bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renin, a marker for left ventricular hypertrophy, in primary aldosteronism: a cohort study
Authors: Köhler Anton , Sarkis Anna-Lina , Heinrich Daniel Alexander , Müller Lisa , Handgriff Laura , Deniz Sinan , Schneider Holger , Künzel Heike , Ladurner Roland , Reincke Martin , Adolf Christian 
Published: September 2021

Context
Primary aldosteronism (PA) causes left ventricular hypertrophy (LVH) via hemodynamic factors and directly by aldosterone effects. Specific treatment by mineralocorticoid receptor antagonists (MRA) or adrenalectomy (ADX) has been reported to improve LVH. However, the cardiovascular benefit could depend on plasma renin concentration (PRC) in patients on MRA.

Patients and objective
We analyzed data from 184 patients from the Munich center of the German Conn’s Registry, who underwent echocardiography at the time of diagnosis and 1 year after treatment. To assess the effect of PRC on cardiac recovery, we stratified patients on MRA according to suppression (n = 46) or non-suppression of PRC (n = 59) at follow-up and compared them to PA patients after ADX (n = 79).

Results
At baseline, patients treated by ADX or MRA had comparable left ventricular mass index (LVMI, 61.7 vs 58.9 g/m2.7, P  = 0.591). Likewise, patients on MRA had similar LVMI at baseline, when stratified into treatment groups with suppressed and unsuppressed PRC during follow-up (60.0 vs 58.1 g/m2.7, P  = 0.576). In all three groups, we observed a significant reduction in LVMI following treatment (P  < 0.001). However, patients with suppressed PRC had no decrease in pro-BNP levels, and the reduction of LVMI was less intense than in patients with unsuppressed PRC (4.1 vs 8.2 g/m2.7, P  = 0.033) or after ADX (9.3 g/m2.7, P  = 0.019). Similarly, in multivariate analysis, higher PRC was correlated with the regression of LVH.

Conclusion
PA patients with suppressed PRC on MRA show impaired regression of LVH. Therefore, dosing of MRA according to PRC could improve their cardiovascular benefit.
Strength Analysis of Traffic Sign Frame
Authors: Gedrimas Giedrius , Sabaliauskas Artūras 
Published: September 2021

Traffic sign frame has to be safe, reliable, and withstand the loads to which it can be exposed during exploitation. This type of product strength is determined by the calculations and tests, which are described in the standards. Prior to the production of a prototype, it is useful to perform strength analysis, using analytical or numerical methods. The article presents the analysis of the existing frame lightening and the strength of lightened frames, using computer-aided design and analysis programs. The analysis showed that the model of this type of product can be lightened, but not all frames can withstand the loads.The paper has been prepared on the basis of G. Gedrimas’ Master Thesis.
Variation in Diagnostic Testing and Empiric Acyclovir Use for HSV Infection in Febrile Infants
Authors: Treasure Jennifer D. , Shah Samir S. , Hall Matt , Mahant Sanjay , Berry Jay G. , Kimberlin David W. , Schondelmeyer Amanda C. 
Published: September 2021

BACKGROUND AND OBJECTIVESClinicians evaluating for herpes simplex virus (HSV) in febrile infants must balance detection with overtesting, and there is no universally accepted approach to risk stratification. We aimed to describe variation in diagnostic evaluation and empirical acyclovir treatment of infants aged 0 to 60 days presenting with fever and determine the association between testing and length of stay (LOS).METHODSIn this retrospective 44-hospital observational study, we used the Pediatric Health Information System database to identify infants aged ≤60 days evaluated for fever in emergency departments from January 2016 through December 2017. We described hospital-level variation in laboratory testing, including HSV, imaging and other diagnostic evaluations, acyclovir use, and LOS. We assessed the relationship between HSV testing and LOS using generalized linear mixed effects models adjusted for age and illness severity.RESULTSIn 24 535 encounters for fever, the median HSV testing frequency across hospitals was 35.6% (interquartile range [IQR]: 28.5%–53.5%) for infants aged 0 to 21 days and 12% (IQR: 8.6%–15.7%) for infants aged 22 to 60 days. Among HSV-tested patients, median acyclovir use across hospitals was 79.2% (IQR: 68.1%–89.7%) for those aged 0 to 21 days and 63.6% (IQR: 44.1%–73%) for those aged 22 to 60 days. The prevalence of additional testing varied substantially by hospital and age group. Risk-adjusted LOS for HSV-tested infants was significantly longer than risk-adjusted LOS for those not tested (2.6 vs 1.9 days, P &lt; .001).CONCLUSIONSSubstantial variation exists in diagnostic evaluation and acyclovir use, and infants who received HSV testing had a longer LOS than infants who did not. This variability supports the need for further studies to help clinicians better risk-stratify febrile infants and to guide HSV testing and treatment decisions.
Time to Blood Culture Positivity by Pathogen and Primary Service
Authors: MacBrayne Christine E. , Williams Manon C. , Prinzi Andrea , Pearce Kelly , Lamb Dustin , Parker Sarah K. 
Published: September 2021

OBJECTIVES
Initiation and continuation of empirical antimicrobial agents for a 48–72-hour observation period is routine practice in the diagnosis and treatment of infants and children with concern for bacteremia. We examined blood cultures at a freestanding pediatric hospital over a 6-year period to determine the time to positivity.

METHODS
Data were extracted for all patients who were hospitalized and had blood cultures drawn between January 2013 and December 2018. Time to positivity was calculated on the basis of date and time culture was collected compared with date and time growth was first reported.

RESULTS
Over a 6-year period, 89 663 blood cultures were obtained, of which 6184 had positive results. After exclusions, a total of 2121 positive blood culture results remained, including 1454 (69%) pathogens and 667 contaminants (31%). For all positive blood culture results, the number and percentage positive at 24, 36, and 48 hours were 1441 of 2121 (68%), 1845 of 2121 (87%) and 1970 of 2121 (93%), respectively. One hundred twenty-five (66 pathogens, 59 contaminants) of the 89 663 cultures (0.14%) yielded positive results between 36 and 48 hours, indicating that 719 patients would need to be treated for 48 hours rather than 36 hours to prevent 1 case of antibiotic termination before positive result. Median times to positive result by pathogen and service line are presented.

CONCLUSIONS
This study reveals that ≤36 hours may be a sufficient period of observation for infants and children started on empirical antimicrobial agents for concern for bacteremia. These findings highlight opportunities for antimicrobial stewardship to limit antimicrobial .
State of Women in Medicine: History, Challenges, and the Benefits of a Diverse Workforce
Authors: Joseph Madeline M. , Ahasic Amy M. , Clark Jesse , Templeton Kim 
Published: September 2021

Women in medicine have made progress since Elizabeth Blackwell: the first women to receive her medical degree in the United States in 1849. Yet although women currently represent just over one-half of medical school applicants and matriculates, they continue to face many challenges that hinder them from entering residency, achieving leadership positions that exhibit final decision-making and budgetary power, and, in academic medicine, being promoted. Challenges include gender bias in promotion, salary inequity, professional isolation, bullying, sexual harassment, and lack of recognition, all of which lead to higher rates of attrition and burnout in women physicians. These challenges are even greater for women from groups that have historically been marginalized and excluded, in all aspects of their career and especially in achieving leadership positions. It is important to note that, in several studies, it was indicated that women physicians are more likely to adhere to clinical guidelines, provide preventive care and psychosocial counseling, and spend more time with their patients than their male peers. Additionally, some studies reveal improved clinical outcomes with women physicians. Therefore, it is critical for health care systems to promote workforce diversity in medicine and support women physicians in their career development and success and their wellness from early to late career.
Comportamento de Consumo Ambientalmente Responsável de Futuros Formadores de Opinião da Capital Paranaense
Authors: Heimann Jaqueline De Paula , Freire Gabriel De Mello , Oliveira Gustavo Silva , De Alvarenga Gabriel a Araujo , Da Silva João Carlos Garzel Leodoro , Steiner Neto Pedro Afonso 
Published: September 2021

Este estudo teve como objetivo verificar o nível de consciência ambiental dos futuros formadores de opinião da Universidade Federal do Paraná no momento de consumo. Os dados foram obtidos por meio da aplicação de questionário aplicado a 180 estudantes de uma IFES. Após análise inicial para testar a multicolinearidade e existência de outliers múltiplos, as variáveis foram submetidas a Análise Fatorial Exploratória. Pelo critério de Kaiser, combinado com a análise do diagrama de sedimentação (scree plot) as variáveis foram agrupadas em 4 fatores, submetidos à análise de confiabilidade pelo cálculo do Alpha de Cronbach. Todos os fatores apresentaram índices adequados para um estudo experimental. O resultado apresenta escala robusta para a mensuração do comportamento desejado, identificando diferenças relevantes de resultados entre os fatores, sugerindo a existência de comportamentos diferenciados para situações específicas.
Patient Activation Measure in Dialysis-Dependent Patients in the United States
Authors: Cukor Daniel , Zelnick Leila R. , Charytan David M. , Shallcross Amanda J. , Mehrotra Rajnish 
Published: September 2021

Significance Statement
The Patient Activation Measure (PAM) is a newly adopted metric by CMS to describe an individual’s knowledge, ability, skills, and confidence in self-managing chronic conditions. The extent to which the PAM is relevant, comprehensive, and associated with clinical, behavioral, and psychosocial outcomes in people with dialysis-dependent kidney failure is, as of yet, unclear. The data we present are the first estimates of association of patient activation with health literacy, mental health, and adherence in patients with dialysis-dependent kidney failure in the United States.
Kidney Outcomes in Long COVID
Authors: Bowe Benjamin , Xie Yan , Xu Evan , Al-Aly Ziyad 
Published: September 2021

Significance Statement
Patients who survive coronavirus disease 2019 (COVID-19) are at higher risk of post-acute sequelae involving pulmonary and several extrapulmonary organ systems—generally referred to as long COVID. However, a detailed assessment of kidney outcomes in long COVID is not yet available. Here we show that, beyond the acute phase of illness, 30-day survivors of COVID-19 exhibited higher risks of AKI, eGFR decline, ESKD, major adverse kidney events (MAKE), and steeper longitudinal decline in eGFR. The risks of kidney outcomes increased according to the severity of the acute infection (categorized by care setting into non-hospitalized, hospitalized, and admitted to intensive care). The findings provide insight into the long-term consequences of COVID-19 on kidney outcomes and suggest that post-acute COVID-19 care should include attention to kidney function and disease.

Background
COVID-19 is associated with increased risk of post-acute sequelae involving pulmonary and extrapulmonary organ systems—referred to as long COVID. However, a detailed assessment of kidney outcomes in long COVID is not yet available.

Methods
We built a cohort of 1,726,683 US Veterans identified from March 1, 2020 to March 15, 2021, including 89,216 patients who were 30-day survivors of COVID-19 and 1,637,467 non-infected controls. We examined risks of AKI, eGFR decline, ESKD, and major adverse kidney events (MAKE). MAKE was defined as eGFR decline ≥50%, ESKD, or all-cause mortality. We used inverse probability–weighted survival regression, adjusting for predefined demographic and health characteristics, and algorithmically selected high-dimensional covariates, including diagnoses, medications, and laboratory tests. Linear mixed models characterized intra-individual eGFR trajectory.

Results
Beyond the acute illness, 30-day survivors of COVID-19 exhibited a higher risk of AKI (aHR, 1.94; 95% CI, 1.86 to 2.04), eGFR decline ≥30% (aHR, 1.25; 95% CI, 1.14 to 1.37), eGFR decline ≥40% (aHR, 1.44; 95% CI, 1.37 to 1.51), eGFR decline ≥50% (aHR, 1.62; 95% CI, 1.51 to 1.74), ESKD (aHR, 2.96; 95% CI, 2.49 to 3.51), and MAKE (aHR, 1.66; 95% CI, 1.58 to 1.74). Increase in risks of post-acute kidney outcomes was graded according to the severity of the acute infection (whether patients were non-hospitalized, hospitalized, or admitted to intensive care). Compared with non-infected controls, 30-day survivors of COVID-19 exhibited excess eGFR decline (95% CI) of −3.26 (−3.58 to −2.94), −5.20 (−6.24 to −4.16), and −7.69 (−8.27 to −7.12) ml/min per 1.73 m2 per year, respectively, in non-hospitalized, hospitalized, and those admitted to intensive care during the acute phase of COVID-19 infection.

Conclusions
Patients who survived COVID-19 exhibited increased risk of kidney outcomes in the post-acute phase of the disease. Post-acute COVID-19 care should include attention to kidney disease.
"Und ich hab damals für dich ge-Voted…" – Online-Kommentarforen zwischen Text, Diskurs und Gemeinschaft
Authors: Naef Marcel 
Published: September 2021

<p class="Standardnachberschrift">Using examples from comment sections in the Swiss online news site <em>watson.ch</em>, we investigate the question whether such online reader communities show traces of communal relationships (in the sense of Max Weber) and if such an understanding is compatible with the concept of discourse communities. To this end, we first outline the conflicting theoretical assumptions that linguistic and sociological understandings of communities imply for the concept of discourse communities. Afterwards, we use selected online reader comments to show how traditional features of community formation can be detected empirically in the comment section. To conclude, we argue that Niklas Luhmann’s systems theory can serve as a framework to integrate different types of community formation processes on an empirical and a theoretical level.</p><p class="Standardnachberschrift"> </p><p class="Standardnachberschrift"> </p>
Pengembangan media pembelajaran berbasis GEO-SEARCH pada materi Geografi pokok bahasan sebaran dan pemanfaatan sumber daya alam
Authors: R Fawaz Sani , Soelistijo Djoko , Wagistina Satti 
Published: September 2021

The purpose of this development is to produce learning media based on GEO-SEARCH. The resulting geo-search learning media is used to support learning in geography subjects. The material chosen for geography is the distribution and utilization of natural resources for class XI high school 1 Tumpang. This research uses the Research and Development (R&D) method of the ADDIE development model. ADDIE development procedures consisting of 5 steps of development, namely: (1) Analysis (Analyze), (2) Design (Design), (3) Product Development (Development), (4) Product Implementation (Implementation), (5) Evaluation (Evaluation).
Tujuan dari pengembangan ini adalah menghasilkan media pembelajaran berbasis GEO-SEARCH. Media pembelajaran geo-search yang dihasilkan digunakan untuk menunjang pembelajaran pada mata pelajaran geografi. Materi yang dipilih pada mata pelajaran geografi adalah materi Sebaran dan Pemanfaatan Sumber Daya Alam untuk kelas XI SMAN 1 Tumpang. Penelitian ini menggunakan metode penelitian dan pengembangan (R&D) dari model pengembangan ADDIE. Prosedur pengembangan ADDIE yang terdiri dari 5 langkah pengembangan yaitu: (1) Analisis (Analyze), (2) Desain (Design), (3) Pengembangan Produk (Development), (4) Implementasi Produk (Implementation), (5) Evaluasi (Evaluation).
Tingkat Kenyamanan Celana Panjang Wanita Ukuran S, M, L di Lembaga Kursus dan Pelatihan (LKP) Happy Banyuwangi
Authors: Nafisah Faizun , Kusumarwardani Hapsari 
Published: September 2021

This study aims to determine the comfort level of women’s long pants in S, M, L size at LKP Happy Banyuwangi in terms of static (in a stationary state) and dynamic (in a state of motion). This study uses descriptive methods using a qualitative. The determination of respondents based on body size S, M, L according to the standart size at LKP Happy. The findings indicate that the static aspects of S size have 7 parts of comfortable pants and the dynamic aspects have 17 comfortable positions and 1 comfortable enough position. Then the M size from the static aspects has 6 parts of comfortable pants and 1 part of calm enough pants, and from the dynamic aspects have 5 comfortable positions, 8 comfortable enough positions, and 5 uncomfortable positions. The last static aspects of L size are 6 parts of comfortable pants and 1-part comfortable enough pants, also from the dynamic aspects 10 comfortable positions, 1 comfortable enough position, and 7 uncomfortable positions. From the results, it shows that the pattern of LKP Happy for women’s long pants in S, M, and L size needs to be fixed.

Penelitian ini bertujuan untuk mengetahui tingkat kenyamanan celana panjang wanita ukuran S, M, L di LKP Happy Banyuwangi yang ditinjau dari segi statis (diam) dan dinamis (dalam keadaan bergerak). Penelitian ini menggunakan metode deskriptif menggunakan pendekatan kualitatif. Penentuan responden berdasarkan ukuran tubuh S, M, L sesuai ukuran standar LKP Happy. Hasil Penelitian menunjukkan bahwa pada ukuran S ditinjau dari aspek statis ada 7 bagian celana nyaman, sedangkan untuk aspek dinamis 17 posisi nyaman dan 1 posisi cukup nyaman. Pada ukuran M ditinjau dari aspek statis ada 6 bagian celana nyaman dan 1 bagian celan cukup nyaman, sedangkan untuk aspek dinamis 5 posisi nyaman, 8 posisi cukup nyaman dan 5 posisi kurang nyaman. Pada ukuran L ditinjau dari aspek statis ada 6 bagian celana nyaman dan 1 bagian celana cukup nyaman, sedangkan aspek dinamis 10 posisi nyaman, 1 posisi cukup nyaman dan 7 posisi kurang nyaman. Kesimpulan dari penelitian ini yaitu, celana panjang wanita menggunakan pola LKP Happy baik untuk ukuran S, sedangkan untuk ukuran M dan L diperlukan adanya perbaikan.
Species distribution and antibiogram of coagulase negative Staphylococci isolated from various clinical specimens in a tertiary care hospital
Authors: Chikkaraddi Uma , Nandihal Namratha W 
Published: September 2021

Coagulase Negative Staphylococci (CoNS) are common inhabitants of skin and mucous membrane, may act as pathogens causing fatal infections especially in immunocompromised patients. CoNS mainly cause infections involving biofilm on implanted biomaterials. Increase in antimicrobial resistance causes difficulties to treat life threatening infections. Despite their growing importance, their speciation is rarely done. Therefore, the present study is undertaken to identify CoNS to the species level and to know their antibiotic susceptibility pattern along with rate of MRCoNS.250 isolates from various clinical specimens were considered in this study. The isolates were identified by colony morphology, Gram staining, catalase, slide and tube coagulase test. Speciation was done by Novobiocin resistance, urease activity, ornithine decarboxylase, pyrrolidonylarylamidase and aerobic acid production from mannose. The antimicrobial susceptibility was performed by Kirby-Bauer's disc diffusion method as per CLSI guidelines.Among 250 CoNS isolates, commonest species identified was (59.2%) followed by (19.6%) and (12.4%). They were commonly isolated in the age group 21 to 30 years (26.8%) and among males(58%). Total of 33.2% were isolated from pus followed by blood(21.6%). Majority species expressed resistance towards nalidixic acid(97.2%) followed by Penicillin(94%), 74.4% to Amoxicillin-Clavulanic acid and 66.4% to Cotrimoxazole. All the isolates were sensitive to Vancomycin. Methicillin resistance among CoNS was 73.2%. : The increased recognition of pathogenic potential in CoNS and emergence of drug resistance among them demonstrates the need to adopt simple laboratory methods to identify the species and determine the antibiotic resistant patterns to help the clinicians in treating the infections caused by CoNS.
A new single run polymerase chain reaction assay for cyclosporiasis in immunocompromised patients
Authors: Singh Rakesh , Katiyar Manish , Gulati Reena , Parameswaran Sreejith , Hamide Abdoul , Rajkumari Nonika 
Published: September 2021

causes human intestinal cyclosporiasis. It is more common in the immunocompromised patients and mainly seen in people living with HIV/AIDS (PLHA), post-renal transplant (PRT) patients and immunocompromised children (IC). Diagnostic microscopy for the oocysts of the parasite is less sensitive, requiring examination of multiple stool samples. Here we developed a new single run polymerase chain reaction (PCR) assay for the detection of and it was used to know the hospital based prevalence of cyclosporiasis. A cross-sectional study was conducted from June 2016 to October 2020 in a tertiary care teaching hospital. A new single run amplification PCR-based diagnostic assay was developed for . Stool samples were collected from 121 PLHA, 135 PRT and 79 immunocompromised children (IC) other than PLHA and PRT. All stool samples were examined for the presence of oocysts as well as tested with new PCR assay. Modified Ziehl-Neelsen staining of the concentrated stool smear did not reveal oocysts of species in any stool specimen. However, new PCR assay detected in 2 stool specimens – one from a PLHA patient and another from a PRT patient, giving a prevalence of 0.6% (2/335), 0.8% (1/121) in PLHA and 0.7% (1/135) in PRT. It was not detected in IC. Cyclosporiasis is infrequent in southern part of India. The new single run PCR assay developed by us is simple and cost effective molecular assay for the detection of .
The Country of “Yellow Lord”: Russia in the Context of the Perception of Europe by the Population of Arabic Mediterranean in the Early Modern Time
Authors: Kobishchanov Taras 
Published: September 2021

The evolution of the identification of imaginary communities, including through group oppositions ‘Friend-Foe’, is one of the least studied phenomena of the historical process. The Muslim-Christian look at each other across the Mediterranean provides an extensive field of research in this regard. In recent decades the scientists prefer to talk about the Mediterranean World as a single space that not only divides but connects the Arab-Muslim and Eastern- and Western-European civilizations. This point of view stands up to the still popular binary oppositions as “East vs. West” or “Christian world vs. Muslim world”. The simplicity of such approach considering the humanity to be divided to culturally incompatible and religiously hostile civilizations is proved in particular by numerous connections between the inhabitants of Europe and the Middle East at the early Modern times. Russia has entered into the close cooperation with the Arab world in the 16th — 18th centuries: first through pilgrim-ages and inter-Orthodox contacts, and in the Catherine epoch by organizing the military invasion of the region. The presented article is about how different groups of Arabs, — Muslims and Christians, people of religion and secular rulers, — were perceiving Europe in general and Russia in particular at the early Modern times.