bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residual Component Culture: Application of Standardized Transfusion Reaction Culture Criteria to Reduce Culture Rates
Authors: Hodge Kyle , Khan Jenna 
Published: November 2023

Abstract
Blood products are often cultured as part of a transfusion reaction (TRXN) workup in order to “not miss” a septic TRXN. These cultures are vulnerable to secondary contamination and are often challenging to interpret due to the lack of a corresponding patient blood culture. Although bacterial contamination of blood products remains a leading cause of transfusion related fatalities, the actual prevalence of primary contamination of blood components is quite low, leading to a low positive predictive value (PPV) for component culture. Given recently mandated mitigation strategies to reduce bacterial contamination of platelets, the PPV of component culture is likely to further decline, making appropriate selection criteria for culture even more critical to conserve laboratory resources and maximize clinical utility. At our institution the decision to culture is at the discretion of the pathology resident and/or transfusion medicine physician. We sought to review our current culture rates and determine if applying standardized indications for component culture could reduce culture rates without impacting diagnostic utility. Clinical symptoms and vital signs were reviewed for the 24-hour period after the reaction for all TRXNs reported from July 2021 to June 2022. Of the 105 reactions reported during the study timeframe, 39 (37%) were cultured, with one positive culture involving a platelet unit. This was deemed a true septic reaction given concordant cultures in the patient. Modified forms of the AABB and BEST culture criteria were then applied to the reported reactions. Modifications were made to provide specific definitions for tachycardia (heart rate &gt; 100bpm and at least 15% increase) and hypotension (SBP &lt; 80mmhg and at least a 30mmHg decrease). Application of the AABB criteria reduces the number of cultures to 22 (21% of reactions) whereas the BEST criteria increases the number of cultures to 51 (49% of reactions). Both criteria captured the true positive septic reaction. Neither criteria were completely concordant with our current practice. Of the 39 reactions selected for culture by our institution, 26 (67%) did not meet AABB criteria and 11 (28%) did not met BEST criteria; 9 and 22 different reactions would have been cultured based on AABB and BEST criteria respectively. Although we are not able to confirm if culturing of the discrepant units would have yielded additional positive cultures, retrospective chart review did not reveal any additional cases of clinically significant sepsis. The modified AABB criteria decreased the culture rate by 56% while still capturing the true positive septic TRXN suggesting that it would be the best option to reduce the cost/burden of culturing products without reducing diagnostic accuracy. Both published criteria do not take into consideration duration of symptoms and clinical interventions, thus clinical judgement remains critical to the decision to culture.
Utility of Vizient Clinical Data Base as a benchmarking tool for laboratory stewardship programs
Authors: Krishnan Subhashree Mallika , Smith Ross , Mathias Patrick , Owens Scott , Schroeder Lee 
Published: November 2023

Abstract
Establishing an effective laboratory stewardship program across healthcare systems to improve patient care has been of growing interest. Despite general guidelines from various organizations, clear definitions for these laboratory-based quality measures, and associated benchmarks, are still lacking. Hence, we utilized Vizient® Clinical Data Base (CDB) as a tool to benchmark our institution against U.S. News and World Reports’ Honor Roll (USNW) healthcare organizations 2021-2022. We focused on inpatient laboratory testing with specific targets including mean laboratory resource units used per patient per day to obtain an overview of our institution’s overall performance, daily basic metabolic panel and CBC test ordering patterns across various service lines, and C-reactive protein (CRP) to erythrocyte sedimentation rate (ESR) order ratios compared to USNW hospitals. As one of the five institutions with the highest mean laboratory resource units used per case per day (12.7) from January 1, 2021-January 31, 2022, we investigated this further to identify tests driving this result. Of all the laboratory tests ordered, blood gas was identified at the 99th percentile compared to peers. Stratifying by service, we found cardiac surgery (17%), general medicine (15%), pulmonary/critical care (11%), neonatology (10%) and transplant (9%) services at our institution were the major contributors to blood gas orders. Investigating daily laboratory test orders (BMP, CBC) showed that our institution was at the 46th and 71st percentile overall, respectively. Further CBC analysis showed that general medicine (28%) and oncology (11%) services were the major contributors for the test volume and highest total resource units used per quarter in 2021. Assessing CRP to ESR ratio depicted that our institution’s ratio of 2.2 was lower compared to USNW hospitals’ average of 2.9, meaning ESR is likely overutilized. In conclusion, Vizient CDB can be used as a resource for benchmarking laboratory utilization patterns. It can be helpful in developing road maps and prioritizing interventions for lab stewardship programs. This study identified a general overuse of laboratory resources at the hospital compared to peers, and identified some intervention targets including blood gas testing and ESR.
Assessing the Reliability of Creatinine-Estimated Glomerular Filtration Rate in Living Kidney Donor Candidates: Does it Measure up to the Measured Rate?
Authors: Lahorewala Sarrah , Xin Yi Xin Yi , Roger Bertholf Roger Bertholf 
Published: November 2023

Abstract
A living donor kidney transplant is the best therapy option for patients with end stage renal disease (ESRD); however, it is associated with an increased risk of ESRD development in the donor. Thorough evaluation of the donor candidate’s kidney function status is essential for the appropriate selection of candidates with minimal risk of post-donation kidney dysfunction.
In this study, glomerular filtration rate (GFR) values measured by iohexol plasma clearance (mGFR) and estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) creatinine equations (eGFR), with and without the race factor (2009 and 2021 CKD-Epi equations, respectively), were compared in a cohort of 303 kidney donor candidates. GFR values were analyzed using Bland-Altman plots, linear regression, Mann-Whitney U tests, and p10 and p30 values.
Bland-Altman analysis revealed a lack of agreement between the 2009 and 2021 CKD-Epi eGFR and corresponding mGFR values, with both equations showing a negative bias of 10 – 11 mL/min/1.73m2 and indicating an underestimation of creatinine-eGFR. eGFR underestimation was confirmed by Mann-Whitney U analysis; median GFR values were significantly lower for both CKD-Epi equations as compared to corresponding iohexol-measured values (2009: 85.86; 2021: 87.29; mGFR: 96.58). Despite the overall underestimation, over 14% of donor candidates with eGFR &gt;90 mL/min/1.73m2 had an mGFR value &lt;90 mL/min/1.73m2. Conversely, 36% - 38% of donors with normal kidney function of &gt;90 mL/min/1.73m2 as determined by iohexol-mGFR had corresponding eGFR values &lt;90 mL/min/1.73m2. eGFR showed a significant but poor correlation with mGFR, with R2 values of 0.2775 and 0.2803, respectively. While the 2021 eGFR equation had better accuracy as compared to the 2009 equation (p30 of 81% versus 76%), it displayed low overall accuracy with a p10 of &lt;43%. Separate analysis of Black donor candidates’ eGFR and mGFR values revealed similar trends as observed for the total cohort. While exclusion of the race factor in the 2021 CKD-Epi equation slightly improved accuracy (p30 of 77% versus 72%), the correlation with mGFR remained poor for both equations (R2: 0.1455 and 0.1377 for the 2009 and 2021 equations, respectively).
The results of this study confirmed that creatinine-eGFR values, regardless of the race factor, differ significantly from iohexol-mGFR. Our data shows that even potential kidney donors with eGFR &gt;90 mL/min/1.73m2 cannot be presumed to have normal kidney function, while eGFR &lt;90 mL/min/1.73m2 cannot accurately exclude donor candidates. We conclude that creatinine-eGFR cannot reliably serve as a substitute for mGFR in the context of living donor kidney function evaluation.
Evaluating the effectiveness of pseudothrombocytopenia (PTCP) panel with alternative anticoagulants on clinically suspicious EDTA-dependent PTCP: a single tertiary hospital experience
Authors: Sheikh Fahad , Malik Preeti , Agustin Arnel , Fang Yanan 
Published: November 2023

Abstract
EDTA is considered the most common anticoagulant to induce pseudothrombocytopenia (PTCP). PTCP panel with alternative anticoagulants (heparin and citrate) has been ordered by clinicians in our hospital for suspicious EDTA-dependent PTCP cases to obtain the correct platelet count (PC). In this study, we aimed to evaluate the effectiveness of alternative anticoagulants on clinically suspicious EDTA-PTCP. We retrospectively identified cases for which PTCP panel (EDTA, heparin, and citrate) was performed from June 2021 to March 2022 using the SAP business intelligence tool. PC was considered significantly different when the difference is more than 25% comparing heparin or citrate to EDTA tubes. Representative cases were chosen for chart review and/or peripheral blood smear review. 200 cases were included in the study. 76 cases had similar PCs in all 3 tubes which represent either true thrombocytopenia or PTCP in all 3 tubes. 17 cases had higher PC on heparin and/or citrate than EDTA which are EDTA-PTCP corrected by alternative anticoagulants (confirmed by smear review). Among those 17 cases: 6/17 had high PC on citrate only, 2/17 on heparin only and 9/17 had higher PC on citrate/heparin. 82 cases had lower PC on heparin only compared to EDTA and 62/82 had heparin exposure. There was 1 case with lower PC on citrate only (no heparin tube) compared to EDTA. 24 cases had lower PC in both heparin and citrate than EDTA tubes (lowest PC on Heparin) and 21/24 have heparin exposure. Peripheral blood smears were reviewed in 39 representative cases. Platelet clumps were identified in the corresponding tubes of all cases. Our study shows that heparin-PTCP is common in hospitalized patients and confirms that heparin is not a suitable alternative anticoagulant for EDTA-PTCP as shown by previous literature. However, many laboratories still use it for EDTA-PTCP. Heparin is known to promote platelet activation which may cause PTCP. The low PC in the heparin tube also seems to be associated with prior heparin exposure. Citrate is a better alternative to EDTA-PTCP. Among cases with low PCs on citrate, nearly all have low PCs on heparin as well. It is interesting to note those cases usually have lower PCs on heparin versus citrate and have prior exposure to heparin. The low PCs on citrate might be partially due to insufficient correction (110%) of PC by the dilution factor of the anticoagulant. Literature showed that a higher corrective factor of PCs is required for citrate. Therefore, a correlation study of PCs in EDTA versus citrate in each lab is needed to establish the corrective factor. Furthermore, delayed processing might be contributing as PCs on citrate are less stable and must be processed within 3 hours.
CytogeneticsRapid Resolution of Medically Relevant Polyunsaturated, Very Long-, Odd-, and Branched-Chain Fatty Acid Methyl Esters
Authors: Nelson Andrew T , McDonald Jeffrey G 
Published: November 2023

Abstract
Fatty acids play an important role in human health and disease. Nearly 100 years ago, the Burrs demonstrated that polyunsaturated fatty acids (PUFAs) were essential for development; subsequent work uncovered the role of PUFAs as precursors to important signaling molecules such as prostaglandins, leukotrienes, and thromboxanes. Very long chain fatty acids (VLCFAs) originally sparked interest over 40 years ago for being elevated in humans with peroxisomal disorders. More recent studies have shown that VLCFAs are elevated in healthy human controls, compared to their diabetic counterparts. In a similar vein, odd chain fatty acids (OCFAs) and branched-chain fatty acids (BCFAs) of the iso and anteiso variety are higher in humans with insulin sensitivity than in insulin resistant individuals. These families of fatty acids are most frequently analyzed as their fatty acid methyl esters (FAMEs) by gas chromatography (GC). Regrettably, even recently published methods resolving BCFAs from their linear correlates have run-times in excess of an hour and, in some cases, over 100 minutes.
Objective: The goal of this study was to decrease the GC run-time for the analysis of FAMEs relevant to human health and disease.
Methods: Baseline resolution of FAMEs required careful combination of the right gas chromatograph, column dimensions, stationary phase, carrier gas, and temperature programming.
Results: We cleanly resolved the FAMEs of all common polyunsaturated, very long-, odd-, and branched-chain fatty acids with baseline separation in only ~15 minutes – a 4-fold improvement over many existing methods.
Conclusion: This method will significantly improve analysis of fatty acids in health and disease, especially in large-scale, clinical studies, by quartering the run time necessary to resolve PUFAs, VLCFAs, OCFAs, and BCFAs.
Association of over the counter “hangover remedy” use with alcohol use problems and consumption patterns among young adults
Authors: Han Dae-Hee , Davis Jordan P , Davies Daryl L , Clapp John D , Pedersen Eric R , Leventhal Adam M 
Published: November 2023

Abstract
This cross-sectional study of young adults examined associations of hangover remedy use with alcohol use problems. Results suggest that ever-use of hangover remedy products was positively associated with alcohol use problem score, drinks per typical drinking day, and alcohol use disorder symptom count. Use of hangover remedies among young adults merits further scientific and regulatory attention.
Characterization of a novel L-fuconate dehydratase involved in the non-phosphorylated pathway of L-fucose metabolism from bacteria
Authors: Watanabe Seiya 
Published: November 2023

ABSTRACT
A sugar acid dehydratase from Paraburkholderia mimosarum, potentially involved in the non-phosphorylated L-fucose pathway, was functionally characterized. A biochemical analysis revealed its unique heterodimeric structure and higher specificity toward L-fuconate than D-arabinonate, D-altronate, and L-xylonate, which differed from homomeric homologs. This unique L-fuconate dehydratase has a poor phylogenetic relationship with other functional members of the D-altronate dehydratase/galactarate dehydratase protein family.
Drug repositioning based on weighted local information augmented graph neural network
Authors: Meng Yajie , Wang Yi , Xu Junlin , Lu Changcheng , Tang Xianfang , Peng Tao , Zhang Bengong , Tian Geng , Yang Jialiang 
Published: November 2023

AbstractDrug repositioning, the strategy of redirecting existing drugs to new therapeutic purposes, is pivotal in accelerating drug discovery. While many studies have engaged in modeling complex drug–disease associations, they often overlook the relevance between different node embeddings. Consequently, we propose a novel weighted local information augmented graph neural network model, termed DRAGNN, for drug repositioning. Specifically, DRAGNN firstly incorporates a graph attention mechanism to dynamically allocate attention coefficients to drug and disease heterogeneous nodes, enhancing the effectiveness of target node information collection. To prevent excessive embedding of information in a limited vector space, we omit self-node information aggregation, thereby emphasizing valuable heterogeneous and homogeneous information. Additionally, average pooling in neighbor information aggregation is introduced to enhance local information while maintaining simplicity. A multi-layer perceptron is then employed to generate the final association predictions. The model’s effectiveness for drug repositioning is supported by a 10-times 10-fold cross-validation on three benchmark datasets. Further validation is provided through analysis of the predicted associations using multiple authoritative data sources, molecular docking experiments and drug–disease network analysis, laying a solid foundation for future drug discovery.
Test-retest reliability of spectral parameterization by 1/f characterization using SpecParam
Authors: McKeown Daniel J , Finley Anna J , Kelley Nicholas J , Cavanagh James F , Keage Hannah A D , Baumann Oliver , Schinazi Victor R , Moustafa Ahmed A , Angus Douglas J 
Published: November 2023

Abstract
SpecParam (formally known as FOOOF) allows for the refined measurements of electroencephalography periodic and aperiodic activity, and potentially provides a non-invasive measurement of excitation: inhibition balance. However, little is known about the psychometric properties of this technique. This is integral for understanding the usefulness of SpecParam as a tool to determine differences in measurements of cognitive function, and electroencephalography activity. We used intraclass correlation coefficients to examine the test-retest reliability of parameterized activity across three sessions (90 minutes apart and 30 days later) in 49 healthy young adults at rest with eyes open, eyes closed, and during three eyes closed cognitive tasks including subtraction (Math), music recall (Music), and episodic memory (Memory). Intraclass correlation coefficients were good for the aperiodic exponent and offset (intraclass correlation coefficients &gt; 0.70) and parameterized periodic activity (intraclass correlation coefficients &gt; 0.66 for alpha and beta power, central frequency, and bandwidth) across conditions. Across all three sessions, SpecParam performed poorly in eyes open (40% of participants had poor fits over non-central sites) and had poor test-retest reliability for parameterized periodic activity. SpecParam mostly provides reliable metrics of individual differences in parameterized neural activity. More work is needed to understand the suitability of eyes open resting data for parameterization using SpecParam.
Impact of Concomitant Thiopurine on the Efficacy and Safety of Filgotinib in Patients with Ulcerative Colitis: Post Hoc Analysis of the Phase 2b/3 SELECTION Study
Authors: Watanabe Kenji , Peyrin-Biroulet Laurent , Danese Silvio , Fujitani Yasushi , Faes Margaux , Oortwijn Alessandra , Lindsay James O , Rogler Gerhard , Hibi Toshifumi 
Published: November 2023

Abstract

Background and Aims
SELECTION is the first study to assess the impact of concomitant thiopurine and other immunomodulator [IM] use on the efficacy and safety of a Janus kinase inhibitor, filgotinib, in patients with ulcerative colitis.

Methods
Data from the phase 2b/3 SELECTION study were used for this post hoc analysis. Patients were randomised [2:2:1] to two induction studies [biologic-naive, biologic-experienced] to filgotinib 200 mg, 100 mg, or placebo. At Week 10, patients receiving filgotinib were re-randomised [2:1] to continue filgotinib or to switch to placebo until Week 58 [maintenance]. Outcomes were compared between subgroups with and without concomitant IM use.

Results
At Week 10, similar proportions of patients in the +IM and −IM groups treated with filgotinib 200 mg achieved Mayo Clinic Score [MCS] response [biologic-naive: 65.8% vs 66.9%; biologic-experienced: 61.3% vs 50.5%] and clinical remission [biologic-naive: 26.0% vs 26.2%; biologic-experienced: 11.3% vs 11.5%]. At Week 58, similar proportion of patients in the +IM and −IM groups treated with filgotinib 200 mg achieved MCS response [biologic-naive: 74.2% vs 75.0%; biologic-experienced: 45.5% vs 61.4%] and clinical remission [biologic-naive: 51.6% vs 47.4%; biologic-experienced: 22.7% vs 24.3%]. The probability of protocol-specified disease worsening during the maintenance study in patients treated with filgotinib 200 mg did not differ between +IM and −IM groups [p = 0.6700]. No differences were observed in the incidences of adverse events between +IM and −IM groups in the induction/maintenance studies.

Conclusions
The efficacy and safety profiles of filgotinib treatment in SELECTION did not differ with or without concomitant IM use.

ClinicalTrials.gov identifier
NCT02914522.
ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer
Authors: O'Dowd Emma L , Tietzova Ilona , Bartlett Emily , Devaraj Anand , Biederer Jürgen , Brambilla Marco , Brunelli Alessandro , Chorostowska Joanna , Decaluwe Herbert , Deruysscher Dirk , De Wever Walter , Donoghue Matthew , Fabre Aurelie , Gaga Mina , van Geffen Wouter , Hardavella Georgia , Kauczor Hans-Ulrich , Kerpel-Fronius Anna , van Meerbeeck Jan , Nagavci Blin , Nestle Ursula , Novoa Nuria , Prosch Helmut , Prokop Mathias , Putora Paul Martin , Rawlinson Janette , Revel Marie-Pierre , Snoeckx Annemiek , Veronesi Giulia , Vliegenthart Rozemarijn , Weckbach Sabine , Blum Torsten G , Baldwin David R 
Published: November 2023

Abstract

Background
Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation.

Methods
A multi-European society collaborative group was convened. 23 topics were identified, primarily from an ERS statement on lung cancer screening, and a systematic review of the literature was conducted according to ERS standards. Initial review of abstracts was completed and full text was provided to members of the group for each topic. Sections were edited and the final document approved by all members and the ERS Science Council.

Results
Nine topics considered most important and frequent were reviewed as standalone topics (interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities). Other topics considered of lower importance or infrequent were grouped into generic categories, suitable for general statements.

Conclusions
This European collaborative group has produced an incidental findings statement that can be followed during lung cancer screening. It will ensure that an evidence-based approach is used for reporting and managing incidental findings, which will mean that harms are minimised and any programme is as cost-effective as possible.