bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy
Authors: Fournier Q. , Serra J.‐C. , Handel I. , Lawrence J.
Published: December 2017

Background

Prechemotherapy absolute neutrophil count (ANC) cutoffs are arbitrary and vary across institutions and clinicians. Similarly, subjective guidelines are utilized for the administration of prophylactic antibiotics in neutropenic dogs.

Objectives

To evaluate the impact of various ANC cutoffs on chemotherapy administration in dogs with lymphoma treated with CHOP chemotherapy and to determine whether an association between prechemotherapy ANC and subsequent toxicity exists. The secondary objective was to evaluate a currently used ANC cutoff to indicate prescription of prophylactic antibiotics.

Animals

Dogs diagnosed with lymphoma treated with CHOP chemotherapy (n = 64).

Methods

Six hundred and fifteen ANCs were stratified into 6 classes. The 3 ANC cutoffs 1.5 × 103/μL, 2.0 × 103/μL, and 2.5 × 103/μL were assessed. The presence of an association between prechemotherapy ANC class and toxicity was determined. Afebrile neutropenic dogs with ANC <1.5 × 103/μL but above the criteria for prophylactic antibiotics were evaluated.

Results

Chemotherapy was not administered in 7% of visits with an ANC cutoff of 1.5 × 103/μL; chemotherapy would not have been administered in 10% and 16% of visits with an ANC cutoff of 2.0 × 103/μL or 2.5 × 103/μL, respectively. There was no association among the 3 lower prechemotherapy ANC classes and toxicity. All dogs with ANC 0.75–1.5 × 103/μL recovered spontaneously without medical intervention.

Conclusion and Clinical Importance

The number of dose delays was minimized with a prechemotherapy ANC cutoff of 1.5 × 103/μL, and the prechemotherapy ANC class 1.5–1.99 × 103/μL was not associated with an increased toxicity. Further investigation of an ANC cutoff near 0.75 × 103/μL in which to prescribe prophylactic antibiotics is indicated.
Retrospective Evaluation of the Effect of Heart Rate on Survival in Dogs with Atrial Fibrillation
Authors: Pedro B. , Dukes‐McEwan J. , Oyama M.A. , Kraus M.S. , Gelzer A.R.
Published: December 2017

Background

Atrial fibrillation (AF) usually is associated with a rapid ventricular rate. The optimal heart rate (HR) during AF is unknown.

Hypothesis/Objectives

Heart rate affects survival in dogs with chronic AF.

Animals

Forty‐six dogs with AF and 24‐hour ambulatory recordings were evaluated.

Methods

Retrospective study. Holter‐derived HR variables were analyzed as follows: mean HR (meanHR, 24‐hour average), minimum HR (minHR, 1‐minute average), maximum HR (maxHR, 1‐minute average). Survival times were recorded from the time of presumed adequate rate control. The primary endpoint was all‐cause mortality. Cox proportional hazards analysis identified variables independently associated with survival; Kaplan‐Meier survival analysis estimated the median survival time of dogs with meanHR <125 bpm versus ≥125 bpm.

Results

All 46 dogs had structural heart disease; 31 of 46 had congestive heart failure (CHF), 44 of 46 received antiarrhythmic drugs. Of 15 dogs with cardiac death, 14 had CHF. Median time to all‐cause death was 524 days (Interquartile range (IQR), 76–1,037 days). MeanHR was 125 bpm (range, 62–203 bpm), minHR was 82 bpm (range, 37–163 bpm), maxHR was 217 bpm (range, 126–307 bpm). These were significantly correlated with all‐cause and cardiac‐related mortality. For every 10 bpm increase in meanHR, the risk of all‐cause mortality increased by 35% (hazard ratio, 1.35; 95% CI, 1.17–1.55; P < 0.001). Median survival time of dogs with meanHR<125 bpm (n = 23) was significantly longer (1,037 days; range, 524‐open) than meanHR ≥125 bpm (n = 23; 105 days; range, 67–267 days; P = 0.0012). Mean HR was independently associated with all‐cause and cardiovascular mortality (P < 0.003).

Conclusions and Clinical Importance

Holter‐derived meanHR affects survival in dogs with AF. Dogs with meanHR <125 bpm lived longer than those with meanHR ≥ 125 bpm.
Gallbladder Mucocele: Variables Associated with Outcome and the Utility of Ultrasonography to Identify Gallbladder Rupture in 219 Dogs (2007–2016)
Authors: Jaffey J.A. , Graham A. , VanEerde E. , Hostnik E. , Alvarez W. , Arango J. , Jacobs C. , DeClue A.E.
Published: December 2017

Background

Gallbladder mucocele (GBM) is an increasingly recognized extrahepatic biliary disease in dogs.

Objectives

To investigate cases of GBM and identify variables associated with survival and the sensitivity and specificity of ultrasonography to identify gallbladder rupture.

Animals

Two hundred and nineteen client‐owned dogs with GBM.

Methods

Multicenter, retrospective study of dogs with GBM, presented from January 2007 to November 2016 to 6 academic veterinary hospitals in the United States. Interrogation of hospital databases identified all cases with the inclusion criteria of a gross and histopathologic diagnosis of GBM after cholecystectomy and intraoperative bacteriologic cultures of at least 1 of the following: gallbladder wall, gallbladder contents, or abdominal effusion.

Results

Two hundred and nineteen dogs fulfilled the inclusion criteria. Dogs with GBM and gallbladder rupture with bile peritonitis at the time of surgery were 2.7 times more likely to die than dogs without gallbladder rupture and bile peritonitis (P = 0.001; 95% confidence interval [CI], 1.50–4.68; n = 41). No significant associations were identified between survival and positive bacteriologic cultures, antibiotic administration, or time (days) from ultrasonographic identification of GBM to the time of surgery. The sensitivity, specificity, positive, and negative likelihood ratios for ultrasonographic identification of gallbladder rupture were 56.1% (95% CI, 39.9–71.2), 91.7% (95% CI, 85.3–95.6), 6.74, and 0.44, respectively.

Conclusion and Clinical Importance

Dogs in our study with GBM and intraoperative evidence of gallbladder rupture and bile peritonitis had a significantly higher risk of death. Additionally, abdominal ultrasonography had low sensitivity for identification of gallbladder rupture.
Unsettled Times for American Families
Authors: Morrill Calvin
Published: December 2017

In Caring for Our Own: Why There Is No Political Demand for New American Social Welfare Rights (2014), Sandra Levitsky reveals how an enduring ideology of family responsibility and a decoupling of social support groups from organized advocacy constrains mass legal mobilization to address long-term elderly care in the United States. This essay argues that American families have entered an unsettled period linked to social inequality, young adult living arrangements, immigration, and institutional shifts related to LGBTQ families, workplace-family conflict, and the criminalization of elder abuse. These changes to the family may create the conditions for questioning the ideology of family responsibility and new possibilities for collective action with potentially contradictory meanings and lines of action, including politicization and legal mobilization.
Multicriteria Fuzzy Analysis for a GIS‐Based Management of Earthquake Scenarios
Authors: D'Urso Maria Grazia , Masi Daniele , Zuccaro Giulio , De Gregorio Daniela
Published: December 2017

Objective of this article is the formulation and the implementation of a decision‐making model for the optimal management of emergencies. It is based on the accurate definition of possible scenarios resulting from prediction and prevention strategies and explicitly takes into account the subjectivity of the judgments of preference. To this end, a multicriteria decision model, based on fuzzy logic, has been implemented in a user‐friendly geographical information system (GIS) platform so as to allow for the automation of choice processes between several alternatives for the spatial location of the investigated scenarios. In particular, we have analyzed the potentialities of the proposed approach in terms of seismic risk reduction, simplifying the decision process leading to the actions to be taken from directors and managers of coordination services. Due to the large number of variables involved in the decision process, it has been proposed a particularly flexible and streamlined method in which the damage scenarios, based on the vulnerability of the territory, have represented the input data to derive a vector of weights to be assigned to different decision alternatives. As an application of the proposed approach, the seismic damage scenario of a region of 400 km2, hit by the 2009 earthquake in L'Aquila (Italy), has been analyzed.
The role of the CroR response regulator in resistance of Enterococcus faecalis to D‐cycloserine is defined using an inducible receiver domain
Authors: Muller Cécile , Massier Sébastien , Le Breton Yoann , Rincé Alain
Published: December 2017

Enterococcus faecalis is an opportunistic multidrug‐resistant human pathogen causing severe nosocomial infections. Previous investigations revealed that the CroRS two‐component regulatory pathway likely displays a pleiotropic role in E. faecalis, involved in virulence, macrophage survival, oxidative stress response as well as antibiotic resistance. Therefore, CroRS represents an attractive potential new target for antibiotherapy. In this report, we further explored CroRS cellular functions by characterizing the CroR regulon: the ‘domain swapping’ method was applied and a CroR chimera protein was generated by fusing the receiver domain from NisR to the output domain from CroR. After demonstrating that the chimera CroR complements a croR gene deletion in E. faecalis (stress response, virulence), we conducted a global gene expression analysis using RNA‐Seq and identified 50 potential CroR targets involved in multiple cellular functions such as cell envelope homeostasis, substrate transport, cell metabolism, gene expression regulation, stress response, virulence and antibiotic resistance. For validation, CroR direct binding to several candidate targets was demonstrated by EMSA. Further, this work identified alr, the gene encoding the alanine racemase enzyme involved in E. faecalis resistance to D‐cycloserine, a promising antimicrobial drug to treat enterococcal infections, as a member of the CroR regulon.
Cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in Persian Gulf region: A case and review
Authors: Mohammadi Rasoul , Mohammadi Abdolrasoul , Ashtari Fereshteh , Khorvash Farzin , Hakamifard Atousa , Vaezi Afsane , Javidnia Javad , Meis Jacques F. , Badali Hamid
Published: December 2017

Cerebral phaeohyphomycosis is frequently a fatal disease caused by truly neurotropic dematiaceous fungi. Although rare, this infection occurs especially among immunocompetent patients, and the clinical symptoms are often misdiagnosed as a cerebral tumour or bacterial brain abscess. The appropriate diagnosis and therapy of cerebral infections by melanized fungi are very challenging if they are caused by mysterious fungi with unknown ecological niche. We reported the second case of cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in Iran and the first culture‐confirmed case. In this report, the differential diagnosis and histopathological findings are discussed and a review of the literature is provided.
Cost‐utility analysis of the National Health Screening Program for chronic kidney disease in Korea
Authors: Go Dun‐Sol , Kim Seon‐Ha , Park Jongha , Ryu Dong‐Ryeol , Lee Hyeon‐Jeong , Jo Min‐Woo
Published: December 2017

Aim

Although a National Health Screening Program (NHSP) for chronic kidney disease (CKD) has been implemented in Korea since 2002, its cost‐effectiveness has never been determined. This study aimed to estimate the cost‐utility of NHSP for CKD in Korea.

Methods

A Markov decision analytic model was constructed to compare CKD screening strategies of the NHSP with no screening. We developed a model that simulated disease progression in a cohort aged 20–120 years or death from the societal perspective.

Results

Biannual screening starting at age 40 for CKD by proteinuria (dipstick) and estimated glomerular filtration ratio had an ICUR of $66 874/QALY relative to no screening. The targeted screening strategy had an ICUR of $37 812/QALY and $40 787/QALY for persons with diabetes and hypertension, respectively. ICURs improved with lower cost strategies. The most influential parameter that might make screening more cost‐effective was the effectiveness of treatment on CKD to decrease disease progression and mortality.

Conclusions

The Korean NHSP for CKD is more cost‐effective for patients with diabetes or hypertension than the general population, consistent with prior studies. Although it is too early to conclude the cost‐effectiveness of the Korean NHSP for CKD, this study provides evidence that is useful in evaluating the cost‐effectiveness of CKD interventions.
Intravenous immunoglobulin in drug and device refractory patients with the symptoms of gastroparesis—an open‐label study
Authors: Ashat M. , Lewis A. , Liaquat H. , Stocker A. , McElmurray L. , Vedanarayanan V. , Soota K. , Howell T. , Kedar A. , Obert J. , Abell T. L.
Published: December 2017

Background

Gastroparesis is a complex clinical entity; many aspects of which remain unknown. Although most patients have idiopathic, diabetic, or postsurgical gastroparesis, many are thought to have measurable neuromuscular abnormalities. Immunotherapy has recently been utilized to treat suspected autoimmune gastrointestinal dysmotility.

Methods

Fourteen patients with symptoms of gastroparesis (Gp) who were refractory to drug/device were selected from 443 Gp patients from 2013 to 2015 who were treated at the University of Louisville motility center. All patients underwent a structural and psychiatric evaluation along with detailed psychological and behavioral examination to rule out eating disorders. We performed detailed neuromuscular evaluation and all 14 patients received at least 12 weeks of intravenous immunoglobulin (400 mg/kg infusion weekly). Response was defined subjectively (symptomatic improvement) using standardized IDIOM score system.

Key Results

All 14 patients had serological evidence and/or tissue evidence of immunological abnormality. Post‐IVIG therapy, there was a significant improvement in symptoms scores for nausea, vomiting, early satiety, and abdominal pain.

Conclusions and Inferences

Although limited by the absence of placebo group, the data illustrate the role of autoimmunity and neuromuscular evaluation in patients with gastroparesis and support the utility of a diagnostic trial of immunotherapy in an effort to improve therapeutic outcomes for such patients.
Elucidating the molecular mechanisms mediating plant salt‐stress responses
Authors: Yang Yongqing , Guo Yan
Published: December 2017

Contents

Summary
523

I.
Introduction
523

II.
Sensing salt stress
524

III.
Ion homeostasis regulation
524

IV.
Metabolite and cell activity responses to salt stress
527

V.
Conclusions and perspectives
532

Acknowledgements
533

References
533

Excess soluble salts in soil (saline soils) are harmful to most plants. Salt imposes osmotic, ionic, and secondary stresses on plants. Over the past two decades, many determinants of salt tolerance and their regulatory mechanisms have been identified and characterized using molecular genetics and genomics approaches. This review describes recent progress in deciphering the mechanisms controlling ion homeostasis, cell activity responses, and epigenetic regulation in plants under salt stress. Finally, we highlight research areas that require further research to reveal new determinants of salt tolerance in plants.
Form–function relationships in a marine foundation species depend on scale: a shoot to global perspective from a distributed ecological experiment
Authors: Ruesink Jennifer L. , Stachowicz John J. , Reynolds Pamela L. , Boström Christoffer , Cusson Mathieu , Douglass James , Eklöf Johan , Engelen Aschwin H. , Hori Masakazu , Hovel Kevin , Iken Katrin , Moksnes Per‐Olav , Nakaoka Masahiro , O'Connor Mary I. , Olsen Jeanine L. , Sotka Erik E. , Whalen Matthew A. , Duffy J. Emmett
Published: December 2017

Form–function relationships in plants underlie their ecosystem roles in supporting higher trophic levels through primary production, detrital pathways, and habitat provision. For widespread, phenotypically‐variable plants, productivity may differ not only across abiotic conditions, but also from distinct morphological or demographic traits. A single foundation species, eelgrassZostera marina, typically dominates north temperate seagrass meadows, which we studied across 14 sites spanning 32–61°N latitude and two ocean basins. Body size varied by nearly two orders of magnitude through this range, and was largest at mid‐latitudes and in the Pacific Ocean. At the global scale, neither latitude, site‐level environmental conditions, nor body size helped predict productivity (relative growth rate 1–2% day‐1at most sites), suggesting a remarkable capacity ofZ. marinato achieve similar productivity in summer. Furthermore, among a suite of stressors applied within sites, only ambient leaf damage reduced productivity; grazer reduction and nutrient addition had no effect on eelgrass size or growth. Scale‐dependence was evident in different allometric relationships within and across sites for productivity and for modules (leaf count) relative to size.Zostera marinaprovides a range of ecosystem functions related to both body size (habitat provision, water flow) and growth rates (food, carbon dynamics). Our observed decoupling of body size and maximum production suggests that geographic variation in these ecosystem functions may be independent, with a future need to resolve how local adaptation or plasticity of body size might actually enable more consistent peak productivity across disparate environmental conditions.
Phenotypic selection and covariation in the life‐history traits of elephant seals: heavier offspring gain a double selective advantage
Authors: Oosthuizen W. Chris , Altwegg Res , Nevoux Marie , Bester M. N. , de Bruyn P. J. Nico
Published: December 2017

Early developmental conditions contribute to individual heterogeneity of both phenotypic traits and fitness components, ultimately affecting population dynamics. Although the demographic consequences of ontogenic growth are best quantified using an integrated measure of fitness, most analyses to date have instead studied individual fitness components in isolation. Here, we estimated phenotypic selection on weaning mass in female southern elephant seals Mirounga leonina by analyzing individual‐based data collected between 1986 and 2016 with capture–recapture and matrix projection models. In support of a hypothesis predicting a gradual decrease of weaning mass effects with time since weaning (the replacement hypothesis), we found that the estimated effects of weaning mass on future survival and recruitment probability was of intermediate duration (rather than transient or permanent). Heavier female offspring had improved odds of survival in early life and a higher probability to recruit at an early age. The positive link between weaning mass and recruitment age is noteworthy, considering that pre‐recruitment mortality already imposed a strong selective filter on the population, leaving only the most ‘robust’ individuals to reproduce. The selection gradient on asymptotic population growth rate, a measure of mean absolute fitness, was weaker than selection on first‐year survival and recruitment probabilities. Weaker selection on mean fitness occurs because weaning mass has little impact on adult survival, the fitness component to which the population growth of long‐lived species is most sensitive. These results highlight the need to interpret individual variation in phenotypic traits in a context that considers the demographic pathways between the trait and an inclusive proxy of individual fitness. Although variation in weaning mass do not translate to permanent survival differences among individuals in adulthood, it explains heterogeneity and positive covariation between survival and breeding in early life, which contribute to between‐individual variation in fitness.
Mechanistic insights into topical tacrolimus for the treatment of atopic dermatitis
Authors: Nakahara Takeshi , Morimoto Hiroshi , Murakami Naofumi , Furue Masutaka
Published: December 2017

More than 15 years have passed since the clinical launch of topical tacrolimus for the treatment of atopic dermatitis. Its efficacy and safety have been clearly demonstrated in many global and domestic short‐term and long‐term clinical trials. Although the prolonged external application of steroids causes many adverse reactions including cutaneous atrophy, no such reactions occur with the use of topical tacrolimus. Therefore, the therapeutic guidelines recommend a combined topical treatment with tacrolimus and steroids. Tacrolimus is a potent immunosuppressant. However, recent studies have revealed its diverse action on the cardinal pathomechanisms of atopic dermatitis. In this review, we summarize the mechanistic role of tacrolimus in various aspects of allergic inflammation including mast cell activation, innate allergic response, pruritus, sensory nerve activation, and skin barrier dysfunction.
Ultrasound‐guided pudendal nerve block in children: A new technique of ultrasound‐guided transperineal approach
Authors: Gaudet‐Ferrand Isabelle , De La Arena Pablo , Bringuier Sophie , Raux Olivier , Hertz Laurent , Kalfa Nicolas , Sola Chrystelle , Dadure Christophe
Published: December 2017

Background

Transperineal pudendal nerve block guided by nerve stimulator is used in pediatric anesthesia as an alternative to caudal analgesia in perineal surgery. The risk of rectal puncture or intravascular injection is inherent to this blinded technique. We described a new technique of transperineal pudendal nerve block, with ultrasound guidance, to improve safety of the technique.

Aims

The first goal of this study was to describe this new technique and to test its feasibility. The second objective was to evaluate intra operative effectiveness and postoperative pain control.

Methods

After parental and children consent, this prospective descriptive study included children aged 1‐15 years, ASA status I‐III, scheduled for general anesthesia associated with bilateral pudendal nerve block for an elective perineal surgery. After standardized general anesthesia, the anesthesiologist performed pudendal nerve block under ultrasound guidance with “out of plane” approach and evaluated the visualization of anatomical structures (ischial tuberosity, rectum, and pudendal artery), of the needle and of the local anesthetic spread. Pudendal nerve block failure was defined as an increase in mean arterial blood pressure or heart rate more than 20% compared to baseline values after surgical incision. In the postoperative period, the need for rescue analgesia was noted.

Results

During the study period, 120 blocks were performed in 60 patients, including 59 boys. Quality of the ultrasonographic image was good in 81% of blocks, with easy visualization of ischium and rectum in more than 95% of cases. Localization of the tip of the needle was possible for all pudendal nerve blocks, directly or indirectly. The spread of local anesthetic was seen in 79% of cases. The block was effective in 88% of cases.

Conclusion

The new technique of ultrasound‐guided pudendal nerve block, described in this study, seems to be easy to perform with a good success rate, and probably improves safety of the puncture and of the injection by real‐time visualization of anatomical structures and local anesthetic spread.
Perioperative management of gastrostomy tube placement in Duchenne muscular dystrophy adolescent and young adult patients: A role for a perioperative surgical home
Authors: Boivin Ariane , Antonelli Richard , Sethna Navil F.
Published: December 2017

Background

In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality.

Aims

The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity.

Methods

We retrospectively examined cases of gastrostomy tube placement in patients of ages 15 years and older between 2005 and 2016. We reviewed preoperative evaluation, anesthetic and surgical management, and postoperative complications.

Results

Twelve patients were identified; 1 had open gastrostomy, 3 laparoscopic gastrostomies, 5 percutaneous endoscopic guided, and 3 radiologically inserted gastrostomy tubes. All patients had preoperative cardiac evaluation with 6 patients demonstrating cardiomyopathy. Nine patients had preoperative pulmonary consultations and the pulmonary function tests reported forced vital capacity of ≤36% of predicted. Eight patients were noninvasive positive pressure ventilation dependent. General anesthesia with tracheal intubation was administered in 8 patients, and intravenous sedation in 4 patients; 1 received sedation supplemented with regional anesthesia and 3 received deep sedation. One patient had a difficult intubation that resulted in trauma and prolonged tracheal intubation. Three patients developed postoperative respiratory complications. Two patients’ procedures were postponed due to inadequate preoperative evaluation and 1 because of disagreement between anesthesia and procedural services as to the optimal approach for airway management.

Conculsion

Optimal management of the perioperative care of Duchenne muscular dystrophy patients requires input from relevant medical specialists, proceduralist and anesthesiologist. This complexity of care coordination presents an opportunity for anesthesiologists to lead a collaborative perioperative team in management of advanced Duchenne patients coming for gastrostomy.
Subcutaneous granuloma annulare involving the scalp
Authors: Thomas Cristina , Morley Keith , Schmidt Birgitta , Hussain Sadaf
Published: December 2017

Subcutaneous granuloma annulare (SGA) is an uncommon subtype of granuloma annulare. There are few reports of this entity solely affecting the scalp. We report a case of biopsy‐proven SGA in a 21‐month‐old boy with six asymptomatic, rock‐hard scalp nodules.
Areolar lymphocytoma in a child: A rare cutaneous presentation of borreliosis
Authors: Ogimi Chikara , Crowell Claudia , Boos Markus D.
Published: December 2017

Lyme disease is a common tick‐borne infection caused by Borrelia burgdorferi in the United States, where infection is most prevalent in the northeastern and mid‐Atlantic states. Although classically associated with erythema migrans, Lyme disease caused by Borrelia species found in Europe may also present with other cutaneous findings. Here we report the case of a girl who was clinically diagnosed with Lyme disease based on her history of recent travel and the appearance of an areolar lymphocytoma; this was confirmed by testing. Testing for European Lyme disease does not follow the testing algorithm that the Centers for Disease Control and Prevention recommends and may be easily missed. Our case serves as an important reminder that common infections can have varying presentations depending on their region of acquisition and may require specialized testing for accurate diagnosis.
Sibling visits and viral infection in the neonatal intensive care unit
Authors: Horikoshi Yuho , Okazaki Kaoru , Miyokawa Shigeko , Kinoshita Kazue , Higuchi Hiroshi , Suwa Junichi , Aizawa Yuta , Fukuoka Kahoru
Published: December 2017

Background

Sibling visits to the neonatal intensive care unit (NICU) are a part of family‐centered care, which is now being increasingly endorsed as a positive development in patient care. Sibling visits, however, pose a risk of viral infection, and hence many NICU in Japan impose strict limits on the practice. The aim of this study was therefore to assess whether sibling visits to the NICU are related to an increase in the nosocomial viral infection rate.

Methods

This retrospective study was conducted between April 2012 and March 2017 at Tokyo Metropolitan Children's Medical Center in Japan. Sibling visits were implemented after screening for symptoms of viral illness. Symptomatic patients in the NICU were tested for common viruses on rapid antigen test and polymerase chain reaction. The number of sibling visits and the rate of nosocomial viral infections were examined on Spearman's correlation test.

Results

The total number of sibling visits and rate of nosocomial viral infection in the NICU was 102 and 0.068 per 1,000 patient‐days during the study period, respectively. The number of enterovirus, respiratory syncytial virus, human metapneumovirus, influenza virus A, and Herpes simplex virus infections was 3, 2, 1, 1, 1, and 1, respectively. No infections were identified after sibling visits. The number of sibling visits and the rate of nosocomial viral infections were not correlated (correlation coefficient, −0.1; P = 0.873).

Conclusion

Sibling visits to the NICU did not result in an increase in the nosocomial viral infection rate.
Integration of radiology and clinical score in pediatric appendicitis
Authors: Aydin Derya , Turan Caner , Yurtseven Ali , Bayindir Petek , Toker Bade , Dokumcu Zafer , Sezak Murat , Saz Eylem Ulas
Published: December 2017

Background

The efficacy of ultrasonography (US) and abdominal X‐ray in combination with Pediatric Appendicitis Score (PAS) is complicated in the diagnosis of acute appendicitis. Abdominal X‐ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. The aim of this study was to determine the value of US and abdominal X‐ray for appendicitis in children when combined with clinical assessment based on PAS, and to establish a practical pathway for acute appendicitis in childhood.

Methods

A prospective, observational cohort study was conducted at an urban, academic pediatric emergency department. Patients were classified at low (PAS 1–4), intermediate (PAS 5–7), or high (PAS 8–10) risk for appendicitis. Low‐risk patients were discharged with telephone follow‐up in ≤10 days; those at intermediate risk underwent X‐ray and US. High‐risk patients received immediate surgical consultation. Patients were grouped on histopathology as having either proven acute appendicitis or no appendicitis.

Results

A total of 288 children were analyzed. Surgery was performed in 134 patients (46.5%), and 128 (95.5%) had positive histopathology. Mean PAS in the patients with and without appendicitis was 7.09 ± 1.42 and 4.97 ± 2.29, respectively (P = 0.00). The rate of missed cases was 6/288 (2%), and the negative appendectomy rate was 6/134 (4.4%). When the score cut‐off was set at 6, the sensitivity and specificity of PAS was 86.7% and 63.1%, respectively. The diagnostic performance of daytime US had a sensitivity of 91.1% and specificity of 71.1%. Also, positive US or PAS >6 or both, had sensitivity and specificity 96.7% and 59.9%, respectively.

Conclusion

US or abdominal X‐ray in children with possible appendicitis should be integrated with PAS to determine the next steps in management. In the case of discordance between the clinical findings and radiology, prolonged observation or further imaging are recommended.
Increased Th17 functions are accompanied by Tregs activities in lupoid leishmaniasis
Authors: Nabavi N. S. , Pezeshkpoor F. , Valizadeh N. , Ahmadi Ghezeldasht S. , Rezaee S. A.
Published: December 2017

The immunopathogenesis of lupoid leishmaniasis is challenging. Although an appropriate immune response is critical for controlling these parasites, inappropriate inflammatory reactions can also promote increased pathology. The role of immune modulatory effect of the main transcription factors and cytokines of T regulatory and Th17 cells in pathogenesis of leishmaniasis chronicity was investigated in this study. The gene expression of interleukin‐10 (IL‐10), transforming growth factor‐β (TGF‐β1), forkhead box P3 (Foxp3), interleukin‐17(IL‐17A) and retinoic acid‐related orphan receptor gamma t (ROrC) was assessed in peripheral blood mononuclear cells of eighty blood samples from cutaneous leishmaniasis (CL) patients with usual lesions (n = 31), lupoid lesions (n = 29) and healthy volunteers (n = 20). Quantitative relative real‐time PCR (qRT‐PCR) was performed using the Taqman and Sybergreen methods for expression of target genes. Expression of Foxp3 (P = .013), IL‐10 (P < .001) and IL‐17A (P < .001) was significantly higher in lupoid patient compare to the nonlupoid group. Expression of Foxp3 (P < .001), IL‐10 (P < .001) and IL‐17A (P = .033) was significantly more in nonlupoid subjects than in healthy volunteers, except for RORγt. These findings suggest that Foxp3+ cells, IL‐10 and IL‐17 play important roles in the immunopathogenesis of CL and that these roles differ depending on the causal leishmania species and different body compartments.
Potential loss of clubroot resistance genes from donor parent Brassica rapa subsp. rapifera (ECD 04) during doubled haploid production
Authors: Fredua‐Agyeman R. , Hwang S.‐F. , Strelkov S. E. , Zhou Q. , Feindel D.
Published: December 2017

Clubroot resistance derived from the oilseed rape/canola Brassica napus ‘Mendel’ has been overcome in some fields in Alberta, Canada, by the emergence of ‘new’ strains of the protist Plasmodiophora brassicae. Resistance to the pathogen was assessed in 112 doubled haploid (DH) lines, derived from B. rapa subsp. rapifera (European clubroot differential (ECD) 04). The lines were evaluated against five single‐spore isolates representing the ‘old’ pathotypes 2, 3, 5, 6 and 8, and 15 field populations representing new strains of P. brassicae. The disease severity index (ID%) data revealed that none of the DH lines were resistant or moderately resistant to the new pathotype 5X (field populations L‐G1, L‐G2, L‐G3) and D‐G3, while 3–42% were resistant or moderately resistant to the other 11 new strains. Using the mean ID induced by the old pathotype 3 (approx. 13.5%) as the baseline, clubroot severity increased by 300–600% when inoculated with the new pathotypes. A significant finding of this study was the fact that ECD 04 showed absolute resistance to all of the old and new P. brassicae strains while the B. napus ‘Mendel’, although resistant to all of the old pathotypes, was resistant to only about 50% of the new strains. Similarly, all of the selected clubroot‐resistant commercial canola cultivars evaluated in this study were susceptible to 87% of the new P. brassicae strains. The molecular data revealed that the breakdown of clubroot resistance in Mendel and the canola cultivars was in part due to the non‐inheritance of the Crr1 gene on the A08 chromosome from ECD 04.
Highly specific assays to detect isolates ofPseudomonas syringaepv.actinidiaebiovar 3 andPseudomonas syringaepv.actinidifoliorumdirectly from plant material
Authors: Andersen M. T. , Templeton M. D. , Rees‐George J. , Vanneste J. L. , Cornish D. A. , Yu J. , Cui W. , Braggins T. J. , Babu K. , Mackay J. F. , Rikkerink E. H. A.
Published: December 2017

Pseudomonas syringaepv.actinidiae(Psa) is responsible for bacterial canker of kiwifruit. Biovar 3 of Psa (Psa3) has been causing widespread damage to yellow‐ and green‐fleshed kiwifruit (Actinidiaspp.) cultivars in all the major kiwifruit‐producing countries in the world. In some areas, including New Zealand,P. syringaepv.actinidifoliorum(Pfm), another bacterial pathogen of kiwifruit, was initially classified as a low virulence biovar of Psa. Ability to rapidly distinguish between these pathovars is vital to the management of bacterial canker. Whole genome sequencing (WGS) data were used to developPCRassays to specifically detect Psa3 and Pfm from field‐collected material without the need to culture bacteria. Genomic data from 36 strains of Psa, Pfm or related isolates enabled identification of areas of genomic variation suitable for primer design. The developed assays were tested on 147 non‐target bacterial species including strains likely to be found in kiwifruit orchards. A number of assays did not proceed because although they were able to discriminate between the different Psa biovars and Pfm, they also produced amplicons from other unrelated bacteria. This could have resulted in false positives from environmental samples, and demonstrates the care that is required when applying assays devised for pure cultures to field‐collected samples. The strategy described here for developing assays for distinguishing strains of closely related pathogens could be applied to other diseases with characteristics similar to Psa.
The relationship between transpiration and nutrient uptake in wheat changes under elevated atmospheric CO2
Authors: Houshmandfar Alireza , Fitzgerald Glenn J. , O'Leary Garry , Tausz‐Posch Sabine , Fletcher Andrew , Tausz Michael
Published: December 2017

The impact of elevated [CO2] (e[CO2]) on crops often includes a decrease in their nutrient concentrations where reduced transpiration‐driven mass flow of nutrients has been suggested to play a role. We used two independent approaches, a free‐air CO2 enrichment (FACE) experiment in the South Eastern wheat belt of Australia and a simulation study employing the agricultural production systems simulator (APSIM), to show that transpiration (mm) and nutrient uptake (g m−2) of nitrogen (N), potassium (K), sulfur (S), calcium (Ca), magnesium (Mg) and manganese (Mn) in wheat are correlated under e[CO2], but that nutrient uptake per unit water transpired is higher under e[CO2] than under ambient [CO2] (a[CO2]). This result suggests that transpiration‐driven mass flow of nutrients contributes to decreases in nutrient concentrations under e[CO2], but cannot solely explain the overall decline.
Temporary grazing exclusion promotes rapid recovery of species richness and productivity in a long‐term overgrazed Campos grassland
Authors: Fedrigo Jean K. , Ataide Pablo F. , Filho Julio Azambuja , Oliveira Lucas V. , Jaurena Martín , Laca Emilio A. , Overbeck Gerhard E. , Nabinger Carlos
Published: December 2017

Moderate grazing intensity is considered the basic requirement to enhance ecosystem function in grasslands. Yet, deterioration by overgrazing is common in many biomes, including Campos grasslands in South America. Understanding how grazing management can lead to recovery of ecosystem function is essential to design and implement effective strategies for sustainable use of this resource. In a long‐term field experiment carried out in Southern Brazil, we studied the effects of temporal grazing exclusions (spring or fall) at moderate and severe livestock grazing intensities (maintained by adjusting contrasting forage allowances) on the species richness, botanical composition, forage mass, sward height, and photosynthetic active radiation intercepted. The experiment was arranged in a completely randomized design with three replications of grazing exclusions, applied simultaneously at moderate and severe grazing intensities. Moderate grazing intensity showed a bimodal structure of shorter and taller canopies, and high species richness. Severe grazing created a shorter and homogeneous sward structure characterized by less standing biomass and species loss. In response to grazing exclusions, sward height, standing biomass, and light interception recovered almost to the levels of moderate grazing. Further, within 2 years grass species richness increased and botanical composition changed toward grasses with erect habit prevailing in moderate grazing intensity. Our study confirms that (1) moderate grazing intensities allow the coexistence of high number of species and (2) spring grazing exclusions of long‐term overgrazed grasslands can lead to a quick start to recover the grass species richness, primary productivity, and species composition like that prevailing in well‐managed grasslands.
Colonization of woodland species during restoration: seed or safe site limitation?
Authors: Aradottir Asa L. , Halldorsson Gudmundur
Published: December 2017

A strategy of assisted natural regeneration uses selective restoration interventions to remove potential barriers to passive natural regeneration and succession toward target ecosystems. In woodland restoration, this may involve the planting of woodland clusters that serve as seed sources for further colonization and/or site amelioration to enhance colonization and growth of the target species. We tested the importance of seed and safe site limitations for the colonization of birch and willows in experimental treatments representing a matrix of revegetation (+/−) and planted birch and willow clusters (+/−) on an eroded area in South Iceland. The revegetation was initiated in the fall of 1999 and clusters of birch and willows planted in 2002. Density of birch and willow seedlings and their distribution among microsites was surveyed in 2005, 2006, 2010, and 2015. Willow seedlings were first noted in 2006 but birch seedlings in 2010. In 2015, seedling density in revegetated plots with planted clusters was over 20 times greater than that of revegetated plots without clusters, indicating a strong seed limitation. No seedlings were found in plots that had not been revegetated, showing very strong microsite limitation. However, revegetation increased the cover of biological soil crust and other microsites favorable for seedling establishment. The results demonstrate that both seed and safe site limit the colonization of birch and willows, key species in woodland restoration, and highlight the importance of identifying barriers to spontaneous succession before selecting restoration strategies.
Palliative care for end‐of‐life patients in a basic emergency service
Authors: Pereira Maria Eduarda Diniz , Barbosa António , Dixe Maria dos Anjos
Published: December 2017

This research sought to describe the care provided by the nursing staff of the Western Department of the Basic Emergency Service for end‐of‐life patients. This was a retrospective, quantitative, exploratory and descriptive (level I) study, which sought to research the nursing records of 83 patients from admission to death. Patients who met the following inclusion criteria were considered eligible: adults; had an oncological or nononcological, advanced and irreversible chronic disease; and died in the Basic Emergency Service in the period from January 2011 to December 2012. An instrument was created for data collection, the content, relevance and adequacy of which was validated by a panel of experts in the area of palliative care. The study protocol was approved by the Institutional Ethics Committee. The main results indicate that the majority of patients died in the Observation Room in a period between the first two and twenty‐four hours. Nursing interventions favoured technical‐instrumental care related to medical prescriptions and service routines such as venous punctures, catheterisations, taking blood samples for analysis, aspiration of secretions, intravenous administration of fluids and drugs for symptomatic control, and monitoring of vital parameters and the state of consciousness. With the proximity of death, the nurses favoured the registration of cardiorespiratory arrest, cardiopulmonary resuscitation manoeuvres and aspiration of secretions. In the recognition of predictive factors of imminent death, the nurses favoured the patient's entry into a comatose state and aggravation of asthenia. In most patients, the entry into agony phase was not diagnosed.
Marriage, the Final Frontier? Same‐Sex Marriage and the Future of the Lesbian and Gay Movement
Authors: Bernstein Mary , Harvey Brenna , Naples Nancy A.
Published: December 2017

Given hostility within segments of LGBT communities toward same‐sex marriage, how do Australian activists justify their efforts toward achieving marriage equality? In this article, we expand the social movement literature by examining how activists construct identity, meaning, and goals in contradistinction to others within the same movement. We draw on interviews with Australian lesbian and gay activists to examine what enables them to pursue the contested goal of same‐sex marriage in light of internal movement critiques that marriage equality will undermine the significance of lesbian and gay identity and impair activism on other issues as a result of the view that equality has been achieved. We expand debates over the post‐gay trajectory of lesbian and gay activism and identity by illustrating how activists attach different, what we term, mobilizing meanings, to the same movement goal which enables them to withstand internal movement critiques. We provide a typology of mobilizing meanings that can be applied more generally.
Should Sociologists Stand Up for Science? Absolutely!
Authors: Ruane Janet M.
Published: December 2017

Standing up for science is part of sociology's mission as a social science. Standing up is also consistent with our field's ethical obligation to identify and avoid research compromised by conflict of interests.
Patriotism and Food Sovereignty: Changes in the Social Imaginary of Small‐Scale Farming in Post‐Euromaidan Ukraine
Authors: Mamonova Natalia
Published: December 2017

This article discusses the relations between patriotism and food sovereignty in post‐Euromaidan Ukraine. It investigates how the rising Ukrainian national identity and patriotic sentiments during the geopolitical conflict with Russia led to a change in the social imaginary of traditional small‐scale farming. Formerly, household farming was seen as a coping strategy of the post‐Soviet population and a relic of the socialist past, doomed to disappear in the nearest future. Nowadays, more and more Ukrainians view small‐scale farming as a sustainable alternative to large‐scale industrial agriculture, which could feed Ukraine (and Europe) with ecological and healthy food. This study uses primary qualitative and quantitative data collected during field research before and after the Euromaidan revolution to reveal how pro‐European aspirations and rising patriotism contribute to the emerging discourses on the ‘rights to food and to farm’ in Ukraine. This transformation could bring a new trajectory to the country's agricultural development and might lead to the emergence of a food sovereignty movement.
Conceptualizing similarities and differences between purpose in life and self‐affirmation
Authors: Burd Kayla A. , Burrow Anthony L.
Published: December 2017

Individuals contend with a variety of threats in daily life and may attempt to deal with them using various cognitive strategies. Two constructs borne from different literatures, purpose in life and self‐affirmation, serve to promote well‐being and to protect individuals from such threats. While self‐affirmation has often been examined as a manipulation, purpose has, until recently, been considered a dispositional resource. However, both self‐affirmation and purpose seem to confer similar advantages in response to threat. This paper reviews the evidence for the protective benefits of both purpose in life and self‐affirmation, describes the mechanisms by which each confers these advantages, and considers the boundary conditions of each. Key similarities and differences are discussed, and we argue that there are broad gaps in the literature regarding where and when these constructs might operate differentially, or why these differences exist. We conclude with a call to researchers to explore empirically how and when these important interventions might be differentially beneficial to those who cultivate them.