bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Institute for Credentialing Excellence Multi-Organization Survey of Certificants
Authors: Francis E , Harrington A , Eschliman P J , Harrington S , Duzan D , Tanabe P 
Published: October 2021

Abstract

Introduction/Objective
The Institute for Credentialing Excellence (ICE) conducted a study to measure the value that credential holders place on certification, collecting survey data from a large sample of more than 12,000 credential holders representing six organizations (4 of which were healthcare). In May of 2019, ASCP BOC sent the survey to 47,384 individuals certified within the last 5 years. Of those who received the survey; 2,038 completed the 80 required questions. A comparison of survey data provided an overview of the top five differences in the full survey data (n=9,407) and the data from respondents credentialed by ASCP BOC (n = 2,038 or 22% of full survey respondents) and highlighted the primary reasons individuals pursue certification.

Methods/Case Report
This survey sought to define certificants’ attitudes toward and experiences with certification. Survey questions were grouped by four primary subject areas:
The Value of Certification for Respondents’ Professions
The Value of Certification for Employers
The Value of Certification Outside the U.S. and Canada
The Value of Certification for Certificants
- Responses of themed queries of full survey data and BOC survey data were viewed side by side and averages, standard deviations and medians were calculated. The top 5 items indicating the highest difference from the full survey data results were highlighted.
- Ranked primary motivational factors for the pursuit of certification were viewed side-by-side.

Results (if a Case Study enter NA)
Based on a side-by-side comparison of full survey data and BOC survey data, only minor differences were noted with the exception of the question pertaining to the perceived value of recertification. Both differences and items of agreement were highlighted.
The top 10 reasons for seeking certification were the same amongst both the full survey and ASCP BOC survey respondents, with minor differences in priority order.

Conclusion
With the exception of the question regarding the value of recertification, discrepancies noted were minor. On most questions pertaining to the various benefits of certification, a majority of respondents gave a positive response about certification and its relationship to beneficial outcomes for their professions, employers, or themselves. It is clear that certificants place a high value on certification and believe that certification provides a number of valuable benefits.
Cytokeratin 7 and Copper Stains Facilitate Diagnosis of Small Duct Primary Sclerosing Cholangitis
Authors: Wilhelm A , Stevenson H L , Kline K 
Published: October 2021

Abstract

Introduction/Objective
Classic primary sclerosing cholangitis (PSC) involves extrahepatic and/or intrahepatic biliary ducts with segmental biliary strictures and dilatations that often allow the diagnosis to be made via cholangiogram. Small duct PSC (sdPSC) is a rare subtype that presents similarly with a cholestatic pattern of injury, yet due to the small size of involved ducts, a cholangiogram is non-diagnostic and diagnosis is dependent on clinical suspicion and liver biopsy. The histopathological features of sdPSC are often subtle and may easily be overlooked. Diagnosis of this entity- though difficult- is important, as early recognition can facilitate the identification of associated disease processes and life-threatening complications.

Methods/Case Report
We encountered a 33-year-old female presenting with intermittent pruritis, episodes of jaundice, and persistently elevated alkaline phosphatase who was misdiagnosed with only fatty liver at an outside institution. Evaluation with MRCP showed no abnormalities within the biliary tract and a liver biopsy was performed to aid in the diagnosis. The H&E and trichrome findings of atrophic bile ducts and some peribiliary sclerosis were extremely subtle and may have been overlooked without clinical suspicion. Cytokeratin 7 (CK7) highlighted cholangiolar metaplasia in hepatocytes and the bile ductular reaction that occurs in cholestatic disease states. A Rhodamine copper stain showed periportal deposition suggestive of chronic biliary obstruction. Use of CK7 and copper stains supported the presence of chronic biliary injury and suboptimal bile flow, confirming the diagnosis of sdPSC.

Results (if a Case Study enter NA)
NA

Conclusion
Diagnosis of sdPSC has historically relied on H&E and trichrome stains. In this case, the findings on H&E and trichrome stains were non-diagnostic, while the use of CK7 and copper stains confirmed the diagnosis of sdPSC. We recommend using CK7 and copper stains to evaluate for sdPSC.
Liver histology in short telomere syndrome: A case report and review of the literature
Authors: Bai L , Liu Y 
Published: October 2021

Abstract

Introduction/Objective
Short telomere syndrome (STS) is a genetically inherited syndrome resulting in premature telomere shortening. STS encompasses a spectrum of clinical manifestations, including dyskeratosis congenita, premature hair graying, bone marrow failure, immunodeficiency, pulmonary fibrosis and liver disease. Liver histopathologic features in STS patients have not been well characterized.

Methods/Case Report
A 46-year-old man presented for dyspnea and cryptogenic cirrhosis. He had a complicated medical history significant for immune thrombocytopenic purpura and splenectomy, recurrent respiratory tract infections, pneumonia, sepsis, primary immunodeficiency, pulmonary mucosa-associated lymphoid tissue lymphoma, and severe hepatopulmonary syndrome. He and his brother had gray hair in their late 20s. He also had a long history of intermittently elevated liver enzymes starting at age 33. A liver biopsy performed 12 years before showed chronic portal inflammation with hepatocellular damage without significant fibrosis. These clinical manifestations prompted an evaluation for a possible telomere biology disorder, which revealed the telomere length was critically short and fell at or below the first percentile for age, supportive of the diagnosis. The most recent liver biopsy showed marked portal lymphocytic inflammation with interface hepatitis, bile ductular reaction and frequent foci of lobular inflammation with focal hepatocyte dropout. Some hepatocytes around the portal tracts were swollen with feathery degeneration and occasional Mallory-Denk bodies. A Rhodanine stain highlighted copper granules in the periportal hepatocytes, suggesting chronic cholestasis. Trichrome and reticulin stains demonstrated portal/periportal/pericellular/perisinusoidal fibrosis and focal bridging fibrosis.

Results (if a Case Study enter NA)
NA

Conclusion
Partly due to the rarity of STS and the risk of bleeding associated with biopsies, liver histology was described in only few limited studies with small samples of STS patients, including inflammation, nodular regenerative hyperplasia, steatohepatitis, hemosiderosis, cholestasis, cirrhosis, and large cell change of hepatocytes. Our case and others suggest liver disease associated with STS demonstrates a spectrum of histopathology. Being aware of these histomorphologic features in STS is important for establishing the correct diagnosis.
Public risk from antibiotic resistant Escherichia coli colonized in urban wildlife
Authors: Leu-Burke G , Madsen C , Bish A , Madsen J 
Published: October 2021

Abstract

Introduction/Objective
Escherichia coli is an especially dangerous health threat to humans when it develops multi- drug resistance. Decreased sensitivity to quinolone and beta-lactam antibiotics has been documented with antibiotic use in health care and agriculture. Migrating birds interact with wastewater treatment plants colonized with drug resistant Escherichia coli potentially transfer to other wildlife. Anchorage is home to 1500 moose and migrating geese providing a potential risk for Escherichia coli colonization. Because fecal contamination is abundant in Anchorage’s greenspaces, we evaluated the presence of Escherichia coli and antibiotic resistance in urban moose.

Methods/Case Report
Between 2018-2020, moose fecal samples were ground collected during the spring thaw within Anchorage Alaska, placed in transport media and cultured to MacConkey agar. Lactose fermenting colonies were further identified as Escherichia coli by biochemical testing and sub-cultured to sheep blood agar for antimicrobial evaluation. Using the Kirby Bauer method, antimicrobial sensitivity for cefpodoxime, ampicillin, piperacillin/tazobactam, gentamycin and ciprofloxacin were performed and interpreted using Clinical Laboratory Standards Institute guidelines

Results (if a Case Study enter NA)
A total of 150 samples were analyzed with 39% positive for Escherichia coli: fourteen in 2018, seventeen in 2019, and twenty-eight in 2020. In 2018, resistance was significant in ampicillin (43%), limited in piperacillin/tazobactam and cefpodoxime (14%). In 2019 found a 40% overall increase of antimicrobial resistance and by 2020 Escherichia coli isolates were resistant in all antibiotics tested: cefpodoxime (100%), ampicillin (96%), piperacillin/tazobactam (43%), gentamycin (35%), and ciprofloxacin (32%).

Conclusion
Measuring resistant patterns of Escherichia coli in wildlife is essential to understand the risk of colonization. Transmission of infectious agents can occur due to environmental exposure and Anchorage has expanded greenspaces resulting in increased human interaction with urban wildlife. In 2018, we found antimicrobial resistance only to ampicillin but subsequent years discovered decrease sensitivity and by 2020 Escherichia coli isolates resistant to one or more antibiotics including beta-lactams, quinolones, and aminoglycosides. The risk of zoonosis of multi-drug resistant Escherichia coli, especially in our housing insecure, has a significant impact for patient outcome.
An algorithmic approach to the use of rapid molecular diagnostics for SARS-CoV-2, influenza viruses, and other respiratory pathogens during an unprecedented respiratory season
Authors: Maris A S , Tao L , Stratton C W , Humphries R M , Schmitz J E 
Published: October 2021

Abstract

Introduction/Objective
The COVID-19 pandemic exacerbated deficiencies of testing personnel, reagents, supplies and disposables, instruments, and automation in many clinical laboratories. Upon entering respiratory season, a strategy was warranted to optimize laboratory resources when supplies were already limited and expected respiratory season test volume was unknown. An algorithm was devised to prioritize test ordering and TAT based on patient clinical scenario.

Methods/Case Report
The institutional respiratory season SARS-CoV-2 algorithm was constructed by a multidisciplinary team including infectious disease, infection prevention, laboratory, and IT/LIS leadership. CDC guidance on influenza testing was incorporated. Antigen-based testing was discontinued; only molecular amplification- based platforms with FDA EUA were utilized. Platforms had a range of TAT (20 minutes to 8 hours) and included fully- automated high throughput, rapid random access, point-of-care, and CDC SARS-CoV-2 assays. Test bundles included SARS-CoV-2 (monoplex), or SARS-CoV-2 + fluA&B (triplex), or SARS-CoV-2 + respiratory pathogen panel (multiplex RPP; includes 22 targets, including flu A&B).

Results (if a Case Study enter NA)
Key factors in the algorithm included whether the patient was outpatient or inpatient, hospital employee or not, symptomatic or not, immunocompetent or immunocompromised, and whether a concurrent order for other respiratory pathogens was included or not. Clinician responses for these factors determined the type of swab collected (wet swab in VTM or dry swab) and how quickly the TAT was indicated for a given patient using a colored-dot sticker system. Priority TAT in decreasing order was symptomatic inpatients, asymptomatic pre- procedure patients, asymptomatic admissions, symptomatic employees, and symptomatic outpatients.

Conclusion
An algorithm for respiratory pathogen testing during an unprecedented respiratory season prioritizes result TAT to an individual patient’s clinical situation while maximizing laboratory stewardship by eliminating redundant influenza testing and requiring ‘all upfront’ orders to avoid add-on orders that require ‘dumpster diving’ for samples. Limitations include inherent differences in sensitivity, LOD, and specificity when multiple different platforms are utilized to detect the same analytes.
Blood Groups of Recipients of COVID-19 Convalescent plasma
Authors: Petersen J M , Jhala D 
Published: October 2021

Abstract

Introduction/Objective
COVID -19 Convalescent plasma therapy (CCP) is under an FDA Emergency Use Authorization to treat hospitalized patients with COVID-19. However, being ill enough to require hospitalization for COVID-19 is a negative outcome. There is also contradictory literature on whether ABO blood group is associated with worse outcomes with COVID-19 disease. Therefore, we share a regional Veterans Administration Medical Center (VAMC) experience comparing the blood groups of patients intended to receive CCP to a control group of patients positive for SARS-CoV-2.

Methods/Case Report
A retrospective review of all patients who had CCP ordered in the year 2020 was performed to identify the blood group of these patients, which was compared to a control population of positive patients early in the pandemic (March 17th, 2020 to May 20th, 2020).

Results (if a Case Study enter NA)
A total of 15 patients had CCP ordered as part of their care with an age range of 56-85 (average 69.7) years of age, entirely male composition, and a racial breakdown of 13 African Americans (86.7%), 1 Caucasian American (6.7%), and 1 Asian American (6.7%). The blood group distribution amongst these 15 patients for CCP was 1 AB+ (6.7%), 5 A+ (33.3%), 4 B+ (26.7%), and 5 O+ (33.3%).
The unrelated control population consisted of 81 SARS-CoV-2 positive patients whose blood groups were distributed as 3 group AB (3.7%), 21 group A (25.9%), 15 group B (18.5%), and 42 group O (51.8%). A Chi squared test did not show a statistically significant difference between the two groups in ABO composition.

Conclusion
The ABO proportions of patients for whom CCP was ordered compared to the control group was not statistically significant. This provides support to the literature arguing that ABO may not be related to worse outcomes such as hospitalization or need for CCP transfusion.
Comparison of virus concentration methods for the reverse-transcriptase quantitative PCR (RT-qPCR)-based detection of bacteriophage Φ6, an enveloped virus surrogate for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, from untreated wastewater at St. George’s University (SGU), Grenada
Authors: Farmer-Diaz K , Matthew-Bernard M , Ramos-Nino M , Fitzpatrick D , Cheetham S 
Published: October 2021

Abstract

Introduction/Objective
With the ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the consequent opening of borders, it is of paramount importance to monitor communities for the presence of potential COVID-19 clusters. Wastewater-based epidemiology (WBE) is an effective way to monitor community spread of pathogens and has been implemented in many countries to identify potential outbreaks. Most standardized methodologies used in WBE for the detection of viruses have been validated for non-enveloped viruses; therefore, there is a need for the creation of a standardized method for the detection of enveloped viruses, such as SARS-CoV-2.

Methods/Case Report
Wastewater seeded with a Pseudomonas syringae bacteriophage (Φ6) was used to test the efficiency of five wastewater virus concentration methods. Two methods were based on AlCl3 flocculation with different pH adjustments. The other methods utilized membrane filtration followed by beef elution: one added a pretreatment with HCl; another added a pretreatment with MgCl2; and finally, an untreated control. A known amount of Bacteriophage Φ6 was used for all methods, and detection was quantified by reverse-transcription quantitative polymerase chain reaction.

Results (if a Case Study enter NA)
The Cq values for each method, ranging from 24.38–38.6, were compared. The highest recovery of Φ6 was obtained with the AlCl3 flocculation method with an adjusted pH of 6, followed in descending order by MgCl2-pretreated sample with beef elution; HCl-pretreated sample with beef elution, the untreated sample, and AlCl3 flocculation method with an adjusted pH of 3.5.

Conclusion
The results suggest that AlCl3 flocculation with an adjusted pH of 6 may be a quick and cost-effective methodology for the detection of enveloped viruses in WBE. This can facilitate the implementation of WBE at SGU, Grenada, as a useful tool to conduct active surveillance and track outbreaks of enveloped viral diseases, such as SARS-CoV-2.
Practical Risk Scoring System for Predicting Severity of COVID-19 Disease
Authors: Petersen J M , Jhala D 
Published: October 2021

Abstract

Introduction/Objective
SARS-CoV-2 has become an international pandemic with numerous casualties. The severity of the COVID-19 disease course depends on several clinical, laboratory, and radiological factors. This has led to risk scoring systems in various populations such as in China, but similar risk scoring systems developed based on the American veteran population are sparse. As a risk scoring system (RSS) would be very useful for future reference in similar pandemics, we share a simple Jhala Risk Scoring System (JRSS) developed early in the pandemic to assess the severity of disease risk.

Methods/Case Report
A retrospective review of all SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) tests collected and performed at the regional Veterans Administration Medical Center (VAMC) serving the Philadelphia and surrounding areas from March 17th, 2020 to May 20th, 2020. Data was collected and analyzed in the same year. These tests were reviewed within the computerized medical record system for demographic, medical history, laboratory test history, and clinical course. Information from the medical records were then scored based on the criteria of the JRSS.

Results (if a Case Study enter NA)
The JRSS, based on age, ethnicity, presence of any lung disease, presence of cardiovascular disease, smoking history, and diabetes history with laboratory parameters correlated and predicted (with statistical significance) which patients would be hospitalized.

Conclusion
The JRSS reached statistical significance in its predictions on informing risk stratification for COVID-19 positive patients. Similar risk scoring systems may play a role in the rapid development of risk scoring in future pandemics of similar nature and thus provide a useful reference point. A simple RSS based on clinical parameters is a highly practical, cost effective and simple system to evaluate need for hospitalization, which is critical for operations in the intensive care unit and simultaneously the use of ventilators.
Necrotizing Fasciitis and Fatal Septic Shock Associated with Streptococcus constellatus
Authors: Rajack F , Naab T J 
Published: October 2021

Abstract

Introduction/Objective
Streptococcus anginosus group consists of three species: S. anginosus, S. intermedius, and S. constellatus (SC), normal flora in the human oral cavity, gastrointestinal and urogenital tracts. What makes them unique is their ability to form abscesses.

Methods/Case Report
We report a case of a 43 year old morbidly obese bipolar male presenting with general malaise and diarrhea. He had a history of uncontrolled diabetes mellitus Type 2 and persistent right thigh wound. Admitting labs revealed diabetic ketoacidosis. Physical examination revealed a right medial thigh ulcer with necrotic scrotal skin, after which he underwent urgent surgical debridement. Wound culture grew SC. Debrided tissue measured 44 x 17 x 4 cm. Histology revealed abscesses next to zones of pale gray necrotic tissue having a granular appearance without associated neutrophils. Gram stain of these pale gray zones revealed sheets of Gram positive cocci, consistent with Stage III necrotizing fasciitis (NF), which has 47% mortality. He died shortly after surgery with death attributed to septic shock. Toxic shock syndrome is most often associated with Group A Streptococcus. However, other rare pathogenic streptococci, including SC, may be associated with a similar syndrome. Gram stain is essential in confirming NF, characterized by pale gray necrosis with a granular appearance.

Results (if a Case Study enter NA)
NA

Conclusion
Our case highlights the risk of fatal NF due to SC. Identification of SC in a deep wound warrants early surgical intervention for adequate source control and administration of appropriate antibiotic. Poor diabetic control and ulcerated chronic thigh wound predisposed our patient to fatal necrotizing fasciitis due to SC, confirmed by Gram stain.
Comparison of longitudinal SARS-CoV-2 nasopharyngeal specimens reveals the transcriptomic COVIDome
Authors: Twa D D , Kuchinski K , Nikiforuk A , Krajden M , Prystajecky N , Jassem A , Sekirov I 
Published: October 2021

Abstract

Introduction/Objective
SARS-Cov-2 is well established to introduce a cytokine-like storm among select individuals that results in multisystem failure and death. Comorbidities, age, oxygen status, and real-time appraisal of inflammatory markers in the blood have been used to risk stratify patients, however, these clinical markers do not comprehensively characterize the at-risk population or disease course. To understand the molecular underpinnings of the primary site of SARS-CoV-2 infection, here, we interrogated the transcriptomic profile of the nasopharyngeal tissue among paired SARS-CoV-2 specimens.

Methods/Case Report
We performed ribosomal depletion RNAseq on 24 primary samples, including 16 paired samples from 8 unique patients who converted between SARS-CoV-2 negative and positive status via clinical diagnostic qRT-PCR. Additional targeted qRT-PCR was performed for ACE2 and TMPRSS2 in an extension sample of 54 paired specimens from 27 unique patients who converted in their SARS-CoV-2 status on the basis of the qRT- PCR test. Differential gene expression, differential correlative expression with ACE2, and correlative expression with viral load was used to identify genes, which were integral to SARS-CoV-2 pathogenesis, so termed the COVIDome. Gene ontologies, pathways, and reactive infiltrate was assessed between specimens and compared with measures of clinical outcome using regression with appropriate correction for multiple hypotheses.

Results (if a Case Study enter NA)
We observed significant enrichment for ontologies of lymphocyte activation, specifically interferon gamma signaling; (P&lt;1E-20) and platelet activation (P&lt;1E-5). Genes specifically enriched across all three modules included: ADAMDEC1, EPSTI1, GRIP2, IRF7, KLHDC7B, OAS3, OASL, PIK3R4, RSAD2, and XAF1. Using CIBERSORT to approximate immune cell populations from bulk RNA, we observed and enrichment for CD4 immune cells, which was associated with viral status (P&lt;0.01) while high-risk gene signatures were associated with measures of clinical outcome (P&lt;0.05).

Conclusion
We characterized the pathogenesis of SARS-CoV-2 in longitudinal nasopharyngeal samples of COVID- 19 patients and related these molecular manifestations with measures of clinical outcome. As proof of principal, our findings suggest additional study in a large, longitudinal extension sample is warranted to validate and assess molecular features of clinical outcome associated with SARS-CoV-2 infection.