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Certain advances in election technology, such as online voting, promise to reduce the administrative overhead of running an election. This has breathed new life into the idea of direct democracy, where voters play a more active role in setting legislation. However it is anticipated that a steady stream of referendums would generate voter fatigue. To combat this fatigue, voters could be allowed to delegate their votes to other (more knowledgeable) voters. This idea is old but has been recently reinvented under the name liquid democracy. In this paper, we consider how ballot secrecy should be defined for liquid democracy. We first show that a natural definition of full secrecy leads to several undesirable outcomes. We then show that these are very difficult to address without enabling voter coercion and vote buying. The purpose of the paper is not to affirm liquid democracy; rather, it is to raise awareness of unseen complexity hiding under our initial presumption that liquid democracy could effortlessly support a secret ballot.

We provide a UTXO model of blockchain transactions that is able to represent both credit and debt on the same blockchain. Ordinarily, the UTXO model is solely used to represent credit and the representation of credit and debit together is achieved using the account model because of its support for balances. However, the UTXO model provides superior privacy, safety, and scalability when compared to the account model. In this work, we introduce a UTXO model that has the flexibility of balances with the usual benefits of the UTXO model. This model extends the conventional UTXO model, which represents credits as unmatched outputs, by representing debts as unmatched inputs. We apply our model to solving the problem of transparency in reverse mortgage markets, in which some transparency is necessary for a healthy market but complete transparency leads to adverse outcomes. Here the pseudonymous properties of the UTXO model protect the privacy of loan recipients while still allowing an aggregate view of the loan market. We present a prototype of our implementation in Tendermint and discuss the design and its benefits.

Presenting your paper at a meeting is an important part of sharing your research with the orthopaedic community. Presentations are generally short and sharp, and careful preparation is key to ensure that the premise, findings, and relevance of your work are successfully conveyed. For most conference papers, the structure will mirror that of a scientific manuscript, with an introduction, materials and methods, results, discussion, and conclusions. Anticipation of potential questions will help to clarify your research for the audience.

Critical evaluation of each section of a paper is needed in order to properly assess the purpose and quality of the paper and to understand the degree to which the results can influence clinical practice. Reviewing a paper is a skill that is best honed by practice, but there is no real formal training during medical school or residency on what to evaluate during a review and what the review process involves for a journal. Thus, this chapter will highlight the major points to review in each section of a paper and will provide a guide for young investigators to use while interpreting the findings of a paper. Additionally, the components of a review submission to a journal will be outlined.

Meta-analyses represent an unbiased way of summarising the evidence on a specific topic. A meta-analysis is a formal process for gathering and evaluating literature to answer a specific question, using statistics to combine the data from randomised controlled trials. However, their use is controversial, as there are several critical conditions and methodological considerations that could produce misleading conclusions. A wide and extensive systematic search, clear-cut inclusion criteria and appropriate data extraction are mandatory when it comes to obtaining all the evidence relating to the investigated topic. Statistical analyses should be performed carefully and all sources of heterogeneity should be explored to avoid dangerous bias. The design and the quality of the included studies should be clearly presented to show the reader the overall quality of the evidence that is presented in the meta-analysis. Finally, the results should be interpreted critically from both a clinical and a statistical point of view.

This contribution deals with the ability or not of the European Union (EU) to act in situations of serious systemic violations of the rule of law in a Member State. It does this by looking at the different available mechanisms including Article 7 in the Treaty on European Union (TEU) and the new Rule of Law Framework and excluding infringement procedures before the Court of Justice of the EU. The contribution also discusses whether as a result of a serious breach of the TEU a Member State could be expelled from the organisation. The TEU contains no provision on expulsion, but the Vienna Convention on the Law of Treaties potentially does. In conclusion, the contribution finds that neither mechanism can be likened to a weapon, nor are they probably dissuasive, but they might be persuasive thanks to a persistent and protracted dialogue. The EU has no realistic choice but to be a gentle civiliser of Member States.

How did Britons view China in 2020, at the height of the Covid-19 pandemic? This paper presents new, detailed evidence of the negative and worsening perceptions of China in the UK across three domains: public opinion (based on survey data collected in autumn 2020), political elites in parliament, and the media. The worsening of perceptions of China emerged in the context of a changing and more contested China policy from the UK government and a greater level of public debate about China, partly a consequence of the onset of the Covid-19 pandemic. The paper places analysis of these perceptions in the context of the development of relations between the UK and China. Together with deteriorating Chinese views of the UK's China policy and controversy over a number of developments in China, widespread negative views about China among the British public and in political circles will constrain UK-China relations from developing in a more positive direction.

In recent years, there has been a growing interest in the use of reference conceptual models to capture information about complex and sensitive business domains (e.g., finance, healthcare, space). These models play a fundamental role in different types of critical semantic interoperability tasks. Therefore, domain experts must be able to understand and reason with their content. In other words, these models need to be cognitively tractable. This paper contributes to this goal by proposing a model clustering technique that leverages on the rich semantics of ontology-driven conceptual models (ODCM). In particular, we propose a formal notion of Relational Context to guide the automated clusterization (or modular breakdown) of conceptual models. Such Relational Contexts capture all the information needed for understanding entities "qua players of roles" in the scope of an objectified (reified) relationship (relator). The paper also presents computational support for automating the identification of Relational Contexts and this modular breakdown procedure. Finally, we report the results of an empirical study assessing the cognitive effectiveness of this approach.

This article elaborates processes of the production and development of ink deckle-edged paper-cutting animation and summarizes its artistic style. The overall style of ink deckle-edged paper-cutting animation has the unique beauty of artistic conception of Chinese traditional arts, modeling of character is featured on fine and delicate, and has characteristic of shading in Chinese ink painting. Its theme is refined and rich in philosophy. At the same time, this article also explores problems existed and future development of ink deckle-edged paper-cutting animation.

This case study examines the European Transport White Paper of 2011 as an example of a planning domain application. The European Union is an economic and political union of some 28 states in Europe. Some of the key premises of the European Union have been to open up markets to free trade within the region and to seek to harmonise technical standards, laws, and processes to facilitate the free movement of people and goods. It is interesting that sustainability is also emphasized as an overarching goal for all areas of European policy making. The European Union employs a wide range of assessment and monitoring mechanisms to track progress on the implementation and performance of policies in the transport area, which is seen as a keystone for the so-called Single European Market. These mechanisms clearly reflect tensions between the different goals and pose challenges for the interpretation of indicators on transportation trends. Also the sheer size and complexity of the Union raises challenges for the effective application of indicator based evidence. The chapter will place the indicator- and application rich example of the ex ante assessment of the European Transport Policy White Paper in the wider context European Union policy making.

This paper analyzes the macroeconomic effects of the Covid-19 epidemic on Euro Area (EA) GDP and inflation, using a stylized New Keynesian model. Covid is interpreted as a combination of aggregate demand and aggregate supply disturbances. Offsetting aggregate demand and supply changes are shown to account for the stability of EA inflation, in the face of Covid. The evidence presented here indicates that Covid-induced aggregate demand and supply shifts were persistent. An aggregate supply contraction is identified as the dominant force driving the sharp fall of EA GDP in 2020.

The formal conclusion of the Comprehensive Agreement on Investments (CAI) has drawn much criticism. Criticisms for member states did not always recognise the same critical points. The case of Italy presents an instance in which the issue rather than laying in the content of the agreement was identified in the process. Not only had Italy been marginalised in the process of negotiation that led to the conclusion of the CAI, but also exponents from the government claim that leading negotiators, amongst which France and Germany, ignored Italy’s doubts about the deal when these were raised. Beyond politics, the paper shows that the Italian business community displays a response to the agreement in line with that of the rest of the EU in its positive assessment of the outcome.

Blanchard and Leigh (Am Econ Rev 103(3):117–120, 2013; IMF Econ Rev 62(2):179–212, 2014) find fiscal multipliers to be underestimated in the EU in the deep recession of the early 2010s. Using two 2013–2018 datasets for 26 EU member states, assembled from Stability and Convergence Programmes and the European Commission’s Spring Forecasts, this paper shows that multiplier estimates in the EU have been overestimated in the post-crisis period. Forecasters then are still not capturing accurately the impact that fiscal policy has on output growth rates and are misestimating in a manner opposite to that reported by Blanchard and Leigh.

This paper examines the robustness of the optimal lockdown strategy to the postulated social welfare criterion. We show that utilitarianism can, under some conditions, imply a COVID-19 variant of Parfit's (1984) Repugnant Conclusion: for any (interior) lockdown with life periods of low quality, there must be a stricter lockdown that is regarded as better, even though this reduces the quality of life periods even more. On the contrary, the ex post egalitarian criterion (giving priority to the worst-off ex post) implies zero lockdown. Varying between its minimal and its maximal levels, the optimal lockdown is not robust to the postulated ethical criterion. We also identify a general ethical dilemma between the goal of saving lives (modeled by the Survivors Number Count axiom) and the goal of giving priority to the worst-off (Hammond Equity).

Most electronic payment systems for applications, such as eTicketing and eToll, involve a single entity acting as both merchant and bank. In this paper, we propose an efficient privacy-preserving post-payment eCash system suitable for this particular use case that we refer to, afterwards, as private eCash. To this end, we introduce a new partially blind signature scheme based on a recent Algebraic MAC scheme due to Chase et al. Unlike previous constructions, it allows multiple presentations of the same signature in an unlinkable way. Using it, our system is the first versatile private eCash system where users must only hold a sole reusable token (i.e. a reusable coin spendable to a unique merchant). It also enables identity and token revocations as well as flexible payments. Indeed, our payment tokens are updated in a partially blinded way to collect refunds without invading user’s privacy. By implementing it on a Global Platform compliant SIM card, we show its efficiency and suitability for real-world use cases, even for delay-sensitive applications and on constrained devices as a transaction can be performed in only 205 ms.

We consider the problem of optimal partisan gerrymandering: a legislator in charge of redrawing the boundaries of equal-sized congressional districts wants to ensure the best electoral outcome for his own party. The so-called gerrymanderer faces two issues: the number of districts is finite and there is uncertainty at the level of each district. Solutions to this problem consists in cracking favorable voters in as many districts as possible to get tight majorities, and in packing unfavorable voters in the remaining districts. The optimal payoff of the gerrymanderer tends to increase as the uncertainty decreases and the number of districts is large. With an infinite number of districts, this problem boils down to concavifying a function, similarly to the optimal Bayesian persuasion problem. We introduce a measure of fairness and show that optimal gerrymandering is accordingly closer to uniform districting (full cracking), which is most unfair, than to community districting (full packing), which is very fair.

From the classical Chinese literary masterpiece Investiture of the Gods to contemporary film animation, Nezha’s image is profound. Examining the portrayals of Nezha, namely in those most celebrated animated films, we argue that his role as the epitome of a ‘god like figure’ is in constant displacement and return. Using the framework of archetype and displacement as advanced by Northrop Frye, with a more pluralistic myth analysis extension found in the myth critique of Gilbert Durand, this article examines the multi-layered mythical mini structures within Nezha’s displacement and return in Chinese animation, to explore the themes, images, and archetype represented by the character from the perspective of Chinese history and culture. We argue that Nezha’s displacement and return in Chinese animation expresses the need and call for a traditional heroic image in a particular era. As such, Nezha’s intertextuality exposes the profound inner patterns that form and refashion the Chinese collective unconscious, performing as a recurring mirror that symbolically inform and transform human experiences in China.

Unlearning has evinced immense traction and opportunity in debates pertaining to organizational learning, innovation, management of change, knowledge management, and new product development, to name but a few. Provided the diversity and expansiveness of the phenomenon, past studies have undertaken both narrative and systematic reviews to synthesize the field of organizational unlearning (OU). Although highly commendable and enlightening, these scholarly efforts would be augmented by contemplating the share of leading management journals towards furthering the research on unlearning. Moreover, a systematic comprehension of the research themes of OU can be instrumental in representing the intellectual structure of the field. For this purpose, we undertake a combination of bibliometric and thematic analysis to identify critical trends that have helped shape unlearning research. The results discern the main scientific actors (articles, authors, journals, universities), research design, and dimensions of OU. In addition, eight clusters of unlearning along with underlying theoretical perspectives are analyzed, which may help scholars integrate the development of one domain to another, formulate pertinent research questions related to OU, and encourage interdisciplinary research.

Urban air pollution and exposure-related health impacts are being noticed and discussed very intensely in India. On the other hand, source-specific control is the primary focus for policymakers; however, diverse and complex sources make it difficult to immediately see the action and consequent impacts on better air quality. Many cities across the world have witnessed high air pollution levels at traffic junctions, more so in all Indian cities. Site-specific air pollution reduction can be a promising solution for managing the pollution level at highly polluted locations. CSIR-National Environmental Engineering Research Institute, India, has designed and developed Wind Augmentation and purifYing Unit (WAYU) to remove particulate and gaseous pollutants from urban hot spots such as traffic locations. In the present study, the authors attempted to evaluate the performance of two different designs of WAYU for the removal of particulate matters from polluted air at different traffic locations in Delhi City, the national capital territory of India. The performance analyses show that the current design of WAYU removes PM10 and PM2.5 concentrations in the range of 34–49% and 19–25%, respectively from the inlet air. The total PM collected from all WAYU devices was 34.19 kg from 120,557 operating hours’ at all the sampling sites. The PM removal rate depends on the size-segregated particulate matter pollution load in the ambient air. Supplementary Information The online version contains supplementary material available at 10.1007/s13762-021-03641-3.

Global annual deaths from Trauma are greater than any other single cause in the global working population, and, more than all contagious diseases added together including COVID-19. The number of people injured, either temporarily or permanently, is greater than any other medical condition. This problem affects Low and Middle Income Countries (LMICs) disproportionately. The numbers are so great as to cause “zone out” and present a human rights issue. This is a particular issue as Trauma presently receives less than 1% of global healthcare funding. This article will highlight and discuss many of the issues and raise some uncomfortable arguments showing that improvement is needed, necessary and achievable.

In this paper, we examine the variation in the outbreak of COVID-19 across departments in continental France. We use information on the cumulated number of deaths, discharged patients and infections from COVID-19 at the department level, and study how these relate to income inequality, controlling for other factors. We find that unfortunately, inequality kills: departments with higher income inequality face more deaths, more discharged (gravely ill) patients and more infections. While other papers have studied the impact of the level of income on the severity of COVID-19, we find that it is in fact the dispersion across incomes within the same department that drives the results. Our results suggest that individuals in relatively more precarious conditions deserve dedicated policies, to avoid that temporary shocks such as COVID-19 lead to permanent increases in inequality.

The aim of this paper is to examine generic competition in the UK, with a special focus on the role of Health Technology Assessment (HTA) on generic market entry and diffusion. In the UK, where no direct price regulation on pharmaceuticals exists, HTA has a leading role for recommending the use of medicines providing a non-regulatory aspect that may influence the dynamics in the generic market. The paper focuses on the role of Technology Appraisals issued by the National Institute for Health and Care Excellence (NICE). We follow a two-step approach. First, we examine the probability of generic entry. Second, conditional on generic entry, we examine the determinants of generic market share. We use data from IQVIA British Pharmaceutical Index (BPI) for the primary care market for 60 products that lost patent between 2003 and 2012. Our results suggest that market size remains one of the main drivers of generic entry. After controlling for market size, intermolecular substitution and difficulty of manufacturing increase the likelihood of generic entry. After generic entry, our estimates suggest that generic market share is highly state dependent. Our findings also suggest that while NICE recommendations do influence generic uptake, there is only marginal evidence they affect generic entry.

This chapter includes complementary reading material as detailed background information to specific topics which can be used for an in-depth analysis by instructors and students. Reference to these articles is given at the end of each corresponding chapter.

The first white paper—Human Rights in China was released by the Chinese government in 1991. This white paper regarded full implementation of human rights as a great ideal and loft goal that human beings have been pursuing. The release of this white paper broke the forbidden area of human rights research, and it exhibited great achievements of human rights protection in China by clarifying the attitudes and principles of the Chinese government to human rights. It maintained the international image of China and laid a foundation for human rights protection career in China. The white paper has become a milestone in the history of Chinese human rights development.

Pervasive technologies such as Artificial Intelligence, Virtual Reality and the Internet of Things, despite their great potential for improved workability and well-being of older workers, entail wide ethical concerns. Aligned with these considerations we emphasize the need to present from the viewpoint of ethics the risks of personalized ICT solutions that aim to remedy health and support the well-being of the ageing population at workplaces. The ethical boundaries of digital technologies are opaque. The main motivation is to cope with the uncertainties of workplaces’ digitization and develop an ethics framework, termed SmartFrameWorK, for personalized health support through ICT tools at workplace environments. SmartFrameWorK is built upon a five-dimensional approach of ethics norms: autonomy, privacy, transparency, trustworthiness and accountability to incite trust in digital workplace technologies. A typology underpins these principles and guides the ethical decision-making process with regard to older worker particular needs, context, data type-related risks and digital tools’ use throughout their lifecycle. Risk analysis of pervasive technology use and multimodal data collection, highlighted the imperative for ethically aware practices for older workers' activity and behaviour monitoring. The SmartFrameWorK methodology has been applied in a case study to provide evidence that personalized digital services could elicit trust in users through a well-defined framework. Ethics compliance is a dynamic process from participants’ engagement to data management. Defining ethical determinants is pivotal towards building trust and reinforcing better workability and well-being in older workers.

Purpose Hong Kong has experienced four waves of COVID-19 since the first case was confirmed in January 2020. Several studies have highlighted the psychological impacts of the outbreak in Hong Kong but have largely ignored the protective factors that contribute to resilience among vulnerable families. This study adopted an ecological resilience framework to explore the impact of this epidemic on members of families with youth with a delinquent tendency/mental health concerns and the ecological protective factors for these vulnerable families. Methods Random sampling based on a sampling frame provided by one of the largest local social service organizations in Hong Kong led to the recruitment of 407 respondents who were interviewed using a battery of standardized questionnaires. Results The results showed that 30.6% and 11.5% of respondents reported a moderate and a severe level of psychological distress, respectively, almost double the percentages reported in a previous study conducted in Hong Kong before the COVID-19 outbreak. Around 36.6% of respondents indicated they had encountered financial problems and almost 40% indicated aggravated financial circumstances since the outbreak. Hierarchical regression analysis revealed that financial stress was the strongest predictor of psychological distress. Structural equation modeling indicated that family support, indoor leisure activities and community resources significantly mediated the negative influence of COVID-19-related stressors on psychological distress of family members. Conclusion Family leisure activities, family support, community spirit and mutual help within the context of social-distancing restrictions may need to be promoted to benefit vulnerable families in Hong Kong under the COVID-19 epidemic.

As the EU officials and their Chinese counterparts emphasised the end of 2020 as the date for a successful conclusion of the Comprehensive Agreement on Investment (CAI, the Agreement), the Baltic states of Estonia, Latvia, and Lithuania were sceptical. However, after discussions, with Lithuania appearing to be the most visible opponent of CAI among the Baltic nations, all three eventually upheld the proposal. Understanding that the ratification of CAI is unlikely after the mutual exchange of sanctions between the EU and PRC in March, 2021, the report nevertheless examines the roots of the Baltic position as a case study of inter-EU bargains, inspects what factors contributed to the Baltic position on the issue of CAI, presents the national pro- and counter-arguments to CAI along the domains of geo-politics, values, and economy, and brings up the dilemmas that remain unsolved.

The emerging market economies (EMEs) are experiencing significant financial distress due to the rapid accumulation of foreign currency-denominated debt in recent years. We develop the foreign exposure indicators such as original sin and currency mismatches using a novel data set. Our computations suggest that Latin American economies suffer from the original sin problem, followed by Central European countries. We find a higher degree of currency mismatches in Argentina, Chile, Colombia, Indonesia, Poland, Mexico, and Turkey. The resurgence of currency mismatches and the Covid-19 pandemic is a stress test for monetary policy frameworks. We find that country’s size, inflation volatility, and exchange rate depreciation cause currency mismatches. We show that the currency mismatch and original sin problem are lower in countries following de-dollarization policies such as limiting debt exposure, effective monetary and fiscal policies, better institutional quality, and export openness. The EMEs need to adopt policies to control currency mismatches, which are consistent with their growth-oriented policies. We suggest the independence of monetary policy, the implementation of macroprudential policies, and the development of offshore bond markets in a local currency. These policies control currency mismatches without changing the growth orientation of the EMEs. South Africa, Hungary, and Asian economies hold lessons for EMEs in controlling currency mismatches.

This study aimed to explore the lived experiences of university teachers who participated in online teaching for the first time during the COVID-19 pandemic. A qualitative method of data collection and inductive thematic analysis were used. The data were collected through a semistructured interview from 11 faculty members who teach in various universities in Pakistan. The analysis presented five themes of the online teaching experience: culture and gender-related issues, teaching effectiveness, challenges in online teaching, coping strategies, and faculty’s’ post-COVID-19 perceptions. The findings reflect that the faculty prioritized to focus on immediate online instructional matters in the wake of the pandemic with a lack of emphasis on global practices for online learning. Experienced and young faculty reported disparities in striking a balance between pedagogy and technology. Moreover, despite the limitations, the experience itself prepared the faculty for a blended learning approach and increased their awareness of global and future challenges. The implications were reported based on the findings.

This paper examines the prominence of East and Southeast Asia as a focus of communications and game studies. The idea of going regional when researching video games comes from the fact that each locale has its trait to construct its gaming industry and gaming environment from which the gaming experience is also reflected differently. The reasons provided, ranging from the regional market's dynamic nature to the attention that the governing states have paid to the gaming industry, help place Asia–Pacific in general and East and Southeast Asia particularly in the global gaming juxtaposition where the other part is usually the Western countries. Examples that help highlight the rising prominence of the regions as the most potential areas are also considered. This review's findings indicate that East and Southeast Asia have gradually built up their reputation by actively joining the designing, processing, and distributing digital products system. Thus, the focus of future research on the regions should be more concerned with video gaming.

Purpose Sense of coherence (SOC) represents coping and can be considered an essential component of mental health. SOC correlates with mental health and personality, but the background of these associations is poorly understood. We analyzed the role of genetic factors behind the associations of SOC with mental health, self-esteem and personality using genetic twin modeling and polygenic scores (PGS). Methods Information on SOC (13-item Orientation of Life Questionnaire), four mental health indicators, self-esteem and personality (NEO Five Factor Inventory Questionnaire) was collected from 1295 Finnish twins at 20–27 years of age. Results In men and women, SOC correlated negatively with depression, alexithymia, schizotypal personality and overall mental health problems and positively with self-esteem. For personality factors, neuroticism was associated with weaker SOC and extraversion, agreeableness and conscientiousness with stronger SOC. All these psychological traits were influenced by genetic factors with heritability estimates ranging from 19 to 66%. Genetic and environmental factors explained these associations, but the genetic correlations were generally stronger. The PGS of major depressive disorder was associated with weaker, and the PGS of general risk tolerance with stronger SOC in men, whereas in women the PGS of subjective well-being was associated with stronger SOC and the PGSs of depression and neuroticism with weaker SOC. Conclusion Our results indicate that a substantial proportion of genetic variation in SOC is shared with mental health, self-esteem and personality indicators. This suggests that the correlations between these traits reflect a common neurobiological background rather than merely the influence of external stressors.

This research article aims to examine the problem of comprehending Chinese diplomatic discourse. We argue that China’s diplomatic discourse is a multilevel and complicated system underpinned by figurative and symbolic semantics, divergent translations into foreign languages, multidimensionality of the cognitive sphere and versatility of communication. The discussions of well-known Chinese scholars on the issue of comprehension of China’s diplomatic discourse are highlighted in the article. We also analyze the concept of a “shared future for humankind,” which is the systemic core of China’s diplomatic discourse today and represents a brand of a global worldview promoted by Chinese leadership. We examine this concept using sociolinguistic, cognitive and pragmatic approaches.

Various e-paper devices also have been released (e.g. Amazon's Kindle DXTM), and their features include paper-like display and low power consumption. In our previous studies, in high light conditions, readability of the backlight LCD dropped significantly, because of the glare of the surrounding background. On the other hand, the readability of the electronic paper is increased, it was easy to read than backlit LCD. The e-paper that have low contrast ratio, evaluation of readability was low. In low light, the evaluation of the readability of the backlit LCD was high. The aim of this experiment was to verify the minimum illumination for comfortable reading with e-paper in low illumination (300 or less lx).

The methods of applying Rasch Model in the analysis of test paper quality are as follows: Wright Map which shows the reader a general knowledge of the whole survey, Multidimensionality Investigations which is used to examine whether test paper measures the latent trait (reading dimension of subjects), Item Fit Order, Bubble Diagram, and so on. Analysis result shows that the reading literacy pilot test paper for Grades 5–6 students in Guangxi meets the requirement generally. Specifically speaking, with covering different ability students and making up reasonably difficulty items, the test items reach the expected test effect. For better and higher application efficiency, the suggestion for usage is that the choice of Rasch Model function and result analysis methods be based on different test goals.

This paper examines the behaviour of mental health care providers in response to marginal payment incentives induced by a discontinuous per diem reimbursement schedule with varying tariff rates over the length of stay. The analyses use administrative data on 12,627 cases treated in 82 psychiatric hospitals and wards in Germany. We investigate whether substantial reductions in marginal reimbursement per inpatient day led to strategic discharge behaviour once a certain length of stay threshold is exceeded. The data do not show gaps and bunches at the duration of treatment when marginal reimbursement decreases. Using logistic regression models, we find that providers did not react to discontinuities in marginal reimbursement by significantly reducing inpatient length of stay around the threshold. These findings are robust in terms of different model specifications and subsamples. The results indicate that if regulators aim to set incentives to decrease LOS, this might not be achieved by cuts in reimbursement over LOS. Electronic supplementary material The online version of this article (10.1007/s10198-020-01241-5) contains supplementary material, which is available to authorized users.

Unwarranted variation in the quality of care challenges the sustainability of healthcare systems. Especially in decentralised healthcare systems, it is crucial to understand the drivers behind regional differences in hospital qualities such as unplanned readmissions. This paper examines the factors that influence the risk of unplanned hospital readmission and the geographic disparity of readmission rate in Italy. We use hospital discharge data from 2010 to 2015 for patients above 65 years old admitted with Acute Myocardial Infarction. Employing hierarchical models, we identified the patient and hospital-level determinants for unplanned readmission. In line with the literature, the risk of readmission increases with age and being male, while hospitals with higher patient volume and capacity tend to have lower unplanned readmission. In particular, we find that after patient risk-adjustments, there are differential effects of hospitalisation length-of-stay on the probability of readmission across the hospitals that are governed by different payment systems. For hospitals under a prospective payment system, the effect of length-of-stay in reducing the probability of readmission is weaker than hospitals under an ex-post global budget, but the overall readmission rates are the lowest. Moreover, there are substantial geographic variations in readmission rate across Local Health Authority and regions, and these variations of unplanned readmission are explained by differences in hospital length-of-stay and surgical procedures used. Our results demonstrate that differential hospital behaviours can be one of the potential mechanisms that drive geographic quality disparities.

In this paper, I use administrative data to estimate the number of deaths, the number of infections, and mortality rates from COVID-19 in Lombardia, the hot spot of the disease in Italy and Europe. The information will assist policy makers in reaching correct decisions and the public in adopting appropriate behaviors. As the available data suffer from sample selection bias, I use partial identification to derive the above quantities. Partial identification combines assumptions with the data to deliver a set of admissible values or bounds. Stronger assumptions yield stronger conclusions but decrease the credibility of the inference. Therefore, I start with assumptions that are always satisfied, then I impose increasingly more restrictive assumptions. Using my preferred bounds, during March 2020 in Lombardia, there were between 10,000 and 18,500 more deaths than in previous years. The narrowest bounds of mortality rates from COVID-19 are between 0.1 and 7.5%, much smaller than the 17.5% discussed in earlier reports. This finding suggests that the case of Lombardia may not be as special as some argue.

In this paper, Moran index of spatial statistics, the spatial lag and spatial error model of spatial econometric economics, combined with Griliches & Jaffe knowledge production function(Knowledge Production Function, KPF), were used in spatial econometric analysis on China’s provincial paper manufacturing RD also find that China’s 31 provincial contribution of green innovation in paper manufacturing sector was mainly achieved by enterprises R&D investment, while the combination of university and enterprise did not show significant effect on green innovation spillovers. The results show effect of knowledge spillovers are exist, but not significant. In the end, according to the conclusions, we draw some advices.

Chinese folk paper-cut is the most representative of artistic form in Chinese folk, which is the basis of folk art and the maternal art, providing good learning and reference for modern graphic design has played. This paper focuses on an in-depth analysis of how the traditional Chinese folk paper-cut art to make combination and fusion in modern graphic design.

The aim of this short communication is to estimate the effects of the implementation of more restrictive lockdown measures on pollution levels in Italy. Using a time series of weekly concentrations of PM10, PM2.5 and NO2 for the period 2016–2020 across 71 provinces, we find that the introduction of lockdown measures reduced the air concentration levels of PM10 and NO2 by 17–18%, while their effect on PM2.5 remains unclear. These results indicate that the lockdown had a significant positive impact in terms of lives saved and improved air quality.

In the general population, psychosis risk phenotypes occur independently of attenuated prodromal syndromes. Neurobiological correlates of vulnerability could help to understand their meaningfulness. Interactions between the occurrence of psychotic-like experiences (PLE) and other psychological factors e.g., distress related to PLE, may distinguish psychosis-prone individuals from those without risk of future psychotic disorder. We aimed to investigate whether (a) correlates of total PLE and distress, and (b) symptom dimension-specific moderation effects exist at the brain structural level in non-help-seeking adults reporting PLE below and above the screening criterion for clinical high-risk (CHR). We obtained T1-weighted whole-brain MRI scans from 104 healthy adults from the community without psychosis CHR states for voxel-based morphometry (VBM). Brain structural associations with PLE and PLE distress were analysed with multiple linear regression models. Moderation of PLE by distress severity of two types of positive symptoms from the Prodromal Questionnaire (PQ-16) screening inventory was explored in regions-of-interest after VBM. Total PQ-16 score was positively associated with grey matter volume (GMV) in prefrontal regions, occipital fusiform and lingual gyri (p

On March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

The Chinese government has instituted a number of policies to actively promote the diffusion of new energy vehicles (NEVs). There is widespread consensus that policy mixes can drive NEV diffusion effectively. To verify this consensus, we construct a two-dimensional framework of NEV policy instruments: producer-orientation versus consumer-orientation instruments, economic in cash versus regulatory instruments and classify NEV policy mixes. Then, we analyse the impact of policy mixes on NEV diffusion among enterprises and consumers by building an evolutionary game model. And according to the concept of stable area in the evolutionary game, we propose a definition of policy effect. The results show: (1) Policy mixes can reduce the saddle point of the auto market game and accelerate the spread of NEVs. In the early stages of the NEV industry, the government should take the policy mix strategy with four policies, and economic in cash instrument should be the main policy. (2) Policy mixes composed of producer-orientation and consumer-orientation instruments have a synergy or complementarity to promote NEV diffusion effectively. (3) With the increasing rate of NEV production and consumption, the government should adopt policy mixes mainly composed of regulatory instruments and rather than economic instruments. Graphical abstract

Purpose Labour market marginalisation (LMM), i.e. long-term unemployment (LTU), long-term sickness absence (LTSA) and disability pension (DP), among young individuals with common mental disorders (CMDs) are a challenge for the welfare system, and refugees and non-refugee migrants seem particularly vulnerable. The aim was to investigate the risk of LMM in young adults with CMDs among refugees and non-refugee migrants compared to Swedish-born individuals and the role of country of birth, duration of residence and age at arrival. Methods A prospective cohort study was conducted including young adults (19–30 years) with inpatient or specialised outpatient healthcare due to CMDs and/or antidepressant prescriptions during 2009 (N = 69,515). Cox regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals for the risk of LMM during 2010–2013. Results Both refugees and non-refugee migrants had a higher risk of LTU compared to Swedish-born individuals (HR refugees: Africa: 2.4; Asia: 2.2; Europe outside EU25: 1.6; South America: 1.4) with highest estimates in refugees from Afghanistan and Syria. Refugees from Africa and Asia had a lower risk of LTSA compared to Swedish-born individuals (HR: 0.6 and 0.7, respectively), particularly refugees from Afghanistan and Iraq. Especially among refugees, a longer duration of residence and a younger age at arrival were associated with a lower risk of LTU. Conclusions The risk of LTU among refugees and non-refugee migrants was higher and the risk of LTSA was lower, compared to Swedish-born individuals. Duration of residence and age at arrival had an influence on the risk of LTU, particularly among refugees.

The present outbreak of coronavirus disease 2019 (COVID-19) has swiftly crossed borders, and inflicted the global mental health issues. It is also affecting peoples’ daily behaviours, economics, prevention strategies and decision-making among policymakers, healthcare organisations and medical centres that may unintentionally weaken COVID-19 control strategies and lead to increased morbidity, as well as mental health care needs globally. Ultimately, this outbreak is leading to further health complications worldwide, such as stress, fear of the unknown, anger, anxiety, denial, depression symptoms, and insomnia. Notwithstanding all the resources used to counter the spread of the virus, further universal strategies are desirable to address the associated mental health problems. The present study uses the qualitative means to investigate the potential impact of COVID-19, the consequences and legal aspects, then recommend policy implications, in an attempt to cover any apparent loopholes. It presents a unique analysis of its kind on the policy and legal aspects of the ongoing pandemic, as regards mental health. It concludes that there is an acute need to prioritising the health care and curative issues, strengthen awareness and address the psychological syndromes or similar complications afflicting members of the general public during this pandemic.

We describe a multilayer perceptron model to predict the laboratory measurements of paper quality using the instantaneous state of the papermaking production process. Actual industrial data from a pilot paper machine was used. The final model met its goal accuracy 95.7% of the time at best (tensile index quality) and 66.7% at worst (beta formation). We anticipate usage possibilities in lowering machine prototyping expenses, and possibly in quality control at production sites.

Almost everyone agrees on the central role that simulation plays in the understanding of complex systems such as the 3D network formed by stacking millions of fibers on top of each other in a paper sheet. Clearly, the computational implementation of the few models which describe the microstructure of paper is far from trivial. Unfortunately, to our knowledge, there is no description in the literature of the methodology used for programming these algorithms. As a contribution towards overcoming this gap, the present article explains the software implementation of key features of a 3D random fiber deposition model into a high-level MATLAB computer code.

Up to the twenty-first century, paper is still widely adopted for recording and reading. However, paper-based materials are fully capable of presenting abstract concepts and complicated knowledge with static text and figures. Learners usually need timely and adequate supports when encountering difficulties during learning. With a consideration of applying technologies, the learning tool must have a certain mobility and accessibility for acquiring facilitative resources. Using the networking capability of smartphone to access digital content from the Internet to enrich conventional paper-based learning activities is worth investigating. This chapter introduces an augmentation-enhanced learning context with an integration of digital content into paper-based materials in order to facilitate learning. Constructive feedback, scaffolding questioning, and procedural scaffolding are three strategies applied into the instructional designs and learning system. Quasi-experiments for personal learning and collaborative learning were also conducted to evaluate the effects on learning performance. The results suggest that the three instructional designs had significantly positive effects on individual’s learning performance. Team’s learning performance and team’s discourse levels were promoted as well. This chapter lays out a strong foundation for researchers to further explore how to better design different learning strategies for different learning subjects in the augmentation-enhanced learning context using smartphones. It is hoped that educational practitioners are able to obtain concrete ideas and solutions on how to better leverage the benefits of both paper-based content and digital learning materials in a real blended learning environment.

While reading documents, people commonly make annotations: they underline or highlight text and write comments in the margin. Making annotations during reading activities has been shown to be an efficient method for aiding understanding and interpretation. In this paper we present a comparison of paper-based and online annotations in the workplace. Online annotations were collected in a laboratory study, making use of the Web-based annotation tool SpreadCrumbs. A field study was out to gather paper-based annotations. The results validate the benefits of Web annotations. A comparison of the online annotations with paper-based annotations provides several insights in user needs for enhanced online annotation tools, from which design guidelines can be drawn.

The user view of the quality of IT-supported health care processes is very important for a successful performance of these processes. Current ap- proaches to process quality do not capture this point of view explicitly. This po- sition paper provides a first collection of indicators for this view. Classification: Process quality, Workflow management, Process optimization, Compliance, Process modelling.