INTRODUCTION:Lupus nephritis is one of the most serious complications of systemic lupus erythematosus (SLE) and can lead to end-stage kidney disease (ESKD). We aimed to assess the relative mortality risk associated with SLE among dialysis patients. METHODS:This retrospective longitudinal cohort study included all dialysis patients in the Okinawa Dialysis Study 30 registry. Cox proportional hazard models were performed to assess mortality. RESULTS:Of 5246 patients, 111 had ESKD secondary to SLE. Compared with ESKD patients secondary to other causes, those with SLE had significantly higher risk of death (HR 2.55, 95% CI 1.81-3.47, p < 0.0001), cardiovascular death (HR 1.94, 95% CI 1.13-3.33, p = 0.0158), and infection death (HR 4.21, 95% CI 2.40-7.37, p < 0.0001) after adjusting for age, era of dialysis initiation, and sex. CONCLUSION:SLE may be independently associated with an increased risk of death in dialysis patients.
Geographers are increasingly interested in islands as sites of critical and creative transformation, their works often characterized by deep commitments to collaborative research and decolonizing agendas. This article considers how four of its authors have come to understand how five other authors channel their academic, activist, and artistic practices for such ends. Our collective aim is to shed light on how islands are productive and powerful spaces for change and our focus is on four decolonizing island geographies-Okinawa, Crete, Kalaallit Nunaat/Greenland, and Trinidad-to which those five collaborating co-authors trace ancestral and cultural ties. We work to shift the centre-stage of research away from certain colonial tendencies in island studies and island geographies and to reframe the Anthropocene in relation to decolonization. So, using slow ontology and engaging in a twist on participatory research, we document and reflect on lived experiences and practices among island academics, activists, and artists as material expressions of the geohumanities.
Japan has long maintained a robust national health system with universal health coverage and accessible antihypertensive therapy. Nevertheless, population-level blood pressure (BP) control remains suboptimal. To address this public health challenge, the Japanese Society of Hypertension published the Guidelines for the Management of Elevated Blood Pressure and Hypertension 2025 (JSH2025), integrating evidence-based recommendations and practical approaches to improve hypertension care. JSH2025 introduces a dual-format structure comprising clinical question sections developed through systematic reviews and consensus-based narrative chapters. The key updates include universal BP targets of <130/80 mmHg across populations, promotion of home BP monitoring, stratified cardiovascular risk assessment, expanded guidance on digital health and behavioral interventions, and condition-specific management strategies for older adults, women, and cancer survivors. We outline the major updates and innovations in JSH2025 and show their clinical and public health implications.
