bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of textile and clothing sector social entrepreneurs
in the transition to the circular economy
Authors: STAICU DANIELA
Published: March 2021

The limits of the present take-make-waste business model are extremely visible when examining the textile and clothing
industry. The concept of circular economy gained traction, which has led to the creation of policy actions throughout the
life cycle of a product and at disposal. Transitioning from linear to circular economy business models requires significant
value-chain changes in both production and consumption patterns. Existing circular business models are paving the way
towards a paradigm shift. However, the literature has not retained much empirical evidence about these sustainabilityoriented
innovators which are invisible and work in anonymity. This study provides a simple, yet rich and unique
overview of the characteristics of circular economy business models in the textile and clothing sector in Romania,
identified through qualitative analysis performed on the entire population of sustainability-oriented innovators identified
in Romania in the textile and clothing sector in a previous study done by the same author. The data was collected using
a structured questionnaire with 37 questions connected to four areas: human resources, legal and fiscal framework,
customers and communication, and materials, tools or technology employed. With a 100% response rate, the real
significance of this paper is that it may have discovered the real contribution of these agents of change in the circular
economy, functional circular business models which have never been studied before as a population.
La naturaleza del sexo: Relecturas sintomáticas del feminismo materialista
Authors:   , Bolla Luisina
Published: March 2021

Desde fines de la década de 1960, un grupo de teóricas francesas nucleadas en torno a la revista Questions Féministes desarrollan diversas investigaciones sobre la categoría de “sexo”. Los análisis de Nicole-Claude Mathieu, Christine Delphy, Colette Guillaumin y Paola Tabet cuestionan los subtextos naturalistas que subyacen al tratamiento del sexo en la teoría marxista y en el feminismo de la época, y proponen una articulación innovadora entre ambos campos, que denominan “feminismo materialista” y que identificamos con las siglas FMF (Feminismo materialista francés). Si bien las investigaciones del FMF constituyen un aporte pionero a la gran área de las teorías feministas y de género, sus análisis han quedado invisibilizados por los relatos hegemónicos del feminismo teórico, elaborados mayormente en los Estados Unidos. Por ello, el objetivo general de esta Tesis es contribuir al estudio de una corriente, que por su heterodoxia y difícil clasificación, no es recuperada en las narrativas canónicas del feminismo contemporáneo. Ello nos conduce a reflexionar sobre el establecimiento de hegemonías académicas en el campo de la teoría feminista y de los estudios de género. Colectivamente, Mathieu, Delphy, Guillaumin y Tabet elaboran una trama original que permite mostrar el carácter plenamente social del sexo, en sentido anti-biologicista. Mostramos que sus categorías centrales (sexo social, diferenciación socio-sexual del trabajo, trabajo doméstico, sexage) construyen una fecunda teoría que analiza las causas materiales y económicas de la opresión de las mujeres, en una perspectiva histórica y anti-naturalista. El recurso a la lectura sintomática posibilita un abordaje conjunto que, sin embargo, no homogeneiza las posiciones de las autoras y que no desestima las tensiones que atraviesan el propio discurso del FMF. Esta clave de interpretación recorre como un hilo subterráneo los diferentes capítulos y permite comprender las contradicciones (productivas) del marxismo clásico y de El segundo sexo de Beauvoir, antecedentes centrales del FMF que emerge desde los silencios de aquellas teorías. En la última parte de la Tesis, se analizan las derivas de la teoría feminista materialista en otras propuestas. En primer lugar, se aborda la propuesta materialista lésbica de Monique Wittig mostrando sus afinidades y deudas con el pensamiento colectivo de la corriente. Sostenemos que su teoría introduce subrepticia e indirectamente las tesis del FMF en el mundo anglosajón, con particular influencia sobre Judith Butler, y contrastamos el modelo del “sexo social” con el esquema anglosajón del “sistema de sexo/género”. Finalmente, analizamos otras derivas del FMF contemporáneas, que vinculan la corriente con otros horizontes de debate y con ciertas teorías latinoamericanas y caribeñas. Ello introduce nuevas preguntas y discusiones que desafían el marco original de análisis.
Néologie et / ou évolution du lexique ?Le cas des innovations sémantiques et celui des archaïsmes
Authors: Sablayrolles Jean-François
Published: March 2021

Une des voies du changement lexical est la néologie sémantique, branche de la néologie générale. Cette approche traditionnelle, reprise par le cognitivisme, est concurrencée par d’autres qui privilégient des évolutions insensibles du sens quand elles apparaissent. Ces deux modes de changements du sens coexistent probablement. Inversement le temps rend obsolètes des lexies, parfois jusqu’à leur disparition. Leur résurgence, comme paléologisme, a le même effet qu’un néologisme et s’oppose en cela à l’archaïsme, connu mais désuet.
Formen und Funktionen von Metaphern in der deutschsprachigen Online-Präventionskommunikation
Authors: Rentel Nadine
Published: March 2021

Metaphern sind ein linguistisches Phänomen, das sich in allen Textsorten bzw. Diskurs­bereichen von Einzel­sprachen nachweisen lässt. Werden Metaphern in Fachtexten verwendet, so verfolgen die Text­produzenten im Rahmen des fach­externen Diskurses häufig das Ziel, fach­spezifische Inhalte möglichst verständlich zu kommunizieren. Im Beitrag wird anhand einer empirischen, qualitativ orientierten Analyse der medizinischen Kommunikation des Deutschen heraus­gearbeitet, welche kommunikativen Funktionen Metaphern in der Präventions­kommunikation innehaben. Zu diesem Zweck wird ein Korpus von Präventions­webseiten zu unterschied­lichen Krankheits­bildern analysiert. Im Rahmen der theoretischen Vorüber­legungen werden die Funktionen von Präventions­kommunikation näher bestimmt, bevor auf die spezifische kommunikative Konstellation von Präventions­botschaften im Internet eingegangen wird. An die Klassifizierung der im Korpus nach­gewiesenen Metaphern in Bezug auf semantische Felder und die entsprechenden Bildspende­bereiche schließt sich die Beschreibung ihrer kommunikativen Funktionen an. Im Zentrum der Ergebnis­diskussion stehen Formen und Funktionen der verwendeten Metaphern, wobei der Frage nachgegangen wird, welche diskursbereich­spezifischen Funktionen diese erfüllen können.
Mögliche Metaphern in der Fachsprache
Authors: Schmale Günter
Published: March 2021

Die sehr zahlreichen Untersuchungen unterschiedlicher Typen fach­sprachlichen Diskurses basieren i.d.R. auf Lakoff / Johnsons kognitiver Metaphern­theorie. Dieser Ansatz vernach­lässigt allerdings, dass Metaphern von Diskurs­teilnehmern verstanden werden müssen, abstrahiert zudem von Faktoren der Kommunikations­situation. Metaphern werden allein vom Analysten kontextfrei bestimmt und kognitiven Konzepten zugeordnet. Auch die semantischen Beziehungen, die einen Schluss von einem (konkreten) Ausgangs­bereich auf einen (abstrakten) Ziel­bereich ermöglichen, werden nicht in intersubjektiv nachvoll­ziehbarer Weise analysiert. Für die semantische Rekonstruktion eignet sich besonders gut Glucksbergs linguistisches interactive property attribution model, demzufolge eine Metapher dann vorliegt, wenn vehicle properties des Ausgangs­bereiches und topic dimensions des Ziel­bereiches eine Schnitt­menge bilden. Auch bei Glucksberg erfolgt jedoch kein systematischer Einbezug kontextuell-situativer Faktoren. Im Anschluss an eine Skizze der Ansätze Lakoff / Johnsons und Glucksbergs analysiert der vorliegende Beitrag deshalb eine längere gesprochen­sprachliche Diskurs­sequenz, i.e. eines vollständigen transkribierten Tages­berichtes des ARD-Korrespondenten an der Frankfurter Börse. Auf der Grundlage von Glucksbergs Modell erlauben es Ko- und Kontext des Berichts, den zahlreichen bildstarken Ausdrücken bspw. aufgrund nach­folgender paraphrastischer Aktivitäten oder auch von thematischen Aspekten bestimmter Sequenzen oder des ganzen Berichtes metaphorischen Charakter zuzu­schreiben. Da die Interpretation metaphorischer Beziehungen stark von Wissen und Kultur des Interpreten abhängig sind, kann es sich aus pragmatischer Perspektive des Sprach­benutzers allerdings stets nur um potentielle Metaphern handeln, die nur durch die Interpretation des jeweiligen Adressaten Gestalt gewinnen können.
“Aprendiendo las letras del poder”
Authors: Cárdenas Muñoz Salomé
Published: March 2021

A partir del análisis de las reformas de la educación intercultural bilingüe (EIB) y de un estudio de caso llevado a cabo en una zona periurbana de Otavalo (Andes septentrionales), se intenta comprender cómo se producen los procesos de estatización y alterización (P. López [2016]) durante el gobierno de Rafael Correa (2007-2017). Combinando el análisis de documentos institucionales con la “etnografía escolar” —entrevistas a profundidad y observación in situ—, este artículo explora los conflictos educativos-territoriales, las fronteras de la (auto)identificación étnica y las distinciones que tienen lugar en una “unidad educativa intercultural bilingüe-guardiana de la lengua [vernácula]” situada entre dos comunidades que, aunque se autoidentifican con la nacionalidad quichua, son históricamente antagónicas (desde la promulgación de las leyes de Reforma Agraria 1964, 1973). Este escuela nace en 2014 como resultado de la unificación de seis otros establecimientos educativos fundados y refundados entre los años 1940 y 1970. En primer lugar, se demuestra que las reformas promueven la coexistencia de tres enfoques: (1) el plurinacional e intercultural del Estado, (2) el esencialista y culturalista y (3) el tecnocrático y meritocrático. En segundo lugar, a partir del estudio de la socialización entre autoridades, maestros, padres y madres de familia en la UE unificada de Otavalo, se evalúan los efectos de las reformas. Se intenta responder a las siguientes interrogantes: ¿Cómo influye el sentido de pertenencia territorial-comunitario en el proceso de reordenamiento educativo-territorial? ¿Qué tensiones emergen entre las formas de identificación estatales y la imagen social que los actores escolares tienen de sí mismos? Finalmente, ¿qué efectos tiene esta política educativa en las aspiraciones de igualdad ciudadana e inclusión/movilidad social de los actores involucrados? El corpus de análisis está constituido por archivos escolares, entrevistas individuales y anotaciones derivadas de la observación participante.
Синтаксическая омонимия как источник и ключ множественного толкования поэтического текста
Authors: Sidorova Marina
Published: March 2021

В статье рассматривается синтаксическая омонимия в русской поэзии на уровне слова, предложения и текста в связи с конститутивными свойствами лирики, прежде всего множественностью толкований. На уровне слова выделяется омонимия предложно-падежных форм, конкуренция компонентов предложения за место подлежащего, частеречная омонимия и омонимия глагольных синтаксем, которая является переходным случаем к омонимии уровня предложения. Синтаксическая омонимия уровня предложения связана с предикативными категориями времени, модальности и лица; распределением модусных и диктумных смыслов, омонимией свободных и фразеологизованных конструкций. Синтаксическая омонимия уровня текста может носить характер отдельных вкраплений непоэтических жанров или заимствования и поэтической трансформации формата, реализуемого всем стихотворением (с указанием на это в названии). В целом результаты анализа синтаксической омонимии подтверждают продуктивность лингвистического рассмотрения лирической поэзии как одной из функциональных реализаций системы общенационального языка, а не отдельной системы особенностей и отклонений.
Representations of climate in the English-speaking press: building a metaphorical interdiscourse
Authors: Peynaud Caroline
Published: March 2021

La presse représente, par essence, un discours intertextuel composé de citations explicites, mais également de références plus implicites qui la placent dans un interdiscours complexe. En particulier, il est admis que les médias s’inspirent largement les uns des autres, créant entre différents articles, genres et publications des liens intertextuels et interdiscursifs qui sont susceptibles d’évoluer dans le temps. La présente étude se propose d’analyser ces liens et, plus particulièrement, ceux constitués par les métaphores appliquées au domaine du climat telles qu’elles sont employées dans la presse généraliste anglophone. La métaphore, qu’elle soit pédagogique ou constitutive d’une théorie, est ici définie comme une projection d’un domaine vers un autre créant une analogie qui permet de mieux comprendre le domaine spécialisé concerné. Le phénomène qui nous intéresse ici est celui de la circulation des métaphores entre presse et discours spécialisé et, au sein du discours de presse, entre journaux, aires géographiques et périodes de temps. Afin de comprendre ce phénomène, un corpus d’articles de presse portant sur le changement climatique publiés dans le Daily Telegraph, le Guardian, le New York Times et USA Today entre 2014 et 2017 a été constitué. Celui-ci est comparé à un corpus de Earth Negotiation Bulletins, rapports issus de la COP21 en 2015. Les métaphores liées au domaine du climat ont été identifiées et analysées notamment à l’aide du logiciel WMatrix et de son outil d’identification des domaines sémantiques. Il apparaît ainsi que les journaux s’inspirent des textes spécialisés, mais n’abordent pas nécessairement les métaphores de la même manière. La période, l’aire géographique et la ligne éditoriale des journaux influencent également l’usage des métaphores.
PEMETAAN KERAWANAN PENYAKIT DEMAM BERDARAH DENGUE DI KOTA PADANG
Authors: Handiny Febry , Rahma Gusni , Rizyana Nurul Prihastita
Published: March 2021

Latar Belakang: Prevalensi Demam Berdarah Dengue (DBD) diperkirakan mencapai 3,9 milyar orang di 128 negara berisiko terinfeksi virus dengue. DBD ditemukan didaerah tropis dan sub-tropis dimana Asia berada pada urutan pertama di dunia dalam kasus DBD setiap tahunnya. WHO melaporkan Indonesia adalah negara dengan jumlah penderita DBD tertinggi di Asia Tenggara.Tujuan: Penelitian ini bertujuan untuk mengetahui jumlah kasus DBD per kecamatan dan sebaran kerawanan penyakit DBD berdasarkan kelembaban udara dan kepadatan penduduk di Kota Padang.Metode: Penelitian ini menggunakan pemodelan spasial faktor-faktor lingkungan fisik yang berpengaruh terhadap kejadian DBD dengan menggunakan sistem informasi geografis. Penelitian ini merupakan penelitian deskriptif berbantuan aplikasi Sistem Informasi Geografis (SIG). Data yang digunakan merupakan data sekunder dari Dinas Kesehatan Kota Padang dan Badan Pusat Statistik (BPS) Kota Padang Tahun 2020. Analisa data menggunakan skoring untuk mengahasilkan zona kerawanan DBD.Hasil: Hasil penelitian menunjukkan bahwa Kecamatan Kurnji, Koto Tangah dan Padang Timur mempunyai kerawanan yang tinggi. Tingkat kerawanan penyakit demam berdarah di Kota Padang ditampilkan dalam bentuk peta.Simpulan: Perlunya upaya pencegahan penyakit DBD berbasis wilayah dalam pengendalian fakto risiko DBD
PENGGUNAAN MOBILE TECHNOLOGY DAN PENELITIAN PARTISIPATORIS UNTUK PENCEGAHAN DROUP-OUT KB SELAMA PANDEMI COVID-19
Authors: Astuti Andari Wuri , Mufdlillah Mufdlillah , Anggraeni Witriani Susasi , Sewoko Ewang
Published: March 2021

Latar Belakang Masalah: Pada masa pandemi COVID-19, Pasangan Usia Subur (PUS) di Indonesia mengalami hambatan untuk melakukan kunjungan di fasilitas kesehatan dikarenakan pembatasa sosial, hal ini juga mempersulit PUS mengakses kontrasepsi. Data menunjukkan bahwa pada rentang Maret sd Mei 2020, terdapat peningkatan jumlah kehamilan di Indonesia. Penelitian ini bertujuan untuk mencegah drop out KB pada PUS selama masa pandemi COVID-19 dengan menggunakan mobile technology dan PAR serta menggali pengalaman stakeholder KB.Metode: Kegiatan yang dimplementasikan dalam penelitian ini ada 2 kegiatan besar yaitu dengan melakukan PAR dengan memberikan pendidikan kesehatan tentang kontrasepsi dan KB. Blended online-offline method diterapkan dalam pendidikan kesehatan ini. Mobile technology dipilih sebagai media untuk memberikan pendidikan kesehatan, WhatsApp dan Youtube video digunakan untuk mengirimkan pesan dan informasi tentang kontrasepsi dan KB, serta memberikan informasi tentang akses kontrasepsi pada masa pandemi COVID-19. Study PAR ini dilaksanakan pada bulan Juni sd Agustus 2020, dan one to one interview dilakukan untuk menggali pengalaman stakeholder.Hasil: Data interview menunjukkan bahwa PUS merasakan bahwa penggunaan mobile technology memberikan manfaat bagi mereka untuk dalam memperoleh pengetahuan dan informasi tentang kontrasepsi dan KB.PAR juga memberikan kesempatan kepada PUS untuk bisa berkontribusi pada sebuah program intervensi kesehatan yang menyebabkan emreka lebih bisa berpartisipasi pada program tersebut. Kader, tokoh masyarakt dan bidan juga merasakan manfaat positif dari program yang dijalankan dalam memberdayakan masyarakat di daerah tersebut.pada masa pandemi COVID-19. Namun demikian, ketidakstabilan jaringan internet dibeberapa daerah dianggap senagai salah satu tantangan pada saat implementasi.Kesimpulan: Diperlukan scope dan tempat yang luas untuk implementasi pada studi yang sam, sehingga mangaaf dari program bisa dirasakan oleh lebihnbanyak masyarat, hal ini secara tidak langsung akan meningkatkan kesdaran ber KB serta menurunkan angka drop out KB pada masa pandemi COVID-19.
Employee Commitment Effect on Organizational Effectiveness: Malaysian Perspective on a Mediator Roles in Leadership Style
Authors: Muda Wan Hanim Nadrah Wan , Isa Khairunesa , Othman Nurul Ain , Atim Asliaty , Wen Goh Khang
Published: March 2021

Leadership style and employee commitment are important human resources in determining organizational performance. It is worth noting that these factors are closely interrelated. To elaborate, implementing a leadership style that caters to the needs of the employees can certainly influence employee commitment levels in an organization. This study aimed to examine the effects of transformational and transactional leadership styles, either as partial or full mediators, on employee commitment to organizational effectiveness. The study involved 130 randomly selected public service officers. Furthermore, three research instruments were used to aid this study, namely, the Multifactor Leadership Questionnaire to measure the respondents’ perceptions of transformational and transactional leadership styles, a three-component model of employee commitment to measure employee commitment, and the Index of Perceived Organizational Effectiveness to measure organizational effectiveness. To determine the effect of a mediator on employee commitment, three regression equations based on the Baron and Kenny model were run through multiple regression analyses. The findings demonstrated that transformational and transactional leadership styles have a partial mediator effect on employee commitment to organizational effectiveness. This study provides some insights into the importance of transformational leadership, especially into the dimension of individualized consideration and the influence of employee commitment on enhancing the effectiveness of an organization.
Temperature Control for a Hospital Using MP 8085
Authors: Abdulqader Mohammed F.
Published: March 2021

This project studies temperature control using a microprocessor with an interfacing circuit. This type of control is studied theoretically and a circuit is designed and implemented by using a software program for a hospital building in Kirkuk city by choosing nearly 10 rooms. The program is written with the reference temperature using an Lm35 sensor that is suitable for this work, where it operates over a T range from 55 to 150, by entering machine code to the Microprocessor 8085 to collect data from sensors in the form of analog values, changes it to digital vales by Analog to Digital Converter, and enters it into the microprocessor. The Microprocessor 8085 takes data from sensors that has been changed to a digital signal by Analog to Digital Converter to receive to fuzzy logic controller, which is the best way in which this type of precision control can be accomplished by controller. Here we try to control the temperature of the system using the fuzzy logic controller from the data coming from the Microprocessor 8085. The Microprocessor 8085 has been selected because the error rate is very low and the results are very accurate.
Preliminary Study of Web Based Decision Support System to Select Manufacturing Industry Suppliers
Authors: Utomo Denny Trias , Pratikto  , Santoso Purnomo Budi , Sugiono
Published: March 2021

Industry 4.0 is an integration between automation and manufacturing industry which requires the use of information technology to implement it. In the operational management framework, there is a supply chain management function that is strongly influenced by quality suppliers. Because choosing a quality new supplier is not an easy thing, we need a reliable application tool and utilizing web-based artificial intelligence technology for the selection of suppliers in the manufacturing industry. The selection of new suppliers is a complex problem because it involves multiple criteria, therefore it is necessary to make a decision support system that is able to complete supplier selection properly. Although the selection of suppliers in the manufacturing industry is not new, in the era of Industry 4.0, a decision support system that is used to choose an absolute supplier based online that must be accessible via the web or mobile application. Therefore the writer's idea in this paper is very relevant to be implemented in the manufacturing industry in all fields in the industrial era 4.0.
Ltspice Simulation of Non Linear Technique SSHI Serial and SSHI Parallel of Piezoelectric Vibration Energy Harvesting
Authors:   Laboratoire d’Ingenierie, de Management Industriel et d’Innovation (LIMII), Faculte ́ des Sciences et techniques (FST), universite Hassan I, settat, morroco., Abderrahim* Mountaciri , El-Mostafa Makroum ,   Laboratoire d’Ingenierie, ́ de Management Industriel et d’Innovation (LIMII), Faculte ́ des Sciences et techniques (FST), universite Hassan I, settat, morroco., Youssefi My Abdelkader ,   Laboratoire d’Ingenierie, ́ de Management Industriel et d’Innovation (LIMII), Faculte ́ des Sciences et techniques (FST), universite Hassan I, settat, morroco
Published: March 2021

in this paper, a simple but effective proposal for piezoelectric energy collectors. synchronized switching harvesting in the SSIH technique (synchronized switch harvesting on parallel inductor consists in placing a switch which will be commanded on closing at the instant when the amplitude of the vibrations passes through the extreme this technique makes it possible to increase the power harvested from a ratio of 8 compared to the power of a harvester based on ac dc converter similarly the SSIH command (synchronized switch harvesting on inductor for LT SPICEs-based simulations of the two techniques is carried out finally a comparison with respect to the standard structure of energy harvesting is made in order to validate theoretical concepts
Characterization of liver Disease Based on Ultrasound Imaging System
Authors:   Department of Biomedical Engineering, King Abdul-Aziz University, KSA., Binjaah Mohammed K. , Aljuhani Abdullah ,   Biomedical Engineer, Ministry of Health, KSA and Studying MSc Electrical and Biomedical Engineering, King Abdulaziz University, KSA., Alqasemi Umar ,   Associate Professor, Department of Electrical and Computer Engineering, King Abdulaziz University, KSA.
Published: March 2021

Computer-Aided Detection (CAD) systems are one of the most effected tools nowadays in aiding physicians in the detection of liver tumors at early stage. In this paper, the CADe system will be built which has the ability to detect the abnormal tumor inside the liver. In order to create that system, different types of classifiers must be implemented. In our CADe system, a support vector machine (SVM) and K-Nearest Neighbor (KNN) will be used as classifiers. A total number of 120 images including the normal and abnormal cases were collected. Initially, the features will be extracted from database images in order to distinguish between the classes of those liver tumors. Then, by using SVM and KNN the images will be classified into two classes normal and abnormal cases. The paper reveals that SVM and KNN, which demonstrated 100 percent precision, 100 percent sensitivity, and 100 percent specificity, were the best classifiers.
A Simulation Magnetic Induction Tomography (MIT) for Agarwood using COMSOL Multiphysics
Authors:   Faculty of Electrical and Electronic Engineering, Universiti Tun Hussein Onn, Johor, Malaysia., Ishak* Nurfarahin , Lee Chua King ,   Faculty of Electrical and Electronic Engineering, Universiti Tun Hussein Onn, Johor, Malaysia, Muji Siti Zarina Mohd ,   Faculty of Electrical and Electronic Engineering, Universiti Tun Hussein Onn, Johor, Malaysia
Published: March 2021

Magnetic induction tomography is an imaging technique used to image electromagnetic properties of an object by using the eddy current effect. (MIT) is a non-destructive method that greatly is used in the agriculture industry. This method provided an opportunity to improve the quality of agricultural products. MIT simulation was used for agarwood existence detection. This paper presented for the simulation system contains 7 channel coils receiver and a channel transmitter which is a sensing detector. This experiment aims to demonstrate the reaction of induced current density and magnetic field at 10 MHz frequency. Then, it also determines the optimal solenoid coil to be used for a better outcome for the magnetic induction system. The simulation result shows that coil diameter, coil length, and coil layer have a crucial role in the great performance of the induced current and magnetic field. The more coil turns, the greater the strength of the permanent magnetic field around the solenoid coil. The result of the simulation is important and needs to be considered to verify the effectiveness of the system for developing the magnetic induction circuit design.
Analysis of Unmet Healthcare Needs in Ireland: A Data Mining Approach
Authors:   Lecturer, Business Information Systems, J. E. Cairnes School of Business & Economics, National University of Ireland, Galway, Ireland., Nachev Dr. Anatoli
Published: March 2021

This study explores data form the Survey of Income and Living Condition (SILC), related to factors contributing to unmet healthcare needs in Ireland. We analysed predisposing, enabling and needs factors by building predictive models and measured the predictor importance by sensitivity analysis. Results show that critical factors for meeting the healthcare needs include financial status, degree of urbanization, indicators of social exclusion and deprivations, and self-perceived general health condition. Identifying and quantifying those factors form raw data may facilitate decision making in the domain
Multivariable Analysis of the Relationship
Between Pain Referral Patterns and the Source
of Chronic Low Back Pain
Authors: DePalma Michael J.
Published: March 2021

Background: Discogenic, facet joint, and sacroiliac joint mediated axial low back pain may
be associated with overlapping pain referral patterns into the lower limb. Differences between
pain referral patterns for these three structures have not been systematically investigated.
Objective: To examine the individual and combined relationship of age, hip/girdle pain, leg
pain, and thigh pain and the source of internal disc disruption (IDD), facet joint pain (FJP), or
sacroiliac joint pain (SIJP) in consecutive chronic low back pain (CLBP) patients.
Design: Retrospective chart review.
Setting: Community based interventional spine practice.
Patients: 378 cases from 358 consecutive patients were reviewed and 157 independent
cases from 153 patients who underwent definitive diagnostic injections were analyzed.
Methods: Charts of consecutive low back pain patients who underwent definitive diagnostic
spinal procedures were retrospectively reviewed. Patients underwent provocation lumbar
discography, dual diagnostic medial branch blocks, or intra-articular diagnostic sacroiliac
joint injections based on clinical presentation. Some subjects underwent multiple diagnostic
injections until the source of their chronic low back pain (CLBP) was identified.
Main Outcome Measurements: Based on the results of diagnostic injections, subjects
were classified as having IDD, FJP, SIJP, or other. The mean age/standard deviation and the
count/percentage of patients reporting hip girdle pain, leg pain, or thigh pain were estimated
for each diagnostic group and compared statistically among the IDD, FJP, SIJP, and other source
groups. Next, the 4 predictor variables were simultaneously modeled with a single multinomial
logistic regression model to explore the adjusted relationship between the predictors and the
source of CLBP.
Results: The mean age was significantly different among the source groups. IDD cases were
significantly younger than FJP, SIJP, and other source groups and FJP cases were significantly
younger than other sources. The age by thigh pain interaction effect was statistically significant
(P = 0.021), indicating that the effect of age on the source of CLBP depends on thigh pain, and
similarly, that the effect of thigh pain on the source of CLBP depends on age.
Limitations: Retrospective study design.
Conclusions: The presence or absence of thigh pain possesses a significant correlation
on the source of CLBP for varying ages, whereas the presence of hip/girdle pain or leg
pain did not significantly discriminate among IDD, FJP, or SIJP as the etiology of CLBP.
Younger age was predictive of IDD regardless of the presence or absence of thigh pain.
Key words: low back pain, intervertebral disc, zygapophyseal joint, sacroiliac joint, pain
referral patterns
Linguistic Adaptation, Validation and
Comparison of 3 Routinely Used Neuropathic
Pain Questionnaires
Authors: Feng Yi
Published: March 2021

Background: Neuropathic pain questionnaires are efficient diagnostic tools for
neuropathic pain and play an important role in neuropathic pain epidemiologic studies in
China. No comparison data was available in regards to the Leeds Assessment of Neuropathic
Symptoms and Signs (LANSS), the Neuropathic Pain Questionnaire (NPQ) and ID Pain within
and among the same population.
Objective: To achieve a linguistic adaptation, validation, and comparison of Chinese
versions of the 3 neuropathic pain questionnaires (LANSS, NPQ and ID Pain).
Study design: A nonrandomized, controlled, prospective, multicenter trial.
Setting: Ten pain centers in China.
Methods: Two forward translations followed by comparison and reconciliation of the
translations. Comparison of the 2 backward translations with the original version was made
to establish consistency and accuracy of the translations. Pilot testing and pain specialists’
evaluations were also required. A total of 140 patients were enrolled in 10 centers
throughout China: 70 neuropathic pain patients and 70 nociceptive pain patients. Reliability
(Cronbach’s alpha coefficients and Guttman split-half coefficients) and validity (sensitivity,
specificity, positive and negative predictive values, receiver operating characteristic [ROC]
curves and the area under the ROC curves) of the 3 questionnaires were determined. ROC
curves and the area under the ROC curves of the 3 questionnaires were also compared.
Results: Chinese versions of LANSS, NPQ and ID Pain had a good reliability (Cronbach’s
alpha coefficients and Guttman split-half coefficients were greater than 0.7). Sensitivity,
specificity, positive and negative predictive values of the Chinese versions of LANSS and ID
Pain were considerably high (> 80%). The area under the ROC curves of LANSS and ID Pain
was significantly higher than that of NPQ (P < 0.05). There was no statistically significant
difference between the area under the ROC curves of LANSS and ID Pain (P > 0.05).
Limitation: The study was based on patients with a high school degree or above, which
limited the application of the 3 neuropathic pain questionnaires to patients with lower
educational levels.
Conclusion: The Chinese versions of LANSS and ID Pain developed and validated by this
study can be used as a diagnostic tool in differentiating neuropathic pain in patients whose
native language is Chinese (Mandarin).
Key words: Neuropathic pain, questionnaire, scale, LANSS, NPQ, ID Pain, reliability,
validity.
An Animal Model for Trigeminal Neuralgia by
Compression of the Trigeminal Nerve Root
Authors: Li Yun-Qing
Published: March 2021

Background: Microvascular compression of the trigeminal nerve root is a major cause
of most trigeminal neuralgia (TN) in patients; however, no reliable animal model to
further study the pathogenesis of TN currently exists.
Objective: Our objective was to establish a novel and practical animal model for
TN by chronic compression of the trigeminal (CCT) nerve root in rats, which would
provide a better animal model to mimic the clinical feature of TN on the research of the
pathogenesis of TN.
Study Design: A randomized, double blind, controlled animal trial.
Methods: Sixteen adult male Sprague-Dawley rats (200-220 g) were randomly
divided into 2 groups: one group that received chronic compression of the trigeminal
nerve root (the CCT group, n=8) and another group that received sham operation
without compression (the sham operation group, n=8). A small plastic filament was
retrogressively inserted into the intracalvarium from the inferior orbital fissure until it
reached the trigeminal nerve root for compression in CCT group. Animal behaviors
were observed for 4 weeks after operation. Immunohistochemistry of glial fibrillary
acidic protein (GFAP), isolectin B4 (IB4), substance P (SP) and calcitonin gene-related
peptide (CGRP) were performed in the trigeminal root entry zone (TREZ) and medullary
dorsal horn (MDH).
Results: The orofacial mechanical allodynia and heat hyperalgesia in the CCT rats
were obviously increased after the operation and lasted for 28 days. Increased facegrooming behavior was also observed in the CCT rats and continued for over 21 days,
returning to baseline by day 28. Immunohistochemistry for GFAP in the TREZ revealed
a progressive extension of astrocytic processes in the ipsilateral TREZ of rats in the CCT
group. Furthermore, the IB4 positive immunoreactive nonpeptidergic C-fiber terminals
in the MDH were reduced for 4 weeks after the operation. Both SP and CGRP, expressed
in the peptidergic C-fiber terminals, were found to be decreased in the ipsilateral MDH
of CCT animals after the trigeminal nerve root injury.
Limitations: CCT animal model with a plastic filament only imitated the mechanical
compression of the trigeminal root but not to display the complex vascular physiological
feature as the microvascular in the TN patient.
Conclusions: The chronic compression of the trigeminal nerve root in rats effectively
induced persistent orofacial neuropathic pain behaviors, and it would provide a novel
and practical animal model for future research on the pathogenesis of TN.
Key words: trigeminal neuralgia, nerve root compression, animal model, mechanical
allodynia, heat hyperalgesia, substance P, calcitonin gene-related peptide, isolectin B4
Determination of the Particulate Size and
Aggregation of Clonidine and Corticosteroids
for Epidural Steroid Injection
Authors: Gazelka Halena M.
Published: March 2021

Background: Epidural injection of corticosteroids is a commonly used treatment for
radicular pain. However, the benefits are often short lived, and repeated injections are often
limited secondary to concerns of side effects from cumulative steroid doses. In addition, rare,
catastrophic complications, including brain and spinal cord embolic infarcts have been attributed
to particulate steroid injections. A previous study has shown that dexamethasone has less
particulate than other corticosteroids, possibly reducing embolic risk. Furthermore, a recent study
indicated that clonidine may be useful in the treatment of radicular pain when administered via
epidural steroid injection. The combination of corticosteroid and clonidine is an intriguing, yet
unstudied, alternative to traditional treatment.
Objective: Our study examines whether mixing clonidine and various corticosteroids results in
increased particle size or aggregation.
Methods: Evaluations under light microscopy for particle size were made of samples of clonidine
alone and clonidine mixed with equal parts of 3 corticosteroids solutions: dexamethasone sodium
phosphate injection, triamcinolone acetonide injectable suspension, and betamethasone sodium
phosphate and betamethasone acetate injectable suspension. Four mL each of clonidine (100 μcg/
mL), clonidine (100 μcg/mL) + dexamethasone sodium phosphate injection (4 mg/mL), clonidine
(100 μcg/mL) + triamcinolone acetonide injectable suspension (40 mg/mL), and clonidine (100
μcg/mL) + betamethasone sodium phosphate and betamethasone acetate injectable suspension
(6 mg/mL) were examined Their particle sizes were compared to measurements taken when each
steroid solution was examined alone.
Results: Clonidine was determined to be nonparticulate when examined by light microscopy.
Clonidine mixed with equal parts of each of the 3 corticosteroids mentioned above did not result
in increased clumping or increased particle size over each of the corticosteroids measured alone.
Conclusion: Mixing clonidine with corticosteroids did not increase particulation compared to
corticosteroids alone. Combining clonidine and corticosteroids for epidural injection may prove
to be a useful treatment for radicular pain. The combination of these is unlikely to result in a
solution that is more likely to cause embolic infarcts than the use of corticosteroids alone.
Key words: steroid, epidural, clonidine, injection, particulate, aggregation
Guidelines Warfare Over Interventional
Techniques: Is There a Lack of Discourse or
Straw Man?
Authors: Manchikanti Laxmaiah
Published: March 2021

Guideline development seems to have lost some of its grounding as a medical
science. At their best, guidelines should be a constructive response to assist practicing
physicians in applying the exponentially expanding body of medical knowledge.
In fact, guideline development seems to be evolving into a cottage industry with
multiple, frequently discordant guidance on the same subject. Evidence Based
Medicine does not always provide for conclusive opinions. With competing interests
of payers, practitioners, health policy makers, and third parties benefiting from
development of the guidelines as cost saving measures, guideline preparation has
been described as based on pre-possession, vagary, rationalization, or congeniality
of conclusion.
Beyond legitimate differences in opinions regarding the evidence that could yield
different guidelines there are potentials for conflicts of interest and various other
issues play a major role in guideline development. As is always the case, conflicts of
interest in guideline preparation must be evaluated and considered.
Following the development of American Pain Society (APS) guidelines there has been
an uproar in interventional pain management communities on various issues related
to not only the evidence synthesis, but conflicts of interest. A recent manuscript
published by Chou et al, in addition to previous publications appear to have limited
clinician involvement in the development of APS guidelines, demonstrates some of
these challenges clearly.
This manuscript illustrates the deficiencies of Chou et al’s criticisms, and demonstrates
their significant conflicts of interest, and use a lack of appropriate evaluations in
interventional pain management as a straw man to support their argument. Further,
this review will attempt to demonstrate that excessive focus on this straw man has
inhibited critique of what we believe to be flaws in the approach.
Key words: Guidelines, interventional pain management, professionalism,
discourse, disclosure, conflicts of interest, evidence-based medicine, comparative
effectiveness research, Patient-Centered Outcomes Research Institute
A Systematic Evaluation of Prevalence and
Diagnostic Accuracy of Sacroiliac Joint
Interventions
Authors: Simopoulos Thomas T.
Published: March 2021

Background: The contributions of the sacroiliac joint to low back and lower extremity pain have
been a subject of considerable debate and research. It is generally accepted that 10% to 25% of
patients with persistent mechanical low back pain below L5 have pain secondary to sacroiliac joint
pathology. However, no single historical, physical exam, or radiological feature can definitively
establish a diagnosis of sacroiliac joint pain. Based on present knowledge, a proper diagnosis can
only be made using controlled diagnostic blocks. The diagnosis and treatment of sacroiliac joint
pain continue to be characterized by wide variability and a paucity of the literature.
Objective: To evaluate the accuracy of diagnostic sacroiliac joint interventions.
Study Design: A systematic review of diagnostic sacroiliac joint interventions.
Methods: Methodological quality assessment of included studies was performed using Quality
Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50%
of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are
presented descriptively and analyzed critically.
The level of evidence was classified as good, fair, or limited (or poor) based on the quality of
evidence developed by the United States Preventive Services Task Force (USPSTF).
Data sources included relevant literature identified through searches of PubMed and EMBASE
from 1966 to December 2011, and manual searches of the bibliographies of known primary and
review articles.
Outcome Measures: In this evaluation we utilized controlled local anesthetic blocks using at
least 50% pain relief as the reference standard.
Results: The evidence is good for the diagnosis of sacroiliac joint pain utilizing controlled
comparative local anesthetic blocks. The prevalence of sacroiliac joint pain is estimated to
range between 10% and 62% based on the setting; however, the majority of analyzed studies
suggest a point prevalence of around 25%, with a false-positive rate for uncontrolled blocks of
approximately 20%. The evidence for provocative testing to diagnose sacroiliac joint pain was fair.
The evidence for the diagnostic accuracy of imaging is limited.
Limitations: The limitations of this systematic review include a paucity of literature, variations in
technique, and variable criterion standards for the diagnosis of sacroiliac joint pain.
Conclusions: Based on this systematic review, the evidence for the diagnostic accuracy of
sacroiliac joint injections is good, the evidence for provocation maneuvers is fair, and evidence for
imaging is limited.
Key words: Chronic low back pain, sacroiliac joint pain, sacroiliitis, sacroiliac joint injection,
sacroiliac joint dysfunction, provocation manuevers, controlled diagnostic blocks, intraarticular
injection, extraarticular injection.
Cephalad Lead Migration Following Spinal Cord
Stimulation Implantation
Authors: Christo Paul J.
Published: March 2021

Lead migration (LM) is the most common complication after spinal cord stimulation
(SCS). Although multiple reports of caudad LM have been described, cephalad
LM has not been reported. Here we describe a case in which a stimulator lead
migrates in the cephalad direction. A 60-year-old male with failed back surgery
syndrome underwent SCS lead implantation via a dual lead approach to the top of
vertebral body (VB) T9. A standard strain relief loop was used for each lead in the
paramedian pocket. Postoperative testing revealed 100% paresthesia coverage
of the painful areas. For the first 4 days, the patient continued to have excellent
coverage; however, by the seventh day, the paresthesias ascended to above the
nipple line. At the 2-week follow-up, cephalad migration of the left lead to the
top of VB T1 was confirmed on fluoroscopy. The patient underwent successful
lead revision in which a single paramedian incision technique was used to place
extra sutures and a “figure-of-eight” strain relief loop. We provide the first case
report of significant cephalad LM following SCS lead implantation. This migration
can occur despite the use of current standard anchoring techniques. Additional
investigation into the mechanism of such LM and lead-securing techniques is
warranted.
Key words: spinal cord stimulation, lead migration, lead revision, strain relief
loop
Urine Drug Testing: Current Recommendations
and Best Practices
Authors: Burton Allen W.
Published: March 2021

Background: The precise role of urine drug testing (UDT) in the practice of pain
medicine is currently being defined. Confusion exists as to best practices, and even to
what constitutes standard of care. A member survey by our state pain society revealed
variability in practice and a lack of consensus.
Objective: The authors sought to further clarify the importance of routine UDT as an
important part of an overall treatment plan that includes chronic opioid prescribing.
Further, we wish to clarify best practices based on consensus and data where available.
Methods: A 20-item membership survey was sent to Texas Pain Society members.
A group of chronic pain experts from the Texas Pain Society undertook an effort to
review the best practices in the literature. The rationale for current UDT practices is
clarified, with risk management strategies outlined, and recommendations for UDT
outlined in detail. A detailed insight into the limitations of point-of-care (enzyme-linked
immunosorbent assay, test cups, test strips) versus the more sensitive and specific
laboratory methods is provided.
Limitations: Our membership survey was of a limited sample size in one geographic
area in the United States and may not represent national patterns. Finally, there is
limited data as to the efficacy of UDT practices in improving compliance and curtailing
overall medication misuse.
Conclusions: UDT must be done routinely as part of an overall best practice program
in order to prescribe chronic opioid therapy. This program may include risk stratification;
baseline and periodic UDT; behavioral monitoring; and prescription monitoring programs
as the best available tools to monitor chronic opioid compliance.
Key words: Urine drug screening, urine toxicology screening, urine drug testing,
chronic pain, addiction, forensic testing