bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defending Democracy and the Rule of Law in the Era of Post-Enlargement
Authors: Schmalenbach Kirsten 
Published: December 2020

Abstract
This contribution critically analyses the four limbs of the EU’s defence mechanism upholding the rule of law within the Union. The first being the individual post accession rule of law mechanism, introduced by the Commission in 2006 for the two new member states Bulgaria and Rumania. The second, and arguably most powerful limb, involves the EU Court of Justice conducting a judicial review of a member state’s rule of law situation, which is of far greater concern for reviewed members than the so-called “nuclear” last-resort option of Art. 7 teu ’s sanction mechanism (fourth limb) that is politically difficult to enact. With a view to the politically fraught Art. 7 teu, the Commission introduced a new “early warning” rule of law framework in 2014 which pre-emptively enables exploring dialogue-based solutions to rule-of law issues as they emerge (third limb).
Variability and Transitions in Precipitation Extremes in the Midwest United States
Authors: Ford Trent W. , Chen Liang , Schoof Justin T. 
Published: December 2020

AbstractMonthly to seasonal precipitation extremes, both flood and drought, are important components of regional climates worldwide, and are the subjects of numerous investigations. However, variability in and transition between precipitation extremes, and associated impacts are the subject of far fewer studies. Recent such events in the Midwest region of the United States, such as the 2011–12 flood to drought transition in the upper Mississippi River basin and the flood to drought transition experienced in parts of Kentucky, Ohio, Indiana, and Illinois in 2019, have sparked concerns of increased variability and rapid transitions between precipitation extremes and compounded economic and environmental impacts. In response to these concerns, this study focuses on characterizing variability and change in Midwest precipitation extremes and transitions between extremes over the last 70 years. Overall we find that the Midwest as a region has gotten wetter over the last seven decades, and that in general the annual maximum and median wetness, defined using the standardized precipitation index (SPI), have increased at a larger magnitude than the annual minimum. We find large areas of the southern Midwest have experienced a significant increase in the annual SPI range and associated magnitude of transition between annual maximum and minimum SPI. We additionally find wet to dry transitions between extremes have largely increased in speed (i.e., less time between extremes), while long-term changes in transition frequency are more regional within the Midwest.
Pyrocumulonimbus Firepower Threshold: Assessing the Atmospheric Potential for pyroCb
Authors: Tory K. J. , Kepert J. D. 
Published: December 2020

AbstractPyrocumulonimbus (pyroCb) clouds are difficult to predict and can produce extreme and unexpected wildfire behavior that can be very hazardous to fire crews. Many forecasters modify conventional thunderstorm diagnostics to predict pyroCb potential, by adding temperature (Δθ) and moisture increments (Δq) to represent smoke plume thermodynamics near the expected plume condensation level. However, estimating these Δθ and Δq increments is a highly subjective process that requires expert knowledge of all factors that might influence future fire size and intensity. In this paper, instead of trying to anticipate these Δθ and Δq increments for a particular fire, the minimum firepower required to generate pyroCb for a given atmospheric environment is considered. This concept, termed the pyroCb firepower threshold (PFT) requires only atmospheric information, removing the need for subjective estimates of the fire contribution. A simple approach to calculating PFT is presented that incorporates only basic plume-rise physics, yielding an analytic solution that offers important insight into plume behavior and pyroCb formation. Minimum increments of Δθ and Δq required for deep, moist convection, plus a minimum cloud-base height (zfc), are diagnosed on a thermodynamic diagram. Briggs’s plume rise equations are used to convert Δθ, zfc, and a mean horizontal wind speed U to a measure of the PFT: the minimum heat flux entering the base of the plume. This PFT is proportional to the product of U, Δθ, and the square of zfc. Plume behavior insights provided by the Briggs’s equations are discussed, and a selection of PFT examples presented.
Risk Factors for Wound Infection in Outpatients With Lower Extremity Burns
Authors: Ladhani Husayn A. , Young Brian T. , Posillico Sarah E. , Yowler Charles J. , Brandt Christopher P. , Claridge Jeffrey A. , Khandelwal Anjay K. 
Published: December 2020

Background We sought to evaluate risk factors for wound infection in patients with lower extremity (LE) burn. Methods Adults presenting with LE burn from January 2014 to July 2015 were included. Data regarding demographics, injury characteristics, and outcomes were obtained. The primary outcome was wound infection. Multivariate logistic regression analysis was performed to identify independent risk factors for wound infection. Results 317 patients were included with a mean age of 43 years and median total body surface area of .8%; 22 (7%) patients had a component of full-thickness (FT) burn; and 212 (67%) patients had below-the-knee (BTK) burn. The incidence of wound infection was 15%. The median time to infection was 5 days, and majority (61%) of the patients developed wound infection by day 5. Patients who developed wound infection were more likely to have an FT burn (22% vs. 5%, P < .001) and BTK burn (87% vs. 64%, P = .002), without a difference in other variables. Multivariate logistic regression analysis showed age (Odds ratio (OR) 1.02 and CI 1.00-1.04), presence of FT burn (OR 5.33 and CI 2.09-13.62), and BTK burn (OR 3.42 and CI 1.37-8.52) as independent risk factors for wound infection (area under the curve = .72). Conclusion Age, presence of FT burn, and BTK burn are independent risk factors for wound infection in outpatients with LE burns.
The association between living in socially fragmented neighbourhoods and psychological distress among immigrant and non-immigrant people aged 45 and over in NSW, Australia
Authors: Tabatabaei-Jafari Hossein , Zulfiqar Tehzeeb , Welsh Jennifer , Bagheri Nasser 
Published: December 2020

Objective: Immigrants’ mental health is a growing public health concern. Neighbourhood characteristics in the host society may contribute to the poor mental health observed among immigrants. In this study, we aimed to investigate the association between neighbourhood-level social fragmentation and socioeconomic characteristics with psychological distress among immigrants and non-immigrants living in Australia. Methodology: We conducted cross-sectional secondary data analysis of 228,039 participants from the Sax Institute’s 45 and Up Study, with psychological distress measured with the Kessler 10 (K10) and area-level social fragmentation and economic advantage/disadvantage measured at the statistical area level 1 (areas containing approximately 400 people). Multilevel logistic models were used to examine the extent to which differences across the least and most fragmented and economic advantage/disadvantage neighbourhoods contributed to the prevalence of high psychological distress (K10 score ⩾ 22). Results: Immigrants accounted for about 23% of the sample. Slightly more immigrants (34.8%) compared to non-immigrants (32.9%) lived in fragmented areas. Although immigrants were over represented in areas with socioeconomic advantage (40% vs 33.9%), the prevalence of high psychological distress in neighbourhoods with higher social fragmentation and socioeconomic disadvantage was higher in immigrants than non-immigrants. Immigrants had 17% (95% confidence interval = [12%, 22%]) higher odds of having high psychological distress compared to non-immigrants. There was no evidence of an interaction between social fragmentation or socioeconomic disadvantage and immigrant status. Living in fragmented or socioeconomically disadvantaged areas was associated with higher psychological distress among immigrants and non-immigrants. English as a second language and low annual income were significant predictors of psychological distress in immigrants over and above area-level characteristics. Conclusion: Immigrants are vulnerable to mental health issues, but the characteristics of the area they live in are also important. Helping immigrants settle into well-integrated and economically advantaged areas may decrease the possibility of mental health issues.
Associations of serum uric acid level with diabetic retinopathy and albuminuria in patients with type 2 diabetes mellitus
Authors: Hou Lin , Shi Yingzhou , Wang Sichao , Chen Qing , Li Qiu , Zhao Meng , Zhou Xinli 
Published: December 2020

Objectives To analyze the associations of serum uric acid (SUA) level with diabetic microvascular complications, including diabetic retinopathy (DR) and diabetic nephropathy (DN), in patients with type 2 diabetes mellitus (DM). Methods Three hundred eighty-nine inpatients with type 2 DM were included in this retrospective analysis. Nonmydriatic fundus cameras were used to identify DR. Urinary albumin creatinine ratio was used to identify DN. Patients were divided into four groups according to SUA quartiles. Results The prevalences of DR and albuminuria increased with increasing SUA level. Multivariate logistic regression analysis showed that, following adjustment for other risk factors, higher levels of SUA (Q3 and Q4) were associated with greater risk for DR, compared with the lower level (Q1) (odds ratio [OR]: 3.056, 95% confidence interval [CI]: 1.506–6.198; OR: 3.417, 95% CI: 1.635–7.139, respectively). Moreover, higher levels of SUA (Q2, Q3, and Q4) were associated with greater risk for albuminuria (OR: 2.418, 95% CI: 1.059–5.522; OR: 7.233, 95% CI: 3.145–16.635; and OR: 8.911, 95% CI: 3.755–21.147, respectively). Conclusions SUA level was independently associated with DR and albuminuria in patients with type 2 DM. Elevated SUA level might be predictive for the occurrence of DR and DN.
Theorising business model innovation: An integrated literature review
Authors: Loon Mark , Quan Xiaohong Iris 
Published: December 2020

The aim of this article is to theorise the business model innovation (BMI) phenomenon as we explore why and how BMI occurs, specifically to answer the question, What are the mechanisms involved? We evaluate extant research by adapting the context-intervention-mechanism-output framework, and adopting a mechanism-based theory building approach for synthesising our findings. This study makes three contributions: first, we enrich epistemology by adopting a process view as we show that BMI is a series of interdependent mechanisms. Second, we identify six mechanisms unique to the phenomenon. Third, we offer a prescient outlook of BMI change as a metatheory. JEL Classifications: M10, O30, O31, O39
Effects of manual acupuncture and electroacupuncture for lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis
Authors: Navarro-Santana Marcos J , Sanchez-Infante Jorge , Gómez-Chiguano Guido F , Cummings Mike , Fernández-de-las-Peñas César , Plaza-Manzano Gustavo 
Published: December 2020

Objective: The aim of this study was to evaluate the effect of acupuncture/electroacupuncture, alone or combined with other interventions, on pain intensity, pain-related disability, and strength in lateral epicondylalgia (LE) of musculoskeletal origin. Databases and data treatment: Electronic databases were searched for randomized clinical trials, where at least one group received acupuncture or electroacupuncture for LE of musculoskeletal origin. To be eligible, trials had to include humans and collect outcomes on pain intensity or pain-related disability in LE. Data were extracted by two reviewers. The risk of bias (RoB) of the trials was assessed using the Cochrane RoB tool, methodological quality was assessed with the Physiotherapy Evidence Database (PEDro) score, and the level of evidence was summarized using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Standardized mean differences (SMDs) using random effects were calculated. Results: A total of 14 trials (10 acupuncture) were included. The meta-analysis found a moderate effect size of acupuncture (SMD = −0.66, 95% confidence interval (CI) = −1.22 to −0.10), but not electroacupuncture (SMD = −0.08, 95% CI = −0.99 to 0.83), in the reduction of elbow pain as compared to a comparative group. Acupuncture exhibited a significant moderate effect size (SMD = −0.51, 95% CI = −0.91 to −0.11) in the improvement of related-disability. Acupuncture (SMD = 0.36, 95% CI = 0.16 to 0.57), but not electroacupuncture (SMD = 0.34, 95% CI = −0.29 to 0.98), exhibited a significant but small effect size on strength. Most significant effects were in the short term. The RoB was low but the heterogeneity of trial results led to a downgrading of the GRADE evidence level. Conclusion: Low-level evidence suggests positive effects of acupuncture, but not electroacupuncture, for pain, related-disability, and strength, in LE of musculoskeletal origin, in the short term.
Does acupuncture combined with antidepressants have a better therapeutic effect on post-stroke depression? A systematic review and meta-analysis
Authors: Zhang Kun , Cui Guangwei , Gao Yuan , Shen Weidong 
Published: December 2020

Objective: To evaluate the effectiveness of acupuncture combined with antidepressants in the treatment of post-stroke depression (PSD). Methods: The following electronic databases were systematically searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Wanfang Data, China National Knowledge Infrastructure and Chongqing VIP database. The primary outcome was the Hamilton depression scale (HAMD) score. Two independent investigators screened for eligible clinical trials. The Cochrane risk of bias tool was used to assess the methodological quality, and RevMan 5.3 was applied for meta-analysis. Results: Thirteen randomized controlled trials (RCTs) involving 904 participants were included in the study. The results of this meta-analysis showed that, compared with antidepressants alone, acupuncture combined with antidepressants led to a significant decrease in the HAMD score (mean difference (MD): −3.60, 95% confidence interval (CI): −4.25 to −2.95, P < 0.001), had a better effective rate (risk ratio (RR): 1.33, 95% CI 1.19 to 1.49, P < 0.001) and lower National Institutes of Health Stroke Scale (NIHSS) scores (MD: −2.39, 95% CI: −3.37 to −1.41, P < 0.001), and led to a significant increase in the Barthel index scores (MD: 8.10, 95% CI: 5.25 to 10.94; P < 0.001). Conclusions: Acupuncture combined with antidepressants showed a more favourable effect on the treatment of PSD than antidepressants alone. However, given the limited methodological quality, more high-quality RCTs conducted based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines are necessary.
Sacral electroacupuncture as a treatment for urge urinary incontinence: a prospective case series
Authors: Chen Shan , Wang Siyou , Xuan Lihua , Xu Fu , Lu Hanti , Lu Jing 
Published: December 2020

Objective: To examine the impact of electroacupuncture (EA) at the ‘four sacral points’ on urge urinary incontinence (UUI). Methods: Twenty-five patients diagnosed with UUI or urgency-predominant mixed urinary incontinence (MUI) were treated by EA at the ‘four sacral points’. EA was performed in the sacrococcygeal region using disposable sterile 0.40-mm-diameter acupuncture needles that were either 100 or 125 mm in length. Treatments were delivered once every other day. Before and after treatment, a questionnaire measuring symptom severity and quality of life associated with UUI was administered. Results: The median total score (interquartile range) from the severity of symptoms and the quality of life questionnaire (Q-score) of the participants was significantly reduced from 12 (7.5, 15) before treatment to 3 (0, 6) after 6 (6, 12) EA treatments. The Q-score of urgency-predominant MUI and UUI was 8 (5, 14.5) and 12.5 (11, 15), respectively, before treatment; after treatment these were reduced to 2 (0, 7.5) and 4.5 (2, 6), respectively. There was no statistically significant difference in the Q-score between urgency-predominant MUI and UUI before and after treatment. Upon treatment completion, seven patients (28%) were ‘cured’ (improvement rate 100%). Treatments were considered ‘markedly effective’ (improvement rate 75% to <100%) in four patients (16%), ‘effective’ (improvement rate 50% to <75%) in eight patients (32%), ‘minimally effective’ (improvement rate 25% to <50%) in three patients (12%), and ‘ineffective’ (improvement rate <25%) in three patients (12%). The overall success rate (comprising ‘cured’, ‘markedly effective’ and ‘effective’ categories) was 76%, and no adverse effects associated with acupuncture treatment were reported. Conclusion: EA at the ‘four sacral points’ was associated with statistically significant improvements in UUI.
Characterization of piezoelectric patch material with hysteresis, saturation, creep, and vibration nonlinearity effects and its application to the active vibration suppression for cantilever beam
Authors: Abdul Satar Mohd Hafiz , Murad Ahmad Firdaus , Ahmad Mazlan Ahmad Zhafran 
Published: December 2020

This research work aims to investigate the presence of four nonlinear characteristics (i.e., hysteresis, saturation, creep, and uncertainty vibration) when a piezoelectric patch material acts as an actuator and sensor for the active vibration suppression of a cantilever beam. The parameters such as different operating frequencies and voltages are taken into account for the piezoelectric patch material characterization and the vibration before and after activation of a proportional–derivative–integral controller in an active vibration suppression system are measured. The effect of different proportional–derivative–integral controller tuning methods, frequency independent, and frequency dependency excitations are the three main contributions to evaluate the performance of active vibration suppression system. From the results, the piezoelectric actuator posed all the four nonlinearity effects while only three are observed in the sensor characteristics, and these effects increased significantly with the increase of operating frequencies and voltages. For the frequency-independent excitation of the active vibration suppression system, the vibration attenuation of the beam shows an improvement from low to higher excitation frequency, except at 500 Hz because of the saturation effect. In terms of controller performances, the proportional gain step-up method shows the best performance by scoring 3/5 of highest vibration attenuation percentages compared with manual and Ziegler–Nichols methods. For the frequency-dependent excitation, the effective frequency range for the active vibration suppression system is determined between 75 and 245 Hz with the highest vibration attenuation of 79.60% occurred at the second natural frequency of the beam.
Choriocapillary vascular density changes in choroidal neovascularization associated with choroidal nevus after anti-VEGF injections
Authors: D’andrea Luca , Fossataro Federica , Cennamo Gilda 
Published: December 2020

Purpose: To evaluate choriocapillary vascular density changes in choroidal neovascularization (CNV) type 2 associated with choroidal nevus using optical coherence tomography angiography (OCT-A) before and after anti-VEGF treatment. Methods: Observational case report. Results: A 25-year-old woman, was referred to Eye Clinic and presented a decreased visual acuity in right eye. Fundus examination showed a pigmented lesion located in macular region associated with subretinal hemorrhages adjacent to the mass in right eye. The diagnosis of choroidal nevus-associated with CNV was made and confirmed by spectral domain (SD)-OCT, OCT-A, and ultrasound examination. Two monthly ranibizumab intravitreal injections (IVT) were performed and a regression of the activity of neovascular lesion was noted. OCT-A showed a reduction of choriocapillaris vessel density (VD) before the treatment and an increase of VD after IVT injections. Conclusion: OCT-A could be a non-invasive and diagnostic tool to evaluate choriocapillaris vascular changes after IVT injections in CNV associated with choroidal nevus.
Social work involvement in the COVID-19 response in China: Interdisciplinary remote networking
Authors: Yu Zhihong , Chen Qiqi , Zheng Guanghuai , Zhu Yuhong 
Published: December 2020

Summary Social workers in China have been involved significantly in the response to the COVID-19 pandemic. This article introduces the innovative interdisciplinary remote networking framework which both provides a guide for medical and community social workers’ involvement during the COVID-19 outbreaks, and also to support interdisciplinary collaboration with the aim of helping individuals and families in need during the pandemic. Findings The implementation of interdisciplinary remote networking, developed by Chinese social workers, has effectively addressed the different domains of need experienced by the affected population and has established a new approach for social work in the field of health. The framework also provides an effective model for setting up a targeted and sustained service system that links social workers with psychological and medical resources, which capitalize on social resources to buffer the negative impacts of the disease. Social workers play an essential role during such a public health emergency, providing critical services for patients and families, medical workers, self-quarantined residents, and the general population. Applications The service mode of interdisciplinary remote networking, based on the frontline experiences of social work interventions in China, may serve as a framework for combating COVID-19 in other countries. The framework is among the initiatives that provide transferrable skills to social work practitioners working in network-based social work services during public health emergencies. Thus, the framework presents implications for future practice development in both disaster social work and also public health social work.