bed in machining accuracy.
Aeroelastic vibration analysis of wind turbine blade with Gurney flap
Authors: Chang Lin , Yu Yingjie , Liu Tingrui
Published: December 2020

In this paper, based on the parametric design of 3 D blades including typical cross-section and natural frequency calculation of the equivalent model, an integral method for aerodynamic performance and aeroelastic vibration analysis of blade with Gurney flap is proposed. Parametric design and unstructured grid are used to pre-process the blades with/without the Gurney flap. The discrete aerodynamic performance parameters distribution including the lift, drag, and torsion coefficients calculated by Fluent is fitted by the nonlinear least square method based on the trust-region algorithm, and the natural frequencies of the rotating blade are accurately solved by the equivalent thin-walled beam model and Green’s functions. Based on the aerodynamic performance coefficients and natural frequencies obtained by the accurate calculation above, the aeroelastic response equation of typical cross-section considering local aerodynamic damping matrix is established, and the vibration response of blade in flap and torsion direction is further described. From the analysis results, it can be seen that the Gurney flap structure can not only bring higher lift performance to the blade, but also can reduce the amplitude and vibration range of aeroelastic vibration, improve the aeroelastic stability of the blade, and prove the effectiveness of Gurney flap.
Influence of balanced suspension on handling stability and ride comfort of off-road vehicle
Authors: Chen Qiang , Bai Xian-Xu Frank , Zhu An-Ding , Wu Di , Deng Xue-Cai , Li Zhi-Dong
Published: December 2020

Handing stability and ride comfort, basic indexes to evaluate vehicle performance, usually cannot be guaranteed simultaneously. Given the contradiction between the two indexes, a new type of suspension – balanced suspension, has attracted wide attentions for years. Balanced suspensions are a device that converts the movement of a wheel into force at the other wheels through a mechanical or hydraulic structure, which might improve ride comfort/handling stability while maintaining the handling stability/ride comfort. As the hydraulically interconnected suspension and hydro-pneumatic suspension show disadvantages of high cost and high installation space requirement, a specific balanced suspension which is connected through a mechanical structure is presented and thoroughly analyzed in this paper. The balanced suspension connects the front and rear suspension motion of the vehicle by means of the lever mechanical connection structure to obtain the comprehensive performance of enhanced vehicle’s ride comfort and handling stability. The half-vehicle mathematical model for ride comfort and the multi-body dynamics model for handling stability are established for the comparison and analysis of the dynamic performance of vehicle when the balanced suspension on and off. In addition, experimental tests of the modified vehicle prototypes when the balanced suspension on and off on the ride comfort and handling stability are conducted. Similar with the simulation results, experimental tests show that the handling stability is nearly unchanged while the ride comfort improves about 15.9% when the balanced suspension is on.
Human-vehicle dynamic model with driver’s neuromuscular characteristic for shared control of autonomous vehicle
Authors: Hanbing Wei , Yanhong Wu , Xing Chen , Jin Xu , Sharma Rahul
Published: December 2020

Over a long period of time, the fully autonomous vehicle is far from commercial application. The concept of ‘human-vehicle shared control (HVSC)’ provides a promising solution to enhance autonomous driving safety. In order to characterize the evolution of the driver’s feature in the process of HVSC, a dynamics model of HVSC with the driver’s neuromuscular characteristic is proposed in this paper. It takes into account the driver’s neuromuscular characteristics, such as stretch reflection, feedback stiffness, etc. By designing a model predictive control (MPC) controller, the feedback of the vehicle’s state and steering torque is constructed. For validation of the model, driving simulation has been conducted in our table-based driving simulator. The vehicle state and the surface electromyography of the driver’s arm working muscle group are collected simultaneously. Subsequently, the hierarchical least square (HLS) parameter identification and unscented Kalman filter (UKF) observer is used to identify and estimate the important characteristic parameters respectively based on the experimental results. The comparisons show that the HVSC can characterize the vehicle’s dynamic state and the driver’s personalized characteristic can be identified by HLS. This paper will serve as a theoretical basis of control strategy allocation between the human and vehicle during shared control for L3 class autonomous vehicle.
Path planning and robust fuzzy output-feedback control for unmanned ground vehicles with obstacle avoidance
Authors: Chen Yimin , Hu Chuan , Qin Yechen , Li Mingjun , Song Xiaolin
Published: December 2020

Obstacle avoidance strategy is important to ensure the driving safety of unmanned ground vehicles. In the presence of static and moving obstacles, it is challenging for the unmanned ground vehicles to plan and track the collision-free paths. This paper proposes an obstacle avoidance strategy consists of the path planning and the robust fuzzy output-feedback control. A path planner is formed to generate the collision-free paths that avoid static and moving obstacles. The quintic polynomial curves are employed for path generation considering computational efficiency and ride comfort. Then, a robust fuzzy output-feedback controller is designed to track the planned paths. The Takagi–Sugeno (T–S) fuzzy modeling technique is utilized to handle the system variables when forming the vehicle dynamic model. The robust output-feedback control approach is used to track the planned paths without using the lateral velocity signal. The proposed obstacle avoidance strategy is validated in CarSim® simulations. The simulation results show the unmanned ground vehicle can avoid the static and moving obstacles by applying the designed path planning and robust fuzzy output-feedback control approaches.
Torque ripple compensation control for hybrid UGVs in mode transition based on current harmonic control of a PMSM
Authors: Zhang Wei , Liu Hui , Zhang Xun , Wu Yunhao , Gao Pu , Wang Zhen , Zhang Wannian
Published: December 2020

Load jumping and mode transitions both cause the unstable dynamic states for compound power-split hybrid Unmanned Ground Vehicles (UGVs), and these phenomena lead to vibrations of the transmission system and longitudinal buffeting of the vehicle. This study presents a feed-forward compensation control strategy for load jumping and mode transitions to reduce the corresponding torsional vibration in hybrid UGVs. The proposed method injects an appropriate harmonic current into a permanent magnet synchronous motor (PMSM) to generate a harmonic torque that is opposite to the load torque, which improves the dynamic response quality of the vehicle load. First, the multimode structure of a hybrid UGV and mode switching vibration and shock are investigated, as well as a feed-forward compensate control architecture is proposed. Second, two models are established the PMSM dynamic model based on the electromagnetic coupling principle and a 2-degree-of-freedom torsional vibration model of transmission system by simplifying the vehicle system. Third, the harmonic current injection method is proposed, and the harmonic current equation is derived. Based on the field-oriented control algorithm, a double closed-loop controller is designed for the torque and speed of the PMSM, and the internal model control method is applied to design the current controller. The simulation results show that the proposed strategy effectively suppresses jerk and that the harmonics current transfers the energy from the mechanical vibrations of the system into electric power fluctuations.
Numerical transient responses of cut-out borne composite panel and experimental validity
Authors: Dewangan Hukum Chand , Panda Subrata Kumar
Published: December 2020

The effect of cut-out parameters (shapes: square and circular; position: concentric/eccentric) on the dynamic deflection values of the curved/flat layered composite panel are verified experimentally with the higher-order finite element solutions first-time. The solutions are obtained using the linear finite element model in the framework of cubic-order displacement filed functions. The necessity of higher-order kinematic model is verified by comparing the experimental transient data by conducting the different test to show the accuracy of the finite element solution. Moreover, the theoretical finite element solutions are obtained using the own experimental elastic property data for the comparison (numerical and experimental) purpose. Finally, the critical behaviour of the proposed numerical model for the dynamic analysis of damaged composite structure is examined by solving different types of example by varying the design constraint parameter including the cut-out factors (shape, size, location and eccentricity). The inclusiveness of each parameter on the time-dependent deflections is expressed in details from the various example including the comparison.
Design of a 3D-printed hand prosthesis featuring articulated bio-inspired fingers
Authors: Cuellar Juan Sebastian , Plettenburg Dick , Zadpoor Amir A , Breedveld Paul , Smit Gerwin
Published: December 2020

Various upper-limb prostheses have been designed for 3D printing but only a few of them are based on bio-inspired design principles and many anatomical details are not typically incorporated even though 3D printing offers advantages that facilitate the application of such design principles. We therefore aimed to apply a bio-inspired approach to the design and fabrication of articulated fingers for a new type of 3D printed hand prosthesis that is body-powered and complies with basic user requirements. We first studied the biological structure of human fingers and their movement control mechanisms in order to devise the transmission and actuation system. A number of working principles were established and various simplifications were made to fabricate the hand prosthesis using a fused deposition modelling (FDM) 3D printer with dual material extrusion. We then evaluated the mechanical performance of the prosthetic device by measuring its ability to exert pinch forces and the energy dissipated during each operational cycle. We fabricated our prototypes using three polymeric materials including PLA, TPU, and Nylon. The total weight of the prosthesis was 92 g with a total material cost of 12 US dollars. The energy dissipated during each cycle was 0.380 Nm with a pinch force of ≈16 N corresponding to an input force of 100 N. The hand is actuated by a conventional pulling cable used in BP prostheses. It is connected to a shoulder strap at one end and to the coupling of the whiffle tree mechanism at the other end. The whiffle tree mechanism distributes the force to the four tendons, which bend all fingers simultaneously when pulled. The design described in this manuscript demonstrates several bio-inspired design features and is capable of performing different grasping patterns due to the adaptive grasping provided by the articulated fingers. The pinch force obtained is superior to other fully 3D printed body-powered hand prostheses, but still below that of conventional body powered hand prostheses. We present a 3D printed bio-inspired prosthetic hand that is body-powered and includes all of the following characteristics: adaptive grasping, articulated fingers, and minimized post-printing assembly. Additionally, the low cost and low weight make this prosthetic hand a worthy option mainly in locations where state-of-the-art prosthetic workshops are absent.
Epididymitis and its aetiologies in a central London sexual health clinic
Authors: Sivaraj Venkateshwaran , Ahamed Azraan , Artykov Ruslan , Menon-Johansson Anatole
Published: December 2020

Epididymitis is a common cause of scrotal pain presentation in sexual health clinics; however, it is unclear what fraction is attributable to transmissible infections. We, therefore, reviewed the aetiologies causing epididymitis. A retrospective data analysis of all cases of epididymitis diagnosed from January 2018 to December 2018 in three sexual health clinics was conducted, collecting demographics, results, management and symptom resolution at two weeks follow up. A total of 127 cases of epididymitis (mean age 32 years, heterosexual 97, MSM 30) were included. Among them 14 cases (11%) were caused by sexual transmitted infections (<35 years n = 9; >35 years n = 5): seven cases of chlamydia, six gonorrhoea, one syphilis and one trichomonas vaginalis. There were three cases of urinary tract infection diagnosed. All cases were treated with antibiotics recommended by the British Association for Sexual Health and HIV (BASHH). At two weeks follow up post-treatment 10 (7%) were symptomatic; 91% did not attend for follow up. Sexually transmitted infections were associated with acute epididymitis in 11% of this study cohort.
Numerical optimization of horizontal-axis wind turbine blades with surrogate model
Authors: Wang Haipeng , Jiang Xiao , Chao Yun , Li Qian , Li Mingzhou , Chen Tao , Ouyang Weirui
Published: December 2020

Wind energy is a widely used and developed the renewable energy, which has developed rapidly. At present, the design of the horizontal axis wind turbine blade mainly used Blade Element Momentum theory. In this paper, an optimization method of the wind turbine blade was proposed for improving the output power. The local twist angles of the blade were optimized. This method combined the surrogate model and the numerical simulation methods. The kriging surrogate model was selected and the next calibration point was chosen by the efficient global optimization algorithm. In this paper, the aerodynamic performances of the optimized blades were discussed in detail and obtained by the numerical simulation method. It was shown that the wind power coefficients and the output powers of the optimized blades were increased. The wind power coefficients of two optimized blades were increased by 4.83% and 3.44%, respectively. The optimized blades were able to capture more kinetic energy from the wind, but the optimized blades were subjected to a greater structural load. The thrust and torque coefficients maintained an increasing tendency for the optimized blades.
The Baigetuobie cemetery: New discovery and human genetic features of Andronovo community’s diffusion to the Eastern Tianshan Mountains (1800–1500 BC)
Authors: Zhu Jiangsong , Ma Jian , Zhang Fan , Cui Yinqiu , Festa Marcella , Xi Tongyuan , Ren Meng , Wang Yinchen , Li Ben , Huang Feixiang
Published: December 2020

Andronovo has been regarded as one of the most powerful cultures in Central Asia, which reflected frequent cultural interflow, people migration, and technique diffusion on the Bronze Age Eurasian steppes. In the past decade, many new discoveries in Xinjiang, such as Adunqiaolu and Jartai, have drawn broad attention to the communication of the Andronovo culture in the central Tianshan Mountains. However, systematic study is still insufficient on the communication and influence of the Andronovo culture or the “Andronovo phenomenon” along the Tianshan Mountains. Based on our comprehensive investigation of tomb structure, funeral rituals and assemblages, this article reclassifies relevant Andronovo remains in Xinjiang into five categories. Two categories represented by the Xiabandi cemetery and the Adunqiaolu show clear resemblance to those at Semirech’ye in all aspects, which indicated people in these regions may have maintained close and consistent interaction. Other three categories in the Kuokesuxi and Tangbalesayi cemetery have different tomb structures and funeral rituals from those typical discoveries of the Andronovo cultures in Central Asia in spite of the their similarity in pottery and bronze ornaments, which can be considered as the result of product exchange or technical communication, rather than population migration. New discovery of the Baigetuobie cemetery with evidence of tomb structure, dating, and human genetic features in the Balikun grassland suggested that there might be a small group of people, probably came from the central Tianshan Mountains or Semirech’ye or further west, had migrated to the Eastern Tianshan Mountains about 1600 BC, which was likely facilitated by the relatively warm and humid environment. They had preserved their traditional tomb architecture and were not active in cultural interaction and population fusion with people of Hami Oasis in the south. Due to some reason unknown, people of Baigetuobie had faded away from Balikun grassland after a short time.
Late-Holocene seasonal moisture variability: Range Creek Canyon, Utah, USA
Authors: Groves Mariangelica , Brunelle Andrea R , Power Mitchell J , Petersen Kenneth L , Lundeen Zachary J
Published: December 2020

A 3300 year-long reconstruction of paleoenvironmental moisture conditions was constructed from a sediment core from North Gate Bog (NGB) in the northern section of Range Creek Canyon within the Colorado Plateau. The methods used to analyze the record include loss on ignition (LOI), magnetic susceptibility (MS), elemental analysis with X-ray fluorescence (XRF), charcoal influx, isotopic analysis, elemental ratios and pollen percentages, influx, and ratios. This study adds two new insights to the paleoenvironmental record of the northern section of the Colorado Plateau. First, four climatic zones were established. Zone 1 (3300–2750 cal yr BP) had 100-year wet to dry variations with droughts recorded from 3300–3200, 3000–2900, and 2800–2700 cal yr BP. Zone 2 (2750–1600 cal yr BP) had an overall dry period with an 800-year transition to increased warmth and winter moisture. Zone 3 (1600–850 cal yr BP) had an overall warm, wet, summer precipitation climate conducive to the establishment of Zea Mays and Pinus edulis, two staple foods of the Fremont culture. The Medieval Climate Anomaly (MCA) registered warm and wet in this part of the Colorado Plateau. Zone 4 (850–0 cal yr BP) had a sharp transition to a drier climate from 850 to 400 cal yr BP. During the Little Ice Age (LIA), wetter climate taxon increases such as Artemisia, Cyperaceae, and Pinus edulis. The second overall finding in this study was that NGB was a place of human activity including Fremont farming. The identification of a Zea mays pollen grain confirms the archeological presumptions that this higher elevation site was used to farm corn along with other sites in Range Creek Canyon (RCC). The post Fremont occupation period was marked by a sharp increase in organic material and a return of pinyon-juniper woodlands.
Cutaneous Kikuchi disease-like inflammatory pattern without lymph node involvement is associated with systemic disease and severe features in lupus erythematous: A case-control study
Authors: Lalevée Sophie , Moguelet Philippe , Hurabielle Charlotte , Senet Patricia , Pha Micheline , Rivière Sebastien , Barbaud Annick , Amoura Zahir , Francès Camille , Chasset Francois
Published: December 2020

Introduction

Kikuchi-Fujimoto disease (KFD) is a self-limited histiocytic necrotizing lymphadenitis sometimes affecting the skin. “Kikuchi disease-like inflammatory pattern” (KLIP) has been described in cutaneous lesions as similar pathological features in patients without lymph node involvement and as a potential clue for the diagnosis of lupus. We aimed to describe KLIP-associated clinical and immunological features in lupus patients with a retrospective case-control study.

Methods

Thirteen cases of KLIP were included as well as thirty-nine age- and sex-matched control lupus patients without KLIP. At the time of KLIP diagnosis, 4/13 patients (31%) had isolated cutaneous lupus erythematosus (CLE) and 9/13 had (69%) systemic lupus erythematosus (SLE) including 6 (46%) with severe haematological, lung, cardiac or renal disease. KLIP features were observed in skin biopsies of different clinical presentations.

Results

Compared with our control group, KLIP patients more frequently had SLE 9/13 (69%) versus 8/39 (21%) (OR 12.9; IC95% [2.86–58.2]; p = 0.0004) and more frequently severe SLE. Two out of four CLE exhibiting KLIP lesions (50%) developed severe SLE with cardiac or renal involvement after 12 and 24 months, respectively. Treatment with thalidomide 100 mg/day allowed rapid and complete clearance of cutaneous lesions in 6/6 KLIP patients. The need to use thalidomide tended to be more frequent in KLIP patients than in controls.

Conclusion

Our study suggests that KLIP features in lupus skin lesions are associated with SLE and severe systemic features. Despite a limited number of isolated CLE patients with KLIP features in the skin, this observation may warrant closer follow-up on patients with a higher risk of developing SLE.
Concordance probability as a meaningful contrast across disparate survival times
Authors: Devlin Sean M , Heller Glenn
Published: December 2020

The performance of time-to-event models is frequently assessed in part by estimating the concordance probability, which evaluates the probabilistic pairwise ordering of the model-based risk scores and survival times. The standard definition of this probability conditions on any survival time pair ordering, irrespective of whether the times are meaningfully separated. Inclusion of survival times that would be deemed clinically similar attenuates the concordance and moves the estimate away from the contrast-of-interest: comparing the risk scores between individuals with disparate survival times. In this manuscript, we propose a concordance definition and corresponding method to estimate the probability conditional on survival times being separated by at least a minimum difference. The proposed estimate requires direct input from the analyst to identify a separable survival region and, in doing so, is analogous to the clinically defined subgroups used for binary outcome area under the curve estimates. The method is illustrated in two cancer examples: a prognostic score in clear cell renal cell carcinoma and two biomarkers in metastatic prostate cancer.
Do the effects of acupuncture vary between acupuncturists? Analysis of the Acupuncture Trialists’ Collaboration individual patient data meta-analysis
Authors: Vickers Andrew J , Vertosick Emily A , Lewith George , MacPherson Hugh , Foster Nadine E , Sherman Karen J , Irnich Dominik , Witt Claudia M , Linde Klaus ,   on behalf of the Acupuncture Trialists’ Collaboration
Published: December 2020

Objectives:

The degree to which the effects of acupuncture treatment vary between acupuncturists is unknown. We used a large individual patient dataset of trials of acupuncture for chronic pain to assess practitioner heterogeneity.

Methods:

Individual patient data linked to identifiable acupuncturists were drawn from a dataset of 39 high-quality trials of acupuncture, where the comparators were either sham acupuncture or non-acupuncture controls, such as standard care or waitlist. Heterogeneity among acupuncturists was assessed by meta-analysis.

Results:

A total of 1206 acupuncturists in 13 trials were included. Statistically significant heterogeneity was found in trials with sham-control groups (p < 0.0001) and non-acupuncture control groups (p <0.0001). However, the degree of heterogeneity was very small, with the observed distribution of treatment effects virtually overlapping that expected by chance. For instance, for non-acupuncture-controlled trials, the proportion of acupuncturists with effect sizes half a standard deviation greater or less than average was expected to be 34%, but was observed to be 37%. A limitation is that the trials included a relatively limited range of acupuncturists, mainly physician-acupuncturists.

Discussion:

Although differences in effects between acupuncturists were greater than expected by chance, the degree of variation was small. This suggests that most chronic pain patients in clinical practice would have similar results to those reported in high-quality trials; comparably, we did not find evidence to suggest that greater standardization of acupuncture practice would improve outcomes. Further research needs to be conducted exploring variability using a sample of acupuncturists with a broader range of practice styles, training and experience.
Effectiveness of self-applied acupressure for cervical pain of benign origin (EDIDO-CUH): a randomized controlled clinical trial
Authors: Susana Calvo Trujillo , Maria Toribio Martín Luisa , Pilar Domenech Senra , María Mingo Moreno Teresa , Pilar Marín Solano , Valentín Martín González , López Alicia Martín , Lerín Aurora García , Vallejo Olga García , Moreno María Teresa Mingo , García Juan Carlos Muñoz , Velasco Carmen Villar , Recio Rocío López , Solano Pilar Marín , García Olga Nieto , Quesada Julia Dorado , Ruiz Inés Manzanas , Nogales Elena López , Muñoz Arancha Cubero , Rodriguez Jesús Bravo , Ciria Rocío Mateo , Alegre SCT, Mª Trinidad García , Blanco Mª Angeles , Larrayoz Irina López , de la Calle Pedro Pablo Sánchez
Published: December 2020

Background:

Cervical pain is a problem with a high prevalence of ~13% of the population, and is more common in women (16.5%). The most affected age group is 65–74 years. Our aim was to assess the effectiveness of self-applied acupressure for decreasing benign-origin cervical pain, under the supervision of a health professional and in combination with usual treatment, as well as to examine its impact on the patient’s self-perceived health condition and their opinion of the technique.

Methods:

Pragmatic, multicenter, controlled clinical trial randomized by healthcare center. A total of 160 patients with benign-origin cervical pain between 18 and 65 years of age who attended primary care were included from 12 healthcare centers in the autonomous community of Madrid by consecutive sampling, and randomly assigned to a control or intervention group. The main outcome variable was pain intensity measured on a visual analogue scale (VAS) and secondary variables were self-perceived quality of life (EuroQol-5D utility index) and functional ability (neck disability index). An explanative model of generalized estimating equations was built taking into account the lack of independence among observations. The analysis was performed over 6 months.

Results:

In total, 150 patients completed the study. Mean age was 45 years (SD: 10.7), 86.7% were women, 86.2% were currently employed, and 57.9% did not perform any physical exercise. Average days experiencing pain was 32.9 (SD: 2.8) and 80% were undergoing previous pharmacological treatment. The quality of life utility index after 3 months was 1.6 points (95% CI: 0.54–2.71) higher in the intervention group. The pain score on the VAS was 0.16 points (95% CI: 0.80–0.48) lower in the intervention group. The health professional explained 10.4% of the reduction in pain observed on the VAS throughout the medical visits.

Conclusion:

Acupressure applied in addition to usual practice appeared to improve cervical pain in the long term. The effectiveness of this technique was partially explained by the health professional that trained the participants on technique application.

Trial registration number::

NCT01855893
Tackling health inequity: a commentary on the potential of acupuncture to improve health outcomes of marginalised populations
Authors: Baker Kirsten , McDonald John , Steel Amie
Published: December 2020

Background:

Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society’s marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage.

Discussion:

Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations are open to engaging with acupuncture treatment. Acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma in conventional health settings such as community clinics and hospitals. There is the suggestion that integrative health settings and group treatment models may improve access and uptake of acupuncture among marginalised groups.

Conclusion:

Evidence suggests that the sociodemographic profile of acupuncture users is diverse and acupuncture therapy holds potential value in the treatment of marginalised populations. Further research that investigates reframing and expanding the scope of practice for acupuncture is timely and may contribute to tackling health inequity.
Beyond Carceral Expansion: Survivors’ Experiences of Using Specialised Courts for Violence Against Women in Ecuador
Authors: Tapia Silvana Tapia
Published: December 2020

This article presents empirical findings addressing the gap between specialised criminal laws on violence against women (VAW) in Ecuador and women’s actual needs and expectations when approaching the country’s specialised penal courts. Given its comprehensive legal system, Ecuador scores highly in protecting women from violence in international rankings. However, based on quantitative data, qualitative case file analysis, and in-depth interviews with survivors, judges, case-workers and judicial employees, this study reveals that, in Ecuador, most lawsuits are dropped without ever reaching a resolution. Because most survivors pursue protection from ongoing violence rather than a conviction, and because advancing a lawsuit can be a source of various forms of stress and fear, survivors usually withdraw from the trial once they are granted a protection order. Nevertheless, this order is lost when complainants fail to appear in court. In addition, police intervention is inadequate and seldom contributes to the effective protection of women. The paper thus augments debates on ‘carceral feminism’, showing that VAW laws are not necessarily bolstering the carceral apparatus on the ground. However, law does mask the state’s disregard toward women’s lived experiences and their lack of access to services that could ensure their protection and safety.
Strachan and the Great War: A Lifelong Quest
Authors: Herwig Holger H.
Published: December 2020

Sir Hew Strachan of the University of St Andrews is the doyen of World War I studies. He approached his work from a serious multinational, multilingual, and comparative perspective. He was never afraid to challenge well-established interpretations and to add fresh analyses of concepts ranging from total war to trench warfare. He was always keen to include diplomacy, politics, imperialism, industrialization, and the sinews of war in his writings. From ‘origins’ to ‘consequences’, Strachan led his readers through the challenging shoals of Great War studies. One can hardly wait for the second instalment of his opus, The First World War: No Quarter.
Hew Strachan and the Sociology of War
Authors: King Anthony
Published: December 2020

Hew Strachan’s contribution to military history has been widely recognized. Signally, he brought a new global perspective to the study of the First World War, while simultaneously arguing for the irretrievably political nature of war. This article makes an unusual and implausible argument. It maintains that in addition to Strachan’s undoubted historical contribution, his work can be read as a form of sociology. Specifically, Strachan’s analysis of the politics of war and the armed forces highlights the way in which interest groups at every level influence defence policy and the conduct of war itself. By prioritizing political interests as a prime explanatory factor, Strachan has, perhaps unwittingly, developed a highly sophisticated sociology of war.
The Effectiveness of Poverty Alleviation Policy: Why Is the Quality of Institutions the Bane in Nigeria?
Authors: Fagbemi Fisayo , Oladejo Babafemi , Adeosun Opeoluwa Adeniyi
Published: December 2020

This article examines the nexus between the quality of institutions and the poverty in Nigeria over the period 1984–2017, using dynamic least squares, canonical cointegrating regression and vector error correction mechanisms. The analysis based on three institutional measures (bureaucratic quality, democratic accountability and rule of law) reveals how the poverty rate could be escalated by entrenched poor governance. The evidence shows that democratic accountability and rule of law are significant for poverty reduction. This reinforces the assertion that accountability and transparency coupled with strict adherence to rule of law in the public sector are the principal components of poverty alleviation. Also, findings reveal that poverty and weak institutions are interconnected and mutually reinforcing in the country. Overall, the findings posit that poverty is widespread in Nigeria due to capacity constraints of public institutions or underlying governance practices. By implication, the article suggests that policymakers should focus on measures that have the greatest leverage for enhancing effective governance oriented towards poverty reduction and development. In addition, tackling socio-economic inequalities, curbing political unrest and building strong institutions are central to ensuring a socially sustainable basis for holistic welfare improvements.
Investigating the Roles of Physical Infrastructure, Financial Development and Human Capital on Economic Growth in Bangladesh
Authors: Ahmed Faroque , Hossain Md. Jamal , Tareque Mohammad
Published: December 2020

This article investigates the dynamic relationship among physical infrastructure, financial development, human capital and economic growth in Bangladesh, employing Autoregressive Distributed Lag (ARDL) bound co-integration and Granger causality test for the period 1985–2019. The study finds a significantly positive long-term impact of physical infrastructure and human capital on economic growth. However, the effect of financial development on growth is found to be negative, and the result suggests that financial development will take place with economic growth. From the policy perspective, this study emphasises increasing investment in physical infrastructure and human capital for Bangladesh to foster long-term economic growth.
Factors Associated With Prediabetes and Diabetes Among Public Employees in Northern Ethiopia
Authors: He Yupeng , Chiang Chifa , Gebremariam Lemlem Weldegerima , Hirakawa Yoshihisa , Yatsuya Hiroshi , Aoyama Atsuko
Published: December 2020

The increasing burden of diabetes mellitus is one of the major public health challenges in African countries, including Ethiopia. This is the first study aimed to identify factors associated with prediabetes and diabetes defined by both fasting blood glucose and glycated hemoglobin in Ethiopians. We analyzed data of a cross-sectional survey (1372 adults aged 25-64 years) conducted between October 2015 and February 2016; multinomial logistic regression models were applied. Abdominal obesity, total cholesterol, and non–high-density lipoprotein cholesterol were independently associated with prediabetes and diabetes in both sexes. Increased triglycerides and religious fasting practices were independently associated with prediabetes and diabetes only in men; hypertension was associated with prediabetes and diabetes only in women, while high-density lipoprotein cholesterol was not associated with prediabetes and diabetes in either sex. Sex differences in the association of triglycerides, hypertension, and dietary habit suggest that different approaches of lifestyle modification may be required for men and women.
Accounting, educational institutions and local government in Italy (1886–1907)
Authors: Semeraro Riccardo , Gregorini Giovanni
Published: December 2020

Although little is known about accounting activities within educational institutions, even less is known about their relevance to local governments. By adopting an Anglo-Foucauldian perspective, an archival-based study is conducted in this article to investigate the accounting practices adopted by a religious congregation for the management of two vocational schools in Brescia, Italy, between 1886 and 1907. In such a context, which lacked an efficient and effective educational system and underwent socio-economic changes as a result of an incipient industrialisation process, the accounting practices proved to be crucial not only to ensure the proper functioning of the institutions under investigation, but also to deal with educational poverty. This study demonstrates that accounting practices have a constitutive role in pursuing equilibrium strategies within the dynamics of local government.
Free vibration analysis of functionally graded magneto-electro-elastic plates with in-plane material heterogeneity
Authors: Zhang Pengchong , Qi Chengzhi , Fang Hongyuan , Sun Xu
Published: December 2020

A three dimensional elasticity analysis for the transverse free vibration characteristics of functionally graded magneto-electro-elastic plates based on the scaled boundary finite element method (SBFEM) incorporated with the precise integration algorithm (PIA) is presented. The material properties of magneto-electro-elastic plates are changing along the in-plane direction with arbitrary mathematical functions. In the proposed methodology, the strategies of only discretizing the in-plane surface and utilizing the two-dimensional spectral elements to construct diagonal coefficient matrices are adopted, which contributes to decreasing the calculation effort. The derivation process begins with the three dimensional governing equations of magneto-electro-elastic materials. Neither the plate mechanical kinematics nor invoking assumptions on the spatial distributions of electric and magnetic quantities are adopted. Built upon the introduced scaled boundary coordinates, the principle of virtual work and the technique of dual vectors, a first order ordinary differential SBFEM matrix equation for the in-plane functionally graded magneto-electro-elastic plates is obtained. Its general solution is analytically denoted as the matrix exponent. To improve the computation accuracy of the matrix exponent, the PIA is utilized to form the stiffness matrix. By virtue of the kinetic energy technique, it is convenient to construct the mass matrix of the in-plane functionally graded magneto-electro-elastic plates based on the SBFEM for the first time. Finally, comparisons of flexural frequency parameters with those from exact solutions and other numerical methods are provided. The accuracy, effectiveness, and versatility of the employed technique are validated. Moreover, additional numerical exercises are conducted to exhibit the influences of boundary conditions, material gradation functions, and aspect ratios on the free vibration behaviors of in-plane functionally graded magneto-electro-elastic rectangular, circular, and perforated plates.
Faultlines and Team Creativity: The Moderating Role of Leaders’ Cognitive Reappraisal
Authors: Liu Xinmei , Zhang Xinxing , Zhang Xiaojie
Published: December 2020

Informational diversity is perceived as the key to improving team creativity. However, alignment along multiple informational diversity attributes, known as information-based faultlines, can both provide diverse knowledge and form subgroup bias. The key to reaping the benefits of information-based faultlines is to understand how to utilize the diversified knowledge and, meanwhile, reduce subgroup bias. This study aims to examine how team leaders’ cognitive reappraisal can play a such role. Based on data from 68 teams, we found that (1) information-based faultlines had a positive effect on knowledge utilization when team leaders’ cognitive reappraisal was high, (2) knowledge utilization had a positive effect on team creativity, and (3) team leaders’ cognitive reappraisal moderated the indirect relationship between information-based faultlines and team creativity through knowledge utilization.