bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing surgeon stress when operating using heart rate variability and the State Trait Anxiety Inventory: will surgery be the death of us?
Authors: Jones K. I. , Amawi F. , Bhalla A. , Peacock O. , Williams J. P. , Lund J. N. 
Published: November 2014

AbstractAimPerformance in the operating room is affected by a combination of individual, patient and environmental factors amongst others. Stress has a potential negative impact on performance with the quality of surgical practice and patient safety being affected as a result. In order to appreciate the level of stress encountered during surgical procedures both objective and subjective methods can be used. This study reports the use of a combined objective (physiological) and subjective (psychological) method for evaluating stress experienced by the operating surgeon.MethodSix consultant colorectal surgeons were evaluated performing eighteen anterior resections. Heart rate was recorded using a wireless chest strap at eight pre‐determined operative steps. Heart Rate Variability indices were calculated offline using computerized software. Surgeon reported stress was collected using the State Trait Anxiety Inventory, a validated clinical stress scale.ResultsA significant increase in stress was demonstrated in all surgeons whilst operating as indicated by sympathetic tone (control: 4.02 ± 2.28 vs operative: 11.42 ± 4.63; P < 0.0001). Peaks in stress according to operative step were comparable across procedures and surgeons. There was a significant positive correlation with subjective reporting of stress across procedures (r = 0.766; P = 0.0005).ConclusionThis study demonstrates a significant increase in sympathetic tone in consultant surgeons measured using heart rate variability during elective colorectal resections. A significant correlation can be demonstrated between HRV measurements and perceived stress using the State Trait Anxiety Inventory. A combined approach to assessing operative stress is required to evaluate any effect on performance and outcomes.
A primary melanoma and its asynchronous metastasis highlight the role of BRAF, CDKN2A, and TERT
Authors: Hosler Gregory A. , Davoli Teresa , Mender Ilgen , Litzner Brandon , Choi Jaehyuk , Kapur Payal , Shay Jerry W. , Wang Richard C. 
Published: November 2014

AbstractBackgroundAlterations in pathways including BRAF, CDKN2A, and TERT contribute to the development of melanoma, but the sequence in which the genetic alterations occur and their prognostic significance remains unclear. To clarify the role of these pathways, we analyzed a primary melanoma and its metastasis.MethodsImmunohistochemistry for BRAF‐V600E, Sanger sequencing of BRAF and the TERT promoter, fluorescence in‐situ hybridization, and telomere analyses were performed on a primary melanoma and its asynchronous cerebellar metastasis. Using the log‐rank test and Cox‐proportional model, the cancer genome atlas (TCGA) cohort of melanomas was analyzed for the effect of BRAF mutation and CDKN2A loss on survival.ResultsThe primary melanoma expressed mutant BRAF‐V600E and possessed a homozygous deletion of CDKN2A. In addition to these early defects, the metastatic lesion also possessed evidence of aneuploidy and an activating mutation of the TERT promoter. In the TCGA melanoma cohort, there was a non‐significant trend toward poor prognosis in early stage cutaneous melanoma patients with concomitant BRAF mutation and CDKN2A loss.ConclusionBRAF mutation and CDKN2A loss occurred early and TERT promoter mutation later in a case of lethal metastatic melanoma. The effects of these pathways on survival warrant further investigation in early stage cutaneous melanoma patients.
Exporting National Champions: China's Outward Foreign Direct Investment Finance in Comparative Perspective
Authors: Gallagher Kevin P. , Irwin Amos 
Published: November 2014

AbstractWe examine the extent to which Chinese development banks have financed the globalization of China's “national champion” firms: specifically, through outward foreign direct investment (OFDI). We create a database of Chinese finance for OFDI and compare our results to the existing literature and available data on Japan, Korea and other Asian nations. We estimate the total value of China's OFDI finance from 2002 to 2012 at US$140bn. As a percentage of total OFDI, China's lending is roughly three times higher than Japan's, the previous global leader in OFDI finance. We identify two major reasons for China's high (31 percent) ratio of OFDI lending to total OFDI. First, China has a greater incentive to give OFDI loans than Japan or Korea ever did because its borrowers are state‐owned so it can more easily channel funds to targeted areas. Second, China has a greater capacity to give OFDI loans because it has significantly higher savings and foreign exchange reserves than Japan and Korea.
Financial Imbalance Index as a New Early Warning Indicator: Methods and Applications in the Chinese Economy
Authors: Ma Yong , Chen Yulu 
Published: November 2014

AbstractBased on the stylized facts of financial crises and systemic risk accumulation, this paper constructs a new financial imbalance index (FII) from the perspective of endogenous financial cycles and assesses its application in China's macro‐financial analysis. The results show that the FII is not only an effective index to detect financial imbalances in China's economic cycles, but is also more accurate than and plays more of a leading role than conventional indicators, such as the consumer price index, the financial conditions index and the purchasing managers indicator. Empirical analysis shows that the FII can be used as an effective indicator to measure systemic financial risk, and can provide policy‐makers and market participants with useful information to make appropriate decisions.
Bridging the Gap between Western and Chinese Evidence in the International Education Market
Authors: Wen Wen , Luo Yan , Hu Die 
Published: November 2014

AbstractUsing a sample of 1674 international students in China, the present study explores sociocultural adaptation and its determinants. The results indicate that sociocultural adaptation among international students in China is largely shaped by the nature of the interaction with host nationals. In particular, among international students, those who experienced higher levels of social interaction with host nationals and received more social support were better poised for sociocultural adaptation. Rather contrary to similar research in the Western context, the study finds that international students from East Asia actually experienced more sociocultural difficulties in China than their counterparts from Western countries. These findings suggest the possibility of China and other oriental countries with sound higher education systems playing more active roles in the global higher education market.
Changes in circulating adiponectin, leptin, glucose and C‐peptide in patients with ketosis‐prone diabetes
Authors: Gupta P. , Liu Y. , Lapointe M. , Yotsapon T. , Sarat S. , Cianflone K. 
Published: November 2014

AbstractAimsTo evaluate circulating adipokines in people with ketosis‐prone diabetes, a heterogeneous disorder characterized by unprovoked ketoacidosis in people with previously unrecognized diabetes.MethodsPatients presenting with ketoacidosis with no previous diabetes diagnosis were compared with patients with previously established Type 1 diabetes. Baseline assessments of autoimmune status (A+/A‐), and β‐cell function (B+/B‐), as well as leptin and adiponectin levels during a standardized mixed‐meal tolerance test of 120 min, were performed. In all, 20 patients with heterogeneous ketosis‐prone diabetes and 12 patients with Type 1 diabetes were evaluated at baseline, 12 and 24 months.ResultsAt baseline, during a mixed‐meal tolerance test, glucose and adiponectin concentrations were lower in patients with ketosis‐prone diabetes than in those with Type 1 diabetes (P = 0.0023 and P < 0.0001, respectively), whereas C‐peptide concentrations were higher, with no significant difference in leptin concentrations. Within 12 months, 11 patients with ketosis‐prone diabetes (all A‐/B+) were discontinued from insulin treatment (ketosis‐prone diabetes ‐ insulin group), while nine patients (four A‐B‐, four A+B‐ and one A‐B+) were maintained on insulin (ketosis‐prone diabetes + insulin group). Fasting C‐peptide levels increased significantly over 24 months in the ketosis‐prone diabetes ‐ insulin group (P = 0.01), while HbA1c levels decreased (P < 0.0001). Overall, the ketosis‐prone diabetes ‐ insulin group had a higher BMI (P = 0.018), yet a lower fasting glucose concentration (P = 0.003) compared with the ketosis‐prone diabetes + insulin group. Over 24 months, the mixed‐meal tolerance test area‐under‐the‐curve of C‐peptide increased in the ketosis‐prone diabetes ‐ insulin group, with no change in ketosis‐prone diabetes + insulin (P < 0.0001). At 24 months, in spite of the higher BMI in the ketosis‐prone diabetes ‐ insulin group, mixed‐meal tolerance test glucose and leptin concentrations were significantly lower (P < 0.0001 and P = 0.017, respectively), while adiponectin levels were higher (P = 0.023) compared with the ketosis‐prone diabetes + insulin group.ConclusionsIn spite of the higher BMI in the ketosis‐prone diabetes ‐ insulin group, lower leptin and higher adiponectin levels may contribute to improved β‐cell function and insulin sensitivity, as evidenced by lower glucose and higher C‐peptide levels. This allows insulin therapy to be withdrawn.
The experiences and impact of transition from child to adult healthcare services for young people with Type 1 diabetes: a systematic review
Authors: Sheehan A. M. , While A. E. , Coyne I. 
Published: November 2014

AbstractIntroductionDespite the transition between child and adult services for young people with Type 1 diabetes mellitus being a high‐risk period, little is known about the impact of healthcare transition upon young people.MethodsA systematic review was conducted using PubMed, PsycINFO, CINAHL and EMBASE. Papers published between January 2001 and June 2014 that examined the impact or experiences of healthcare transition in young people with Type 1 diabetes were included. Data were extracted by two independent reviewers and integrated by narrative synthesis.ResultsA total of 8990 citations were reviewed and 43 studies were included in the review, 24 of which explored the impact of transition and 24 examined experiences of transition. There were mixed results in terms of the change in glycaemic control and diabetes‐related hospitalizations, but all studies assessing attendance found worse attendance post‐transition. Data regarding experiences reported that young people and parents experienced greater difficulty in accessing and maintaining diabetes health care. Young people were required to develop independent self‐management and self‐advocacy skills to navigate the transition and adult health care, but some were inadequately prepared for this.ConclusionsAlthough the impact of healthcare transition on outcomes for young people with Type 1 diabetes is unclear due to the paucity of high‐quality studies, transition appears to be associated with decreased clinic attendance. There is some preliminary evidence of a positive impact of structured transition programmes. Experiences of healthcare transition illuminate the barriers to smooth transitions and the need for better integration and continuity of care.
Circulating markers of inflammation and endothelial function, and their relationship to diabetic retinopathy
Authors: Sasongko M. B. , Wong T. Y. , Jenkins A. J. , Nguyen T. T. , Shaw J. E. , Wang J. J. 
Published: November 2014

AbstractAimTo examine the relationships of serum markers of inflammation and endothelial function to diabetic retinopathy.MethodsWe recruited 224 patients with diabetes (85 with Type 1 and 139 with Type 2 diabetes) aged 18–70 years. Serum markers of inflammation (high‐sensitivity C‐reactive protein) and endothelial function (soluble intercell adhesion molecule‐1, vascular cell adhesion molecule‐1, E‐selectin, endothelin‐1 and total nitrite) were assessed using nephelometry, immunoassays and spectroscopy. Diabetic retinopathy was graded from two‐field fundus photographs according to the Airlie House Classification system and was categorized into no diabetic retinopathy, mild non‐proliferative diabetic retinopathy, moderate non‐proliferative diabetic retinopathy and vision‐threatening diabetic retinopathy, the latter comprising severe non‐proliferative diabetic retinopathy, proliferative diabetic retinopathy or clinically significant macular oedema. Multinomial logistic regression was used to assess the associations between serum markers and diabetic retinopathy.ResultsIn the study, 64% of patients (144/224) had diabetic retinopathy and 25% (57/244) had vision‐threatening diabetic retinopathy. After controlling for age, gender, diabetes duration, HbA1c, systolic blood pressure, total and HDL cholesterol, smoking, the use of insulin or oral hypoglycaemic agents, nephropathy and cardiovascular disease, a positive association was found between increasing high‐sensitivity C‐reactive protein levels and the presence of vision‐threatening diabetic retinopathy (odds ratio 1.26; 95% CI 1.05–1.51, per sd increase in high‐sensitivity C‐reactive protein). After stratifying by BMI ( ≥ 30 and < 30 kg/m2), this association was found to be more pronounced in people with a BMI ≥ 30 kg/m2 (odds ratio 2.9; P for interaction = 0.019). No associations were found between serum markers of endothelial activation and diabetic retinopathy.ConclusionsHigher C‐reactive protein levels, but not markers of endothelial function, may be related to more severe diabetic retinopathy. This finding suggests that inflammatory processes are involved in severe diabetic retinopathy, particularly in patients with a BMI ≥ 30 kg/m2.
Influence of temperature on germination ofQuercus ilexinPhytophthora cinnamomi,P. gonapodyides, P. quercinaandP. psychrophilainfested soils
Authors: Martín‐García J. , Solla A. , Corcobado T. , Siasou E. , Woodward S. 
Published: November 2014

SummaryThe influence of temperature on germination ofQuercus ilexacorns inPhytophthorainfested soils was quantified for the first time. Radicle damage and mortality ofQ. ilexseeds germinating at 17, 20, 23 and 26°C inPhytophthora cinnamomi,P. gonapodyides, P. quercinaandP. psychrophilainfested soils were assessed and related toin vitromycelium growth of the same isolates of the pathogens. The optimum growth temperatures of isolates ofP. cinnamomi,P. gonapodyides,P. quercinaandP. psychrophilawere 20–23, 23–26, 20–23 and 20°C, respectively. At 17 and 20°C, all fourPhytophthoraspecies caused 100% acorn mortality, whereas at 26°C, acorn mortality was 100, 10, 25 and 0% inP. cinnamomi,P. gonapodyides, P. quercinaandP. psychrophilainfested soils, respectively. At 23°C,P. cinnamomiandP. gonapodyidesreduced acorn radicle length more thanP. quercinaandP. psychrophila, whereas at 26°C, onlyP. cinnamomicaused further reduction in radicle length. The higher susceptibility of germinating acorns in comparison to seedlings reported in the literature indicates age‐related susceptibility ofQ. ilextoPhytophthora. The seedling/pathogen growth ratio was inversely related to the reduction in radicle length at different temperatures ( = 0.84, p < 0.0001), suggesting that rapid germination may allow seedlings to escape from infection. Increasing temperatures had different effects on damage to acorns depending on the pathogen present in the soil, indicating thatPhytophthoraspecies × temperature interactions determinedQ. ilexgermination. The effects of temperature on the impacts ofPhytophthoraspecies based on climate change predictions for Mediterranean countries are discussed.
Increased expression of TRPV1 in the trigeminal ganglion is involved in orofacial pain during experimental tooth movement in rats
Authors: Qiao Hu , Gao YuNan , Zhang Caidi , Zhou Hong 
Published: November 2014

To investigate whether transient receptor potential vanilloid type 1 (TRPV1) is involved in pain induced by experimental tooth movement, experiments were performed in male Sprague‐Dawley rats weighing 200–250 g. Directed face‐grooming behavior was used to evaluate nocifensive behavior in rats during experimental tooth movement. The distribution of TRPV1 in the trigeminal ganglion (TG) was evaluated by immunohistochemistry, and its expression was detected by western blotting at several time points following the application of various magnitudes of force during tooth movement. Immunohistochemical analysis revealed that TRPV1 was expressed in TG, and its expression was increased after experimental tooth movement. Western blot results also showed that experimental tooth movement led to a statistically significant increase in expression of TRPV1 protein in TG. Meanwhile, the time spent on directed face‐grooming peaked on day 1 and thereafter showed a gradual decrease. In addition, both the change in TRPV1 expression in the TG and directed face‐grooming behavior were modulated in a force‐dependent manner and in concert with initial orthodontic pain responses. Our results reveal that TRPV1 expression is modulated by experimental tooth movement and is involved in tooth‐movement pain.
Quantifying drylands' drought resistance and recovery: the importance of drought intensity, dominant life history and grazing regime
Authors: Ruppert Jan C. , Harmoney Keith , Henkin Zalmen , Snyman Hennie A. , Sternberg Marcelo , Willms Walter , Linstädter Anja 
Published: November 2014

AbstractProjected global change will increase the level of land‐use and environmental stressors such as drought and grazing, particularly in drylands. Still, combined effects of drought and grazing on plant production are poorly understood, thus hampering adequate projections and development of mitigation strategies. We used a large, cross‐continental database consisting of 174 long‐term datasets from >30 dryland regions to quantify ecosystem responses to drought and grazing with the ultimate goal to increase functional understanding in these responses. Two key aspects of ecosystem stability, resistance to and recovery after a drought, were evaluated based on standardized and normalized aboveground net primary production (ANPP) data. Drought intensity was quantified using the standardized precipitation index. We tested effects of drought intensity, grazing regime (grazed, ungrazed), biome (grassland, shrubland, savanna) or dominant life history (annual, perennial) of the herbaceous layer to assess the relative importance of these factors for ecosystem stability, and to identify predictable relationships between drought intensity and ecosystem resistance and recovery. We found that both components of ecosystem stability were better explained by dominant herbaceous life history than by biome. Increasing drought intensity (quasi‐) linearly reduced ecosystem resistance. Even though annual and perennial systems showed the same response rate to increasing drought intensity, they differed in their general magnitude of resistance, with annual systems being ca. 27% less resistant. In contrast, systems with an herbaceous layer dominated by annuals had substantially higher postdrought recovery, particularly when grazed. Combined effects of drought and grazing were not merely additive but modulated by dominant life history of the herbaceous layer. To the best of our knowledge, our study established the first predictive, cross‐continental model between drought intensity and drought‐related relative losses in ANPP, and suggests that systems with an herbaceous layer dominated by annuals are more prone to ecosystem degradation under future global change regimes.
Association between level of brachial‐ankle pulse wave velocity and onset of activities of daily living impairment in community‐dwelling older individuals
Authors: Kuroiwa Yumi , Miyano Ichiro , Nishinaga Masanori , Takata Jun , Shimizu Yuji , Okumiya Kiyohito , Matsubayashi Kozo , Ozawa Toshio , Kitaoka Hiroaki , Doi Yoshinori , Yasuda Nobufumi 
Published: November 2014

AimThe purpose of the present study was to clarify the longitudinal association between brachial‐ankle pulse wave velocity (baPWV) and the onset of impairment in activities of daily living (ADL) among community‐dwelling individuals.MethodsDeaths and the onsets of ADL impairment during 3 years were followed for 450 individuals without ADL impairment at entry who were aged 65 years or older (men : women 181:269; mean age 77 years). They were dichotomized on the median baPWV value at entry.ResultsWithin 3 years, 28 died and 60 had an onset of ADL impairment. The high baPWV group had a higher incidence of deaths (high baPWV group vs low baPWV group, 9.3% vs 3.1%) and ADL impairment (high baPWV group vs low baPWV group, 20.7% vs 9.3%). After adjustment for age, sex and systolic blood pressure, as compared with the low baPWV group, the high baPWV group had increased risk for mortality (adjusted odds ratio 3.22; 95% confidence interval 1.26–8.22) and the onset of ADL impairment (adjusted odds ratio 1.94; 95% confidence interval 1.03–3.63). When the onset of ADL impairment was grouped according to medical conditions that preceded/accompanied the onset of ADL impairment, elevated baPWV was associated with increased risk for the onset of ADL impairment after/accompanying fall/fracture.ConclusionsThe assessment of arterial stiffness by baPWV contributes to identifying functionally independent community‐dwelling older individuals at risk for ADL impairment, in particular ADL impairment associated with fall/fracture, as well as for mortality. Geriatr Gerontol Int 2015; 15: 840–847.
Incidence of skin tears in the extremities among elderly patients at a long‐term medical facility in Japan: A prospective cohort study
Authors: Sanada Hiromi , Nakagami Gojiro , Koyano Yuiko , Iizaka Shinji , Sugama Junko 
Published: November 2014

AimThere is a lack of data from cohort studies for the incidence of skin tears among an elderly population in an Asian country. We estimated the cumulative incidence of skin tear, and identify its risk factor.MethodsThe present prospective cohort study was carried out at a long‐term medical facility in Japan. Participants included patients (n = 368) aged 65 years or older receiving hospital care. The 3‐month cumulative incidence of skin tears was estimated by identifying them using direct inspection of the extremities. In order to find the risk factors for the skin tear incidence, odds ratios and their 95% confidence intervals of skin tear development in association with the factors were estimated using logistic regression analyses.ResultsA total of 14 patients developed skin tears, and their cumulative incidence was 3.8%. No patients with skin tears developed multiple wounds on their extremities. Half of the skin tears occurred on the outside of the right forearm, and just three skin tears were found in the lower legs. Multiple logistic analyses showed that pre‐existing skin tears (odds ratio 15.42, 95% confidence interval 3.53–67.43, P < 0.001) and a 6‐point decrease in the total score of the Braden Scale (odds ratio 0.10, 95% confidence interval 0.01–0.83, P < 0.033) were significantly associated with skin tear development.ConclusionsPatients with pre‐existing skin tears and a low score of the Braden Scale have a higher risk of skin tear development during 3 months. These factors could be used to identify patients requiring prevention care for skin tears. Geriatr Gerontol Int 2015; 15: 1058–1063.