bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying an enhanced recovery approach to endoscopic procedures: Local experience with progression to day-case transurethral resection of bladder tumour
Authors: Wells Hannah L , Lazenbury Abigail , Fairchild Lucy , Harris Mark 
Published: February 2020

Objective: Transurethral resection of bladder tumour (TURBT) is a common urological procedure. With improvements in technology, technique and community support, our unit was able to implement a dedicated day-case pathway for patients undergoing TURBT. The aim of this study was to prove that this has been a safe and cost-effective improvement to our urology service. Patients and methods: A retrospective audit was carried out of 312 elective TURBT cases performed in one centre between 2011 and 2014 (36 excluded for lack of data/emergency status). Data were gathered regarding length of stay, causes of delayed discharge, readmissions and resection quality. Results: In 2011, 11% of TURBTs were performed as day cases, and 66% had an overnight stay. After introduction of the TURBT pathway, by 2014, 68% patients went home the same day, and 21% had an overnight stay. The 30-day readmission rate in 2011 was 7% (mostly following overnight stays), whereas 6% were readmitted in 2014. Resection quality was comparable across the two groups. Conclusion: Our experience suggests that day-case TURBT can be widely implemented without compromising quality or patient safety. Level of evidence: Not applicable for this multicentre audit.
Video Analysis of Concussion Exposures in a National Collegiate Athletic Association Division I Football Team
Authors: Austin Ashley V. , Sasser Phillip , Tanabe Kawai , MacKnight John M. , Kent Jeremy B. 
Published: February 2020

Background: Research into improving player safety of sport-related concussion (SRC) in American football has been an ongoing endeavor. In an attempt to better understand the incidence of SRCs in American football, research has focused on the characteristics of SRC during gameplay. Determining SRC specifics and assessing them quantitatively can help identify high-risk scenarios and predict exposure risk. Purpose: To identify and assess the incidence of SRCs in a National Collegiate Athletic Association football team by comparing field location, player positions, collision partners, and player cues. Study Design: Descriptive epidemiology study. Methods: We used physician sideline reports of diagnosed concussions from a Division I football team from September 2010 to December 2018. Game videos were analyzed to identify the field location where the SRC occurred, collision partner, and player behavior postconcussion. The incidence of in-game SRCs by position was also assessed. We used the “words of estimative probability” model to categorize each concussion as certain, almost certain, probable, or even on the basis of our confidence in identifying them using game film. Results: This study examined 44 SRCs that occurred over 9 seasons. The SRC incidence was significantly higher in the middle defense (5-20 yards from the line of scrimmage) compared with all other field locations (relative risk, 2.46; 95% CI, 1.14-5.29; P < .05). In-game collision partners were most commonly defensive backs. The most common player cue was a hand to helmet/face mask. The positions with the highest SRC incidence by athlete-exposure, game position, and position play belonged to the defensive backs, wide receivers, and running backs. Conclusion: The middle defense had a significantly higher incidence of SRCs than all other field locations. We pose a new method to categorize concussions during video analysis by using words of estimative probability. Knowledge of SRC gameplay characteristics can potentially guide the medical staff and medical observer to better identify them.
Human Capital: The Key to the Longevity of a Family Business
Authors: Rajan Soumya , Ganesh Priya , Mehra Nandini 
Published: February 2020

Globally, family-owned businesses are the oldest and most predominant form of an enterprise, forming an integral part of the organised and unorganised sectors of free economies. Over the years, with the greater longevity of family businesses in India, there has been a dynamic and strategic shift in Indian families from being ‘family businesses’ to ‘business families’. This shift has come with its own set of challenges, most critical among them being the challenges related to ‘human capital’ for these businesses. The need to balance familial relationships with the pragmatism of business is a unique interplay which creates multiple complexities and inter-related issues for all family members alike. With close to 75 per cent of the Indian workforce employed by family-owned businesses, it is important to dive deeper into the human resources (HRs) function in Indian Family businesses. Our endeavour is to understand the challenges of HRs in a family business and how this differs from larger corporations or non-family businesses.
Identification and characterization of circRNAs in the skin during wool follicle development in Aohan fine wool sheep
Authors: Zhao Ranran , Liu Nan , Han Fuhui , Li Hegang , Liu Jifeng , Li Lanlan , Wang Guoyi , He Jianning 
Published: February 2020

Abstract
Background
Aohan fine wool sheep (AFWS) is a historically bred fine wool sheep, cultivated in China. The wool has excellent quality and good textile performance. Investigating the molecular mechanisms that regulate wool growth is important to improve wool quality and yield. Circular RNAs (circRNAs) are widely expressed non-coding RNAs that can act as competitive endogenous RNAs (ceRNAs) to bind to miRNAs. Although circRNAs have been studied in many fields, research on their activity in sheep wool follicles is limited. To understand the regulation of circRNAs in the growth of fine wool in sheep, we used RNA-Seq to identify circRNAs in sheep shoulder skin samples at three developmental stages: embryonic day 90 (E90d), embryonic day 120 (E120d), and at birth (Birth).

Results
We identified 8753 circRNAs and found that 918 were differentially-expressed. We then analyzed the classification and characteristic of the circRNAs in sheep shoulder skin. Using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), we identified the source genes of circRNAs, which were mainly enriched in cellular component organization, regulation of primary metabolic processes, tight junctions, and the cGMP-PKG and AMPK signaling pathways. In addition, we predicted interactions between 17 circRNAs and eight miRNAs, using miRanda software. Based on the significant pathways, we speculate that circ_0005720, circ_0001754, circ_0008036, circ_0004032, circ_0005174, circ_0005519, and circ_0007826 might play an important role in regulating wool follicle growth in AFWS. Seven circRNAs were randomly selected to validate the RNA-Seq results, using qRT-PCR.

Conclusion
Our results provide more information about circRNAs regulation of wool follicle development in AFWS, and establish a solid foundation for future research.
Awareness of ADHD in primary care: stakeholder perspectives
Authors: French B. , Perez Vallejos E. , Sayal K. , Daley D. 
Published: February 2020

Abstract
Background
Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It is therefore essential that GPs have a clear understanding of the disorder and its care pathways. While previous studies have highlighted potential barriers in GPs’ ADHD awareness, this qualitative study aims to further explore individual stakeholders’ experiences.

Methods
Semi-structured interviews explored the views of multiple stakeholders- GPs (n = 5), healthcare specialists (n = 5), patients (adults with ADHD n = 5) and parents (n = 5) with experience of the presentation and management of ADHD in primary care. These interviews were analysed using thematic analyses and following principles of grounded theory.

Results
Stakeholders described ADHD assessment, diagnosis and treatment as an intricate process. Many factors affected this process such as complex pathways, lack of services, limited GP recognition and knowledge, and communicative difficulties between and within multiple stakeholders.

Conclusion
This analysis underlines the significant impact that receiving (or not) a diagnosis can have, and further explores muddled ADHD care pathways, highlighting key issues around GP identification and the shortage of adult services. Implications for practice and future research are discussed, suggesting a strong need for more commissioned pathways and GP specific educational programs.
Addressing safety risks in integrated care programs for older people living at home: a scoping review
Authors: Lette Manon , Ambugo Eliva A. , Hagen Terje P. , Nijpels Giel , Baan Caroline A. , de Bruin Simone R. 
Published: February 2020

AbstractBackgroundMany older people live at home, often with complex and chronic health and social care needs. Integrated care programs are increasingly being implemented as a way to better address these needs. To support older people living at home, it is also essential to maintain their safety. Integrated care programs have the potential to address a wide range of risks and problems that could undermine older people’s ability to live independently at home. The aim of this scoping review is to provide insight into how integrated care programs address safety risks faced by older people living at home - an area that is rather underexplored.MethodsSafety was conceptualised as preventing or reducing the risk of problems, associated with individual functioning and behaviour, social and physical environments, and health and social care management, which could undermine older people’s ability to live independently at home. For this scoping review a systematic literature search was performed to identify papers describing integrated care programs where at least one intervention component addressed safety risks. Data were extracted on the programs’ characteristics, safety risks addressed, and the activities and interventions used to address them.ResultsNone of the 11 programs included in this review explicitly mentioned safety in their goals. Nevertheless, following the principles of our conceptual framework, the programs appeared to address risks in multiple domains. Most attention was paid to risks related to older people’s functioning, behaviour, and the health and social care they receive. Risks related to people’s physical and social environments received less attention.ConclusionEven though prevention of safety risks is not an explicit goal of integrated care programs, the programs address a wide range of risks on multiple domains. The need to address social and environmental risks is becoming increasingly important given the growing number of people receiving care and support at home. Prioritising a multidimensional approach to safety in integrated care programs could enhance the ability of health and social care systems to support older people to live safely at home.
Leptospirosis in an asplenic patient -case report
Authors: García-Méndez J. , Cervera-Ceballos E. , Atilano-López D. , Arroyo-Escalante S. , Moncada-Barrón D. , Leyva-Leyva M. , Hernández-Castro R. , Carrillo-Casas E. M. 
Published: February 2020

Abstract
Background
The presentation of clinical leptospirosis has been historically associated with animal workers, slaughterhouse workers and medical veterinarians. This association has shifted to be related to flooding events and outdoor activities; few cases are related to high-risk factors found in immunosuppressed patients. Scarcely a handful of cases have serological evidence of immune response against Leptospira serovar Bratislava representing serogroup Australis, a serovar associated with poor reproductive performance in swine and horses, and recently with cats.

Case presentation
Herein, we describe a rare clinical presentation of disseminated Leptospira infection in an immunosuppressed 65-year-old woman. She was admitted to the emergency room with fever, bacteraemia, bilateral uveitis and pulmonary involvement. The patient denied outdoor activities; she only had wide exposure to faeces and urine from cats living in her home. Her medical history included idiopathic thrombocytopenic purpura (ITP) diagnosed at the age of 18. She did not respond to medical treatment, and a splenectomy was performed. At age 60, she was diagnosed with Chronic Myeloid Leukemia (CML), and was treated with a tyrosine kinase inhibitor (TKI) –Imatinib. The patient voluntarily discontinued the treatment for the last 6 months. After extensive workup, no microorganisms were identified by the commonly used stains in microbiology. The diagnosis was performed through dark-field microscopy, microagglutination test (MAT), Leptospira genus-specific PCR, the IS1500 PCR for identification of pathogenic species, and 16S based sequencing for the genus identification.

Conclusion
Immunosuppressed patients may acquire uncommon infections from ubiquitous microorganisms. In this case, serology evidence of exposure to Leptospira serovar Bratislava by MAT and the presence of the Leptospira genus were identified. It should be on mind for the diagnosis in otherwise healthy patients, and thoroughly search on splenectomised patients exposed to animals. Additionally, this report highlights the usefulness of PCR for diagnosis of this potentially life-threatening illness.
Association between gene polymorphisms of voltage-dependent Ca2+ channels and hypertension in the Dai people of China: a case-control study
Authors: Huang Lifan , Chu Yan , Huang Xiaoqin , Ma Shaohui , Lin Keqin , Huang Kai , Sun Hao , Yang Zhaoqing 
Published: February 2020

Abstract
Background
Abnormal calcium homeostasis related to the development of hypertension. As the key regulator of intracellular calcium concentration, voltage-dependent calcium channels (VDCCs), the variations in these genes may have important effects on the development of hypertension. Here we evaluate VDCCs variability with respect to hypertension in the Dai ethnic group of China.

Methods
A total of 1034 samples from Dai individuals were collected, of which 495 were used as cases, and 539 were used as controls. Blood pressure was measured using a standard mercury measurement method, three times with a rest for 5 min, and the average was used for analyses. Seventeen single nucleotide polymorphisms (SNPs) in the four protein-coding genes (CACNA1A, CACNA1C, CACNA1S, CACNB2) of VDCCs were identified by multiplex PCR-SNP typing technique. Chi-square tests and regression models were used to analyse the associations of SNPs with hypertension.

Results
The results of chi-square tests showed that the allele frequencies of 5 SNPs were significantly different between the case and the control groups (P < 0.05), but the statistical significance was lost after Bonferroni’s correction. However, after adjusting for BMI, age, sex and other factors by logistic regression analyses, the results showed that 5 SNPs consistent with chi-square tests (rs2365293, rs17539088, rs16917217, rs61839222 and rs10425859) were still statistically positive.

Conclusions
This finding suggested that the significant association of these SNPs with hypertension may be noteworthy in future studies.
Regulatory T cells participate in the recovery of ischemic stroke patients
Authors: Santamaría-Cadavid María , Rodríguez-Castro Emilio , Rodríguez-Yáñez Manuel , Arias-Rivas Susana , López-Dequidt Iria , Pérez-Mato María , Rodríguez-Pérez Manuel , López-Loureiro Ignacio , Hervella Pablo , Campos Francisco , Castillo José , Iglesias-Rey Ramón , Sobrino Tomás 
Published: February 2020

AbstractBackgroundRecent preclinical studies have shown that regulatory T cells (Treg) play a key role in the immune response after ischemic stroke (IS). However, the role of Treg in human acute IS has been poorly investigated. Our aim was to study the relationship between circulating Treg and outcome in human IS patients.MethodsA total of 204 IS patients and 22 control subjects were recruited. The main study variable was good functional outcome at 3 months (modified Rankin scale ≤2) considering infarct volume, Early Neurological Deterioration (END) and risk of infections as secondary variables. The percentage of circulating Treg was measured at admission, 48, 72 h and at day 7 after stroke onset.ResultsCirculating Treg levels were higher in IS patients compared to control subjects. Treg at 48 h were independently associated with good functional outcome (OR, 3.5; CI: 1.9–7.8) after adjusting by confounding factors. Patients with lower Treg at 48 h showed higher frequency of END and risk of infections. In addition, a negative correlation was found between circulating Treg at 48 h (r = − 0.414) and 72 h (r = − 0.418) and infarct volume.ConclusionsThese findings suggest that Treg may participate in the recovery of IS patients. Therefore, Treg may be considered a potential therapeutic target in acute ischemic stroke.
DNA methylation-based measures of accelerated biological ageing and the risk of dementia in the oldest-old: a study of the Lothian Birth Cohort 1921
Authors: Sibbett Ruth A. , Altschul Drew M. , Marioni Riccardo E. , Deary Ian J. , Starr John M. , Russ Tom C. 
Published: February 2020

Abstract
Background
Previous studies have demonstrated an association between DNA methylation-based measures of accelerated ageing and age-related health outcomes and mortality. As a disease closely associated with advancing age, we hypothesized that DNA methylation-based measures of accelerated ageing might be associated with risk for dementia. This study therefore aimed to examine the association between four recognised measures of age acceleration and subsequent dementia.

Methods
Study subjects (n = 488) were members of the Lothian Birth Cohort 1921. Dementia case ascertainment used data from death certificates, electronic hospital records, and clinical reviews. Venous blood samples were taken at baseline, at age 79 years. DNA methylation and measures of epigenetic age were calculated in accordance with Horvath’s epigenetic clock tutorial, using the online calculator (https://dnamage.genetics.ucla.edu/). From these values, four measures of accelerated ageing were calculated: extrinsic epigenetic age acceleration (EEAA), intrinsic epigenetic age acceleration (IEAA), AgeAccelPheno and AgeAccelGrim. Competing risk regression models – with death as a competing risk – were performed to examine the association between each measure of accelerated ageing and incident dementia. APOE ɛ4 status, sex, age, smoking status, history of cardiovascular disease, cerebrovascular disease, hypertension, and diabetes were included as covariates.

Results
None of the multivariate models revealed a positive association between increased epigenetic age acceleration and dementia risk. Across all included models, never-smoking increased risk for dementia (HR 1.69 [1.06, 2.71], p = 0.03), and having no APOE ɛ4 alleles reduced risk for dementia (HR 0.44 [0.29, 0.67], p < 0.001).

Conclusions
The present study did not demonstrate any consistent association between DNA methylation-based measures of accelerated ageing and dementia in subjects aged over 79 years. Further, larger studies – including separate analyses of dementia subtypes – are required to further investigate the potential association between DNA methylation-based measures of accelerated ageing and dementia.
Injections of concentrated bone marrow aspirate as treatment for Discogenic pain: a retrospective analysis
Authors: Wolff Michael , Shillington Jon Mark , Rathbone Christopher , Piasecki Shawn K. , Barnes Brian 
Published: February 2020

Abstract
Background
There are an overwhelming number of patients suffering from low back pain (LBP) resulting from disc pathology. Although several strategies are being developed pre-clinically, simple strategies to treat the large number of patients currently affected is still needed. One option is to use concentrated bone marrow aspirate (cBMA), which may be effective due to its intrinsic stem cells and growth factors.

Methods
Thirty-three patients who received intradiscal injections of cBMA to relieve LBP were followed up based on Numeric Rating Scale (NRS), Oswestry Low Back Pain Disability Index (ODI), and Short Form-36 Health Survey (SF-36) scores. Patients were also subdivided into those with a pre-injection NRS > 5 and pre-injection NRS ≤ 5. The proportion of patients demonstrating at least 50% improvement (and 95% confidence intervals) from baseline at five follow-up visits for each outcome was evaluated.

Results
At least 50% improvement in NRS was observed for 13.8, 45.8, 41.1, 23.5, and 38.9% of patients across five follow-up visits, out to 1 year. When stratified by high (> 5) versus low (≤ 5) baseline NRS scores, the values were 14.3, 45.5, 71.4, 22.2, and 44.4% among those with high baseline pain, and 13.3, 46.2, 20.0, 25.0, and 33.3% among those with low baseline pain. The 50% improvement rates across visits were 4.3, 28.6, 30.0, 22.2, and 30.8% for SF-36, and 4.2, 26.7, 36.4, 55.6, and 30.8% for ODI.

Conclusions
Intradiscal cBMA injections may be effective to reduce pain and improve function. Patients with relatively higher initial pain may have potential for greatest improvement.
Arthroscopic side-to-side repair for complete radial posterior lateral meniscus root tears
Authors: Zhuo Hongwu , Chen Qiang , Zhu Fugui , Li Jian 
Published: February 2020

Abstract
Background
The aim of this study was to determine the radiographic, second-look, and functional outcomes after arthroscopic side-to-side repair for complete radial posterior lateral meniscus root tears (PLMRTs).

Methods
Patients who underwent arthroscopic side-to-side repair for complete radial PLMRTs were identified. Clinical assessment consisted of symptoms (locking, catching, giving way and effusion), examinations of joint-line tenderness and McMurray test, and subjective scores of International Knee Documentation Committee (IKDC), Lysholm, and Tegner. In addition, postoperative MRI scan and second-look arthroscopy were performed to assess the healing status of the repaired meniscus.

Results
Twenty-nine patients met the inclusion criteria. The mean age was 25.41 years. The mean follow-up period was 26.68 months. During the follow-up, none of the patients had symptoms of meniscal retear, lateral joint-line tenderness or a positive McMurray test. The postoperative subjective scores of IKDC, Lysholm, and Tegner improved significantly compared to the preoperative values (P = 0.01). Postoperative MRI scan showed that 28/29 (96.6%) patients achieved meniscus healing. Twenty-two patients underwent second-look arthroscopy, among whom 19 (86.4%) patients showed complete meniscus healing and 3 (13.6%) patients showed partial healing.

Conclusion
Arthroscopic side-to-side repair was a valuable surgical repair technique for complete radial PLMRTs, which leaded to significant improvements in both objective and subjective functional outcomes with a high rate of meniscus healing.

Level of evidence
Level IV, case series.