bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 4131737: Atherosclerotic Cardiovascular Disease Risk Management in a Primary Care Residency Clinic
Authors: Manalo Kathryn , Tieliwaerdi Xiarepati , Jackson Megan , Arrigo Alexis , Mascara Mariah , Maharjan Srijana , Gadani Mrudula 
Published: November 2024

The 2018 AHA/ACC Multisociety Guideline on the Management of Blood Cholesterol recommends to target an LDL-C <70mg/dL in very high risk ASCVD patients. If the patient is on maximally tolerated statin therapy and LDL-C remained >70mg/dL, addition of ezetimibe was recommended. If LDL continued to be elevated, the addition of PCSK9 inhibitor was discussed. In 2019, the European Atherosclerosis Society recommended lowering the target LDL-C goal to <55mg/dL in patients with very high ASCVD risk. This is based on prior studies demonstrating dose-dependent reduction in ASCVD with LDL-C reduction. The purpose of this study is to identify individuals at very high ASCVD risk and determine if they are on optimal medical therapy to achieve LDL <55mg/dL with the intention to improve atheroscloertic cardiovascular risk management in primary care residency clinics.
A review of electronic medical records from a primary care residency clinic was performed. Patients with hyperlipidemia and prior ASCVD event were identified. Additional data including lipid panel and current medical management were collected. Patients were stratified into very high risk and not very high risk groups according to AHA classification and analyzed.
A total of 1,727 patients were found to have hyperlipidemia and a prior ASCVD event. The not very high risk group had an average age of 51 years with 54% (n=40) females and 45.9% (n=34) males. The very high risk group contained 95.7% (n=1,653) patients. The average age in the very high risk group was 68 years with 53.2% (n=879) of patients being female and 46.8% (n=774) being males. Of those patients, 73.6% (n=1,216) had an LDL ≥ 55 mg/dL. In these patients, 563 were on high intensity statin, 163 on moderate intensity statin and 15 on low intensity statin. There were 475 patients not on any statin. Of those on statin therapy, 66 were on ezetimibe alone and 10 were on both ezetimibe and PCSK9 inhibitors.
Over 95% of patients with a prior ASCVD event were identified as being very high risk. Our data demonstrates that 3 in 4 patients were not on optimal medical therapy based on a stricter LDL goal. There was poor escalation of medical therapy as not all patients were on high intensity statin and only 10% of patients were on ezetimibe while even fewer patients were on additional PCSK9 inhibitor therapy. This study highlights the importance of risk stratification and vigilance in optimizing medical therapy.
Abstract 4134417: Cardiotoxicity Conundrum: Distinguishing Immune Checkpoint Inhibitor Myocarditis from Fluorouracil Cardiotoxicity in Concurrent Therapy
Authors: Hu Vivian , Naidu Ishan , Singh Nausheen , Akinmolayemi Oludamilola , SAHNI GAGAN 
Published: November 2024

Case Description:
The patient is a 37-year-old male with metastatic gastroesophageal junction adenocarcinoma presenting with chest pain and dyspnea two days after initiation of leucovorin, fluorouracil, oxaliplatin (FOLFOX), and nivolumab therapy. He was tachycardic and hypotensive with elevated cardiac biomarkers and globally reduced left ventricular systolic function. Suspecting immune checkpoint inhibitor (ICI) myocarditis versus fluorouracil (5-FU) cardiotoxicity, he was treated simultaneously for both.

After starting high-dose steroids and before uridine triacetate, he had improved symptoms, cardiac function, biomarkers, and invasive hemodynamics. Though his endomyocardial biopsy did not show inflammatory cell infiltrates, his CMR demonstrated increased T1 and T2 relaxation times consistent with myocarditis. Testing revealed normal dihydropyrimidine dehydrogenase (DPD) activity. He completed uridine triacetate and was discharged on a steroid taper. At follow-up, he remained clinically stable, tolerating oxaliplatin and docetaxel (FLOT) initiation and nivolumab rechallenge without 5-FU.

Discussion:
This case is challenging as the presentation does not conclusively identify a causative agent. The patient’s symptom severity suggests ICI myocarditis, while the early onset points to 5-FU cardiotoxicity. His quick recovery of cardiac function after medication cessation suggests 5-FU-associated Takotsubo cardiomyopathy. His improvement after steroids raises concern for an adverse immunologic response as in ICI myocarditis or idiosyncratic reactions to oxaliplatin with 5-FU.

This patient received ICI therapy and chemotherapy, increasing his risk for cardiac immune-related adverse events. His protracted 5-FU infusion increased his risk for 5-FU cardiotoxicity, but his normal DPD activity mitigates this risk. Although his biopsy was negative, it cannot exclude ICI myocarditis. By the IC-OS 2021 consensus, he meets the criteria for ICI myocarditis presenting 48 hours after nivolumab exposure with cardiogenic shock, elevated cardiac biomarkers, decline in cardiac function, and CMR with elevated T1 and T2 relaxation times. Yet, his biomarkers remained normal with nivolumab rechallenge, arguing against ICI myocarditis and suggesting 5-FU as the culprit.
Early recognition and differentiation of the culprit in concurrent therapies impact management and future treatment options. Rechallenge carries risk and requires interdisciplinary collaboration to ensure patient safety.
Abstract 4136516: Intraventricular pseudoaneurysm: A diagnosis with high mortality that demands a good eye
Authors: Beauti Wisam , Biondi Nicholas , Nabavizadeh Pooneh , hong michael , Hitchins Janki , Pisati Maanas , Dovtchinova-Crowly Anissiia 
Published: November 2024

Traumatic left ventricular (LV) pseudoaneurysms (PSA) are rare, life-threatening complications of blunt chest trauma and the management is heavily reliant on early identification and diagnosis.
A healthy 55-year-old female presented after blunt chest trauma from a car accident. Bedside echocardiogram revealed a mid-septal LV discontinuity with myocardial outpouching. Lab work was significant for high sensitivity troponin of 22,000 ng/L which peaked at 24,000 in 5 hours. ECG revealed normal sinus rhythm with a QRS duration of 102ms. No ventricular ectopy was detected. Transthoracic echocardiograph (TTE) using echo contrast agent and computed tomography (CT) scan confirmed the intraventricular pseudoaneurysm (Fig 1-A&B).
A transesophageal echocardiogram (TEE) showed an intact PSA at 3.7 x 2.5 cm LV PSA with a 5mm neck extending from the mid septum superiorly into the right ventricle (RV) with no Doppler evidence of rupture or shunt (Fig 2). With cardiology and cardiac surgery shared decision making, conservative therapy was elected in the setting of polytrauma and hemodynamic stability. Serial TTEs showed stable size and appearance of the PSA during her month long hospitalization.

Cardiac magnetic resonance imaging (cMRI) 7 months later showed significant improvement in the PSA size to 0.3 cm
2
and extensive myocardial remodeling (Fig 1-C).

LV septal PSA is rare following blunt chest trauma, and it confers a considerable risk of rupture with the highest risk occurring within 3 months of formation. Untreated PSA presents with risks including thromboembolism, infection, and arrhythmia. Multimodal cardiac imaging is paramount for diagnosis and surveillance. There are no guidelines for serial monitoring in hemodynamically stable patients and an individualized approach should be taken. In this patient TTE, TEE, and CT imaging modalities were utilized. Our patient progressed without complication following conservative management with shrinking and scarring of the aneurysm characterized by the cMRI.
Abstract 4136804: Effect of Obesity on Arrhythmia Recurrence and Complications following Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation in the REAL-AF Registry
Authors: Peng Gary , Thorne Christopher , Varley Allyson , Osorio Jose , Goyal Sandeep , Zei Paul 
Published: November 2024

Introduction:
Obesity is an important risk factor for atrial fibrillation and its prevalence in the United States is rising. The effect of obesity on outcomes following pulmonary vein isolation in a contemporary setting has not been extensively evaluated.

Research Questions:
- Is higher body mass index (BMI) associated with increased risk of atrial arrhythmia recurrence following pulmonary vein isolation?

- Is higher BMI associated with increased risk of post-procedural complications?

Method:
- The REAL-AF (Real-world Experience of Catheter Ablation for the Treatment of Symptomatic Paroxysmal and Persistent Atrial Fibrillation; ClinicalTrials.gov Identifier: NCT04088071) Registry is a multicenter, prospective observational registry of patients undergoing radiofrequency catheter ablation of atrial fibrillation. We included 2666 patients with paroxysmal atrial fibrillation undergoing index ablation from January 2018 through April 2023. We excluded patients with missing covariates.

- The primary outcome was freedom from atrial arrhythmia following ablation. Rhythm monitoring was standardized using patch monitor at 6 month and 1 year. Time-to-event analysis was performed using a 3-month blanking period.

Results:
- Baseline characteristics are shown in Table 1. The median follow-up was 382 days (IQR: 363-410).

- There was a trend toward higher rate of atrial arrhythmia following ablation for patients in the highest BMI group compared with the reference group (BMI<25) (
BMI≥40:
HR = 1.41 (0.94-2.12), p= 0.092). There was no difference in the rate of atrial arrhythmia for other BMI groups (
BMI 25 - <30:
HR = 0.90 (0.65-1.23), p = 0.5;
BMI 30 - <35:
HR = 0.89 (0.64-1.23), p = 0.5;
BMI 35 - <40:
HR = 0.87 (0.57-1.32), p = 0.5). This trend persisted following adjustment for baseline covariates (
BMI 25 - <30:
HR = 1.01 (0.77-1.33), p > 0.9;
BMI 30 - <35:
HR = 0.97 (0.72-1.32), p = 0.9;
BMI 35 - <40:
HR = 1.01 (0.66-1.55), p > 0.9;
BMI≥40:
HR = 1.57 (0.96-2.57), p =0.071).

- First-pass isolation rates progressively decreased with higher BMI (Table 2).
- Complication rates were low across all BMI groups (Table 2).

Conclusions:
- Severely obese patients with BMI ≥40 experience higher risk of atrial arrhythmia following radiofrequency catheter ablation of paroxysmal atrial fibrillation compared with normal weight individuals. This corresponds with lower rates of first-pass isolation at higher BMI.

- Patients across BMI categories experience similarly low rates of procedural complication.
Abstract 4137564: Management of Atrial Flutter (AFL) Using Intrinsic Antitachycardia Pacing (iATP) Protocol
Authors: Silverstein Joshua , Gupta Manasvi , Duan Chaojing , Phalunas Caitlin , Shaw George , Liu Emerson , Cherian Tharian , Belden William , Friehling Mati , Belden Elizabeth , Lathia Minesh , Bailey Grace , Thosani Amit 
Published: November 2024

Background:
The recently introduced iATP algorithm augments traditional ventricular antitachycardia pacing (ATP) with programmed stimulation (PS) resulting in greater efficacy terminating ventricular tachycardia than traditional ATP in avoiding ICD shocks. The use of iATP in the atrium may similarly enhance termination of atrial arrhythmias, avoiding prolonged arrhythmia burden or need for cardioversion.

Objective:
To compare efficacy of 3 atrial ATP protocols (PROT[GS1] ) in either converting AFL to sinus rhythm or accelerating AFL to atrial fibrillation (AF).

Methods:
Patients presenting in AFL for ablation were recruited. Patents underwent all three pacing protocols, twice, and in random order (6 times total).

1. PROT 1 – Ramp pacing at 91% of tachycardia cycle length (TCL) for 13 beats with 5 or 10ms decrement, avoiding pacing cycle length (CL) <160 ms.
2. PROT 2 – Ramp pacing at 81% of TCL for 13 beats again with 5 or 10ms decrement, avoiding CL <160 ms.
3. PROT 3 (iATP) – Drive train of 88% of TCL for 15 beats with singles, doubles, and triples down to atrial effective refractory period.
If AFL terminated, it was re-induced with PS or burst pacing.
Termination and CL acceleration to AF are defined as the positive effect. No effect is defined as the negative effect. CL acceleration and termination were treated similarly in the analysis because AF is clinically easier to manage than AFL.

Results:
Of the 21 patients enrolled, 17 completed the entire protocol. 4 patients (excluded from analysis) did not complete the protocol due to non-inducibility following AFL termination. The TCL of the AFL ranged from 190ms to 290ms. PROT 1 terminated AFL 6 out of 34 attempts (17.6%). PROT 2 terminated AFL 7 out of 34 attempts (20.5%). iATP terminated AFL 13 out of 34 attempts (38%). It also accelerated AFL more frequently than the other two protocols (PROT 1:1, 2:4, 3:8).

Conclusion:
Atrial iATP was significantly more effective in either terminating or accelerating AFL, compared to ramp pacing protocols.
Countering Radicalization in the North Caucasus
Authors: Popov Maxim 
Published: November 2024

Abstract
By the mid-2010s, a significant decrease in the number of jihadists in the North Caucasus, in addition to internal ideological differences, was facilitated by fundamental factors: the lack of mass support in local Muslim communities, the anti-terrorism activities of the state, its informational and ideological support, and the policy of post-conflict integration. The number of supporters of the Caucasus Emirate decreased due to the split after the 2014 Olympics in Sochi; in 2015, the Caucasus Emirate officially ceased its activities, and after 2017, the flow of radical Islamists leaving Russia and joining ISIS stopped—violent extremism has begun to de-escalate in the region. To reduce ethnoreligious extremism and strengthen the integration of Muslims into Russian society, the federal government adopted a multi-level deradicalization strategy, including anti-terrorism operations and a large-scale policy of co-optation and support for moderate Russian Muslim leaders and their traditional communities.
Expanders of the Realm
Authors: Ferrario Marco 
Published: November 2024

Abstract
The Bīsutūn inscription carries an Old Persian coda dedicated to Darius’ expedition against the Sakā (DBp col. V § 74). The campaign’s geography and the identity of the defeated have been often discussed. Instead, the reasons behind both the campaign and its prominence in the inscription have been neglected. This article contextualizes the episode within its Ancient Near Eastern framework of imperial discourse on universal rulership and the limits thereof. Then, it provides an anthropological reading of the inscription through the prism of sacred (divine) kingship, seeking to account for the paramount importance of Central Asian (border)lands within the mental maps—even the cosmology—of the dawning Empire. This approach puts front stage the proactive role of local élites in negotiating their own position(ality) under, and sometimes—even simultaneously—against, Persian power.
Ossetic Boar
Authors: Dzitstsoity Yuriy , Falileyev Alexander 
Published: November 2024

Abstract
The article deals with the Ossetic word for ‘boar’ against the backgrounds of modern Ossetic porcine terminology. The Common Iranian name of the beast has survived in Ossetic anthroponymy only. Due to taboos many descriptive names for ‘boar’ are in use, such as ‘forest pig’, etc. The standard term (Digorian) tusk’a ‘boar’ was discussed by V. Abaev on a number of occasions, and the doyen of Ossetic studies considered it among Ossetic-European isoglosses in view of Eng. tusk, etc. The paper adds Iron evidence never mentioned before in its discussion and reassesses several questions regarding its alleged borrowing from Gothic. It is shown that the currently accepted approach to the pre-history of the Ossetic word as a linguistic loan at least requires adjustments, and that the term may well be of indigenous origin.
Russian Orientalistics (Vostokovedenie)
Authors: Zelenev Evgenij 
Published: November 2024

Abstract
This article examines the history, current state and prospects of Oriental and African Studies (OAS) in modern Russia. It explains why there are several educational models of OAS at bachelor’s and master’s degree in Russia and describes the current situation where 22 Russian universities offering OAS programmes produce graduates with mostly only two majors, i.e., historians and philologists. The article addresses the position of OAS among modern Russian scientific disciplines. Another aim is to trace the historical logic of the development of Oriental Studies and related African Studies in Russia, placing the discourse in the context of the Eastern Question, or the political fate of the Ottoman Empire. Finally, it identifies and justifies some current alternative trends in the development of OAS in Russian education and science.
Jesus and Nationalism in Republican China
Authors: Cen Esther G. 
Published: November 2024

Abstract
Historians recognize the twentieth century as an age of nationalism in the Majority World. During times of foreign dominance and internal division, nationalism often united the masses and ignited social reformation. At the turn of the twentieth century, various social movements emerged in the land now known as the People’s Republic of China, motivating young people in cities such as Peking and Shanghai to seek salvation for their country. In response to China’s crisis, Chinese Christian educators and theologians offered their perspectives on saving China by developing Christlike character. This study explores two key players: T.C. Chao (赵紫宸) and Princeton S. Hsu (徐松石). By comparing their views on China’s problems, nationalism, and China’s salvation, I present two strategies for contextualizing Christianity in Republican China: preaching the Social Gospel and promoting Christianity’s indigenization. Despite their courage and ingenuity, their contextual theology ultimately tends to domesticate Jesus and adapt theology to fit their cultural and societal agendas.
Towards a Redefinition of Squatter Rights: Adverse Possession in Ghana and the United Kingdom
Authors: Faakye Solomon 
Published: November 2024

Abstract
A squatter may under certain circumstances extinguish the title of the registered proprietor and obtain good title. Many arguments have been made for and against these extensive rights. The broad consensus appears to be that in relation to registered land, there is less justification for it. The English Land Registration Act 2002 substantially modified the effect of adverse possession on registered land making adverse possession inapplicable to registered lands. Under Ghana’s new land law; Land Act, 2020 (Act 1036), except for public lands, a claim in adverse possession can defeat title to land whether registered or unregistered. This feature of Ghana’s land law appears unsatisfactory in light of the policy justifying land title registration. Using a comparative approach, this work evaluates adverse possession law in Ghana and England within the context of its objectives. The work established that the current regime on adverse possession does not effectively promote the objectives of land registration and requires reform.
Investigating visual perspective taking and belief reasoning in autistic adults: A pre-registered online study
Authors: Lara Green Rachel , Joanne Carrington Sarah , Shaw Daniel Joel , Kessler Klaus 
Published: November 2024

As many autistic individuals report mentalizing difficulties into adulthood, the current pre-registered study investigated potential differences in belief reasoning and/or visual perspective taking between autistic and non-autistic adults. The Seeing-Believing task was administered to 121 gender-balanced participants online (57 with a self- reported diagnosis of an autism spectrum condition and 64 without), as well as Raven’s Progressive Matrices (on which the groups did not significantly differ) and the Autism Spectrum Quotient. Non-autistic adults replicated previous findings with this task, revealing slower responses to belief-reasoning than to perspective-taking trials. Autistic adults did not show significantly slower or more error-prone performance during perspective taking and/or belief reasoning. In fact, the autistic group committed significantly fewer mistakes, including fewer altercentric intrusions. The main group difference in response times was a steeper increase with increasing angular disparity between self and other in the autistic group. We discuss our findings in terms of differences in self-other control, but emphasise that our findings cannot be explained in terms of simplistic deficit-based notions of autism and suggest that autistic adults might favour slightly different strategies when judging another’s perspective or belief. Lay abstract Many autistic individuals report difficulties in social situations, where they are required to think about what goes on in others’ minds. These states of the mind can include how others perceive the world around them, their beliefs, or their desires. While research has shown that autistic children could be delayed in developing their full capacity in this regard, less is known about how adults process others’ experiences and beliefs. Here we used a novel task and asked adults to participate online. Participants self-reported whether they had been diagnosed with autism or not and we split them into two groups depending on their response. We also asked participants to fill in a self-report questionnaire about social preferences and habits and we also asked them to conduct a test of their nonverbal reasoning ability. Importantly, the autistic and the non-autistic groups did not differ in their nonverbal reasoning abilities, and on our task, we observed that the autistic group committed fewer mistakes than the non-autistic group. Autistic participants were particularly fast and made fewer mistakes on those responses that overlapped with their own view and belief of reality. In conclusion, our findings do not support a simple view of autism in terms of deficits in either social or more general thinking abilities. Instead, autistic adults might favour slightly different ways of thinking about other’s experiences and beliefs that is more firmly linked to their own experience and knowledge.