bluuebunny/crossref_metadata_2025_split huggingface dataset:
788. Risk Factors for Severe COVID-19 Breakthrough Infections: A Retrospective, Nationwide Cohort Study
Authors: Vo Austin D , Branch-Elliman Westyn , La Jennifer , Ronan Matthew , Brophy Mary , Wu Julie , Do Nhan , Strymish Judith , Fillmore Nathanael , Monach Paul 
Published: December 2022

Abstract

Background
COVID-19 vaccines reduce the incidence of severe clinical outcomes, however, some patients remain at risk of severe disease. The primary aim of this large, nationwide retrospective cohort was to identify risk factors for severe disease despite vaccination.

Methods
Nationwide cohort study of US Veteran patients with laboratory-confirmed SARS-CoV-2 infection after vaccination. The primary outcome was development of severe COVID-19 disease, defined as a hospitalization within 14 days of a positive SARS-CoV-2 diagnostic test and either SpO2 ≤ 94%, receipt of supplemental oxygen, mechanical ventilation, or death within 28 days. Exposure variables included demographic and clinical risk factors, receipt of an additional vaccine dose, and calendar months since initial vaccination series. Data were analyzed using logistic regression, and adjusted odds ratios (aORs) are presented.

Results
Among 111,151 breakthrough infections, 110,760 had disease severity assessments and were included. 14,690/110,790 (13.3%) were hospitalized with severe COVID-19 or died. Risk factors for severe disease are presented in Figure 1.
The strongest risk factor for severe disease despite vaccination was age. Immunocompromising conditions, including immunosuppressive medications (Cytokine-blocking, aOR, 1.73, CI, 1.37–2.18; receipt of glucocorticoids, aOR, 2.41, CI, 2.25, 2.58; leukocyte inhibitory, aOR 2.44, CI, 1.98–2.99; lymphocyte-depleting, aOR, 2.12, 1.61–2.79), cytotoxic chemotherapy within 6 months (aOR, 2.69; CI, 2.25, 3.21), and leukemias/lymphomas were also associated with increased risk (aOR, 1.84, CI, 1.59–2.14), as were chronic conditions associated with end-organ disease. Receipt of an additional (booster) dose of vaccine was associated with reduced odds of severe disease, with risk reduction from vaccination and boosting strongest during the months immediately following vaccine doses.
Variables with aOR &lt;1 are associated with reduced odds of severe breakthrough infections and variables with aOR &gt;1 are associated with increased odds of severe breakthrough infections. Referent groups for multicategory variables are listed in bold. Presented with a logarithmic scale.

Conclusion
In this nationwide cohort, we identified risk factors for severe disease despite vaccination. Findings can be used to inform outreach efforts for booster vaccinations and to inform clinical decision making about risk and to identify patients who would benefit from interventions in addition to vaccination, such as pre-exposure prophylaxis and antiviral therapy.

Disclosures
Westyn Branch-Elliman, MD, MMSc, DLA Piper,LLC/Medtronic: Advisor/Consultant|Gilead Pharmaceuticals: Grant/Research Support Paul Monach, MD, PhD, Celgene / Bristol-Myers Squibb: Advisor/Consultant|ChemoCentryx: Advisor/Consultant|Gilead: Grant/Research Support|Kiniksa: Advisor/Consultant.
795. Awareness and Interest in PrEP Options Among US Cisgender Women – A National Survey
Authors: Poteat Tonia , Sarkar Supriya , Ragone Leigh , Rawlings Keith , Rinehart Alex R , Hill Jennifer N , Gallington Kyli , Coyne Karin S , Vannappagari Vani 
Published: December 2022

Abstract

Background
Cisgender women continue to have low pre-exposure prophylaxis (PrEP) uptake in the US, despite making up almost 20% of new HIV infections. The gap between the number of women who would benefit from PrEP and those who use PrEP highlights the unmet need for HIV prevention in women. As new prevention options, such as long-acting (LA) injectable PrEP, become available, it is important to understand PrEP awareness and preferences among women to help meet this need. Awareness, willingness, and usage of PrEP as well as HIV prevention preferences were assessed among sexually active women in the US.

Methods
Cisgender women were recruited through a geolocation targeted social media campaign and completed a self-administered, cross-sectional, online survey on demographics, sexual health and behavior, healthcare access, PrEP awareness and history, and PrEP intention and preferences. Eligible participants were cisgender women, 18 years or older, who reported an unknown or HIV-negative status, currently resided in the US, and reported vaginal or anal sex in the past six months. Descriptive statistics were calculated using SAS v9.4.

Results
From November to December 2021, 961 participants completed the survey (median age: 28.0 years; Black non-Hispanic: 34.7%; Black Hispanic: 19.9%; White non-Hispanic: 21.3%; White Hispanic: 12.0%; Another race: 9.1%). A majority had heard of PrEP (70.6%) and LA PrEP (50.1%) as a way to prevent HIV; however, a smaller proportion had spoken to a healthcare provider (HCP) about PrEP (37.8%), had ever used PrEP (19.7%), or were currently on PrEP (9.3%). While PrEP awareness was high across all racial and ethnic groups, PrEP discussions with an HCP and PrEP usage was lowest among Black, non-Hispanic women (Figure 1). Most participants (78.8%) expressed intent to regularly use any HIV prevention method and 66.0% reported likelihood of using LA PrEP if it were available. Condoms were the most favored prevention option (46.7%) followed by HCP administered LA PrEP (24.3%), vaginal ring (9.0%), self-administered LA PrEP (8.8%), and oral PrEP (6.7%).

Conclusion
Although most women demonstrated high PrEP awareness and interest, many had never discussed PrEP with an HCP. The availability of LA PrEP may be an important opportunity for HCPs to discuss a preferred PrEP option with women.

Disclosures
Tonia Poteat, PhD, MPH, PAC, Merck & Co. Inc: Advisor/Consultant|Viiv Healthcare: Advisor/Consultant Supriya Sarkar, PhD, MPH, ViiV Healthcare: Salary|ViiV Healthcare: Stocks/Bonds Leigh Ragone, MS, GlaxoSmithKline: Stocks/Bonds|ViiV Healthcare: Employment Keith Rawlings, MD, ViiV Healthcare: Employee Alex R. Rinehart, PhD, ViiV Healthcare: Stocks/Bonds Vani Vannappagari, MBBS, MPH, PhD, ViiV Healthcare: I am full time employee of ViiV Healthcare and receive GlaxoSmithKline stock as part of my compensation package|ViiV Healthcare: Stocks/Bonds.
LB2305. Long Term Benefits from Early Antiretroviral Therapy Initiation in HIV Infection: Findings from the Extended Follow-up of the START Trial
Authors: Babiker Abdel G , Lundgren Jens , Sharma Shweta , Grund Birgit , Phillips Andrew , Kan Virginia L , Matthews Gail , Klingman Karin L , Neaton James D 
Published: December 2022

Abstract

Background
Deferral of antiretroviral therapy (ART) initiation until CD4 count &lt; 350 cells/μL in people with CD4 &gt; 500 increases risk of AIDS and serious non-AIDS (SNA) conditions. Evidence from randomized trials is lacking to assess the extent to which ongoing excess risk due to having deferred initiation is reduced once ART is initiated and viral load suppressed.

Methods
START randomized 4684 ART-naïve HIV+ adults with CD4 &gt; 500 cells/μL to start ART immediately (IMM, n=2325) or defer ART until CD4 &lt; 350 cells/μL or AIDS developed (DEF, n= 2359). In 2015 the study demonstrated a 57% reduction in the risk of the primary endpoint (AIDS, SNA or death) for IMM ART; all assigned to DEF were recommended to start ART. Follow up continued to 31Dec2021. To determine whether the benefit of IMM compared to DEF was maintained, increased, or reduced, Cox models were used to estimate and compare hazard ratios (HR, IMM:DEF), for the primary endpoint and its components from randomization through 31Dec2015 (Pre 2016) with the period 1Jan2016 through 31Dec2021 (Post 2016). HRs for all follow-up, randomization through 31Dec2021, were also estimated.

Results
Pre 2016, median CD4 was 648 cells/μL in IMM and 460 cells/μL in DEF at ART initiation, a difference of 188 cells/μL (95% CI: 180-197); at the end of 2015, 98.9% of IMM and 84.8% of DEF were prescribed ART. The percentage of follow-up time spent on ART pre 2016 was 94.5% for IMM and 35.5% for DEF; and the average difference in CD4 count was 199 cells/μL. This contrasts with post 2016 during which the percentage of follow-up time on ART was 99.5% for IMM and 95.6% for DEF; and the average difference in CD4 was 155 cells/mL (Figure 1).
During both time periods, initiation of ART led to rapid declines in HIV RNA to ≤ 200 copies/mL. For the primary endpoint and each component, the benefit of IMM compared to DEF in Post 2016 was reduced compared to Pre 2016 (Figure 2).
Overall follow-up, from randomization to 2021 (median 9.3 years), the HR for the primary endpoint was 0.61 (95%CI: 0.49, 0.76; p&lt; 0.001).

Conclusion
Among people with CD4 &gt; 500, the excess risk of AIDS and SNA conditions associated with delaying ART initiation is substantially diminished soon after ART is initiated, but persistent excess risk remains. The results reinforce the importance of early diagnosis of HIV and prompt initiation of ART.

Disclosures
Gail Matthews, MBChB, PhD, Abbvie Inc: Grant/Research Support|Astra Zeneca: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Grant/Research Support|Janssen: Advisor/Consultant|Janssen: Grant/Research Support|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support.
Reaching Viral Suppression Among People With HIV With Suspected Treatment Failure who Received Enhanced Adherence Counseling in Southern Nigeria: A Retrospective Analysis
Authors: Akpan Uduak , Nwanja Esther , Ukpong Kufre-Abasi , Toyo Otoyo , Nwaokoro Pius , Sanwo Olusola , Gana Bala , Badru Titilope , Idemudia Augustine , Pandey Satish Raj , Khamofu Hadiza , Bateganya Moses 
Published: December 2022

Abstract

Background
This study assessed viral load (VL) testing and viral suppression following enhanced adherence counseling (EAC) among people with HIV (PWH) with suspected treatment failure and identified factors associated with persistent viremia.

Methods
We conducted a retrospective review of electronic medical records of PWH aged 15 years or older who had received antiretroviral therapy (ART) for at least 6 months as of December 2020 and had a high viral load (HVL; ≥1000 copies/mL) across 22 comprehensive HIV treatment facilities in Akwa Ibom State, Nigeria. Patients with HVL were expected to receive 3 EAC sessions delivered in person or virtually and repeat VL testing upon completion of EAC and after documented good adherence. At 6 months post–EAC enrollment, we reviewed the data to determine client uptake of 1 or more EAC sessions, completion of 3 EAC sessions, a repeat viral load (VL) test conducted post-EAC, and persistent viremia with a VL of ≥1000 copies/mL. Selected sociodemographic and clinical variables were analyzed to identify factors associated with persistent viremia using SPSS, version 26.

Results
Of the 3257 unsuppressed PWH, EAC uptake was 94.8% (n = 3088), EAC completion was 81.5% (2517/3088), post-EAC VL testing uptake was 75.9% (2344/3088), and viral resuppression was 73.8% (2280/3088). In multivariable analysis, those on ART for &lt;12 months (P ≤ .001) and those who completed EAC within 3 months (P = .045) were less likely to have persistent viremia.

Conclusions
An HVL resuppression rate of 74% was achieved, but EAC completion was low. Identification of the challenges faced by PWH with a higher risk of persistent viremia is recommended to optimize the potential benefit of EAC.
Ockham's Nominalism
Authors: Panaccio Claude 
Published: December 2022

Abstract
William of Ockham is a towering figure in the history of philosophy and is commonly seen as the most important nominalist thinker of the Middle Ages. His nominalism basically consists of three theses: there are no universals in the external world; no relations either; and no quantities considered as distinct entities. This book provides an introduction to Ockham’s defense of these positions and to what they amount to in metaphysics, semantics, and epistemology. It thus displays the outlines of a rich and carefully crafted nominalist system that is still of great philosophical interest today. In so doing, the book situates Ockham’s thought with respect to several salient contemporary debates in philosophy.
Domination at Work
Authors: Vrousalis Nicholas 
Published: December 2022

Abstract
This book is about how power converts the service of others into servitude. As a matter of logic, servitude presupposes dominion. So what is dominion? What kinds of transactions, in general, does it censure? And what is the character of these transactions under capitalism Chapter 2 offers provisional answers to these questions. It argues that domination is violation of the requirements of rightful individual freedom: subjection of purposiveness to the choices of others. Applied to work, such subjection entails unjust unilateral control over the productive purposiveness of others. The chapter introduces the Non-Servitude Proviso, which grounds the subjected-purposiveness idea on a number of possible justifications: Kantian, republican, and recognitional. Exploitation is what happens when unilateral control over labour capacity translates into unreciprocated labour flow. With the help of a simple economic model, the chapter applies the Proviso to capital and discusses its implications for ‘clean’ capitalist accumulation. Capital, I argue, is monetized title to subsumed labour.
How Exploiters Dominate
Authors: Vrousalis Nicholas 
Published: December 2022

Abstract
This chapter argues that exploitation is a dividend of servitude. It does this by extending, refining, and defending the domination conception of exploitation. The chapter kicks off by arguing that what makes exploitation unjust is that it constitutes domination-induced unilateral service to others. After rebutting John Roemer’s influential critique of surplus labour, it shows that exploitation is necessarily cashed out in terms of labour time or effort. The chapter then criticizes competing contemporary accounts of exploitation, the vulnerability view and the fairness view. It argues that they fail to do justice to the servitude dimension and to account for important counterexamples.
Climate and the Picturesque in the American Tropics
Authors: Boyden Michael 
Published: December 2022

AbstractClimate and the Picturesque in the American Tropics shows how the writings of American travelers in the Caribbean registered and pushed forward a form of climatic awareness between 1770 and 1860, a pivotal period in modern history fraught with debates over slavery, environmental destruction, and colonialism. Offering novel readings of authors including J. Hector St. John de Crèvecœur, Leonora Sansay, William Cullen Bryant, Nathaniel Hawthorne, Sophia Peabody, Ralph Waldo Emerson, and James McCune Smith in light of their engagements with the American tropics, the book shows that these authors drew on a climatic epistemology that fused science and sentiment in ways that citizen science is aspiring to do today. Climate and the Picturesque in the American Tropics thus poses a significant departure from other works in the Environmental Humanities that conceive of climatic enlightenment as a recent development or trace its beginnings back to romantic nature writing. By suggesting a new genealogy of modern climate thinking, Climate and the Picturesque in the American Tropics urges us to reconsider the roots of deeply ingrained ideas of tropicality that continue to inform current debates on climate debt and justice.
Phenomenalism
Authors: Pelczar Michael 
Published: December 2022

AbstractJ.S. Mill famously equates physical things with “permanent possibilities of sensation.” In this view, known as phenomenalism, a rock is a tendency for experiences to occur as they do when people perceive a rock, and similarly for all other physical things. Phenomenalism develops Mill’s theory in detail, defends it against the objections responsible for its current unpopularity, and uses it to shed light on important questions in metaphysics, the philosophy of science, and the philosophy of mind. Identifying physical things with possibilities of sensation establishes a transparent connection between the world of physics and the world of sense, provides an attractive alternative to currently fashionable structuralist and panpsychist metaphysics, offers a fresh perspective on the problem of consciousness, and yields a satisfying theory of perception, all by taking two things notoriously resistant to reduction---chance and experience---and constructing everything else out of them.
Agreement marking in Croatian Sign Language
Authors: Milković Marina , Wilbur Ronnie 
Published: December 2022

AbstractWe argue that failure to accurately identify sign components led to misconceptions that sign languages (SLs) violate generalizations about spoken-language verb agreement. Because it was assumed that verb phonological path movement (from location A to location B) carried agreement information, it was claimed that (1) only a subset of verbs shows agreement, leading to search for triggers; and (2) object agreement is more common, with subject agreement visible when object is marked. We argue, following Lourenço (2018), that when locations themselves are recognized as marking agreement with arguments (co-localization), the apparent SL anomalies disappear: previously excluded verb signs not containing path movement are now included, as intransitives agreeing with one argument, often subject-only. Instead of searching for agreement triggers, we identify what blocks agreement. Presence of path movement is related to event properties (Wilbur, 2008; 2010). Our analysis supports Lourenço’s model using data from Croatian Sign Language (HZJ).
A multiple-agreement approach to auxiliary clitic drop in Croatian
Authors: Willer-Gold Jana , Peti-Stantić Anita 
Published: December 2022

AbstractThe chapter introduces an under-studied phenomenon of auxiliary clitic drop by presenting the data from the first comprehensive experimental study in mixed-category clitic clusters in Croatian. The study comprised of four experiments pairing acceptability judgement and forced-choice tasks to examine auxiliary clitic drop when preceded by Canonical and Reverse PCC, and when preceded by nominal clitic varying in person and case value. The data capture person effects that show no interaction with categorical factors (double-object vs object-auxiliary clitic clusters), suggesting that auxiliary clitic drop should be considered as an instance of person-ordering constraint. The analysis focuses on an asymmetry in person-gender feature values and applies a multiple-agreement gender-relativized probe to account for the optionality of subject-agreeing auxiliary being dropped when preceded by 1st or 2nd person object accusative clitic.
Agreement in Turkish relative clauses
Authors: Gračanin-Yuksek Martina 
Published: December 2022

AbstractThe suffix that marks the verb of a Turkish relative clause depends on the relativized constituent: if it is the subject, the suffix is -(y)An, if it is a non-subject, the suffix is -DIK. However, sometimes the relativization of non-subjects—e.g. oblique objects in passive constructions—results in the suffix -(y)An. The chapter accounts for these facts in terms of complementizer agreement, arguing that the choice of the suffix depends on how many goals value the uninterpretable Op- and φ-features on C. If C enters (a) successful Agree relation(s) with a single goal, the relative clause is marked by -(y)An. If C enters (a) successful Agree relation(s) with more than one goal, the suffix is -DIK. The analysis derives the difference between subject and non-subject relative clauses; it also extends to cases in which the relativized constituent is not the subject, but the relative clause is nevertheless marked by -(y)An.
Metacommunity concepts, approaches, and directions with Odonata
Authors: Bried Jason T. , Alves-Martins Fernanda , Brasil Leandro S. , McCauley Shannon J. 
Published: December 2022

Abstract
Metacommunity thinking is a rapidly advancing framework for integrated local and regional multispecies ecology. This chapter begins by discussing the background on this thinking. It goes on to focus on the central factors of scale and dispersal. Next, it attempts to justify odonates as model organisms in metacommunity ecology. It then mentions some current themes in the odonate metacommunity literature. The bulk of the chapter explores selected empirical approaches for studying odonate metacommunities. Via these explorations, it offers several directions for metacommunity research and applications using odonates as model organisms and covers mass effects as they relate to bioassessment and spatial prioritization, as well as dispersal limitation and ecological restoration.
ReadingGilgamešin the Zagros Mountains
Authors: Van De Mieroop Marc 
Published: December 2022

AbstractCuneiform writing was invented in Babylonia, the southern half of modern-day Iraq, and manuscripts from that region written in the early centuries of the second millennium bc provide the best information on how it was taught. The literature created there is known to us primarily from clay tablets used in the schools of the prominent cities Nippur and Ur, but remains from the small village of Meturan on the fringes of Babylonia in the Zagros Mountains show that exorcists there, too, read it and elaborated on it. The materials from all these places allow us to recognize three literary idioms: Sumerian, Akkadian, and bilingual Sumero-Akkadian, with intricate relationships among them.
Vernaculars That Changed the World
Authors: Van De Mieroop Marc 
Published: December 2022

AbstractTwo languages first attested in writing in the first millennium bc had an enormous impact on the history of writing: Phoenician and Aramaic. The Phoenician alphabet is the basis of almost all alphabetic scripts in later history, while the use of Aramaic over time spread over a vast area of the Near East and beyond. A rich evidentiary base allows for a reconstruction of the early history of the Aramaic language, which shows a gradual expansion of its use in writing both geographically and in the types of materials recorded. The Persian Empire especially contributed to its spread by adopting it as a transnational chancellery language. Although the evidence of literary texts is limited, what exists shows complex interactions with the cosmopolitan tradition still preserved in the heartland of the empires. In contrast, the evidence for Phoenician writings is limited and relatively short-lived. It often appears in bilingual contexts, including with Greek, and funerary inscriptions dominate. No Phoenician literature survives despite Greco-Roman claims of its existence.
From Minority Languages to World Literatures
Authors: Van De Mieroop Marc 
Published: December 2022

AbstractHebrew, the language of the states of Israel and Judah, had a relatively short history as a vernacular of daily use, being replaced by Aramaic by the 2nd century bc. As a literary idiom, however, its impact on world literature was enormous, and the Hebrew Bible shows numerous interactions with the Babylonian cosmopolitan tradition. Those have been the subject of many scholarly analyses, with widespread disagreement over how and when Hebrew authors could have encountered cuneiform writings and how their works relate to the Mesopotamian ones. It is argued here that they were familiar with cuneiform literature in all its aspects and that they mimicked and subverted its texts in acts of resistance against the empires that promoted it, producing counter-texts. The history of biblical exegesis, which started when the text was still under development, shows how reasoning shifted away from the Babylonian approach to one focusing on contents rather than form.