bluuebunny/crossref_metadata_2025 huggingface dataset:
tomm22 Knockdown-Mediated Hepatocyte Damages Elicit Both the Formation of Hybrid Hepatocytes and Biliary Conversion to Hepatocytes in Zebrafish Larvae
Authors: Wu Jianchen , Choi Tae-Young , Shin Donghun
Published: March 2017

The liver has a highly regenerative capacity. In the normal liver, hepatocytes proliferate to restore lost liver mass. However, when hepatocyte proliferation is impaired, biliary epithelial cells (BECs) activate and contribute to hepatocytes. We previously reported in zebrafish that
upon severe hepatocyte ablation, BECs extensively contribute to regenerated hepatocytes. It was also speculated that BEC-driven liver regeneration might occur in another zebrafish liver injury model in which temporary knockdown of the mitochondrial import gene tomm22 by morpholino antisense
oligonucleotides (MO) induces hepatocyte death. Given the importance of multiple BEC-driven liver regeneration models for better elucidating the mechanisms underlying innate liver regeneration in the diseased liver, we hypothesized that BECs would contribute to hepatocytes in tomm22
MO-injected larvae. In this MO-based liver injury model, by tracing the lineage of BECs, we found that BECs significantly contributed to hepatocytes. Moreover, we found that surviving, preexisting hepatocytes become BEC‐hepatocyte hybrid cells in tomm22 MO-injected larvae. Intriguingly,
both the inhibition of Wnt/β-catenin signaling and macrophage ablation suppressed the formation of the hybrid hepatocytes. This new liver injury model in which both hepatocytes and BECs contribute to regenerated hepatocytes will aid in better understanding the mechanisms of innate liver regeneration in the diseased liver.
Economic Evaluation of Brentuximab Vedotin for Persistent Hodgkin Lymphoma
Authors: Babashov V. , Begen M.A. , Mangel J. , Zaric G.S.
Published: March 2017

Background: We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin lymphoma (hl) in the post–autologous stem-cell transplantation (asct) failure period, from the perspective of the Canadian health care payer. Methods: We developed a decision-analytic model to simulate lifetime costs and benefits of brentuximab vedotin compared with best supportive care for the treatment of patients with hl after failure of asct. Administrative data from Ontario were used to set the model parameters. Results: In the base case, treatment with brentuximab vedotin resulted in incremental quality-adjusted life-years (qalys) of 0.544 and an incremental cost of $89,366 per patient, corresponding to an incremental cost-effectiveness ratio (icer) of $164,248 per qaly gained. The icer was sensitive to the cost of brentuximab vedotin, the hazard ratio used to assess the efficacy of brentuximab vedotin treatment, and health state utilities. Conclusions: In light of the available information, brentuximab vedotin has an icer exceeding $100,000 per qaly gained, which is a level often classified as having “weak evidence for adoption and appropriate utilization” in Canada. However, it is worth noting that provincial cancer agencies take into account not only the costs and associated icer, but also other factors such as a lack of alternative treatment options and the clinical benefits of expensive cancer drugs. Pricing arrangements should be negotiated, and risk-sharing agreements or patient access schemes should be explored.
Listening through Narratives: Using a Narrative Approach When Discussing Fertility Preservation Options with Young Cancer Patients
Authors: Roher S.I.G. , Gibson J. , Gibson B.E. , Gupta A.A.
Published: March 2017

Despite clinical practice guideline recommendations mandating that fertility preservation be discussed with young cancer patients, many providers fail to initiate such discussions with adolescents. Researchers and clinicians often focus on system-level changes to improve access to fertility preservation for adolescents and young adults in Canada. However, little of the available information considers the way in which health care providers approach those discussions. Research has shown that, even when fertility preservation options are broached with adolescents, survivors often report dissatisfaction with those conversations, thus raising additional concerns about their content and quality. Here, we consider how a narrative approach—and the Frank narrative typology in particular—could improve the quality of such conversations by helping providers to more accurately and thoughtfully respond to the needs of adolescent patients when discussing the possibility of fertility preservation. Based on findings from a qualitative research project, we provide concrete suggestions for how to more sensitively approach fertility preservation conversations with male adolescent cancer patients and survivors.
Exercise Guidelines for Cancer Survivors: Are Fitness and Quality-of-life Benefits Enough to Change Practice?
Authors: Courneya K.S.
Published: March 2017

Since the mid-1980s, exercise has been tested as an intervention strategy to help cancer patients prepare for treatments, cope with treatments, and recover after treatments. [...]
Updates from the 2016 American Society of Hematology Annual Meeting: Practice-Changing Studies in Untreated Follicular Lymphoma
Authors: Owen C. , MacDonald D. , Aw A. , Christofides A.
Published: March 2017

The 2016 annual meeting of the American Society of Hematology took place in San Diego, California, 3–6 December. At the meeting, results from key studies on the first-line treatment of follicular lymphoma were presented. Of those studies, key oral presentations included two analyzing data from the gallium study, which evaluated the efficacy and safety of obinutuzumab plus chemotherapy (G-chemo) compared with rituximab plus chemotherapy (R-chemo), followed, in responding patients with follicular lymphoma, by obinutuzumab or rituximab maintenance; results from the sabrina study, which evaluated the efficacy and safety of subcutaneous compared with intravenous rituximab; results of a cost-effectiveness analysis of first-line treatment with bendamustine and rituximab from a Canadian perspective; and results from the SAKK 35/10 study, which evaluated the safety and efficacy of rituximab plus lenalidomide compared with rituximab monotherapy. Our meeting report describes the foregoing studies and includes interviews with the Canadian investigators, plus commentaries by those investigators about the potential impact on Canadian practice.
The Plant Orthology Browser: An Orthology and Gene‐Order Visualizer for Plant Comparative Genomics
Authors: Tulpan Dan , Leger Serge
Published: March 2017

Worldwide genome sequencing efforts for plants with medium and large genomes require identification and visualization of orthologous genes, while their syntenic conservation becomes the pinnacle of any comparative and functional genomics study. Using gene models for 20 fully sequenced plant genomes, including model organisms and staple crops such as Aegilops tauschii Coss., Arabidopsis thaliana (L.) Heynh., Brachypodium distachyon (L.) Beauv., turnip (Brassica rapa L.), barley (Hordeum vulgare L.), rice (Oryza sativa L.), sorghum [Sorghum bicolor (L.) Moench], wheat (Triticum aestivum L.), red wild einkorn (Triticum urartu Tumanian ex Gandilyan), and maize (Zea mays L.), we computationally predicted 1,021,611 orthologs using stringent sequence similarity criteria. For each pair of plant species, we determined sets of conserved synteny blocks using strand orientation and physical mapping. Gene ontology (GO) annotations are added for each gene. Plant Orthology Browser (POB) includes three interconnected modules: (i) a gene‐order visualization module implementing an interactive environment for exploration of gene order between any pair of chromosomes in two plant species, (ii) a synteny visualization module providing unique interactive dot plot representations of orthologous genes between a pair of chromosomes in two distinct plant species, and (iii) a search module that interconnects all modules via free‐text search capability with online as‐you‐type suggestions and highlighting that allows exploration of the underlining information without constraint of interface‐dependent search fields. The POB is a web‐based orthology and annotation visualization tool, which currently supports 20 completely sequenced plant species with considerably large genomes and offers intuitive and highly interactive pairwise comparison and visualization of genomic traits via gene orthology.
Search for Interstellar LiH in the Milky Way
Authors: Neufeld David A. , Goldsmith Paul F. , Comito Claudia , Schmiedeke Anika
Published: March 2017

We report the results of a sensitive search for the 443.952902 GHz

transition of the lithium hydride (LiH) molecule toward two interstellar clouds in the Milky Way, W49N and Sgr B2 (Main), that has been carried out using the Atacama Pathfinder Experiment telescope. The results obtained toward W49N place an upper limit of

on the LiH abundance,

, in a foreground, diffuse molecular cloud along the sight line to W49N, corresponding to 0.5% of the solar system lithium abundance. Those obtained toward Sgr B2 (Main) place an abundance limit 

in the dense gas within the Sgr B2 cloud itself. These limits are considerably smaller that those implied by the tentative detection of LiH reported previously for the z = 0.685 absorber toward B0218+357.
High Lyman Continuum Escape Fraction in a Lensed Young Compact Dwarf Galaxy at z = 2.5
Authors: Bian Fuyan , Fan Xiaohui , McGreer Ian , Cai Zheng , Jiang Linhua
Published: March 2017

We present the HST WFC3/F275W UV imaging observations of A2218-Flanking, a lensed compact dwarf galaxy at redshift

. The stellar mass of A2218-Flanking is

and SFR is

yr−1 after correcting the magnification. This galaxy has a young galaxy age of 127 Myr and a compact galaxy size of

. The HST UV imaging observations cover the rest-frame Lyman continuum (LyC) emission (∼800 Å) from A2218-Flanking. We firmly detect (

) the LyC emission in A2218-Flanking in the F275W image. Together with the HST F606W images, we find that the absolute escape fraction of LyC is

based on the flux density ratio between 1700 and 800 Å (

). The morphology of the LyC emission in the F275W images is extended and follows the morphology of the UV continuum morphology in the F606W images, suggesting that the f
800 is not from foreground contaminants. We find that the region with a high star formation rate surface density has a lower

(higher

) ratio than the diffused regions, suggesting that LyC photons are more likely to escape from the region with the intensive star-forming process. We compare the properties of galaxies with and without LyC detections and find that LyC photons are easier to escape in low-mass galaxies.
Analysis of NATO and EU Approaches to Capability Planning Process
Authors: Petráš Zdeněk
Published: March 2017

The aim of the article is to bring out results of the comparative analysis of NATO and EU defence planning processes. The comparative analysis was focused on identification of those findings which are identical for both NATO and the EU and which might be also beneficial for optimising the national defence planning process within the Czech Ministry of Defence. From this perspective, the key analysis outcome is identification of similar phases which were found out while comparing respective NATO´s and EU´s planning tools, i.e. J-DARTS and SAEP Process. Even if NATO and the EU are using a different terminology and different approaches to achieve expected results, the substance of respective phases is almost identical. A course of action how to implement the analysis outcomes into the national defence planning process might be the subject of a follow on research.
Entre sécurité des soins et injonctions à la performance économique au bloc opératoire : faut-il choisir ?
Authors: Gentil Stéphanie
Published: March 2017

Dans un contexte où les établissements de santé sont incités à l’efficience, tout en devant répondre à des impératifs de sécurité des soins, l’article interroge les complémentarités possibles entre ces deux types de performance. La question de la sécurité des soins est explorée sous l’angle des recherches sur les « Organisations hautement fiables » (HRO), en adoptant une lecture « gestionnaire » de ce courant, à travers l’étude des dispositifs organisationnels, rarement abordés en tant que tels dans les écrits sur les HRO [Lorino, 2005 ; Brabet, 2005]. L’étude empirique de deux blocs opératoires met à l’épreuve des faits, et du contexte de rationalisation économique actuel, les principes décrits par le courant des HRO. Elle révèle que les dispositifs organisationnels développés dans le cadre de la rationalisation économique peuvent aussi répondre à des impératifs de sécurité des soins. La complémentarité entre logiques d’efficience et de sécurité repose toutefois sur le travail d’adaptation des dispositifs que réalisent les personnels paramédicaux face à l’événement. La survenue d’événements au bloc opératoire requiert un pilotage de ces performances au plus près de l’activité. Cette proposition appelle à ouvrir la « boîte noire » de l’activité, en déplaçant le regard des directions du travail de structuration en amont de l’action vers le travail d’organisation effectivement réalisé par les personnels soignants, afin de mieux le prendre en compte et le faciliter.
Les enjeux de la sécurité des objets connectés et applications de santé
Authors: Allaert François-André , Mazen Noël-Jean , Legrand Louis , Quantin Catherine
Published: March 2017

Le marché des objets connectés et des applications de santé (OCS) est en plein essor et devrait représenter plusieurs milliards d’euros de chiffre d’affaires dans les prochaines années. Leur développement aura un impact similaire à ce que nous avons connu avec le développement d’internet au début de ce siècle mais plus encore il devrait bouleverser l’organisation de notre système de santé, changer profondément les modalités de prise en charge des patients et révolutionner la prévention, mais il pourrait aussi remettre en question le secret médical et la protection des données personnelles. Cet article analyse les conséquences sociétales des OCS, la nécessité d’une double évaluation médicale et éthique et l’impérative nécessité de l’établissement d’un référentiel de sécurité auxquels pourront se conformer les industriels dans l’optique d’un contrôle non pas a priori mais a posteriori pour ne pas bloquer l’innovation.
La qualité de l’offre des services par les professionnels de santé au Cameroun : cas d’expérimentation dans les hôpitaux publics de Yaoundé à travers une analyse qualitative inductive
Authors: Nguina Ekeme Paulin-Bertrand , Awomo Ndongo Jean Colbert
Published: March 2017

L’objectif de cet article est d’étudier la façon dans laquelle les professionnels de santé conçoivent, mettent en œuvre et évaluent les services de santé qu’ils offrent aux patients, dans l’optique d’une amélioration de leur qualité dans les formations sanitaires au Cameroun, plus précisément dans 5 hôpitaux publics de différentes catégories de la ville de Yaoundé. Au terme d’une analyse qualitative inductive, il ressort de cette étude que ces formations sanitaires, ne disposant pas encore de normes d’accréditation, les professionnels de santé qui y travaillent apprécient de manière subjective la qualité des services qu’ils offrent. L’accueil, le dialogue, l’appréciation des services rendus par les usagers et les parties prenantes constituent ainsi les principaux critères sur lesquels ils se basent. Puisque la qualité est conçue comme un construit multidimensionnel et hiérarchique dont les critères doivent être adaptés au contexte socio-culturel dans lequel l’évaluation est pratiquée, cet article fait ressortir les paramètres de la qualité des services offerts dans le contexte des organisations étudiées. Cet apport permettrait aux décideurs publics et autres partenaires du secteur de la santé camerounais de mieux structurer les critères d’appréciation de la qualité des services de santé tout en tenant compte des normes d’accréditations universelles comme celles de l’Organisation Mondiale de la Santé. Ce qui améliorerait le bien-être des populations bénéficiaires. Conflits d’interêts : aucun.
Chapter 3. Bioethics diversity and a possible “Global Bioethics”: Reflections from the perspective of the social system
Authors: Morishita Naoki
Published: March 2017

Que veut dire la soi-disante diversité de la bioéthique ? Une bioéthique universaliste est-elle possible ? La diversité des dimensions historique, structurelle ou idéologique du système social sont la cause de la diversité de la bioéthique. Les idées universalistes d’une ‘bioéthique globale’ sont considérées comme rien d’autre que des illusions impérialistes au sein du modèle de consensus pour résoudre des lacunes de communication. S’il existe une bioéthique globale tout à fait différente, elle est possible en tant que médiateur à l’intérieur du modèle parallèle, qui fournit quelques suggestions à chaque partie dans le conflit, admettant différentes diversités des trois dimensions de tous les systèmes.
Une nation, avec des caractéristiques taiwanaises
Authors: Dubois de Prisque Emmanuel
Published: March 2017

L’émergence de l’identité taïwanaise à Taiwan s’est faite contre la Chine, tout contre. La lecture de trois ouvrages parus récemment aux éditions René Viénet nous aide à en retracer le cheminement, de l’immédiat après-guerre à l’époque contemporaine.
La culture démocratique chilienne : des origines à la crise de légitimité contemporaine
Authors: Montero Darío
Published: March 2017

Les récentes protestations semblent exprimer une profonde critique de la démocratie, et de la manière dont cet idéal moderne a été interprété et mis en pratique au Chili. La crise actuelle de légitimité peut se comprendre comme une confrontation entre deux imaginaires sociaux dont les origines remontent à la période initiale de la république, et qui, prit ensemble, constituent la culture démocratique chilienne. Dans cette perspective de long terme, le présent article cherche à comprendre le « choc fondateur » d’auto-compréhensions politiques qui eurent lieu entre 1810 et 1833, en montrant comment celui-ci détermina la trajectoire et les caractéristiques de cette culture démocratique telle que nous la connaissons aujourd’hui. Depuis le début du xix e  siècle, un imaginaire libéral-individualiste, teinté d’éléments autoritaires hérités de la période coloniale, entra en conflit avec un imaginaire populaire-démocratique, coextensif à tous les peuples hispano-américains, qui affirmait la valeur de la communauté et de la participation citoyenne au niveau local. Les mouvements sociaux, surtout de type « politico-constituants » comme ceux qui ont émergé au Chili depuis 2006, sont interprétés ici comme héritiers de cet imaginaire populaire originel et, par conséquent, constituent des exemples où émerge une crise d’allégeance envers les pratiques et institutions politiques officielles.
La légitimation des inégalités socio-économiques au Chili
Authors: Théodore Rachel
Published: March 2017

Dans cet essai, nous proposons une réflexion sur la légitimation des grandes inégalités socio-économiques au sein de la société chilienne. Selon nous, cette société s’est construite autour d’un imaginaire social fondé sur l’idée de hiérarchie. Cette représentation hiérarchique de l’ordre social a pour conséquence principale l’existence d’une inégalité morale fondamentale entre les individus, fondée sur une inégalité de considération , qui se matérialise au travers d’un éventail de marqueurs, de distinctions et discriminations au plan social. Cette inégalité morale est donc véhiculée par les mœurs et les pratiques sociales, qui reproduisent un agencement de l’ordre social hérité de l’histoire particulière du pays et légitime intrinsèquement les inégalités socio-économiques. Cependant, cette mentalité inégalitaire s’est lentement effritée sous l’action d’un l’idéal égalitaire qui s’est progressivement déployé depuis les années 1950 et qui remet de plus en plus en cause les anciennes représentations collectives, créant des tensions croissantes au sein de la société.
Plus de « pre-textes » pour lire José Donoso
Authors: Galarraga-Oropeza Víctor
Published: March 2017

Dans une première lecture des manuscrits conservés dans la Bibliothèque de l’Université d’Iowa, et en suivant quelques fondamentaux de la génétique textuelle, cet article explore les liens de filiation très peu discutés entre deux ouvrages du chilien José Donoso, notamment Ce lieu sans limites (1966) et L’obscène oiseau de la nuit (1970). Les denses relations intertextuelles et le complexe processus de composition mis en évidence par les manuscrits offrent aux lecteurs de nouveaux éléments pour lire (et relire) non seulement ces deux romans mais peut-être l’œuvre entière de Donoso. Ils contribuent également à rendre plus complexes et productives les discussions au tour des sujets controversés – marginaux – comme la (homo)sexualité dans l’œuvre de l’auteur latino-américain.
Comprendre le phénomène de dépendance envers les réseaux sociaux numériques : les effets de l’habitude et de la surcharge informationnelle dans le cas de Facebook
Authors: Kefi Hajer , Mlaiki Alya , Kalika Michel
Published: March 2017

Les réseaux sociaux numériques (RSN) connaissent un développement exponentiel sans précédent. Certains de leurs usages pourraient en revanche induire des effets négatifs sur les individus et les organisations, et sont entrain, à ce titre, de susciter l’intérêt d’un courant émergent de la recherche. Cet article vise particulièrement à comprendre un de ces effets : le phénomène de dépendance à ces plateformes. Une large revue de la littérature en management des systèmes d’information et en psychosociologie est mobilisée à cet effet. Elle donne lieu à un modèle explicatif original qui stipule que l’utilité perçue et la maîtrise comportementale perçue peuvent contribuer à l’installation d’habitudes d’usage et à une surcharge informationnelle, qui conjointement et, sous l’effet de l’influence sociale, peuvent conduire à une dépendance perçue. Ce modèle est testé grâce à une enquête en ligne auprès d’une population de 248 utilisateurs de Facebook en utilisant la méthode PLS appliquée à la modélisation par les équations structurelles. Les résultats obtenus permettent de confirmer le rôle central joué par l’habitude et la surcharge informationnelle dans ce mécanisme, selon le type d’usage considéré (professionnel et/ou privé) et où l’on relève un impact significatif de l’effet genre. Les implications théoriques et managériales de ce travail, ainsi que les voies de recherche ultérieures auxquelles il peut ouvrir la voie, sont ensuite discutées.
The Leader–Clinician Advocate in Advancing Student Clinical Learning
Authors: Bleich Michael R.
Published: March 2017

The visionary, think-ahead leader realizes a responsibility to ensure that a steady pipeline of qualified professionals exists. In the settings where they lead, academic partnerships can ensure that students are socialized and adequately prepared for existing and emerging job roles. Concept-based learning, NCLEX-RN test plans, and 12 strategies to ensure leader–clinician engagement with students are presented.

J Contin Educ Nurs.
2017;48(3):99–101.
Proyecto POLCOR. Análisis de las políticas deportivas en los programas electorales
Authors: Táboas-Pais María Inés , Canales-Lacruz Inma , Rey-Cao Ana
Published: March 2017

Este artículo presenta un análisis del discurso político, vinculado a las prácticas físico-deportivas, de los partidos que concurrieron a las elecciones generales del año 2011 en España. El sistema de codificación desarrollado permite identificar mediante el análisis de contenido de los programas electorales los posicionamientos ideológicos, las preferencias y principales propuestas de actuación política de los partidos respecto al deporte y otras prácticas corporales. Los resultados del análisis de contenido mostraron un discurso homogeneizador centrado en la economía de la salud y el rendimiento deportivo, y en él adquieren importancia las propuestas a favor de unir la cultura corporal con el medio ambiente. Frente a este discurso dominante se constató la existencia de voces divergentes. Estos hallazgos evidencian las principales propuestas de actuación política y capitales hegemónicos en el campo de las actividades físico-deportivas.
Ethical Use in the Teaching of ICT and Initial Teacher Training
Authors: Nuzzaci Antonella
Published: March 2017

The use of technology within the field of education by those who are responsible for the training of teachers has not always been an undisputed subject of discussion. The ethical issues are often linked to the use of new media within the field of education, and the procedural and logistic difficulties are identified as the main sources of concern in the professionalization of teachers; difficulties which sometimes lead to unjustified hypotheses on the social and educational nature of training. The relationship among quality, ethics and technology requires the development of new literacy prospects and innovative training methods to operate through information and communication networks that are able to widen the repertoire of teachers and of cultural and professional educators. Similarly, the quality of their teaching activity strictly relies on the political support shown towards their professional development. The study reports on the development of tools that try to understand the point of view of initial training teachers on the ethical use of technology within the field of education, by making use of the competence indicators available in the literature, and investigates their level of ethical awareness with regard to the multimodal and multicultural nature of ICT. The study focuses on the validation of the tools described above, and especially on the “ethical dilemmas” of future teachers in the use of ICT and on their degree of “ethical awareness,” by referring to the results of previous international studies.
Considerations for Medication Management and Anticoagulation During Continuous Renal Replacement Therapy
Authors: Thompson Ashley , Li Fanny , Gross A. Kendall
Published: March 2017

Providing safe and high-quality care to critically ill patients receiving continuous renal replacement therapy (CRRT) includes adequate drug dosing and evaluation of patients’ response to medications during therapy. Pharmacokinetic drug studies in acute kidney injury and CRRT are limited, considering the number of medications used in critical care. Therefore, it is important to understand the basic principles of drug clearance during CRRT by evaluating drug properties, CRRT modalities, and how they affect medication clearance. Few published studies have addressed drug disposition and clinical response during CRRT. Additionally, clotting in the CRRT circuit is a concern, so a few options for anticoagulation strategies are presented. This article reviews (1) the CRRT system and drug property factors that affect medication management, (2) the evidence available to guide drug dosing, and (3) anticoagulation strategies for critically ill patients receiving CRRT.
Continuous Renal Replacement Therapy: Case Vignettes
Authors: Garwood Charlotte , Sandoval Cass Piper , Wonnacott Robert , Sadler Craig , Dirkes Susan
Published: March 2017

The most common indication for continuous renal replacement therapy (CRRT) in critically ill patients is acute kidney injury with hemodynamic instability. Typically, the patient has metabolic disturbances and potential or actual fluid overload that require intervention. Certain critical care diagnoses and/or conditions or therapies present unique CRRT management approaches. Case vignettes are used to present the unique management of CRRT in critically ill patients with rhabdomyolysis, heart failure, and respiratory failure requiring extracorporeal membrane oxygenation.
Continuous Renal Replacement Therapy Update: An Emphasis on Safe and High-Quality Care
Authors: Schell-Chaple Hildy
Published: March 2017

Continuous renal replacement therapy (CRRT) was introduced more than 40 years ago as a renal support option for critically ill patients who had contraindications to intermittent hemodialysis and peritoneal dialysis. Despite being the most common renal support therapy used in intensive care units today, the tremendous variability in CRRT management challenges the interpretation of findings from CRRT outcome studies. The lack of standardization in practice and training of clinicians along with the high risk of CRRT-related adverse events has been the impetus for the recent expert consensus work on identifying quality indicators for CRRT programs. This article summarizes the potential complications that establish CRRT as a high-risk therapy and also the recently published best-practice recommendations for providing high-quality CRRT.
Antigen Density Dictates Immune Responsiveness following Red Blood Cell Transfusion
Authors: Arthur Connie M. , Patel Seema R. , Smith Nicole H. , Bennett Ashley , Kamili Nourine A. , Mener Amanda , Gerner-Smidt Christian , Sullivan Harold C. , Hale J. Scott , Wieland Andreas , Youngblood Benjamin , Zimring James C. , Hendrickson Jeanne E. , Stowell Sean R.
Published: March 2017

Although RBC transfusion can result in the development of anti-RBC alloantibodies that increase the probability of life-threatening hemolytic transfusion reactions, not all patients generate anti-RBC alloantibodies. However, the factors that regulate immune responsiveness to RBC transfusion remain incompletely understood. One variable that may influence alloantibody formation is RBC alloantigen density. RBC alloantigens exist at different densities on the RBC surface and likewise exhibit distinct propensities to induce RBC alloantibody formation. However, although distinct alloantigens reside on the RBC surface at different levels, most alloantigens also represent completely different structures, making it difficult to separate the potential impact of differences in Ag density from other alloantigen features that may also influence RBC alloimmunization. To address this, we generated RBCs that stably express the same Ag at different levels. Although exposure to RBCs with higher Ag levels induces a robust Ab response, RBCs bearing low Ag levels fail to induce RBC alloantibodies. However, exposure to low Ag–density RBCs is not without consequence, because recipients subsequently develop Ag-specific tolerance. Low Ag–density RBC–induced tolerance protects higher Ag–density RBCs from immune-mediated clearance, is Ag specific, and occurs through the induction of B cell unresponsiveness. These results demonstrate that Ag density can potently impact immune outcomes following RBC transfusion and suggest that RBCs with altered Ag levels may provide a unique tool to induce Ag-specific tolerance.
Impact of CRAB Symptoms in Survival of Patients with Symptomatic Myeloma in Novel Agent Era
Authors: Nakaya Aya , Fujita Shinya , Satake Atsushi , Nakanishi Takahisa , Azuma Yoshiko , Tsubokura Yukie , Hotta Masaaki , Yoshimura Hideaki , Ishii Kazuyoshi , Ito Tomoki , Nomura Shosaku
Published: March 2017

The acronym CRAB summarizes the most typical clinical manifestations of multiple myeloma, these being hypercalcemia, renal failure, anemia, and bone disease. CRAB can be used to distinguish between active, symptomatic multiple myeloma and monoclonal gammopathy of undermined significance or smoldering myeloma. The distinction is relevant not only for classification and diagnosis but also for therapy. CRAB factors influence the prognosis of multiple myeloma. However, it is unclear whether the presence of CRAB factors has an influence on the prognosis of myeloma treated with novel agents. In the current study, patients with hypercalcemia and bone disease showed a significantly worse prognosis, whereas anemia and renal failure showed no difference in survival. Novel agents used for treatment of patients with renal failure suggested a favorable outcome compared with conventional therapy. Bone disease was the most common factor and may have the strongest prognostic value in symptomatic myeloma patients using novel agents.
The Efficacy of Colchicine and Dapsone Combination Therapy in Relapsed Immune Thrombocytopenia
Authors: Rattanathammethee Thanawat , Theerajangkhaphichai Wasan , Rattarittamrong Ekarat , Hantrakool Sasinee , Chai-Adisaksopha Chatree , Norasetthada Lalita , Tantiworawit Adisak
Published: March 2017

The aim of the present paper is to evaluate the efficacy and safety of colchicine and dapsone combination therapy in cases of steroid-dependent, relapsed and refractory immune thrombocytopenia (ITP). This is a retrospective study of ITP patients who attended the Hematology Clinic at Chiang Mai University Hospital (Thailand) from 1 January 2008 to 30 September 2014. Medical records and clinical data were reviewed for efficacy and adverse effects. Sixty-four ITP patients received the combination therapy. The median age was 46 years and 70.3% were female. The majority (65.6%) were relapsed ITP patients. Median platelet count before starting treatment was 22.6 × 109/L. The response rate was 82.8%, with 75.0% of patients having a complete response. Median time to response was 8 weeks. The response rate was higher in relapsed patients (90.4%) compared to refractory (61.5%) and steroid-dependent patients (77.8%). Steroid treatment was discontinued in 30 patients (50%) following combination therapy. The most common side effect was hemolysis due to dapsone which was found in eight patients (12.5%). We can therefore conclude that combination therapy with colchicine and dapsone is an alternative second-line therapy option in relapsed ITP cases with acceptable side effects.
A case of schwannoma of the common peroneal nerve in the knee
Authors: Öz Tayyar Taylan , Aktaş Birol , Özkan Korhan , Özturan Burak , Kilic Bulent , Demiroğlu Murat
Published: March 2017

Schwannomas are benign neurogenic tumors of peripheral nerves that originate from neural sheath. The aim of this case report is to bring to mind the schwannoma in the patient with knee pain. A 39-year-old woman presented with a complaint of knee pain of three months history. After surgical intervention, the patient’s complaints completely disappeared in the post-operative period. This should come to mind in the differential diagnosis of knee pain.
A biomechanical comparison of 4-strand and 5-strand anterior cruciate ligament graft constructs
Authors: Broadhead Matthew L. , Singla Animesh A. , Bertollo Nicky , Broe David , Walsh William R.
Published: March 2017

Hamstring tendon autografts are used for reconstruction of the anterior cruciate ligament. This study tested the hypothesis that a 5-strand hamstring autograft construct is superior in strength to a 4-strand construct. Four-strand and 5-strand tendon grafts constructs were prepared from ovine flexor tendons and then tested in a uniaxial electromechanical load system with suspensory fixation. The 4-strand and 5-strand constructs were pre-conditioned, stressrelaxed and loaded to ultimate failure. Stress-relaxation, stiffness and ultimate load were compared using a one-way ANOVA. There were no statistical differences in stress-relaxation, initial stiffness, secondary stiffness or ultimate load between 4-strand and 5-strand split tendon graft constructs. Inconsistent failure patterns for both 4-strand and 5-strand constructs were observed. The additional strand in the 5-strand construct may be shielded from stress with additional weakness secondary to the use of suspensory fixation. The potential biological benefit of religamentization and bony integration, with more autologous tissue in the intra-articular space and bony tunnels remains unknown.
Differential Ability of Selected Postural-Control Measures in the Prediction of Chronic Ankle Instability Status
Authors: Knapp Danielle , Lee Sae Yong , Chinn Lisa , Saliba Susan A. , Hertel Jay
Published: March 2017

Context: Chronic ankle instability (CAI) is a term used to identify a condition associated with recurrent ankle sprains and persistent symptoms. Balance deficits, evaluated using center-of-pressure (COP) force-plate measurements, have been shown to occur in people with CAI.

Objective: To determine the differential abilities of selected force-plate postural-control measures to assess CAI.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: A total of 63 individuals with CAI (30 men, 33 women: age = 22.3 ± 3.7 years, height = 169.8 ± 9.6 cm, mass = 70.7 ± 14.3 kg) and 46 healthy controls (22 men, 24 women: age = 21.2 ± 4.1 years, height = 173.3 ± 9.2 cm, mass = 69.2 ± 13.2 kg) volunteered.

Intervention(s): Participants performed 3 10-second trials of quiet, single-limb stance on a force plate under 2 conditions: eyes open and eyes closed.

Main Outcome Measure(s): Measures of COP area, COP velocity, COP SD, COP range of excursion, percentage of COP range used, time-to-boundary absolute minimum, time-to-boundary mean of the minima, and time-to-boundary SD of the minima were calculated. All measures with the exception of COP area were calculated in both the mediolateral (ML) and anteroposterior directions. For each measure, a receiver operator curve analysis was created, and the corresponding area under the curve was tested. The optimal diagnostic threshold value for each measure was determined, and the corresponding positive and negative likelihood ratios were calculated.

Results: Three eyes-closed, single-limb force-plate measures (COP ML SD, ML percentage of COP range used, and time-to-boundary absolute minimum) predicted CAI status. However, all 3 measures had positive likelihood ratios associated with only small shifts in the probability of a patient with a positive test having CAI and negative likelihood ratios associated with very small shifts in the probability of a patient with a negative test not having CAI.

Conclusions: No single force-plate measure was very effective in predicting if an individual had CAI or not.
National Athletic Trainers' Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise
Authors: Turocy Paula Sammarone , DePalma Bernard F. , Horswill Craig A. , Laquale Kathleen M. , Martin Thomas J. , Perry Arlette C. , Somova Marla J. , Utter Alan C.
Published: March 2017

Objective: To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals.

Background: Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement.

Recommendations: Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance.
Stability of Measurement Outcomes for Voluntary Task Performance in Participants With Chronic Ankle Instability and Healthy Participants
Authors: Van Deun Sara , Stappaerts Karel , Levin Oron , Janssens Luc , Staes Filip
Published: March 2017

Context: Acceptable measurement stability during data collection is critically important to research. To interpret differences in measurement outcomes among participants or changes within participants after an intervention program, we need to know whether the measurement is stable and consistent.

Objective: To determine the within-session stability of muscle activation patterns for a voluntary postural-control task in a group of noninjured participants and a group of participants with chronic ankle instability (CAI).

Design: Descriptive laboratory study.

Setting: Musculoskeletal laboratory.

Patients or Other Participants: Twenty control participants (8 men, 12 women; age = 21.8 ± 2.4 years, height = 164.3 ± 13.4 cm, mass = 68.4 ± 17.9 kg) and 20 participants with CAI (12 men, 8 women; age = 21.2 ± 2.1 years, height = 176 ± 10.2 cm, mass = 71.7 ± 11.3 kg).

Intervention(s): Participants performed 4 barefoot standing trials, each of which included a 30-second double-legged stance followed by a 30-second single-legged stance in 3 conditions: with vision, without vision, and with vision on a balance pad.

Main Outcome Measure(s): The activity of 7 muscles of the lower limb was measured for the stance task in the 3 different conditions for each trial. The onset of muscle activity and muscle recruitment order were determined and compared between the first and the fourth trials for both groups and for each condition.

Results: We found no differences in the onset of muscle activity among trials for both groups or for each condition. The measurement error was 0.9 seconds at maximum for the control group and 0.12 seconds for the CAI group. In the control group, 70% to 80% of the participants used the same muscle recruitment order in both trials. In the CAI group, 75% to 90% used the same recruitment order.

Conclusions: Within 1 session, measurement stability for this task was acceptable for use in further research. Furthermore, no differences were found in measurement stability across conditions in the control or CAI groups.
Performance of Healthy Braced Participants During Aerobic and Anaerobic Capacity Tasks
Authors: Rishiraj Neetu , Taunton Jack E. , Niven Brian , Lloyd-Smith Robert , Regan William , Woollard Robert
Published: March 2017

Context: Knee braces were introduced in sports approximately 30 years ago. However, the effects of a functional knee brace (FKB) on aerobic and anaerobic performance after fatigue are unknown.

Objective: To investigate whether FKB use in noninjured participants hindered performance during aerobic (Léger beep test) and anaerobic (repeated high-intensity shuttle test [RHIST]) tasks.

Design: Crossover study.

Setting: Laboratory.

Patients or Other Participants: Twenty-seven healthy male provincial and national basketball and field hockey athletes (age = 19.4 ± 3.0 years, range, 17–26 years; height = 182.6 ± 6.8 cm, range, 168–196 cm; mass = 80.0 ± 9.1 kg, range, 66–108 kg).

Intervention(s): Each participant was provided a custom-fitted FKB and performed 5 nonbraced (NBR) testing sessions over 3 days, followed by 5 braced (BR) testing sessions over 3 days, for a total of 17.5 hours of testing per condition. During each testing session, participants performed 1 trial of the Léger beep test and 1 trial of the RHIST in each condition.

Main Outcome Measure(s): Predicted maximal oxygen consumption (V˙o2max) and time performance measures were recorded for each NBR and BR trial.

Results: Initial performance levels were lower for BR than NBR for both the Léger beep test (BR = 44.3 mL/kg/min, NBR = 47.3 mL/kg/min; F1,26 = 8.726; P = .007) and the RHIST (BR = 16.5 seconds, NBR = 16.2 seconds; F1,26 = 13.98, P = .001). However, with continued FKB use, the aerobic performance measure remained higher for only the first 2 BR testing sessions (NBR = 46.9 mL/kg/min, BR = 42.4 mL/kg/min; F3.0,79.8 = 4.95, P = .003). For the anaerobic test, no performance difference was noted between the testing conditions (NBR = 16.2 seconds, BR = 16.4 seconds; P = .7), whereas fatigue levels were lower during BR testing sessions (NBR = 33%, BR = 31%). After 14.0 hours of FKB use, performance levels were almost equal between the testing conditions (NBR = 47.6 mL/kg/min, BR = 46.1 mL/kg/min).

Conclusions: We found an initial decrement in performance when the FKB was used during an aerobic or anaerobic task. However, after 14.0 hours of FKB use, accommodation to the FKB was possible.
Risk of Hepatitis B and C Infections in Tehranian Wrestlers
Authors: Kordi Ramin , Neal Keith , Pourfathollah Ali Akbar , Mansournia Mohammad Ali , Wallace W. Angus
Published: March 2017

Context: Although bloodborne infections are among the most important global health issues, limited data are available on bloodborne infections in athletes.

Objective: To determine and compare the prevalence of markers of hepatitis B (HBV) and hepatitis C (HCV) viruses and the risk factors for these infections among wrestlers in Tehran and among a control group of athletes in the same geographic area who took part in low- to moderate-contact sports (ie, volleyball and soccer).

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: A total of 420 male wrestlers were randomly selected from 28 wrestling clubs in Tehran using a cluster-sample–setting method. The control group (205 volleyball players from 21 clubs and 205 soccer players from 16 clubs) was selected from the same geographic area.

Main Outcome Measure(s): The risk factors for HBV and HCV and serum levels of anti-HBcAg (antibodies to the HBV core antigen), HBsAg (HBV surface antigen), and anti-HCV (antibodies to HCV) in both groups.

Results: The prevalence of anti-HBcAg was 13.4% (95% confidence interval [CI] = 10.2%, 16.7%) in wrestlers and 10.9% (95% CI = 7.9%, 14.0%) in the control group. The prevalence of HBsAg was 1.2% (95% CI = 0.2%, 2.2%) in wrestlers and 0.5% (95% CI = −0.2%, 1.2%) in the control group. The prevalence of anti-HCV was 0.5% (95% CI = −0.2%, 1.1%) in wrestlers and 0 in the control group. Some risk factors for bloodborne infections were more common in the wrestlers than in the control group.

Conclusions: Within the limits of our study, we found no evidence that participation in Tehranian wrestling increased HBV or HCV transmission when compared with transmission in athletes participating in low- to moderate-contact sports. Prevention of bloodborne infections in Tehranian wrestlers should be focused not only on appropriate care for bleeding injuries but also on general risk factors for these conditions.