bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the WATCH‐DM and TRS‐HF
DM
Risk Scores to Predict the Risk of Incident Hospitalization for Heart Failure Among Adults With Type 2 Diabetes: A Multicohort Analysis
Authors: Segar Matthew W. , Patel Kershaw V. , Hellkamp Anne S. , Vaduganathan Muthiah , Lokhnygina Yuliya , Green Jennifer B. , Wan Siu‐Hin , Kolkailah Ahmed A. , Holman Rury R. , Peterson Eric D. , Kannan Vaishnavi , Willett Duwayne L. , McGuire Darren K. , Pandey Ambarish 
Published: June 2022

Background

The WATCH‐DM (weight [body mass index], age, hypertension, creatinine, high‐density lipoprotein cholesterol, diabetes control [fasting plasma glucose], ECG QRS duration, myocardial infarction, and coronary artery bypass grafting) and TRS‐HF
DM
(Thrombolysis in Myocardial Infarction [TIMI] risk score for heart failure in diabetes) risk scores were developed to predict risk of heart failure (HF) among individuals with type 2 diabetes. WATCH‐DM was developed to predict incident HF, whereas TRS‐HF
DM
predicts HF hospitalization among patients with and without a prior HF history. We evaluated the model performance of both scores to predict incident HF events among patients with type 2 diabetes and no history of HF hospitalization across different cohorts and clinical settings with varying baseline risk.

Methods and Results

Incident HF risk was estimated by the integer‐based WATCH‐DM and TRS‐HF
DM
scores in participants with type 2 diabetes free of baseline HF from 2 randomized clinical trials (TECOS [Trial Evaluating Cardiovascular Outcomes With Sitagliptin], N=12 028; and Look AHEAD [Look Action for Health in Diabetes] trial, N=4867). The integer‐based WATCH‐DM score was also validated in electronic health record data from a single large health care system (N=7475). Model discrimination was assessed by the Harrell concordance index and calibration by the Greenwood‐Nam‐D’Agostino statistic. HF incidence rate was 7.5, 3.9, and 4.1 per 1000 person‐years in the TECOS, Look AHEAD trial, and electronic health record cohorts, respectively. Integer‐based WATCH‐DM and TRS‐HF
DM
scores had similar discrimination and calibration for predicting 5‐year HF risk in the Look AHEAD trial cohort (concordance indexes=0.70; Greenwood‐Nam‐D’Agostino
P
>0.30 for both). Both scores had lower discrimination and underpredicted HF risk in the TECOS cohort (concordance indexes=0.65 and 0.66, respectively; Greenwood‐Nam‐D’Agostino
P
<0.001 for both). In the electronic health record cohort, the integer‐based WATCH‐DM score demonstrated a concordance index of 0.73 with adequate calibration (Greenwood‐Nam‐D’Agostino
P
=0.96). TRS‐HF
DM
score could not be validated in the electronic health record because of unavailability of data on urine albumin/creatinine ratio in most patients in the contemporary clinical practice.

Conclusions

The WATCH‐DM and TRS‐HF
DM
risk scores can discriminate risk of HF among intermediate‐risk populations with type 2 diabetes.
Hydrophilic Versus Lipophilic Statin Treatments in Patients With Renal Impairment After Acute Myocardial Infarction
Authors: Kang Min Hye , Kim Weon , Kim Jin Sug , Jeong Kyung Hwan , Jeong Myung Ho , Hwang Jin‐Yong , Hur Seung Ho , Hwang Hyeon Seok 
Published: June 2022

Background
Hydrophilic and lipophilic statins have similar efficacies in treating coronary artery disease. However, specific factors relevant to renal impairment and different arterial pathogeneses could modify the clinical effects of statin lipophilicity, and create differences in protective effects between statin types in patients with renal impairment.

Methods and Results

A total of 2062 patients with acute myocardial infarction with an estimated glomerular filtration rate <60 mL/min per 1.73 m
2
were enrolled from the Korea Acute Myocardial Infarction Registry between November 2011 and December 2015. The primary end point was a composite of 2‐year major adverse cardiac and cerebrovascular events (MACEs) after acute myocardial infarction occurrence. MACEs were defined as all‐cause death, recurrent myocardial infarction, revascularization, and stroke. Propensity‐score matching and Cox proportional hazards regression were performed. A total of 529 patients treated with hydrophilic statins were matched to 529 patients treated with lipophilic statins. There was no difference in the statin equivalent dose between the 2 statin groups. The cumulative event rate of MACEs, all‐cause mortality, and recurrent myocardial infarction were significantly lower in patients treated with hydrophilic statins in the propensity‐score matched population (all
P
<0.05). In the multivariable Cox regression analysis, patients treated with hydrophilic statins had a lower risk for composite MACEs (hazard ratio [HR], 0.70 [95% CI, 0.55–0.90]), all‐cause mortality (HR, 0.67 [95% CI, 0.49–0.93]), and recurrent myocardial infarction (HR, 0.40 [95% CI, 0.21–0.73]), but not for revascularization and ischemic stroke.

Conclusions
Hydrophilic statin treatment was associated with lower risk of MACEs and all‐cause mortality than lipophilic statin in a propensity‐score matched observational cohort of patients with renal impairment following acute myocardial infarction.
Machine Learning–Based Risk Model for Predicting Early Mortality After Surgery for Infective Endocarditis
Authors: Luo Li , Huang Sui‐qing , Liu Chuang , Liu Quan , Dong Shuohui , Yue Yuan , Liu Kai‐zheng , Huang Lin , Wang Shun‐jun , Li Hua‐yang , Zheng Shaoyi , Wu Zhong‐kai 
Published: June 2022

Background
The early mortality after surgery for infective endocarditis is high. Although risk models help identify patients at high risk, most current scoring systems are inaccurate or inconvenient. The objective of this study was to construct an accurate and easy‐to‐use prediction model to identify patients at high risk of early mortality after surgery for infective endocarditis.

Methods and Results

A total of 476 consecutive patients with infective endocarditis who underwent surgery at 2 centers were included. The development cohort consisted of 276 patients. Eight variables were selected from 89 potential predictors as input of the XGBoost model to train the prediction model, including platelet count, serum albumin, current heart failure, urine occult blood ≥(++), diastolic dysfunction, multiple valve involvement, tricuspid valve involvement, and vegetation >10 mm. The completed prediction model was tested in 2 separate cohorts for internal and external validation. The internal test cohort consisted of 125 patients independent of the development cohort, and the external test cohort consisted of 75 patients from another center. In the internal test cohort, the area under the curve was 0.813 (95% CI, 0.670–0.933) and in the external test cohort the area under the curve was 0.812 (95% CI, 0.606–0.956). The area under the curve was significantly higher than that of other ensemble learning models, logistic regression model, and European System for Cardiac Operative Risk Evaluation II (all,
P
<0.01). This model was used to develop an online, open‐access calculator (
http://42.240.140.58:1808/
).

Conclusions
We constructed and validated an accurate and robust machine learning–based risk model to predict early mortality after surgery for infective endocarditis, which may help clinical decision‐making and improve outcomes.
Tracking Frank Stella: An Empirical Evaluation of Art-Historical Issues in an Eye-Movement and Questionnaire Study
Authors: De Winter Stefanie , Wagemans Johan 
Published: June 2022

Abstract
An eye-tracking and questionnaire study was set up in collaboration with the Van Abbemuseum (Eindhoven, The Netherlands) to investigate the perception and appreciation of three Frank Stella paintings from the 60s (Tuxedo Park and Effingham I from the collection of the museum and a hand-painted replica of Hiraqla Variation II). Effingham and Hiraqla were shown next to a printed copy without fluorescent colors, for a direct comparison between the two versions. The main purpose of the study was to assess whether the works were experienced according to Stella’s prescriptions as defined in his Modernist ‘logic’: all-overness, flatness, instantaneousness and self-referentiality. We found that the perception of Tuxedo resulted in a well-structured, coherent heatmap, while a more or less even distribution of fixations over the surface was found in the case of Effingham and Hiraqla (and their copies), which indicates that Stella’s target of all-overness was achieved better in the last two works. Although Stella claimed to have created “flat and frontal” paintings, depth was experienced, especially in Tuxedo and the Hiraqla replica. In the latter, this was mainly caused by the protruding fluorescent colors. Also, in this work more fixations were found in fluorescent-colored areas when corrected for area size. No such effect was found in the original Effingham painting. Most participants found only Effingham to be instantaneously capturable. In the case of Tuxedo, the specific material qualities, like alkyd and open canvas, were rarely recognized, which undermines Stella’s aim for self-referentiality. Participants noticed the fluorescent effect in the Hiraqla replica, but they did not mention other material qualities. A reverse effect was found for Effingham.
Is There a Need for an Update of the Theory of Deterrence? US Failure in North Korea
Authors: Kivimäki Timo 
Published: June 2022

Abstract
This article will answer why the United States failed in deterring North Korea from its development of nuclear weapons focusing on the basic logic of deterrence and identifying a historical deficiency. This is related to the failure to understand that in addition to the predictability of punishment, in case of unwanted behaviour of the target of deterrence, the non-punishment of non-aggressive action also needs to be made predictable. Focusing on this deficiency in the relationship of deterrence between the United States and North Korea, this article answers the question of why American deterrence has failed to prevent the emergence of North Korea as a de facto nuclear weapons power. The general proof of the failure of post-Cold War deterrence uses statistics of conflict, while the investigation of American deterrence vis-à-vis North Korea will use theory-guided process tracing based on evidence from declassified, primarily American, documents.
Investigating Extratropical Influence on the Equatorial Atlantic Zonal Bias with Regional Data Assimilation
Authors: Liu Tianying , Liu Zhengyu , Zhao Yuchu , Zhang Shaoqing 
Published: June 2022

Abstract
A reversal of zonal sea surface temperature (SST) gradient in the equatorial Atlantic is a common bias in climate models. Studies to investigate the origin of this bias mainly focused on the tropics itself. Applying the regional data assimilation method in the GFDL CM2.1 model, we investigate the combined and respective influences of the northern and southern extratropics on this bias. It is found that the reversed zonal SST gradient bias is caused to a considerable extent by the extratropical atmosphere, especially by the northern extratropics. This extratropical impact on the equator occurs mainly through influencing the Hadley circulation. Therefore, the ITCZ position in boreal spring in this model most likely determines the dominant role of northern extratropics in the spring equatorial westerly bias and additionally the zonal SST gradient bias. Due to the cold bias in the extratropical atmosphere, the northward shift of the ITCZ coupled with the increased meridional SST gradient caused by assimilating the northern extratropics strengthens the cross-equatorial southeasterly wind, thus correcting the spring equatorial westerly bias. The strengthened spring equatorial easterlies further steepen the thermocline slope and enhance the eastern upwelling, thus reproducing the summer cold tongue and finally improving the annual-mean zonal SST gradient bias.
Long-Term Survival of Patients After Total Pharyngolaryngoesophagectomy With Gastric Pull-Up Reconstruction for Hypopharyngeal or Laryngeal Cancer Invading Cervical Esophagus
Authors: Bich Tran Anh , Vuong Nguyen Lam , Cam Tu Nguyen Cong Huyen Ton Nu , Truong Tran Minh , Trung Lam Viet 
Published: June 2022

Objectives: Hypopharyngeal and laryngeal cancers are aggressive and usually diagnosed at advanced stage with esophagus invasion. Total pharyngolaryngoesophagectomy with gastric pull-up reconstruction has been a common surgery for these cancers but long-term outcomes are still questionable. This study aimed to investigate short-term and long-term outcomes of patients who underwent this surgery. Methods: Patients with hypopharyngeal or laryngeal cancer invading cervical esophagus who underwent total pharyngolaryngoesphagectomy with gastric pull-up between 2012 and 2016 was included and followed up until 2021. Short-term outcomes were complications and long-term outcomes were overall survival (OS) and disease-free survival (DFS). Results: Fifty patients were included with a mean age of 60.3 years and 94% were male. Pyriform fossa was the most common primary site of tumor (50%), followed by posterior hypopharyngeal wall (18%) and postcricoid region (18%). Mean operating time, postoperative oral intake and hospital stay was 363.1 ± 43.6 minutes, 8.8 ± 3.6 days and 14.2 ± 3.0 days respectively. Complications occurred in 15 patients (30%) without any in-hospital death. During the follow-up period, 17 patients had recurrence and 35 patients died. Median (95% confidence interval [CI]) OS and DFS time were 30 (21-37) and 30 (19-36) months. Five-year OS and DFS probability (95% CI) were 22.6% (12.8-39.7) and 22.7% (12.9-39.8). Conclusions: Total pharyngolaryngoesophagectomy with gastric pull-up is feasible and safe. However, even with curative surgery and multimodal treatment, advanced pharyngeal or laryngeal cancer with cervical esophagus invasion still has poor survival outcome.
Low Dose Betahistine in Combination With Selegiline Increases Cochlear Blood Flow in Guinea Pigs
Authors: Kloos Benedikt , Bertlich Mattis , Spiegel Jennifer L. , Freytag Saskia , Lauer Susanne K. , Canis Martin , Weiss Bernhard G. , Ihler Friedrich 
Published: June 2022

Objective: Betahistine is frequently used in the pharmacotherapy for Menière’s Disease (MD). Little is known about its mode of action and prescribed dosages vary. While betahistine had an increasing effect on cochlear microcirculation in earlier studies, low dose betahistine of 0.01 mg/kg bw or less was not able to effect this. Selegiline inhibits monoaminooxidase B and therefore potentially the breakdown of betahistine. The goal of this study was to examine whether the addition of selegiline to low dose betahistine leads to increased cochlear blood flow. Methods: Twelve Dunkin-Hartley guinea pigs were anesthetized, the cochlea was exposed and a window opened to the stria vascularis. Blood plasma was visualized by injecting fluoresceinisothiocyanate-dextrane and vessel diameter and erythrocyte velocity were evaluated over 20 minutes. One group received low dose betahistine (0.01 mg/kg bw) and selegiline (1 mg/kg bw) i.v. while the other group received only selegiline (1 mg/kg bw) and saline (0.9% NaCl) as placebo i.v. Results: Cochlear microcirculation increased significantly ( P < .001) in guinea pigs treated with low dose betahistine combined with selegiline by up to 58.3 ± 38.7% above baseline over a period of up to 11 minutes. In one guinea pig, the increase was 104.6%. Treatment with Selegiline alone did not affect microcirculation significantly. Conclusions: Low dose betahistine increased cochlear microcirculation significantly when combined with selegiline. This should be investigated in further studies regarding dose-effect relation in comparison to betahistine alone. Side effects, in particular regarding circulation, should be considered carefully in view of the clinical applicability of a combination therapy in patients with MD.
Functional and Esthetic Outcomes of L-Shaped Augmentation Rhinoplasty in Indonesian Noses
Authors: Widodo Dini Widiarni , Asmoro Satria Dipo Putra , Wardani Retno Sulistyo , Affandi Dewo Aksoro , Oriza Imelda Ika Dian 
Published: June 2022

Objectives: We investigated the satisfaction and nasal airway function of patients who underwent L-shaped augmentation rhinoplasty using rhinoplasty outcomes evaluation (ROE). Nasal obstruction was evaluated using the nasal obstruction symptom evaluation (NOSE) and peak nasal inspiratory flowmeter (PNIF) score. We explored the correlation between tip projection, ROE, NOSE, and PNIF scores. Methods: We conducted a pre-and post-experimental study of 16 adult Indonesian patients who underwent L-shaped augmentation rhinoplasty. We used the neurotic scale to rule out patients with body dysmorphic disorder (BDD), and patients with low-to-moderate neurotic scores were included as participants. Results: For all patients who underwent augmentation rhinoplasty, the median score of the NOSE questionnaire decreased from 12.5 to 5 after surgery ( P = .005). The ROE median satisfaction scores also increased from 7.00 to 14.00 postoperatively ( P = .001). The median PNIF preoperative score increased from 92 (70-130) to 115 (105-155) postoperatively. There was an increase in tip projection from 1.5 (1.1-2) preoperative to 2.05 (1.8-2.5) postoperative. There was a significant correlation between ∆ tip projection and ∆ NOSE ( P = .048), with a moderate correlation ( r = .502). However, there was no significant correlation between ∆ tip projection and ∆ PNIF ( P = .080) and ∆ ROE ( P = .302). Conclusion: The increase in ROE and PNIF, and the decrease in NOSE score after surgery revealed that the augmented L-shaped rhinoplasty technique has high satisfaction rates in both the nasal esthetics and functions of patients. The tip projection increment was proven to elevate nasal function subjectively in a certain range of tip height difference evaluated by the NOSE score.
Nutrient intake and adherence to the Nordic nutrition recommendations in a Swedish cohort with abdominal obesity
Authors: Sedin Åsa , Landin-Olsson Mona , Cloetens Lieselotte 
Published: June 2022

Background The Nordic Nutrition Recommendations (NNR) are developed to promote public health and to prevent food-related diseases such as obesity and cardiovascular diseases. Objective To investigate the nutrient intake and adherence to the NNR in a Swedish cohort with abdominal obesity. Design Dietary intake data were collected using 3-day food diaries and anthropometry and clinical chemistry parameters were measured at baseline of a long-term intervention studying weight-loss management. Results Eighty-seven subjects with abdominal obesity successfully completed a 3-day food diary. Twelve of these subjects were excluded for further analysis due to implausible low-energy reporting. The remaining 75 subjects (76% females) had mean age of 52.3 ± 10.1 years and a mean body mass index of 34.3 ± 3.1 kg/m2. Mean total fat intake (41.2 ± 7.0E%) was exceeded by 56% of the sample size compared to the maximum recommended intake (RI) of 40E%, whereas mean carbohydrate intake (40.4 ± 8.0E%) was lower than the RI (45–60E%). The intake of saturated fatty acids was high compared to the NNR with only 2 women and none of men reported intakes within the RI of <10 E%. Adherence to the RI for dietary fibre was very low (16.0% and 13.3% when expressed as g/d and g/MJ, respectively). Analyses of micronutrient intake showed lowest adherences for vitamin D and sodium. Conclusions The nutrient intake in our subjects compared to NNR was rather low with a high total fat intake, particularly too high intake of saturated fatty acids, high salt consumption, and very low dietary fibre and vitamin D intake. More effort is clearly needed to promote healthy dietary habits among subjects with obesity.
Face and content validity, acceptability, feasibility, and implementability of a novel outcome measure for children with life-limiting or life-threatening illness in three sub-Saharan African countries
Authors: Namisango Eve , Bristowe Katherine , Murtagh Fliss EM , Downing Julia , Powell Richard A , Atieno Mackuline , Abas Melanie , Ali Zipporah , Luyirika Emmanuel BK , Meiring Michelle , Mwangi-Powell Faith N , Higginson Irene J , Harding Richard 
Published: June 2022

Background: The Children’s Palliative Care Outcome Scale (C-POS) is the first measure developed for children with life-limiting and -threatening illness. It is essential to determine whether the measure addresses what matters to children, and if they can comprehend and respond to its items. Aim: To determine the face and content validity, comprehensiveness, comprehensibility, acceptability and feasibility, and implementability of the C-POS. Design: Mixed methods (1) Content validation: mapping C-POS items onto an evidence-based framework from prior evidence; (2) Comprehensiveness, comprehensibility, acceptability feasibility, and implementability: qualitative in-depth and cognitive interviews with a purposive sample of children and young people ( n = 6), family caregivers ( n = 16), and health workers ( n = 12) recruited from tertiary facilities in Kenya, South Africa, and Uganda. Results: (1) C-POS content mapped on to palliative care domains for (a) children (i.e. physical (e.g. symptoms), social (e.g. play/socialize), psychological (e.g. happy)) and (b) families (i.e. psychological (e.g. worry), social (e.g. information), and help and advice). (2) C-POS items were well understood by children and their caregivers, acceptable, and relevant. Completion time was a median of 10 min, patients/caregivers and health workers reported that using the C-POS improved their communication with children and young people. Methodological and content issues included: (i) conceptual gap in the spiritual/existential domain; (ii) further consideration of developmental, age-appropriate items in the social and psychological domains, and (iii) linguistic complexity and difficulty in proxy rating. Conclusion: C-POS items capture the core symptoms and concerns that matter to children and their families. C-POS is feasible, comprehensible, and acceptable for use in clinical settings; areas for further development and improvement are identified.
Measurement Invariance and Relationships Among School Connectedness, Cyberbullying, and Cybervictimization: A Comparison Among Canadian, Chinese, and Tanzanian Adolescents
Authors: Law Danielle M , Xiao Bowen , Onditi Hezron , Liu Junsheng , Xie Xiaolong , Shapka Jennifer 
Published: June 2022

The aim of the present study was to evaluate the measurement invariance of the School Connectedness Scale for Chinese, Canadian, and Tanzanian adolescents, and to explore the inter association between school connectedness and cyberbullying/cybervictimization. Participants included 3872 adolescents from urban settings in China ( N= 2053, M age=16.36 years, SD = 1.14 years; 44.6% boys), Canada ( N = 642, M age = 12.13 years, SD = 0.77 years; 50.1% boys), and Tanzania ( N = 1056 , M age=15.87 years, SD = 2.03 years; 52.8% boys). Adolescents self-reported their cybervictimization and cyberbullying experiences, as well as their perceived school connectedness. Multigroup Confirmatory Factor Analysis revealed an approximate measurement invariance of the scale across the three countries. Chinese students showed the lowest levels of school connectedness while Tanzanian students showed the highest. The findings of the multivariate multigroup regression analyses across the three countries revealed similar relationships between school connectedness and cyberbullying/cybervictimization, thus broadening our understanding of school connectedness and its relationship to cyberbullying/cybervictimization across these three different countries.