bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Safety of Performing Laparoscopic Gastrectomy for Gastric Cancer by Trainees after Sufficient Experience in Assisting
Authors: Nunobe Souya , Hiki Naoki , Tanimura Shinya , Nohara Kyoko , Sano Takeshi , Yamaguchi Toshiharu 
Published: October 2012

AbstractBackgroundLaparoscopic gastrectomy (LAG) is increasingly performed to treat gastric cancer. However, the procedure remains complicated, and an optimal system for educating clinicians about LAG has not been established.MethodsOur training system centers on understanding the anatomical appearance under laparoscopy and the standardized steps of LAG, including the roles of the scopist and the assistant. The trainees participated in LAG procedures as a scopist and an assistant in 30–35 cases, before conducting their first LAG case. The data of 788 consecutive patients with early gastric cancer who underwent LAG were also reviewed.ResultsDuring the study period, nine trainees performed a total of 215 LAG (27.3 %) with trainers, while 563 LAG were conducted by the two trainers (71.4 %). The surgical outcomes including operative time, blood loss, and retrieval of lymph nodes were almost equivalent for both the trainers and the trainees. The total experience among the trainees as scopist and as first assistant was 45.0 and 41.4 cases, respectively, and the trainees had experienced 33.8 cases as a scopist and 35.3 cases as an assistant before they performed their first LAG as an operator. After commencing experience as an operator, the average operation time of the trainees reached that of the trainers within six cases and their learning curve reached a plateau.ConclusionsOur training system based on attaining sufficient experience as an assistant and scopist in the simulation of a LAG procedure was effective for ensuring clinical safety for LAG performed by a trainee with experienced surgeons.
Comparison of the secondary metabolites in two scales of cephalosporin C (CPC) fermentation and two different post-treatment processes
Authors: Cao Ying-Xiu , Lu Hua , Qiao Bin , Chen Yao , Yuan Ying-Jin 
Published: October 2012

Abstract
Cephalosporin C (CPC) is the precursor of a class of antibiotics that were more effective than traditional penicillins. CPC production is performed mainly through fermentation by Acremonium chrysogenum, whose secondary metabolism was sensitive to the environmental changes. In the present work, secondary metabolites were measured by ion-pair reversed-phase liquid chromatography tandemed with hybrid quadrupole time-of-flight mass spectrometry, and the disparity of them from two scales of CPC fermentations (pilot and industrial) and also two different post-treatment processes (oxalic acid and formaldehyde added and control) were investigated. When fermentation size was enlarged from pilot scale (50 l) to industrial scale (156,000 l), the remarkable disparities of concentrations and changing trends of the secondary metabolites in A. chrysogenum were observed, which indicated that the productivity of CPC biosynthesis was higher in the large scale of fermentation. Three environmental factors were measured, and the potential reasons that might cause the differences were analyzed. In the post-treatment process after industrial fermentation, the changes of these secondary metabolites in the tank where oxalic acid and formaldehyde were added were much less than the control tank where none was added. This indicated that the quality of the final product was more stable after the oxalic acid and formaldehyde were added in the post-treatment process. These findings provided new insight into industrial CPC production.
How Has the Economic Downturn Affected Communities and Implementation of Science‐Based Prevention in the Randomized Trial of Communities That Care?
Authors: Kuklinski Margaret R. , Hawkins J. David , Plotnick Robert D. , Abbott Robert D. , Reid Carolina K. 
Published: October 2012

AbstractThis study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science‐based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science‐based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science‐based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science‐based prevention were also relatively low in both periods.
Autoethnographic Expression and Cultural Translation in Tian Yage's Short Stories
Authors: Liou Liang-ya 
Published: October 2012

AbstractThis article explores how three short stories set in 1980s Taiwan by the Taiwanese aboriginal writer Tian Yage (Tuobasi Tamapima) can be read as autoethnographic fiction as well as modern fiction, portraying contemporary Taiwanese aboriginal society caught between indigenous folkways and colonial modernity, and how the narrators of the stories tackle cultural translation. I begin with a discussion of Sun Ta-chuan's caution in 1991 as the Taiwan Aboriginal Movement was evolving into the Taiwan Aboriginal Cultural Revivalist Movement. After analysing anthropology's relationship with aborigines and imperialism, I apply Mary Louise Pratt's concept of autoethnography to the aboriginal activists' ethnographic studies and personal narratives. I argue that, prior to the Taiwan Aboriginal Cultural Revivalist Movement, Tian sought to construct an aboriginal cultural identity vis-à-vis the metropolis and to envision a cultural revival within the indigenous community, while he also explored the dilemmas and difficulties that arose from these. In the last section, I apply Homi K. Bhabha's theory of the untranslatable in cultural translation to further examine the language, the narrative voice and the form of both autoethnographic fiction and modern fiction in Tian's stories. I argue that writing Chinese-language modern fiction is a tacit recognition on Tian's part of the legacy of colonial modernity, but the purpose is to manoeuvre for a rethinking of the Taiwanese modern subject. As the narrative voice of his stories is one of an aboriginal speaking as a subject rather than an object, speaking with the backdrop of the aboriginal village as the locus of indigenous traditions vis-à-vis the dominant society, Tian is implicitly demanding aboriginal rights and a reconsideration of the Taiwanese modern subject as well as a shift in the paradigm of historiography on Taiwan.
Politics and Business Group Formation in China: The Party in Control?
Authors: Brødsgaard Kjeld Erik 
Published: October 2012

AbstractAs a result of economic reform and administrative restructuring in China, a number of powerful state-owned business groups (“national champions”) have emerged within sectors of strategic importance. They are headed by a new corporate elite which enjoys unprecedentedly high levels of remuneration and managerial independence from government agencies and which derives legitimacy from symbolizing China's economic rise. However, through thenomenklaturasystem, the Party controls the appointment of the CEOs and presidents of the most important of these enterprises and manages a cadre transfer system which makes it possible to transfer/rotate business leaders to take up positions in state and Party agencies. In order to conceptualize the coexistence of the contradicting forces for further enterprise autonomy and continued central control that characterizes the evolving relationship between business groups and the Party-state, this paper proposes the notion of integrated fragmentation.
Shifting Fiscal Control to Limit Cadre Power in China's Townships and Villages
Authors: Oi Jean C. , Babiarz Kim Singer , Zhang Linxiu , Luo Renfu , Rozelle Scott 
Published: October 2012

AbstractIn contrast to its decentralized political economy model of the 1980s, China took a surprising turn towards recentralization in the mid-1990s. Its fiscal centralization, starting with the 1994 tax reforms, is well known, but political recentralization also has been under way to control cadres directly at township and village levels. Little-noticed measures designed to tighten administrative and fiscal regulation began to be implemented during approximately the same period in the mid-1990s. Over time these measures have succeeded in hollowing out the power of village and township cadres. The increasing reach of the central state is the direct result of explicit state policies that have taken power over economic resources that were once under the control of village and township cadres. This article examines the broad shift towards recentralization by examining the fiscal and political consequences of these policies at the village and township levels. Evidence for this shift comes from new survey data on village-level investments, administrative regulation and fiscal oversight, as well as township-level fiscal revenues, expenditures, transfers (between counties and townships) and public-goods investments.
Health Care Reform and Patients' Trust in Physicians in Urban Beijing
Authors: Tam Waikeung 
Published: October 2012

AbstractThe Chinese health care system has experienced profound changes in recent decades, including the retrenchment of government financial support. These changes and their subsequent adverse impacts have prompted the Chinese media and some academics to suggest that patients have a relatively low level of trust in physicians in China today. As the first step in exploring the state of patient trust in physicians in public hospitals in urban China, and its determinants, we conducted a survey of 434 patients from 26 public hospitals in urban Beijing between December 2009 and January 2010. Conducted by the Horizon Research Group, our survey asked the patient respondents how they viewed the physicians they were currently seeing, focusing on the following dimensions of trust: physician agency, technical competence, interpersonal competence, and information provided by physicians. Our survey results show a relatively high level of patients' trust in their physicians. Moreover, our in-patient respondents reported a higher level of trust than out-patient respondents with regard to physician agency, interpersonal competence and information provision. Regression analyses also find that patients' self-reported health status, the level of public hospitals from which they received treatment, the duration of their illness, and the frequency of exposure to negative media reports of physicians and hospitals are important determinants of patients' trust in physicians.
Counting Cadres: A Comparative View of the Size of China's Public Employment
Authors: Ang Yuen Yuen 
Published: October 2012

AbstractIs China's public bureaucracy overstaffed? To answer this basic question objectively, one needs to define public employment in the contemporary Chinese context; survey data sources available to measure public employment; and finally, compare China's public employment size with that of other countries. Using a variety of new sources, this article performs all three tasks. It also goes further to clarify the variance betweenbianzhi(formally established posts) and actual staffing size, as well as other permutations of thebianzhisystem, especiallychaobian(exceeding thebianzhi). A key finding is that China's net public employment per capita is not as large as often perceived; quite the contrary, it is one-third below the international mean. However, it is clear that the actual number of employees in the party-state bureaucracy has grown – and is still growing – steadily since reforms, despite repeated downsizing campaigns. Such expansion has been heavily concentrated at the sub-provincial levels and amongshiye danwei(extra-bureaucracies).
The End of the CCP's Resilient Authoritarianism? A Tripartite Assessment of Shifting Power in China
Authors: Li Cheng 
Published: October 2012

AbstractThis essay challenges the widely held view of the CCP's purported “resilient authoritarianism,” which asserts that China's one-party political system is able to enhance the state capacity to govern effectively through institutional adaptations and policy adjustments. An analysis of the recent and still unfolding Bo Xilai crisis reveals the flaws in China's political system, including nepotism and patron–client ties in the selection of leaders, rampant corruption, the growing oligarchic power of state-owned enterprises, elites' contempt for the law and the potential failure to broker deals between competing factions in the Party leadership. The essay argues that the CCP's “authoritarian resilience” is a stagnant system, both conceptually and empirically, because it resists much-needed democratic changes in the country. The problems of the resilient authoritarianism thesis is traceable to the monolithic conceptualizing of China – the failure to appreciate seemingly paradoxical transformative trends in the country, which this essay characterizes as three paralleled developments, namely, 1) weak leaders, strong factions; 2) weak government, strong interest groups; and 3) weak Party, strong country. One should not confuse China's national resilience (in terms of the emerging middle class, new interest group politics, and dynamic society) with the CCP's capacity and legitimacy to rule the country. The essay concludes that if the CCP intends to regain the public's confidence and avoid a bottom-up revolution, it must abandon the notion of “authoritarian resilience” and embrace a systematic democratic transition with bold steps towards intra-Party elections, judicial independence and a gradual opening of the mainstream media.
Effect of temperature, relative humidity and rainfall on rotavirus infections in Kolkata, India
Authors: SUMI A. , RAJENDRAN K. , RAMAMURTHY T. , KRISHNAN T. , NAIR G. B. , HARIGANE K. , KOBAYASHI N. 
Published: October 2012

SUMMARYRotavirus is a common viral cause of severe diarrhoea. For the underlying cause of rotavirus seasonality, the meteorological factor has been suspected, whereas quantitative correlation between seasonality and meteorological factor has not been fully investigated. In this study, we investigated the correlation of temporal patterns of the isolation rate of rotavirus with meteorological condition (temperature, relative humidity, rainfall) in Kolkata, India. We used time-series analysis combined with spectral analysis and least squares method. A 1-year cycle explained underlying variations of rotavirus and meteorological data. The 1-year cycle for rotavirus data was correlated with an opposite phase to that for meteorological data. Relatively high temperature could be associated with a low value of isolation rate of rotavirus in the monsoon season. Quantifying a correlation of rotavirus infections with meteorological conditions might prove useful in predicting rotavirus epidemics and health services could plan accordingly.
Microbial population responses in three stratified Antarctic meltwater ponds during the autumn freeze
Authors: Safi Karl , Hawes Ian , Sorrell Brian 
Published: October 2012

AbstractThe planktonic microbial communities of three meltwater ponds, located on the McMurdo Ice Shelf, were investigated from the end of January 2008 to early April, during which almost the entire pond volumes froze. The ponds were comprised of an upper mixed layer overlying a salt-stabilized density gradient in which planktonic communities were primarily embedded. Plankton comprised all components of the “microbial loop”, though carnivorous protists were rare. As the ponds froze and light became increasingly limited, it was expected conditions would induce physiological changes altering the functional role of autotrophic and heterotrophic microplankton within the ponds. The results showed that microbial groups responded to the onset of winter by declining in abundance, though an exception was the appearance of filamentous cyanobacteria in the water column in March. As freezing progressed, autotrophs declined more rapidly than heterotrophs and grazing rates and abundances of mixotrophic and heterotrophic organisms increased. Grazing pressure on bacteria and picophytoplankton also increased, in part explaining their decline over time. The results indicate that stressors imposed during freezing select for increasing heterotrophy within the remaining microbial communities, although all components of the food web eventually decline as the final freeze approaches.
Pilot study of nurse-led rheumatic heart disease echocardiography screening in Fiji – a novel approach in a resource-poor setting
Authors: Colquhoun Samantha M. , Carapetis Jonathan R. , Kado Joseph H. , Reeves Benjamin M. , Remenyi Boglarka , May William , Wilson Nigel J. , Steer Andrew C. 
Published: October 2012

AbstractWe designed a pilot study of a training module for nurses to perform rheumatic heart disease echocardiography screening in a resource-poor setting. The aim was to determine whether nurses given brief, focused, basic training in echocardiography could follow an algorithm to potentially identify cases of rheumatic heart disease requiring clinical referral, by undertaking basic two-dimensional and colour Doppler scans. Training consisted of a week-long workshop, followed by 2 weeks of supervised field experience. The nurses’ skills were tested on a blinded cohort of 50 children, and the results were compared for sensitivity and specificity against echocardiography undertaken by an expert, using standardised echocardiography definitions for definite and probable rheumatic heart disease. Analysis of the two nurses’ results revealed that when a mitral regurgitant jet length of 1.5 cm was used as the trigger for rheumatic heart disease identification, they had a sensitivity of 100% and 83%, respectively, and a specificity of 67.4% and 79%, respectively. This pilot supports the principle that nurses, given brief focused training and supervised field experience, can follow an algorithm to undertake rheumatic heart disease echocardiography in a developing country setting to facilitate clinical referral with reasonable accuracy. These results warrant further research, with a view to developing a module to guide rheumatic heart disease echocardiographic screening by nurses within the existing public health infrastructure in high-prevalence, resource-poor regions.
Neuropsychological Test Performance and Cognitive Reserve in Healthy Aging and the Alzheimer's Disease Spectrum: A Theoretically Driven Factor Analysis
Authors: Mitchell Meghan B. , Shaughnessy Lynn W. , Shirk Steven D. , Yang Frances M. , Atri Alireza 
Published: October 2012

AbstractAccurate measurement of cognitive function is critical for understanding the disease course of Alzheimer's disease (AD). Detecting cognitive change over time can be confounded by level of premorbid intellectual function or cognitive reserve and lead to under- or over-diagnosis of cognitive impairment and AD. Statistical models of cognitive performance that include cognitive reserve can improve sensitivity to change and clinical efficacy. We used confirmatory factor analysis to test a four-factor model composed of memory/language, processing speed/executive function, attention, and cognitive reserve factors in a group of cognitively healthy older adults and a group of participants along the spectrum of amnestic mild cognitive impairment to AD (aMCI-AD). The model showed excellent fit for the control group (χ2= 100;df= 78; CFI = .962; RMSEA = .049) and adequate fit for the aMCI-AD group (χ2= 1750;df= 78; CFI = .932; RMSEA = .085). Although strict invariance criteria were not met, invariance testing to determine if factor structures are similar across groups yielded acceptable absolute model fits and provide evidence in support of configural, metric, and scalar invariance. These results provide further support for the construct validity of cognitive reserve in healthy and memory impaired older adults. (JINS, 2012,18, 1–10)
Impact of counselling on exclusive breast-feeding practices in a poor urban setting in Kenya: a randomized controlled trial
Authors: Ochola Sophie A , Labadarios Demetre , Nduati Ruth W 
Published: October 2012

AbstractObjectiveTo determine the impact of facility-based semi-intensive and home-based intensive counselling in improving exclusive breast-feeding (EBF) in a low-resource urban setting in Kenya.DesignA cluster randomized controlled trial in which nine villages were assigned on a 1:1:1 ratio, by computer, to two intervention groups and a control group. The home-based intensive counselling group (HBICG) received seven counselling sessions at home by trained peers, one prenatally and six postnatally. The facility-based semi-intensive counselling group (FBSICG) received only one counselling session prenatally. The control group (CG) received no counselling from the research team. Information on infant feeding practices was collected monthly for 6 months after delivery. The data-gathering team was blinded to the intervention allocation. The outcome was EBF prevalence at 6 months.SettingKibera slum, Nairobi.SubjectsA total of 360 HIV-negative women, 34–36 weeks pregnant, were selected from an antenatal clinic in Kibera; 120 per study group.ResultsOf the 360 women enrolled, 265 completed the study and were included in the analysis (CG n 89; FBSICG n 87; HBICG n 89). Analysis was by intention to treat. The prevalence of EBF at 6 months was 23·6 % in HBICG, 9·2 % in FBSICG and 5·6 % in CG. HBICG mothers had four times increased likelihood to practise EBF compared with those in the CG (adjusted relative risk = 4·01; 95 % CI 2·30, 7·01; P = 0·001). There was no significant difference between EBF rates in FBSICG and CG.ConclusionsEBF can be promoted in low socio-economic conditions using home-based intensive counselling. One session of facility-based counselling is not sufficient to sustain EBF.