bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Reversal of Renin Suppression With Long-Term Renal Outcome in Medically Treated Primary Aldosteronism
Authors: Katsuragawa Sho , Goto Atsushi , Shinoda Satoru , Inoue Kosuke , Nakai Kazuki , Saito Jun , Nishikawa Tetsuo , Tsurutani Yuya 
Published: July 2023

BACKGROUND:
Renin suppression in primary aldosteronism indicates mineralocorticoid receptor activation via excessive aldosterone secretion, inducing renal damage. We investigated whether the reversal of renin suppression after the initiation of mineralocorticoid receptor antagonist therapy was associated with long-term renal outcomes in medically treated patients with primary aldosteronism.

METHODS:
This retrospective cohort study included 318 patients with primary aldosteronism treated with mineralocorticoid receptor antagonist between 2008 and 2020 at the Yokohama Rosai Hospital in Japan. The posttreatment renin status was defined as unsuppressed (ie, reversal of renin suppression) when individual plasma renin activity after the initiation of mineralocorticoid receptor antagonist (post-plasma renin activity) was ≥1.0 ng/mL per hour; otherwise, it was defined as suppressed. We analyzed the association of posttreatment renin status with subsequent longitudinal estimated glomerular filtration rate changes using linear mixed-effects models for repeated measurements, adjusting for potential confounders.

RESULTS:

The posttreatment renin status of 119 patients was unsuppressed (median post-plasma renin activity, 1.7 ng/mL per hour) and that of 199 patients was suppressed (median post-PRA, 0.5 ng/mL per hour). Through the median follow-up period of 3.1 years, the decline in estimated glomerular filtration rate was milder among patients with the unsuppressed posttreatment renin (−0.46 [95% CI, −0.63 to −0.28] mL/min per 1.73 m
2
per year) than those with suppressed posttreatment renin (−1.41 [95% CI, −1.56 to −1.27] mL/min per 1.73 m
2
per year; difference, 0.96 [95% CI, 0.72–1.20] mL/min per 1.73 m
2
per year).

CONCLUSIONS:
Our findings may highlight the importance of reversing renin suppression with optimal mineralocorticoid receptor antagonist titration in medically treated primary aldosteronism, which could mitigate adverse renal outcomes.
Separate and Joint Associations of Remnant Cholesterol Accumulation and Variability With Carotid Atherosclerosis: A Prospective Cohort Study
Authors: Wang Jinqi , Jin Rui , Jin Xiaohan , Wu Zhiyuan , Zhang Haiping , Han Ze , Xu Zongkai , Liu Yueruijing , Zhao Xiaoyu , Guo Xiuhua , Tao Lixin 
Published: July 2023

Background
We aimed to examine separate and joint associations of remnant cholesterol (RC) accumulation and variability with the risk of carotid atherosclerosis (CAS) in the general population.

Methods and Results
A total of 6213 participants who underwent 3 sequential health examinations during 2010 to 2015 were enrolled and were followed up until December 31, 2021. Cumulative RC (cumRC) and RC variability among the 3 visits were the exposure of interest in our study. Adjusted Cox models were performed to calculate the hazard ratio (HR) and 95% CI. C‐statistics, integrated discrimination improvement, and the net reclassification index were used to estimate the incremental predictive ability. During a median follow‐up of 4.00 years, 2613 participants developed CAS. Higher cumRC (HR, 1.33 [95% CI, 1.17–1.52]) and greater RC variability (HR, 1.22 [95% CI, 1.08–1.39]) were significantly associated with elevated risk of CAS, independent of traditional cardiovascular risk factors and low‐density lipoprotein cholesterol. Participants were divided into 4 groups according to the median of cumRC and RC variability to assess their joint associations. Compared with “low cumRC and low variability,” “high cumRC and high variability” had the highest risk of CAS, followed by “high cumRC and low variability” and “low cumRC and high variability.” Finally, joint assessment of RC accumulation and variability had the significantly highest incremental effect on the predictive value of CAS versus single‐time‐point measures of RC.

Conclusions
Excessive cumRC levels and greater RC variability were each independently associated with higher incidence of CAS, and their coexistence could further yield significantly higher risks.
Association Between Claims‐Defined Frailty and Outcomes Following 30 Versus 12 Months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: Findings From the EXTEND‐DAPT Study
Authors: Faridi Kamil F. , Strom Jordan B. , Kundi Harun , Butala Neel M. , Curtis Jeptha P. , Gao Qi , Song Yang , Zheng Luke , Tamez Hector , Shen Changyu , Secemsky Eric A. , Yeh Robert W. 
Published: July 2023

Background
Frailty is rarely assessed in clinical trials of patients who receive dual antiplatelet therapy (DAPT) after percutaneous coronary intervention. This study investigated whether frailty defined using claims data is associated with outcomes following percutaneous coronary intervention, and if there is a differential association in patients receiving standard versus extended duration DAPT.

Methods and Results

Patients ≥65 years of age in the DAPT (Dual Antiplatelet Therapy) Study, a randomized trial comparing 30 versus 12 months of DAPT following percutaneous coronary intervention, had data linked to Medicare claims (n=1326), and a previously validated claims‐based index was used to define frailty. Net adverse clinical events, a composite of all‐cause mortality, myocardial infarction, stroke, and major bleeding, were compared between frail and nonfrail patients. Patients defined as frail using claims data (12.0% of the cohort) had higher incidence of net adverse clinical events (23.1%) compared with nonfrail patients (10.7%;
P
<0.001) at 18‐month follow‐up and increased risk after multivariable adjustment (adjusted hazard ratio [HR], 2.24 [95% CI, 1.38–3.63]). There were no differences in effects of extended duration DAPT on net adverse clinical events for frail (HR, 1.42 [95% CI, 0.73–2.75]) and nonfrail patients (HR, 1.18 [95% CI, 0.83–1.68]; interaction
P
=0.61), although analyses were underpowered. Bleeding was highest among frail patients who received extended duration DAPT.

Conclusions
Among older patients in the DAPT Study, claims‐defined frailty was associated with higher net adverse clinical events. Effects of extended duration DAPT were not different for frail patients, although comparisons were underpowered. Further investigation of how frailty influences ischemic and bleeding risks with DAPT are warranted.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00977938.
Some Eschatological Perspectives on the Loss of Biodiversity and Extinction
Authors: Conradie Ernst M. 
Published: July 2023

Abstract
This article explores the loss of biodiversity and species extinction from the perspective of Christian eschatology and, more specifically, the hope for eternal life. A thought experiment on the coexistence of various hominid and hominin species is entertained in order to gain some clarity on the nature of the problems posed by extinction. The question is then raised whether any of the traditional eschatological symbols of the reign of God, a final judgment, the resurrection of the dead, or eternal life can be retrieved to address the problems posed by extinction. It is argued that each of these symbols poses serious difficulties in this regard while there is an apparent contradiction embedded in the notion of eternal life. This is not resolved through notions of ‘objective immortality,’ as this by itself eternalizes the injustices of history. With Joseph Sittler, it is argued that only some notion of cosmic redemption can suffice, but how this is to be imagined remains elusive.
Reversing the Rain of Death That Threatens Us All
Authors: Gushee David P. , Lutz Alexander John Paul 
Published: July 2023

Abstract
This essay considers the Christian ethical meanings of species loss. We begin with a description of the Dutch colonization of Mauritius, which entailed grave and irreversible species losses that foreshadowed current global realities. Revisiting the Gaia hypothesis, we argue that the whole of creation, including humanity, is interconnected and interdependent, and that it is disastrous when humans ignore our connection to the Earth community. Christians must therefore respond to species loss at theological, ethical, and spiritual levels. The imago dei and the dominion mandate must be construed by Christians to mean responsibility as the most powerful species in the Earth community to offer loving care to the whole of creation. Human responsibility must be highlighted, not archaic understandings of divine power and human weakness. Human connectedness to—rather than alienation from—creation must be nurtured before species loss finally overtakes humanity itself.
Ending Extinction
Authors: van Urk-Coster Eva 
Published: July 2023

Abstract
Given that today’s mass extinction of species is driven by human activity, it matters profoundly how the place and role of humans vis-à-vis the earth’s biodiversity is construed. In this regard, Anglican theologian Christopher Southgate argues that the idea of being created in God’s image (imago Dei) results in an eschatological calling to counter both anthropogenic and natural extinction as co-redeemers with God. How should Southgate’s perspective be evaluated in light of the ever-worsening extinction crisis and our attempts to mitigate it through conservation efforts? To answer this question, this article connects systematic theology with ethnographic research in the environmental humanities. In particular, it engages the work of philosopher and anthropologist Thom van Dooren on ‘extinction stories’ in order to explore how human and nonhuman life is interrelated in conservation. It is argued that speaking of humans as co-redeemers is problematic, given the crucial difference between God’s saving and redeeming work and human faulty and contingent ‘doings’ in conservation that remain ambiguous.
Newsmarks as an Interactional Resource for Indexing Remarkability: A Qualitative Analysis of Arabic waḷḷāhi and English really
Authors: Marmorstein Michal , Szczepek Reed Beatrice 
Published: July 2023

Abstract
This paper presents a study of Arabic waḷḷāhi (lit. ‘by God’) and English really when they are used interactionally as newsmarks. The literature has claimed that the role of newsmarks in conversation is to treat prior talk as news, to open up a slot for further talk, to express doubt or disbelief, and to implement requests for confirmation. A close analysis of waḷḷāhi and really shows that they do not necessarily follow the patterns described by previous research. Instead, the data suggest that newsmarks primarily contribute to the construction of prior talk as remarkable, that is, tellable and noteworthy; and that some previously described functions are epiphenomenal of this more basic property. The data are recordings of naturally occurring everyday conversations in British English and Egyptian Arabic, with English translations.
4. A Partnership of Equals
Authors: Auspos Patricia 
Published: July 2023

The extraordinary partnership that Beatrice and Sydney Webb embarked on when they married in 1892 spanned almost fifty years and left a lasting mark on British sociology, social welfare policy, and public administration. Groomed to make a Society marriage, Beatrice Potter (1858-1943) grew up believing that love and career were incompatible goals for a woman. Her disastrous relationship with the prominent, domineering politician Joseph Chamberlain reinforced that conviction. After it became clear that they would not marry, Beatrice made a name for herself as a social investigator, studying London’s poor in the late 1880s. But she could not shake off her obsessive love for Chamberlain.
When Sidney Webb (1859-1947), a Fabian Socialist and a clerk in the Colonial Office, fell in love with Beatrice in 1890, he assured her that she could enjoy love and work. After a year of agonizing doubt, she agreed to marry him because she believed he would be the ideal partner for her work. But she was not passionately in love with him, as she had been with Chamberlain. She did not find Sydney physically attractive and was embarrassed by his lower class origins.
It took Beatrice ten years to be fully happy with Sidney and a marriage that was focused almost entirely on work. Instead of having children, they wrote books together. They investigated social and economic issues, campaigned for sweeping changes in education and social policy, sat on government commissions, and were instrumental in founding the London School of Economics. When they married, Sidney vowed they would show the world what a marriage of true equals looked like. Beatrice agreed, but always recoiled from any suggestion that she was the dominant partner in the relationship. Their collaboration, in sharp contrast to the Youngs’ partnership, was fundamentally egalitarian: it acknowledged Beatrice’s contributions as much as Sidney’s and allowed each to play a variety of public roles. Beatrice headed a public campaign to rewrite Britain’s Poor Law legislation, and sat on several government commissions during World War I. Sidney was elected to Parliament and held two Cabinet posts. They are buried together in Westminster Abbey, the only non-royal couple to be so honored. But their seemingly idyllic union was marred for many years by Beatrice’s yearning for a more romantically compelling partner than Sydney and her sublimated passion for the dominating Chamberlain.
Factors Associated With Postoperative Decisional Regret in Patients Undergoing Gastrointestinal Cancer Surgery: A Prospective Cohort Study
Authors: Kinoshita Hiromitsu , Nishigori Tatsuto , Nakabe Takayo , Shimoike Norihiro , Sato Keiko , Imanaka Yuichi , Obama Kazutaka , Matsumura Yumi 
Published: July 2023

Background Surgery is recommended as the first-line treatment option to cure resectable gastrointestinal (GI) cancer. However, patients occasionally feel postoperative regret after surgery. To date, it is not clear which factors are associated with patient regret after GI cancer surgery. The aim of this study was to investigate factors related to postoperative decision regret in patients undergoing surgery for GI cancer. Methods The present prospective study used questionnaires to analyze postoperative decision regret in patients undergoing GI cancer surgery in our institution between February and July 2020. Decision regret that patients felt after surgery was quantitatively measured using the decision regret scale (DRS). Multivariable linear regression models were used to examine factors related to postoperative decision regret. Results Among 70 patients analyzed, the median (interquartile range) DRS score was 10.0 (.0-25.0). Multivariable analysis showed that preoperative Trust in Physician Scale score (partial regression coefficient (B) = −.77; 95% confidence interval (CI) = −1.13 to −.41; P < .001) and postoperative complications (B = 9.17; 95% CI = 2.20 to 16.15; P = .0011) were significantly associated with DRS score. Discussion Preoperative trust in physician and postoperative complications were significantly associated with postoperative decision regret in patients undergoing surgery for GI cancer. Although patients may regret their choice of surgery when postoperative complications occur, trust in their physician may help reduce feelings of regret.
Provision of community mental health care before and during the COVID-19 pandemic: A time series analysis in Peru
Authors: Villarreal-Zegarra David , Segovia-Bacilio Piero , Paredes-Angeles Rubí , Vilela-Estrada Ana Lucía , Cavero Victoria , Diez-Canseco Francisco 
Published: July 2023

Background: A consequence of the COVID-19 pandemic was that the provision of mental health services was reduced in several countries around the world, while the demand for mental health services increased. Aims: Our study aims to determine any variation in the number of users served, health appointments, and care activities conducted at 58 Peruvian community mental health centers (CMHCs) between March 2019 and October 2021. Methods: Our study used an observational design and analyzed information from the care provided in CMHCs. We evaluate the number of users served, health appointments, and care activities performed per month. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account each month of the evaluation. Results: We had 988,456 unique users during the period evaluated. Regarding diagnoses, 7.4% ( n = 72,818) had a severe mental problem, 39.4% ( n = 389,330) a common mental problem, and 53.2% ( n = 526,308) others health problems. The study found a reduction in the number of users served and health care appointments at the 58 CMHCs in March 2020, the month in which the closure measures were declared to reduce COVID-19 infections in Peru. This reduction was followed by an upward trend in the three variables during the pandemic in the 58 CMHCs studied. In, November 2020, 9 months after the pandemic started, the deficit in the average number of users served per month was recovered. Conclusions: Our study suggests that CMHCs in the Peruvian system were able to regain care capacity approximately 1 year after the pandemic. In addition, we discuss the efforts made to respond to mental health needs in the context of a global health crisis.
Early occupational therapy in mechanically ventilated patients improves functional status: Study protocol
Authors: Álvarez Evelyn , Garrido Maricel , Salech Felipe , Rojas Verónica , Jara Nicole , Farías José I. , Ponce Daniela , Tobar Eduardo 
Published: July 2023

Background: Experts suggest implementing measures that include analgesia, sedation, delirium prevention and early mobilization (ASDM) in patients undergoing mechanical ventilation (MV) to reduce complications. However, there is limited evidence of occupational therapy in these patients. The aim of the research is to compare functional independence in patients undergoing MV of an intensive and early occupational therapy protocol versus to standard ASDM strategy. Method/Design: A prospective, multicenter, randomized clinical trial, with parallel groups (control and intervention groups). Participants will be hospitalized patients, over 18 years of age, admitted to the intensive care unit (ICU) and with the need of invasive MV. The intervention group will receive two daily 30-minute sessions of occupational therapy for 10 days. This study will research the effect of occupational therapy on functional independence, motor and cognitive status, evaluating at days 28 and 90. Discussion: This work contributes to the theoretical and practical work of occupational therapists who work in the ICU. The implementation of protocols of occupational therapy in mechanically ventilated patients can contribute to the independence and functionality of patients. Conclusion: Our research aims to contribute to the generation of systematized, organized, and feasible protocols that can be implemented in ICU. Trial Registration: ClinicalTrials.gov NCT04819529
Effect of Anterior Tibial Closing Wedge Osteotomy on Coronal Tibial Alignment in Relation to Preoperative Medial Proximal Tibial Angle and Wedge Height
Authors: Mayer Philipp , Schuster Philipp , Schlumberger Michael , Michalski Stefan , Geßlein Markus , Beel Wouter , Immendörfer Micha , Richter Jörg 
Published: July 2023

Background: The posterior tibial slope has been identified as an anatomic risk factor for anterior cruciate ligament insufficiency and reruptures after anterior cruciate ligament reconstruction. Anterior tibial closing wedge osteotomy for correction of sagittal plane deformities has the potential to cause an unintended change in coronal plane alignment. Purpose: To evaluate the effects of anterior tibial closing wedge osteotomies for correction of posterior tibial slope on coronal plane alignment using an infratuberosity surgical approach and to identify predictive factors for a change in medial proximal tibial angle (MPTA). Study Design: Case series; Level of evidence, 4. Methods: This study reports on retrospectively obtained data from radiographic measurements of 38 anterior tibial closing wedge osteotomies. All patients underwent revision anterior cruciate ligament reconstruction and had undergone ≥1 previous anterior cruciate ligament reconstruction. In all patients, an infratuberosity approach was used with angular stable plate fixation. Pre- and postoperative radiographs were examined retrospectively to detect changes in the sagittal and coronal plane alignment (posterior tibial slope and MPTA). A multivariate regression analysis was used to identify predictors for a change in MPTA. Results: The study group consisted of 14 women and 24 men whose mean ± SD age at the index procedure was 31.6 ± 8.7 years (range, 17-51 years). Posterior tibial slope decreased significantly (by 7.2° ± 2.3°; P < .001) from 14.6° ± 2.0° preoperatively to 7.4° ± 2.1° postoperatively. MPTA decreased significantly by 1.3° ± 1.5° ( P = .005) from pre- to postoperative measurement. Mean wedge height was 9.3 ± 1.1 mm. A lower preoperative MPTA (coefficient = 0.32; P = .017; 95% CI, 0.06-0.59) and larger wedge height (coefficient = 0.48; P = .029; 95% CI, 0.05-0.9) were significant predictive factors for a decrease in MPTA. Conclusion: Anterior tibial closing wedge osteotomy for posterior tibial slope reduction resulted in a slight but significant decrease of the MPTA in the coronal plane. These changes were dependent on the preoperative MPTA and the wedge height.