The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the Committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Seventh Edition of the JCA Special Issue continues to maintain this methodology and rigor to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Seventh Edition, like its predecessor, has consistently applied the category and grading system definitions in the fact sheets. The general layout and concept of a fact sheet that was used since the fourth edition has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. The Seventh Edition discusses 87 fact sheets (14 new fact sheets since the Sixth Edition) for therapeutic apheresis diseases and medical conditions, with 179 indications, which are separately graded and categorized within the listed fact sheets. Several diseases that are Category IV which have been described in detail in previous editions and do not have significant new evidence since the last publication are summarized in a separate table. The Seventh Edition of the JCA Special Issue serves as a key resource that guides the utilization of therapeutic apheresis in the treatment of human disease. J. Clin. Apheresis 31:149-162, 2016. © 2016 Wiley Periodicals, Inc.

Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue

As companies strive to develop artefacts intended for services instead of traditional sell-off, new challenges in the product development process arise to promote continuous improvement and increasing market profits. This creates a focus on product life-cycle components as companies then make life-cycle commitments, where they are responsible for the function availability during the extent of the life-cycle, i.e. functional products. One of these life-cycle components is manufacturing; therefore, companies search for new approaches of success during manufacturability evaluation already in engineering design. Efforts have been done to support early engineering design, as this phase sets constraints and opportunities for manufacturing. These efforts have turned into design for manufacturing methods and guidelines. A further step to improve the life-cycle focus during early engineering design is to reuse results and use experience from earlier projects. However, because results and experiences created during project work are often not documented for reuse, only remembered by some people, there is a need for design support. Knowledge engineering (KE) is a methodology for creating knowledge-based systems, e.g. systems that enable reuse of earlier results and make available both explicit and tacit corporate knowledge, enabling the automated generation and evaluation of new engineering design solutions during early product development. There are a variety of KE-approaches, such as knowledge-based engineering, case-based reasoning and programming, which have been used in research to develop design for manufacturing methods and applications. There are, however, opportunities for research where several approaches and their interdependencies, to create a transparent picture of how KE can be used to support engineering design, are investigated. The aim of the research presented in this thesis is to create new methods for design for manufacturing, by using several approaches of KE, and find the beneficial and less beneficial aspects of these methods in comparison to each other and earlier research. This thesis presents methods and applications for design for manufacturing using KE. KE has been employed in several ways, namely rule-based, rule-, programmingand finite element analysis (FEA)-based, and ruleand plan-based, which are tested and compared with each other. Results show that KE can be used to generate information about manufacturing in several ways. The rule-based way is suitable for supporting life-cycle commitments, as engineering design and manufacturing can be integrated with maintenance and performance predictions during early engineering design, though limited to the firing of production rules. The rule-, programmingand FEA-based way can be used to integrate computer-aided design tools and virtual manufacturing for non-linear stress and displacement analysis. This way may also bridge the gap between engineering designers and computational experts, even though this way requires a larger effort to program than the rule-based. The ruleand planbased way can enable design for manufacturing in two fashions – based on earlier manufacturing plans and based on rules. Because earlier manufacturing plans, together with programming algorithms, can handle knowledge that may be more intricate to capture as rules, as opposed to the time demanding routine work that is often automated by means of rules, several opportunities for designing for manufacturing exist.

Methods and Applications

OBJECTIVES: To develop evidence-based recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with septic shock and other sepsis-associated organ dysfunction. DESIGN: A panel of 49 international experts, representing 12 international organizations, as well as three methodologists and three public members was convened. Panel members assembled at key international meetings (for those panel members attending the conference), and a stand-alone meeting was held for all panel members in November 2018. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and group heads, as well as within subgroups, served as an integral part of the guideline development process. METHODS: The panel consisted of six subgroups: recognition and management of infection, hemodynamics and resuscitation, ventilation, endocrine and metabolic therapies, adjunctive therapies, and research priorities. We conducted a systematic review for each Population, Intervention, Control, and Outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak, or as a best practice statement. In addition, "in our practice" statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate. RESULTS: The panel provided 77 statements on the management and resuscitation of children with septic shock and other sepsis-associated organ dysfunction. Overall, six were strong recommendations, 52 were weak recommendations, and nine were best-practice statements. For 13 questions, no recommendations could be made; but, for 10 of these, "in our practice" statements were provided. In addition, 49 research priorities were identified. CONCLUSIONS: A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations. Despite this challenge, these recommendations regarding the management of children with septic shock and other sepsis-associated organ dysfunction provide a foundation for consistent care to improve outcomes and inform future research.

Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

Background Acute graft-versus-host disease (GVHD) remains a major limitation of allogeneic stem-cell transplantation; not all patients have a response to standard glucocorticoid treatment....

https://www.nejm.org/doi/pdf/10.1056/NEJMoa1917635?articleTools=true

Ruxolitinib for Glucocorticoid-Refractory Acute Graft-versus-Host Disease

Erratum: Special issue: Clinical applications of therapeutic apheresis: An evidence based approach. 5th edition

Fatigue in Hematopoietic Cell Transplantation Survivors: Correlates, Care Team Communication, and Patient-Identified Mitigation Strategies.

Therapeutic apheresis (TA) plays an important role in the management of various hemorrhagic and thrombotic disorders, either as a primary or an adjunctive therapy. It is a procedure in which blood is separated from a patient, a portion of which is then removed or otherwise manipulated with the remainder being returned back to the patient. The goal of TA is to remove an abnormal or unrequired solute or cellular component of the blood and is often used in conjunction with the replacement of fluid or colloid. Because many of the conditions for which TA may be indicated are uncommon, with limited clinical studies to guide decision making, the American Society for Apheresis (ASFA) frequently updates a compiled list of indications providing grades of evidence to support their recommendations. More common hemorrhagic and thrombotic indications for which TA is used include, but not limited to, thrombotic thrombocytopenia purpura and certain other thrombotic microangiopathies, polycythemia vera, thrombocytosis, and pulmonary-renal syndromes.

Laura Connelly-Smith

Papers

Erratum: Special issue: Clinical applications of therapeutic apheresis: An evidence based approach. 5th edition

Fatigue in Hematopoietic Cell Transplantation Survivors: Correlates, Care Team Communication, and Patient-Identified Mitigation Strategies.

Therapeutic Apheresis—Applications for Hemorrhagic and Thrombotic Disorders

Therapeutic plasma exchange in the management of immune checkpoint inhibitor‐associated immune‐related adverse effects: A review

Neuropathy and Muscle Cramps in Autologous and Allogeneic Hematopoietic Cell Transplantation Survivors.