bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leadership's Impact on E-commerce Growth and Crisis Management in Post-Lignite Urban Transitions
Authors: Gkanatsiou Margarita Aimilia , Triantari Sotiria , Chatzidimitriou Efthymia 
Published: September 2024

In today's dynamic business environment, traditional management grapples with challenges posed by global factors such as competition, shifting consumer preferences, and political shifts. Increasingly, businesses are leveraging e-commerce for growth and adept crisis management (Strauss and Frost, 2012)Crisis management blends entities' technical expertise to manage emerging threats with political nuances, necessitating rapid identification and response in ambiguous situations, all while maintaining clarity (Boin, 2008). This study delves into the significance of leadership in e-commerce adoption and crisis navigation, spotlighting the transition of Western Macedonia from a coal-centric economy. Emphasis is placed on leadership's pivotal role in navigating these intricate dynamics.
Διαχρονική εξέλιξη του θεσμού του διευθυντή στην Ελλάδα και τα προσόντα που απαιτούνται
Authors: Κωνσταντινίδης Θεόδωρος 
Published: September 2024

Το σύγχρονο και συνεχώς μεταβαλλόμενο και εξελισσόμενο κοινωνικό πολιτικό περιβάλλον της χώρας μας επηρεάζει και το χώρο της εκπαίδευσης που αποτελεί έναν ζωντανό και ανοιχτό προς την κοινωνία οργανισμό. Επιβάλλει διευθυντές με δεξιότητες, ιδιαίτερα προσωπικά χαρακτηριστικά, επιστημονικά θωρακισμένους και γνωσιακά καταρτισμένους σε θέματα δημόσιας και σχολικής διοίκησης που θα μπορέσουν να ανταποκριθούν σε νεοτερισμούς χαράσσοντας νέο δρόμο και νέους ορίζοντες στα εκπαιδευτικά δρώμενα της χώρας μας. Η αποδοχή των διευθυντών τόσο εντός της σχολικής μονάδας όσο και ευρύτερα εξαρτάται από το επίπεδο των προσόντων, γνώσεων και της πρακτικής εφαρμογής τους. Με το τρόπο αυτό θα δημιουργηθεί ένα αποτελεσματικό, αποδοτικό και παραγωγικό σχολείο που θα πετυχαίνει τους θεσπισμένους στόχους, βασιζόμενο πάντοτε σε ηθικές αρχές και αξίες.Οι διευθυντές των ελληνικών σχολικών μονάδων βρίσκονται αντιμέτωποι με προκλήσεις και η αντιμετώπισή τους καθορίζει τον τρόπο διοίκησης του σχολείου και ενδεχομένως την μελλοντική τους πορεία στη νέα πραγματικότητα που διαμορφώνεται καθημερινά. Ο διευθυντής βρίσκεται στην κορυφή της σχολικής διοικητικής πυραμίδας και είναι τόσο διοικητικός όσο και παιδαγωγικός υπεύθυνος στο χώρο του σχολείου (Αριθμ. Φ. 353.1./324/105657/Δ1/ΦΕΚ 1340/16/10/2002). Όπως τονίζει η Σπυροπούλου (2010), από τις αρχές του ‘80 έως και σήμερα κύριο κριτήριο για την κατάκτηση διευθυντικής θέσης είναι τα έτη εκπαιδευτικής προϋπηρεσίας. Παρά τις προσπάθειες που έχουν γίνει από την πολιτεία κατά καιρούς ώστε να αποκτήσει πιο επιστημονικό χαρακτήρα η διαδικασία επιλογής, δεν έχει κατορθωθεί ακόμη ένας σχεδιασμός όμοιος, ώστε να μπορεί να αποτελέσει βάση για μια πιο προοδευτική προσέγγιση.
Traumatic brain injuries in sports - neurological aspects
Authors: Paziewska Adrianna Marta , Jurasz Karolina , Cymer Radosław , Rzeska Ewa , Rogulski Michał 
Published: September 2024

Traumatic Brain Injury (TBI) was characterized as alternation in brain function or any other sign of brain pathology resulting from external force. Sport-related traumatic brain injury (SR-TBI) calculated as up to 20% of all TBA. Different diagnostic tools, such as CT scan or MRI, are utilized in clinical assessment of the patients, however there is a necessity of further investigation of new diagnostic methods such as biomarkers. A long-term repetitive brain injury can lead in consequence to a Chronic Traumatic Encephalopathy (CTE). Neuroprotection, treatment and rehabilitation play a crucial role in both prevention and recovery of TBI patients.
Intermittent fasting - a diet to fight type 2 diabetes and obesity - current state of knowledge
Authors: Mazurek Joanna , Stachowicz Hubert , Adamczyk Monika , Baran Aleksandra , Bartos Weronika , Ptasznik Magdalena , Piotrowska-Żołnierczuk Magdalena , Podrażka Miłosz , Lenart Justyna , Flegiel Ewelina 
Published: September 2024

Obesity is a chronic disease that requires diagnosis and treatment. Excess body fat and metabolic disorders, resulting from the disease, are associated with the risk of numerous complications. Among the most widespread are type 2 diabetes, hypertension, dyslipidemia, atherosclerosis, non-alcoholic fatty liver disease and sleep apnea syndrome. Weight reduction significantly improves prognosis, and can mitigate or even reverse complications. A dietary method gaining popularity recently is intermittent fasting. It involves alternating periods of eating and fasting according to a fixed time schedule. There are different types of diet, differing in the length of the fasting period. Intermittent fasting affects the human body by regulating the diurnal rhythm, inducing metabolic switching, that is switching from using glucose as an energy source to lipid oxidation, and by modulating the composition of the gut microbiota. The effects of the diet, proven in clinical trials, include weight loss, improved glucose tolerance, lowered hemoglobin A1c and insulin levels, and improved tissue sensitivity to insulin. However, there is no evidence supporting the superiority of intermittent fasting over continuous calorie restriction. Intermittent fasting also carries a risk of adverse effects, the most serious of which are hypoglycemic episodes. These occur especially in people with type 2 diabetes and taking diabetes medications.
Although intermittent fasting appears to be a promising strategy in the fight against obesity and type 2 diabetes, further research is needed to evaluate its long-term effects on the human body.
Epilepsy After Brain Injury – Understanding the Link and Managing the Condition
Authors: Kałuża Jessica Adriana , Bochenek Oliwia , Nowak Aleksandra , Koper Mateusz , Konaszczuk Adrian , Ratyna Klaudia , Kozyra Oliwia , Szypuła Zofia , Paluch Katarzyna , Skarbek Małgorzata 
Published: September 2024

Post-Traumatic Epilepsy (PTE) is a neurological disorder characterized by recurrent seizures that occur as a result of traumatic brain injury (TBI). It represents a significant medical challenge due to its complex pathophysiology, diverse clinical manifestations, and the long latency period between the initial injury and the onset of epilepsy. It typically manifests weeks, months, or even years after the initial trauma, complicating the prognosis and management of head injury patients. The incidence of PTE varies widely, influenced by the severity and nature of the brain trauma, with higher risks associated with penetrating injuries, severe brain contusions, and hemorrhagic lesions. Pathogenetic mechanisms involve a cascade of molecular and cellular events, including neuroinflammation, blood-brain barrier disruption, and neuronal hyperexcitability, which contribute to the formation of epileptic networks. Diagnosis relies on a detailed patient history, neuroimaging, and electroencephalography (EEG) to confirm seizure activity and exclude other causes. It is often delayed and complicates early intervention strategies. Current management primarily focuses on seizure control through antiepileptic drugs (AEDs), but response rates are variable, and many patients suffer from drug-resistant epilepsy. Advances in neuroimaging and biomarker research hold promise for earlier detection and targeted therapies. This review synthesizes recent findings on the epidemiology, pathophysiology, diagnosis, and management of PTE, highlighting the need for a multidisciplinary approach to improve outcomes for individuals affected by this condition.
Innovative Paradigms and Established Strategies in Tooth Revitalization: A Review
Authors: Khan Ahmad Shah , Khan Zahid Mehmood , Ishaque Palwasha , Zubair Muhammad , Zahra Syeda Fatima Tu , Ashfaq Sana 
Published: September 2024

Revitalization has emerged as an innovative treatment approach for immature permanent teeth with necrotic pulp. This article presents a comprehensive analysis of revitalization, focusing on its principles, clinical protocols and outcomes. The article highlights the importance of thorough diagnosis and assessment of the pulp and peri-apical condition to determine the suitability of revitalization. Various factors influencing the success of revitalization, such as the use of scaffolds, growth factors and stem cells, are discussed. Additionally, a case that was treated with a PRP scaffold is also presented. Overall, revitalization shows promise in promoting pulp regeneration and improving treatment outcomes in selected cases of pulp necrosis. CPD/Clinical Relevance: To introduce research-based knowledge to GDPs about the procedure and prognosis of tooth revitalization.
Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?
Authors: Yang Xiaobin , Yan Tinglin , Bao Zhexuan , Ouyang Kexiong , Huang Luo 
Published: September 2024

Aims/Background For inexperienced dental students, impacted wisdom tooth extraction is a complex procedure involving a series of intricate steps. This study compared the effectiveness of step-by-step and all-in-one teaching methods for dental students learning impacted wisdom tooth extraction, by evaluating their practical abilities, understanding, and learning satisfaction. Methods Fifty dental students were randomly assigned to either a step-by-step teaching group (Group S) or an all-in-one teaching group (Group A) for impacted wisdom tooth extraction training. Their skills were assessed using the Assessment of Competency in Exodontia Skills (ACES) scoring system, and their theoretical knowledge was tested in a test. The students also completed a questionnaire to gauge their satisfaction regarding the teaching method received. Results The students in Group S demonstrated superior performance in clinical procedures compared to Group A, evidenced by the significantly higher ACES scores (p < 0.05). There was no significant difference in theoretical exam scores between the two groups (p > 0.05). The students in Group S reported higher general satisfaction (p < 0.05), suggesting a preference for the step-by-step approach. The results also showed that satisfaction toward hands-on practice and teaching sessions significantly contributed to general satisfaction, while satisfaction with mastery of clinical skills did not. Conclusion The step-by-step teaching method was more effective in improving students’ clinical skills and augmenting their satisfaction during impacted wisdom tooth extraction training. Our findings support the use of incremental learning approaches in dental education to enhance both clinical competencies and students’ learning experiences.
Sarcopenia Predicts Postoperative Complications and Survival of Colorectal Cancer Patients Undergoing Radical Surgery
Authors: Wang Jiwei , Chen Yi , He Jixin , Yin Chunmei , Xie Ming 
Published: September 2024

Aims/Background Previous literature has indicated that sarcopenia is related to poor outcomes after radical resection for colorectal cancer (CRC). However, its effect on the postoperative clinical outcomes of CRC remains controversial. This study aimed to elucidate the predictive value of sarcopenia for postoperative complications and survival in CRC patients. Methods This investigation retrospectively assessed the clinical data of 226 CRC patients who underwent radical resection at the Department of Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University from January 2018 to December 2020. Sarcopenia was diagnosed according to the recommendations of the Asian Working Group for Sarcopenia in 2019, and patients were categorized into sarcopenia and non-sarcopenia groups. Multivariate and univariate analyses were employed to assess the risk factors for postoperative complications. The Kaplan-Meier method and survival curve were used to analyze postoperative survival time. Cox proportional hazards regression models were used to evaluate risk factors affecting the prognosis of CRC patients. Results This investigation included 226 patients, of which 68 were diagnosed with sarcopenia. Furthermore, it was revealed that sarcopenia was linked with older age (p < 0.001), low body mass index (p < 0.001), high prevalence of diabetes (p = 0.002), high cystatin level (p = 0.017), and low 3rd lumbar spine (L3) planar skeletal muscle index (p < 0.001), but was not related to the tumour stage or the gender. Moreover, sarcopenia was also correlated with increased occurrence of all postoperative complications (p = 0.050). The results of the multivariate analysis indicated that sarcopenia was an independent risk factor for postoperative complications (odds ratio (OR): 7.154; 95% confidence interval (CI): 2.261–22.633; p = 0.017). The Kaplan-Meier analysis revealed that sarcopenia patients had significantly lower 5-year disease-free survival (DFS) (48.5% vs 59.5%; log-rank p = 0.033) and 5-year overall survival (OS) (57.4% vs 77.2%; log-rank p < 0.001) rates. Sarcopenia was an independent risk factor for poor DFS (hazard ratio (HR) = 1.404; p = 0.016) and OS (HR = 1.290; p = 0.021). Conclusion In CRC patients undergoing radical surgery, sarcopenia is an independent risk factor for postoperative complications. Sarcopenia may be a predictive factor for the prognosis and survival of CRC patients undergoing radical resection.
Aetiology of patient dissatisfaction following primary total knee arthroplasty in the era of robotic-assisted technology
Authors: Gardner Jonathan , Roman Elliott R. , Bhimani Rohat , Mashni Sam J. , Whitaker John E. , Smith Langan S. , Swiergosz Andrew , Malkani Arthur L. 
Published: September 2024

AimsPatient dissatisfaction following primary total knee arthroplasty (TKA) with manual jig-based instruments has been reported to be as high as 30%. Robotic-assisted total knee arthroplasty (RA-TKA) has been increasingly used in an effort to improve patient outcomes, however there is a paucity of literature examining patient satisfaction after RA-TKA. This study aims to identify the incidence of patients who were not satisfied following RA-TKA and to determine factors associated with higher levels of dissatisfaction.MethodsThis was a retrospective review of 674 patients who underwent primary TKA between October 2016 and September 2020 with a minimum two-year follow-up. A five-point Likert satisfaction score was used to place patients into two groups: Group A were those who were very dissatisfied, dissatisfied, or neutral (Likert score 1 to 3) and Group B were those who were satisfied or very satisfied (Likert score 4 to 5). Patient demographic data, as well as preoperative and postoperative patient-reported outcome measures, were compared between groups.ResultsOverall, 45 patients (6.7%) were in Group A and 629 (93.3%) were in Group B. Group A (vs Group B) had a higher proportion of male sex (p = 0.008), preoperative chronic opioid use (p < 0.001), preoperative psychotropic medication use (p = 0.01), prior anterior cruciate ligament (ACL) reconstruction (p < 0.001), and preoperative symptomatic lumbar spine disease (p = 0.004). Group A was also younger (p = 0.023). Multivariate analysis revealed preoperative opioid use (p = 0.012), prior ACL reconstruction (p = 0.038), male sex (p = 0.006), and preoperative psychotropic medication use (p = 0.001) as independent predictive factors of patient dissatisfaction.ConclusionThe use of RA-TKA demonstrated a high rate of patient satisfaction (629 of 674, 93.3%). Demographics for patients not satisfied following RA-TKA included: male sex, chronic opioid use, chronic psychotropic medication use, and prior ACL reconstruction. Patients in these groups should be identified preoperatively and educated on realistic expectations given their comorbid conditions.Cite this article: Bone Jt Open 2024;5(9):758–765.
Incidence and predictors of hypocalcemia in end-stage renal disease patients on denosumab therapy: A systematic review and meta-analysis
Authors: Siddiqui Abdul Hannan , Shaikh Misbah , Salman Afia , Fahim Muhammad Ahmed Ali , Batool Fizzah , Mari Tahreem , Musani Sarah , Fareed Muneeb , Rehan Rooma , Hassni Amna , Nizami Urooj , Amir Ayesha , Moeed Abdul , Surani Salim R 
Published: September 2024

BACKGROUND
Denosumab inhibits the receptor activator of nuclear factor kappa-ligand. It markedly increases bone mineral density and has been proven to reduce the risk of fractures. However, numerous adverse effects, notably hypocalcemia, are prevalent in patients with end-stage renal disease (ESRD).
AIM
To analyze the incidence and predictors of hypocalcemia caused by denosumab compared to control in patients with ESRD.
METHODS
We conducted this study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Scopus, Cochrane Central, and EMBASE were systematically searched from inception through March 2024. All original studies investigating the effects of denosumab on patients with ESRD compared to control were extracted. The primary outcomes of our study were the incidence of mild, severe, and very severe hypocalcemia. Secondary outcomes included serum levels of intact parathyroid hormone, calcium, and phosphate. The results were pooled and analyzed using a random-effects model.
RESULTS
Seven articles comprising 3240 patients were included in our study. Patients treated with denosumab had a significantly increased incidence of mild hypocalcemia [risk ratio (RR): 2.79; 95% confidence interval (CI): 0.99-7.91; P = 0.05; I ² = 37%] and of very severe hypocalcemia (RR: 9.58; 95%CI: 1.58-57.98; P = 0.01; I ² = 49%). However, an increase in the occurrence of severe hypocalcemia was non-significant (RR: 4.23; 95%CI: 0.47-38.34; P = 0.20; I ² = 96%). Alternatively, denosumab showed a significant decrease in serum intact parathyroid hormone [mean difference (MD): -433.20, 95%CI: -775.12 to -91.28, I 2 = 98%, P = 0.01], while there was a non-significant decrease in phosphate (MD: -0.47, 95%CI: -1.35 to 0.41, I 2 = 88%, P = 0.30) and calcium levels (MD: -0.33, 95%CI: -0.95 to 0.29, I 2 = 94%, P = 0.29).
CONCLUSION
Our study demonstrated that denosumab is significantly associated with mild and very severe hypocalcemia in patients with ESRD making it necessary to detect and prevent this side effect of treatment.
Developmental dyslexia in children with perinatal exposure to hypoxia: A systematic review
Authors: Radtke Bartosz M. , Lipowska Małgorzata , Bieleninik Łucja , Łada-Maśko Ariadna , Krempla-Patron Katarzyna , Nowicki Rafał , Gradys Gabriela , Brykała Anna , Pacuła Judyta , Arasimowicz Marek , Sajewicz-Radtke Urszula 
Published: September 2024

Background
Research on a health-related event at the stage of labour and the occurrence of adverse outcomes at the school age has provided inconclusive results. Thus far, no systematic reviews have been conducted. Thus, the objective of this study is to investigate the association between hypoxia during pregnancy or delivery and the subsequent occurrence of a developmental dyslexia in school-age children.

Methods
We used a standard search strategy of electronic databases (PubMed, PsycINFO, Web of Science, EMBASE, and Cochrane Library) and handsearching. We included observational studies (cohort studies, case-control studies) that consider as an exposure the presence of hypoxia during pregnancy or delivery, and as an outcome, developmental dyslexia in school-age children. Two reviewers independently conducted the search and determined eligibility, which was not restricted by language or year of publication.

Results
The search took place until 1 April 2023. Of the 1,336 abstracts screened, 6 were assessed for eligibility. Of the six eligible studies, no studies met the pre-specified eligibly criteria.

Conclusions
We were unable to assess the association between hypoxia and developmental dyslexia, as no eligible studies were found. Thus, the association between hypoxia during pregnancy or delivery and dyslexia in school-age children remains unknown.
Myosteatosis and the clinical outcomes of patients with liver cirrhosis: A meta-analysis
Authors: Xue Haojie , Liu Yihan , Liu Yang , Li Han , Liang Qian , Ma Longhui , Liu Junying , Zhao Ming 
Published: September 2024

Objectives
This study aimed to examine the potential correlation between myosteatosis and the prognosis of patients diagnosed with liver cirrhosis by a meta-analysis.

Methods
Cohort studies of relevance were acquired through comprehensive searches of the Medline, Web of Science, and Embase databases. To account for heterogeneity, a random-effects model was employed to combine the findings.

Results
The meta-analysis included 10 retrospective and four prospective cohort studies, encompassing a total of 4287 patients diagnosed with cirrhosis. The pooled findings indicated a notable decline in transplant-free survival (TFS) among individuals with liver cirrhosis and myosteatosis compared to those without this condition (risk ratio: 1.94; 95% confidence interval: 1.61 to 2.34, p < 0.001; I2 = 49%). The predefined subgroup analyses demonstrated consistent findings across various categories, including Asian and non-Asian studies, prospective and retrospective cohort studies, patients with cirrhosis overall and those who underwent transjugular intrahepatic portosystemic shunt, studies with different follow-up durations (< or ≥ 24 months), studies employing univariate and multivariate analyses, and studies with and without an adjustment for sarcopenia (p > 0.05 for all subgroup differences). Additionally, Egger’s regression test indicated the presence of significant publication bias (p = 0.044). However, trim-and-fill analysis by including three hypothesized studies showed consistent results.

Conclusions
The presence of myosteatosis in individuals diagnosed with liver cirrhosis may potentially be linked to a poor TFS prognosis. Further investigations are required to ascertain whether enhancing myosteatosis could potentially yield a survival advantage for this particular patient population.
Markedness Neutralisation and the Unity of Opposites in Heraclitus
Authors: Begley Keith 
Published: September 2024

In this article, I shed new light on a misunderstood aspect of Heraclitus’ style. The opposites employed by Heraclitus are often of equal status except that one member of each pair may also appear as a designation for the encompassing whole. I begin by discussing two interpretations of this phenomenon, which were put forward by Roman Dilcher and Alexander Mourelatos. The phenomenon is, I suggest, better understood as being an example of what is known as markedness neutralisation. I argue that this phenomenon should be interpreted as further undermining what Mourelatos identified as a naïve paratactic metaphysics of mere things (NMT), to which Heraclitus was reacting by beginning to develop a hypotactic metaphysics of hierarchies and dependencies as part of a view of the world as being logos-textured. Further, I consider a series of three problems that were put forward by Dilcher, which he thinks must be addressed by anyone who claims that Heraclitus held a unity of opposites thesis. I also consider some related issues, and provide some responses.
An Extremely Rare Presentation of Mucinous Adenocarcinoma Originating From Meckel Diverticulum Masquerading in a Young Woman With Crohn's Disease
Authors: Fawaris Nada , Shariq Sohail , Elnaggar Mohamed , Kubba Faris , Haria Rashmi 
Published: September 2024

ABSTRACT
Mucinous adenocarcinoma with signet cell features originating from Meckel diverticulum (MD) is an extremely rare primary malignant tumor. A woman in her 30s presented with multiple episodes of vomiting, abdominal pain, and constipation. She had a history of stricturing Crohn's disease and managed well with steroids, azathioprine, and infliximab. This time, a computed tomography scan showed distal ileal small-bowel obstruction. Urgent surgery for a nonsettling small bowel obstruction was performed. MD was incidentally found and was concerning for malignancy. This case report illustrates how this extremely rare malignancy was behaving like Crohn's disease, which delayed the diagnosis and treatment.