bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractObjective 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

SummaryEnterococcus 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

SummaryCerebral 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

ABSTRACTAimAlthough 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.MethodsA 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.ResultsBiannual 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.ConclusionsThe 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

AbstractBackgroundGastroparesis 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.MethodsFourteen 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 ResultsAll 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 InferencesAlthough 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

SummaryExcess 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.
Mechanistic insights into topical tacrolimus for the treatment of atopic dermatitis
Authors: Nakahara Takeshi , Morimoto Hiroshi , Murakami Naofumi , Furue Masutaka 
Published: December 2017

AbstractMore 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

SummaryBackgroundTransperineal 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.AimsThe 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.MethodsAfter 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.ResultsDuring 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.ConclusionThe 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

SummaryBackgroundIn 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.AimsThe 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.MethodsWe 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.ResultsTwelve 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.ConculsionOptimal 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

AbstractSubcutaneous 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

AbstractLyme 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

AbstractBackgroundSibling 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.MethodsThis 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.ResultsThe 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).ConclusionSibling 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

AbstractBackgroundThe 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.MethodsA 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.ResultsA 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.ConclusionUS 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

SummaryThe 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.