bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to Human Immunodeficiency Virus Is Associated With Altered Composition of Maternal Microchimeric T Cells in Infants
Authors: Armistead Blair , Peters M Quinn , Houck John , Carlson Marc , Balle Christina , Mulugeta Nolawit , Gray Clive M , Jaspan Heather B , Harrington Whitney E 
Published: October 2024

Abstract
Human immunodeficiency virus–exposed but uninfected infants (iHEU) display altered immunity and are at increased risk of infection. We previously reported that iHEU have decreased maternal microchimerism (MMc)—maternal cells transferred to the offspring in utero/during breastfeeding. We quantified MMc in T-cell subpopulations in iHEU and HIV-unexposed infants (iHU) to determine whether a selective deficiency in MMc contributes to altered cellular immunity. Across all infants, MMc levels were highest in CD8+ T cells; however, the level of CD8+ T-cell MMc was lower in iHEU versus iHU. In limited functional studies, we did not identify cytomegalovirus-specific MMc during infant primary infection.
Diplomacy with the DPRK during the Nakasone administration: With a focus on two-track diplomacy at the governmental and nongovernmental levels
Authors: Choi Ji-hee 
Published: October 2024

Abstract
The study investigates Japan's diplomacy towards North Korea (DPRK) during the Yasuhiro Nakasone administration (1983–1986), focusing on two-track diplomacy involving governmental and non-governmental efforts. While maintaining strong ties with the USA and South Korea (ROK), Nakasone sought to improve Japan–DPRK relations amidst Cold War tensions. Japan utilized informal diplomacy through channels like the Japan–DPRK Dietmen's League and the Socialist Party, despite obstacles like the Rangoon bombing and US skepticism. The research highlights Japan's efforts to manage relations with both DPRK and ROK and its role in regional strategies such as cross-recognition diplomacy involving China and the Soviet Union. Archival materials from Japanese and ROK diplomatic sources shed light on Japan’s diplomatic approach, which balanced international pressure and regional engagement. It concludes that while Japan's relationships with the ROK and the USA limited its governmental diplomacy, non-governmental initiatives played a critical role, paving the way for future developments in Japan–DPRK relations.
The Ethics of Weeping in Islam
Authors: Heck Paul L 
Published: October 2024

ABSTRACT
Literature on weeping in Islam and emotions in general, although on the rise, is still limited. This article, focusing on Islam’s heritage of lament for sin, seeks to contribute to the study of religiously informed emotions by highlighting the interests in heavenly purposefulness that depictions of weeping seek to convey. Such purposefulness, the data suggests, is not only penitential but also redemptive and bears ethical fruits for the community as a whole. Weeping in Islam is, then, not mere emotional expression; attention must therefore be paid to the spirit or ethical tone accompanying depictions of pious weeping, illustrated here by two works on weeping, one by Ibn Qudāma al-Maqdisī (d. 1223) and the other by Ibn Abī al-Dunyā (d. 894). The study of emotionality in Islam, as illustrated in this article with the example of weeping, can enrich our appreciation of religious subjectivity in Islam and its place in Islam’s overall heritage of ethics.
Implementation of a Pharmacist-Driven Vancomycin Area Under the Concentration-Time Curve Monitoring Program Using Bayesian Modeling in Outpatient Parenteral Antimicrobial Therapy
Authors: Gillett Eric , Aleissa Muneerah M , Pearson Jeffrey C , Solomon Daniel A , Kubiak David W , Dionne Brandon , Edrees Heba H , Okenla Adetoun , Chan Brian T 
Published: October 2024

Abstract

Background
Current vancomycin monitoring guidelines recommend monitoring 24-hour area under the concentration-time curve (AUC) to minimum inhibitory concentration ratios for patients with serious methicillin-resistant Staphylococcus aureus infections. However, there are sparse data on the safety, feasibility, and efficacy of vancomycin AUC monitoring for outpatients. Traditional AUC pharmacokinetic calculations require 2 concentrations, while bayesian software allows for single-concentration AUC estimations.

Methods
We conducted a single-center, quasi-experimental, interrupted time series study of patients enrolled in the outpatient parenteral antimicrobial therapy program at our institution for vancomycin management. Our institution implemented a pharmacist-driven vancomycin AUC monitoring program from September 2019 to February 2020, and again from September 2022 to March 2023. Patients enrolled underwent vancomycin monitoring using an AUC goal of 400–600 mg⋅h/L, estimated through bayesian modeling. Patients enrolled in the outpatient parenteral antimicrobial therapy program from July 2021 through August 2022 for trough-based monitoring were used for comparison. The primary outcome was nephrotoxicity incidence, defined as a serum creatinine increase by ≥0.5 mg/dL or ≥50% during outpatient vancomycin therapy.

Results
We enrolled 63 patients in the AUC group and 60 patients in the trough-based group. Nephrotoxicity was significantly lower in the AUC cohort (6.3% vs 23.3%; P = .01). The number of unusable vancomycin concentrations was also significantly lower in the AUC cohort (0% vs 6%; P &lt; .01). There was no difference in composite 90-day all-cause mortality or readmission (33.3% vs 38.3%; P = .56).

Conclusions
Following implementation of a pharmacist-driven AUC monitoring program, patients were less likely to develop nephrotoxicity during outpatient vancomycin therapy.
Food retailer actions toward the National Strategy on Hunger, Nutrition, and Health to promote nutrition security: Applicability of the Business Impact Assessment-Obesity as a monitoring tool
Authors: DeNunzio Maria , Houghtaling Bailey , Kraak Vivica , Gardezi Maaz , Serrano Elena , Misyak Sarah 
Published: October 2024

ABSTRACT
The White House National Strategy on Hunger, Nutrition, and Health (National Strategy) encourages actions across government and society to promote nutrition security. Nutrition security includes adequate food, diet quality, and equity, and food retail settings can promote these major concepts. Of all National Strategy whole-of-society calls to action, food retailers can contribute to 15 calls as key actors. However, there is currently no standardized monitoring tool to track food retailers’ commitments and actions toward the National Strategy to promote nutrition security. The Business Impact Assessment-Obesity and population-level nutrition (BIA-Obesity), a tool originally developed for corporate accountability monitoring, can be tailored for the National Strategy and nutrition security, given its standardized indicators and process to assess food company policies and commitments across six domains. We discuss the fit of the BIA-Obesity indicators for tracking food retailers’ commitments and actions across four pillars of the National Strategy. Existing indicators are appropriate to monitor components of Pillar 1: Improve Food Access and Affordability; Pillar 2: Integrate Nutrition and Health; Pillar 3: Empower All Consumers to Make and Have Access to Healthy Choices; and Pillar 5: Enhance Nutrition and Food Security Research. We suggest expanding current indicators to include equity, local foods, the digital food environment, and food waste reduction to improve alignment of the BIA-Obesity with the National Strategy. Application of the BIA-Obesity as an existing tool can facilitate data cohesion and more rapid assessment of the food retailer landscape to mutually meet nutrition security goals by 2030.
Text “HEALER”: Using Text Mentorship to Engage American Indians and Alaska Natives Interested in the Health Professions
Authors: Vasquez Guzman Cirila Estela , Fernandez Jasmine , Uh Christina , Craig Rushing Stephanie , Donald Caitlin , Spector Dove , Stephens David , Peterson Roger , Taylor Cynthia , Pinela Cristi , Wistrom Jeremiah , Carney Patricia A. , Brodt Erik 
Published: October 2024

Abstract

Problem
The persistent underrepresentation of American Indians and Alaska Natives (AIANs) in the health professions and the decline of AIAN matriculants into health-related programs suggest interventions are needed. The authors developed Healers, a text message mentoring service, to engage and support AIANs interested in the health professions.

Approach
Healers, launched in 2018, seeks to reach urban and rural high school/college-aged AIANs and other AIANs. Individuals subscribe by texting “HEALER” to a numeric code using their mobile device. Two concurrent intervention strategies include (1) a 17-week schedule of scripted texts and (2) live weekly office hours with 2 health pathway coaches. During the pilot year (June 2018 to June 2019), participants were recruited via national conferences, health fairs, social media, and word of mouth. Intake and exit surveys were conducted. Content analysis of text messages received during office hours was conducted.

Outcomes
During the pilot, 304 subscribers opted into Healers and generated 2,933 text messages. Intake survey respondents included high school students (n = 18/77, 23.4%), college students (n = 29/77, 37.7%), and others (n = 29/77, 37.7%). They represented 60 Tribes from 28 U.S. states. Among exit survey respondents, 26/28 (92.9%) reported Healers was useful, 25/27 (92.6%) reported it exposed them to new health professions, 26/27 (96.3%) expressed stories from AIAN health professionals were valuable, and 25/26 (96.2%) reported pursuing a health professions career seemed possible. Five themes emerged from the analysis of 346 texts received from participants during office hours: cultural support, mentorship, opportunities, wellness, and community building.

Next Steps
Based on the pilot data concerning reach and impact, the Healers service has continued to enroll subscribers, host office hours, and promote the program. Future research should examine which careers interest participants and factors leading to successful enrollment in health pathway programs and attainment of health professions degrees.
Changes in Auditory Performance Following a Virtual Reality Music Concert
Authors: Grinn Sarah K. , Notaro Dana E. , Shokar Jatinder K. , Cheng Chin-I 
Published: October 2024

Objectives:
The purpose of this study was to evaluate threshold and suprathreshold auditory risk from a newly popular platform of music concert entertainment; virtual reality (VR) headsets. Recreational noise exposure to music is the primary source of hearing hazard in young-adults, with noise doses of in-person concert venues and music festivals well in excess of the recommended daily exposure recommendation from the National Institute for Occupational Safety and Health. While research on the relationship between personal music players and noise-induced hearing loss risk is abundant, no study has yet evaluated noise-induced hearing loss risk from VR headsets, which are newest to the commercial market at this time.

Design:
Thirty-one young-adult participants (18 to 25 years) with normal-hearing sensitivity (0 to 16 dB HL) experienced a VR music concert and participated in three data collection timepoints: Session A preexposure, Session A post-exposure, and Session B post-exposure. Participants underwent baseline testing for audiometry (0.25 to 20 kHz), distortion product otoacoustic emission testing (1 to 10 kHz), and Words-in-Noise testing. Participants then wore a commercially available VR headset (Meta Quest 2) and experienced a freely available online VR music concert (via the video-sharing website “YouTube”). The VR music concert duration was 90 min set to maximum volume, which yielded an average sound level equivalent of 78.7 dBA, max sound level of 88.2 dBA, and LC peak sound level of 98.6 dBA. Post-exposure testing was conducted immediately at the conclusion of the VR concert, and again within 24 hr to 1 week after the exposure. Participants also answered a questionnaire that estimated noise exposure history (National Acoustics Laboratory “Noise Calculator”).

Results:
Post-exposure deficit was not observed in DPOAEs or Words-in-Noise score (p’s > 0.05). However, statistically significant temporary post-exposure deficit was observed in audiometry at 4, 8, and 12.5 kHz (p’s < 0.05) (mean differences: 2 to 3 dB HL). Twenty-four hours and 1-week post-exposure measurements revealed no permanent changes from baseline measurements (p’s > 0.05) aside from one spurious difference at 12.5 kHz. Males tended to exhibit a significantly higher noise history score on average than females. The primary, secondary, and tertiary sources of noise hazard history in this young-adult cohort included amplified music.

Conclusions:
These preliminary data suggest that VR music concerts—which are likely to produce a substantially lower noise dose than in-person music concerts—may still be capable of producing at least slight, temporary threshold shifts on the order of 2 to 3 dB HL. Future research should include VR headsets in personal music player risk assessment, as the VR music concert platform is increasing rapidly in popularity among young-adults.
EUS–guided therapies for primary and secondary prophylaxis in gastric varices—An updated systematic review and meta-analysis
Authors: Chandan Saurabh , Nguyen Andrew Khoi , Mohan Babu P. , Deliwala Smit , Ramai Daryl , Kassab Lena L. , Muthusamy Arunkumar , Facciorusso Antonio , Kamal Faisal , Bilal Mohammad , Samanta Jayanta , Adler Douglas G. 
Published: October 2024

Abstract

Background and Objectives
Gastric varices (GVs) are associated with a higher risk of uncontrolled bleeding and death when compared with esophageal varices. While endoscopic glue injection therapy has been traditionally used for secondary prophylaxis in GV, data regarding primary prophylaxis continue to emerge. Recently, EUS–guided therapies have been used in GV bleeding.

Methods
We conducted a comprehensive search of several major databases from inception to June 2022. Our primary goals were to estimate the pooled rates of treatment efficacy, GV obliteration, GV recurrence, and rebleeding with EUS-guided therapy in primary and secondary prophylaxis. Overall adverse events and technical failures were assessed. Random-effects model was used for our meta-analysis, and heterogeneity was assessed using the I
2 % statistics.

Results
Eighteen studies with 604 patients were included. In primary prophylaxis, pooled rate of GV obliteration was 90.2% (confidence interval [CI], 81.1–95.2; I
2 = 0). With combination EUS–glue and coil therapy, the rate was 95.4% (CI, 86.7%–98.5%; I
2 = 0). Pooled rate of posttherapy GV bleeding was 4.9% (CI, 1.8%–12.4%; I
2 = 0). In secondary prophylaxis, pooled rate of treatment efficacy was 91.9% (CI, 86.8%–95.2%; I
2 = 12). With EUS-glue, EUS-coil, and combination EUS–glue and coil, the rates were 94.3% (CI, 88.9%–97.1%; I
2 = 0), 95.5% (CI, 80.3%–99.1%; I
2 = 0), and 88.7% (CI, 76%–95.1%; I
2 = 14), respectively. Pooled rate of GV obliteration was 83.6% (CI, 71.5%–91.2%; I
2 = 74). With EUS-glue, EUS-coil, and combination EUS–glue and coil, the rates were 84.6% (CI, 75.9%–90.6%; I
2 = 31), 92.3% (CI, 81.1%–97.1%; I
2 = 0), and 84.5% (CI, 50.8%–96.7%; I
2 = 75), respectively. Pooled rates of GV rebleeding and recurrence were 18.1% (CI, 13.1%–24.3%; I
2 = 16) and 20.6% (CI, 9.3%–39.5%; I
2 = 66), respectively.

Conclusion
Our analysis shows that EUS-guided therapy for GVs is technically feasible and clinically successful in both primary and secondary prophylaxis of GV.
Implementation of a Standardized Tool for Root Cause Analysis Selection
Authors: Wahlstedt Eric , Levy Brittany E. , Scott Emma , Stephens Wesley , Fletcher Kristen E. , Harris Andrew 
Published: October 2024

Objectives:
This study sought to determine if a standardized root cause analysis (RCA2) selection algorithm, developed by the Veterans Affairs, would select high-risk events for RCA.

Methods:
Physician-entered incident reports for all surgical service admissions and perioperative visits were queried over 12 months in the DATIX Clinical Incident Management System. Independent reviewers assigned potential harm and event frequency scores using an institutional scoring system and then calculated and rounded average scores. These were classified using RCA2 terminology (catastrophic, major, moderate, minor for harm; frequent, occasional, uncommon, remote for frequency). The scores were then evaluated with the standardized Safety Assessment Code Matrix (SAC) algorithm from the National Patient Safety Foundation’s RCA2 guidelines to determine Potential Harm Scores. The SAC combines severity and probability to determine the necessity of conducting an RCA. Catastrophic and major high-frequency events (matrix score = 3) were classified as “RCA recommended.” The study then compared cases selected for RCAs using the updated RCA2 algorithm against cases selected using a current, institutional-specific RCA selection process.

Results:
One hundred four cases were reviewed, comprising 20 catastrophic, 48 major harm, 26 moderate harm, and 10 minor harm events. After removing 9 high-variance cases, our institution’s current selection process selected 18 cases for RCAs, including 6/20 catastrophic, 8/39 major harm, and 4/36 moderate/minor harm events. Only 17.3% of cases had an RCA completed, while the standardized RCA2 algorithm recommended investigation for 56.7% of patient safety events, based on SAC Matrix scoring. Current RCA selection processes rendered 4 RCAs on low potential harm or low-frequency events, while 45 potential high-frequency, high potential harm events did not complete RCAs.

Conclusions:
Standardizing the selection of patient safety incidents for RCA using the RCA2 algorithm improves case identification based on the event frequency and potential harm score. Thus, this algorithm has the potential to advance patient safety.
The Effect of Hospital-to-Home Discharge Interventions on Reducing Unplanned Hospital Readmissions: A Systematic Review and Meta-analysis
Authors: Demir Avcı Yasemin , Gözüm Sebahat , Karadag Engin 
Published: October 2024

Background and Objectives:
Unplanned hospital readmissions (UHRs) constitute a persistent health concern worldwide. A high level of UHRs imposes a burden on individuals, their families, and health care system budgets. This systematic review and meta-analysis aimed to evaluate the effectiveness of discharge interventions in the transition from hospital to home in the context of reducing UHRs.

Methods:
The study design was a meta-analysis of randomized and nonrandomized controlled trials. Eight databases were searched. The effect on UHR rates (odds ratio [OR]) of discharge interventions in the transition from hospital to home was calculated at a 95% confidence interval (95% CI) based on meta-regression and meta-analysis of random-effects models.

Results:
Results showed that discharge interventions were effective in reducing rehospitalizations (effectiveness/OR =1.39; 95% CI, 1.24-1.55). It was furthermore determined that the studies showed heterogeneous characteristics (P ≤ .001, Q = 50.083, I
2 = 44.093; df = 28). According to Duval and Tweedie's trim and fill results, there was no publication bias. Interventions in which telephone communications and hospital visits (OR = 1.64; 95% CI, 1.25-2.16; P < .001) were applied together were effective among patients with cardiovascular diseases (OR = 1.54; 95% CI, 1.28-2.09; P < .001), and it was found that UHRs were reduced within a period of 90 days (OR = 1.68; 95% CI, 1.16-2.42; P < .001). It was also found that discharge interventions applied to transitions from hospital to home had a diminishing effect on UHRs as the publication dates of the reviewed studies advanced from the past to the present (OR = 0.015; 95% CI, 0.002-0.003; P < .001).

Conclusion:
Supporting and facilitating cooperation between health care professionals and families should be a key focus of discharge interventions.
Patient Satisfaction and QoL in SUI: Results With Single-Incision or Full-Length Slings
Authors: Erickson Ty , Gheiler Edward , Hanson Craig E. , McCrery Rebecca , Parekh Mitesh , Parva Mohamad , Tu Le Mai 
Published: October 2024

Importance
Understanding treatment impact on quality of life of patients with stress urinary incontinence (SUI) in the short- and long-term is vital to optimizing treatment success.

Objectives
This study aimed to report 36-month patient satisfaction and quality of life results from a 522 study of single-incision and full-length slings in SUI.

Study Design
This was a secondary analysis of the Altis 522 study, a prospective, multicenter, nonrandomized, noninferiority cohort study comparing the Altis single-incision sling to full-length slings for the treatment of SUI. The current study endpoints are patient-reported outcomes on quality of life related to continence status at 6, 12, 18, 24, and 36 months, measured through patient-reported, validated questionnaires: Urogenital Distress Inventory, Incontinence Impact Questionnaire, Patient Global Impression of Improvement, and Surgical Satisfaction Questionnaire.

Results
A total of 355 women underwent the sling procedure (184, Altis group; 171, comparator group). At 36 months, 140 (76.0%) of Altis and 101 (59.1%) of comparator group patients were assessed. Patient Global Impression of Improvement at 36 months indicated that 92.9% of Altis and 90.1% of comparator patients reported that their condition was “very much better” or “much better” (P = 0.444). Urogenital Distress Inventory at 36 months indicated improvement in quality of life in both groups with a mean change from baseline of 41.7 ± 19.3 (Altis group; n = 140) versus 44.4 ± 22.2 (comparator group; n = 101) (P = 0.305). The Incontinence Impact Questionnaire indicated average quality-of-life improvement of 50% in both groups from presurgery to 36 months, with a mean change from baseline of 51.8 ± 25.8 (Altis group) versus 50.2 ± 25.1 (comparator group) (P = 0.619).

Conclusions
This 36-month study demonstrated the lasting, positive effect that surgical intervention can have on patients with SUI.