bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of contourite systems in the late Cretaceous Chalk Sea along the Tornquist Zone
Authors: Hübscher Christian , Hseinat Mu'ayyad Al , Schneider Matthias , Betzler Christian 
Published: November 2018

AbstractBased on integration of seismic reflection and well data analysis this study examines two major contourite systems that developed during the late Cretaceous in the southern Baltic Sea. The evolution of these Chalk Sea contourite systems between the Kattegat and the southern Baltic Sea started when Turonian to Campanian inversion tectonics overprinted the rather flat sea floor of the epeiric Chalk Sea. The Tornquist Zone and adjacent smaller blocks were uplifted and formed elongated obstacles that influenced the bottom currents. As a consequence of the inversion, the sea floor west of the Tornquist Zone tilted towards the north‐east, creating an asymmetrical sub‐basin with a steep marginal slope in the north‐east and a gentle dipping slope in the south‐west. A south‐east directed contour current emerged in the Coniacian or Santonian along the south‐western basin margin, creating contourite channels and drifts. The previously studied contourite system offshore Stevns Klint is part of this system. A second, deeper and north‐west directed counter‐flow emerged along and parallel to the Tornquist Zone in the later Campanian, but was strongest in the Maastrichtian. This bottom current moderated the evolution of a drift‐moat system adjacent to the elevated Tornquist Zone. The near surface Alnarp Valley in Scania represents the Danian palaeo‐moat that linked the Pomeranian Bay with the Kattegat. The previously studied contourite system in the Kattegat represents the north‐western prolongation of this system. This study links previous observations from the Kattegat and offshore Stevns Klint to the here inferred two currents, a more shallow, south‐east directed and a deeper, north‐west directed flow.
Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock
Authors: Castaño Pablo , Plaza Maribel , Molina Fernando , Hincapié Carolina , Maya Wilmar , Cataño Juan , González Javier , León Alba , Jaimes Fabián 
Published: November 2018

AbstractObjectiveTo assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies.MethodsProspective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted.ResultsA total of 705 patients with severe sepsis were included. No differences were found in positive‐culture patients (n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics (OR = 0.90; 95% CI = 0.55–1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive (OR = 1.04; 95% CI = 0.99–1.08) or negative cultures (OR = 0.98; 95% CI = 0.92–1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7–18 days for the whole cohort).ConclusionsNo associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay.
Multiplex blood group typing by cellular surface plasmon resonance imaging
Authors: Szittner Zoltan , Bentlage Arthur E.H. , van der Donk Eric , Ligthart Peter C. , Lissenberg‐Thunnissen Suzanne , van der Schoot C. Ellen , Vidarsson Gestur 
Published: November 2018

BACKGROUNDBlood‐group typing of donors and patients is essential to avoid incompatible transfusions. Transfusion of incompatible RBCs may result in alloimmunization complicating future transfusions or in the presence of antibodies in adverse reactions. With more than 300 blood group antigens identified, it is difficult to provide fully compatible blood. Currently, standard practice is to match for the most immunogenic antigens. While the current agglutination‐based RBC‐typing methods are reliable for testing a selected number of antigens, they are not easily adaptable for high‐throughput multiplex blood typing beyond the current standard.STUDY DESIGN AND METHODSSurface plasmon resonance (SPR) is a label‐free method to follow molecular—and, very recently, also cellular—interactions in real time. Demonstration of binding of RBCs to blood group antigen‐specific antibodies by SPR has already been achieved. Here, we demonstrate the generation of an SPR array equipped with clinically relevant blood group antibodies (A, B, and Rh blood groups). To validate this method, we blindly compared typing of 946 blood donors with results of current diagnostic agglutination‐based methods.RESULTSRBC typing was achieved by monitoring RBC binding to blood group–specific antibodies on the sensor simultaneously within 5 minutes per sample. Regeneration of the chip was robust, allowing for typing of at least 100 samples. The typing results gave a 100% match with classical serology with all antibodies tested besides anti‐E/e monoclonals, which gave inconsistent results due to low antibody specificity.CONCLUSIONThis study demonstrates that SPR‐based RBC typing for multiple antigens can be realized simultaneously with high‐quality antibodies, enabling reduced hands‐on time and possibly improving cost efficiency.
Quality of erythrocyte concentrates derived from lipemic whole blood donations
Authors: de Laleijne‐Liefting Lara A.E. , Lagerberg Johan W. , de Korte Dirk 
Published: November 2018

IntroductionSeveral studies indicate that lipemic plasma can have an adverse effect on the quality of platelets and red blood cell concentrates (RCC) during storage. The aim of this study was to expand the knowledge of donor characteristics in relation to RCC storage quality.Materials and methodsDonor characteristics of lipemic whole blood (WB) donations were obtained. As control, historical data on donor characteristics were used. RCCs in SAGM were produced from these lipemic WB donations, and in vitro quality during cold storage was determined. In plasma, triglyceride levels were determined. Results were compared with normal, non‐lipemic donations.ResultsA total of 26 lipemic WB donations were evaluated of which only two were obtained from a female donor. Mean age of donors in this study was 50 years. A total of 18 donors (69%) showed overweight (BMI 25–30) or were obese (BMI > 30). Lipemic donations were drawn between 2:40 and 8:40 PM, with 22 donations after 6:00 PM. Triglyceride levels in lipemic plasma were on average 5·9 mmol/L. At day 42 of storage, the lipemic group showed significant higher haemolysis (1·24 ± 0·82%), as compared to the control group (0·30 ± 0·14%).DiscussionHaemolysis during storage was greatly enhanced in RCCs from lipemic WB donations. Based on the limited set of donations in this evaluation, a tentative conclusion is that highest chance of lipemic plasma exists in donations from men over 50 years with BMI > 25, donating in the evening. Based on these investigations, our blood service decided not to use lipemic WB for the production of (cellular) blood products.
Leopard tortoises in southern Africa have greater genetic diversity in the north than in the south (Testudinidae)
Authors: Spitzweg Cäcilia , Hofmeyr Margaretha D. , Fritz Uwe , Vamberger Melita 
Published: November 2018

AbstractIn contrast to mammals, little is known about the phylogeographic structuring of widely distributed African reptile species. With the present study, we contribute data for the leopard tortoise (Stigmochelys pardalis). It ranges from the Horn of Africa southward to South Africa and westwards to southern Angola. However, its natural occurrence is disputed for some southern regions. To clarify the situation, we used mtDNA sequences and 14 microsatellite loci from 204 individuals mainly from southern Africa. Our results retrieved five mitochondrial clades; one in the south and two in the north‐west and north‐east of southern Africa, respectively, plus two distributed further north. Using microsatellites, the southern clade matched with a well‐defined southern nuclear cluster, whilst the two northern clades from southern Africa corresponded to another nuclear cluster with three subclusters. One subcluster had a western and central distribution, another occurred mostly in the north‐east, and the third in a small eastern region (Maputaland), which forms part of a biodiversity hotspot. Genetic diversity was low in the south and high in the north of our study region, particularly in the north‐east. Our results refuted that translocations influenced the genetic structure of leopard tortoises substantially. We propose that Pleistocene climatic fluctuations caused leopard tortoises to retract to distinct refugia in southern and northern regions and ascribe the high genetic diversity in the north of southern Africa to genetic structuring caused by the survival in three refuges and subsequent admixture, whereas tortoises in the south seem to have survived in only one continuous coastal refuge.
Experiences of compassion fatigue in direct care nurses: a qualitative systematic review
Authors: Salmond Erin , Salmond Susan , Ames Margaret , Kamienski Mary , Holly Cheryl 
Published: November 2018

ABSTRACT

Objective:
The objective of this review was to describe the experiences of direct care nurses with work-related compassion fatigue.

Introduction:
The cumulative demands of experiencing and helping others through suffering have been considered to contribute to the potential of compassion fatigue. However, there is a lack of clarity on what specifically contributes to and constitutes compassion fatigue. Nurses suffering from compassion fatigue experience physical and emotional symptoms that leave them disconnected from patients and focused on the technical rather than the compassionate components of their role. This disconnect can also affect personal relationships outside of work.

Inclusion criteria:
This review included any qualitative studies describing the experiences of direct care nurses from any specialty or any nursing work setting.

Methods:
This review followed the Joanna Briggs Institute (JBI) approach for qualitative systematic reviews. Studies included in this review include those published in full text, English and between 1992, when the concept of compassion fatigue was first described, and May 2017, when the search was completed. The main databases searched for published and unpublished studies included: PubMed, CINAHL, Academic Search Premiere, Science Direct, Scopus, PsycINFO, Web of Science and the Virginia Henderson Library.

Results:
Twenty-three papers, representing studies conducted in seven countries and 821 total nurse participants, met the criteria for inclusion. From these, a total of 261 findings were extracted and combined to form 18 categories based on similarity in meaning, and four syntheses were derived: i) Central to the work of nursing and the professional environment in which nurses work are significant psychosocial stressors that contribute to compassion stress and, if left unchecked, can lead to compassion fatigue; ii) Protection against the stress of the work and professional environment necessitates that the individual and team learn how to respond to “the heat of the moment”; iii) Nurses and other administrative and colleague staff should be alert to the symptoms of compassion fatigue that present as profound, progressive, physical and emotional fatigue: a feeling that the nurse just can’t go on and a sense of being disconnected and drained, like a gas tank on empty; and iv) Keeping compassion fatigue at bay requires awareness of the threat of compassion fatigue, symptoms of compassion fatigue, and the need for work-life balance and active self-care strategies.

Conclusions:
The major conclusions of this review are that compassion fatigue prevention and management must be acknowledged, and both personal and organizational coping strategies and adaptive responses are needed to keep nurses balanced, renewed and able to continue compassionate connection and caring.
Calcineurin–AKAP interactions: therapeutic targeting of a pleiotropic enzyme with a little help from its friends
Authors: Gildart Moriah , Kapiloff Michael S. , Dodge‐Kafka Kimberly L. 
Published: November 2018

AbstractThe ubiquitous Ca2+/calmodulin‐dependent phosphatase calcineurin is a key regulator of pathological cardiac hypertrophy whose therapeutic targeting in heart disease has been elusive due to its role in other essential biological processes. Calcineurin is targeted to diverse intracellular compartments by association with scaffold proteins, including by multivalent A‐kinase anchoring proteins (AKAPs) that bind protein kinase A and other important signalling enzymes determining cardiac myocyte function and phenotype. Calcineurin anchoring by AKAPs confers specificity to calcineurin function in the cardiac myocyte. Targeting of calcineurin ‘signalosomes’ may provide a rationale for inhibiting the phosphatase in disease.
Mental health-related emergency department presentations and hospital admissions in a cohort of urban Aboriginal children and adolescents in New South Wales, Australia: findings from SEARCH
Authors: Williamson Anna , Skinner Adam , Falster Kathleen , Clapham Kathleen , Eades Sandra J , Banks Emily 
Published: November 2018

ObjectivesThe aim of the current study is to quantify mental health-related emergency department (ED) presentations and hospitalisations, and associated child and family characteristics, in children recruited through four Aboriginal Community Controlled Health Organisations.SettingFour Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban or large regional centres in New South Wales, Australia.Participants1476 Aboriginal children aged 0–17 years at recruitment to the Study of Environment on Aboriginal Resilience and Child Health.Primary outcome measuresED presentations and hospital admissions with a primary mental health diagnosis obtained via linkage to population health datasets.ResultsOver a median of 6-year follow-up, there were 96 ED presentations affecting 62 children (10.7/1000 person-years) and 49 hospitalisations affecting 34 children (5.5/1000 person-years) for mental health conditions. Presentations/admissions increased with age. ED presentation was increased with: living in foster versus parental care (adjusted rate ratio (RR)=3.97, 95% CrI 1.26 to 11.80); high versus low baseline child emotional/behavioural problems (adjusted RR=2.93, 95% CrI 1.50 to 6.10); and caregiver chronic health conditions versus none (adjusted RR=2.81, 95% CrI 1.31 to 6.63). Hospitalisations were significantly increased with caregiver unemployment versus home duties (adjusted RR=4.48, 95% CrI 1.26 to 17.94) and caregiver chronic health problems versus none (adjusted RR=3.83, 95% CrI 1.33 to 12.12).ConclusionsTertiary care for mental health issues was relatively common among participating Aboriginal children, with risk elevated for those living in foster care, with prior mental health and behavioural problems and with carers with chronic illness and/or unemployment. While this study suggests high rates of serious mental health events among children from participating communities, the optimum means for reducing these rates, and the need for tertiary care, has not yet been determined. Such information is urgently required to inform policy and programmes to support Aboriginal child and adolescent mental health.
Exploring variation in how ambulance services address non-conveyance: a qualitative interview study
Authors: Knowles Emma , Bishop-Edwards Lindsey , O’Cathain Alicia 
Published: November 2018

ObjectivesThere is considerable variation in non-conveyance rates between ambulance services in England. The aim was to explore variation in how each ambulance service addressed non-conveyance for calls ending in telephone advice and discharge at scene.DesignA qualitative interview study.SettingTen large regional ambulance services covering 99% of the population in England.ParticipantsBetween four and seven interviewees from each ambulance service including managers, paramedics and healthcare commissioners, totalling 49 interviews.MethodsTelephone semistructured interviews.ResultsThe way interviewees in each ambulance service discussed non-conveyance within their organisation varied for three broad themes. First, ambulance service senior management appeared to set the culture around non-conveyance within an organisation, viewing it either as an opportunity or as a risky endeavour. Although motivation levels to undertake non-conveyance did not appear to be directly affected by the stability of an ambulance service in terms of continuity of leadership and externally assessed quality, this stability could affect the ability of the organisation to innovate to increase non-conveyance rates. Second, descriptions of workforce configuration differed between ambulance services, as well as how this workforce was used, trained and valued. Third, interviewees in each ambulance service described health and social care in the wider emergency and urgent care system differently in terms of availability of services that could facilitate non-conveyance, the amount of collaborative working between health and social care services and the ambulance service and complexity related to the numbers of services and healthcare commissioners with whom they had to work.ConclusionsThis study suggests that factors within and outside the control of ambulance services may contribute to variation in non-conveyance rates. These findings can be tested in a quantitative analysis of factors affecting variation in non-conveyance rates between ambulance services in England.
Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014–2016
Authors: Sharapova Saida , Reyes-Guzman Carolyn , Singh Tushar , Phillips Elyse , Marynak Kristy L , Agaku Israel 
Published: November 2018

IntroductionTobacco use mostly begins in adolescence and young adulthood. Earlier age of initiation of cigarette smoking is associated with greater nicotine dependence and sustained tobacco use. However, data are limited on the age of initiation of non-cigarette tobacco products, and the association between using these products and nicotine dependence and progression to established use.MethodsCombined 2014–2016 National Youth Tobacco Survey data, a nationally representative cross-sectional survey of US students in grades 6–12 yielded 19 580 respondents who reported ever using any of five tobacco products: electronic cigarettes, cigarettes, cigars, smokeless tobacco and hookah. Analyses assessed age of reported first use of each product among ever-users, overall and by sex and race/ethnicity. Current daily use, past 30-day use, feelings of craving tobacco and time to first tobacco use after waking were assessed by age of first use.ResultsAmong ever-users, weighted median age for first use was 12.6 years for cigarettes, 13.8 years for cigars, 13.4 years for smokeless tobacco, 14.1 years for hookah and 14.1 years for e-cigarettes. First trying these tobacco products at age ≤13 years was associated with greater current use of the respective product and nicotine dependence compared with initiating use at age >13 years.ConclusionsFirst tobacco use at age ≤13 years is associated with current daily and past 30-day use of non-cigarette tobacco products, and with the development of nicotine dependence among youth ever-users. Proven tobacco prevention interventions that reach early adolescents are important to reduce overall youth tobacco use.
TLR Signaling Is Activated in Lymph Node–Resident CLL Cells and Is Only Partially Inhibited by Ibrutinib
Authors: Dadashian Eman L. , McAuley Erin M. , Liu Delong , Shaffer Arthur L. , Young Ryan M. , Iyer Jessica R. , Kruhlak Michael J. , Staudt Louis M. , Wiestner Adrian , Herman Sarah E. M. 
Published: November 2018

Abstract

Chronic lymphocytic leukemia (CLL) is a malignancy of mature B cells driven by B-cell receptor (BCR) signaling and activated primarily in the lymph node. The Bruton's tyrosine kinase (BTK) inhibitor ibrutinib effectively inhibits BCR-dependent proliferation and survival signals and has emerged as a breakthrough therapy for CLL. However, complete remissions are uncommon and are achieved only after years of continuous therapy. We hypothesized that other signaling pathways that sustain CLL cell survival are only partially inhibited by ibrutinib. In normal B cells, Toll-like receptor (TLR) signaling cooperates with BCR signaling to activate prosurvival NF-κB. Here, we show that an experimentally validated gene signature of TLR activation is overexpressed in lymph node–resident CLL cells compared with cells in the blood. Consistent with TLR activation, we detected phosphorylation of NF-κB, STAT1, and STAT3 in lymph node–resident CLL cells and in cells stimulated with CpG oligonucleotides in vitro. CpG promoted IRAK1 degradation, secretion of IL10, and extended survival of CLL cells in culture. CpG-induced TLR signaling was significantly inhibited by both an IRAK1/4 inhibitor and ibrutinib. Although inhibition of TLR signaling was incomplete with either drug, the combination achieved superior results, including more effective inhibition of TLR-mediated survival signaling. Our data suggest an important role for TLR signaling in CLL pathogenesis and in sustaining the viability of CLL cells during ibrutinib therapy. The combination of ibrutinib with a TLR pathway inhibitor could provide superior antitumor activity and should be investigated in clinical studies.

Significance:
CLL relies on the concomitant cooperation of B-cell receptor and Toll-like receptor signaling; inhibition of both pathways is superior to inhibition of either pathway alone.