bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posttransfusion purpura with antibodies against human platelet antigen‐4a following checkpoint inhibitor therapy: a case report and review of the literature
Authors: Vu Khoan , Leavitt Andrew D. 
Published: September 2018

BACKGROUNDPosttransfusion purpura (PTP) is a rare condition characterized by severe thrombocytopenia following receipt of blood products. Most reported PTP cases involve alloantibodies directed against human platelet antigen (HPA)‐1a. We present a case of PTP‐mediated severe thrombocytopenia associated with alloantibodies directed against HPA‐4a in the setting of combination checkpoint inhibitor therapy.CASE REPORTA 62‐year‐old woman with rectal melanoma that progressed on combination checkpoint inhibitors (ipilimumab and nivolumab) was admitted for abdominoperineal resection. She received multiple blood products during surgery, and between the sixth and eighth days post‐surgery her platelet (PLT) count decreased from 126 × 109/L to a nadir of 1 × 109/L. She received intravenous immunoglobulin (IVIG), steroids, and romiplostim with eventual recovery of her PLT count to 50 × 109/L 20 days after surgery. She tested positive for anti‐HPA‐4a and was shown not to express HPA‐4a, confirming a diagnosis of PTP.CONCLUSIONAlloantibodies strongly reactive to HPA‐4a were detected in this patient who received multiple blood products during abdominoperineal resection surgery. Her thrombocytopenia improved with prompt administration of IVIG, steroids, and romiplostim. PTP must always be considered in patients with acute severe thrombocytopenia after receipt of blood products, and treatment should not be delayed while awaiting laboratory confirmation. To our knowledge, this is the second reported case of PTP with antibodies against HPA‐4a.
Secondary thrombotic microangiopathy with severely reduced ADAMTS13 activity in a patient with Capnocytophaga canimorsus sepsis: a case report
Authors: Smeets Nori J.L. , Fijnheer Rob , Sebastian Silvie , De Mast Quirijn 
Published: September 2018

BACKGROUNDThe Gram‐negative bacillus Capnocytophaga canimorsus may cause a severe illness resembling thrombotic thrombocytopenic purpura (TTP). The pathogenesis and optimal therapy of this secondary thrombotic microangiopathy (TMA) remain uncertain.CASE REPORTA 63‐year‐old Caucasian man was admitted with suspicion for TTP, but blood cultures grew C. canimorsus. Initial investigations revealed severe thrombocytopenia, a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity level of less than 1%, and strongly elevated D‐dimer and lactate dehydrogenase levels. He made a full recovery with antibiotics and plasma infusion for 3 days. Plasmapheresis was not performed. Retrospective determination of serial ADAMTS13 activity levels revealed that ADAMTS13 activity had already increased to 25% at the start of plasma infusion.CONCLUSIONThis case highlights that a C. canimorsus sepsis may cause a secondary TMA with a severe ADAMTS13 deficiency. It also illustrates that the adjunctive role of plasma exchange or plasma infusion is doubtful as ADAMTS13 activity levels increased with antibiotics alone.
Acute kidney injury secondary to traumatic rhabdomyolysis in a dog
Authors: Chen Hilla , Aroch Itamar , Segev Gilad 
Published: September 2018

AbstractObjectiveTo describe the clinical course and successful management of a dog with crush syndrome, rhabdomyolysis, myoglobinuria, and associated acute kidney injury (AKI).Case SummaryAn 8‐year‐old female, neutered, mixed‐breed dog was referred to the Veterinary Teaching Hospital due to crush injury and suspected AKI. Blood tests and urinalysis showed markedly increased serum creatine kinase activity, myoglobinuria, and AKI. The dog was managed successfully with intermittent hemodialysis, and completely recovered.New or Unique Information ProvidedThis is the first report of a dog with crush syndrome with secondary myoglobinuria and AKI.
Modulation of Cortical Activity by High-Frequency Whole-Body Vibration Exercise: An fNIRS Study
Authors: Choi Dong-Sung , Lee Hwang-Jae , Shin Yong-II , Lee Ahee , Kim Hee-Goo , Kim Yun-Hee 
Published: September 2018

Context: Whole-body vibration (WBV) has shown many positive effects on the human body in rehabilitation and clinical settings in which vibration has been used to elicit muscle contractions in spastic and paretic muscles. Objective: The purpose of this study was to investigate whether WBV exercise (WBVe) differently modulates the cortical activity associated with motor and prefrontal function based on its frequency. Methods: A total of 18 healthy male adults (mean age: 25.3 [2.4] y) participated in this study and performed WBVe (Galileo Advanced plus; Novotec Medical, Pforzheim, Germany) under 3 different vibration frequency conditions (4-mm amplitude with 10-, 20-, and 27-Hz frequencies) and a control condition (0-mm amplitude with 0-Hz frequency). Each condition consisted of 2 alternating tasks (squatting and standing) every 30 seconds for 5 repetitions. All subjects performed the 4 conditions in a randomized order. Main Outcome Measure: Cortical activation during WBVe was measured by relative changes in oxygenated hemoglobin concentration over the primary motor cortex, premotor cortex, supplementary motor area, and prefrontal and somatosensory cortices using functional near-infrared spectroscopy. Results: Oxygenated hemoglobin concentration was higher during the 27-Hz vibration condition than the control and 10-Hz vibration conditions. Specifically, these changes were pronounced in the bilateral primary motor cortex (P < .05) and right prefrontal cortex (P < .05). In contrast, no significant changes in oxygenated hemoglobin concentration were observed in any of the cortical areas during the 10-Hz vibration condition compared with the control condition. Conclusion: This study provides evidence that the motor network and prefrontal cortical areas of healthy adult males can be activated by 27-Hz WBVe. However, WBVe at lower frequencies did not induce significant changes in cortical activation.
Functional Movement Patterns and Body Composition of High-Level Volleyball, Soccer, and Rugby Players
Authors: Campa Francesco , Piras Alessandro , Raffi Milena , Toselli Stefania 
Published: September 2018

Context: Sports practice leads athletes to develop a specific body composition, coordination patterns, and basic motor skills based on the different tactical and physical needs. Objectives: To present and compare a wide range of functional movement patterns and body composition (BC) parameters of high-level male athletes playing different sports and to determine if there was a relationship between the parameters examined. Design: Cross-sectional study. Setting: Team facilities. Participants: A total of 30 volleyball, 25 soccer, and 30 rugby players (age = 25.9 [5.0] y and body mass index = 25.6 [4.1] kg/m2). Interventions: Functional movement patterns and anthropometric measurements were collected by a physician specifically trained. Main Outcome Measures: Body mass index, fat mass, fat-free mass, upper-arm muscle and fat area, calf muscle and fat area, thigh muscle and fat area, and functional movement screen (FMS) scores. In addition to considering the FMS total score, the authors separated the screen into 3 parts: FMSmove, FMSflex, and FMSstab. Results: The rugby players showed a higher number of asymmetrical and dysfunctional movements than the other athletes (P < .01), while the highest scores in FMSflex were obtained by the volleyball players (P < .01). In addition, most of the asymmetrical and painful movements in the athletes were measured on the shoulder mobility test. Muscle and fat areas differed significantly among the athletes (P < .05). Significant associations were found between movement patterns and several BC variables. In particular, large negative correlations were measured between percentage of fat mass (r = −.616; P < .01), upper-arm fat area (r = −.519; P < .01), and FMS total score. Conclusions: Functional movement patterns and BC differ in athletes according to the sport practiced. Furthermore, reaching an optimal BC is essential to achieve a satisfactory quality of movement.
Classifying atopic dermatitis: protocol for a systematic review of subtypes (phenotypes) and associated characteristics
Authors: Mulick Amy R , Allen Victoria , Williams Hywel C , Grindlay Douglas J C , Pearce Neil , Abuabara Katrina , Langan Sinéad M 
Published: September 2018

IntroductionAtopic dermatitis is a complex disease with differing clinical presentations. Many attempts have been made to identify uniform subtypes, or phenotypes, of atopic dermatitis in order to identify different aetiologies, improve diagnosis, estimate more accurate clinical prognoses, inform treatment andmanagement or predict treatment efficacy andeffectiveness. However, no consensus yet exists on exactly what defines these phenotypes or how many there are and whether they are genuine or statistical artefacts. This review aims to identify previously reported phenotypes of atopic dermatitis, the features used to define them and any characteristics or clinical outcomes significantly associated with them.Methods and analysisWe will search Ovid Embase, Ovid MEDLINE and Web of Science from inception to the latest available date at the time of the search for studies attempting to classify atopic dermatitis in humans using any cross-sectional or longitudinal epidemiological or interventional design. Primary outcomes are atopic dermatitis phenotypes, features used to define them and characteristics associated with them in subsequent analyses. A secondary outcome is the methodological approach used to derive them. Two reviewers will independently screen titles and abstracts for inclusion, extract data and assess study quality. We will present the results of this review descriptively and with frequencies where possible.Ethics and disseminationEthical approval is not required for this study as it is a systematic review. We will report results from this systematic review in a peer-reviewed journal. The main value of this study will be to inform further research.PROSPERO registration numberCRD42018087500
Policy addressing suicidality in children and young people: a scoping review protocol
Authors: Gilmour Lynne , Duncan Edward , Maxwell Margaret 
Published: September 2018

IntroductionSuicide is one of the leading causes of death among children and young people globally and a major public health issue. Government policies determine how much recognised health issues are prioritised and set the context for investment, development and delivery of services. A review of policies concerning children and young people who are suicidal could shed light on the extent that this public health issue is prioritised and highlight examples of best practice in this area. There has never been a review to explore how policy worldwide addresses the specific needs of this vulnerable population. This review will map the key policy documents and identify their relevance to the review question: how does policy address the treatment and care of children and young people who experience suicidality? (international, national (UK) and local (Scotland)).MethodologyEmploying scoping review methodological guidance a systematic and transparent approach will be taken. Preliminary searches will facilitate the identification of MeSh terms, subject headings, individual database and platform nuances. A full search strategy will be created to search five databases: CINAHL, PsychInfo, Medline, Web of Science and Cochrane. Government and other key agency websites (eg, WHO, Unicef) will be searched to identify policy documents. The reference lists of identified documents will be checked. A second reviewer will independently screen and cross validate eligible studies for final inclusion. A data extraction template will then be used to extract key information. We will report our findings using narrative synthesis and tabulate findings, by agreed key components.Ethics and disseminationEthical approval is not required to conduct a scoping review. We will disseminate the findings through a peer-reviewed publication and conference presentation.
Essential fracture and orthopaedic equipment lists in low resource settings: consensus derived by survey of experts in Africa
Authors: Chan Yuen , Banza Leonard , Martin Jr Claude , Harrison William J 
Published: September 2018

IntroductionLow/middle-income countries (LMICs) have a growing need for trauma and orthopaedic (T&O) surgical interventions but lack surgical resources. Part of this is due to the high amount of road traffic accidents in LMICs. We aimed to develop recommendations for an essential list of equipment for three different levels of care providers.MethodsThe Delphi method was used to achieve consensus on essential and desirable T&O equipment for LMICs. Twenty experts with T&O experience from LMICs underwent two rounds of questionnaires. Feedback was given after each round of questionnaires. The first round of questionnaire consisted of 45 items graded on a Likert scale with the second round consisting of 50 items. We used an electronic questionnaire to collect our data for three different levels of care: non-operative-based provider, specialist provider with operative fracture care and tertiary provider with operative fracture care and orthopaedics.ResultsAfter two rounds of questionnaires, recommendations for each level of care in LMICs included 4 essential equipment items for non-operative-based providers; 27 essential equipment items for specialist providers with operative fracture care and 46 essential equipment items for tertiary providers with operative fracture care and orthopaedic care.ConclusionThese recommendations can facilitate in planning of appropriate equipment required in an institution which in turn has the potential to improve the capacity and quality of T&O care in LMICs. The essential equipment lists provided here can help direct where funding for equipment should be targeted. Our recommendations can help with planning and organising national T&O care in LMICs to achieve appropriate capacity at all relevant levels of care.
Presenting a strong and united front to tobacco industry interference : a content analysis of Australian newspaper coverage of tobacco plain packaging 2008–2014
Authors: Miller Caroline Louise , Brownbill Aimee Lee , Dono Joanne , Ettridge Kerry 
Published: September 2018

ObjectivesIn 2012, Australia was the first country in the world to introduce plain or standardised tobacco packaging, coupled with larger graphic health warnings. This policy was fiercely opposed by industry. Media coverage can be an influential contributor to public debate, and both public health advocates and industry sought media coverage for their positions. The aim of this study was to measure the print media coverage of Australian’s plain packaging laws, from inception to roll-out, in major Australian newspapers.MethodsThis study monitored mainstream Australian print media (17 newspapers) coverage of the plain packaging policy debate and implementation, over a 7-year period from January 2008 to December 2014. Articles (n=701) were coded for article type, opinion slant and topic(s).DesignContent analysis.ResultsCoverage of plain packaging was low during preimplementation phase (2008–2009), increasing sharply in the lead into legislative processes and diminished substantially after implementation. Articles covered policy rationale, policy progress and industry arguments. Of the news articles, 96% were neutrally framed. Of the editorials, 55% were supportive, 28% were opposing, 12% were neutral and 5% were mixed.ConclusionsProtracted political debate, reflected in the media, led to an implementation delay of plain packaging. While Australian media provided comprehensive coverage of industry arguments, news coverage was largely neutral, whereas editorials were mostly supportive or neutral of the policy. Countries seeking to implement plain packaging of tobacco should not be deterred by the volume of news coverage, but should actively promote the evidence for plain packaging in the media to counteract the arguments of the tobacco industry.
Curricula and methods for physician compassion training: protocol for a systematic review
Authors: Patel Sundip , Pelletier-Bui Alexis , Smith Stephanie , Roberts Michael B , Kilgannon Hope J , Trzeciak Stephen , Roberts Brian W 
Published: September 2018

IntroductionCompassionate patient care has been associated with improved clinical outcomes for patients. However, current evidence suggests that healthcare is experiencing a compassion crisis, with physicians frequently overlooking opportunities to treat patients with compassion. Although there is evidence that compassionate care can be enhanced through training interventions, it is currently unclear what specific skills and behaviours ought to be taught and how best to transfer this information to the learner. The objectives of this systematic review are to collate the world’s literature on compassion training to determine (1) the specific skills and behaviours that should be taught (curriculum), and (2) the methods of training that are most effective at improving compassionate patient care.Methods and analysisWe will perform a qualitative systematic review of studies aimed at improving compassionate patient care among physicians and physicians in training. We will comprehensively search CENTRAL, MEDLINE, EMBASE and CINAHL. Additional recommended techniques for systematic reviews of complex evidence will be performed including pursuing selected ‘references of references’, electronic citation tracking and consulting experts in the field. Two investigators will independently review all search results. After identification and inclusion of papers, we will use a standardised form for data extraction. We will use tables to describe the study populations, interventions tested (including specific skill/behaviours taught and training methods used), outcome measures and effects of interventions on outcome measures compared with control groups. Where appropriate, meta-analysis will be used for quantitative analysis of the data.Ethics and disseminationThe proposed systematic review does not require ethical approval since no individual patient-level data will be collected. Results of this study will contribute to the understanding of compassion training and help inform the development of compassion training curricula.PROSPERO registration numberCRD42018095040.
Forced air warming during sedation in the cardiac catheterisation laboratory: a randomised controlled trial
Authors: Conway Aaron , Ersotelos Suzanna , Sutherland Joanna , Duff Jed 
Published: September 2018

ObjectiveForced air warming (FAW) during general anaesthesia is a safe and effective intervention used to reduce hypothermia. The objective of this study was to determine if FAW reduces hypothermia when used for procedures performed with sedation in the cardiac catheterisation laboratory.MethodsA parallel-group randomised controlled trial was conducted. Adults receiving sedation in a cardiac catheterisation laboratory at two sites were randomised to receive FAW or usual care, which involved passive warming with heated cotton blankets. Hypothermia, defined as a temperature less than 36°C measured with a sublingual digital thermometer after procedures, was the primary outcome. Other outcomes were postprocedure temperature, shivering, thermal comfort and major complications.ResultsA total of 140 participants were randomised. Fewer participants who received FAW were hypothermic (39/70, 56% vs 48/69, 70%, difference 14%; adjusted RR 0.75, 95% CI=0.60 to 0.94), and body temperature was 0.3°C higher (95% CI=0.1 to 0.5, p=0.004). FAW increased thermal comfort (63/70, 90% vs51/69, 74% difference 16%, RR 1.21, 95% CI=1.04 to 1.42). The incidence of shivering was similar (3/69, 4% vs 0/71 0%, difference 4%, 95% CI=−1.1 to 9.8). One patient in the control group required reintervention for bleeding. No other major complications occurred.ConclusionFAW reduced hypothermia and improved thermal comfort. The difference in temperature between groups was modest and less than that observed in previous studies where use of FAW decreased risk of surgical complications. Therefore, it should not be considered clinically significant.Trial registration numberACTRN12616000013460.
Therapeutically Active RIG-I Agonist Induces Immunogenic Tumor Cell Killing in Breast Cancers
Authors: Elion David L. , Jacobson Max E. , Hicks Donna J. , Rahman Bushra , Sanchez Violeta , Gonzales-Ericsson Paula I. , Fedorova Olga , Pyle Anna M. , Wilson John T. , Cook Rebecca S. 
Published: September 2018

Abstract
Cancer immunotherapies that remove checkpoint restraints on adaptive immunity are gaining clinical momentum but have not achieved widespread success in breast cancers, a tumor type considered poorly immunogenic and which harbors a decreased presence of tumor-infiltrating lymphocytes. Approaches that activate innate immunity in breast cancer cells and the tumor microenvironment are of increasing interest, based on their ability to induce immunogenic tumor cell death, type I IFNs, and lymphocyte-recruiting chemokines. In agreement with reports in other cancers, we observe loss, downregulation, or mutation of the innate viral nucleotide sensor retinoic acid-inducible gene I (RIG-I/DDX58) in only 1% of clinical breast cancers, suggesting potentially widespread applicability for therapeutic RIG-I agonists that activate innate immunity. This was tested using an engineered RIG-I agonist in a breast cancer cell panel representing each of three major clinical breast cancer subtypes. Treatment with RIG-I agonist resulted in upregulation and mitochondrial localization of RIG-I and activation of proinflammatory transcription factors STAT1 and NF-κB. RIG-I agonist triggered the extrinsic apoptosis pathway and pyroptosis, a highly immunogenic form of cell death in breast cancer cells. RIG-I agonist also induced expression of lymphocyte-recruiting chemokines and type I IFN, confirming that cell death and cytokine modulation occur in a tumor cell–intrinsic manner. Importantly, RIG-I activation in breast tumors increased tumor lymphocytes and decreased tumor growth and metastasis. Overall, these findings demonstrate successful therapeutic delivery of a synthetic RIG-I agonist to induce tumor cell killing and to modulate the tumor microenvironment in vivo.
Significance: These findings describe the first in vivo delivery of RIG-I mimetics to tumors, demonstrating a potent immunogenic and therapeutic effect in the context of otherwise poorly immunogenic breast cancers. Cancer Res; 78(21); 6183–95. ©2018 AACR.