bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 4135239: Pausing Under Pressure: Ocular Hypertension as an Atypical Cause of Heart Block
Authors: Pietrini Nicholas , HYDER SYED , Hamilton David , Jasty Uma , Deshmukh Amrish 
Published: November 2024

A 67-year-old male with a history of hypertension presented to the emergency department with abnormal cardiac monitor results. Prior to this, he was diagnosed with primary open-angle glaucoma by ophthalmology and underwent left-sided aqueous tube shunt placement, which was complicated by hypotony requiring revision and holding of all topical glaucoma medications. Concurrently, he was noted to have an irregular heart rhythm during a routine physical. In office ECG showed normal sinus rhythm, but subsequent 14-day continuous ECG monitor showed sinus bradycardia with nadir heart rate of 21 beats-per-minute and 114 ventricular pauses (longest 4.8 seconds) primarily due to second-degree atrioventricular (AV) block, Mobitz type 1, but also periods of high-grade AV block. He was sent to the emergency department for expedited pacemaker evaluation. On further review, heart block and ventricular pauses occurred exclusively over a 12-hour period that temporally coincided with a hospitalization for acute ocular hypertension following shunt revision. His intraocular pressure peaked at 56 mmHg (normal range 10-21 mmHg), then normalized to 21 mmHg after acetazolamide and anterior chamber paracentesis. Bradycardia resolved following ophthalmic intervention. Bradyarrhythmias were attributed to excess vagal tone from acute ocular hypertension via an atypical but recognized cause of the oculocardiac reflex, and pacemaker placement was avoided.
The oculocardiac reflex is a reflex bradycardia involving the trigeminal and vagus nerves. Cardiac effects are consistent with other vagally-mediated bradyarrhythmias, including sinus bradycardia, AV block, and even asystole. This reflex occurs commonly during traction on extraocular muscles during strabismus surgery, but can be seen in other orbital and ocular stimuli. To our knowledge, this is the first documented case of ocular hypertension leading to atrioventricular block through this mechanism. This case illustrates the importance of (1) clinical context of abnormal events during extended cardiac monitoring, (2) understanding the oculocardiac reflex as a cause of bradyarrhythmias, and (3) ruling out reversible medical causes of dysrhythmias prior to permanent device implantation.
Abstract 4138007: Mechanisms of Mitral Regurgitation in Fabry Disease
Authors: Vecerova Alena , Linhart Ales 
Published: November 2024

Introduction:
Fabry disease, caused by mutations in the gene encoding alpha-galactosidase A, results in the accumulation of globotriaosylceramide (Gb3), leading to systemic complications including cardiac involvement such as mitral regurgitation (MR).

The aim of this study is to investigate the association between MR severity and mitral leaflet morphology in Fabry disease patients. A cohort of 38 symptomatic Fabry disease patients with moderate or significant MR was followed up.
Mitral leaflet morphology was categorized as normal, fibrodegenerative changes, or leaflet thickening. MR severity varied, with the primary cause being leaflet restriction. Additionally, left ventricular outflow tract obstruction (LVOTO) and annular dilatation were observed. The study suggests that MR in Fabry disease is primarily due to leaflet restriction, either through degenerative changes or leaflet thickening.
This study investigates the association between MR severity and mitral leaflet morphology in Fabry disease patients.

Methods:
A cohort of 38 symptomatic Fabry disease patients with moderate or significant MR was followed up. Echocardiographic assessments were conducted to determine MR severity and categorize mitral leaflet morphology. Statistical analyses were performed to evaluate associations between MR severity and leaflet morphology.

Echocardiographic assessments of the mitral valve were conducted using a Vivid E95 Cardiac Ultrasound and meticulously analyzed using the EchoPAC
TM
and TOMTEC Imaging Systems. A crucial aspect of the examination involved measuring all components of the mitral valve and determining the requisite angles to evaluate each mechanism thoroughly.

Results:
Most patients exhibited leaflet restriction as the primary cause of MR, with varying degrees of severity. Mitral leaflet morphology was categorized as normal in 15,8%, fibrodegenerative changes were in 31,5% and leaflet thickening in 52,7%.

In addition, outflow tract obstruction (LVOTO) was observed in 15,7% but without systolic anterior motion (SAM) and annular dilatation (dilatation of anteroposterior annulus more than 35 mm in systole) was present in 66%.

Conclusion:
The study suggests that MR in Fabry disease is primarily attributed to leaflet restriction, either due to degenerative changes or leaflet thickening. An additional, albeit not unexpected, finding not always considered is the presence of anteroposterior annular dilatation in some cases.
Polygenic Risk Scores and Extreme Coronary Artery Calcium Phenotypes (CAC=0 and CAC≥1000) in Adults ≥75 Years Old: The ARIC Study
Authors: Dzaye Omar , Razavi Alexander C. , Dardari Zeina A. , Wang Frances M. , Honda Yasuyuki , Nasir Khurram , Coresh Josef , Howard-Claudio Candace M. , Jin Jin , Yu Bing , de Vries Paul S. , Wagenknecht Lynne , Folsom Aaron R. , Blankstein Ron , Kelly Tanika N. , Whelton Seamus P. , Mortensen Martin Bødtker , Wang Ziqiao , Chatterjee Nilanjan , Matsushita Kunihiro , Blaha Michael J. 
Published: November 2024

BACKGROUND:
Coronary artery calcium (CAC) is heterogeneous in older age and is incompletely explained by traditional atherosclerotic cardiovascular disease risk factors. The extremes of subclinical atherosclerosis burden are strongly associated with either a low or high 10-year risk of incident atherosclerotic cardiovascular disease, respectively. However, the genetic underpinnings of differences in arterial aging remain unclear. We sought to determine the independent association of 2 polygenic scores for coronary heart disease (CHD) with CAC in adults ≥75 years of age.

METHODS:
There were 1865 ARIC (Atherosclerosis Risk in Communities) participants who underwent genetic testing at visit 1 (1987–1989) and CAC scans at visit 7 (2018–2019). In the primary analysis, an externally derived multi-ancestry polygenic CHD risk score was calculated for both White and Black participants. Results were confirmed using a separate ARIC-derived polygenic CHD risk score, including ≥6 million variants computed for White participants. We used multivariable logistic regression models to assess the association of polygenic CHD risk with CAC, after adjusting for baseline, time-averaged lifestyle, traditional risk factors, and local ancestry principal components.

RESULTS:
In the primary analysis, the average age was 80.6 years old, 61.6% were women, and the median CAC score was 246 (189 participants with CAC=0, 364 participants with CAC≥1000). Compared with persons below the 20th percentile of polygenic CHD risk, persons with polygenic-CHD risk above the 80th percentile had 82% lower odds of having CAC=0 (odds ratio, 0.18 [95% CI, 0.09–0.37]) and had >4-fold higher odds of CAC≥1000 (odds ratio, 4.77 [95% CI, 2.88–7.88]). On a continuous scale, each SD increment increase in the polygenic risk score was associated with a 78% higher CAC score. Results were nearly identical using a second confirmatory polygenic CHD risk score in White participants.

CONCLUSIONS:
Polygenic CHD risk is robustly associated with a lower prevalence of CAC=0 and a higher prevalence of CAC≥1000 in adults ≥75 years of age, beyond lifestyle and traditional risk factors. These results suggest a heritable contribution to distinct healthy and unhealthy arterial aging phenotypes that persist throughout the life course.
Chinese Views of Strategic Stability: Implications for U.S.-China Relations
Authors: Logan David C. 
Published: November 2024

Abstract
China's nuclear buildup and intensifying U.S.-China strategic competition have raised concerns about the future of nuclear dynamics between China and the United States. As U.S.-China nuclear competition escalates, understanding Chinese views of strategic stability will be important for managing this dimension of the relationship between these two global powers. During the Cold War, different conceptions of strategic stability influenced how the Soviet Union and the United States constructed their nuclear forces and approached arms control. For the U.S. strategic community, strategic stability consisted of crisis stability and arms race stability. This article analyzes extensive Chinese-language sources and finds that Chinese writings identify four pillars of strategic stability: nuclear mutual vulnerability, the overall state of bilateral relations, the nuclear taboo, and beliefs about the controllability of nuclear escalation. Chinese strategists perceive each of these four pillars as eroding, in part because of U.S. actions. The findings have important implications for understanding China's nuclear force development, nuclear dynamics in East Asia, and U.S.-China relations.
Towards Creating Synergy for the Realisation of Right to Health in International Human Rights and Shariah
Authors: Khan Danyal 
Published: November 2024

Abstract
In most of the literature on international human rights in Muslim states, Shariah principles are interpreted in a way to limit the scope of human rights such as freedom of speech, religion, and non-discrimination. In this paper, I want to argue that Shariah principles can be used to enhance the Muslim states’ obligations related to the right to health. After exploring the health-related emphasis in the primary sources of Shariah, I argue that the obligations of Muslim states to the right to health are dual, as parties to the International Bill of Rights and Shariah status in Muslim constitutionalism. I will set a theoretical framework for bridging international human rights with Shariah where synergy is possible.
Georgia and Sasanian Iran
Authors: Gvelesiani Mariam 
Published: November 2024

Abstract
This article examines the impact of Sasanian hegemony in Georgia (Kartli/Iberia) on the monuments of early Christian Georgia’s material culture. It explores how Sasanian political power and influence were conveyed through visual imagery, depicting Kartli as an adaptive yet creatively distinct realm that incorporated many elements of Sasanian art and culture into early Christian iconography. The article focuses on some iconographic motifs representing the Sasanian concept of royalty and their adaptation to Georgian culture, analyzed through both Iranian and Georgian visual sources, as well as Georgian textual data.
The Case of a Molokan Woman from the Archive of the Erivan Uezd Court (Mid-19th Century)
Authors: Shuvaeva Elena , Arakelova Victoria 
Published: November 2024

Abstract
The article focuses on a court case of the Erivan Uezd of the mid-19th century, involving a Molokan woman Lukeriya Korsakova. The lawsuit “Case of Lukeriya Korsakova’s settlement among the Molokans of the Erivan Uezd, March 7, 1847–May 21, 1848” was initiated as a result of the woman’s transition from Orthodoxy to the Molokan sectarianism, what was punishable by exile. The trial lasted from 1844 to 1848, and the case passed through several instances. The authors try to reconstruct the details and specifics of the case of the defendant Lukeriya Korsakova on the basis of archival documents.
The Sons of Esau and Lot: Reevaluating National States in Deuteronomy 2
Authors: Johnson Sophia R.C. 
Published: November 2024

Abstract
In an attempt to trace the tradition of nationalism back to ancient Israel, public intellectual Yarom Hazony reads Deuteronomy 2 as a representation of ancient values of land-bounded autonomy and cultural homogeny. However, he overlooks two key aspects of the passage: 1) the familial and theological reasoning behind the divine protection of the other peoples, and 2) the messy aetiologies of how those peoples came to inhabit their lands. God calls the Edomites, Moabites, and Ammonites “brothers” and “sons of Esau” or “Lot,” suggesting that the prohibition against invasion is not based on respect for sovereignty but instead mythological family and relative social connection. Thus, using postcolonial theories of group identity from Gayatri Spivak, this article argues that Deut 2 does not represent an ancient (pre)conception of the nation-state but rather a (re)negotiation of group relations and social identities in connection to co-habitation of the Levant.
Comparative Law and Natural Law in the UAE Constitutional Adjudication
Authors: Abiad Nisrine 
Published: November 2024

Abstract
Unlike other comparative jurisdictions that may remain silent on the possibility for supreme courts to use comparative law and natural law, the UAE legislator has allowed the Federal Supreme Court to invoke these two sources in its adjudication since the Court was established in 1973. This paper examines the legal framework that supports this permission, especially in light of Decree-Law Number 33-2022, which brought about a revision affecting it. The paper aims to define the space given to comparative law and natural law vis-à-vis UAE positive law. Furthermore, through an empirical approach, this paper examines the Federal Supreme Court case law to analyse the extent of its recourse to comparative law and/or to natural law in constitutional adjudication.
Consumer acceptance of entomophagy in Belgium: insect-based food appropriateness and influence of personal factors
Authors: Detilleux L. , Dogot T. , Franceschini S. , Francis F. , Caparros Megido R. 
Published: November 2024

Abstract
The issue of consumer acceptance is largely investigated in the literature relative to entomophagy, as edible insects are not a common part of European food habits. This topic was also discussed in the current study, which analysed 1,382 responses to an online survey in Belgium. The first aim of this research was to study the potential influence of personal factors, including field of work, on consumer acceptance. The second objective was to determine the most appropriate context for entomophagy, regarding timing and style of preparation. Gender, nationality and field of work of respondents were identified as influencing factors, while age was identified as a factor that did not impact consumer acceptance. Personal factors that influenced acceptance must be used as discriminating factors to select willing consumers of edible insects. Regarding context, edible insects were not appropriate at breakfast, while they were considered as snacks. Such considerations provide useful information in determining the most appropriate insect-based food for European markets.
What are the Short and Long-Term Impacts of Animal Assisted Interventions on the Therapy Animals?
Authors: Lewis Amelia 
Published: November 2024

Abstract
Animal assisted interventions (AAIs) are practices used for human wellbeing, whereby interactions with non-human animals are used for therapeutic purposes. AAIs can be offered clinically, to those suffering physical or mental illness; those who have a learning disability or neurodevelopmental disorder; people requiring occupational therapy or enrichment in settings such as prisons and nursing homes, and as an adjunct to formal education in classrooms. Whilst some AAIs are low risk, AAI animals can be placed in emotionally challenging situations, or even situations where they may be at physical risk. At present, there is a paucity of literature examining the welfare of AAI animals, and the practice remains unregulated. This paper therefore discusses the potential welfare issues for animals used in ‘animal assisted interventions’, and suggests how those issues could be addressed.
Topographical and functional analysis of different surgical strategies for advanced pellucid marginal degeneration: A long term follow-up
Authors: Mosca Luigi , Carlà Matteo Mario , Guccione Laura , Vico Umberto De , Scartozzi Luca , Fasciani Romina , Rizzo Stanislao 
Published: November 2024

Purpose To compare clinical and topographical outcomes of three different surgical strategies for advanced pellucid marginal degeneration (PMD). Methods Retrospective, interventional case series of 8 advanced PMDs undergoing three different surgical interventions: Sliding Keratoplasty (SK), Sliding Keratoplasty with Relaxing Incision (SKRI), Sector Lamellar Keratoplasty (SLK). Pre-operatively and at 1, 3, 6, 12-month and final follow-up (50.8 ± 20.6 months) post-operatively, we collected: uncorrected and corrected distance visual acuity (UDVA and CDVA), spherical equivalent (SE), refractive astigmatism (RA), corneal Ks, topographical astigmatism (TA) and calculated against-the-rule (ATR) component. Results CDVA significantly improved from 6 months after surgery ( p = 0.04), while final CDVA was at least 20/40 in 75% of eyes. As desired, surgery led to an overcorrection toward with-the-rule astigmatism at 1-month, which then decreased at 12-month and at final follow-up ( p < 0.05). The ATR-component was significantly decreased at 1-month (1.9 ± 1.1 vs. 17.6 ± 6.3 D pre-operatively, p = 0.0015) and remained quite stable over time (4.2 ± 4.2 D at final follow-up). In subgroup analysis, SK and SKRI offered better CDVA and lower RA, while SLK showed more TA stability. The ATR component, comparing baseline and final follow-ups, decreased from 16.8 ± 8.3 D to 5.9 ± 3.6 after SK; from 18.9 ± 3.6 D to 3.3 ± 3.3 D after SKRI; from 17.0 ± 10.3 D to 1.9 ± 1.5 D after SLK. Conclusion The surgical treatment of advanced PMD showed long-term favourable outcomes. SK and SKRI offered better visual outcomes, but were more inclined to astigmatism regression over time. Conversely, SLK had more stable results but offered worse refractive outcomes.
Patterns of eConsult use: A retrospective analysis of usage comparing two models deployed at an academic medical center
Authors: Grim Stephanie , Miller Devin , Mooneyhan Ellen , Kessler Rodger , Fuhlbrigge Anne , Thomas John F 
Published: November 2024

Introduction Electronic consultations (eConsults) have been implemented by numerous academic medical centers (AMCs) to improve communication and address access to specialty care. As these models proliferate, we must understand their comparative benefit and use in various settings. Methods This retrospective, descriptive analysis compares eConsult utilization trends at an AMC that has deployed an internal effort and an external pivot. Relevant metrics are presented using counts and proportions or median and range where appropriate. Results The internal AMC program demonstrated sustained growth from years 1 through 6, while the external pivot demonstrated considerable growth in year 1, followed by a steady decline in subsequent years. Endocrinology generated the highest number of eConsult orders in both programs (AMC 21%, external pivot 16%). Conversion rates to in-person visits were higher in the external pivot (22%) than in the internal AMC program (14%). Median response time across all specialties was faster (17 hours) for the AMC program than the external pivot (23 hours). The median number of eConsults ordered by any single primary care provider was 3 in both programs. The percentage of providers using the eConsult ordering system only once was approximately 30% in both programs. eConsults were primarily ordered by physicians (68%) at the AMC and physician assistants (40%) in the external pivot. Discussion The current study highlights similarities and differences between internal and external eConsult programs that can inform future “right-sizing” of care according to patient needs while promoting local care delivery and improving efficiencies at the AMC.
The natural history of paediatric trigger thumbs. A prospective cohort study
Authors: Chew Ee Ming , Sim Noah Yu Ting , Lee Nicole Kim Luan , Wong Kenneth Pak Leung , Chua Yi Ling , Chia Dawn Sinn Yii 
Published: November 2024

The aim of this study was to report the natural history of paediatric trigger thumbs, determining the rate and factors predictive of spontaneous resolution. A total of 62 patients presenting with 79 thumbs locked in flexion were observed for a mean of 4.2 years. The median age at presentation was 20.5 months. The spontaneous resolution rate was 37% at 5 years and 50% at 8 years of follow-up. Of the thumbs, 27% had undergone surgery at 5 years and 48% at 8 years. Thumbs that spontaneously resolved did so at a mean of 3.4 years. Thumbs presenting with an interphalangeal joint angle of less than 30° were likely to resolve spontaneously, with a sensitivity of 0.50 and specificity of 0.82. It is reasonable to offer observation alone for 4 to 5 years as the first line of management for paediatric trigger thumb. Level of evidence: III
Slovenian Translation, Cross-Cultural Adaptation, and Content Validation of the Updated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2)
Authors: Drole Kristina , Steffen Kathrin , Paravlic Armin 
Published: November 2024

Background: The updated Oslo Sports Trauma Research Questionnaire on Health Problems (OSTRC-H2) has been translated into a limited set of languages and lacks full validation of its new measures. Purpose: To (1) translate, cross-culturally adapt, and evaluate the measurement properties of the OSTRC-H2 for the Slovenian population and (2) investigate the construct validity for the severity score and time lost due to a health problem. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The OSTRC-H2 was translated from English to Slovenian (OSTRC-H2-SLO) according to international guidelines. A 15-week study was conducted among 188 elite athletes, with a test-retest performed in the 10th week. Internal consistency, reliability, content validity, feasibility, and potential ceiling effects were investigated. Internal consistency was measured using the Cronbach alpha coefficient, while reliability was measured with the intraclass correlation coefficient (ICC). Construct validity was measured with the Spearman rank correlation coefficient ( rS). Results: There was a 95% response rate and an 18% mean weekly prevalence of health problems. The OSTRC-H2-SLO showed excellent test-retest reliability (ICC, 0.94 [95% CI, 0.67-0.99]), with a Cronbach α of .93. A strong positive correlation was found between the OSTRC-H2-SLO severity score and days lost due to an acute injury ( rS = 0.754), overuse injury ( rS = 0.785), and illness ( rS = 0.894) ( P < .001 for all). Moderate to strong negative correlations were observed between severity score and total load (training and competition load in hours) as well as between days lost and total load ( P < .001 for all). Conclusion: The OSTRC-H2-SLO was found to be valid, reliable, and well accepted among Slovenian athletes. The authors confirmed the questionnaire's construct validity and identified total load as an indicator of an increase in the severity score. Registration: NCT05471297 (ClinicalTrials.gov identifier).