Relevant Criteria Research Articles

Towards More Equitable Urban Greening: A Framework for Monitoring and Evaluating Co-Governance

Urban greening has grown in significance in Europe and worldwide as a presumed “public good” initiative, delivering a range of benefits for human health and wellbeing. To redress inequalities in the distribution of such benefits, attention has turned to the potential of collaborative governance. Indicator-based frameworks have also begun to receive attention for their ability to monitor and evaluate not only the performance of greening interventions, but also the policies, practices, and norms that influence their planning and implementation, with a view to transforming governance arrangements. Extensive sets of indicators have been proposed in the literature; however, few studies have addressed the process of adapting monitoring frameworks to the limited resources and highly specific conditions of local government. We address this gap by providing an account of an early phase in developing and contextualising a framework to assess governance of urban greening in seven European cities. Following review of existing indicator sets and literature related to co-governing urban green space, we compiled a set of 126 indicators and clustered these according to normative principles underpinning successful co-governance. We then worked with city representatives to contextualise a subset of 80 indicators and link them to relevant objectives. We found that organising indicators according to principles and applying the criteria of relevance and feasibility was useful to make an abstract concept operational and to promote strategic thinking. However, we also found evidence of likely barriers to using indicators in practice, chief among them the limited agency of responsible staff, with implications for the potential to politicise indicators and thereby guide transformative change.

Association between the Composite Dietary Antioxidant Index and periodontitis in US adults: a cross-sectional analysis.

The pathogenesis of periodontitis may be related to host-mediated inflammatory and immune responses caused by accumulation of oral microbial plaque. Nutrients have anti-inflammatory and pro-inflammatory capabilities. Dietary intake of antioxidants and micronutrients is associated with the inflammatory burden of the diet. The Composite Dietary Antioxidant Index (CDAI) is a composite index for assessing the antioxidant properties of a diet and the relationship with periodontitis is unclear. The aim of this study was to investigate the relationship between periodontitis and CDAI. The study was a cross-sectional design and included 7471 participants from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 database. Participants were divided into experimental and control groups according to the relevant criteria, where the control group consisted of participants with no/mild periodontitis (including 3646 participants) and the experimental group consisted of participants with moderate/severe periodontitis (including 3825 participants). First, baseline characteristics 22 of the two groups of participants were compared. Weighted logistic regression analyses was used to explore the relationship between periodontitis and CDAI. And the linear relationship between the two was assessed using restricted cubic spline. Finally, subgroup analyses was used to assess model stability. Differences between the two groups of participants were statistically significant in age, gender, race, education, ratio of household income to poverty(PIR), body mass index(BMI), smoking status, drinking status, and prevalence of diabetes. CDAI, as a continuous variable, was not found to be significantly associated with periodontitis. The CDAI was converted to categorical variables according to quartile. In model1, participants in the second and third quartile groups had a lower risk of developing periodontitis compared with participants in the lowest quartile group(OR(95%CI):0.81(0.681,0.963),P=0.021;OR(95%CI):0.811(0.691,0. 951),P=0.014;respectively). In model2, participants in the second, third, and fourth quartile groups had a lower risk of developing periodontitis compared to the lowest quartile group(OR(95%CI):0.803(0.66,0.978),P=0.0349;OR(95%CI):0.753( 0.632, 0.897),P=0.0028;OR(95%CI):0.753(0.617,0.92),P=0.0083;respectively). There was a non-linear relationship between CDAI and periodontitis (p non-linearity = 0.0055), with the inflection point occurring at a CDAI equal to 0.6342. There is a nonlinear relationship 44 between CDAI and periodontitis in US adults. However, further prospective studies are still needed to validate our results.

Digital transformation of marketing: The case of Düzce province hotel businesses

Today, as in every field, digital transformation is experienced in marketing. This transformation changes the way businesses do business and provides various benefits. For this reason, examining the effects of digital marketing on hotel businesses, which play a vital role in the tourism sector, is crucial. In this context, the study aims to determine the level of use of digital marketing techniques of three-star and above hotel businesses in Düzce Province and the effect of digital marketing activities of these businesses on sales figures. The qualitative research method was applied in the study. The data related to the research were obtained through face-to-face interviews with the managers of 10 hotel businesses in Düzce that meet the relevant criteria. According to the research findings; some observe that hotel businesses operating in Düzce have limited digital marketing investments. However, it has been observed that hotel managers’ level of awareness of the potential of digital marketing is high. It has been determined that hotel businesses use social media and search engine marketing and that front-office personnel carry out digital marketing activities. It is also concluded that there is a positive and strong relationship between digital marketing activities and sales figures of hotel businesses.

The value of the reflective discussion in decision-making using multi-criteria decision analysis (MCDA): an example of determining the value contribution of tabelecleucel for the treatment of the Epstein Barr virus-positive post-transplant lymphoproliferative disease (EBV+ PTLD)

BackgroundThe aim of this study was to assess the contribution of the reflective multidisciplinary discussion in determining the value contribution of innovative drugs through the multi-criteria decision analysis (MCDA). This methodology considers all relevant criteria for healthcare decision-making in a global, transparent, and systematic manner and from the perspective of relevant stakeholders. The determination of value contribution of tabelecleucel for the treatment of Epstein-Barr virus-positive post-transplant lymphoproliferative disease (EBV+ PTLD) compared to salvage therapy was used as an example.ResultsTabelecleucel obtained a value contribution score of 0.63 and increased to 0.75 after the reflective discussion. EBV+ PTLD was considered a life-threatening disease (5.0 ± 0.0), with a significant unmet need for an approved treatment (5.0 ± 0.0). Tabelecleucel was perceived as bringing improvements in terms of efficacy (4.2 ± 0.8) and safety (3.8 ± 0.8) compared to the salvage therapy. Most experts considered that the high efficacy and safety results could represent an improvement in the quality of life of patients (2.3 ± 1.2) along with savings in medical costs (2.3 ± 2.0) and non-medical costs (2.7 ± 1.6) compared to the salvage therapy. However, others emphasized the need of more evidence to confirm these improvements and savings over time. Tabelecleucel was regarded as potentially modifying the clinical course of the disease (4.3 ± 0.8) and supported by high-quality evidence (3.2 ± 0.4). All contextual criteria were valued highly positively for tabelecleucel. "Safety/Tolerability" and "Other medical costs" were the criteria that experienced the highest change in the re-test conducted after the reflective discussion. The reflective discussion allowed resolving doubts or misinterpretations of the experts, so the re-test obtained more accurate and consistent results of the value contribution of tabelecleucel.ConclusionsThe study shows that the MCDA methodology is a useful tool for decision-making on innovative treatments for the management of rare diseases. It also highlights the importance of reflective multidisciplinary discussion for its ability to resolve doubts or misinterpretations of experts, subsequently allowing to obtain more consistent and reliable results on the value contribution of the drug, being potentially more positive.

Social face processing in chronic severe traumatic brain injury: Altered decoding of emotions and mental states but preserved gaze cueing of attention

The processing of social information transmitted by facial stimuli is altered in individuals with traumatic brain injury (TBI). This study investigated whether these alterations also affect the mechanisms underlying the orienting of visual attention in response to eye-gaze signals. TBI patients and a control group of healthy individuals matched on relevant criteria completed a spatial cueing task. In this task, a lateral visual target was presented along with a task-irrelevant face, with the gaze averted to the left or right. Arrows pointing towards the left or right were also used as non-social control stimuli. Social cognition abilities were further investigated through tests based on decoding emotional expressions and mental states conveyed by facial stimuli. The decoding of emotions and mental states was worse in the TBI group than in the control group. However, both groups demonstrated reliable and comparable orienting of attention to both eye-gaze and arrow stimuli. Despite impairments in certain aspects of social face processing among TBI patients, gaze cueing of attention appears to be preserved in this neuropsychological population.

Evidence-based recommendations for gene-specific ACMG/AMP variant classification from the ClinGen ENIGMA BRCA1 and BRCA2 Variant Curation Expert Panel

The ENIGMA research consortium develops and applies methods to determine clinical significance of variants in hereditary breast and ovarian cancer genes. An ENIGMA BRCA1/2 classification sub-group, formed in 2015 as a ClinGen external expert panel, evolved into a ClinGen internal Variant Curation Expert Panel (VCEP) to align with Food and Drug Administration recognized processes for ClinVar contributions. The VCEP reviewed American College of Medical Genetics and Genomics/Association of Molecular Pathology (ACMG/AMP) classification criteria for relevance to interpreting BRCA1 and BRCA2 variants. Statistical methods were used to calibrate evidence strength for different data types. Pilot specifications were tested on 40 variants and documentation revised for clarity and ease of use. The original criterion descriptions for 13 evidence codes were considered non-applicable or overlapping with other criteria. Scenario of use was extended or re-purposed for eight codes. Extensive analysis and/or data review informed specification descriptions and weights for all codes. Specifications were applied to pilot variants with pre-existing ClinVar classification as follows: 13 uncertain significance or conflicting, 14 pathogenic and/or likely pathogenic, and 13 benign and/or likely benign. Review resolved classification for 11/13 uncertain significance or conflicting variants and retained or improved confidence in classification for the remaining variants. Alignment of pre-existing ENIGMA research classification processes with ACMG/AMP classification guidelines highlighted several gaps in the research processes and the baseline ACMG/AMP criteria. Calibration of evidence strength was key to justify utility and strength of different data types for gene-specific application. The gene-specific criteria demonstrated value for improving ACMG/AMP-aligned classification of BRCA1 and BRCA2 variants.

How interdisciplinary is it? A new method for quantifying interdisciplinarity in student teams & examination of a large project-based program

ABSTRACT The European Higher Education Area and the US National Academies of Science, Engineering, and Medicine have called on higher education to support interdisciplinary learning. The National Academies recommend evaluating interdisciplinary education against relevant criteria, but beyond listing student majors, institutions cannot easily quantify interdisciplinarity in education. The Rao-Stirling diversity index, which incorporates measures of cognitive distance, is used to quantify the interdisciplinarity of research. This study extends the use of the Rao-Stirling diversity index to the context of higher education to: (1) determine whether it provides a more nuanced measure of interdisciplinarity than number of majors, and (2) to examine patterns in interdisciplinarity across 79 student teams in Georgia Tech’s Vertically Integrated Projects Program (N = 1218). The analysis employed cognitive distances developed in a previous study. Distributions of diversity indexes and enrollment by major were examined across the program, along with visualizations for 4 teams. Results show the Rao-Stirling diversity index provided a more comprehensive measure of team interdisciplinarity, and it indicated higher interdisciplinarity in more teams and in comparatively smaller teams than the number of majors would imply. Indexes across the program were examined graphically and explored through regression. Results indicated that higher interdisciplinarity was associated with smaller team size, implying a possible need for additional support for these teams. The utility of the index in quantifying the interdisciplinarity of teams and in revealing a previously unknown pattern confirm its usefulness within the context of higher education. Limitations, implications for research and practice, and future directions are discussed.

Life cycle assessment and multi-criteria decision-making for sustainable building parts: criteria, methods, and application

PurposeSustainable building design relies heavily on building parts, with crucial consideration for climate and environmental impact. Due to numerous criteria and diverse alternatives, employing multi-criteria decision-making (MCDM) to choose the best alternative is essential. Yet, relevant criteria and suitable MCDM methods for life cycle-based building planning still need to be determined. This study highlights prevalent environmental criteria and offers guidance on MCDM approaches for sustainable building parts.MethodsThis study introduces an innovative approach by integrating life cycle assessment and MCDM. This provides comprehensive decision support for planners. A systematic literature review identifies environmental criteria for building parts and is validated in expert workshops. Thus, the relevance of criteria across the building life cycle is established. Furthermore, the study analyzes MCDM approaches in the built environment. From this, the study employs and evaluates the Analytical Network Process (ANP) and Analytical Hierarchy Process (AHP) in a case study. Thereby, it offers insights into effective decision-making methodologies for sustainable building practices.ResultsThis research categorizes environmental criteria for building parts and buildings into emissions, energy, resources, and circularity. Among 26 building part-related criteria, the global warming potential is highlighted. While the AHP is widely used in MCDM, a standardized method in planning processes is yet to emerge. Applying the ANP and AHP reveals similar rankings for the best and worst alternatives in a case study focused on selecting the optimal ceiling structure. Ribbed or box slab ceiling constructions are favored over reinforced concrete and composite timber-concrete constructions.ConclusionsThis study presents a novel method for life cycle-based MCDM challenges, identifying key environmental criteria. While material correlations exist, evaluating building parts demands simultaneous consideration of multiple criteria. Future research aims to compare further MCDM methods regarding their applicability, transparency, and ranking to enhance decision-making in sustainable construction. These investigations are essential for refining decision-making processes in the built environment, ensuring effective and transparent sustainability planning approaches.

Enhancing building robustness through a fuse-based segmentation framework

The most widely used design approaches today for improving the robustness of buildings rely on improving continuity within the structural system to ensure that loads supported by failed components can be redistributed to the rest of the system. Although this is effective for small initial failures, it can increase the risk of disproportionate collapse after larger initial failures due to collapsing elements pulling down parts of the structure that would otherwise be unaffected. This form of continuity-enabled collapse propagation can be avoided by dividing a structure into different segments. However, completely separating parts of a building results in lower performance under operational conditions, against lateral loads, and after small initial failures. In fact, the advantages of both continuity and segmentation can be combined through a fuse-based segmentation approach in which predefined segment borders ensure connectivity after small initial failures but separate to isolate collapse after larger initial failures. To ensure that this approach is used effectively to improve the robustness of building structures, a design framework is proposed in this article to systematically consider relevant structural and geometric criteria in order to define suitable segmentation configurations for reinforced concrete and steel framed building structures. An application to a realistic case study is also presented to demonstrate the effectiveness of the proposed framework in enhancing structural robustness.

Assessing the integration of refugee health data into national health information systems in Jordan, Lebanon, and Uganda

BackgroundWith the increasing number of protracted refugee crises globally, it is essential to ensure strong national health information systems (HIS) in displacement settings that include refugee-sensitive data and disaggregation by refugee status. This multi-country study aims to assess the degree of integration of refugee health data into national HIS in Jordan, Lebanon, and Uganda and identify the strengths and weaknesses of their national HIS in terms of collecting and reporting on refugee-related health indicators.MethodsThe study employs a comparative country analysis approach using a three-phase framework. The first phase involved reviewing 4120 indicators compiled from global health organizations, followed by a multi-stage refinement process, resulting in 45 indicators distributed across five themes. The second phase consisted of selecting relevant criteria from the literature, including data sources, annual reporting, disaggregation by refugee status, refugee population adjustments, accuracy, and consistency. The third phase involved assessing data availability and quality of the selected indicators against these criteria.ResultsOur analysis uncovered significant challenges in assessing the health status of refugees in Jordan, Lebanon, and Uganda, primarily stemming from limitations in the available health data and indicators. Specifically, we identified significant issues including incomplete local data collection with reliance on international data sources, fragmented data collection from various entities leading to discrepancies, and a lack of distinction between refugees and host populations in most indicators. These limitations hinder accurate comparisons and analyses. In light of these findings, a set of actionable recommendations was proposed to guide policymakers in the three countries to improve the integration of refugee health data into their national HIS ultimately enhancing refugees’ well-being and access to healthcare services.ConclusionThe current status of refugee-related health data in Jordan, Lebanon, and Uganda indicates the need for improved data collection and reporting practices, disaggregation by refugee status and better integration of refugee health data into national HIS to capture the health status and needs of refugees in host countries. Key improvement strategies include establishing a centralized authority for consistent and efficient data management, fostering transparent and inclusive data governance, and strengthening workforce capacity to manage refugee health data effectively.

AI in the newsroom: a collective case study about newsworker-AI collaboration in the German newspaper industry

ABSTRACT The adoption of AI in newsrooms can fundamentally change journalistic processes. Nowadays, AI is increasingly able to fulfil journalistic tasks, evolving the roles and interaction of newsworkers and AI. Given its high impact, the question arises how AI and newsworkers can collaborate productively in the newsroom to maintain or even improve journalistic quality. This study analyses newsworker-AI collaboration at four German newspaper publishers through the lens of Human-Machine Communication (HMC). Based on the data, a model for the evaluation of newsworker-AI collaboration is developed and validated. The results show that the interaction intensity between newsworkers and AI as well as the creation of knowledge in the newsroom can be identified as relevant evaluation criteria for newsworker-AI collaboration.

Democratic Regression in Brazil under the Bolsonaro Presidency

In this paper we analysed the quality of democracy during the presidency of Brazilian President Jair Bolsonaro between 2018 and 2022. Our research question was whether an erosion of democracy, or more precisely a reduction of the quality of Brazilian’s democracy, took place during that time or not. To answer these questions, we used relevant democracy criteria as analytical tools. Methodologically, this study we conducted a thorough literature review and an expert interview with a Brazilian social scientist. As a result, we concluded that based on the findings in the fields of vertical accountability, political rights, civil liberties, and horizontal accountability there was indeed a decline of democratic quality during Bolsonaro’s presidency.

The Introduction of a New Shareholder Dispute Resolution System in the Netherlands

The Dutch Parliament has recently made some radical changes in the system to regulate shareholder disputes in the Netherlands. The current system is flawed and underused. Shareholder disputes are mainly solved through an expensive bypass via the so-called inquiry-procedure at the Enterprise Chamber (EC). In the new system, the EC will be the only competent court for shareholder disputes. The relevant criteria are clarified and expanded. The procedure will be less formal and the EC can decide on related claims too. As a result, the new system aims to facilitate a swift settlement of all claims and conflicts between the parties involved in a shareholder dispute. A comparison with the highly used and popular Belgian system shows that there are some interesting differences. This article concludes by predicting that the new Dutch dispute regulation will be heavily used and will make the inquiry-procedure superfluous.

CEO Preferences in Forming TMTs: Criteria Relevance, Trade-offs and Impact of Organizational Factors

CEO Preferences in Forming TMTs: Criteria Relevance, Trade-offs and Impact of Organizational Factors

Favipiravir pharmacokinetics in COVID-19 patients with moderate to severe kidney dysfunction: Lessons learned.

There is limited information on favipiravir pharmacokinetics in critically ill patients and no studies on pharmacokinetics in patients with moderate and severe kidney dysfunction. The aim was to determine favipiravir pharmacokinetics (oral, 1,600 mg, q12h on day 1, then 600 mg, q12h for 4 days) in critically ill COVID-19 patients with kidney dysfunction and to compare those with observations reported in healthy adults. In a descriptive study, blood samples taken from patients meeting the relevant criteria (estimated glomerular filtration rate <60mL/min) were collected and analyzed. Analysis of blood samples was done by high performance liquid chromatography (HPLC), and the maximal concentration (Cmax), the time of maximal concentration (tmax), half-life (T1/2) and area under the curve (AUC0-12h) of favipiravir were calculated (WinNonlin) and compared to reported data in healthy subjects after first administration. Based on analysis of samples collected in 7 patients, the Cmax (29.99 vs. 64.5 µg/mL) of favipiravir was decreased, T1/2 (5.8 vs. 4.8 hours) longer, tmax delayed, while total exposure was lower (AUC0-12: 192.53 vs. 446.09 μg/mL) compared to reported data in healthy subjects after first administration. Exposure remained lower up to day 5. In patients with kidney dysfunction related to COVID-19, favipiravir did not reach the expected exposure. This may be due to poorer and delayed absorption, and subsequent altered disposition. Population pharmacokinetic and mechanistic studies are needed to better explore the relevant covariates and to determine the optimal dose in these patients, as this drug is likely of relevance for other indications.

Locating triarchic model constructs in the hierarchical structure of a comprehensive trait-based psychopathy measure: Implications for research and clinical assessment.

The triarchic model posits that distinct trait constructs of boldness, meanness, and disinhibition underlie psychopathy. The triarchic model traits are conceptualized as biobehavioral dimensions that can be assessed using different sets of indicators from alternative measurement modalities; as such, the triarchic model would hypothesize that these traits are not confined to any one item set. The present study tested whether the triarchic model dimensions would emerge from a hierarchical-structural analysis of the facet scales of the Elemental Psychopathy Assessment (EPA), an inventory designed to comprehensively index psychopathy according to the five-factor personality model. Study participants (Ns = 811, 170) completed the EPA and three different scale sets assessing the triarchic traits along with criterion measures of antisocial/externalizing behaviors. Bass-ackwards modeling of the EPA facet scales revealed a four-level structure, with factors at the third level appearing similar to the triarchic trait dimensions. An analysis in which scores for the Level-3 EPA factors were regressed onto corresponding latent-trait dimensions defined using the different triarchic scale sets revealed extremely high convergence (βs = .84-.91). The Level-3 EPA factors also evidenced validity in relation to relevant criteria, approximating and sometimes exceeding that evident for the Level-4 EPA factors. Together, these results indicate that the triarchic trait constructs are embedded in a psychopathy inventory designed to align with a general personality model and effectively predict pertinent external criteria. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Decision Support System for Determining the Best School Extracurricular Activities by Combining the ROC and MAUT Methods

The various extracurricular activities at school make students confused and difficult to choose which extracurricular activities are more suitable for participation. However, sometimes there are also students choosing extracurricular activities based on many of their friends. Therefore, determining the best school extracurricular activities is the best solution for students as a reference to find which is the best extracurricular activity. The criteria used in this study in choosing the best extracurricular activities are Regional Event Activities, Allocation, Creativity and Talent Channeling. By utilizing SPK, decision makers can make more systematic decisions, based on a deeper understanding of the various alternatives available and relevant criteria. SPK or decision support system is a technique that has the ability to determine a decision using a technical design based on alternatives and predetermined criteria. SPK or decision support system is a technique that has the ability to determine a decision using a technical design based on alternatives and predetermined criteria. In the context of extracurricular school selection, combining the ROC (Rank Order Centroid) and MAUT (Multi-Attribute Utility Theory) methods in a Decision Support System is an interesting approach. The ROC method is used to cluster and rank schools based on certain criteria, while MAUT helps in the calculation of appropriate weights for these criteria. By integrating these two methods, the SPK can provide a more structured guideline in the selection of extracurricular activities that suit students' interests and needs. The research results obtained show that the Futsal alternative is the first recommendation as the best extracurricular with a final value of 0.655086.

Understanding bank lending and its relationship with profitability and non-performing loans: a meta-analysis

PurposeThis study is a meta-analysis of the relationship between bank lending, profitability and non-performing loans (NPLs), and the purpose is to identify a research gap in studying this very crucial triad.Design/methodology/approachFirstly, relevant keywords are used to pull the studies from the Scopus and Web of Science (WoS) databases. The initial result is then narrowed down using relevant search criteria by manually filtering the studies based on the title and abstracts, out of which meta-analysis has been done of the findings of the top 200 papers (citation-based).FindingsThe literature in this field of study indicates heterogeneous results for relationships between bank lending and NPLs, bank lending and profitability and also NPLs and profitability. The meta-analysis of the results also reveals that the behaviour of these variables shows heterogeneity, which, based on the literature review, can be attributed to the different economic conditions during the study period and thus indicates nonlinearity in the behaviour of these variables.Originality/valueThis review explores the interrelationship of three variables, as they are very important to strike a proper balance between growth and safety in the banking industry, but the same has been inadequately researched in past studies.

Vendor Selection in the Cosmetic Industry using Analytics Hierarchy Process (A Case Study of Saejiva Company)

The Indonesian fragrance industry, under the cosmetic industry, is growing, with an increasing income per capita in the perfume category, despite a dip in 2020. The global natural fragrance market, growing at an estimated 9% CAGR from 2023 to 2032, shows a strong preference for essential oil-based fragrances. Essential oils, derived from natural plant parts, are costly to produce due to large-scale machinery, skilled labor, and environmental factors. Companies often outsource these aspects to reduce costs and focus on core competencies like marketing and sales. Saejiva, a natural fragrance brand, currently faces challenges in vendor selection, experiencing issues with inefficiency, delays, and poor product quality from previous vendors, has the effect of reducing potential profits and necessitating a reevaluation of their vendor choices. This study uses the Analytical Hierarchy Process (AHP) to help Saejiva select a new vendor by prioritizing criteria that meet the company’s requirements and recommending the best vendor. Data was collected through literature reviews to identify relevant criteria, Focus Group Discussions (FGD) to find essential criteria for the company, and AHP questionnaires. Saejiva’s C-level executives acted as experts in the FGDs and AHP questionnaires to determine criteria priorities and vendor alternatives. The results showed the importance levels of criteria as follows: capability (0.3668), quality (0.1848), cost (0.1382), service (0.1068), capacity (0.0654), delivery (0.0606), warranty (0.0525), and performance history (0.0249). The importance levels of vendor alternatives were SKI (3.1994), AVF (2.7415), and SHB (2.0591). Thus, the best vendor recommended for Saejiva is SKI as the next vendor.

Rates and predictors of cardiovascular and non-cardiovascular outcomes in heart failure with preserved ejection fraction.

The detailed sub-categories of death and hospitalization, and the impact of comorbidities on cause-specific outcomes, remain poorly understood in heart failure (HF) with preserved ejection fraction (HFpEF). We sought to evaluate rates and predictors of cardiovascular (CV) and non-CV outcomes in HFpEF. The Karolinska-Rennes study was a bi-national prospective observational study designed to characterize HFpEF (ejection fraction ≥45%). Patients were followed for cause-specific death and hospitalization. Baseline characteristics were pre-selected based on clinical relevance and potential eligibility criteria for HFpEF trials. The associations between characteristics and cause-specific outcomes were assessed with univariable and multivariable Cox regressions. Five hundred thirty-nine patients [56% females; median (inter-quartile range) age 79 (72-84) years; NT-proBNP/BNP 2448 (1290-4790)/429 (229-805) ng/L] were included. Over 1196 patient-years follow-up [median (min, max) 744days (13-1959)], there were 159 (29%) deaths (13 per 100 patient-years: CV 5.1 per 100, dominated by HF 3.9 per 100; and non-CV 5.8 per 100, dominated by cancer, 2.3 per 100). There were 723 hospitalizations in 338 patients (63%; 60 per 100 patient-years: CV 33 per 100, dominated by HF 17 per 100; and non-CV 27 per 100, dominated by lung disease 5 per 100). Higher age and natriuretic peptides, lower serum natraemia and NYHA class III-IV were independent predictors of CV death; lower serum natraemia, anaemia and stroke of non-CV death; and anaemia and lower serum natraemia of non-CV death or hospitalizations. There were no apparent predictors of CV death or hospitalization. In a clinical cohort hospitalized and diagnosed with HFpEF, death and hospitalization rates were roughly similar for CV and non-CV causes. CV deaths were predicted primarily by severity of HF; non-CV deaths primarily by anaemia and prior stroke. Lower serum sodium predicted both. Hospitalizations were difficult to predict.