bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forearm muscle mitochondrial capacity and resting oxygen uptake: Relationship to symptomatic fatigue in persons with multiple sclerosis
Authors: DePauw Elizabeth M , Rouhani Mitra , Flanagan Aidan M , Ng Alexander V 
Published: June 2021

Background Mitochondrial dysfunction has been implicated in the pathogenesis of multiple sclerosis (MS). Whether mitochondrial alterations are a function of ambulatory dysfunction or are of a non-ambulatory systemic nature is unclear. Objective To compare oxidative capacity, and rest muscle oxygen consumption (mVO2) in the upper limb of persons with multiple sclerosis (PwMS) to a control group (CON), whereby an upper limb would be comparatively independent of ambulation or deconditioning. Methods Near infra-red spectroscopy was used to measure oxidative capacity of the wrist flexors in PwMS (n = 16) and CON (n = 13). Oxidative capacity was indicated by the time constant (TC) of mVO2 recovery following brief wrist flexion contractions. Measurements included well-being, depression, symptomatic fatigue, disability, handgrip strength, cognition, and functional endurance. Analysis was by T-tests and Pearson correlations with p ≤ 0.05. Data are mean (SD). Results TC of mVO2 recovery was slower in PwMS (MS = 47(14) sec, CON = 36(11) sec; p = 0.03). No significant correlations were found between oxidative capacity and any other measures. Rest mVO2 was not different between groups, but correlated with symptomatic fatigue (r = 0.694, p = 0.003) and strength (0.585, p = 0.017) in PwMS. Conclusion Oxidative capacity was lower in the wrist flexors of PwMS, possibly indicating a systemic component of the disease. Within PwMS, rest mVO2 was associated with symptomatic fatigue.
Clinical features and corresponding immune function status of recurrent viral polymerase chain reaction positivity in patients with COVID-19 : A meta- analysis and systematic review
Authors: Ren Xingxiang , Wang Xiankun , Ge Ziruo , Cui Shuping , Chen Zhihai 
Published: June 2021

Introduction: Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020. Since then, several studies have found COVID-19 patients with recurrent viral polymerase chain reaction (PCR) positivity. Methods: On May 6, 2021, an exhaustive literature search of the Web of Science, PubMed, Cochrane Library, Chinese National Knowledge Infrastructure databases, Embase, Wan Fang Data, VIP database, Sinomed database, BioRxiv, MedRxiv, and Research Square was conducted to find describing the laboratory indicators of recurrent and non-recurrent viral PCR positivity in patients with COVID-19. The data were statistically analyzed using STATA version 15.0. Results: In total, 22 studies—comprising 5154 laboratory-confirmed COVID-19 cases—were included in the analyses. Patients with less severe COVID-19 illness (i.e. those clinically classified as mild or common-type) seemed to exhibit recurrent PCR positivity more commonly than patients with more severe illness (i.e. those classified as severe or critical). There were also significant differences between the two groups in terms of the rates of headaches and dizziness, in addition to the levels of aspartate aminotransferase, C reactive protein, interleukin-6, and lactate dehydrogenase. Further, there were variations in the ratio of CD4+ T cells/CD8+ T cells on admission to the hospital. Conclusion: In comparison to COVID-19 patients with non-recurrent viral PCR positivity, patients with recurrent virus PCR positivity seem to experience more severe immune function suppression upon hospital admission.
Mental Stress, Anxiety and Depressive Symptoms and Interleuken-6 Level among Healthcare Workers during the COVID-19 Pandemic
Authors: Amer Shaimaa A. A. M. , Fouad Ahmed Mahmoud , El-Samahy Mohamed , Hashem Asmaa A. , saati Abdullah A. , Sarhan Anas A. , Anani Maha 
Published: June 2021

Objectives This study aimed to evaluate the interleukin-6 (IL-6) levels and its relationship to stress, anxiety, and depressive symptoms among healthcare workers (HCWs) compared to controls during the COVID-19 pandemic. Methods A total of 80 HCWs in Suez Canal University Hospital in Ismailia, Egypt, and 80 controls were analyzed during the COVID-19 pandemic. The Depression, Anxiety and Stress Scale (DASS 21) questionnaire was used, and serum IL-6 level was determined in both groups. Results IL-6 levels were high in 81.2% (65) of HCWs compared to 36% (45) of controls ( P < .05). The DASS score was higher in participants with high IL-6 levels (>3 ng/mL) than in those with mild to moderate levels ( P < .05). The regression model revealed that the type of work as a healthcare staff, irregular or night shift, and stress were predictors of increased IL-6 levels among the studied sample ( P < .05) (odds ratio = 20.30, 2.44, and 2.04, respectively). Conclusion The IL-6 level and DASS score were higher in HCWs compared to those in controls during the COVID-19 pandemic. The type of work as a healthcare staff, stress, and irregular or night shift were predictors of increased IL-6 levels.
No differences in clinical outcomes and cartilage repair between opening wedge and closed wedge high tibial osteotomies at short-term follow-up: A retrospective case series analysis
Authors: Akamatsu Tomotaka , Kumagai Ken , Yamada Shunsuke , Nejima Shuntaro , Sotozawa Masaichi , Ogino Takahiro , Inaba Yutaka 
Published: June 2021

Purpose: The aim of this study was to assess differences in clinical outcomes and postoperative cartilage repair between opening wedge high tibial osteotomy (OWHTO) and closed wedge HTO (CWHTO) for medial osteoarthritis (OA) of the knee. Methods: A total of 90 knees of 76 patients who underwent OWHTO (45 knees of 40 patients) and CWHTO (45 knees of 36 patients) was followed-up for 2 years. Cartilage repair at the medial compartment was arthroscopically classified into the following stages: Stage 1 (no reparative change); Stage 2 (partial coverage with white cartilaginous tissue); and Stage 3 (full coverage with white cartilaginous tissue). Clinical outcomes were assessed using Knee Society scores, and radiographic assessment was carried out by anatomical femorotibial angle (aFTA). Results: Regarding preoperative OA grade, varus alignment, and function score, CWHTO patients showed more advanced OA status than OWHTO patients. Knee scores and function scores were significantly improved after surgery with both HTO procedures (P < 0.05), with no significant difference between the two procedures. Cartilage repair of stage 2 or 3 was found in more than 80% of the subjects in the medial femoral condyle and more than 60% in the medial tibial condyle. However, there were no significant differences between the two HTO procedures. Multivariate logistic regression analysis showed that preoperative International Cartilage Repair Society (ICRS) grade was the only factor affecting cartilage repair. Conclusions: CWHTO improved clinical outcomes and cartilage status as much as OWHTO. Although the effects of cartilage repair on clinical outcomes are unknown, HTO is an effective treatment option even for severe medial OA of the knee.
Do Share Repurchases Distort Stock Prices? Evidence from the United States and Malaysia
Authors: Chee Chong-Meng , Razak Nazrul Hisyam bin Ab , Noordin Bany Ariffin bin Amin 
Published: June 2021

Heavy share buyback years after the global finance crisis 2008–2009 drew criticism from scholars and financial press that share repurchases were being used by firms to manipulate their stock prices. This paper examines whether a greater firm’s repurchase intensity distorts stock prices reflecting to information. We analyse 2 sets of unbalanced panel data that contain a sample of 337 US and another sample of 167 Malaysian repurchasing firms between 2012 and 2016. Contrary to the criticism, we find that a greater firms’ share buyback intensity in the USA stimulates faster incorporation of information in price and results in more efficient stock prices. The main findings hold true and are robust when an alternative measure of share repurchase intensity was used. The findings of US sample support the notion that share repurchase serves as a signalling tool and price support to promote more efficient stock prices. We also find no strong evidence supporting the notion that shares repurchased by Malaysian firms distort stock prices. JEL Classifications: G10, G14, G35
Management of Vertical Sternal Fracture Nonunion in Elite-Level Athletes
Authors: Bardos Andrea , Sabhrawal Sanjeeve , Tytherleigh-Strong Graham 
Published: June 2021

Background: Sternal fractures are rare, and they can be treated nonoperatively. Vertical sternal fractures have rarely been reported. Purpose: To describe the management and surgical treatment of a series of elite-level athletes who presented with symptomatic nonunions of a vertical sternal fracture. Study Design: Case series; Level of evidence, 4. Methods: Patients with an established symptomatic nonunion of a vertical sternal fracture, as diagnosed by computed tomography (CT) or magnetic resonance imaging (MRI), underwent open reduction and internal fixation using autologous bone graft and cannulated lag screws. The patients were assessed preoperatively and at the final follow-up using the Rockwood sternoclavicular joint (SCJ) score; Constant score; and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores. Bony union was confirmed on postoperative CT scan. Results: Five patients (4 men and 1 woman) were included; all were national- or international-level athletes (rugby, judo, show-jumping, and MotoGP). The mean age at surgery was 23.4 years (range, 19-27 years), the mean time from injury to referral was 13.6 months (range, 10-17 months), and the mean time from injury to surgery was 15.8 months (range, 11-20 months). The mean follow-up was 99.4 months (range, 25-168 months). There was a significant improvement after surgery in the mean Rockwood SCJ score (from 12.6 to 14.8 [ P < .05]), Constant score (from 84 to 96.4 [ P < .05]; 80% met the minimal clinically important difference [MCID] of 10.4 points), and QuickDASH (from 6.8 to 0.98 [ P < .05]; 0% met the MCID of 15.9 points). Four of the patients were able to return to sport at their preinjury level, and 1 patient retired for nonmedical reasons. All of the fractures had united on the postoperative CT scan. There were no postoperative complications. Conclusion: Vertical fractures of the sternum are very rare and tend to behave clinically like an avulsion fracture injury to the capsuloligamentous structure of the inferior SCJ. The requirement of advanced imaging to diagnose this injury means that the actual incidence and natural history are not known. For high-demand athletes, early identification, surgical reduction, and fixation are likely to achieve the best outcome.
“Can Someone as Young as You Really Feel That Much Pain?” – A Survey on How People With Fibromyalgia Experience Healthcare in Sweden
Authors: Hasselroth Rebecka , Björling Gunilla , Faag Carina , Bose Catarina Nahlén 
Published: June 2021

Background Research show that fibromyalgia has low credibility in healthcare, leading to poor treatment, lack of knowledge and disinterest. Therefore, people with fibromyalgia feel frustration, fear, anxiety and disappointment. Objective: The aim of this study was to explore the experiences of people with fibromyalgia in their encounters with healthcare personnel in Sweden. Method: A cross-sectional design, where 409 people with fibromyalgia answered an anonymous online patient-reported experience measure, developed specific for the study, with six closed questions and one open-ended question. Descriptive statistics were analysed by response frequencies. Correlation analysis were performed between demographic and clinical variables with the answers from the closed questions. Free-text answers were analysed with content analysis. Results: A third experienced the treatment as bad (34%) and that they were not being taken seriously (30.5%). Almost half (47%) always or mostly felt fear of seeking healthcare related to fibromyalgia and that the health care personnel did not understand their diagnosis (46%). The majority (54%) experienced that the health care personnel did not understand how fibromyalgia affected them or how they could help them. The findings were confirmed in the free-text answers that were categorized into: Scepticism and disregard, Ignorance and disinterest and Professionalism and empathy. There were positive significant correlations between age and five of the questions (ρ = .105–.181, p < .05–p < .01), indicating that lower age is correlated with a worse experience. Furthermore, the duration of fibromyalgia showed a significant correlation with feeling afraid of seeking healthcare because of fibromyalgia (ρ = .144, p < .01), the shorter duration, the greater was the fear of seeking healthcare. Conclusion: As a third of patients with fibromyalgia had bad experiences with healthcare, especially younger patients, knowledge about fibromyalgia needs to be increased and the patients should be taken seriously and treated respectfully, as well as given adequate support.
Segmentationstendenzen im Management?
Authors: Schirmer Frank 
Published: June 2021

Das “Management” als Vertreter von Kapitalinteressen auf betrieblicher Ebene der industriellen Beziehungen wird in weiten Teilen der Organisationstheorie, betriebswirtschaftlichen Organisationslehre und Industriesoziologie - meist implizit - als Interessenblock konzeptualisiert, der einheitlich an Kapitalinteressen orientiert ist. Die Realitätsnähe dieser Vorstellung ist allerdings zu bezweifeln. Im vorliegenden Beitrag wird in Analogie zum Konzept der Arbeitsmarktsegmentation das Konzept der “Managementsegmentation” eingeführt und als gedankliches Modell fruchtbar gemacht, um Interessendifferenzierungen im Management zu verorten, von denen angenommen wird, daß sie relativ stabil sind und/oder zunehmend an Stabilität gewinnen (etwa durch die Einführung von Sprecherausschüssen für leitende Angestellte) und das Gefüge betrieblicher Arbeitsbeziehungen berühren bzw. verändern. Der konzeptionelle und vor allem der empirische Forschungsstand zu dieser Fragestellung müssen insgesamt als sehr rudimentär eingestuft werden.
Weiterbildungskonzepte deutscher Unternehmen
Authors: Pullig Karl-Klaus 
Published: June 2021

Mehr als 100 aktuelle Weiterbildungsprogramme größerer deutscher Unternehmen wurden daraufhin untersucht (1) welche Weiterbildungskonzeptionen heute als typisch gelten können und (2) welche zukunftsweisenden Akzente sie enthalten. Einige Ergebnisse der Analyse: Als Folge der Bemühungen, Weiterbildung möglichst bedarfs- bzw. transferorientiert zu betreiben, verzichten einige (große) Unternehmen bereits ganz auf die üblichen Weiterbidungsprogramme und Weiterbildungsangebote zugunsten gezielter Hilfestellungen bei konkreten, abteilungsspezifischen Bildungsproblemen oder zugunsten langfristiger Personalentwicklungs- und Organisationsentwicklungsprozesse; andere versuchen den Weiterbildungsbedarf genauer zu ermitteln und über Vor- und Nachbereitungen den Nutzen zu erhöhen. Die Sozialkompetenz gilt neben der Fachkompetenz unbestritten als förderungswürdig. Bildungskooperationen mit Verbänden, anderen Unternehmen, Bildungsinstitutionen ect. nehmen zu. Die zentralen Weiterbildungsabteilungen verstehen sich oft als Anbieter umfangreicher Dienstleistungen.
A midwife’s exploration into how power & hierarchy influence both staff and patient safety
Authors: Elliott-Mainwaring Helen 
Published: June 2021

My experiences as a legitimate informal whistle-blower have afforded me an understanding of the dichotomy that is Trust allegiance and misplaced brand loyalty over and above both patient and staff safety, such that when poor care is spoken of as a potential or experienced from either angle, the general rule within healthcare management is not to acknowledge, reflect, mitigate and learn in order to improve, but instead to gaslight, deny and subordinate such that from a staff safety perspective they are caught between a rock and a hard place. This paper explores some of the opportunities which healthcare organizations could embrace to positively influence the effects of power and hierarchy on staff safety. Aims This paper discusses the bigger picture of maternity services safety. Methods This is a discussion piece. Findings For some healthcare staff it is preferable to remain quiet, not rock the proverbial boat, and maintain deeply loyal allegiances to their employers over and above public protection. For others, the journey of honesty, integrity and tenacity carries a high price in terms of personal energy, health and financial compromise. Conclusion This exploration into how power & hierarchy influence both staff and patient safety has identified and briefly explored some of the tensions created by misplaced brand loyalty inherent within healthcare institutions, and the legacy of harms resulting.
A comprehensive database for integrated analysis of omics data in autoimmune diseases
Authors: Martorell-Marugán Jordi , López-Domínguez Raúl , García-Moreno Adrián , Toro-Domínguez Daniel , Villatoro-García Juan Antonio , Barturen Guillermo , Martín-Gómez Adoración , Troule Kevin , Gómez-López Gonzalo , Al-Shahrour Fátima , González-Rumayor Víctor , Peña-Chilet María , Dopazo Joaquín , Sáez-Rodríguez Julio , Alarcón-Riquelme Marta E. , Carmona-Sáez Pedro 
Published: June 2021

Abstract
Background
Autoimmune diseases are heterogeneous pathologies with difficult diagnosis and few therapeutic options. In the last decade, several omics studies have provided significant insights into the molecular mechanisms of these diseases. Nevertheless, data from different cohorts and pathologies are stored independently in public repositories and a unified resource is imperative to assist researchers in this field.

Results
Here, we present Autoimmune Diseases Explorer (https://adex.genyo.es), a database that integrates 82 curated transcriptomics and methylation studies covering 5609 samples for some of the most common autoimmune diseases. The database provides, in an easy-to-use environment, advanced data analysis and statistical methods for exploring omics datasets, including meta-analysis, differential expression or pathway analysis.

Conclusions
This is the first omics database focused on autoimmune diseases. This resource incorporates homogeneously processed data to facilitate integrative analyses among studies.
Concomitant acute myocardial infarction and acute pulmonary embolism caused by paradoxical embolism: a case report
Authors: Chen Weiwei , Yu Zhixi , Li Siming , Wagatsuma Kenji , Du Beibei , Yang Ping 
Published: June 2021

AbstractBackgroundDue to its low incidence and diverse manifestations, paradoxical embolism (PDE) is still under-reported and is not routinely considered in differential diagnoses. Concomitant acute myocardial infarction (AMI) and acute pulmonary embolism (PE) caused by PDE has rarely been reported.Case presentationA 45-year-old woman presented with acute chest pain and difficulty with breathing. Multiple imaging modules including ECG, echocardiography, emergency cardioangiogram (CAG), and CT angiography of the pulmonary arteries showed acute occlusion of the posterolateral artery and acute PE. After coronary aspiration, no residual stenosis was observed. One month later, a bubble study showed inter-atrial communication via a patent foramen ovale (PFO). The AMI in this patient was finally attributed to PDE via the PFO. PFO closure was performed, and long-term anticoagulation was prescribed to prevent recurrent thromboembolic events.ConclusionsPDE via PFO is a rare etiology of AMI, especially in patients with concomitant AMI and PE. Clinicians should be vigilant of this possibility and close the inter-atrial channel for secondary prevention.
Benchmarking of provider competencies and current training for prevention and management of obesity among family medicine residency programs: a cross-sectional survey
Authors: Orjuela-Grimm Manuela , Butsch W. Scott , Bhatt-Carreño Silvia , Smolarz B. Gabriel , Rao Goutham 
Published: June 2021

Abstract
Background
U.S. physicians lack training in caring for patients with obesity. For family medicine, the newly developed Obesity Medicine Education Collaborative (OMEC) competencies provide an opportunity to compare current training with widely accepted standards. We aimed to evaluate the current state of obesity training in family medicine residency programs.

Methods
We conducted a study consisting of a cross-sectional survey of U.S. family medicine residency program leaders. A total of 735 directors (including associate/assistant directors) from 472 family medicine residency programs identified from the American Academy of Family Physicians public directory were invited via postal mail to complete an online survey in 2018.

Results
Seventy-seven program leaders completed surveys (16% response rate). Sixty-four percent of programs offered training on prevention of obesity and 83% provided training on management of patients with obesity; however, 39% of programs surveyed reported not teaching an approach to obesity management that integrates clinical and community systems as partners, or doing so very little. Topics such as behavioral aspects of obesity (52%), physical activity (44%), and nutritional aspects of obesity (36%) were the most widely covered (to a great extent) by residency programs. In contrast, very few programs extensively covered pharmacological treatment of obesity (10%) and weight stigma and discrimination (14%). Most respondents perceived obesity-related training as very important; 65% of the respondents indicated that expanding obesity education was a high or medium priority for their programs. Lack of room in the curriculum and lack of faculty expertise were reported as the greatest barriers to obesity education during residency. Only 21% of the respondents perceived their residents as very prepared to manage patients with obesity at the end of the residency training.

Conclusion
Family medicine residency programs are currently incorporating recommended teaching to address OMEC competencies to a variable degree, with some topic areas moderately well represented and others poorly represented such as pharmacotherapy and weight stigma. Very few program directors report their family medicine residents are adequately prepared to manage patients with obesity at the completion of their training. The OMEC competencies could serve as a basis for systematic obesity training in family medicine residency programs.