bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gum chewing combined with oral intake of a semi‐liquid diet in the postoperative care of patients after gynaecologic laparoscopic surgery
Authors: Pan Yuping , Chen Li , Zhong Xiaorong , Feng Suwen 
Published: November 2016

Aim and objectivesTo evaluate the effects of gum chewing combined with a semi‐liquid diet on patients after gynaecologic laparoscopic surgery.BackgroundPrevious studies suggested that chewing gum before traditional postoperative care promotes the postoperative recovery of bowel motility and function after open and laparoscopic surgery. However, gum chewing combined with a semi‐liquid diet has not been reported in postoperative care of patients following gynaecologic laparoscopic surgery.DesignA prospective randomised study.MethodsTotal 234 patients were randomly assigned after elective gynaecologic laparoscopic surgery to a gum chewing and semi‐liquid diet group, a semi‐liquid only diet group or a liquid diet group. The gum chewing and semi‐liquid diet group chewed sugar‐free gum with an oral intake of a semi‐liquid diet six hours postoperatively. The semi‐liquid only diet and liquid diet groups received a semi‐liquid diet or a liquid diet, respectively. The time to first bowel sounds, time to first regular postoperative bowel sounds, time to first passage of flatus, time to first defecation, serum gastrin and incidences of hunger, nausea, vomiting and abdominal distension were recorded. Hunger and gastrointestinal sensations were assessed using a four‐point scale. Serum gastrin was assayed pre‐ and postoperatively using a gastrin radioimmunoassay kit.ResultsThe gum chewing and semi‐liquid diet group had first bowel sounds, first regular bowel sounds, first passage of flatus and first defecation earlier than the semi‐liquid only and liquid groups. Increased serum gastrin was observed in the gum chewing and semi‐liquid diet group. Incidences of nausea, vomiting and abdominal distention were not significantly different between these groups.ConclusionChewing gum combined with an oral intake of a semi‐liquid diet is safe and accelerates the postoperative recovery of bowel function. It might be recommended as a better postoperative care regimen for patients after gynaecologic laparoscopic surgery.Relevance to clinical practiceThis study developed a new postoperative diet regimen to improve the postoperative care of patients undergoing laparoscopic gynecologic surgery.
Changes in self‐efficacy, collective efficacy and patient outcome following interprofessional simulation training on postpartum haemorrhage
Authors: Egenberg Signe , Øian Pål , Eggebø Torbjørn Moe , Arsenovic Mirjana Grujic , Bru Lars Edvin 
Published: November 2016

Aims and objectivesTo examine whether interprofessional simulation training on management of postpartum haemorrhage enhances self‐efficacy and collective efficacy and reduces the blood transfusion rate after birth.BackgroundPostpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide, although it is preventable in most cases. Interprofessional simulation training might help improve the competence of health professionals dealing with postpartum haemorrhage, and more information is needed to determine its potential.DesignMultimethod, quasi‐experimental, pre–post intervention design.MethodsInterprofessional simulation training on postpartum haemorrhage was implemented for midwives, obstetricians and auxiliary nurses in a university hospital. Training included realistic scenarios and debriefing, and a measurement scale for perceived postpartum haemorrhage‐specific self‐efficacy, and collective efficacy was developed and implemented. Red blood cell transfusion was used as the dependent variable for improved patient outcome pre–post intervention.ResultsSelf‐efficacy and collective efficacy levels were significantly increased after training. The overall red blood cell transfusion rate did not change, but there was a significant reduction in the use of ≥5 units of blood products related to severe bleeding after birth.ConclusionThe study contributes to new knowledge on how simulation training through mastery and vicarious experiences, verbal persuasion and psychophysiological state might enhance postpartum haemorrhage‐specific self‐efficacy and collective efficacy levels and thereby predict team performance. The significant reduction in severe postpartum haemorrhage after training, indicated by reduction in ≥5 units of blood transfusions, corresponds well with the improvement in collective efficacy, and might reflect the emphasis on collective efforts to counteract severe cases of postpartum haemorrhage.Relevance to clinical practiceInterprofessional simulation training in teams may contribute to enhanced prevention and management of postpartum haemorrhage, shown by a significant increase in perceived efficacy levels combined with an indicated reduction of severe postpartum haemorrhage after training.
The mental healthcare needs of undocumented migrants: an exploratory analysis of psychological distress and living conditions among undocumented migrants in Norway
Authors: Myhrvold Trine , Småstuen Milada Cvancarova 
Published: November 2016

Aims and objectivesTo explore undocumented migrants’ mental healthcare needs and more specifically to explore how undocumented adults living in Norway perceive psychological distress, to gather insight on their living conditions and to explore associated living condition risk factors.BackgroundUndocumented migrants are defined both nationally and internationally as an especially vulnerable group with regard to their health status, living conditions and barriers to access to health care and social welfare.DesignAn exploratory mixed‐methods design using primarily quantitative data with a qualitative component was implemented.MethodsSocio‐demographic data on 90 undocumented migrants were obtained, and self‐report questionnaire on psychological distress was completed, supplemented by qualitative data obtained through interviews.ResultsThe level of psychological distress was extremely high in our group of undocumented migrants. Leaving their home country because of war or persecution, economic strain, homelessness, hunger and having experienced abuse was significantly positively associated with psychological distress. Contrary to what was predicted, having family and work was not significantly associated with the reduction of psychological distress. Additional qualitative data indicate that having family entails great responsibilities and work implies exploitation to such an extent that any potential positive influence this has on mental health, such as a sense of belonging and a reasonable standard of living, is outweighed.ConclusionsThe high level of psychological distress indicates a need of additional diagnostic evaluation and mental health care. The living conditions were so marginal that their day‐to‐day existence was threatened.Relevance to clinical practiceWe recognised a need for an interdisciplinary and dynamic approach to mental health care. Undocumented migrants are in need of a minimum of psychological and material support assuring basic needs such as shelter and appropriate food and access to health care and social welfare.
Implant Treatment in the Predoctoral Clinic: A Retrospective Database Study of 1091 Patients
Authors: Prasad Soni , Hambrook Christopher , Reigle Eric , Sherman Katherine , Bansal Naveen , Hefti Arthur 
Published: November 2016

AbstractPurposeThis retrospective study was conducted at the Marquette University School of Dentistry to (1) characterize the implant patient population in a predoctoral clinic, (2) describe the implants inserted, and (3) provide information on implant failures.Materials and MethodsThe study cohort included 1091 patients who received 1918 dental implants between 2004 and 2012, and had their implants restored by a crown or a fixed dental prosthesis. Data were collected from patient records, entered in a database, and summarized in tables and figures. Contingency tables were prepared and analyzed by a chi‐squared test. The cumulative survival probability of implants was described using a Kaplan‐Meier survival curve. Univariate and multivariate frailty Cox regression models for clustered observations were computed to identify factors associated with implant failure.ResultsMean patient age (±1 SD) at implantation was 59.7 ± 15.3 years; 53.9% of patients were females, 73.5% were Caucasians. Noble Biocare was the most frequently used implant brand (65.0%). Most implants had a regular‐size diameter (59.3%). More implants were inserted in posterior (79.0%) than in anterior jaw regions. Mandibular posterior was the most frequently restored site (43%); 87.8% of implants were restored using single implant crowns. The overall implant‐based cumulative survival rate was 96.4%. The patient‐based implant survival rate was 94.6%. Implant failure risk was greater among patients than within patients (p < 0.05). Age (>65 years; hazard ratio [HR] = 3.2, p = 0.02), implant staging (two‐stage; HR = 4.0, p < 0.001), and implant diameter (wide; HR = 0.4, p = 0.04) were statistically associated with implant failure.ConclusionsTreatment with dental implants in a supervised predoctoral clinic environment resulted in survival rates similar to published results obtained in private practice or research clinics. Older age and implant staging increased failure risk, while the selection of a wide implant diameter was associated with a lower failure risk.
Increased novel single nucleotide polymorphisms in weedy rice populations associated with the change of farming styles: Implications in adaptive mutation and evolution
Authors: Song Dong‐Yuan , Wang Zhe , Song Zhuo‐Jun , Zhou Cheng‐Chuan , Xu Peng‐Hao , Yang Jie , Yang Ji , Lu Bao‐Rong 
Published: November 2016

AbstractSubstantial genetic variation is found in weedy rice (Oryza sativa f. spontanea Roshev.) populations from different rice‐planting regions with the change of farming styles. To determine the association of such genetic variation with rice farming changes is critical for understanding the adaptive evolution of weedy rice. We studied weedy‐rice specific novel single nucleotide polymorphisms (SNPs) by genome‐wide comparison between DNA sequences of weedy and cultivated rice, in addition to polymerase chain reaction fingerprinting at 22 selected novel SNP loci in weedy rice populations. A great number of novel SNPs were identified across the weedy rice genome. High frequencies of the novel SNPs were determined at the 22 selected loci, although with considerable variation among weedy rice populations in different rice‐planting regions. The highest frequency (∼57%) of novel SNPs was identified in weedy rice populations from Jiangsu that experienced the most dramatic changes in rice farming styles, including the shift from transplanting to direct seeding, and from indica to japonica varieties. The lowest frequency (∼29%) was detected in weedy rice populations from Northeast China, where rice farming has undergone relatively less change. The association between frequencies of novel SNPs in weedy rice populations and the extent of changes in rice farming styles suggests the critical role of adaptive mutation and accumulation of the mutation influenced by human activities in the rapid evolution of weedy rice.
Exploring the pteridophyte flora of the Eastern Afromontane biodiversity hotspot
Authors: Liu Hong‐Mei , Zhang Shou‐Zhou , Wan Tao , Kamau Peris W. , Wang Zheng‐Wei , Grall Aurelie , Hemp Andreas , Schneider Harald 
Published: November 2016

AbstractIn this review, we explore our current understanding of the fern and lycophyte diversity occurring in the Eastern Afromontane Biodiversity Hotspot (EABH). The review explores the species diversity of this region in the context of the Afromadagascan pteridophyte diversity based on an exhaustive species list assembled in the synopsis of Afromadagascan pteridophytes published by Roux in 2009. The list was updated by incorporating recent progress in our understanding of the taxonomy and phylogeny of these plants. Evidence for a distinct pteridophyte flora occurring in the East African mountain region was discovered using ordination and clustering analyses. This EABH floras shares links to other Afromadagascan pteridophyte floras such as the one in the tropical lowland forests of central and western Africa. These floras share the dominance of species that preferably occur in humid climates whereas other African pteridophyte floras tend to contain a higher proportion of xeric adapted ferns. The phylogenetic composition of the EABH pteridophyte flora was assessed by comparing global versus local proportion of orders, families, and genera. This analysis revealed distinct patterns that are partly caused by the radiation of Blotiella and Triplophyllum besides selective colonization of species pre‐adapted to Afromadagascan climates. In situ speciation in the East African tropical mountains may have contributed to the global diversity of widespread genera such as Asplenium and Pteris. In summary, this is the first comprehensive attempt to assess the pteridophyte diversity of the East African mountains providing the framework for future studies on their conservation, ecology, and evolution.
Assessment of the Fecal Microbiota in Beef Calves
Authors: Weese J.S. , Jelinski M. 
Published: November 2016

BackgroundThere is increasing interest in the fecal microbiota, but study in calves has been limited.Hypothesis/ObjectivesTo evaluate the fecal microbiota of beef calves and cows on different farms, and to preliminarily explore the impact of antimicrobial exposure.AnimalsA total of 172 animals, 156 (91%) calves and 16 (9.3%) cows, were enrolled from 5 cow‐calf farms.MethodsThe fecal bacterial microbiota was assessed through sequencing of 16S rRNA gene (V4 region) amplicons.ResultsThere were significant differences in the relative abundances of numerous phyla between calves on different farms. Farms could be separated into 2 groups: 1 (farms B and C) dominated by Firmicutes and 1 (farms A, D, and E) with predominance of Proteobacteria and Actinobacteria. Richness (median 2,974 versus 1,477, P = .008), diversity (51.4 versus 29.1, P = .0029), and evenness (0.73 versus 0.68, P = .006) were higher in cows. Over‐represented operational taxonomic units (OTUs) in cows tended to be from the classes Bacilli and Bacteroidia, whereas Clostridia and Actinobacteria were most prominently over‐represented in calves. There were differences in community membership (P = .028) and structure (P = .029) in calves that had a history of antimicrobial exposure compared those that did not. Eight (89%) over‐represented OTUs in the untreated group were Firmicutes (7 from the order Clostridiales), compared to only 3 (38%) (2 Clostridiales) in the untreated group.Conclusions and Clinical ImportanceInterfarm variation should be investigated to determine the causes and potential implications for health and production. Antimicrobial exposure may have an impact on the fecal microbiota at individual and farm levels.
The clinic is my woodshed: a new paradigm for learning and refining communication skills
Authors: Haidet Paul , Picchioni Michael 
Published: November 2016

AbstractJazz cats use the term ‘woodshedding’ to denote a period of intense practice during which they aim to take their playing up a few notches. Developing expertise, whether we are speaking musically or talking about communicating with patients, requires a lifelong commitment to such practice. For physicians, the woodshed is not a practice room or an isolated space. No: clinical environments are the woodsheds; they are the only places in which one can hone communication skills. The idea of ‘shedding’ in the setting of routine practice challenges prevailing notions about communication skills training and has implications for how such skills should be learned, nurtured and assessed. In this essay, we use stories of woodshedding from jazz music history to discuss concepts related to deliberative practice, formal education and learning communities.
Where do physicians start and end?
Authors: H Ellaway Rachel , Topps David , Topps Maureen 
Published: November 2016

AbstractMedical education is primarily about training physicians and maintaining their capabilities over time. Given that physicians are the primary focus of the field, there is a need for a clear idea of what physicians are or could be. This paper seeks to explore this issue by posing the simple question: ?Where do physicians start and end?’ In doing so, the authors explore a series of different conceptual frames, including those of a physician’s physical dimensions, their cellular boundaries, personal intentions and beliefs, professional identity, regulation, entrustability, professional performance, extended cognition, and disability. This existential look at the concept of a physician demonstrates the plurality of medical education scholarship and the implications of the many intersecting points of view in the field.
The stringent response plays a key role in Bacillus subtilis survival of fatty acid starvation
Authors: Pulschen André A. , Sastre Diego E. , Machinandiarena Federico , Crotta Asis Agostina , Albanesi Daniela , de Mendoza Diego , Gueiros‐Filho Frederico J. 
Published: November 2016

SummaryThe stringent response is a universal adaptive mechanism to protect bacteria from nutritional and environmental stresses. The role of the stringent response during lipid starvation has been studied only in Gram‐negative bacteria. Here, we report that the stringent response also plays a crucial role in the adaptation of the model Gram‐positive Bacillus subtilis to fatty acid starvation. B. subtilis lacking all three (p)ppGpp‐synthetases (RelBs, RelP and RelQ) or bearing a RelBs variant that no longer synthesizes (p)ppGpp suffer extreme loss of viability on lipid starvation. Loss of viability is paralleled by perturbation of membrane integrity and function, with collapse of membrane potential as the likely cause of death. Although no increment of (p)ppGpp could be detected in lipid starved B. subtilis, we observed a substantial increase in the GTP/ATP ratio of strains incapable of synthesizing (p)ppGpp. Artificially lowering GTP with decoyinine rescued viability of such strains, confirming observations that low intracellular GTP is important for survival of nutritional stresses. Altogether, our results show that activation of the stringent response by lipid starvation is a broadly conserved response of bacteria and that a key role of (p)ppGpp is to couple biosynthetic processes that become detrimental if uncoordinated.
Multiple transporters are involved in natamycin efflux in Streptomyces chattanoogensis L10
Authors: Wang Tan‐Jun , Shan Yi‐Ming , Li Han , Dou Wei‐Wang , Jiang Xin‐Hang , Mao Xu‐Ming , Liu Shui‐Ping , Guan Wen‐Jun , Li Yong‐Quan 
Published: November 2016

SummaryAntibiotic‐producing microorganisms have evolved several self‐resistance mechanisms to prevent auto‐toxicity. Overexpression of specific transporters to improve the efflux of toxic antibiotics has been found one of the most important and intrinsic resistance strategies used by many Streptomyces strains. In this work, two ATP‐binding cassette (ABC) transporter‐encoding genes located in the natamycin biosynthetic gene cluster, scnA and scnB, were identified as the primary exporter genes for natamycin efflux in Streptomyces chattanoogensis L10. Two other transporters located outside the cluster, a major facilitator superfamily transporter Mfs1 and an ABC transporter NepI/II were found to play a complementary role in natamycin efflux. ScnA/ScnB and Mfs1 also participate in exporting the immediate precursor of natamycin, 4,5‐de‐epoxynatamycin, which is more toxic to S. chattanoogensis L10 than natamycin. As the major complementary exporter for natamycin efflux, Mfs1 is up‐regulated in response to intracellular accumulation of natamycin and 4,5‐de‐epoxynatamycin, suggesting a key role in the stress response for self‐resistance. This article discusses a novel antibiotic‐related efflux and response system in Streptomyces, as well as a self‐resistance mechanism in antibiotic‐producing strains.
Exopolysaccharides promote Myxococcus xanthus social motility by inhibiting cellular reversals
Authors: Zhou Tianyi , Nan Beiyan 
Published: November 2016

SummaryThe biofilm‐forming bacterium Myxococcus xanthus moves on surfaces as structured swarms utilizing type IV pili‐dependent social (S) motility. In contrast to isolated cells that reverse their moving direction frequently, individual cells within swarms rarely reverse. The regulatory mechanisms that inhibit cellular reversal and promote the formation of swarms are not well understood. Here we show that exopolysaccharides (EPS), the major extracellular components of M. xanthus swarms, inhibit cellular reversal in a concentration‐dependent manner. Thus, individual wild‐type cells reverse less frequently in swarms due to high local EPS concentrations. In contrast, cells defective in EPS production hyper‐reverse their moving direction and show severe defects in S‐motility. Surprisingly, S‐motility and wild‐type reversal frequency are restored in double mutants that are defective in both EPS production and the Frz chemosensory system, indicating that EPS regulates cellular reversal in parallel to the Frz pathway. Here we clarify that besides functioning as the structural scaffold in biofilms, EPS is a self‐produced signal that coordinates the group motion of the social bacterium M. xanthus.
The effects of menstrual phase on orthodontic pain following initial archwire engagement
Authors: Long H , Gao M , Zhu Y , Liu H , Zhou Y , Liao L , Lai W 
Published: November 2016

ObjectivesTo explore the effects of menstrual cycle on orthodontic pain following initial archwire engagement.MethodsFemale participants with regular menstrual cycles were recruited and assigned into follicular group or luteal group. Demographical and baseline variables were collected: age, education, menstrual duration, anxiety, oral health impact profile‐14 (OHIP‐14), and index of complexity outcome and need (ICON). Following initial archwire engagement, orthodontic pain was determined through visual analogue scale (VAS) on 1st day, 2nd day, and 3rd day. Demographical and baseline variables were compared between the two groups. Two‐way repeated‐measures anova was used to examine the effects of menstrual phase, time, and their interactions on orthodontic pain. Multivariate linear regression was employed to examine the independent effect of each variable on orthodontic pain.ResultsFinally, 37 and 39 were assigned to the follicular and luteal groups, respectively, with balanced demographical and baseline data. Orthodontic pain was significantly affected by menstrual phase and time (both P < 0.001), but there was no interaction (P > 0.05). Moreover, orthodontic pain was independently predicted by menstrual phase, OHIP, education level, and anxiety (all P < 0.05).ConclusionWe suggest that practitioners arrange female patients to receive initial archwire engagement during their follicular phases to relieve orthodontic pain.