bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiotensin Receptor‐Neprilysin Inhibitor Is Associated With Improved Cardiac Autonomic Function in Heart Failure
Authors: Boehmer Andreas A. , Schubert Tim , Rothe Moritz , Keim Christoph , Wiedenmann Lilli , Ruckes Christian , von Stuelpnagel Lukas , Theurl Fabian , Schreinlechner Michael , Dobre Bianca C. , Kaess Bernhard M. , Bauer Axel , Ehrlich Joachim R. 
Published: July 2024

Background
Heart failure with reduced ejection fraction is associated with potentially deleterious imbalance of the cardiac autonomic nervous system. Sacubitril/valsartan (angiotensin receptor‐neprilysin inhibitor [ARNI]) reduces cardiovascular mortality and hospitalization for heart failure with reduced ejection fraction. Whether ARNI affects the cardiac autonomic nervous system has not been studied.

Methods and Results

This investigator‐initiated, prospective, single‐center cohort study compared heart rate (HR) variability, HR, deceleration capacity, and periodic repolarization dynamics as noninvasive measures of the cardiac autonomic nervous system before and after initiation of ARNI therapy. Patients underwent standardized 12‐lead Holter‐ECG, echocardiography and laboratory testing before and 3 months after start of therapy. End points were changes in HR variability (SD of normal‐to‐normal intervals, mean square of differences between consecutive R‐R intervals), HR, deceleration capacity, and periodic repolarization dynamics as well as ventricular function and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). Of 63 patients with heart failure with reduced ejection fraction enrolled, 48 (76.2%) patients were still on ARNI at follow‐up. SD of normal‐to‐normal intervals increased from 25 to 36 milliseconds (
P
<0.001), mean square of differences between consecutive R‐R intervals increased from 12 to 19 milliseconds (
P
<0.001), HR decreased from 73±9 bpm to 67±4 bpm, (
P
<0.001), and deceleration capacity increased from 2.1 to 4.4 milliseconds (
P
<0.001). A trend for periodic repolarization dynamics reduction was observed (5.6 deg
2
versus 4.7 deg
2
,
P
=0.09). Autonomic changes were accompanied by increased left ventricular ejection fraction (29±6% versus 40±8%,
P
<0.001) and reduced NT‐proBNP (3548 versus 685 ng/L,
P
<0.001). Correlation analysis showed a significant relationship between volume‐unloading (as evidenced by NT‐proBNP reduction) and autonomic improvement.

Conclusions
Three months of ARNI therapy resulted in a significant increase in cardiac parasympathetic tone. The improvement in autonomic properties may be mediated by “volume unloading” and likely contributes to the beneficial effects of ARNI in heart failure with reduced ejection fraction.

Registration

URL:
https://www.clinicaltrials.gov
; Unique Identifier: NCT04587947.
Association of Transcranial Doppler Microembolic Signal With Short‐Term Mortality in Acute Ischemic Stroke and Active Cancer
Authors: Toi Sono , Higuchi Eiko , Hosoya Megumi , Arai Satoko , Ishizuka Kentaro , Mizuno Takafumi , Hoshino Takao , Tsutsumi Yukiko , Kitagawa Kazuo 
Published: July 2024

Background
This study aimed to clarify the characteristics and survival prediction value of transcranial Doppler microembolic signals (MES) in patients with acute cerebral infarction and active cancer.

Methods and Results

Between 2017 and 2022, 1089 cases of acute cerebral infarction were recorded within 7 days of disease onset. Among them, transcranial Doppler was successful in 33 patients who had active cancer, and these data were analyzed in this study. The primary outcomes were stroke recurrence and mortality at 3 months. The study population had the following characteristics [median (interquartile range)]: age, 70 years (63–78); body mass index, 21.6 (20–24), National Institutes of Health Stroke Scale 3 (1–6), and modified Rankin Scale score at discharge 1 (1–4). The most common cancer types were lung (24%), pancreatic (24%), and intestinal (18%). MES was present in 16 of 33 patients (48.5%). The presence and number of MES were significantly associated with the levels of D‐dimer (
P
<0.001) and C‐reactive protein (
P
=0.012). Moreover, the presence of MES was associated with multiple ischemic lesions and the 3‐territory sign on magnetic resonance imaging. Of the 33 patients, 9 died at 3 months, and 1 had stroke recurrence. On Cox multivariate analysis, using the MES‐negative group as a reference, the presence of MES was significantly associated with all‐cause death (adjusted hazard ratio, 12.19 [95% CI, 1.45–216.85];
P
=0.020).

Conclusions
In patients with acute ischemic stroke and active cancer, the presence of MES was associated with D‐dimer and C‐reactive protein levels and multiple and 3‐territory ischemic lesions, and was predictive of short‐term survival.
Alterations in the Salivary Microbiome and Metabolism in Patients With Carotid Atherosclerosis from Rural Northeast China
Authors: Wu Yahong , Xing Liying , Lu Lijie , Liu Shuang , Zhao Dan , Lin Li , Wang Songlin , Li Chen , Pan Yaping 
Published: July 2024

Background
Periodontitis and atherosclerosis are both chronic inflammatory diseases with a high prevalence. Increasing evidence supports the independent association between severe periodontitis and atherosclerotic cardiovascular disease, in which oral microorganisms may play an important role. We aimed to evaluate the characteristic changes of salivary microbiome and metabolome in patients with carotid atherosclerosis (CAS) and periodontitis.

Methods and Results

The subjects were obtained from a cross‐sectional study that included 1933 participants aged 40 years or older from rural northeast China. The study enrolled 48 subjects with CAS and 48 controls without CAS matched by sex, age, body mass index, and prevalence of hypertension, diabetes, and dyslipidemia. We performed full‐length 16S rDNA gene sequencing and untargeted metabolomics of saliva samples from 96 subjects. We found that CAS was closely associated with an increased abundance of
Streptococcus
,
Lactobacillus
, and
Cutibacterium
. Furthermore, patients with CAS had higher prevalence of severe periodontitis than the control group. Notably, periodontal pathogens such as
Tannerella
and
Anaeroglobus
were not only associated with periodontitis but also enriched in patients with CAS, whereas periodontal health‐associated
Neisseria
was more abundant in those without CAS. We also identified 2 lipid metabolism pathways, including glycerophospholipid and sphingolipid metabolism, as associated with CAS. The levels of trimethylamine
N
‐oxide and inflammatory mediator leukotriene D4 were significantly higher in patients with CAS, whereas the levels of carnosine were significantly lower, than those in controls. Additionally, serum levels of inflammatory marker high‐sensitivity C‐reactive protein were significantly increased in CAS and positively correlated with the abundance of
Anaeroglobus
and leukotriene D4 in saliva.

Conclusions
Our study suggests that characteristic changes in salivary microbiota and metabolites are closely related to CAS, and periodontitis and associated microorganisms may be involved in the initiation and progression of CAS.
Eighteen‐Month Real‐World Experience Using Mavacamten for Treatment of Obstructive Hypertrophic Cardiomyopathy in a Racially Diverse Population
Authors: Ramonfaur Diego , Gasperetti Alessio , Blake Victoria E. , Rivers Bryana , Kassamali Ali A. , Kasper Edward K. , Barouch Lili A. , Wu Katherine C. , Madrazo Jose A. , Carrick Richard T. 
Published: July 2024

Background
Patients with obstructive hypertrophic cardiomyopathy have increased symptomatic burden. Mavacamten was recently approved for treatment of obstructive hypertrophic cardiomyopathy based on 2 randomized controlled trials. However, its use under real‐world conditions and in diverse populations is under‐studied.

Methods and Results

This was a prospective observational cohort study of patients seen at the Johns Hopkins HCM center and prescribed mavacamten for obstructive hypertrophic cardiomyopathy between July 7, 2022 and January 6, 2024. Patients were followed longitudinally, with serial echocardiography and clinical evaluation as mandated by the risk evaluation and mitigation strategy program. Sixty‐six patients received mavacamten (mean age 59 years, 47% male, 29% non‐White [Black, Hispanic/Latino, Asian, Native Hawaiian or Pacific Islander], 47% obese). Before treatment, all patients had New York Heart Association class II (51.5%) or III (48.5%) heart failure symptoms. Initial maximum peak left ventricular outflow tract gradient was 107±46 mm Hg. Median treatment duration was 9 months. For patients on mavacamten after ≥6 months (n=43), symptoms improved by ≥1 New York Heart Association class in 72% of patients, and peak left ventricular outflow tract gradient decreased by 80±46 mm Hg, eliminating hemodynamically significant left ventricular outflow tract obstruction in 79.1% of patients. Mavacamten was temporarily discontinued in 3 patients due to left ventricular ejection fraction decrease <50%. There were no medication‐related adverse events. Effectiveness and safety were similar between White and non‐White patients, but symptomatic relief was attenuated in patients with body‐mass index ≥35 kg/m
2
.

Conclusions
Mavacamten was effective and safe when used under real‐world conditions in a racially diverse population of symptomatic patients with obstructive hypertrophic cardiomyopathy. Patients with comorbid obesity were less likely to experience symptomatic improvement while on mavacamten.
Temporal Changes in Long‐Term Outcomes of Venous Thromboembolism From the Warfarin Era to the Direct Oral Anticoagulant Era
Authors: Kaneda Kazuhisa , Yamashita Yugo , Morimoto Takeshi , Chatani Ryuki , Nishimoto Yuji , Ikeda Nobutaka , Kobayashi Yohei , Ikeda Satoshi , Kim Kitae , Inoko Moriaki , Takase Toru , Tsuji Shuhei , Oi Maki , Takada Takuma , Otsui Kazunori , Sakamoto Jiro , Ogihara Yoshito , Inoue Takeshi , Usami Shunsuke , Chen Po‐Min , Togi Kiyonori , Koitabashi Norimichi , Hiramori Seiichi , Doi Kosuke , Mabuchi Hiroshi , Tsuyuki Yoshiaki , Murata Koichiro , Takabayashi Kensuke , Nakai Hisato , Sueta Daisuke , Shioyama Wataru , Dohke Tomohiro , Nishikawa Ryusuke , Ono Koh , Kimura Takeshi 
Published: July 2024

Background
There have been limited data on the changes in clinical outcomes after the introduction of direct oral anticoagulants (DOACs) for venous thromboembolism (VTE) in real clinical practice. We evaluated the changes in management strategies and long‐term outcomes from the warfarin era to the DOAC era.

Methods and Results

We compared the 2 series of multicenter COMMAND VTE (Contemporary Management and Outcomes in Patients With Venous Thromboembolism) registries in Japan enrolling consecutive patients with acute symptomatic VTE: Registry 1: 3027 patients in the warfarin era (2010–2014) and Registry 2: 5197 patients in the DOAC era (2015–2020). The prevalence of DOAC use increased more in Registry 2 than in the Registry 1 (Registry 1: 2.6% versus Registry 2: 79%,
P
<0.001). The cumulative 5‐year incidence of recurrent VTE was significantly lower in Registry 2 than in Registry 1 (10.5% versus 9.5%,
P
=0.02), and the risk reduction of recurrent VTE in Registry 2 remained significant even after adjusting the confounders (hazard ratio [HR], 0.78 [95% CI, 0.65–0.93];
P
=0.005). The cumulative 5‐year incidence of major bleeding was not significantly different between the 2 registries (12.1% versus 13.7%,
P
=0.26), and the risk of major bleeding between the 2 registries was not significantly different even after adjusting the confounders (HR, 1.04 [95% CI, 0.89–1.21];
P
=0.63).

Conclusions
Along with the shift from warfarin to DOACs, there was a lower risk of recurrent VTE in the DOAC era than in the warfarin era, whereas there was no apparent change in the risk of major bleeding, which might still be an unmet need even in the DOAC era.
Sociodemographic Correlates of High Cardiovascular Health Across Childhood and Adolescence: A Prospective Study Among 2 Cohorts in the ECHO Consortium
Authors: Perng Wei , Galai Noya , Zhao Qi , Litonjua Augusto , Geiger Sarah , Sauder Katherine A. , O'Shea T. Michael , Hivert Marie‐France , Oken Emily , Dabelea Dana , Aris Izzuddin M. ,   the ECHO Cohort Consortium
Published: July 2024

Background
This study seeks to characterize cardiovascular health (CVH) from early childhood to late adolescence and identify sociodemographic correlates of high CVH that serve as levers for optimizing CVH across early life.

Methods and Results
Among 1530 youth aged 3 to 20 years from 2 cohorts in the ECHO (Environmental Influences on Child Health Outcomes) consortium, we first derived CVH scores on the basis of the Life's Essential 8 construct comprising 4 behavioral (nicotine use/exposure, physical activity, sleep, and diet) and 4 health factors (body mass index, blood pressure, non–high‐density lipoprotein cholesterol, and fasting glucose) during early childhood (mean age, 3.5 years), middle childhood (8.0 years), early adolescence (13.3 years), and late adolescence (17.8 years). Next, we used generalized regression to estimate the probability of high (versus not high) CVH with respect to sociodemographic characteristics. Overall CVH score was stable across life stages: 81.2±7.6, 83.3±8.0, and 81.7±8.9 of 100 possible points in early childhood, middle childhood, and early adolescence, respectively. Accordingly, during these life stages, most children (63.3%–71.5%) had high CVH (80 to <100). However, CVH declined by late adolescence, with an average score of 75.5±10.2 and 39.4% high CVH. No children had optimal CVH (score=100) at any time. Correlates of high CVH include non‐Hispanic White race and ethnicity, maternal college education, and annual household income >$70 000. These associations were driven by behavioral factors.

Conclusions
Although most youth maintained high CVH across childhood, the decline by late adolescence indicates that cardiovascular disease prevention should occur before the early teen years. Disparities in high CVH over time with respect to sociodemographic characteristics were explained by behavioral factors, pointing toward prevention targets.
Sound Investments: Music and Finance at Mid-Century
Authors: Maizels Michael 
Published: July 2024

Abstract
The histories of finance and music are more interconnected than they might at first appear. From ancient ideas on the mathematical harmony of the universe to ultra-contemporary approaches driven by networked data, the flow of sounds and the circulation of capital have long traced one another’s shadow. Indeed, since the publication of Jacques Attali’s Noise in 1977, musicologists and sound scholars have been probing how music as an expression of mathematical knowledge has intersected with a range of intellectual, social, and economic shifts.
Cooperation and Defection in the East African Community
Authors: Mwatela Raphael Z. 
Published: July 2024

Abstract
This paper looks at the role of regime types and political leadership in influencing regional integration in the East African Community (EAC). Although the EAC is one of the most highly integrated Regional Economic Communities in Africa, and there are many instances where member states cooperate with decisions made at the EAC level to strengthen integration, in other instances members choose to defect from regional commitments. The study used secondary data sources to determine why this is so and employed game theory to understand the game of cooperation and defection among the players, who are the member states of the EAC. Kenya, Uganda and Tanzania were selected as case studies because they are the founding members of the EAC and are assumed to be most invested in deeper cooperation within the EAC. The study found that member states make conscious, calculated decisions to cooperate or defect on specific issues after gauging the costs and payouts associated with each action.
The Ethiopia-Egypt Controversy on the Renaissance Dam and the Role of a Benefit-Sharing Approach in the Nile Basin
Authors: Alamineh Asabu Sewenet 
Published: July 2024

Abstract
The Nile River has been both an engine of development and a cause of controversy among its riparian states for millennia. This paradox took on an international dimension with the inception of the Grand Ethiopian Renaissance Dam (GERD). Using a qualitative research method, this paper investigates the GERD controversy and the role of a benefit-sharing approach in the Nile Basin. The dam negotiations have been hampered by unjust colonial treaties, the hardline interests of Egypt and Ethiopia, politicisation, uncertainty about the consequences of the dam’s use and lopsided third-party intervention. The paper argues that the adoption of a benefit-sharing approach in the basin can sustain the Nile ecosystem, promote regional peace, increase water flow and decrease unnecessary expenses through modest intraregional cooperation. The resolution of the Nile Basin conflict thus relies on identifying the potential of the basin and on integrated cooperative frameworks adopted by the technocrats of its riparian states and international experts.
Bilingual Language Dominance and Code-switching Patterns
Authors: Olson Daniel J. 
Published: July 2024

Abstract
Code-switching, the alternation between two languages in an interaction, is a salient characteristic of bilingual speech, but there is substantial variability in code-switching patterns among bilinguals. Language dominance, the relative strength of a bilingual’s languages, has been suggested as a key factor that impacts both the frequency with which a bilingual engages in code-switching and the directionality of code-switching. This study examines the relationship between language dominance and code-switching engagement and directionality. A total of 454 Spanish–English bilinguals completed questionnaires regarding language dominance, code-switching engagement, and code-switching directionality. Results demonstrated an impact of language dominance on code-switching engagement, with more balanced bilinguals reporting greater code-switching, although significant individual variation remained. A weak link between language dominance and directionality was also found. These findings suggest that while language dominance may serve to constrain a bilingual’s range of possible engagement with code-switching, it represents a distinct characteristic of a bilingual’s language profile.
Absent Animals: The Anthropocentric Focus of the Book of Ruth
Authors: Atkins Peter Joshua 
Published: July 2024

Abstract
The book of Ruth is the only text of the Hebrew Bible which lacks a single mention of a nonhuman animal. As such, it has not been studied by scholars with an interest in animals within biblical texts. This article critically addresses this omission of nonhuman animals from Ruth by locating this neglect within the context of other troubling ideological binaries (such as gender, sexuality, ethnicity, class) which are operative in the narrative. Through an attentiveness to the lack of animals during the famine, harvest, and threshing of the grain in the book, this article suggests that the narrative obscures the crucial contribution of nonhuman animals to society as well as the care they deserve. This therefore indicates how the book of Ruth operates with an anthropocentric human/animal hierarchy whereby nonhumans can be disposed of to advance the interests of humans.
‮ממולח טוהר‬‎: Qumranic and Medieval Exegesis
Authors: Ariel Chanan 
Published: July 2024

Abstract
The phrase ‮ממולח טוהר‬‎ appears four times in the Songs of the Sabbath Sacrifice, describing the firmament and the angels’ garments. John Strugnell, followed by most scholars, proposed that the phrase be understood as “purely blended.” An examination of the context in which the phrase appears in the Songs supports the possibility that its use began as a reference to the brightness of the firmament and was then extended to apply to the angels’ garments. Our review of the semantic field of the four roots common to the descriptions of the preparation of the incense, the garments, and the firmament—‮דק״ק‬‎, ‮מל״ח‬‎, ‮רק״ע‬‎, and ‮שח״ק‬‎—(a semantic field that was already recognized by the medieval Hebrew grammarians) strengthens the claim of Jean Carmignac, rejected by most scholars, that ‮ממולח‬‎ means “thin and fine.” In my opinion, the phrase ‮ממולח טוהר‬‎ is to be understood as “characterized by a thin, fine brightness.”
“Is the Embryo a Living Being?” (Aët. 5.15)
Authors: Zatta Claudia 
Published: July 2024

Abstract
Building on previous studies, this essay discusses the use of embryological images and analogies in Anaximander, Empedocles, Democritus, and Lucretius. It pursues their intertextual connections arguing that in ancient philosophy embryology was not only relevant for conceiving the early formation of the cosmos as has been claimed so far, but that it also shaped the conception of the primeval rise of animal life and the living processes of plants.
A Neurocognitive Model for Analyzing End Time Narratives: the Book of Revelation 14–16 as a Test Case
Authors: Høgenhaven Jesper , Bach Melissa Sayyad , Geertz Armin W. 
Published: July 2024

Abstract
In this article, we introduce a neurocognitive model as a useful analytical approach to a wide range of representations (written, oral, and/or visual) of a comprehensive and dramatic collapse of the world order (cosmic, social, and/or moral). We gather these variegated representations under the term End Time Narratives (ETN). The widespread reception of ETNs, and their popularity and variability across different periods and cultures, is evidence that these representations continually affect us and hold power over us. Prominent and well-known examples of ETNs are the Jewish and Christian apocalypses from antiquity, which have been widely influential through the centuries. This prevalence raises the question of why ETNs exercise such an influence. The reasons, we suggest, are based on the following hypotheses: (1) that the efficacy and attraction of ETNs can be traced to identifiable cognitive mechanisms, (2) that these underlying mechanisms are linked to certain emotional reactions activated by the particular structure and design of these narratives, and (3) ETNs – as cultural products – seem to be designed and structured to elicit cognitive and emotional responses through effects on the brain. To investigate the possible neurocognitive and psychological mechanisms that are simulated and enacted in recipients by ETNs, we apply the model through an “enactive reading” of a classical ETN, the Book of Revelation 14–16.
Heraclitus on First (and Further) Hearings
Authors: Spelman Henry , Tor Shaul 
Published: July 2024

Abstract
The words τὸ πρῶτον in Heraclitus B1 have been subjected to competing construals, yet this dilemma, and its stakes, are almost never discussed. We argue that the common translation of ἀκούσαντες τὸ πρῶτον, ‘when once they have heard it’, faces insurmountable philosophical, stylistic, and linguistic objections. We make a new case for the alternative construal, ‘after they have heard it for the first time’. This yields a linguistically better account of the Greek, and a philosophically more satisfying one in the broader context of B1 and Heraclitus’ thought. Finally, we examine the larger programmatic implications of the small phrase τὸ πρῶτον for Heraclitus’ book.