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While many instructors are aware of the Literary Digest 1936 poll as an example of biased sampling methods, this article details potential further explorations for the Digest’s 1924-1936 quadrennial U.S. presidential election polls. Potential activities range from lessons in data acquisition, cleaning, and validation, to basic data literacy and visualization skills, to exploring one or more methods of adjustment to account for bias based on information collected at that time. Students can also compare how those methods would have performed. One option could be to give introductory students a first look at the idea of “sampling adjustment” and how this principle can be used to account for difficulties in modern polling, but the context is rich in other opportunities that can be discussed at various times in the course or in more advanced sampling courses.

Abstract BackgroundGlobally, 1 in 3 people live with health conditions that could be improved with rehabilitation. Ideally, this is provided by trained professionals delivering evidence-based dose, intensity, and content of rehabilitation for optimal recovery. The widely acknowledged inability of global health care providers to deliver recommended levels of rehabilitation creates an opportunity for technological innovation. Design processes that lack close consideration of users’ needs and budgets, however, mean that many rehabilitation technologies are neither useful nor used. To address this problem, our multidisciplinary research group have established a cocreation center for rehabilitation technology that places the end user at the center of the innovation process. ObjectiveThis study aims to present the participatory cocreation model that has been developed from our center and illustrate the approach with 2 cases studies. MethodsThe model is built around user participation in an intensive rehabilitation program (2-hour sessions, 2‐5 times per week, and 8-week duration), supervised by qualified therapists but delivered exclusively through commercial and prototype technology. This provides participants (chronic stroke survivors with movement and/or speech disability) with a rich experience of rehabilitation technology, enabling them to provide truly informed feedback, as well as creating an observatory for the research team. This process is supported by short-term focus groups for specific product development and a longer-term advisory group to consider broader issues of adoption and translation into everyday health care. ResultsOur model has been active for 3 years with 92 (92%) out of 100 participants completing the program. Five new technologies have evolved from the process with further ideas logged for future development. In addition, it has led to a set of cocreated protocols for technology-enriched rehabilitation, including recruitment, outcome measures, and intervention structure, which has allowed us to replicate this approach in an acute hospital ward. ConclusionsSuboptimal rehabilitation limits recovery from health conditions. Technology offers the potential support to increase access to recommended levels of rehabilitation but needs to be designed to suit end users and not just their impairment. Our cocreation model, built around participation in an intensive, technology-based program, has produced new accessible technology and demonstrated the feasibility of our overall approach to providing the rehabilitation that people need, for as long as needed.

Background. Each year, approximately 5000 New Zealanders are admitted to hospital with first-time acute coronary syndrome (ACS). The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) is a prospective longitudinal cohort study embedded within the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry in six hospitals. The objective of MENZACS is to examine the relationship between clinical, genomic, and cardiometabolic markers in relation to presentation and outcomes post-ACS. Methods. Patients with first-time ACS are enrolled and study-specific research data is collected alongside the ANZACS-QI registry. The research blood samples are stored for future genetic/biomarker assays. Dietary information is collected with a food frequency questionnaire and information about physical activity, smoking, and stress is also collected via questionnaire. Detailed family history, ancestry, and ethnicity data are recorded on all participants. Results. During the period between 2015 and 2019, there were 2015 patients enrolled. The mean age was 61 years, with 60% of patients aged Conclusion. MENZACS represents a cohort with optimal contemporary management and will be a significant epidemiological bioresource for the study of environmental and genetic factors contributing to ACS in New Zealand’s multi-ethnic environment. The study will utilise clinical, nutritional, lifestyle, genomic, and biomarker analyses to explore factors influencing the progression of coronary disease and develop risk prediction models for health outcomes.

Abstract Background Antithrombotic medications (antiplatelets and anticoagulants) reduce the risk of cardiovascular disease (CVD), but with the disadvantage of increasing bleeding risk. Ethnicity and socioeconomic deprivation are independent predictors of major bleeds among patients without CVD, but it is unclear whether they are also predictors of major bleeds among patients with CVD or atrial fibrillation (AF) after adjustment for clinical variables. Methods Prospective cohort study of 488,107 people in New Zealand Primary Care (including 64,420 Māori, the indigenous people of New Zealand) aged 30–79 years who had their CVD risk assessed between 2007 and 2016. Participants were divided into three mutually exclusive subgroups: (1) AF with or without CVD (n = 15,212), (2) CVD and no AF (n = 43,790), (3) no CVD or AF (n = 429,105). Adjusted hazards ratios (adjHRs) were estimated from Cox proportional hazards models predicting major bleeding risk for each of the three subgroups to determine whether ethnicity and socioeconomic deprivation are independent predictors of major bleeds in different cardiovascular risk groups. Results In all three subgroups (AF, CVD, no CVD/AF), Māori (adjHR 1.63 [1.39–1.91], 1.24 [1.09–1.42], 1.57 [95% CI 1.45–1.70], respectively), Pacific people (adjHR 1.90 [1.58–2.28], 1.30 [1.12–1.51], 1.62 [95% CI 1.49–1.75], respectively) and Chinese people (adjHR 1.53 [1.08–2.16], 1.15 [0.90–1.47], 1.13 [95% CI 1.01–1.26], respectively) were at increased risk of a major bleed compared to Europeans, although for Chinese people the effect did not reach statistical significance in the CVD subgroup. Compared to Europeans, Māori and Pacific peoples were generally at increased risk of all bleed types (gastrointestinal, intracranial and other bleeds). An increased risk of intracranial bleeds was observed among Chinese and Other Asian people and, in the CVD and no CVD/AF subgroups, among Indian people. Increasing socioeconomic deprivation was also associated with increased risk of a major bleed in all three subgroups (adjHR 1.07 [1.02–1.12], 1.07 [1.03–1.10], 1.10 [95% CI 1.08–1.12], respectively, for each increase in socioeconomic deprivation quintile). Conclusion Ethnicity and socioeconomic status should be considered in bleeding risk assessments to guide the use of antithrombotic medication for the management of AF and CVD.

Background: Walking, sit-to-stand (STS) and sit-to-walk (STW) are all considered important functional tasks in achieving independence after stroke. Despite knowledge that sensitive measurement of movement patterns is crucial to understanding neuromuscular restitution, there is surprisingly little information available about the detailed biomechanical characteristics of, and relationships between, walking, sit-to-stand and sit-to-walk, particularly in the important time window early after stroke. Hence, here, the study aimed to: Identify the biomechanical characteristics of and determine any differences in both movement fluidity (hesitation, coordination and smoothness) and duration of movement phases, between sit-to-stand (STS) and sit-to-walk (STW) in people early after stroke.Determine whether measures of movement fluidity (hesitation, coordination, and smoothness) and movement phases during sit-to-stand (STS) and/or sit-to-walk (STW) are correlated strongly to commonly used measures of walking speed and/or step length ratio in people early after stroke.Methods: This study consisted of secondary data analysis from the SWIFT Cast Trial. Specifically, we investigated movement fluidity using established assessments of smoothness, hesitation and coordination and the time duration for specific movement phases in a group of 48 people after stroke. Comparisons were made between STS and STW and relationships to walking measures were explored.Results: Participants spent significantly more time in the initial movement phase, flexion momentum, during STS [mean time (SD) 1.74 ±1.45 s] than they did during STW [mean time (SD) 1.13 ± 1.03 s]. STS was also completed more smoothly but with more hesitation and greater coordination than the task of STW. No strong relationships were found between movement fluidity or duration with walking speed or step length symmetry.Conclusions: Assessment of movement after stroke requires a range of functional tasks and no one task should predominate over another. Seemingly similar or overlapping tasks such as STS and STW create distinct biomechanical characteristics which can be identified using sensitive, objective measures of fluidity and movement phases but there are no strong relationships between the functional tasks of STS and STW with walking speed or with step-length symmetry.

Purpose: We performed a systematic review and meta-analysis of studies reporting the incidence of radiation induced brachial plexopathy (RIBP) and the associated radiotherapy doses to this structure. Methods: Databases were queried without language restriction for cohort studies reporting RIBP incidence and associated brachial plexus dose maximum dose (bpDmax). Studies specifying RIBP relative risk (RR) effect size were selected for meta-analysis. RRs for RIBP from each study were converted to a regression coefficient (β) and standard error corresponding to a continuous representation of bpDmax. The adjusted β from individual studies were combined using a random effects model and weighted by inverse variance (1/SE2). The trim and fill approach was used to assess publication bias. Results: We identified 25 studies that included 37 unique patient cohorts eligible for analysis. Seventeen cohorts experienced an RIBP incidence ≤5%, of which 6 cohorts exceeded conventional plexus constraints of 60 Gy for bpDmax. Five of the 6 cohorts were simulated with 3D-CT techniques. Meta-analysis of eligible studies demonstrated a significant increase in RIBP risk for each Gy increase in bpDmax (RR, 1.11; 95% CI 1.07–1.15). Results remained significant after adjustment for publication bias and when sensitivity analysis was performed. Conclusions: Our results suggest that current brachial plexus constraints of 60–66 Gy are safe. Meta-analysis provides a log-linear model to quantify the association of brachial plexus dose and RIBP risk, and thus inform the therapeutic ratio for dose escalation. Further prospective studies reporting dosimetric data can better refine this model and inform brachial plexus constraint guidelines. Keywords: Brachial plexus, Radiation induced brachial plexopathy, Normal tissue constraints, Radiotherapy

Abstract Background Stroke rehabilitation often uses the motor relearning concept that require patients to perform active practice of skill-specific training and to receive feedback. Treadmill training augmented with real-time visualisation feedback and functional electrical stimulation may have a beneficial synergistic effect on motor recovery. This study aims to determine the feasibility of this kind of enhanced treadmill training for gait rehabilitation among patients after stroke. A system for dynamic visualisation of lower-limb movement based on 3-dimentional motion capture and a computer timed functional electrical stimulation system was developed. Participants received up to 20-min enhanced treadmill training instead of their over-ground gait training once or twice a week for 6 weeks at Coathill hospital, Lanarkshire, United Kingdom. Number of training sessions attended, and training duration were used to assess feasibility. Ankle kinematics in the sagittal plane of walking with and without functional electrical stimulation support of the pre-tibial muscles were also compared and used to confirm the functional electrical stimulation was triggered at the targeted time. Results Six patients after stroke participated in the study. The majority of participants were male (5/6) with a age range from 30 to 84 years and 4/6 had left hemiplegia. All participants suffered from brain infarction and were at least 3 months after stroke. Number of training sessions attended ranged from 5 to 12. The duration of training sessions ranged from 11 to 20 min. No serious adverse events were reported. The computerised functional electrical stimulation to the pre-tibial muscles was able to reduce plantarflexion angle during the swing phase with statistical significance (p = 0.015 at 80%; p = 0.008 at 90 and 100% of the gait cycle). Conclusions It is safe and feasible to use treadmill gait training augmented with real-time visual feedback and computer-controlled functional electrical stimulation with patients after stroke in routine clinical practice. Trial registration NCT03348215. Registered 20 November 2017.

Abstract Background Cardiac rehabilitation (CR) is an essential component of contemporary management for patients with coronary heart disease, including following an acute coronary syndrome (ACS). CR typically involves education and support to assist people following an ACS to make lifestyle changes and prevent subsequent events. Despite its benefits, uptake and participation in tradition CR programs is low. The use of mobile technologies (mHealth) offers the potential to improve reach, access, and delivery of CR support. We aim to determine the effectiveness and cost-effectiveness of a text-messaging intervention (Text4Heart II) to improve adherence to medication and lifestyle change in addition to usual care in people following an ACS. A second aim is to use the RE-AIM framework to inform the potential implementation of Text4Heart II within health services in New Zealand. Methods Text4Heart II is a two-arm, parallel, superiority randomized controlled trial conducted in two large metropolitan hospitals in Auckland, New Zealand. Three hundred and thirty participants will be randomized to either a 24-week theory- and evidence-based personalized text message program to support self-management in addition to usual CR, or usual CR alone (control). Outcomes are assessed at 6 and 12 months. The primary outcome is the proportion of participants adhering to medication at 6 months as measured by dispensed records. Secondary outcomes include medication adherence at 12 months, the proportion of participants adhering to self-reported healthy behaviors (physical activity, fruit and vegetable consumption, moderating alcohol intake and smoking status) measured using a composite health behavior score, self-reported medication adherence, cardiovascular risk factors (lipids, blood pressure), readmissions and related hospital events at 6 and 12 months. A cost-effectiveness analysis will also be conducted. Using the RE-AIM framework, we will determine uptake and sustainability of the intervention. Discussion The Text4Heart II trial will determine the effectiveness of a text-messaging intervention to improve adherence to medication and lifestyle behaviors at both 6 and 12 months. Using the RE-AIM framework this trial will provide much needed data and insight into the potential implementation of Text4Heart II. This trial addresses many limitations/criticisms of previous mHealth trials; it builds on our Text4Heart pilot trial, it is adequately powered, has sufficient duration to elicit behavior change, and the follow-up assessments (6 and 12 months) are long enough to determine the sustained effect of the intervention. Trial registration Australian New Zealand Clinical Trials Registry, ID: ACTRN12616000422426 . Registered retrospectively on 1 April 2016.

Stroke is a worldwide healthcare problem, which often causes long-term motor impairment, handicap, and disability. Optical motion analysis systems are commonly used for impairment assessment due to high accuracy. However, the requirement of equipment-heavy and large laboratory space together with operational expertise makes these systems impractical for local clinic and home use. We propose an alternative, cost-effective and portable, decision support system for optical motion analysis, using a single camera. The system relies on detecting and tracking markers attached to subject's joints, data analytics for calculating relevant rehabilitation parameters, visualization, and robust classification based on graph-based signal processing. Experimental results show that the proposed decision support system has the potential to offer stroke survivors and clinicians an alternative, affordable, accurate, and convenient impairment assessment option suitable for home healthcare and telerehabilitation.

Abstract Objective: To compare the cardiovascular disease (CVD) risk profiles of Indian and European patients from routine primary care assessments in the northern region of New Zealand. Method: Anonymous CVD risk profiles were extracted from PREDICT (a web‐based decision support program) for Indian and European patients aged 35–74 years. Linear regression models were used to obtain mean differences adjusted for age, gender and deprivation. Results: At recruitment, Indian participants (n=8,830) were younger than Europeans (n=47,091), in keeping with national guidelines that recommend earlier CVD risk assessment for Indians. Compared with Europeans, a greater proportion of Indian participants lived in areas of higher deprivation and had a two to four‐fold greater burden of diabetes in all age groups. Indian participants had a significantly lower proportion of smokers and a lower mean systolic blood pressure. The respective cardiovascular risk factor profiles lead to similar age‐adjusted Framingham five‐year CVD risk scores. Conclusions and implications: National data sources indicate that there are higher rates of hospitalisations and deaths from CVD in Indians compared with Europeans. Our study found similar predicted CVD risk in these two populations despite markedly different clustering of risk factors, suggesting that the Framingham risk equation may underestimate risk in Indians. There is a need for better ethnicity coding to identify all South Asian ethnicities.

A new polymorph of the title compound, C36H30OSi2·2C7H8, is reported, which is triclinic (P-1) instead of possessing the previously reported rhombohedral symmetry [Hönle et al. (1990). Acta Cryst. C46, 1982–1984]. Each of the –SiPh3 units are related by the inversion center. The Si—O—Si moiety is linear with the O atom sitting on an inversion center, and the O—Si—(toluene ring centroid) angle is 3.69 (15)°. Each toluene molecule is 5.622 (2) Å from the Si atom and has its closest contacts with the phenyl rings outside of the van der Waals radii.

Introduction: Emergency departments (ED) function as a health and social safety net, regularly taking care of patients with high social risk and need. Few studies have examined ED-based interventions for social risk and need. Methods: Focusing on ED-based interventions, we identified initial research gaps and priorities in the ED using a literature review, topic expert feedback, and consensus-building. Research gaps and priorities were further refined based on moderated, scripted discussions and survey feedback during the 2021 SAEM Consensus Conference. Using these methods, we derived six priorities based on three identified gaps in ED-based social risks and needs interventions: 1) assessment of ED-based interventions; 2) intervention implementation in the ED environment; and 3) intercommunication between patients, EDs, and medical and social systems. Results: Using these methods, we derived six priorities based on three identified gaps in ED-based social risks and needs interventions: 1) assessment of ED-based interventions, 2) intervention implementation in the ED environment, and 3) intercommunication between patients, EDs, and medical and social systems. Assessing intervention effectiveness through patient-centered outcome and risk reduction measures should be high priorities in the future. Also noted was the need to study methods of integrating interventions into the ED environment and to increase collaboration between EDs and their larger health systems, community partners, social services, and local government. Conclusion: The identified research gaps and priorities offer guidance for future work to establish effective interventions and build relationships with community health and social systems to address social risks and needs, thereby improving the health of our patients.

One of the reasons why the Kyoto Protocol has been environmentally ineffective is the flaws in the land use, land-use change and forestry (LULUCF) accounting rules, including voluntary accounting for Article 3.4 activities, the adoption of a definition of forest management that allowed parties to preferentially include and exclude forest lands, and allowing parties with net emissions from LULUCF in 1990 to include deforestation emissions in their 1990 emissions base year. Three proposed amendments to the LULUCF rules for the post-2012 regime are discussed and analysed: (1) a force majeure rule, (2) a baseline-and-credit system for forest management and (3) an ‘emissions-to-atmosphere’ approach for harvested wood products. Although these proposals have the potential to significantly improve the accounting framework, there are still significant problems such as the failure to account for the biophysical effects of forest activities, uncertainties associated with the application of the forest management baseline-and-credit system and continuing optional coverage of Article 3.4 activities. [ABSTRACT FROM PUBLISHER]

The inverse-trans-influence has been shown to operate in high oxidation state actinide complexes. Here, the authors report tetravalent cerium, uranium and thorium bis(carbene) complexes with trans C=M=C cores where experimental and theoretical data also suggest the presence of an inverse-trans-effect.

The electronic structure of a series of uranium and cerium hexachlorides in a variety of oxidation states was evaluated at both the correlated wavefunction and density functional (DFT) levels of theory. Following recent experimental observations of covalency in tetravalent cerium hexachlorides, bonding character was studied using topological and integrated analysis based on the quantum theory of atoms in molecules (QTAIM). This analysis revealed that M–Cl covalency was strongly dependent on oxidation state, with greater covalency found in higher oxidation state complexes. Comparison of M–Cl delocalisation indices revealed a discrepancy between correlated wavefunction and DFT-derived values. Decomposition of these delocalisation indices demonstrated that the origin of this discrepancy lay in ungerade contributions associated with the f-manifold which we suggest is due to self-interaction error inherent to DFT-based methods. By all measures used in this study, extremely similar levels of covalency between complexes of U and Ce in the same oxidation state was found.

Nature Communications 8: Article number: 14137 (2017); Published: 3 February 2017; Updated: 5 February 2018 The original version of this Article contained a typographical error in Fig. 2, where reagent H2C(Ph2PNSiMe3)2 was incorrectly given as H2C(PNSiMe3)2. This has now been corrected in both the PDF and HTML versions of the Article.

Clarireedia jacksonii sp. nov. formerly Sclerotinia homoeocarpa F.T. Bennett, one of the causal agents of dollar spot, is the most widespread pathogen in turfgrass systems. Dollar spot (DS) affects both cool- and warm-season grasses, during a wide range of environmental conditions. Field studies were conducted at Clemson University, Clemson, SC, on a creeping bentgrass [Agrostis stolonifera L. var. palustris (Huds) cv. Crenshaw] putting green for 2 consecutive years from August to October in year 1 and July to September in year 2. The objective of the studies was to evaluate biological control agents (BCAs) and synthetic fungicides at reduced rates for their efficacy controlling dollar spot. Four replications of 1.5 × 1.5-m plots were used in the experimental design. Treatments included the following: Bacillus subtilis (BS); plant extract oils (EO) including clove oil + wintergreen oil + thyme oil; extract of Reynoutria sachalinensis (RS); Bacillus licheniformis (BL); chlorothalonil (CL); and azoxystrobin + propiconazole (AzP). Synthetic fungicides were used at reduced rates in combination with biological control agents, to evaluate curative control efficacy of various combinations. All reduced synthetic programs, except CL + EO, provided acceptable disease severity (≤15%) at the end of year 1 and acceptable (≥7) turfgrass visual quality. Azoxystrobin + propiconazole, CL, AzP + BL, AzP + EO, AzP + BS all provided ≤15% disease severity and ≥7 visual turfgrass quality 14 days after the last application in year 2.

This essay reads Marvell’s mower poems and ‘The Garden’ as case studies in the ethics of vulnerability that collectively work to illuminate a potential for joyful connection—with people, but also with the natural world—in the practice of critique, which otherwise has a melancholic potential for over-identifying with its object. Whereas vulnerability commonly denotes susceptibility to harm, this essay builds on the work of Erinn Gilson to show that vulnerability is ontological, a shared feature of human existence that makes both harm and connection possible. Vulnerability figures in the poems through the relationships they depict: between the mower and himself, Juliana, and the grass. As a counterbalance to the various strategies that they deploy to escape the vulnerability (and potentiality for harm) occasioned by these relationships, the poems also present the possibility of an ‘innocent’, non-violent relationship of mutual fruitfulness with the grass—a possibility that at least hypothetically extends to relationships with other people. These latter possibilities suggest a form of critique that escapes its melancholic temperament—the presumption that the world portends only harm—and allows even complicity to contain the potential for joyful, mutual, and fruitful connection with others.