bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractAimThe 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.MethodA 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).ResultsOf 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.ConclusionPatients 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

AbstractRationale, aims and objectivesVariation 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.MethodsWe 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.ResultsClinicians 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.ConclusionWorkup 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

AbstractIn 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 ApplicationsManual 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

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

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

AbstractBackgroundThe 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.MethodsWe 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.ResultsThe 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.ConclusionThis 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

SummaryLatino 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

AbstractThe 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.
Transparency by Conformity: A Field Experiment Evaluating Openness in Local Governments
Authors: ben‐Aaron James , Denny Matthew , Desmarais Bruce , Wallach Hanna 
Published: July 2016

AbstractSunshine 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.
A novel enteric neuron–glia coculture system reveals the role of glia in neuronal development
Authors: Le Berre‐Scoul Catherine , Chevalier Julien , Oleynikova Elena , Cossais François , Talon Sophie , Neunlist Michel , Boudin Hélène 
Published: July 2016

Key points
Unlike astrocytes in the brain, the potential role of enteric glial cells (EGCs) in the formation of the enteric neuronal circuit is currently unknown.
To examine the role of EGCs in the formation of the neuronal network, we developed a novel neuron‐enriched culture model from embryonic rat intestine grown in indirect coculture with EGCs.
We found that EGCs shape axonal complexity and synapse density in enteric neurons, through purinergic‐ and glial cell line‐derived neurotrophic factor‐dependent pathways.
Using a novel and valuable culture model to study enteric neuron–glia interactions, our study identified EGCs as a key cellular actor regulating neuronal network maturation.
AbstractIn the nervous system, the formation of neuronal circuitry results from a complex and coordinated action of intrinsic and extrinsic factors. In the CNS, extrinsic mediators derived from astrocytes have been shown to play a key role in neuronal maturation, including dendritic shaping, axon guidance and synaptogenesis. In the enteric nervous system (ENS), the potential role of enteric glial cells (EGCs) in the maturation of developing enteric neuronal circuit is currently unknown. A major obstacle in addressing this question is the difficulty in obtaining a valuable experimental model in which enteric neurons could be isolated and maintained without EGCs. We adapted a cell culture method previously developed for CNS neurons to establish a neuron‐enriched primary culture from embryonic rat intestine which was cultured in indirect coculture with EGCs. We demonstrated that enteric neurons grown in such conditions showed several structural, phenotypic and functional hallmarks of proper development and maturation. However, when neurons were grown without EGCs, the complexity of the axonal arbour and the density of synapses were markedly reduced, suggesting that glial‐derived factors contribute strongly to the formation of the neuronal circuitry. We found that these effects played by EGCs were mediated in part through purinergic P2Y1 receptor‐ and glial cell line‐derived neurotrophic factor‐dependent pathways. Using a novel and valuable culture model to study enteric neuron–glia interactions, our study identified EGCs as a key cellular actor required for neuronal network maturation.
Metaboreflex activation delays heart rate recovery after aerobic exercise in never‐treated hypertensive men
Authors: Peçanha Tiago , de Brito Leandro Campos , Fecchio Rafael Yokoyama , de Sousa Patricia Nascimento , da Silva Junior Natan Daniel , de Abreu Andrea Pio , da Silva Giovanio Vieira , Mion‐Junior Décio , Forjaz Cláudia Lúcia de Moraes 
Published: July 2016

Key points
Recent evidence indicates that metaboreflex regulates heart rate recovery after exercise (HRR).
An increased metaboreflex activity during the post‐exercise period might help to explain the reduced HRR observed in hypertensive subjects.
Using lower limb circulatory occlusion, the present study showed that metaboreflex activation during the post‐exercise period delayed HRR in never‐treated hypertensive men compared to normotensives.
These findings may be relevant for understanding the physiological mechanisms associated with autonomic dysfunction in hypertensive men.
AbstractMuscle metaboreflex influences heart rate (HR) regulation after aerobic exercise. Therefore, increased metaboreflex sensitivity may help to explain the delayed HR recovery (HRR) reported in hypertension. The present study assessed and compared the effect of metaboreflex activation after exercise on HRR, cardiac baroreflex sensitivity (cBRS) and heart rate variability (HRV) in normotensive (NT) and hypertensive (HT) men. Twenty‐three never‐treated HT and 25 NT men randomly underwent two‐cycle ergometer exercise sessions (30 min, 70% ) followed by 5 min of inactive recovery performed with (occlusion) or without (control) leg circulatory occlusion (bilateral thigh cuffs inflated to a suprasystolic pressure). HRR was assessed via HR reduction after 30, 60 and 300 s of recovery (HRR30s, HRR60s and HRR300s), as well as by the analysis of short‐ and long‐term time constants of HRR. cBRS was assessed by sequence technique and HRV by the root mean square residual and the root mean square of successive differences between adjacent RR intervals on subsequent 30 s segments. Data were analysed using two‐ and three‐way ANOVA. HRR60s and cBRS were significant and similarly reduced in both groups in the occlusion compared to the control session (combined values: 20 ± 10 vs. 26 ± 9 beats min–1 and 2.1 ± 1.2 vs. 3.2 ± 2.4 ms mmHg−1, respectively, P < 0.05). HRR300s and HRV were also reduced in the occlusion session, although these reductions were significantly greater in HT compared to NT (−16 ± 11 vs. −8 ± 15 beats min–1 for HRR300s, P < 0.05). The results support the role of metaboreflex in HRR and suggest that increased metaboreflex sensitivity may partially explain the delayed HRR observed in HT men.
Job satisfaction and associated factors among healthcare staff: a cross-sectional study in Guangdong Province, China
Authors: Lu Yong , Hu Xiao-Min , Huang Xiao-Liang , Zhuang Xiao-Dong , Guo Pi , Feng Li-Fen , Hu Wei , Chen Long , Hao Yuan-Tao 
Published: July 2016

ObjectivesThis cross-sectional study aimed to explore job satisfaction among healthcare staff in Guangdong following the health system reforms in 2009, and to investigate the association between job satisfaction and work stress, work–family conflict and doctor–patient relationship.DesignCross-sectional survey.SettingThe Fifth National Health Service Survey was carried out in Guangdong, China.ParticipantsAll participants in this study were healthcare staff including physicians, nurses and public health staff from hospitals, health service centres and health clinics. A total of 6583 questionnaires were distributed and collected. After excluding the incomplete questionnaires, 5845 questionnaires were included for the analysis.Outcome measuresSociodemographic information and scores for evaluating job satisfaction, work stress, work–family conflict and doctor–patient relationship were obtained using the questionnaire developed by the National Health and Family Planning Commission of the People's Republic of China. To assess the significantly associated factors on job satisfaction of the healthcare staff in Guangdong, a binary logistic regression model was used.ResultsBased on the 5845 valid responses of the healthcare staff who worked in Guangdong, the mean score of overall perception of job satisfaction was 3.99 on a scale of 1–6. Among the sociodemographic variables, occupation, educational background, professional status, years of service, annual income and night shift frequency significantly influenced the level of job satisfaction. Work stress, work–family conflict and doctor–patient relationship also had significant effect on job satisfaction.ConclusionsThe overall job satisfaction exceeded slightly dissatisfied (score 3) and approached slightly satisfied (score 4). Measures to enhance job satisfaction include the reduction of workload, increase of welfare, maintaining moderate stress and balancing work–family conflict. Moreover, relevant laws should be issued to protect the healthcare staff from violent acts.