bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-183 Improving Turnaround Time of Critical Value Reporting by Reducing Redundant Workflow
Authors: Chuang F 
Published: September 2023

Abstract

Background
Most laboratories and hospital patient safety committee define the critical value parameter together, and laboratory should notice the doctor when critical value reporting. “Critical value” as a result refers to the patient may be life-threatening or in imminent danger and require immediate treatment by a doctor. Especially, Troponin-I result is greatly affect door to balloon time. As soon as the critical value reporting, the patient will get therapy earlier. For patient safety, we implemented some methods to reduce the turnaround time of critical value reporting.

Methods
(1) Shorten the distance between specimen receiver and testing operator from 2 meter to 0 meter. Specimens are analyzed sooner due to reduced unnecessary walk. (2) Assess the difference of results between first and second exam, there are no significant difference. Reducing unnecessary repeat test to report critical value as soon as possible. (3) Reading barcode by both clockwise and counterclockwise way to improve barcode reading performance of analyzer, and reducing unnecessary re-label or manual operate.

Results
Emergency patient critical value report in 30 min completion rate increased from 80.5% to 93.3%. Inpatient critical value report in 60 min completion rate increased from 94.1% to 96.6%. Troponin-I report in 30 min completion rate increased from 89.3% to 97.0%.

Conclusion
Doctors treat according to result from laboratory, and delayed report is an impediment to patient care. Particularly critical value reports, that causes delays in urgent patient treatment. We reduced unnecessary work to short turnaround time for critical value reporting, patient will get better therapy faster, and further improve patient safety.
A-187 The Effect of Ambient Temperature on Potassium During Hot Months: The Seasonal Pseudohypokalemia Delima!
Authors: Khoury R , Gudaitis P , Gandhi A , Gudaitis D 
Published: September 2023

Abstract

Background
Laboratory tests are vital tools for the clinicians and it is becoming more and more the most the decision maker for the management of patients. Blood samples are drawn from patients and transported to the laboratory for analysis; samples are exposed to various temperatures during transportation which could have an effect on test results. We studied the effect of seasonal change on the potassium results using lithium heparin plasma tubes.

Method
We compared the results collected from one day/month each from January 2022 to August 2022 from patients residing in Long-Term Care Facilities and were transported to the laboratory during which the samples were exposed to ambient temperature. A total of 16 086 specimens were collected using Lithium heparin plasma tubes up to 8/8/2022, sample on 8/15/22 were collected using serum gel separation tubes. Statistical analysis was done using Analyse-it.

Results
our results showed an increase in hypokalemia with the increase in ambient temperature, the highest incidence of hypokalemia was during the month of June to August which corresponds with the higher ambient temperature. There was an increase in hypoglycemia at the same time of the increase in hypokalemia. The percentage of samples with hypokalemia was normalized when serum (SST) tubes were used.

Conclusion
Seasonal pseudohypokalemia is phenomena that is seen when the samples are transported to the laboratory from different collection sites during the hot temperature. The increase in hypokalemia could be due to an increase in glucose metabolism and the cellular uptake of potassium or could be mediated by sodium-potassium-exchange-ATPase. Serum samples were less affected by the temperature change than lithium heparin plasma. It is very important to emphasis on the temperature during transporting samples to the laboratory to avoid seasonal pseudohypokalemia in the hot temperature season and hyperkalemia during the cold temperature season.
A-206 Association of Lipids and Glucose with High-sensitivity CRP (hs-CRP) in a Community-based Adult Population
Authors: Li H , White Al-Habeeb N , Catomeris P 
Published: September 2023

Abstract

Background
Research and clinical studies have established a pivotal role of inflammation in the development and progression of both cardiac and vascular diseases, responsive to injurious factors such as smoking, hypertension, dyslipidemia, and hyperglycemia. This study analyzed the association of various lipids, HbA1c and glucose with high-sensitivity CRP (hs-CRP), a marker of low-grade chronic inflammation, in a community-based adult population.

Methods
Data analysis was carried out on within-collection results obtained from adults (&gt; = 20 yrs) from 2019 to 2022. Tests included hs-CRP, with cholesterol (n = 74 560), triglycerides (n = 74 551), LDL-C (n = 73 426), HDL-C (n = 74 458), non-HDL-C (n = 69 808), ApoB (n = 3122), Lp(a) (n = 4444), fasting glucose (n = 42 954) or HbA1c (n = 62 486). All tests were performed on Roche Cobas instrumentation. Chi square tests were performed to evaluate the association between each lipid and glycemic indicator with hs-CRP. Relative risk (RR) and odds ratio (OR) were calculated to assess the strength of the association.

Results
Chi-square test demonstrated association of hs-CRP with HDL-C, triglycerides, HbA1c, non-HDL-C, LDL-C, fasting glucose, cholesterol and ApoB, but not Lp(a). Increased risk and odds to have elevated hs-CRP (3.0 -10.0 mg/L) were observed with abnormal glucose and lipid levels. Higher RR and OR were seen with decreased HDL-C and elevated HbA1c, fasting glucose, triglycerides, and non-HDL-C. Slightly increased RR and OR were also observed with elevated LDL-C, ApoB, but not Lp(a).

Conclusion
Glucose and most lipid parameters were associated with hs-CRP. Stronger association was observed with HDL-C and carbohydrates (glucose and triglycerides), followed by triglycerides-rich non-HDL-C. LDL-C, ApoB and cholesterol had weaker association, and Lp(a) had no association with hs-CRP. This observation from a large data set from a community population may provide helpful insight to prevention and clinical management of low-grade chronic inflammation.
A-219 A Multiplexed Targeted Assay for Gangliosides Using Liquid Chromatography-Tandem Mass Spectrometry
Authors: Kim J , Byeon S , Oglesbee D , Matern D , Schultz M J , Pandey A 
Published: September 2023

Abstract

Background
Gangliosides are a family of complex lipids that are molecules composed of glycosphingolipid with one or more sialic acid linked on the sugar moieties. Gangliosides are recognized to play an important role in many biological processes and the alterations in ganglioside profiles have been observed in some neurodegenerative diseases, neuropathies and lysosomal disorders. Gangliosidoses are a group of inherited lysosomal enzyme deficiencies characterized by an accumulation of incompletely degraded gangliosides in the lysosome. While the diagnosis of gangliosidoses can be accomplished by measurement of enzymatic activities and/or molecular genetic testing, biomarker analysis could facilitate monitoring affected patients, including those enrolled in clinical trials of new treatment approaches (ie., substrate reduction or gene therapies). We developed a rapid and sensitive LC-MS/MS assay that allows simultaneous quantification of multiple gangliosides and other glycosphingolipids and tested it in serum and plasma of patients with a diagnosis of GM2-gangliosidosis.

Methods
Gangliosides and other glycosphingolipids were extracted from 20 µL serum or plasma using chloroform:methanol (1:2, v/v). A multiplexed LC-MS/MS assay was developed that targeted several ganglioside species (GM3, GM2, GM1, GD3, GD2, GD1, GT3, GT2, GT1 and GQ1) along with several glycosphingolipid species (GlcCer, LacCer, Gb3, Gb4 and GA2). This assay was performed on a triple quadrupole mass spectrometer with scheduled MRM in both negative and positive ion modes after internal standards (GM3 18:0-d5, GM1 17:0, GA2 17:0 and Gb3 18:0-d3) were spiked into clinical samples.

Results
The multiplexed targeted assay applied to serum and plasma from controls (47 and 49 samples, respectively) and three GM2-gangliosidosis patients for identification and quantification of the targeted gangliosides and other glycosphingolipids. The abundance of GM2 and GM1 gangliosides inserum and plasma of patients with GM2-gangliosidosis was significantly higher than in the control group (P  &lt;  0.0001) whereas GM3 levels were significantly lower (P &lt;  0.005). Other gangliosides including GD3, GD2, GD1 and GT1 and glycosphingolipids such as GlcCer, LacCer and Gb3 were not significantly different between these patients and controls.

Conclusion
A multiplexed targeted assay for glycosphingolipids including gangliosides was developed. This assay will be further validated for potential use in the diagnosis and monitoring of patients with additional gangliosidoses.
A-222 Comparative Analysis of Clinical and Laboratory Parameters of Brazilian Patients with Severe Hipertriglyceridemia
Authors: Costa C L , Castelo M C , Veras V R , Ramos L T , Fernandes V O , Lima R S , Vasconcelos M P , Lima G P , Araujo J S , Montenegro A D , Queiroz L L , Ponte C M , Flor A C , Melo I D , Lopes A C , Montenegro R M 
Published: September 2023

Abstract

Background
The presence of elevated and sustained levels of triglycerides (TG) should raise the suspicion of primary causes of hypertriglyceridemia (HT), in which related genetic mutations would be identified. Thus, the aim of this study was to compare clinical and laboratory parameters of Brazilian patients with different etiologies of severe hypertriglyceridemia.

Methods
All patients with severe HT (considered as detection of TG above 880 mg/dL on at least 2 occasions) followed in the dyslipidemia outpatient clinic of Federal University of Ceará/Brazil, whose molecular study to investigate genetic variants potentially related to hypertriglyceridemia and pancreatitis has been previously performed (ABCA1 AGPAT2 AKT2 APOA5 APOC2 BSCL2 CAV1 CFTR CIDEC CTRC CYP27A1 GPIHBP1 LIPA LIPE LMF1 LMNA LMNB2 LPL PLIN1 POLD1 PPARG PRSS1 PSMB8 SMPD1 SPINK1 ZMPSTE24) were evaluated.

Results
Sixty-six patients were evaluated, identifying 39 (59%) with severe primary HT. Familial Chylomicronemia Syndrome (FCS) was identified in 14 (36%) of the 39 cases of severe primary HT. The main findings are shown in table 1. Compared with other etiologies, FCS patients presented an increased, precocious and recurrent incidence of pancreatitis, earlier detection and higher levels of TG. In patients with severe HT without identification of primary causes, a high incidence of alcoholism and diabetes was observed, with a tendency to higher glycated hemoglobin values among these, in addition to median Body Mass Index compatible with obesity.

Conclusion
FCS patients had the most severe clinical presentation of HT. The high prevalence of secondary factors for HT in patients with a negative genotype reinforces the indication of adequate management of these variables even in cases of primary etiology, aiming at not overlapping pathological mechanisms. In cases of severe HT, metabolic control is still a challenge.
A-224 Comparative Analysis of Clinical and Laboratory Parameters of Different Subtypes of Familial Partial Lipodistrophy
Authors: Veras V R , Castelo M C , Costa C L , Vasconcelos L T , Fernandes V O , Lima R S , Vasconcelos M P , Lima G P , Araujo J S , Montenegro A D , Ponte C M , Queiroz L L , Melo I D , Flor A C , Lopes A C , Montenegro R M 
Published: September 2023

Abstract

Background
Lipodystrophy is a disease characterized by changes in body fat deposits. They are classified according to the extent of fat loss (generalized or partial) and the form of inheritance (inherited or acquired). Family partial lipodystrophy (FPL) are rare forms characterized by distribution of centripetal body adiposity, poorly controlled diabetes mellitus (DM) and severe dyslipidemia.

Methods
Fourty-two FPL patients were evaluated, whose were followed in the lipodistrophy outpatient clinic of the Federal University of Ceará/Brazil. Twenty-two had previous positive molecular test for FPL, among which 19 had an LMNA mutation and 3 had a PPARG mutation. Twenty patients had a negative genetic test but met clinical criteria for lipodystrophy, which were thigh skinfold &lt;20 mm for females and &lt;10 mm for males or fat mass ratio (FMR) between trunk and lower limbs &gt;1.2. Eight patients in the negative genotype group met criteria for Köbberling Syndrome (Köb index &gt;3.477). The others 12 patients were classified as FPL indeterminate subtype (FPLX).

Results
PFL+ patients perceived the lipodystrophic phenotype before the other groups. All groups had high A1c medians, with the Köbberling group having the highest median (9.1%). However, patients with FPL+ had a higher median insulin dose. Diabetic polyneuropathy was the most prevalent complication in the three groups. Median peak triglycerides were similar for the three groups, with the Köbberling group having the greatest variability. There no pancreatitis episodes in the FPL+ group, but Köbberling e FPLX did. The main findings are shown in Table 1.

Conclusion
FPL is a disease with a broad spectrum of phenotype and genotype. It is usually associated with poor DM control, early DM complications and severe hypertriglyceridemia, as our patients demonstrated. In these cases, metabolic control is still a challenge.
A-228 Performance Evaluation of the LabGenius C-CT/NG-BMX Assay for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae
Authors: Lim Y , Kweon O , Lee M 
Published: September 2023

Abstract

Background
The LabGenius C-CT/NG-BMX assay (LabGenius CT/NG; BIOMEDUX, Gyeonggi-do, Republic of Korea) is a recently developed real-time polymerase chain reaction assay that can simultaneously detect sexual transmitted pathogens (Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG)) in vaginal swab specimen or urine specimen.

Methods
To evaluate the analytical performance, a total of 343 vaginal swab and 167 urine specimens were selected to compare the LabGenius CT/NG with the BD MAX™ CT/GC/TV (Becton, Dickinson and Company, NJ, USA). In addition, using binomial logistic regression analysis, we estimated the limit of detection which 95% (Lod95) detection rate were achieved in the LabGenius CT/NG.

Results
The LabGenius CT/NG showed almost perfect agreement with the BD MAX™ CT/GC/TV (κ = 0.826 for CT, κ = 0.944 for NG), and overall agreements between two assays were 91.6% for CT and 97.8% for NG, respectively. The LoD95 values using vaginal swab and urine specimens were 9.9 and 7.8 copies/uL for CT, and 7.6 and 5.1 copies/uL for NG, respectively.

Conclusion
In this study, LabGenius CT/NG demonstrated acceptable analytical performance compared to BD MAX™ CT/GC/TV, and this assay could be a cost-effective option for routine and follow-up test for detection of sexual transmitted pathogens.
A-229 Immune Biomarkers Associated with COVID-19 Disease Severity in an Urban, Hospitalized Population
Authors: Chambliss A B , Aljehani M , Tran B , Chen X , Elton E , Garri C , Ung N , Matasci N , Gross M E 
Published: September 2023

Abstract

Background
We sought to identify immune biomarkers associated with severe Coronavirus disease 2019 (COVID-19) in patients admitted to a large public county hospital during the early phase of the SARS-CoV-2 pandemic. We hypothesized that we could identify clinically relevant immune markers at the time of initial hospital admission that could be used to predict the course of COVID-19 illness.

Methods
The study population consisted of SARS-CoV-2 positive patients admitted for COVID-19 (n = 58) or controls (n = 14) at the Los Angeles County University of Southern California Medical Center between April-December 2020. Immunologic markers including chemokine/cytokines (IL-6, IL-8, IL-10, IP-10, MCP-1, TNFα) and serologic markers against SARS-CoV-2 antigens (including spike subunits S1 and S2, receptor binding domain (RBD), and nucleocapsid (N)) were assessed in serum collected on the day of admission using custom MILLIPLEX® immunoassay panels. Result values were computed using mean fluorescent intensity in individual samples fit to a standard curve using a 5PL logistic formula with power law variance. Comparison of patient demographic, clinical, cytokines and immunoglobulins characteristics between mild vs moderate/severe COVID-19 groups were conducted using Wilcoxon tests for continuous variables and Chi-square tests for categorical variables. Linear support vector machine models were fitted to perform the binary classification task of predicting mild vs moderate/severe COVID-19 using the python library scikit-learn.

Results
SARS-CoV-2 antibody levels were significantly elevated in patients with the highest COVID-19 disease severity, with IgM S1, IgG N, IgG RBD, IgG S1, and IgG S2 showing statistical significance between mild vs moderate/severe disease group medians (P = 0.037, 0.032, 0.007, 0.003, and 0.015, respectively). Of the chemokines/cytokines tested, only IP-10 showed significance across the disease groups (medians 640.8 pg/mL in mild, 493.3 pg/mL in moderate/severe, and 259.9 pg/mL in control, overall P = 0.005). The linear support vector machine model achieved an accuracy of 64% and an AUROC of 0.81 in predicting COVID-19 severity status. The most important clinical variables for predicting disease severity were white blood cell count, diastolic blood pressure, and platelet count, while the most important serologic markers were IgG anti-SARS-CoV-2 N, S1, S2, TNF-α, IP-10, and IL-10.

Conclusion
Our results suggest that IP-10 and anti-SARS-CoV-2 antibody measurements could be useful to identify patients most likely to experience the most severe forms of the disease. Strengths of this study include a focus on a racially and ethnically diverse patient population and a combined analysis of both cytokine/chemokine and immune response (antibody) biomarkers. However, we emphasize that our subjects were enrolled at a time before widespread vaccination against SARS-CoV-2.
A-233 Novel Microfluidic System for Antimicrobial Susceptibility Testing
Authors: Bajer-Borstyn S , Zurawska G 
Published: September 2023

Abstract

Background
Aiming to enhance antibiotic susceptibility testing (AST), BacterOMIC combines microdilution AST with cutting-edge microfluidics to quantitatively evaluate all clinically relevant antibiotics on a single disposable panel. In this study, we evaluated the performance of BacterOMIC in determining minimum inhibitory concentrations (MICs) of selected agents against Gram-positive and Gram-negative bacteria and in detecting the presence of extended spectrum beta-lactamase (ESBL) produced by Enterobacterales.

Methods
Using the BacterOMIC UNI Panel, we characterized bacterial strains collected from Polish hospitals in 2020–2022. We inoculated the BacterOMIC panels with bacterial suspensions in cation-adjusted Mueller-Hinton broth at a density of 5*10^5 CFU/mL. The panels then incubated in an analyzer for 16 h, and results were automatically calculated via built-in analytical software. For comparison, we obtained reference MIC data from laboratories contracted for determining strain MIC values via microdilution. We calculated the essential agreement (EA%) and bias according to ISO20776.We also qualitatively assessed several antibiotics via our panel. Categorical agreement (CA%) and discrepancies were determined for these antibiotics according to ISO20776.To assess ESBL detection, we compared BacterOMIC results with data obtained in our internal laboratory using the MIC Test Strip ESBL (Liofilchem).

Results
With the BacterOMIC system, CA% values exceeded 90% for amoxicillin, benzylpenicillin, ceftazidime/avibactam, ciprofloxacin, erythromycin, gentamicin, meropenem, moxifloxacin, tedizolid, and vancomycin. EA% values exceeded 90% for the following antimicrobials, with a bias of less than 30%.
By comparing with our reference method, we found that BacterOMIC detected ESBL with a specificity of 92% (confidence interval [CI] 95%; 81%–98%) and sensitivity of 97% (CI 95%; 84%–99%).

Conclusions
Our data demonstrate that BacterOMIC provides reliable MIC and ESBL results for assessing the drug susceptibility of Gram-positive and Gram-negative bacteria against 25 agents in a single panel. Thus, the BacterOMIC system provides a valuable tool for automated AST systems.
A-240 Rapid and Reliable Identification of Microorganisms from Early Growth of Positive Blood Cultures Using MALDI-TOF Mass Spectrometry
Authors: Roemmich B L , Yarbrough M L , Alvarado K K 
Published: September 2023

Abstract

Background
Rapid identification of organisms causing bloodstream infections is critical for treatment. Traditional workflows rely on 18–24 h growth of isolated colonies. Our objective was to evaluate identification of early growth using Bruker and VITEK® MS PRIME MALDI-TOF systems.

Materials
Positive blood cultures (BACT/ALERT® FA/FN Plus; bioMérieux VIRTUO®) were included if bottles were positive &lt;8 h and had time-to-positivity of &lt;40 h. Broths were sub-cultured to blood agar and incubated at 35°C/5% CO2. MALDI-TOF identification of 6–8 h growth (short incubation, SI) and 18–24 h growth (standard incubation, SDI) was performed by a high (HEU, &gt;1 year) and low (LEU, &lt;1 month) experience user. Each identification was performed using standard set-up for Bruker and VITEK MS PRIME, and target set-up using VITEK PICKMETM pen. Identification level and time-to-result (TTR) were measured and compared using Fisher’s exact and t-test.

Results
53 organisms (36 Gram-positive, 15 Gram-negative, 2 yeast) were isolated from 50 blood cultures. The HEU achieved species-level identification for 87% on VITEK MS PRIME using routine set-up and PICKME after SI vs 74% on Bruker, while 66% and 70% of organisms were identified on VITEK MS PRIME vs 75% on Bruker by the LEU (Table). After SDI, ≥94%(HEU) and ≥87%(LEU) of organisms were identified, with no differences noted by set-up or user experience (P &gt; 0.05). Species-level identification after SI was higher for Gram-negative (100%) vs Gram-positive (67–86%) organisms for the HEU. PICKME pen usage increased identifications to 100% from 67% for Gram-negatives for the LEU. For mixed cultures (n = 3), only 1 of 2 organisms was identified after SI. TTR was significantly longer(P &lt; 0.05) for SI vs SDI and Bruker vs VITEK MS PRIME for the HEU.

Conclusions
Identification of microorganisms after short incubation on solid media achieves early, reliable identification for a majority of positive blood cultures without need for additional hands-on time or extraction.