bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empagliflozin reduced long-term HbA1c variability and cardiovascular death: insights from the EMPA-REG OUTCOME trial
Authors: Ceriello Antonio , Ofstad Anne Pernille , Zwiener Isabella , Kaspers Stefan , George Jyothis , Nicolucci Antonio 
Published: October 2020

Abstract
Background
Glucose variability has been associated with cardiovascular outcomes in type 2 diabetes, however, the interplay between glucose variability, empagliflozin and cardiovascular death has not been explored. In the EMPA-REG OUTCOME trial, empagliflozin reduced the risk of cardiovascular death by 38%. We explore post-hoc the association between HbA1c variability and cardiovascular death, and the potential mediating effects of HbA1c variability on empagliflozin’s cardiovascular death reductions.

Methods
In total, 7,020 patients with type 2 diabetes and established cardiovascular disease received placebo, empagliflozin 10 mg or 25 mg. We defined within-patient HbA1c variability as standard deviation, coefficient of variation and range of HbA1c measurements (%) post-baseline. First, we compared HbA1c variability until week 28 and 52 by Wilcoxon tests. We explored the association between cardiovascular death and HbA1c variability in placebo and pooled empagliflozin arms separately with landmark analyses at week 28 and 52, and additionally with HbA1c variability as a time-dependent co-variate. We used Cox regression models adjusted for baseline risk factors including changes in HbA1c from baseline to week 12, and the interaction term HbA1c variability* treatment.

Results
HbA1c variability was lower with empagliflozin compared to placebo. In all Cox analyses, high HbA1c variability increased the risk for cardiovascular death in both treatment arms with no interaction with treatment: e.g. an increase in HbA1c variability of one unit for the standard deviation at week 28 was associated with a subsequent increased risk of CV death with HRs of 1.97 (95% CI 1.36, 2.84) and 1.53 (1.01, 2.31) in the placebo and empagliflozin groups, separately, interaction p-value 0.3615.

Conclusions
HbA1c variability was reduced by empagliflozin and high values of HbA1c variability were associated with an increased risk of cardiovascular death. Empagliflozin’s reduction in cardiovascular death did not appear to be mediated by reductions in HbA1c variability.
ClinicalTrials.gov number, NCT01131676
High NEMO score values in nailfold videocapillaroscopy are associated with the subsequent development of ischaemic digital ulcers in patients with systemic sclerosis
Authors: Del Papa Nicoletta , Pignataro Francesca , Maglione Wanda , Minniti Antonina , Sambataro Domenico , Sambataro Gianluca , Valentini Gabriele , Caporali Roberto , Vitali Claudio 
Published: October 2020

Abstract
Background
Nailfold videocapillaroscopy (NVC) is a feasible method that allows the observation of the microvascular changes that mark the course of systemic sclerosis (SSc). In previous studies, we demonstrated that the NEMO score, i.e. the cumulative number of microhaemorrhages and microthromboses, is a good indicator of the steady-state level and overtime changes of disease activity (DA) in SSc.

Objectives
To verify whether high NEMO scores, which mirror a very active microvascular derangement in the fingers, may be associated with the subsequent development of ischaemic digital ulcers (IDUs).

Methods
The NEMO score was assessed at baseline (T0) in 98 patients with SSc, all classified according to the ACR-EULAR criteria. Of them, 90 were females, 48 had the limited and 50 had the diffuse cutaneous variant of SSc. Afterwards, the patients were closely followed up for 2 years, and the appearance of new IDUs recorded at any time of the follow-up. The T0-NEMO score values of patients who developed IDUs were compared to those of patients who did not. A receiver operating curve (ROC) was constructed, and the area under the curve (AUC) calculated by plotting the sensitivity and 1-specificity of the different NEMO score values in predicting the subsequent development of IDUs.

Results
During the follow-up, 38 out of 98 patients developed one or more IDUs. The NEMO score at T0 was significantly higher in those who developed IDUs with respect to those who did not [median 14.5 (95% CI 11.0–21.5) and 4.5 (95% CI 4.0–6.0), respectively, p < 0.0001]. The ROC curve derived from different T0-NEMO score values had an AUC of 0.79 (95% CI 0.69–0.86, p < 0.0001). A NEMO score of ≥ 12 had a sensitivity of 83.3% (95% CI 71.5–91.7) and a specificity of 63.2% (95% CI 46.0–78.2), with positive (P) and negative (N) predictive (PV) values of 58.9% (95% CI 44.7–72.2) and 85.6% (71.8–94.4), respectively. A NEMO score of ≥ 16 had a sensitivity of 95.0% (95% CI 86.1–99.0) and a NPV of 93.4% (77.5–99.2).

Conclusions
Being a valid tool to measure DA levels in SSc, the NEMO score also appears to be closely related to the subsequent development of IDUs in this disease.
A case of recurrent herpes simplex 2 encephalitis, VZV reactivations, and dominant partial interferon-gamma-receptor-1 deficiency supports relevance of IFNgamma for antiviral defense in humans
Authors: Körholz Julia , Richter Nicole , Schäfer Jochen , Schuetz Catharina , Roesler Joachim 
Published: October 2020

Abstract
Background
Unlike infections with mycobacteria, reports of unusual viral infections in interferon-gamma-receptor (IFNγR) deficient patients are scarce. Therefore, discussion about increased susceptibility to viral infections in these patients is ongoing.

Case presentation
We describe a 51-year-old male with dominant partial interferon-gamma-receptor-1 (IFNγR1)-deficiency and recurrent Herpes simplex 2 meningoencephalitis as well as other viral reactivations since childhood.

Conclusions
This case further confirms an enhanced risk for viral disease in IFNγR-deficient patients and a role of interferon gamma for human antiviral defense.
Distance variable improvement of time-series big data stream evaluation
Authors: Wibisono Ari , Mursanto Petrus , Adibah Jihan , Bayu Wendy D. W. T. , Rizki May Iffah , Hasani Lintang Matahari , Ahli Valian Fil 
Published: October 2020

AbstractReal-time information mining of a big dataset consisting of time series data is a very challenging task. For this purpose, we propose using the mean distance and the standard deviation to enhance the accuracy of the existing fast incremental model tree with the drift detection (FIMT-DD) algorithm. The standard FIMT-DD algorithm uses the Hoeffding bound as its splitting criterion. We propose the further use of the mean distance and standard deviation, which are used to split a tree more accurately than the standard method. We verify our proposed method using the large Traffic Demand Dataset, which consists of 4,000,000 instances; Tennet’s big wind power plant dataset, which consists of 435,268 instances; and a road weather dataset, which consists of 30,000,000 instances. The results show that our proposed FIMT-DD algorithm improves the accuracy compared to the standard method and Chernoff bound approach. The measured errors demonstrate that our approach results in a lower Mean Absolute Percentage Error (MAPE) in every stage of learning by approximately 2.49% compared with the Chernoff Bound method and 19.65% compared with the standard method.
Early- and late anthracycline-induced cardiac dysfunction: echocardiographic characterization and response to heart failure therapy
Authors: Kamphuis Janine A. M. , Linschoten Marijke , Cramer Maarten J. , Doevendans Pieter A. , Asselbergs Folkert W. , Teske Arco J. 
Published: October 2020

Abstract
Background
Anthracycline-induced cardiac dysfunction (ACD) is a notorious side effect of anticancer treatment. It has been described as a phenomenon of a continuous progressive decline of cardiac function, eventually leading to dilated cardiomyopathy (DCM). This progressive nature suggests that patients with a delayed ACD diagnosis have greater compromise of cardiac function and more adverse remodeling, with a poor response to heart failure (HF) treatment. This study aimed to delineate the impact of a delayed ACD diagnosis on echocardiographic characteristics and response to HF treatment.

Methods and results
From the population of our cardio-oncology outpatient clinic, 92 ACD patients were included in this study (age 51.6 ± 16.2 years, median cumulative anthracycline dose 329 [200–329] mg/m2), and a median follow-up of 25.0 [9.6–37.2] months after ACD diagnosis. Median time to ACD diagnosis for patients diagnosed early (< 1 year) and late (> 1 year) was 4.0 vs. 47.7 months respectively. There were no echocardiographic differences between patients diagnosed early vs. late (LVEF 43.6 ± 4.9% vs. 43.0 ± 6.2% and iEDV 63.6 vs. 62.9 mL/m2). Eighty-three percent of patients presented with mild LV dysfunction and in 79% the LV was not dilated. Patients diagnosed early were more likely to have (partial) recovery of cardiac function upon HF treatment initiation (p = 0.015).

Conclusions
In the setting of a cardio-oncology outpatient clinic, patients with ACD presented with a hypokinetic non-dilated cardiomyopathy, rather than typical DCM. Timing of ACD diagnosis did not impact HF disease severity. However, in patients receiving an early diagnosis, cardiac function was more likely to recover upon HF treatment.
Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome
Authors: Strozzi Maja , Besic Kristina Maric , Ivana Knezevic Stromar , Darko Anić 
Published: October 2020

Abstract
Background
Budd-Chiari syndrome is defined as a hepatic venous outflow track obstruction of various etiology, which appears at different levels. The inferior vena cava outflow membrane is an unusual, but a potentially treatable cause. The percutaneous treatment has emerged as a very promising management mode for such patients. Follow-up results are favorable for balloon angioplasty and/or stenting, with minimal re-stenosis rates.

Case presentation
We report a case of a young woman, earlier operated on congenital heart defect and with previous pulmonary embolic incident after childbirth, with no evidence of thrombophilia. She was admitted to our institution for a suspected right atrial tumor. After the diagnosis of Budd-Chiari syndrome caused by membranous inferior vena cava obstruction, a percutaneous treatment of a thick membrane was successfully performed, using an unusual technique.

Conclusion
Balloon angioplasty should be considered in cases of membranous obstruction of vena cava, where a focal obstruction is causing the symptoms. In our patient, the anatomy was not suitable for stenting, and balloon dilatation was successful just after the membrane was pulled apart with a big balloon in a “Rashkind-like” procedure.
Change in decision-making skills and risk for eating disorders in adolescence: A population-based study
Authors: Francesconi M. , Flouri E. , Harrison A. 
Published: October 2020

AbstractBackgroundDespite the growing interest in the involvement of decision-making under conditions of risk in the onset of eating disorders in adolescence, no studies have investigated how the development of decision-making across that period may influence such a risk. Using data from the Millennium Cohort Study this study explored whether changes in performance on the Cambridge Gambling Task (CGT) between age 11 and age 14 were associated with presence of eating disorder (ED) symptoms at age 14.MethodsLatent class analysis was used to identify groups with distinct profiles based on their responses to questions investigating eating and dieting at age 14. CGT change scores were used as predictors of latent class membership in a logistic regression while accounting for confounders.ResultsIn our sample of 11,303 participants, the best class solution was a two-class one reflecting high and low risk for ED symptoms. Higher risk-taking scores and lower quality of decision-making scores at age 11 were associated with increased odds of belonging to the high-risk group at age 14. Risk-taking was reduced from age 11 to age 14, but a smaller reduction was associated with a higher probability of being in the higher risk group at age 14. The change over time in the other CGT measures was not associated with risk for ED symptoms.ConclusionsAtypical change in risk-taking from early to middle adolescence may be implicated in the risk of ED symptoms in middle adolescence. These results should be replicated in clinical samples.
Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population
Authors: Nakanishi Koki , Daimon Masao , Yoshida Yuriko , Sawada Naoko , Hirose Kazutoshi , Iwama Kentaro , Yamamoto Yuko , Ishiwata Jumpei , Hirokawa Megumi , Kaneko Hidehiro , Nakao Tomoko , Mizuno Yoshiko , Morita Hiroyuki , Di Tullio Marco R , Homma Shunichi , Komuro Issei 
Published: October 2020

Abstract

Purpose
Although subclinical hypothyroidism (SCH) is a common clinical entity and carries independent risk for incident heart failure (HF), its possible association with subclinical cardiac dysfunction is unclear. Left ventricular global longitudinal strain (LVGLS) and left atrial (LA) phasic strain can unmask subclinical left heart abnormalities and are excellent predictors for HF. This study aimed to investigate the association between the presence of SCH and subclinical left heart dysfunction in a sample of the general population without overt cardiac disease.

Methods
We examined 1078 participants who voluntarily underwent extensive cardiovascular health check-ups, including laboratory tests and 2-dimensional speckle-tracking echocardiography to assess LVGLS and LA reservoir, conduit, and pump strain. SCH was defined as an elevated serum thyroid-stimulating hormone level with normal concentration of free thyroxine.

Results
Mean age was 62 ± 12 years, and 56% were men. Seventy-eight (7.2%) participants exhibited SCH. Individuals with SCH had significantly reduced LA reservoir (37.1 ± 6.6% vs 39.1 ± 6.6%; P = 0.011) and conduit strain (17.3 ± 6.3% vs 19.3 ± 6.6%; P = 0.012) compared with those with euthyroidism, whereas there was no significant difference in left ventricular ejection fraction, LA volume index, LVGLS, and LA pump strain between the 2 groups. In multivariable analyses, SCH remained associated with impaired LA reservoir strain, independent of age, traditional cardiovascular risk factors, and pertinent laboratory and echocardiographic parameters. including LVGLS (standardized β −0.054; P = 0.032).

Conclusions
In an unselected community-based cohort, individuals with SCH had significantly impaired LA phasic function. This association may be involved in the higher incidence of HF in subjects with SCH.
The Queer Thresholds of Heresy
Authors: Han Ju Hui Judy 
Published: October 2020

AbstractDisputes over heresy are not new or uncommon, as mainline Protestant denominations in South Korea have historically deemed numerous minor sects and radical theologies to be heretical to the Christian faith. However, when the largest evangelical denomination in the country, the Presbyterian Church in Korea (Hapdong), began investigating Reverend Lim Borah (Im Pora) of the Sumdol Hyanglin Church in 2017 and subsequently ruled her ministry to be heretical, they charted new grounds by denouncing LGBTI-affirming theology and ministry as heresy. This article traces the semantic ambiguity and politics of the term for heresy, idan, and highlights the intersection of heretical Christianity, gender and sexual nonconformity, and ideological dissidence. The argument is that growing interests in queer theology and calls for LGBTI-affirming ministry stoked the flames of efforts by beleaguered Protestant denominations to use heresy to discredit and stigmatize dissident practices, and that rather than simply stifle dissent, the subsequent controversy also exposed the limits of dominant power and the contours of vital resistance.
On the Structure of Bottlenecks in Processes
Authors: Dawande Milind , Feng Zhichao , Janakiraman Ganesh 
Published: October 2020

Process capacity and the associated notions of bottleneck activities and bottleneck resources—which are responsible for limiting process capacity to its present value—are fundamental concepts in the operations management literature. However, for processes that involve collaboration and multitasking, there is little clarity in the literature on what bottlenecks are, what they look like, and how they can be identified. In this paper, we formulate and analyze graph-theoretic optimization problems that determine bottleneck structures of activities and the associated bottleneck sets of resources in deterministic, single-product processes with possibly multiple copies of one or more resources and possibly multiple sets of resources that can perform each activity. In the presence of both collaboration and multitasking, sets of activities that are interconnected in a specific manner via shared resources form bottleneck structures that are responsible for limiting capacity. We use the collaboration graph of the process to either characterize bottleneck structures completely or identify graphical structures that must necessarily be part of any bottleneck structure. Our analysis reveals a natural hierarchy in the algorithmic approach for identifying bottleneck structures as processes become increasingly sophisticated, ranging from the “easy” case where the simple bottleneck formula correctly identifies bottlenecks to more complex cases where one needs to solve progressively complicated mathematical programs. In turn, this understanding helps us obtain prescriptive answers to several questions of interest to managers, for example, the budget-constrained procurement of resources to maximize capacity improvement and the design of processes to increase capacity without procuring additional resources. This paper was accepted by Jayashankar Swaminathan, operations management.
Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy
Authors: Lundsberg Lisbet S. , Cutler Abigail S. , Stanwood Nancy L. , Yonkers Kimberly A. , Gariepy Aileen M. 
Published: October 2020

CONTEXTResearch into the relationship between pregnancy intention and perinatal depression or low social support is limited. Women's perspectives on pregnancy and their associations with perinatal depression could help in developing targeted efforts for screening and intervention.METHODSIn 2014–2015, 161 women seeking pregnancy testing or abortion care at clinics in New Haven, Connecticut, were surveyed. They were asked about pregnancy context (intentions, planning, wantedness, desirability, timing and happiness), and the Edinburgh Depression Screen (EDS) and the Modified Kendler Social Support Index (MKSSI) were used to identify possible antenatal depression and low social support, respectively. Multivariable logistic regression analysis was employed to examine associations between pregnancy context and these outcomes.RESULTSOn average, participants were 27 years old and at nine weeks’ gestation. One‐fifth reported a previous diagnosis of depression or anxiety, and 22% and 33% screened positive for depression (EDS scores of 13 or higher and 10 or higher, respectively); 52% received low social support (MKSSI score of 3.2 or less). Regression analysis found that pregnancies described as unintended, poorly timed or undesired were associated with depression at the higher cutoff (odds ratios, 3.2–4.5); all unfavorable pregnancy measures were associated with depression at the lower cutoff. Ambivalence regarding pregnancy timing, intention, wantedness and desirability was associated with increased odds of depression by either EDS score. Unplanned pregnancies and those about which the woman was ambivalent were associated with low social support.CONCLUSIONSFindings support the need to screen women for depression early in pregnancy and to integrate assessments of pregnancy context into the evaluation of potential risk factors.
Hereditary Hemorrhagic Telangiectasia and Refractory Ascites
Authors: Thandassery Ragesh B. , Patel Rahul S. , Grewal Priya 
Published: October 2020

ABSTRACT
Hereditary hemorrhagic telangiectasia is a rare autosomal dominant disease that can involve the liver. The presence of arteriohepatic venous shunts can lead to high output cardiac failure and biliary ischemia, whereas arterioportal venous shunts can result in portal hypertension. Cirrhosis and nodular regenerative hyperplasia are also reported in these patients. Management of these patients in the setting of symptomatic liver disease is challenging. Transarterial embolization and hepatic artery ligation are usually considered palliative options. In selected cases, orthotopic liver transplantation can cure both liver disease and heart failure.
NS-Raubgut an der Hochschule für Jüdische Studien Heidelberg
Authors: Zschommler Philipp 
Published: October 2020

Abstract
Auf den ersten Blick mag es ungewöhnlich erscheinen, dass auch eine jüdische Institution untersuchen muss, ob sie im Besitz von NS-Raubgut ist. Doch die Bibliothek der 1979 gegründeten Hochschule für Jüdische Studien (HfJS) Heidelberg erwarb 1988 den Nachlass des zwei Jahre zuvor verstorbenen westfälischen Landesrabbiners Emil Davidovic, der als Auschwitzüberlebender für seine Bibliothek zunächst Bücher in Prag und dann in Westfalen erworben hatte. Das Provenienzprojekt an der Hochschule für Jüdische Studien Heidelberg (HfJS) untersucht seinen Nachlass auf raubgutverdächtige Bücher. Als ehemalige Eigentümer konnten bisher vor allem Jüdinnen und Juden aus dem von den Nationalsozialisten eingerichteten „Protektorat Böhmen und Mähren“ wie auch westfälische Provenienzen ermittelt werden. Im Folgenden werden die ersten Forschungsergebnisse erläutert, die Art der Dokumentation beschrieben und die angestrebte Restitution der als NS-Raubgut identifizierten Bücher erörtert.
Spuren einer frühen Verfolgungsgeschichte: Die Bücher von Otto Elias
Authors: de Rudder Anneke 
Published: October 2020

Abstract
Die Staats- und Universitätsbibliothek Hamburg betreibt seit vielen Jahren Provenienzforschung. Zurzeit werden die Sondersammlungen auf NS-Raubgut überprüft, vor allem Erwerbungen aus dem Handel. Eine aktuelle Recherche betrifft die 1938 erworbenen Bücher des Dortmunder Rechtsanwalts Otto Elias, der sich schon kurz nach der NS-Machtübernahme das Leben nahm. Sein Exlibris ist der Anlass, sich mit einer frühen Verfolgungsgeschichte zu beschäftigen und den Weg seiner Bücher in die Bibliothek zu rekonstruieren.
Motivating in the Production-Oriented Approach: From Theory to Practice
Authors: Zhang Lingli 
Published: October 2020

AbstractMotivating is the most creative phase of the Production-Oriented Approach (POA), making it different from other teaching approaches from the outset. This study aims to introduce the theory of motivating and its application to College English teaching practice by adopting dialectal research (DR). First, it gives an overall introduction to motivating, including its function, steps, and categories. Then it demonstrates two rounds of motivating practice in teaching College English by using the POA-based textbook iEnglish. The first round of motivating practice mainly focuses on how to follow the three steps of motivating in a specific case, namely, the teacher providing scenarios, the students trying out the productive activity, and the teacher explaining the productive objectives. The second round attempts to apply the criteria of motivating effectiveness to practice, namely, authentic communication, cognitive challenges and appropriate productive objectives. Furthermore, the teaching effectiveness of the motivating practice is appraised by both the teacher’s and students’ retrospective evaluations. Finally, some suggestions for motivating design and future research are proposed.