bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Determinants of Health Improve Predictive Accuracy of Clinical Risk Models for Cardiovascular Hospitalization, Annual Cost, and Death
Authors: Hammond Gmerice , Johnston Kenton , Huang Kristine , Joynt Maddox Karen E. 
Published: May 2020

Background:
Risk models in the private insurance setting may systematically underpredict in the socially disadvantaged. In this study, we sought to determine whether US minority Medicare beneficiaries had disproportionately low costs compared with their clinical outcomes and whether adding social determinants of health (SDOH) into risk prediction models improves prediction accuracy.

Methods and Results:

Retrospective observational cohort study of 2016 to 2017 Medicare Current Beneficiary Survey data (n=3614) linked to Medicare fee-for-service claims. Logistic and linear regressions were used to determine the relationship between race/ethnicity and annual costs of care, all-cause hospitalization, cardiovascular hospitalization, and death. We calculated the observed-to-expected (O:E) ratios for all outcomes under 4 risk models: (1) age+sex, (2) model 1+clinical comorbidity adjustment, (3) model 2+SDOH, and (4) SDOH alone. Our sample was 44% male and 11% black or Hispanic. Among minorities, adverse clinical outcomes were inversely related to cost. After multivariable adjustment, blacks/Hispanics had higher rates of cardiovascular hospitalization (incidence rate ratio, 1.78;
P
=0.012) but similar annual costs ($−336,
P
=0.77) compared with whites. Among whites, models 1 to 4 all showed similar O:E ratios, suggesting high accuracy in risk prediction using current models. Among minorities, adjustment for age, sex, and comorbidities underpredicted all-cause hospitalization by 20% (O:E, 1.20) and cardiovascular hospitalization by 70% (O:E, 1.70) and overpredicted death by 21% (O:E, 0.79); adding SDOH brought O:E near 1 for all outcomes. Among both groups, the SDOH risk model alone performed with equal or superior accuracy to the model based on clinical comorbidities.

Conclusions:
A paradoxical relationship was observed between clinical outcomes and costs among racial and ethnic minorities. Because of systematic differences in access to care, cost may not be an appropriate surrogate for predicting clinical risk among vulnerable populations. Adjustment for SDOH improves the accuracy of risk models among racial and ethnic minorities and could guide use of prevention strategies.
Different Microcirculation Response Between Culprit and Non‐Culprit Vessels in Patients With Acute Coronary Syndrome
Authors: Jo Yoon‐Sung , Moon Hyeyeon , Park Kyungil 
Published: May 2020

Background
This study investigated whether the microvascular dysfunction differed between culprit and non‐culprit vessels in patients with acute coronary syndrome who underwent percutaneous coronary intervention.

Methods and Results

In 115 prospectively recruited patients, after successful percutaneous coronary intervention, culprit and non‐culprit intracoronary hemodynamic measurements were performed and repeated at 6‐month follow‐up.
13
N‐ammonia positron emission tomography was performed at 6‐month follow‐up visit to determine absolute myocardial blood flow. The resistance values of each vessel were calculated using the coronary pressure data and the myocardial blood flow values obtained from
13
N‐ammonia positron emission tomography data. We compared the measurements between culprit and non‐culprit vessels and assessed changes in microvascular dysfunction during the study period. In 334 vessels (115 culprit and 219 non‐culprit), the culprit vessel group showed a lower fractional flow reserve and coronary flow reserve than the non‐culprit vessel group at baseline and 6‐month follow‐up, respectively. The value of index of microcirculatory resistance was different between the 2 groups in the baseline but not at 6‐month follow‐up. The microvascular resistance at rest and hyperemic microvascular resistance were not different between the 2 groups, but resistance to stenosis was higher in the culprit vessel group, under both resting and hyperemic status (
P
=0.02 and
P
<0.01, respectively). In the culprit vessel analysis, the fractional flow reserve and index of microcirculatory resistance decreased whereas coronary flow reserve increased (
P
<0.01 for all) at 6‐month follow‐up. However, there was no change in index of microcirculatory resistance, coronary flow reserve, and fractional flow reserve from baseline to 6‐month follow‐up in the non‐culprit vessel analysis.

Conclusions
The observed microvascular dysfunction in acute coronary syndrome is limited to the culprit vessel territory in the acute phase, which is relatively recovered in the chronic phase and there is no out‐of‐culprit territory involvement.

Registration

URL:
https://www.clini​caltr​ials.gov
; Unique identifier: NCT04169516.
Increased Cardiometabolic and Mortality Risk Following Childhood Maltreatment in the United Kingdom
Authors: Chandan Joht Singh , Okoth Kelvin , Gokhale Krishna Margadhamane , Bandyopadhyay Siddhartha , Taylor Julie , Nirantharakumar Krishnarajah 
Published: May 2020

Background
Childhood maltreatment remains a significant public health issue associated with a number of poor health outcomes. This study explores the association between childhood maltreatment and the subsequent development of cardiometabolic disease and all‐cause mortality.

Methods and Results

Using a
UK
primary care database between January 1, 1995 and December 31, 2018, we conducted a population‐based open retrospective cohort study. We matched 80 657 adult patients with a historic recording of childhood maltreatment or maltreatment‐related concerns (exposed group) to 161 314 unexposed patients. Outcomes of interest were the development of cardiovascular disease, hypertension, type 2 diabetes mellitus, and risk of all‐cause mortality. During the study period there were 243 new diagnoses of cardiovascular disease (incidence rate 8.3 per 10 000 person‐years) in the exposed group compared with 254 in the unexposed group (incidence rate 4.6 per 10 000 person‐years). Following adjustment for key covariates, this translated to an adjusted incidence rate ratio of 1.71 (95%
CI
1.42–2.06). Additionally, the exposed group had an increased risk of hypertension (adjusted incidence rate ratio 1.42; 95%
CI
, 1.26–1.59), type 2 diabetes mellitus (adjusted incidence rate ratio 2.13; 95%
CI
, 1.86–2.45) and all‐cause mortality (adjusted incidence rate ratio 1.75; 95%
CI
, 1.52–2.02) during the study period compared with the unexposed group.

Conclusions
Considering the high prevalence of exposure to childhood maltreatment, we have demonstrated the substantial associated burden of preventable cardiometabolic disease. There is a clear need to ensure that public health approaches are implemented to prevent the adverse consequences following exposure to childhood maltreatment.
Development and Validation of a Porous Theory of Mind Scale
Authors: van Elk Michiel , Maij David , Rutjens Bastiaan 
Published: May 2020

Abstract
We report the results of an empirical investigation of the extent to which supernatural believers endorse a porous conception of the mind, i.e., the belief that one’s thoughts can be directly perceived by others. We developed a porous theory of mind (PToM) scale, tested its factor structure by using both exploratory and confirmatory factor analyses, and showed its relation with supernatural beliefs in three studies in the Netherlands and one study with North-American participants. We found that endorsement of a PToM is positively related to paranormal beliefs. We also showed that the endorsement of a porous view of the mind differs in meaningful ways between people from different religious backgrounds (i.e., Protestants vs. Catholics; spiritualists vs. religious believers). The finding that supernatural believers endorse a porous conception of the mind fits well with recent work in the field of the anthropology of religion and the psychology of paranormal beliefs. We propose that our PToM scale provides a parsimonious measurement tool (i.e., consisting only of 4 items) that circumvents socially desirable responding, while providing direct insight in the endorsement of paranormal beliefs.
Epistemic Vigilance and the Science/Religion Distinction
Authors: Talmont-Kaminski Konrad 
Published: May 2020

Abstract
Both science and religion are human endeavours that recruit and modify pre-existing human capacity to engage in epistemic vigilance. However, while science relies upon a focus on content vigilance, religion focusses on source vigilance. This difference is due, in turn, to the function of religious claims not being connected to their accuracy – unlike the function of scientific claims. Understanding this difference helps to understand many aspects of scientific and religious institutions.
Conflictual Identities: The State and Feminist Women in the Islamic Republic of Iran
Authors: Sedghi Hamideh 
Published: May 2020

Abstract
This study explores the tensions between the state and women’s efforts to construct an alternative vision of gender equality and feminism. The experiences of the One Million Signatures Campaign for the Repeal of Discriminatory Laws offer new perspectives on women’s struggles to carve out their own space and place in society. But how and why does the state construct and reproduce patriarchal norms and practices? Conversely, how do women, specifically feminists, address and engage the state in their attempts to form their own feminist rights and gender identities? Although it is important to understand that both the state and women draw on their own political and cultural preferences, I argue that constructing feminist identities is often an uphill battle, as women encounter resistance from the state that is not gender neutral and is patriarchal.
The Essence of Analogy: Conflict Termination and State-building Lessons from Bosnia-Herzegovina to Syria
Authors: Grgić Gorana 
Published: May 2020

Abstract
From the perspective of Bosnia-Herzegovina (BiH) today, the legacy of the Dayton Peace Agreement (DPA) remains mixed. The dominant view is that the DPA is the origin of its political impasse, economic stagnation, and failed nation-building. Yet, it is indisputable that DPA has been successful in preventing the recurrence of a major violent ethnic conflict in BiH. More recently, the failures of Syrian peace talks to yield a durable settlement have evoked the lessons from the DPA. However, most analyses have concluded the parallels with the Bosnian war and its resolution are misplaced given the complexity and severity of the war in Syria. This article argues for a more nuanced approach to distilling the Dayton legacy, particularly when it is employed as a historical analogy. It highlights the usefulness of the DPA as an analogy for successful conflict termination, while offering lessons about the pitfalls of externally imposed consociational arrangements.
In the Streets and at the Table: Civil Society Coordination during Peace Negotiations
Authors: Nilsson Desirée , Svensson Isak , Teixeira Barbara Magalhães , Lorenzo Luís Martínez , Ruus Anton 
Published: May 2020

Abstract
When bringing armed conflicts to a peaceful end, the inclusion of civil society in peacemaking is a vital task. However, whereas previous research on civil society inclusion has made significant advancements, surprisingly little attention has been paid to analyzing how civil resistance and mass action may interact with more elite-driven approaches during peace processes. This study addresses this research gap by examining the interplay between elite and mass-based civil society approaches in three different peace processes in civil wars in Africa in the post-Cold War period: Liberia, the Central African Republic (CAR), and Burundi. We advance the literature by developing a framework that focuses on coordination of these different efforts and we explore this interplay empirically. With this study, we aim to broaden the research agenda, allowing for future synergies at the research frontier of mass action and the inclusion of civil society in peace processes.
States as Drivers of Regionalization? Examining Negotiations in International Economic Organizations
Authors: Panke Diana 
Published: May 2020

Abstract
The political regulation of the economy takes place on domestic, regional and international levels. Often, states are members of regional and international organizations (ROs and IOs) with competencies in the economic realm. This study explores the effects of such overlaps in membership and policy focus, and examines negotiations in economic Ios. It studies the phenomenon of states being drivers of regionalization of international negotiations. This analysis reveals that states make a conscious choice to influence regionalization of international economic policies. States with strong export sectors and strong economies are more inclined to act on behalf of their RO in international economic negotiations. Apart from incentives, capacities also matter. States need to have domestic and diplomatic capacities to become active in Ios in the first place.
The Controversial Role of Litigation in the Struggle to Revive Individual Access to the Tribunal of the Southern African Development Community
Authors: de Wet Erika 
Published: May 2020

Abstract
The article examines four categories of litigation that were undertaken in the wake of the suspension of the sadc Tribunal. The first category of proceedings concerned a claim and request for an advisory opinion under the African Charter on Human and Peoples’ Rights (African Charter); the second related to arbitration proceedings based on the sadc Protocol on Finance and Investment (fip); the third focussed on proceedings regarding the potential unconstitutionality of a government’s participation in the suspension of the sadc Tribunal; while the fourth concerned conflicts between the sadc and employees before the Botswana High Court. In analysing these proceedings, the article assesses whether litigation thus far undertaken is likely to increase pressure on sadc member states to reinstate some form of individual complaints procedure before the sadc Tribunal.
Questioning the Conditional Visibility of the Chinese
Authors: Montt Strabucchi Maria , Chan Carol 
Published: May 2020

Abstract
Despite a long history of Chinese presence in Chile and the Americas, the Chinese tend to remain in a state of conditional visibility. Questioning the paradoxical ubiquity and invisibility of expressions of Chineseness in the physical and cultural landscape of Santiago, we examine cultural and discursive processes of (re)production that contribute to this scenario. Informed by understandings of identity and contextualized by the history of the Chinese presence in Chile, we consider the diverse ways in which Chinese people and Chineseness are portrayed on Chilean television and in films and theatre plays. We examine how these representations enable forms of subordination and silencing, and/or highlight the agency of Chinese persons. We show that while Chineseness and Chinese people are typically depicted as one-dimensional and incomprehensible, some productions visibilize and problematize such empty stereotypes. Finally, we demonstrate how these representations resignify Chineseness in a broader Latin American and global context.
Gazing into Their Hearts: On the Appearance of Kabbalistic Pietism in Thirteenth-century Castile
Authors: Brown Jeremy Phillip 
Published: May 2020

Abstract
The historiography of medieval Jewish pietism has duly described the development of new discourses of pietistic ethics in Judeo-Arabic, as well as the corpus of Hebrew pietistic and penitential literature composed by the Rhineland pietists. Scholars have long clung to the consensus that the contemporaneous appearance of Kabbalah did not give rise to a characteristic mode of penitential pietism of its own prior to early modern period. This article argues against that consensus. Evidence from Moses de León’s writings points to the conclusion that, already in thirteenth-century Castile, kabbalists sought to impart modes of supererogatory living in accord with their esoteric speculations. This article shows how de León constructed at least three different penitential programs based upon his Kabbalah. Focusing on the program of the “Unnamed Composition,” this article coordinates the appearance of kabbalistic pietism with a variety of historical factors, including the proliferation of Franciscan mendicants in medieval Castile.
Parameter Sensitivity of the WRF–LETKF System for Assimilation of Radar Observations: Imperfect-Model Observing System Simulation Experiments
Authors: Maldonado Paula , Ruiz Juan , Saulo Celeste 
Published: May 2020

AbstractSpecification of suitable initial conditions to accurately forecast high-impact weather events associated with intense thunderstorms still poses a significant challenge for convective-scale forecasting. Radar data assimilation has been showing encouraging results to produce an accurate estimate of the state of the atmosphere at the mesoscale, as it combines high-spatiotemporal-resolution observations with convection-permitting numerical weather prediction models. However, many open questions remain regarding the configuration of state-of-the-art data assimilation systems at the mesoscale and their potential impact upon short-range weather forecasts. In this work, several observing system simulation experiments of a mesoscale convective system were performed to assess the sensitivity of the local ensemble transform Kalman filter to both relaxation-to-prior spread (RTPS) inflation and horizontal localization of the error covariance matrix. Realistic large-scale forcing and model errors have been taken into account in the simulation of reflectivity and Doppler velocity observations. Overall, the most accurate analyses in terms of RMSE were produced with a relatively small horizontal localization cutoff radius (~3.6–7.3 km) and large RTPS inflation parameter (~0.9–0.95). Additionally, the impact of horizontal localization on short-range ensemble forecast was larger compared to inflation, almost doubling the lead times up to which the effect of using a more accurate state to initialize the forecast persisted.
The Importance of the Social Environment in Achieving High Levels of Physical Activity and Fruit and Vegetable Intake in African American Church Members
Authors: Heredia Natalia , Nguyen Nga , McNeill Lorna H. 
Published: May 2020

Purpose: African Americans experience a high burden of chronic diseases and cancers that are prevented and ameliorated with physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study is to identify individual, social, and neighborhood variables associated with African Americans attaining high levels of both behaviors. Design: This study is a cross-sectional analysis. Settings and Participants: Cohort of African Americans adults recruited from black churches in the Greater Houston area. Measures: Self-administered questionnaires collected in 2012 assessed correlates and behavioral outcome variables (PA and FV consumption). A combined 4-category behavioral outcome was created: high PA/high FV, low PA/high FV, high PA/low FV, and low PA/low FV. Analysis: Standard and stepwise multinomial logistic regression examined the association between the various variables and the behavioral outcome. Results: This sample (n = 1009) had a mean age of 49 years, was mostly female, and obese. Compared to the low PA/low FV intake group, the high PA/high FV intake group had significantly lower odds of individual-level variables (worrying about getting cancer, perceived stress, loneliness, and financial strain) and higher odds of social-level variables (social status, social cohesion, social organization involvement, and social norms). Only social-level variables remained significantly associated with higher odds of high PA/high FV intake in stepwise regression. Conclusion: These findings indicate that social influences may be most critical for high PA and FV intake in African Americans adults.
Prevalence and risk factors of herpes zoster infection in patients with biopsy proven lupus nephritis undergoing immunosuppressive therapies
Authors: Mok Chi Chiu , Tse Sau Mei , Chan Kar Li , Ho Ling Yin 
Published: May 2020

Objectives To study the prevalence of herpes zoster infection in patients with biopsy-confirmed lupus nephritis undergoing immunosuppressive therapies. Methods Patients who had histologically active lupus nephritis between 2004 and 2018 were retrospectively reviewed. Clinical and laboratory data at baseline and six months post-therapy were collected. The incidence of herpes zoster reactivation within two years of lupus nephritis treatment was calculated. Risk factors for herpes zoster reactivation were studied by logistic regression. Results Patients ( N = 251) with 311 episodes of lupus nephritis were studied (92% women; age 34.2 ± 14.2 years; histological classes III/IV ± V (69%)). Within two years of therapy, 55 (18%) episodes of lupus nephritis were complicated by herpes zoster infection (incidence 8.84/100 patient-years). Fourteen episodes (25%) of herpes zoster were treated by intravenous anti-viral drugs in hospital but disseminated disease or mortality was not reported. Significant post-herpetic neuralgia developed in 9% of the episodes. Patients with herpes zoster reactivation, compared with those without, were more likely to have first-time renal disease and a shorter systemic lupus erythematosus duration at lupus nephritis than those without. Disease activity, treatment response and other clinical/laboratory parameters were not significantly different between patients with and without herpes zoster reactivation. Herpes zoster-infected patients had been treated with a significantly higher dose of prednisolone as induction therapy. Logistic regression revealed that first-time renal disease, peak daily mycophenolate mofetil dose and cumulative cyclophosphamide dose during induction therapy were significantly associated with herpes zoster reactivation. Conclusions Herpes zoster reactivation is common in lupus nephritis patients but unpredictable from clinical parameters. Although adverse outcomes of herpes zoster infection are uncommon, using the minimally effective doses of mycophenolate mofetil and cyclophosphamide during induction therapy may help reduce the risk of herpes zoster infection.
Predicting Financial Health of Banks for Investor Guidance Using Machine Learning Algorithms
Authors: Viswanathan P. K. , Srinivasan Suresh , Hariharan N. 
Published: May 2020

While earlier studies have focused excessively on bankruptcy prediction of banks, this study classifies banks based on their financial strength from the perspective of retail depositors who currently do not have an authentic guiding framework that helps them identify banks with higher risk profiles. Using machine learning techniques, we classify 44 Indian banks into distinct categories of financial health based on 12-year data from 2005 to 2017. We first use unsupervised learning to identify a pattern leading to logical groups in terms of financial health and then move to supervised learning for prediction. Using linear discriminant analysis (LDA), Classification and Regression Tree (CART) and Random Forest methods, we predict the cluster membership with the associated explanatory power alongside. We also compare our classification with the credit ratings awarded by rating agencies and highlight certain discrepancies that exist between what is predicted by our models and the credit rating awards. JEL Codes: C53; M10