bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational therapy students’ technological skills: Are ‘generation Y’ ready for 21st century practice?
Authors: Hills Caroline , Ryan Susan , Smith Derek R. , Warren‐Forward Helen , Levett‐Jones Tracy , Lapkin Samuel
Published: July 2016

Background/aim

Technology is becoming increasingly integral to the practice of occupational therapists and part of the everyday lives of clients. ‘Generation Y’ are purported to be naturally technologically skilled as they have grown up in the digital age. The aim of this study was to explore one cohort of ‘Generation Y’ occupational therapy students’ skills and confidence in the use of technologies relevant to contemporary practice.

Methods

A cross‐sectional survey design was used to collect data from a cohort of 274 students enrolled in an Australian undergraduate occupational therapy programme.

Results

A total of 173 (63%) students returned the survey. Those born prior to 1982 were removed from the data. This left 155 (56%) ‘Generation Y’ participants. Not all participants reported to be skilled in everyday technologies although most reported to be skilled in word, Internet and mobile technologies. Many reported a lack of skills in Web 2.0 (collaboration and sharing) technologies, creating and using media and gaming, as well as a lack of confidence in technologies relevant to practice, including assistive technology, specialist devices, specialist software and gaming.

Conclusions

Overall, the results suggested that this group of ‘Generation Y’ students were not universally skilled in all areas of technology relevant to practice but appear to be skilled in technologies they use regularly. Recommendations are therefore made with view to integrating social networking, gaming, media sharing and assistive technology into undergraduate programmes to ensure that graduates have the requisite skills and confidence required for current and future practice.
A Tale of One City: The Devo Manc Deal and Its Implications for English Devolution
Authors: Kenealy Daniel
Published: July 2016

On 2 November 2014 George Osborne stood in the impressive great council chamber of Manchester town hall and, flanked by the ten leaders of Greater Manchester's local authorities, announced a devolution deal for the city‐region. Greater Manchester would receive a significant package of powers over transport, housing, planning, skills, business support and welfare in exchange for creating new governance structures, including a directly elected mayor for the city‐region. This article explores the background to the Devo Manc deal, arguing that it is the product of both a long history of local government collaboration in Greater Manchester and George Osborne's desire for a sweeping restructure of English governance. It traces how the key decisions were taken quickly and by a small number of key officials. The article also identifies some flaws in Devo Manc and considers whether it is an appropriate model for other city‐regions in the UK.
Unknown unknowns: essential genes in quest for function
Authors: Danchin Antoine , Fang Gang
Published: July 2016

The experimental design of a minimal synthetic genome revealed the presence of a large number of genes without ascribed function, in part because the abstract laws of life must be implemented within ad hoc material contraptions. Creating a function needs recruitment of some pre‐existing structure and this reveals kludges in their set‐up and history. Here, we show that looking for functions as an engineer would help in discovery of a significant number of those, proposed together with conceptual handles allowing investigators to pursue this endeavour in other contexts.
Proof‐of‐Concept Study to Assess the Nociceptin Receptor Antagonist LY2940094 as a New Treatment for Alcohol Dependence
Authors: Post Anke , Smart Trevor S. , Jackson Kimberley , Mann Joanne , Mohs Richard , Rorick‐Kehn Linda , Statnick Michael , Anton Raymond , O'Malley Stephanie S. , Wong Conrad J.
Published: July 2016

Background

This was a proof‐of‐concept study to evaluate the efficacy of LY2940094, a nociceptin/orphanin FQ peptide receptor antagonist, in reducing alcohol consumption in actively alcohol‐drinking patients with alcohol dependence.

Methods

Eighty‐eight patients, 21 to 66 years of age, diagnosed with alcohol dependence, reporting 3 to 6 heavy drinking days per week, were randomized (1:1) to 8 weeks of treatment with once‐daily oral placebo (N = 44) or 40 mg/d of LY2940094 (N = 44). The primary efficacy analysis was the change from baseline in number of drinks per day (NDD) utilizing mixed‐model repeated measures comparing LY2940094 and placebo in Month 2 of the 8‐week double‐blind treatment period. The probability that the difference relative to placebo in NDD was ≤0 at endpoint was calculated, and a probability ≥80% was considered to be evidence that LY2940094 was associated with the reduction in NDD.

Results

After 8 weeks of treatment, reduction in mean NDD did not differ between LY2940094 versus placebo (−1.4 vs. −1.5, respectively, 44% probability of greater reduction relative to placebo), but there was a greater reduction in the mean percentage of heavy drinking days in a month with LY2940094 versus placebo (−24.5 vs. −15.7%, respectively, 93% probability of a greater reduction relative to placebo), and an increase in the mean percentage of abstinent days in a month compared to placebo (9.1 vs. 1.9%, respectively, 91% probability of a greater increase relative to placebo). Patients who were treated with LY2940094 showed decreased plasma levels of gamma‐glutamyl transferase with probabilities ≥98% for greater reduction compared with placebo at Weeks 1, 4, 6, and 8. Treatment‐emergent adverse events in ≥5% of patients treated with LY2940094 included insomnia, vomiting, and anxiety. There were no serious adverse events or significant changes in laboratory assessments or vital signs with LY2940094.

Conclusions

Although not reducing the NDD, LY2940094, compared to placebo, did reduce heavy drinking days and increased abstinence days in patients with alcohol dependence.
Effect of polymorphisms in the CAMKMT gene on growth traits in Ujumqin sheep
Authors: Ma Xiaomeng , Guan Long , Xuan Junli , Wang Huihua , Yuan Zehu , Wu Mingming , Liu Ruizao , Zhu Caiye , Wei Caihong , Zhao Fuping , Du Lixin , Zhang Li
Published: July 2016

Our previous genome‐wide association study in sheep revealed that OAR3‐84073899.1 (SNP31) in intron 8 of the CAMKMT gene was significantly associated with post‐weaning gain at the genomic level. Herein, we performed a replication study to investigate single nucleotide polymorphisms (SNPs) within the CAMKMT gene exons, and 1000 bp of the 5′‐ and 3′‐intranslated regions (UTRs) and their associations with growth traits in Ujumqin sheep. Five SNPs were identified through DNA pool sequencing technology: SNP26 in the 5′‐UTR, SNP06 in exon 5, SNP07 in exon 8 and SNP27 and SNP28 in the 3′‐UTR. Six SNPs, including SNP31 in intron 8, were genotyped in the validation group of 343 Ujumqin sheep, and each SNP was classified into three genotypes. The chi‐square test suggested that all the variations were in Hardy–Weinberg equilibrium (P > 0.05) except for SNP28 and SNP31. Linkage disequilibrium analysis showed that SNP07 and SNP31 were strongly linked. An association analysis suggested that SNP06 was significantly associated with chest girth at 6 months of age (P < 0.05). SNP07 exhibited significant correlation with body weight and chest girth at 4 months of age and with body weight, chest girth and chest width at 6 months of age (P < 0.05). SNP27 was highly associated with body weight and chest girth at 4 months of age (P < 0.05), and SNP28 was extremely significantly associated with body weight and chest girth at 4 months of age and with chest girth at 6 months of age (P < 0.01). SNP31 was significantly associated with body weight and shin circumference at 4 months of age and with post‐weaning gain (P < 0.05). Association analysis of the combined effect of SNP07 and SNP31 showed significant correlation with body weight and chest girth at four of months of age (P < 0.05) and with body weight and chest girth at 6 months of age (P < 0.05). These results indicate that the SNPs could be used as meritorious and available genetic markers in growth traits breeding and that the CAMKMT gene may be one of the key candidate genes that affect Ujumqin economic traits.
Head and neck adaptive radiotherapy: Predicting the time to replan
Authors: Brown Elizabeth , Owen Rebecca , Harden Fiona , Mengersen Kerrie , Oestreich Kimberley , Houghton Whitney , Poulsen Michael , Harris Selina , Lin Charles , Porceddu Sandro
Published: July 2016

Aim

Head and neck (H&N) cancer patients can undergo anatomical change throughout radiotherapy treatment. Adaptive radiotherapy (ART) is effective in addressing the impact of this change on the planned dose distribution. The aim of this study was to identify pretreatment factors that influence the need for and timing of replanning for patients receiving chemoradiotherapy for node‐positive nasopharyngeal (NPC) and oropharyngeal carcinoma (OPC).

Methods

Of 110 patients enrolled in a prospective H&N ART study, 21 (19%) underwent a second planning scan (re‐CT) and were included in this review. Univariate and multivariate analysis was used to compare those patients who were replanned with those that were not. Factors influencing the timing of replanning were assessed including patient and tumor characteristics and structure volume details.

Results

Of the five replanned patients, three were diagnosed with NPC (P = 0.06) and had significantly larger initial nodal volumes (median volume 140.3 cc vs. 39.1 cc, P = 0.019). Overall the median time of re‐CT was significantly different between replanned and non‐replanned patients, with replanned patients having an earlier re‐CT: median fraction 18 versus fraction 23 (P = 0.01). Specifically, NPC patients who were replanned had a re‐CT performed earlier than OPC patients (median fraction 11 vs. 20).

Conclusion

For H&N patients with large nodes receiving definitive chemoradiotherapy, replanning may be considered at the commencement of week 3 for NPC patients and in week 4 of treatment for OPC patients. This information may facilitate a forward planning approach to H&N ART that enables allocation of departmental resources prior to treatment commencement.
Street Violence against Women in India: Mapping Prevention Strategies
Authors: Bhattacharyya Rituparna
Published: July 2016

Street violence against women (SVAW) in India is highly under researched. This article aims to understand the contextual factors responsible for the occurrence ofSVAWin five cities of North‐east India: Agartala, Kohima, Imphal, Shillong, and Guwahati. The aftermath of an horrific gang rape and the subsequent death of a 23‐year‐old woman in a moving bus in New Delhi in December 2012 served as a wake‐up call for the Government of India (GOI), augmenting the need to understand the issues ofSVAW. On December 23, 2012, theGOIconstituted the Justice Verma Committee (JVC) who prepared a 630‐page report, submitted to the Prime Minister of India, which identified “failure of governance” as the central cause ofSVAW. Based on some of the recommendations of theJVCreport, theGOIpassed the Criminal Law Amendment Bill, 2013. Drawing upon semi‐structured interviews from qualitative research in combination with a questionnaire survey, this research aims to understand the factors that allowSVAWto persist. Using recommendations of theJVCreport and the Justice Usha Mehra Commission, the Criminal Law Amendment Act,, as well as research findings, this article is an attempt to inform prevention strategies aimed at escalating the safety of women in public spaces of the study region.
Glucagon‐like peptide‐1 receptor signalling reduces microvascular thrombosis, nitro‐oxidative stress and platelet activation in endotoxaemic mice
Authors: Steven Sebastian , Jurk Kerstin , Kopp Maximilian , Kröller‐Schön Swenja , Mikhed Yuliya , Schwierczek Kathrin , Roohani Siyer , Kashani Fatemeh , Oelze Matthias , Klein Thomas , Tokalov Sergey , Danckwardt Sven , Strand Susanne , Wenzel Philip , Münzel Thomas , Daiber Andreas
Published: July 2016

Background and Purpose

Excessive inflammation in sepsis causes microvascular thrombosis and thrombocytopenia associated with organ dysfunction and high mortality. The present studies aimed to investigate whether inhibition of dipeptidyl peptidase‐4 (DPP‐4) and supplementation with glucagon‐like peptide‐1 (GLP‐1) receptor agonists improved endotoxaemia‐associated microvascular thrombosis via immunomodulatory effects.

Experimental Approach

Endotoxaemia was induced in C57BL/6J mice by a single injection of LPS (17.5 mg kg‐1 for survival and 10 mg kg‐1 for all other studies). For survival studies, treatment was started 6 h after LPS injection. For all other studies, drugs were injected 48 h before LPS treatment.

Key Results

Mice treated with LPS alone showed severe thrombocytopenia, microvascular thrombosis in the pulmonary circulation (fluorescence imaging), increased LDH activity, endothelial dysfunction and increased markers of inflammation in aorta and whole blood (leukocyte‐dependent oxidative burst, nitrosyl‐iron haemoglobin, a marker of nitrosative stress, and expression of inducible NOS). Treatment with the DPP‐4 inhibitor linagliptin or the GLP‐1 receptor agonist liraglutide, as well as genetic deletion of DPP‐4 (DPP4−/− mice) improved all these parameters. In GLP‐1 receptor‐deficient mice, both linagliptin and liraglutide lost their beneficial effects and improvement of prognosis. Incubation of platelets and cultured monocytes (containing GLP‐1 receptor protein) with GLP‐1 receptor agonists inhibited the monocytic oxidative burst and platelet activation, with a GLP‐1 receptor‐dependent elevation of cAMP levels and PKA activation.

Conclusions and Implications

GLP‐1 receptor activation in platelets by linagliptin and liraglutide strongly attenuated endotoxaemia‐induced microvascular thrombosis and mortality by a cAMP/PKA‐dependent mechanism, preventing systemic inflammation, vascular dysfunction and end organ damage.

Linked Articles

This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc
Innovations in Practice: Evaluating clinical outcome and service utilization in an AMBIT‐trained Tier 4 child and adolescent mental health service
Authors: Griffiths Helen , Noble Abbi , Duffy Fiona , Schwannauer Matthias
Published: July 2016

Background

To present clinical outcome data of the Adolescent Mentalization‐based Integrative Treatment (AMBIT)‐trained NHS Lothian Tier 4 child and adolescent mental health service in the context of service utilization and engagement.

Method

Data were obtained for a 2‐year period that included details of all face‐to‐face contacts between young people and clinicians along with routinely collected clinical outcomes data relating to anxiety, depression, symptoms of psychosis and quality of life.

Results

Improvements were observed in quality of life, symptoms and distress across the course of the intervention. Overall attendance rates were high (80%). Relative to those who were better engaged, the less well‐engaged group received the same number of appointments but spent longer in the service (χ2(1) = 5.26, p = .022), had more professionals involved in their care (χ2(1) = 4.91, p = .027) and showed a nonsignificant trend to more inpatient admissions. Later engagement was not associated with distress or symptoms at entry into the service with the exception of negative symptoms in the Early Psychosis Support Service cohort. Age and two quality of life factors were associated with later engagement (p < .05).

Conclusions

Our AMBIT‐trained Tier 4 CAMH service demonstrates change over the course of intervention consistent with the service model's theoretical expectations. Engagement with the service may be associated more with factors related to social circumstance and functioning than with key symptoms and distress. Less well‐engaged young people utilize increased service resource. AMBIT's mentalizing focus may improve service provision for young people who are poorly engaged with mental health services.
Memory‐Based Simple Heuristics as Attribute Substitution: Competitive Tests of Binary Choice Inference Models
Authors: Honda Hidehito , Matsuka Toshihiko , Ueda Kazuhiro
Published: July 2016

Some researchers on binary choice inference have argued that people make inferences based on simple heuristics, such as recognition, fluency, or familiarity. Others have argued that people make inferences based on available knowledge. To examine the boundary between heuristic and knowledge usage, we examine binary choice inference processes in terms of attribute substitution in heuristic use (Kahneman & Frederick, 2005). In this framework, it is predicted that people will rely on heuristic or knowledge‐based inference depending on the subjective difficulty of the inference task. We conducted competitive tests of binary choice inference models representing simple heuristics (fluency and familiarity heuristics) and knowledge‐based inference models. We found that a simple heuristic model (especially a familiarity heuristic model) explained inference patterns for subjectively difficult inference tasks, and that a knowledge‐based inference model explained subjectively easy inference tasks. These results were consistent with the predictions of the attribute substitution framework. Issues on usage of simple heuristics and psychological processes are discussed.
The non‐motor side of the honeymoon period of Parkinson's disease and its relationship with quality of life: a 4‐year longitudinal study
Authors: Erro R. , Picillo M. , Vitale C. , Amboni M. , Moccia M. , Santangelo G. , Pellecchia M. T. , Barone P.
Published: July 2016

Background and purpose

Very little is known about the progression of non‐motor symptoms (NMSs) in Parkinson's disease (PD) and there are no longitudinal studies exploring this topic from the earliest stage, when patients receive the diagnosis. We here report on the progression of NMSs over 4 years from diagnosis in a cohort of de‐novo, previously untreated, patients with PD.

Methods

Consecutive de‐novo (disease duration < 2 years), untreated patients with PD were enrolled in this observational study. Evaluations were then scheduled every 2 years and included assessment of motor and non‐motor features as well as of quality of life measures.

Results

Sixty‐one patients were prospectively followed‐up for 4 years from diagnosis. The majority of NMSs increased over time and significantly affected quality of life, whereas motor disability did not. There was no significant association between NMSs and dopaminergic therapy in terms of both drug class and total levodopa‐equivalent daily dosage. Excessive daytime sleepiness was the only NMS correlating with therapy with dopamine agonists. Female patients were more likely to have worse quality of life.

Conclusions

Non‐motor symptoms significantly increase over time, with a different progression rate for each one. NMSs significantly affect quality of life in PD and we here demonstrated that this was especially the case when patients were in their (motor) honeymoon period. Future trials should target non‐dopaminergic networks and consider NMSs in their outcomes.
Stomatal response to humidity and CO2 implicated in recent decline in US evaporation
Authors: Rigden Angela J. , Salvucci Guido D.
Published: July 2016

Evapotranspiration, defined as the total flux of water from the land surface to the atmosphere, is a major component of the hydrologic cycle and surface energy balance. Although evapotranspiration is expected to intensify with increasing temperatures, long‐term, regional trends in evapotranspiration remain uncertain due to spatially and temporally limited direct measurements. In this study, we utilize an emergent relation between the land surface and atmospheric boundary layer to infer daily evapotranspiration from historical meteorological data collected at 236 weather stations across the United States. Our results suggest a statistically significant (α = 0.05) decrease in evapotranspiration of approximately 6% from 1961 to 2014, with a significant (α = 0.05) sharp decline of 13% from 1998 to 2014. We attribute the decrease in evapotranspiration mostly to declines in surface conductance, but also to offsetting changes in longwave radiation, wind speed, and incoming solar radiation. Using an established stomatal conductance model, we explain the changes in inferred surface conductance as a response to increases in carbon dioxide and, more recently, to an abrupt decrease in atmospheric humidity.
An ecoregion assessment of projected tree species vulnerabilities in western North America through the 21st century
Authors: Mathys Amanda S. , Coops Nicholas C. , Waring Richard H.
Published: July 2016

Forest ecosystems across western North America will likely see shifts in both tree species dominance and composition over the rest of this century in response to climate change. Our objective in this study was to identify which ecological regions might expect the greatest changes to occur. We used the process‐based growth model 3‐PG, to provide estimates of tree species responses to changes in environmental conditions and to evaluate the extent that species are resilient to shifts in climate over the rest of this century. We assessed the vulnerability of 20 tree species in western North America using the Canadian global circulation model under three different emission scenarios. We provided detailed projections of species shifts by including soil maps that account for the spatial variation in soil water availability and soil fertility as well as by utilizing annual climate projections of monthly changes in air temperature, precipitation, solar radiation, vapor pressure deficit and frost at a spatial resolution of one km. Projected suitable areas for tree species were compared to their current ranges based on observations at >40 000 field survey plots. Tree species were classified as vulnerable if environmental conditions projected in the future appear outside that of their current distribution ≥70% of the time. We added a migration constraint that limits species dispersal to <200 m yr−1 to provide more realistic projections on species distributions. Based on these combinations of constraints, we predicted the greatest changes in the distribution of dominant tree species to occur within the Northwest Forested Mountains and the highest number of tree species stressed will likely be in the North American Deserts. Projected climatic changes appear especially unfavorable for species in the subalpine zone, where major shifts in composition may lead to the emergence of new forest types.
Towards Miscanthus combustion quality improvement: the role of flowering and senescence
Authors: Jensen Elaine , Robson Paul , Farrar Kerrie , Thomas Jones Sian , Clifton‐Brown John , Payne Roger , Donnison Iain
Published: July 2016

In commercially grown Miscanthus × giganteus, despite imposing a yield penalty, postwinter harvests improve quality criteria for thermal conversion and crop sustainability through remobilization of nutrients to the underground rhizome. We examined 16 Miscanthus genotypes with different flowering and senescence times for variation in N, P, K, moisture, ash, Cl and Si contents, hypothesizing that early flowering and senescence could result in improved biomass quality and/or enable an earlier harvest of biomass (in autumn at peak yield). Ideal crop characteristics at harvest are low N and P to reduce future fertilizer inputs, low K and Cl to reduce corrosion in boilers, low moisture to reduce spoilage and transportation costs, and low Si and ash to reduce slagging and consequent operational downtime. Stems and leaves were harvested during summer, autumn and then the following spring after overwinter ripening. In spring, stem contents of N were 30–60 mg kg−1, P were 203–1132 mg kg−1, K were 290–4098 mg kg−1, Cl were 10–23 mg kg−1 and moisture were 12–38%. Notably, late senescence resulted in increased N, P, K, Cl, moisture and ash contents, and should therefore be avoided for thermochemical conversion. Flowering and senescence led to overall improved combustion quality, where flowered genotypes tended towards lower P, K, Cl and moisture contents; marginally less, or similar, N, Si and ash contents; and a similar higher heating value, compared to those that had not flowered. Such genotypes could potentially be harvested in the autumn. However, one genotype that did not flower in our trial exhibited sufficiently low N and K content in autumn to meet the ENplus wood pellet standards for those traits, and some of the lowest P, moisture and ash contents in our trial, and is thus a target for future research and breeding.
Evaluation of three fully automated immunoassay systems for detection of IgA anti‐beta 2‐glycoprotein I antibodies
Authors: Pérez D. , Martínez‐Flores J. A. , Serrano M. , Lora D. , Paz‐Artal E. , Morales J. M. , Serrano A.
Published: July 2016

Introduction

In recent years, we have been witnessing increased clinical interest in the determination of IgA anti‐beta 2‐glycoprotein I (aB2GPI) antibodies as well as increased demand for this test. Some ELISA‐based diagnostic systems for IgA aB2GPI antibodies detection are suboptimal to detect it. The aim of our study was to determine whether the diagnostic yield of modern detection systems based on automatic platforms to measure IgA aB2GPI is equivalent to that of the well‐optimized ELISA‐based assays.

Methods

In total, 130 patients were analyzed for IgA aB2GPI by three fully automated immunoassays using an ELISA‐based assay as reference. The three systems were also analyzed for IgG aB2GPI with 58 patients.

Results

System 1 was able to detect IgA aB2GPI with good sensitivity and kappa index (99% and 0.72, respectively). The other two systems had also poor sensitivity (20% and 15%) and kappa index (0.10 and 0.07), respectively. On the other hand, kappa index for IgG aB2GPI was >0.89 in the three systems.

Conclusion

Some analytical methods to detect IgA aB2GPI are suboptimal as well as some ELISA‐based diagnostic systems. It is important that the scientific community work to standardize analytical methods to determine IgA aB2GPI antibodies.
Evaluation of a rolling rehabilitation programme for patients with non‐specific low back pain in primary care: an observational cohort study
Authors: Arden Kathleen , Fatoye Francis , Yeowell Gillian
Published: July 2016

Aim

The Back Rehabilitation Programme (BRP) is a group exercise programme for patients with non‐specific low back pain (NSLBP) that combines cognitive behavioural therapy principles and therapeutic exercise to empower patients to self‐manage their condition. Poor attendance and high attrition rates resulted in changes to the format of the programme from a standard sequential approach to a continual rolling approach. The aim of this study was to evaluate the effectiveness of this new approach on patient outcomes and its impact on attendance rates.

Method

A service evaluation, using a retrospective, observational cohort design, of all patients with NSLBP who attended the BRP during a 12‐month period was undertaken. Outcome measures used were as follows: Bournemouth Questionnaire (BQ); fitness tests: sit to stand test, step test and walk test (taken at baseline and post programme); and attendance (taken post programme).

Results

Of the patients, 56% had an improved BQ score ≥ 47%, indicating a clinically significant change. Inferential testing showed statistically significant improvements in the BQ and all three fitness tests post programme (P< 0.0001). In total, 62 patients attended the rolling BRP, and 41 patients (66%) completed. Thus, the percentage of patients completing the new programme had doubled compared with the original standard programme.

Conclusion

Patients with NSLBP who attended the continual rolling BRP show clinical and statistical improvements. The rolling format also appeared to enhance patient attendance. As such, the rolling BRP should be considered by practitioners as an effective management strategy when treating patients with NSLBP.
Working up rectal bleeding in adult primary care practices
Authors: Weingart Saul N. , Stoffel Elena M. , Chung Daniel C. , Sequist Thomas D. , Lederman Ruth I. , Pelletier Stephen R. , Shields Helen M.
Published: July 2016

Rationale, aims and objectives

Variation in the workup of rectal bleeding may result in guideline‐discordant care and delayed diagnosis of colorectal cancer. Accordingly, we undertook this study to characterize primary care clinicians' initial rectal bleeding evaluation.

Methods

We studied 438 patients at 10 adult primary care practices affiliated with three Boston, Massachusetts, academic medical centres and a multispecialty group practice, performing medical record reviews of subjects with visit codes for rectal bleeding, haemorrhoids or bloody stool. Nurse reviewers abstracted patients' sociodemographic characteristics, rectal bleeding‐related symptoms and components of the rectal bleeding workup. Bivariate and multivariable logistic regression models examined factors associated with guideline‐discordant workups.

Results

Clinicians documented a family history of colorectal cancer or polyps at the index visit in 27% of cases and failed to document an abdominal or rectal examination in 21% and 29%. Failure to order imaging or a diagnostic procedure occurred in 32% of cases and was the only component of the workup associated with guideline‐discordant care, which occurred in 27% of cases. Compared with patients at hospital‐based teaching sites, patients at urban clinics or community health centres had 2.9 (95% confidence interval 1.3–6.3) times the odds of having had an incomplete workup. Network affiliation was also associated with guideline concordance.

Conclusion

Workup of rectal bleeding was inconsistent, incomplete and discordant with guidelines in one‐quarter of cases. Research and improvements strategies are needed to understand and manage practice and provider variation.
Combined Application of Decision Tree and Fuzzy Logic Techniques for Intelligent Grading of Dried Figs
Authors: Banakar Ahmad , Zareiforoush Hemad , Baigvand Mehrdad , Montazeri Mehdi , Khodaei Jalal , Behroozi‐Khazaei Nasser
Published: July 2016

In this study, the quality assessment of dried figs was performed using a machine vision system and data mining techniques. Images from five different classes were obtained using a color CCD camera. After preprocessing and segmentation of the images, 52 features including 6 from size and shape, 4 from texture and 42 from color information were extracted. To find and select the best features for figs grading, the correlation‐based feature selection was utilized. It was found that five features (Mouth Area, Homogeneity, Variance value for R, Variance value for B and Kurtosis value for B/R + G+B) surpassed the other features in the attribute selection process. Afterwards, a combined decision tree‐fuzzy logic (DT‐FL) technique was developed to classify the dried figs based on the superior features. Comparison of validation stage of the utilized DT classifiers indicated that the DT with REP algorithm was the best classifier with an accuracy of 91.74%.

Practical Applications

Manual grading is a costly and time‐consuming method for dried figs grading. Besides, human inspectors' judgment in quality inspection is usually incompatible with each other. Another method for dried figs sorting is mechanical method. This type of product sorting is carried out based on shape properties. It is evident that use of such methods cannot guarantee the precise sorting of figs because the other important quality indices such as decay and defects cannot be controlled. Therefore, utilization of new technologies such as machine vision and artificial intelligence can be a suitable solution for automated inspection of figs. In this study, the quality grading of dried figs was performed using a machine vision system and data mining techniques. Using such a combined classifying model in the form of an automatic sorting system, it is effectively possible to sort different grades of dried figs with high levels of reliability, speed and accuracy.
Assessment of the relationship between red blood cell distribution width and preganecy hypertension disease
Authors: Sen‐yu Wang , Chao Xu
Published: July 2016

Aims

The aim of this study was to explore the correlation between red blood cell distribution width (RDW) and Preganecy Heypertion Disease (PHD) .

Methods

A retrospective study was carried out involving 149 pregnancies with PHD(67 gestational hypertension, 39 Mild preeclampsia, 24 severe preeclampsia and 19 eclampsia) and 70 health pregnant women as controls. The data of RDW were reviewed from antenatal and delivery records. Explored the correlation between RDW and PDH through Logistic Regression analysis, analyzed the clinical value of RDW to predict PHD by receiver operating characteristic (ROC) curve analysis.

Results

RDW in different gestational time(20th week, 24th week, 28th week) of different pregnant women groups had differences (P < 0.05), but pregnant women in the same group had no difference from 20th week to 28th week(P > 0.05). Logistic regression analysis showed that RDW was a risk factor for PHD (odds ratio 2.683; 95 % confidence interval 1.472–6.096), the optimal RDW‐CV threshold was 14.1 % to predict PHD by the ROC curve, the sensitivity and speciality were 72.5 % and 77.9 %.

Conclusions

RDW as a new chronic inflammation mediator, which was a high‐risk factor of PHD, also had certain clinical value to predict the occurrence of PHD.
Use of the Foley catheter versus a double balloon cervical ripening catheter in pre‐induction cervical ripening in postdate primigravidae
Authors: Sayed Ahmed Waleed Ali , Ibrahim Zakia Mahdy , Ashor Osama Elsayed , Mohamed Mariam Lotfi , Ahmed Magdy Refaat , Elshahat Amal Mohamed
Published: July 2016

Aim

To compare the efficacy of two mechanical devices for pre‐induction of labor cervical ripening: the Foley catheter and the Cook cervical ripening balloon.

Methods

This interventional study included 78 postdate primigravid women randomly allocated into two groups: the Foley or Cook balloon catheter. Removal of the catheters was planned approximately 12 h after insertion if spontaneous expulsion had not occurred. The main outcome measures included changes in Bishop score, insertion to delivery time, mode of delivery and occurrence of adverse effects.

Results

Spontaneous expulsion of the Foley catheter was encountered more frequently than the Cook (89.2% vs 78.4%; P = 0.03). However, the median Bishop score was significantly higher when using the Cook compared with the Foley catheter after balloon removal (6 vs 5; P = 0.03). The duration from balloon insertion to expulsion and from insertion to delivery was significantly shorter in the Foley group compared with the Cook balloon group (6:19 ± 2:1 vs 7:26 ± 2:25 h; P = 0.03 and 13:50 ± 4:00 vs 15:16 ± 4:30 h; P = 0.03, respectively). There were no significant differences in other outcomes, such as the amount of oxytocin units used, mode of delivery, pain encountered during or after insertion and overall patient satisfaction.

Conclusions

Use of the Cook cervical ripening catheter results in greater cervical ripening compared with the Foley catheter. However, the duration from balloon insertion to expulsion and then delivery were significantly shorter when using the Foley catheter; therefore, we recommend its use, particularly in low resource settings.
Supporting Caregivers of Rural Veterans Electronically (SCORE)
Authors: Hicken Bret L. , Daniel Candice , Luptak Marilyn , Grant Marren , Kilian Shirley , Rupper Randall W.
Published: July 2016

Background

The increasing prevalence of dementia, including among rural veterans, highlights the improved outcomes possible for caregivers who receive effective support. However, providing these complex interventions in rural areas presents challenges. Internet‐based and telephone‐based caregiver support can potentially expand access to effective support.

Methods

We designed a multisite intervention for caregivers of veterans with dementia. Caregivers were stratified into 2 cohorts based on their use or nonuse of the Internet. Each cohort was then randomized to either a technology or telephone‐delivered support group within each cohort. All groups had a care manager who monitored the 4‐ to 6‐month multicomponent program of assessments, educational content, and skills training. Caregiver outcome measures included burden, anticipatory grief, depression, family conflict, and a desire to institutionalize the care recipient.

Results

The majority of comparative effectiveness outcomes were not different between caregivers receiving technology interventions versus those receiving telephone‐delivered support. This was true for the 68% of caregivers using home Internet and the 32% nonusers, as well as the 53% rural versus 47% urban caregivers. For experienced Internet users, a meaningful difference in the Marwit Grief Inventory was noted for caregivers receiving Internet versus telephone support, particularly for the Isolation Subscale.

Conclusion

This study demonstrates the feasibility and acceptability of using a variety of modalities to deliver caregiver support to a group of largely older, rural, spousal caregivers of veterans with dementia. The potential for reducing isolation for caregivers capable of receiving this intervention through the Internet is a promising finding.
Becoming American, becoming obese? A systematic review of acculturation and weight among Latino youth
Authors: McLeod D. L. , Buscemi J. , Bohnert A. M.
Published: July 2016

Latino youth have the highest rate of overweight and obesity across ethnic and racial groups, placing these individuals at increased risk for a variety of negative immediate and long‐term health outcomes. Many studies have shown that acculturative factors play a role in this process for adults, while less is known about the impact of these factors for children and adolescents. This study systematically reviews the current literature on acculturative factors and obesity among Latino children. Three hundred and seventy‐nine studies were independently reviewed by two coders for eligibility. Twenty‐nine studies met eligibility criteria and were included in the final review. Results indicated that relations between acculturation and obesity among Latino children are equivocal. Across studies reviewed, the significance and directionality of this relation differed. Heterogeneity across studies reviewed, including age, specific population and measures used for assessing acculturation, likely contributed to the mixed results. To provide greater clarity on the role of acculturative factors on obesity, future studies should (i) utilize a longitudinal design; (ii) control for potential confounding factors such as socioeconomic status; and (iii) examine potential moderating and mediating influences.
Peptide vaccination therapy: Towards the next generation
Authors: Tsukahara Tomohide , Hirohashi Yoshihiko , Kanaseki Takayuki , Nakatsugawa Munehide , Kubo Terufumi , Sato Noriyuki , Torigoe Toshihiko
Published: July 2016

The aim of peptide vaccination therapy is to stimulate and activate peptide‐specific T cells to reject tumor cells. This strategy has been promoted by the discovery of tumor‐associated antigens recognized by T cells. Peptide vaccination therapy can induce immune responses in some cancer patients but the objective clinical response rates are still low. To improve of the efficacy of peptide vaccination therapy: (i) cancer stem cell antigens specifically expressed in carcinoma/sarcoma stem‐like cells but not in normal cells are needed; (ii) peptide vaccination therapy should be performed in the earlier stages; and (iii) memory T stem cells should be regulated to maintain long‐lasting immune responses to the peptide vaccination.
Balancing Inventory and Stockout Risk in Retail Supply Chains Using Fast‐Ship
Authors: Chen Hao‐Wei , Gupta Diwakar , Gurnani Haresh
Published: July 2016

In this study, we consider a two‐retailer, one‐supplier supply chain in which retailers satisfy excess demand by offering to directly ship out‐of‐stock items on an expedited basis at no extra cost to customers. This practice is referred to as the fast‐ship option. We consider two scenarios along with the fast‐ship option. In the first scenario, retailers transship when out of stock, whereas in the second scenario, they do not. If they do not transship, some customers may perform the search on their own. In each scenario, the wholesale prices are either exogenous, or chosen endogenously by the supplier. For both cases, we determine the supplier's and the retailers’ optimal decisions. The key research question we ask and answer is the following: which of the two scenarios is preferred by either player when all decisions are made optimally? We show that when fewer customers are willing to search on their own and wholesale prices are exogenous, both the supplier and the retailers prefer to transship. In addition, the decision maker in a centralized chain will have the exact same preference as that of players in a decentralized setting when the retailers’ and the supplier's preferences coincide and wholesale prices are exogenous. This preference concordance does not hold if wholesale prices are endogenous.
The Perils of Sharing Information in a Trade Association under a Strategic Wholesale Price
Authors: Shamir Noam , Shin Hyoduk
Published: July 2016

We study the incentives of a group of retailers, organized as a trade association and sourcing the product from a single manufacturer, to exchange private forecast information. We compare two widely used policies by the trade association in practice: exclusionary information exchange and non‐exclusionary information exchange. Under the exclusionary policy, only retailers who contribute their private information are exposed to the pool of shared information, whereas under the non‐exclusionary policy, all of the members of the trade association are exposed to the pool of shared information regardless of any contribution to this pool. We show that when the wholesale price is exogenous, the retailers have an incentive to share information under both policies. However, when the manufacturer is aware of the exchange of information among the retailers, she sets the wholesale price more aggressively, even without being exposed to the actual shared information. This wholesale pricing effect reduces the retailers' incentives to share information to such extent that under the non‐exclusionary policy, no information is shared in equilibrium. Under the exclusionary policy, it is possible to reach a full information‐sharing equilibrium, but this equilibrium can make the retailers worse‐off compared with the case in which no information is shared. Furthermore, it is also possible for the manufacturer to become worse‐off when the retailers share information. We also discuss the effect of market size on the incentives of the retailers to exchange information and how by committing to a certain wholesale price level early, the manufacturer can induce the retailers to exchange information.
Transparency by Conformity: A Field Experiment Evaluating Openness in Local Governments
Authors: ben‐Aaron James , Denny Matthew , Desmarais Bruce , Wallach Hanna
Published: July 2016

Sunshine laws establishing government transparency are ubiquitous in the United States; however, the intended degree of openness is often unclear or unrealized. Although researchers have identified characteristics of government organizations or officials that affect the fulfillment of public records requests, they have not considered the influence that government organizations have on one another. This picture of independently acting organizations does not accord with the literature on diffusion in public policy and administration. This article presents a field experiment testing whether a county government's fulfillment of a public records request is influenced by the knowledge that its peers have already complied. The authors propose that knowledge of peer compliance should induce competitive pressures to comply and resolve legal ambiguity in favor of compliance. Findings indicate peer conformity affects both in the time to initial response and in the rate of complete request fulfillment.
The World Health Organization Measles Programmatic Risk Assessment Tool—Romania, 2015
Authors: Kriss Jennifer L. , Stanescu Aurora , Pistol Adriana , Butu Cassandra , Goodson James L.
Published: July 2016

Despite global improvement in annual measles incidence and mortality since 2000, progress toward elimination goals has slowed. The World Health Organization (WHO) European Region (EUR) established a regional goal for measles and rubella elimination by 2015. Romania is one of 13 EUR countries in which measles remains endemic. To identify barriers to meeting programmatic targets and to aid in prioritizing efforts to strengthen measles elimination strategy implementation, the WHO and U.S. Centers for Disease Control and Prevention developed a measles programmatic risk assessment tool that uses routinely collected data to estimate district‐level risk scores. The WHO measles programmatic risk assessment tool was used to identify high‐risk areas in order to guide measles elimination program activities in Romania. Of the 42 districts in Romania, 27 (64%) were categorized as very high or high risk. Many of the very‐high‐risk districts were clustered in the western part of the country or were clustered around the capital Bucharest in the southeastern part of the country. The overall risk scores in the very‐high‐risk districts were driven primarily by poor surveillance quality and suboptimal population immunity. The measles risk assessment conducted in Romania was the first assessment to be completed in a European country. Annual assessments using the programmatic risk tool could provide valuable information for immunization program and surveillance staff at the national level and in each district to guide activities to enhance measles elimination efforts, such as strengthening routine immunization services, improving immunization campaign planning, and intensifying surveillance.