bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel modulation approach of flat force–displacement characteristic of linear electro-mechanical converter for electro-hydraulic servo-proportional valve
Authors: Meng Bin , Heng Yaozhen , Li Sheng
Published: July 2022

Flat force–displacement characteristic has crucial influence on the performance of linear electro-mechanical converter of electro-hydraulic servo-proportional valves. The commercial proportional solenoids obtain such features by welding a non-magnetic separator ring, which is complicated and time-consuming. This article presents a novel modulation approach to obtain the flat force–displacement characteristic of linear electro-mechanical converter by constructing a by-pass air gap. Taking an existing linear force motor as an example, the force–displacement characteristic curves of the linear force motor with by-pass air gap and without by-pass air gap are both studied using magnetic circuit analysis and finite element method under different excitation currents. Based on the finite element method simulated data, the response surface method is used to perform the experiment design for structure parameters of linear force motor with by-pass air gap, and the quadratic fitting equations are obtained for further optimization. To balance conflicted design objectives such as linearity, mean value of output force and power-to-weight ratio, the structural parameters of the linear force motor with by-pass air gap are optimized using a multi-objective optimization algorithm based on particle swarm. Prototypes of linear force motor with by-pass air gap and without by-pass air gap are both manufactured, and a special test rig is built. The static and dynamic experimental results are consistent with the theoretical analysis. The former proves that the linear force motor with by-pass air gap can obtain a nearly flat force–displacement curve with reasonable parameter optimization and also improve output force, and the latter reveals that a linear electro-mechanical converter with flat–displacement characteristic has better working stability over common ones. The proposed modulation approach provides a new approach for the design of flat force–displacement characteristic of linear electro-mechanical converter.
Elevated Soluble Podoplanin Associates with Hypercoagulability in Patients with Nephrotic Syndrome
Authors: Ji Ying , Wang Yan-Li , Xu Fang , Jia Xi-Bei , Mu Su-Hong , Lyu Hui-Yan , Yuan Xue-Ying , Na Shi-Ping , Bao Yu-Shi
Published: July 2022

Podoplanin (PDPN) promotes platelet aggregation and activation by interacting with C-type lectin-like receptor 2(CLEC-2) on platelets. The interaction between the upregulated PDPN and platelet CLEC-2 stimulates venous thrombosis. PDPN was identified as a risk factor for coagulation and thrombosis in inflammatory processes. Hypercoagulability is defined as the tendency to develop thrombosis according to fibrinogen and/or D dimer levels. Nephrotic syndrome is also considered to be a hypercoagulable state. The aim of this study is to investigate the association of soluble PDPN/CLEC-2 with hypercoagulability in nephrotic syndrome. Thirty-five patients with nephrotic syndrome and twenty-seven healthy volunteers were enrolled. PDPN, CLEC-2 and GPVI concentrations were tested by enzyme-linked immunosorbent assay (ELISA). Patients with nephrotic syndrome showed higher serum levels of PDPN and GPVI in comparison to healthy controls ( P < .001, P = .001). PDPN levels in patients with nephrotic syndrome were significantly correlated with GPVI (r = 0.311; P = .025), hypoalbuminemia (r = −0.735; P < .001), hypercholesterolemia (r = 0.665; P < .001), hypertriglyceridemia (r = 0.618; P < .001), fibrinogen (r = 0.606; P < .001) and D-dimer (r = 0.524; P < .001). Area under the curve (AUC) for the prediction of hypercoagulability in nephrotic syndrome using PDPN was 0.886 (95% CI 0.804-0.967, P < .001). Cut-off value for the risk probability was 5.88 ng/ml. The sensitivity of PDPN in predicting hypercoagulability was 0.806, and the specificity was 0.846. When serum PDPN was >5.88 ng/ml, the risk of hypercoagulability was significantly increased in nephrotic syndrome (OR = 22.79, 95% CI 5.92-87.69, P < .001). In conclusion, soluble PDPN levels were correlated with hypercoagulability in nephrotic syndrome. PDPN has the better predictive value of hypercoagulability in nephrotic syndrome as well as was a reliable indicator of hypercoagulable state.
Improvements to a vehicle’s ride comfort by controlling the vertical component of the driving force based on in-wheel motors
Authors: Kopylov Semen , Phanomchoeng Gridsada , Ambrož Miha , Petan Žiga , Kunc Robert , Qiu Yi
Published: July 2022

Relocating the electric motor to a position inside the wheel offers a variety of benefits, such as reduced overall vehicle weight, more efficient production of vehicles, more flexible design and better road handling because of the accurate torque control on each wheel. However, the motor also increases the unsprung mass, which can impair the ride comfort of the vehicle. In this paper, we propose and investigate a control strategy using the vertical component of the driving force provided by an in-wheel motor for better ride comfort and handling dynamics. In the next stage, a mathematical model of the vehicle with coupled longitudinal, lateral, and vertical dynamics was introduced. The parameters of the vehicle were measured and collected from an actual car equipped with in-wheel motors. To analyze the performance of the controller, a model of the vehicle was tested in a series of simulations. The straight-line acceleration test indicated an improvement to the ride comfort of 31.8% in terms of the RMS vertical vibrations of the sprung mass. The control is achieved without any deterioration of the tire load and the vehicle’s longitudinal dynamics. The stable lateral dynamics of the controlled vehicle was confirmed using a sine-sweep steering excitation, conducted on a perfectly smooth road surface with a constant longitudinal acceleration.
Vulnerability to the Effects of Conflicting Health Information: Testing the Moderating Roles of Trust in News Media and Research Literacy
Authors: Nagler Rebekah H. , Vogel Rachel I. , Rothman Alexander J. , Yzer Marco C. , Gollust Sarah E.
Published: July 2022

Background

Exposure to conflicting health information can produce negative affective and cognitive responses, including confusion and backlash, and the effects of this exposure can even “carry over” and reduce people’s receptivity to subsequent messages about health behaviors for which there is scientific consensus. What is not known is whether certain population subgroups are more vulnerable to such carryover effects.

Aims

This study investigates whether carryover effects of exposure to conflicting information are moderated by two factors, trust in news media and research literacy, testing the hypothesis that lower trust and higher literacy could protect against such effects.

Method

The analysis draws on data from a longitudinal population-based experiment ( N = 2,716), in which participants were randomly assigned to view health news stories and social media posts that either did or did not feature conflicting information, and subsequently exposed to ads from existing health campaigns about behaviors for which there is scientific consensus. Structural equation modeling was used to test study hypotheses.

Results

Neither lower trust in news media nor higher research literacy protected against carryover effects, as effects were observed across levels of both trust and literacy. Although level of research literacy did not affect whether carryover effects were observed, it did shape how those effects emerged.

Conclusion

The public, regardless of their level of trust in news media or research literacy, is vulnerable to the downstream effects of exposure to conflicting health information. Targeted health communication interventions are needed to improve messaging about evolving science and, in turn, increase receptivity to public health recommendations.
“If a (queer) revolt is to come”: Toward a sensuous pedagogy for dis/orienting management learning
Authors: Steyaert Chris
Published: July 2022

This article embarks on a hopeful exploration of queer phenomenology in order to reorient management learning toward the senses, the body, and the spaces of learning and teaching we inhabit during education. Starting from Michel Serres’ long-standing provocation that “If a revolt is to come, it will have to come from the five senses,” I ask whether and how we might reissue his timely call amid today’s understandings of sensuous and embodied learning as the “conditions of arrival” have changed considerably since its first articulation. Therefore, I propose to queer such a sensorial revolt by turning to Ahmed’s queer phenomenology as her understanding of dis/orientation as “the sixth sense” enables us to sensuously reorient management learning. To concretize and illustrate sensuous learning through dis/orientation, I draw on Fabian Ramos and Laura Roberts “pedagogy of wonder,” which forms part of their decolonial feminist educational work. In the epilogue, I introduce a new angle by revisiting Matthew Lopez’s play The Inheritance and suggest that my queer attempt to refuse the inheritance of heteronormative learning and education also enables generations of diverse people to learn, in sensuous ways, from each other and from each other’s otherness.
The effect of virtual proximity and digital adoption on international tourism flows to Southern Europe
Authors: Guedes Alexandre , Faria Samuel , Gouveia Sofia , Rebelo João
Published: July 2022

This paper extends the traditional gravity model to explain the effect of digitalization on international tourism flows to five Southern European countries, where tourism plays an important economic role. The analysis is based on balanced panel data covering the period 2004–2019. Internet-user statistics and Google Trends search data are used as a proxy for digital adoption and virtual proximity, respectively, by source markets. Results lend support to the notion that virtual proximity rather than digital adoption aided international travel, demonstrating that digitalization cannot be interpreted as a fluid and vague concept that exerts a consistent effect. Results also present evidence that Southern European countries should not be treated as a block of homogenous destinations. These findings inform stakeholders regarding the significance of digital platforms as strategic tools to empower consumers.
Transmedia storytelling, diegetic paratexts, and the limits of real time
Authors: Adams Caitlin , Barbour Kim
Published: July 2022

The category of ‘transmedia story’ is generally assumed to be static. That is, once a multi-platform story world has been classified as transmedia, it is assumed that this classification applies on an ongoing basis. However, these classifications may in fact need to be revisited, particularly when a story is told in ‘real time’ across social platforms that privilege immediacy. In this paper, we examine the relationship between diegetic social media paratexts and the core text they connect to, using the example of in online transmedia story The Lizzie Bennet Diaries. We argue that once the narrative has concluded, the transmedia status of the story becomes problematic, given the effort required to stitch together the different transmedial components. Utilising qualitative and quantitative content analysis, the show is analysed to determine the relationship between the different elements of the text as presented on YouTube and Twitter. The diegetic paratexts distributed through social media site Twitter contribute to the narrative by expanding upon the events of the core text conveyed on YouTube, and providing context – but never resolution – to the plot. The Twitter paratexts are inherently dependent on the core text but are also directional in that audience members must move from one platform to another in order to engage with the full story. Additionally, the temporal model of release for the core text changes the impact of the diegetic paratexts, while limiting the longevity of the transmedia aspects to the text as a result of dispersed narrative and dependency created by the relationship between textual elements. This analysis helps to extend understandings of transmedia storytelling as we propose the concept of ‘transmedia artefacts’, a category for narratives that transform once they are no longer able to be engaged with as live online objects.
The role of news media knowledge for how people use social media for news in five countries
Authors: Schulz Anne , Fletcher Richard , Nielsen Rasmus Kleis
Published: July 2022

Concern over misinformation on social media has amplified calls to improve the public’s knowledge about how news is produced, distributed and financed. This study investigates the relationship between people’s news media knowledge and the ways in which they use social media for news using online survey data in five countries: the United Kingdom, United States, Germany, Spain and Sweden ( N = 10,595). We find that people with higher news media knowledge are more likely to include social media in their news repertoire – but not as their main or only source of news. Second, we find that news media knowledge is positively associated with paying attention to source and editorial cues. When it comes to different social endorsement cues, news media knowledge is positively associated with paying attention to the person who shared the news, but negatively associated with paying attention to the number of likes, comments and shares.
Making Sense of Word Reading Difficulties: Principles of Clinical Assessment
Authors: Zipoli Richard P.
Published: July 2022

Speech-language pathologists (SLPs) are increasingly called upon to help assess students with word-recognition difficulties, including dyslexia. Although SLPs tend to have comparatively strong knowledge regarding the phonological awareness skills that support word reading, findings from survey research indicate that many SLPs report limited knowledge and training on word recognition and phonics. The purpose of this article is to provide a systematic framework for assessing and interpreting students’ word reading skills. Five potential components of word reading assessment will be examined: word recognition, phonological decoding, automaticity, performance with specific phonics patterns, and reading multimorphemic and multisyllabic words. Emphasis will be given to how specific test formats and procedures can be used to help identify patterns of word reading difficulty.
Functional outcomes of elbow injuries managed according to the Wrightington classification of elbow fracture-dislocations
Authors: Hamoodi Zaid , Singh Jagwant , Elvey Michael H , Watts Adam C
Published: July 2022

Background

This study aims to review the functional outcomes of patients managed by the application of the Wrightington elbow fracture-dislocation classification system and its corresponding management algorithms.

Methods

This is a retrospective consecutive case series of patients over the age of 16 with an elbow fracture-dislocation managed according to the Wrightington classification. The primary outcome was the Mayo Elbow Performance Score (MEPS) at the last follow-up. Range of movement (ROM) and complications were collected as a secondary outcome.

Results

Sixty patients qualified for inclusion (32 female, 28 male) with a mean age of 48 years (19–84). Fifty-eight (97%) patients completed a minimum of three months follow-up. Mean follow-up was six months (3–18). The median MEPS at the final follow-up was 100 (interquartile range [IQR] 85–100) and median ROM of 123° (IQR 101–130) degrees. Four patients underwent secondary surgery and had improved outcomes with the average MEPS score improving from 65 to 94 following the second surgery.

Conclusions

The results of this study show that good outcomes can be achieved for complex elbow fracture-dislocations through pattern recognition and management with an anatomically based reconstruction algorithm as described by the Wrightington classification system.
Implant Survival in Tissue-Engineered Mandibular Reconstruction—Early Experiences
Authors: Mañón Victoria A. , Oda Nicholas , Boudreaux Emeric , Tran Huy , Young Simon , Melville James C.
Published: July 2022

Study Design

This article is to evaluate the early outcomes of dental implants placed in bone generated with tissueengineering techniques, specifically recombinant human bone morphogenic protein-2 (rhBMP-2), allogeneicbone particulate, and bone marrow aspirate concentrate (BMAC) in patients with resection of benignpathology.

Objective

To evaluate the long-term prognosis of dental implants placed in tissue engineered mandibular reconstruction.

Methods

We retrospectively evaluated 12 patient records, all of whom underwent segmental mandibular resection of benign pathology and reconstruction with a combination of BMAC, rhBMP-2, and allogeneic bone. Collecteddata points included the patient's age, gender, medical and social histories, implant site and placement date, resection/reconstruction date, final prosthesis, pathology resected, and follow-up dates (average 25 monthsof follow-up). Implant success was defined as clinical osseointegration (immobility), absence of peri-implantradiolucency, and absence of infection.

Results

Twelve patients met inclusion criteria with a total of 46 implants. The overall implant survival rate was 91.3%. There were 4 implant failures occurring in two patients: 1 failure in Patient 3 and 3 failures in Patient 8. Neitherpatient had any existing medical comorbidities or social history known to increase the risk for implant failure. The average implant placement occurred 11.6 months after mandibular reconstruction.

Conclusions

Preliminary findings of implant placement in bone generated with tissue engineering techniques have shown to be another predictable alternative for orofacial rehabilitation. Practical Implications: Dental rehabilitationusing dental implants is a predictable treatment option for patients that have required reconstruction of largebony defects status post resection of benign pathology using novel tissue engineering techniques.
Could chlorophyllins improve the safety profile of beta-d-N4-hydroxycytidine versus N-hydroxycytidine, the active ingredient of the SARS-CoV-2 antiviral molnupiravir?
Authors: Clark Nicole F. , Taylor-Robinson Andrew W. , Heimann Kirsten
Published: July 2022

Plain Language Summary

Could natural plant pigment (chlorophyll) derivatives (chlorophyllins) improve the safety of the antiviral Molnupiravir, used to treat COVID-19 disease?

Molnupiravir, a specific SARS-CoV-2 antiviral, may cause adverse genetic changes and thereby create potential host cell damage (through genotoxicity and DNA stressors). In our opinion, this side effect of treatment could be reduced if the antiviral was taken as a combined therapy with chlorophyllins. Specifically, we hypothesise that chlorophyllins might improve the overall effectiveness of molnupiravir, typically used to treat patients suffering from COVID-19. Chlorophyllins, antioxidants derived from natural plant chlorophyll, are safe, effective and non-toxic antioxidants that could combat possible genotoxic flow-on effects of molnupiravir. In addition, as they possess antiviral properties, treatment with chlorophyllins may enhance the overall antiviral effect via a mechanism different to molnupiravir.
Observer performance evaluation of the feasibility of a deep learning model to detect cardiomegaly on chest radiographs
Authors: Ajmera Pranav , Kharat Amit , Gupte Tanveer , Pant Richa , Kulkarni Viraj , Duddalwar Vinay , Lamghare Purnachandra
Published: July 2022

Background

Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR (>0.55) is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR chest X-rays (CXRs) aids in the early diagnosis of clinical conditions.

Purpose

We propose a deep learning (DL)-based model for automatic CTR calculation to assist radiologists with rapid diagnosis of cardiomegaly and thus optimise the radiology flow.

Material and Methods

The study population included 1012 posteroanterior CXRs from a single institution. The Attention U-Net DL architecture was used for the automatic calculation of CTR. An observer performance test was conducted to assess the radiologist’s performance in diagnosing cardiomegaly with and without artificial intelligence assistance.

Results

U-Net model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], specificity >99%, precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0.88 [95% CI: 0.85, 0.91]. Furthermore, the sensitivity of the reviewing radiologist in identifying cardiomegaly increased from 40.50% to 88.4% when aided by the AI-generated CTR.

Conclusion

Our segmentation-based AI model demonstrated high specificity (>99%) and sensitivity (80%) for CTR calculation. The performance of the radiologist on the observer performance test improved significantly with provision of AI assistance. A DL-based segmentation model for rapid quantification of CTR can therefore have significant potential to be used in clinical workflows by reducing radiologists’ burden and alerting to an abnormal enlarged heart early on.
Exploring Prospective Classroom Teacher Question Types for Productive Classroom Dialogue
Authors: Soysal Yilmaz , Soysal Somayyeh
Published: July 2022

Purpose

This study explores prospective classroom teacher (PCT) question types and their role in initiating productive student-led talk.

Design/Approach/Methods

This study is a naturalistic inquiry focusing on the structure, nature, and productivity of PCT questions using data collected from 24 fourth-grade (exit-level) PCTs. Video-based data were analyzed via systematic observation.

Findings

This study identified nine types of teacher questions. Of these, six types—namely, communicating, monitoring-framing, critiquing, legitimating, evidencing, and modeling—were explicitly related to productive classroom talk indicators. While the remaining three question types—observe-compare-predict, concluding and naming, and maintaining—contributed to the variation in PCT questions, they were not directly linked to the indicators of talk productivity. Moreover, the critiquing, legitimating, and modeling questions expected to foster talk productivity were seldom asked, with classroom discourse dominated by communicating questions.

Originality/Value

The literature has yet to observe and systematically analyze the productivity of PCTs’ in-class questions. In addressing this gap, this study presents a wide-ranging and qualitatively oriented coding catalogue to identify several aspects of academically productive classroom discourse that can be triggered and maintained by PCTs’ questioning behaviors.
Reading Strategies and Reading Achievement in Middle School: Kazakhstani Young Learners
Authors: Akhmetova Aigul , Imambayeva Gaysha , Csapó Benő
Published: July 2022

This study explores the reading strategies (RSs) of bilingual and monolingual young learners in their first and second languages (L1 and L2, respectively)—either Kazakh or Russian as the L1 and L2—and English as a foreign language (L3). It also examines the influence of RSs on the learners’ performance on reading comprehension tests in the three languages. The test results showed significant differences in L1, L2, and L3.The results for reading achievement were generally poor but significantly different between the monolinguals and bilinguals. No significant gender differences were found in the reading test results or in the use of reading strategies while reading. However, the analysis indicated that although the probability of using other strategies while completing the tasks in L1, L2, and L3 was clear, more bilingual learners used advanced RSs than monolinguals. The findings on RSs provide an in-depth understanding of the differences between young, bilingual, and monolingual Kazakhstani learners in their use of RSs while reading in their respective languages. The results have significant implications for practice, suggesting placing more emphasis on developing reading strategies while learning how to read in the first and second languages.
Association Between Early Postoperative Graft Signal Intensity and Residual Knee Laxity After Anterior Cruciate Ligament Reconstruction
Authors: Chiba Daisuke , Yamamoto Yuji , Kimura Yuka , Sasaki Eiji , Sasaki Shizuka , Tsuda Eiichi , Ishibashi Yasuyuki
Published: July 2022

Background:

Magnetic resonance imaging (MRI) graft signal intensity is associated with graft damage after anterior cruciate ligament reconstruction (ACLR). However, little is known about the relationship between graft signal intensity and residual laxity of the reconstructed knee based on patient age.

Purpose/Hypothesis:

To evaluate the relationship between graft signal intensity and residual laxity in younger and older patients who underwent ACLR. We hypothesized that higher graft signal intensity would be associated with reduced postoperative knee stability.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 192 patients who underwent double-bundle ACLR were recruited. Proton density–weighted and T2-weighted MRI was performed at 3, 6, and 12 months after surgery, and the signal intensity ratio (SIR) of the anteromedial and posterolateral bundles was measured as the graft signal intensity reference values. At 12 months after surgery, if the KT-1000 arthrometer measurement exhibited a side-to-side difference of ≥2 mm, the patient was determined as having anterior knee laxity. Rotatory knee laxity was defined as a positive pivot shift with International Knee Documentation Committee grade ≥1. The Mann-Whitney U test was used to compare the SIR in patients with and without residual laxity. The Spearman correlation coefficient was used to evaluate the relationship between demographic parameters and the SIR. Based on receiver operating characteristic curves, the optimal SIR cutoff values to predict residual laxity were calculated, and logistic regression analysis was conducted.

Results:

Of 192 patients, 26 (13.5%) had anterior knee laxity, and 20 (10.4%) had rotatory knee laxity. The SIR was negatively correlated with age. In younger patients (<30 years; n = 135), those with residual laxity had a significantly higher SIR than those without laxity; this relationship was not significant in older patients (≥30 years; n = 57). Based on receiver operating characteristic curves and logistic regression analysis, the cutoff values that were determined for the SIR were significantly associated with a higher odds ratio of residual laxity.

Conclusion:

Graft signal intensity decreased with patient age. Patients with higher graft signal intensity in the early postoperative phase after ACLR exhibited a higher prevalence of residual laxity, particularly in younger patients.
Examining the Impact of Community Sponsorship on Early Refugee Labor Market Outcomes in the United States
Authors: Crane Linn Emily
Published: July 2022

As the number of refugees in need of resettlement continues to climb worldwide, advocates and policy makers are searching for ways to leverage new support from private individuals, faith groups, and community organizations to complement and extend the capacity of traditional government resettlement programs. The United States is one of many countries considering the possibility of a “private sponsorship” model, which would allow private individuals and community groups to resettle refugees independent of traditional government resettlement agencies. While this particular resettlement model has not been implemented in the United States in more than four decades, the country has a long history of community involvement in refugee resettlement. Many resettlement agencies operate vibrant community sponsorship (or co-sponsorship) programs, 1 in which community groups partner with resettlement agencies in delivering services and material support to refugees. However, due to a lack of publicly available data, the impact of this co-sponsorship model has been woefully understudied.

This paper offers a preliminary exploration of community sponsorship and its impact on early refugee labor market outcomes. Using administrative data from the Lutheran Immigration and Refugee Service (LIRS), this paper finds that: Refugees with community sponsors have higher English language enrollment rates 90 days after arrival than refugees without sponsors. Refugees with community sponsors who are enrolled in an early employment program known as Matching Grant have higher rates of employment and of full-time employment 180 days after arrival than those enrolled in Matching Grant who do not have sponsors. Community sponsorship is especially beneficial for refugees with low levels of English language proficiency and lack of family ties in their location of resettlement, as well as refugees resettling in areas with higher unemployment.

This paper also identifies and recommends several areas for further study, including: The variation of existing community sponsorship models in use across the United States and their impacts on refugee integration outcomes locally. The impact of community sponsorship on integration indicators, in addition to early labor market outcomes.
2020 American Community Survey: Use with Caution, An Analysis of the Undercount in the 2020 ACS Data Used to Derive Estimates of the Undocumented Population
Authors: Warren Robert
Published: July 2022

This paper analyzes and provides estimates of the undercount of the foreign-born in the US Census Bureau’s 2020 American Community Survey (ACS). It confirms that a differential undercount occurred in the 2020 ACS. In particular, noncitizens that arrived from Central American countries after 1981 had undercount rates of 15–25 percent, but undercount of noncitizens that arrived from European countries in the same period was not detectable by the methods described in this paper. The Center for Migration Studies of New York (CMS) and others use ACS data to derive annual estimates of the US undocumented population. The Census Bureau recently reported that the total population count for the 2020 Census was consistent with the count for recent censuses, despite the Covid-19 pandemic and the Trump administration’s interference in the 2020 Census. Nonetheless, the accuracy of 2020 ACS data for the noncitizen population that arrived after 1981 remains a major concern given the fear generated by the Trump administration’s abusive rhetoric and anti-immigrant policies. The estimates set forth in this paper were derived by analyzing trends in annual ACS data for 2016–2020 compiled from the IPUMS website (Ruggles et al. 2021). Decennial census data cannot be used for this purpose because data on country of birth, citizenship, and year of immigration are not collected in the census. However, it is reasonable to believe that the 2020 census and the 2020 ACS experienced similar challenges because they were conducted under comparable conditions. The patterns of undercount of noncitizens described here for the 2020 ACS are likely mirrored in the 2020 census and will reduce federal funding and representation to affected cities and states for the next decade.
Early Radiographic Outcomes of Minimally Invasive Chevron Bunionectomy Compared to the Modified Lapidus Procedure
Authors: Cody Elizabeth A. , Caolo Kristin , Ellis Scott J. , Johnson A. Holly
Published: July 2022

Background:

Minimally invasive (MIS) bunion surgery has become increasingly popular. Although early reports on outcomes have been encouraging, no study to date has compared outcomes from the MIS chevron and Akin procedures to the modified Lapidus procedure. Our primary aim was to compare early radiographic outcomes of the MIS chevron and Akin osteotomies to those of the modified Lapidus procedure in patients with comparable deformities, and secondarily to compare clinical outcomes.

Methods:

Patients were retrospectively reviewed for inclusion from a prospectively collected foot and ankle registry. Patients were eligible if they underwent either the MIS bunionectomy or modified Lapidus procedure and had preoperative and minimum 5-month postoperative weightbearing radiographs. Forty-one patients who underwent MIS bunionectomy were matched to 41 patients who underwent Lapidus bunionectomy based on radiographic parameters. Demographics, radiographic parameters, complications, reoperations, and PROMIS scores were compared between groups.

Results:

Both groups achieved similar radiographic correction. There was no significant difference in pre- or postoperative PROMIS scores between groups. Procedure duration was significantly faster in the MIS group ( P < .001). Bunion recurrence (hallux valgus angle ≥20 degrees) occurred in 1 MIS patient and 2 Lapidus patients, with all patients asymptomatic. The most common reason for reoperation was removal of hardware (4 patients in the MIS group, 2 patients in the Lapidus group).

Conclusion:

This is the first study to our knowledge to compare early radiographic outcomes between MIS bunionectomy and the modified Lapidus procedure in patients matched for bunion severity. We found that patients with similar preoperative deformities experience similar radiographic correction following MIS chevron and Akin osteotomies vs modified Lapidus bunionectomy. Further research is needed to investigate satisfaction differences between the procedures, longer-term outcomes, and which deformities are best suited to each procedure.

Level of Evidence:

Level III, Retrospective case control study.
Secondary Koro Presenting as Delusional Disorder: A Case Series
Authors: Chakraborty Avik , Bhattacharjee Debanjan , Bandyopadhyay Ujjwal
Published: July 2022

Koro, a culture-bound syndrome originating from Southeast Asia is characterized by a perception of acute retraction of the penis, accompanied by an acute panic-like reaction of impending danger or death. Koro-like symptoms are considered variants of classical Koro syndrome and differ from it phenomenologically.

We described here a case series of secondary Koro, presenting as a delusional disorder who remitted on treatment with antipsychotics and maintained the improvement on follow-up.

It is important to differentiate between classical Koro with Koro-like syndrome, with exploration of any delusional core during clinical assessment for better categorization and management.
Kaznakhtite, Ni6Co3+2(CO3)(OH)16⋅4H2O, a new natural layered double hydroxide, the member of the hydrotalcite supergroup
Authors: Kasatkin Anatoly V. , Britvin Sergey N. , Krzhizhanovskaya Maria G. , Chukanov Nikita V. , Škoda Radek , Göttlicher Jörg , Belakovskiy Dmitry I. , Pekov Igor V. , Levitskiy Victor V.
Published: July 2022

Kaznakhtite, ideally Ni6Co3+2(CO3)(OH)16⋅4H2O, is a new member of the hydrotalcite group within the hydrotalcite supergroup. The mineral was discovered at the Kaznakhtinskiy ultrabasic massif, Altai Republic, SW Siberia, Russia. It occurs as powdery aggregates forming flattened lenses up to 1.5 × 0.5 cm and veinlets up to 1 cm long and up to 1 mm thick in aggregates of chrysotile, lizardite, stichtite and dolomite. Other associated minerals include brucite, chromite, heazlewoodite, manganochromite, magnetite and magnesioferrite. Kaznakhtite aggregates are composed of tiny platy grains up to 0.01 mm across. Kaznakhtite is light green and translucent in aggregates. It has an earthy lustre and white streak. Cleavage is micaceous on {001}. Dcalc = 2.864 g cm–3. The mineral is optically uniaxial (–) with ɛ = 1.657(3) and ω = 1.676(3), and weakly pleochroic in greenish hues, ω > ɛ. Chemical composition (wt.%, electron microprobe, Co valence state determined by XANES spectroscopy, CO2 and H2O calculated by stoichiometry) is: MgO 2.15, NiO 47.40, ZnO 0.22, Al2O3 0.16, Cr2O3 0.98, Co2O3 17.42, Cl 0.63, CO2 5.05, H2O 24.60, –O=Cl –0.14, total 98.47. The empirical formula calculated based on the sum of all metal cations = 8 apfu is (Ni5.54Mg0.47Zn0.02)Σ6.03(Co3+1.83Cr0.11Al0.03)Σ1.97C1.00O2.99(OH)15.84Cl0.16⋅4H2O. Infrared spectroscopy confirmed the presence of CO32– anions, OH– groups and H2O molecules. The crystal structure was refined by the Rietveld method with RB = 0.19%. Kaznakhtite is trigonal, space group R͞3m, a = 3.0515 (3), c = 23.180 (3) Å, V = 186.93 (4) Å3 and Z = 3/8. The strongest lines of the powder X-ray diffraction pattern [d, Å (I, %) (hkl)] are: 7.72 (100) (003); 3.863 (24) (006); 2.630 (4) (101); 2.576 (10) (012); 2.294 (6) (015); 1.950 (4) (018); 1.526 (4) (110); and 1.497 (4) (113). Kaznakhtite is a Co3+ analogue of reevesite, Ni6Fe3+2(CO3)(OH)16⋅4H2O. The mineral is named after its type locality.
Framework for connecting the mobility challenges in low density areas to smart mobility solutions: the case study of Estonian municipalities
Authors: Agriesti Serio Angelo Maria , Soe Ralf-Martin , Saif Muhammad Atiullah
Published: July 2022

Innovation in mobility is proceeding at fast pace, the future disrupting technologies ranging from automation and connectivity to micro-mobility and electric propulsion. This research effort is justified by the impressive array of challenges that urban centres will face in the following decades, such as ageing population, urbanization and pollution. It is therefore understandable why the concept of Smart City is being researched and the major cities around the world are already carrying out trials for Smart Mobility Solutions. Still this trend, as many others, is not evenly spread but follows the urban/rural divide characterizing many of the current socio-economical phenomena. This paper, following the principles of responsible innovation, tries to build the case for a renewed research effort about smart mobility in low density areas. This is accomplished by presenting the results of a wide surveying effort across Estonian municipalities, focusing on the outputs from rural and small suburban centres. The results report what are the main mobility challenges across the region and what hindering factors are preventing envisioned solutions. Finally, the paper ties the identified mobility challenges to available Smart Mobility Solutions that arose from the surveying activity and from literature, assessing both feasibility and transferability.
Cold exposure induces lipid dynamics and thermogenesis in brown adipose tissue of goats
Authors: Liu Xin , Tang Jing , Zhang Runan , Zhan Siyuan , Zhong Tao , Guo Jiazhong , Wang Yan , Cao Jiaxue , Li Li , Zhang Hongping , Wang Linjie
Published: July 2022

Background

Adaptive thermogenesis by brown adipose tissue (BAT) is important to the maintenance of temperature in newborn mammals. Cold exposure activates gene expression and lipid metabolism to provide energy for BAT thermogenesis. However, knowledge of BAT metabolism in large animals after cold exposure is still limited.

Results

In this study, we found that cold exposure induced expression of BAT thermogenesis genes and increased the protein levels of UCP1 and PGC1α. Pathway analysis showed that cold exposure activated BAT metabolism, which involved in cGMP-PKG, TCA cycle, fatty acid elongation, and degradation pathways. These were accompanied by decreased triglyceride (TG) content and increased phosphatidylcholine (PC) and phosphatidylethanolamine (PE) content in BAT.

Conclusion

These results demonstrate that cold exposure induces metabolites involved in glycerolipids and glycerophospholipids metabolism in BAT. The present study provides evidence for lipid composition associated with adaptive thermogenesis in goat BAT and metabolism pathways regulated by cold exposure.
Development of a factorial survey for use in an international study examining clinicians’ likelihood to support the decision to initiate invasive long-term ventilation for a child (the TechChild study)
Authors: Quirke Mary Brigid , Alexander Denise , Masterson Kate , Greene Jo , Walsh Cathal , Leroy Piet , Berry Jay , Polikoff Lee , Brenner Maria
Published: July 2022

Background

The decision to initiate invasive long-term ventilation for a child with complex medical needs can be extremely challenging. TechChild is a research programme that aims to explore the liminal space between initial consideration of such technology dependence and the final decision. This paper presents a best practice example of the development of a unique use of the factorial survey method to identify the main influencing factors in this critical juncture in a child’s care.

Methods

We developed a within-subjects design factorial survey. In phase 1 (design) we defined the survey goal (dependent variable, mode and sample). We defined and constructed the factors and factor levels (independent variables) using previous qualitative research and existing scientific literature. We further refined these factors based on expert feedback from expert clinicians and a statistician. In phase two (pretesting), we subjected the survey tool to several iterations (cognitive interviewing, face validity testing, statistical review, usability testing). In phase three (piloting) testing focused on feasibility testing with members of the target population (n = 18). Ethical approval was obtained from the then host institution’s Health Sciences Ethics Committee.

Results

Initial refinement of factors was guided by literature and interviews with clinicians and grouped into four broad categories: Clinical, Child and Family, Organisational, and Professional characteristics. Extensive iterative consultations with clinical and statistical experts, including analysis of cognitive interviews, identified best practice in terms of appropriate: inclusion and order of clinical content; cognitive load and number of factors; as well as language used to suit an international audience. The pilot study confirmed feasibility of the survey. The final survey comprised a 43-item online tool including two age-based sets of clinical vignettes, eight of which were randomly presented to each participant from a total vignette population of 480.

Conclusions

This paper clearly explains the processes involved in the development of a factorial survey for the online environment that is internationally appropriate, relevant, and useful to research an increasingly important subject in modern healthcare. This paper provides a framework for researchers to apply a factorial survey approach in wider health research, making this underutilised approach more accessible to a wider audience.
Methodological perspectives on the study of the health effects of unemployment – reviewing the mode of unemployment, the statistical analysis method and the role of confounding factors
Authors: Norström Fredrik , Hammarström Anne
Published: July 2022

Introduction

Studying the relationship between unemployment and health raises many methodological challenges. In the current study, the aim was to evaluate the sensitivity of estimates based on different ways of measuring unemployment and the choice of statistical model.

Methods

The Northern Swedish cohort was used, and two follow-up surveys thereof from 1995 and 2007, as well as register data about unemployment. Self-reported current unemployment, self-reported accumulated unemployment and register-based accumulated unemployment were used to measure unemployment and its effect on self-reported health was evaluated. Analyses were conducted with G-computation, logistic regression and three estimators for the inverse probability weighting propensity scores, and 11 potentially confounding variables were part of the analyses. Results were presented with absolute differences in the proportion with poor self-reported health between unemployed and employed individuals, except when logistic regression was used alone.

Results

Of the initial 1083 pupils in the cohort, our analyses vary between 488–693 individuals defined as employed and 61–214 individuals defined as unemployed. In the analyses, the deviation was large between the unemployment measures, with a difference of at least 2.5% in effect size when unemployed was compared with employed for the self-reported and register-based unemployment modes. The choice of statistical method only had a small influence on effect estimates and the deviation was in most cases lower than 1%. When models were compared based on the choice of potential confounders in the analytical model, the deviations were rarely above 0.6% when comparing models with 4 and 11 potential confounders. Our variable for health selection was the only one that strongly affected estimates when it was not part of the statistical model.

Conclusions

How unemployment is measured is highly important when the relationship between unemployment and health is estimated. However, misspecifications of the statistical model or choice of analytical method might not matter much for estimates except for the inclusion of a variable measuring health status before becoming unemployed. Our results can guide researchers when analysing similar research questions. Model diagnostics is commonly lacking in publications, but they remain very important for validation of analyses.
Relationship between patient experience and hospital readmission: system-level survey with deterministic data linkage method
Authors: Wong Eliza Lai-Yi , Poon Chin-Man , Cheung Annie Wai-Ling , Chen Frank Youhua , Yeoh Eng-Kiong
Published: July 2022

Background

Linkage of public healthcare data provides powerful resources for studying from a comprehensive view of quality of care than information for a single administrative database. It is believed that positive patient experiences reflect good quality of health care and may reduce patient readmission. This study aimed to determine the relationship between patient experience and hospital readmission at a system level by linking anonymous experience survey data with de-identified longitudinal hospital administrative admissions data.

Methods

Data were obtained by linking two datasets with anonymised individual-level records from seven largest-scale acute public hospitals over seven geographical clusters in Hong Kong. Selected records in the two datasets involving patient experience survey (PES) (2013 survey dataset) and healthcare utilization (admissions dataset) were used. Following data cleaning and standardization, a deterministic data linkage algorithm was used to identify pairs of records uniquely matched for a list of identifiers (10 selected variables) between two datasets. If patient’s record from the survey dataset matched with the hospitalization records in the admissions dataset, they were included in the subsequent analyses. Bivariate analyses and multivariable logistic regression models were performed to evaluate the associations between hospital readmission in the next calendar month and patient experience.

Results

The overall matching rate was 62.1% (1746/2811) for PES participants aged 45 or above from the survey dataset. The average score for overall inpatient experience was 8.10 (SD = 1.53). There was no significant difference between matched patients and unmatched patients in terms of their score for the perception of overall quality of care received during hospitalization (X2 = 6.931, p-value = 0.14) and score for overall inpatient experience (X2 = 7.853, p-value = 0.25). In the multivariable model, readmission through the outpatient department (planned admission) in the next calendar month was significantly associated with a higher score given to the overall quality of care received (adjusted OR = 1.54, 95%CI = 1.09–2.17), while such association was absent for readmission through Accident and Emergency department (adjusted OR = 0.75, 95%CI = 0.50–1.12).

Conclusions

This study demonstrated the feasibility of routine record linkage, with the limited intrusion of patients’ confidentiality, for evaluating health care quality. It also highlights the significant association between readmission through planned readmission and a higher score for overall quality of care received. A possible explanation might be the perceived better co-ordination between outpatient departments and inpatient service and the well-informed discharge plan given to this group of patients.