bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous Presence of Non- and Highly Mutated Keyhole Limpet Hemocyanin (KLH)-Specific Plasmablasts Early after Primary KLH Immunization Suggests Cross-Reactive Memory B Cell Activation
Authors: Giesecke Claudia , Meyer Tim , Durek Pawel , Maul Jochen , Preiß Jan , Jacobs Joannes F. M. , Thiel Andreas , Radbruch Andreas , Ullrich Reiner , Dörner Thomas 
Published: May 2018

Abstract
There are currently limited insights into the progression of human primary humoral immunity despite numerous studies in experimental models. In this study, we analyzed a primary and related secondary parenteral keyhole limpet hemocyanin (KLH) immunization in five human adults. The primary challenge elicited discordant KLH-specific serum and blood effector B cell responses (i.e., dominant serum KLH-specific IgG and IgM levels versus dominant KLH-specific IgA plasmablast frequencies). Single-cell IgH sequencing revealed early appearance of highly (&gt;15 mutations) mutated circulating KLH-specific plasmablasts 2 wk after primary KLH immunization, with simultaneous KLH-specific plasmablasts carrying non- and low-mutated IgH sequences. The data suggest that the highly mutated cells might originate from cross-reactive memory B cells (mBCs) rather than from the naive B cell repertoire, consistent with previous reported mutation rates and the presence of KLH-reactive mBCs in naive vaccinees prior to immunization. Whereas upon secondary immunization, serum Ab response kinetics and plasmablast mutation loads suggested the exclusive reactivation of KLH-specific mBCs, we, however, detected only little clonal overlap between the peripheral KLH-specific secondary plasmablast IgH repertoire and the primary plasmablast and mBC repertoire, respectively. Our data provide novel mechanistic insights into human humoral immune responses and suggest that primary KLH immunization recruits both naive B cells and cross-reactive mBCs, whereas secondary challenge exclusively recruits from a memory repertoire, with little clonal overlap with the primary response.
Inability To Detect Cross-Reactive Memory T Cells Challenges the Frequency of Heterologous Immunity among Common Viruses
Authors: Rowntree Louise C. , Nguyen Thi H. O. , Halim Hanim , Purcell Anthony W. , Rossjohn Jamie , Gras Stephanie , Kotsimbos Tom C. , Mifsud Nicole A. 
Published: May 2018

Abstract
Human memory T cells that cross-react with epitopes from unrelated viruses can potentially modulate immune responses to subsequent infections by a phenomenon termed heterologous immunity. However, it is unclear whether similarities in structure rather than sequence underpin heterologous T cell cross-reactivity. In this study, we aimed to explore the mechanism of heterologous immunity involving immunodominant epitopes derived from common viruses restricted to high-frequency HLA allotypes (HLA-A*02:01, -B*07:02, and -B*08:01). We examined EBV-specific memory T cells for their ability to cross-react with CMV or influenza A virus–derived epitopes. Following T cell immunoassays to determine phenotype and function, complemented with biophysical and structural investigations of peptide/HLA complexes, we did not detect cross-reactivity of EBV-specific memory T cells toward either CMV or influenza A virus epitopes presented by any of the selected HLA allomorphs. Thus, despite the ubiquitous nature of these human viruses and the dominant immune response directed toward the selected epitopes, heterologous virus-specific T cell cross-reactivity was not detected. This suggests that either heterologous immunity is not as common as previously reported, or that it requires a very specific biological context to develop and be clinically relevant.
Massive carbon addition to an organic-rich Andosol increased the subsoil but not the topsoil carbon stock
Authors: Zieger Antonia , Kaiser Klaus , Ríos Guayasamín Pedro , Kaupenjohann Martin 
Published: May 2018

Abstract. Andosols are among the most carbon-rich soils, with an average of
254 Mg ha−1 organic carbon (OC) in the upper 100 cm. A current
theory proposes an upper limit for OC stocks independent of increasing carbon
input, because of finite binding capacities of the soil mineral phase. We
tested the possible limits in OC stocks for Andosols with already large OC
concentrations and stocks (212 g kg−1 in the first horizon,
301 Mg ha−1 in the upper 100 cm). The soils received large inputs
of 1800 Mg OC ha−1 as sawdust within a time period of 20 years.
Adjacent soils without sawdust application served as controls. We determined
total OC stocks as well as the storage forms of organic matter (OM) of five
horizons down to 100 cm depth. Storage forms considered were pyrogenic
carbon, OM of < 1.6 g cm−3 density and with little to no
interaction with the mineral phase, and strongly mineral-bonded OM forming
particles of densities between 1.6 and 2.0 g cm−3 or
> 2.0 g cm−3. The two fractions
> 1.6 g cm−3 were also analysed for aluminium-organic matter
complexes (Al–OM complexes) and imogolite-type phases using ammonium-oxalate–oxalic-acid extraction and X-ray diffraction (XRD). Pyrogenic organic carbon represented only up to 5 wt % of OC, and thus
contributed little to soil OM. In the two topsoil horizons, the fraction
between 1.6 and 2.0 g cm−3 had 65–86 wt % of
bulk soil OC and was dominated by Al–OM complexes.
In deeper horizons, the
fraction > 2.0 g cm−3 contained 80–97 wt % of the
bulk soil's total OC and was characterized by a mixture of Al–OM complexes
and imogolite-type phases, with proportions of imogolite-type phases
increasing with depth. In response to the sawdust application, only the OC
stock at 25–50 cm depth increased significantly (α=0.05, 1-β=0.8). The increase was entirely due to increased OC in the two fractions
> 1.6 g cm−3. However, there was no significant increase
in the total OC stocks within the upper 100 cm. The results suggest that long-term large OC inputs cannot be taken up by the
obviously OC-saturated topsoil but induce downward migration and gradually
increasing storage of OC in subsurface soil layers. The small additional OC
accumulation despite the extremely large OC input over 20 years, however,
shows that long time periods of high input are needed to promote the downward
movement and deep soil storage of OC.
A simple temperature-based method to estimate heterogeneous frozen ground within a distributed watershed model
Authors: Follum Michael L. , Niemann Jeffrey D. , Parno Julie T. , Downer Charles W. 
Published: May 2018

Abstract. Frozen ground can be important to flood production and is often
heterogeneous within a watershed due to spatial variations in the available
energy, insulation by snowpack and ground cover, and the thermal and moisture
properties of the soil. The widely used continuous frozen ground index (CFGI)
model is a degree-day approach and identifies frozen ground using a simple
frost index, which varies mainly with elevation through an elevation–temperature relationship. Similarly, snow depth and its insulating
effect are also estimated based on elevation. The objective of this paper is
to develop a model for frozen ground that (1) captures the spatial
variations of frozen ground within a watershed, (2) allows the frozen
ground model to be incorporated into a variety of watershed models, and
(3) allows application in data sparse environments. To do this, we
modify the existing CFGI method within the gridded surface subsurface
hydrologic analysis watershed model. Among the modifications, the snowpack
and frost indices are simulated by replacing air temperature (a surrogate for
the available energy) with a radiation-derived temperature that aims to
better represent spatial variations in available energy. Ground cover is also
included as an additional insulator of the soil. Furthermore, the modified
Berggren equation, which accounts for soil thermal conductivity and soil
moisture, is used to convert the frost index into frost depth. The modified
CFGI model is tested by application at six test sites within the Sleepers
River experimental watershed in Vermont. Compared to the CFGI model, the
modified CFGI model more accurately captures the variations in frozen ground
between the sites, inter-annual variations in frozen ground depths at a given
site, and the occurrence of frozen ground.
Long-term temporal trajectories to enhance restoration efficiency and sustainability on large rivers: an interdisciplinary study
Authors: Eschbach David , Schmitt Laurent , Imfeld Gwenaël , May Jan-Hendrik , Payraudeau Sylvain , Preusser Frank , Trauerstein Mareike , Skupinski Grzegorz 
Published: May 2018

Abstract. While the history of a fluvial hydrosystem can provide essential
knowledge on present functioning, historical context remains rarely
considered in river restoration. Here we show the relevance of an
interdisciplinary study for improving restoration within the framework of a
European LIFE+ project on the French side of the Upper Rhine (Rohrschollen
Island). Investigating the planimetric evolution combined with historical
high-flow data enabled us to reconstruct pre-disturbance hydromorphological
functioning and major changes that occurred on the reach. A deposition
frequency assessment combining vertical evolution of the Rhine thalweg,
chronology of deposits in the floodplain, and a hydrological model revealed
that the period of incision in the main channel corresponded to high rates of
narrowing and lateral channel filling. Analysis of filling processes using
Passega diagrams and IRSL dating highlights that periods of engineering works
were closely related to fine sediment deposition, which also presents
concomitant heavy metal accumulation. In fact, current fluvial forms,
processes and sediment chemistry around Rohrschollen Island directly reflect
the disturbances that occurred during past correction works, and up to today.
Our results underscore the advantage of combining functional restoration with
detailed knowledge of the past trajectory to (i) understand the functioning
of the hydrosystem prior to anthropogenic disturbances, (ii) characterize the
human-driven morphodynamic adjustments during the last 2 centuries,
(iii) characterize physico-chemical sediment properties to trace
anthropogenic activities and evaluate the potential impact of the restoration
on pollutant remobilization, (iv) deduce the post-restoration evolution
tendency and (v) evaluate the efficiency and sustainability of the
restoration effects. We anticipate our approach will expand the toolbox of
decision-makers and help orientate functional restoration actions in the
future.
Indigenous access barriers to health care services in London, Ontario
Authors: McConkey Stephanie 
Published: May 2018

Introduction: Indigenous peoples in Canada suffer higher rates of health inequalities and encounter a number of health services access barriers when compared to their non-Indigenous counterparts. Indigenous peoples experience social and economic challenges, cultural barriers, and discrimination when accessing mainstream health services.
Methods: In London, Ontario, 21 interviews and 2 focus groups (n = 25) with service providers were completed, each session spanning approximately 1 to 1.5 hours. Interviews were voice recorded and transcribed verbatim. Themes were identified using NVIVO 10 software.
Findings: Approximately 2 to 5% of clients are Indigenous in hospital-based services. There are a number of social factors that influence whether Indigenous peoples access health services. Indigenous peoples do not have access to adequate pain medications because physicians are reluctant to provide Indigenous patients with pain medications due to common perceptions of addiction. Indigenous peoples also have barriers accessing a family physician because physicians are reluctant to take on new patients with complex health needs.
Conclusion: Systemic discrimination is still alive in the health care system; therefore, there is a need for cultural safety training among physicians to increase awareness of access barriersand challenges that many Indigenous patients face when seeking health care.
Collaborative care models for integrating mental health and primary care
Authors: Maskell Rachelle , Rudkovska Anna , Kfrerer Marisa , Sibbald Shannon 
Published: May 2018

Background: Mental health service demands in Ontario often result in long wait times and a lack of access to specialized services. As a result, primary care providers are frequently required to provide mental health care for patients with complex diagnoses despite a lack of support or sufficient training. To address these issues, a shift toward collaborative models of mental health care delivery is occurring.
Objective: This paper aims to assess whether evidence-based policy recommendations to improve collaborative mental health care are addressed in the recent Patients First documents.
Methods: To achieve this, a qualitative analysis was conducted using NVivo10©.
Results: While many of the evidence-based policy recommendations were mirrored in the Patients First documents, very few addressed collaborative mental health care directly.
Implications: More research is required to fully understand the effects of the implementation of Patients First on mental health systems and services.
The detrimental effects of obstetric evacuation on Aboriginal women’s health
Authors: Corrado Ann Marie 
Published: May 2018

In Western society, many colonial practices, such as the removal of Aboriginal women from their communities prior to birth, still detrimentally affects Aboriginal peoples’ lives. Health Canada’s evacuation policy for pregnant Aboriginal women living in rural and remote areas involves nurses, who are employed by the federal government, coordinating the transfer of all pregnant women to urban cities at 36-38 weeks gestational age to await the birth of their baby.1 The policy states that it is founded on concerns for the wellbeing of Aboriginal women, in an attempt to “curb First Nations’ child and maternal mortality rates”.1 However, there is a need to problematize the practice of obstetric evacuation given its colonial roots and its impact on Aboriginal women. The objective of this review paper is to explore and bring awareness to some of the consequences of Canada’s evacuation policy for pregnant Aboriginal women who live in rural and remote regions. Morespecifically, this paper, drawing on ethnographic research previously conducted with Canadian Aboriginal women on their lived experiences of prenatal care and birth, will examine the lack of social support, loss of control, and lack of culturally competent care that Aboriginal women face. The findings demonstrate an urgent need for policy makers to also consider the lived experience of Aboriginal women when making decisions that impact their health.
Cover art
Authors: Yu Richard Ying 
Published: May 2018

Cover art by Richard Ying Yu.
Description: The Canadian Healthcare system is an efficient system that provides care for its patients. However, there are still many aspects of it that need to be addressed and improved, including Indigenous health, mental health, long wait times, and the current ongoing opioid crisis. I wanted to draw a cartoon that could encapsulate these broad aspects that need to be improved in a simple picture with minimal clutter. I decided that a sick Canada could represent that and the Schulich stethoscope represents our important role in addressing these heath care disparities.
The case for a student run clinic in London
Authors: Abou-Hamde Yara , Hopfgartner Adam 
Published: May 2018

Student Run Clinics (SRCs) are an emerging form of primary healthcare involving the collaboration of students and licensed health care professionals. SRCs aim to identify healthcare needs in the community and to meet those needs with supervised clinical and non-clinical services, education, and outreach. The SRC model provides students with direct patient interaction to complement classroom learning and develop extracurricular clinical skills.
The Alliance of Students Providing Interprofessional Resources and Education (ASPIRE) is a new interdisciplinary student group from the University of Western Ontario, Fanshawe College, and the University of Waterloo. Using established Canadian SRCs as a framework, ASPIRE is working to start a London-based SRC. A recent review of healthcare needs and social determinants of health completed by ASPIRE for the City of London identified a high incidence of mental health conditions and HIV in the community. Furthermore, the adequate provision of primary healthcare in London is complicated by transportation issues, financial constraints, and language barriers among underserved and minority populations. These concerns may be addressed by care provided by professional students from various disciplines organized by ASPIRE.
The future of ASPIRE includes health promotion in the London community with presentations on topics such as opioid addiction and overdose prevention, diabetic foot care, and smoking cessation. ASPIRE will continue to work towards a transition into a larger role in health promotion and health advocacy, with the ultimate goal of establishing an SRC in the City of London.
Cannabis for pain management: Pariah or panacea?
Authors: Hudson Roger , Puvanenthirarajah Nirushan 
Published: May 2018

Cannabis has been used in a medicinal context throughout recorded history and across diverse cultures to aid in the treatment of a wide array of ailments. Remarkably, clinical and preclinical investigations are only recently beginning to reveal the neurobiological mechanisms responsible for the clinically-relevant actions of cannabis that have been acknowledged by medical pharmacopeia for millennia. The therapeutic potential of cannabis-derived phytochemicals such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are currently being explored in several contexts. Experimental evidence suggests that modulation of signal transduction pathways underlying cellular excitability, as well as interactions with the endocannabinoid and serotonin systems, which modulate emotion and pain sensitivity under physiological conditions, are among the mechanisms responsible for its clinical efficacy. Interestingly, the diverse pharmacodynamic profile of CBD suggests a synergistic interaction with current first- and second-line medications used in the treatment of neuropathic pain to produce clinically meaningful therapeutic benefits. To advance understanding of the neurobiological mechanisms underlying therapeutic cannabis use in pain management and to integrate its use into modern clinical practices, it is important to understand medicinal cannabis use in historic and medical contexts. This review highlights the copious history of medical practices incorporating the use of cannabis, and discusses the potential pharmacological mechanisms responsible for its therapeutic efficacy in the management of neuropathic pain.
APLICAÇAO DO SISTEMA DE INDICADORES DE QUALIDADE AMBIENTAL URBANA PARA METRÓPOLES COSTEIRAS (SIMEC) NAS REGIOES METROPOLITANAS DO RECIFE (PE), RIO DE JANEIRO (RJ) E NA REGIÃO DE JOINVILLE- SC
Authors: Adão Nilton Manoel Lacerda , Polette Marcus 
Published: May 2018

O presente artigo aplica um Sistema de Indicadores de Qualidade Ambiental Urbana para Metrópoles Costeiras (SIMeC) nas Regiões Metropolitanas do Recife e do Rio de Janeiro e na Região de Joinville no Norte/Nordeste Catarinense. São três aglomerados urbanos que apresentam como características em comum a integração de diferentes municípios em território costeiro. O SIMeC é um sistema de indicadores que objetiva mensurar, avaliar e monitorar as metrópoles costeiras tendo como fundamentos as dimensões da prosperidade urbana propostas pela UN-Habitat (2012) e com a estrutura DPSIR. Ao comparar as três realidades, o SIMeC se apresentou como um instrumento adequado para compreensão das realidades urbanas e costeiras em regiões de diferentes extensões e realidades, sendo possível identificar as deficiências do processo de gestão territorial nas diferentes dimensões da qualidade ambiental urbana.
Autonomie, verantwoordelijkheid in gebondenheid
Authors: Donner J.P.H. 
Published: May 2018

Autonomie, verantwoordelijkheid in gebondenheid
Gedurende de tweede Miguel Pourier-lezing te Kralendijk, Bonaire, op 29 oktober 2017 stond prof. mr. J.P.H. Donner stil bij de nieuwe staatkundige structuur binnen het Koninkrijk na 10 oktober 2010 en de gevolgen hiervan.
Verhaalsfrustratie door en met een SPF: enige beschouwingen naar aanleiding van het arrest Resort of the World/Maple Leaf (HR 7 oktober 2016, ECLI:NL:HR:2016:2285, NJ 2017/124)
Authors: Bakker P.S. 
Published: May 2018

Verhaalsfrustratie door en met een SPF: enige beschouwingen naar aanleiding van het arrest Resort of the World/Maple Leaf (HR 7 oktober 2016, ECLI:NL:HR:2016:2285, NJ 2017/124)
In deze bijdrage staat het arrest HR 7 oktober 2016, ECLI:NL:HR:2016:2285, NJ 2017/124 (Resort of the World/Maple Leaf) centraal. Alvorens het arrest te bespreken, zal worden ingegaan op het leerstuk van de vereenzelviging in algemene zin, waarbij de in dat kader belangrijke arresten HR 9 juni 1995, NJ 1996/213 (Krijger/Citco) en HR 13 oktober 2000, ECLI:NL:HR:2000:AA7480, NJ 2000/698, m.nt. J.M.M. Maeijer (Rainbow) aan bod zullen komen. Geconcludeerd kan worden dat er klemmende redenen moeten zijn om aan de afzonderlijke identiteit van een rechtspersoon voorbij te gaan. Tevens wordt in het arrest bevestigd dat de formele hoedanigheid van de handelende persoon niet beslissend is voor de vraag van toerekening van kennis en dat voor terughoudendheid bij de toerekening van zogeheten interne kennis aan een rechtspersoon geen plaats is.
A survey of the views and capabilities of community pharmacists in Western Australia regarding the rescheduling of selected oral antibiotics in a framework of pharmacist prescribing
Authors: Sinkala Fatima , Parsons Richard , Sunderland Bruce , Hoti Kreshnik , Czarniak Petra 
Published: May 2018

BackgroundAntibiotic misuse in the community contributes to antimicrobial resistance. One way to address this may be by better utilizing community pharmacists’ skills in antibiotic prescribing. The aims of this study were to examine the level of support for “down-scheduling” selected antibiotics and to evaluate factors determining the appropriateness of community pharmacist prescribing for a limited range of infections, including their decision to refer to a doctor.MethodsSelf-administered questionnaires, including graded case vignette scenarios simulating real practice, were sent to Western Australian community pharmacists. In addition to descriptive statistics and chi-square testing, a General Estimating Equation (GEE) was used to identify factors associated with appropriateness of therapy and the decision to refer, for each of the seven vignettes.ResultsOf the 240 pharmacists surveyed, 90 (37.5%) responded, yielding 630 responses to seven different case vignettes. There was more than 60% respondent support for expanded prescribing (rescheduling) of commonly prescribed antibiotics. Overall 426/630 (67.6%) chose to treat the patient while the remaining 204/630 (32.4%) referred the patient to a doctor. Of those electing to treat, 380/426 (89.2%) opted to use oral antibiotics, with 293/380 (77.2%) treating with an appropriate selection and regimen. The GEE model indicated that pharmacists were more likely to prescribe inappropriately for conditions such as otitis media (p= 0.0060) and urinary tract infection in pregnancy (p < 0.0001) compared to more complex conditions. Over 80% of all pharmacists would refer the patient to a doctor following no improvement within 3 days, or within 24 h in the case of community acquired pneumonia. It was more common for younger pharmacists to refer the patient to a doctor (p = 0.0165).DiscussionThis study adds further insight into community pharmacy/pharmacist characteristics associated with appropriateness of oral antibiotic selection and the decision to refer to doctors. These findings require consideration in designing pharmacist over-the-counter prescribing models for oral antibiotics.