Publications by authors named "Laura Stephens"

Article processing charges are increasingly being levied on authors via publication fees to provide open access to readers. These charges may impose challenges to early career physicians seeking to publish research but pathology journal article processing charges have not been investigated to date. We aimed to quantify pathology journal article processing charges and investigate the potential associated factors.

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  • The ASFA Attending Physician Subcommittee reviewed 2023 apheresis literature and selected the top 10 seminal articles in the field.
  • They focused on four main topics: donor apheresis, therapeutic apheresis, education, and cellular therapy, using PubMed and OVID for research.
  • The chosen articles met key criteria such as novel findings, practice-changing results, and relevance to current clinical practice, while excluding case reports, reviews, and meta-analyses.
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  • Hemolytic disease of the fetus and newborn (HDFN) results from maternal antibodies attacking the fetal red blood cells, but current clinical monitoring practices for it are inconsistent across institutions.
  • A survey of 103 US institutions revealed that while most conduct maternal antibody testing, methods and follow-up practices vary significantly, with only 27% employing cell-free fetal DNA testing to assess fetal risk.
  • The findings indicate a need for standardization in laboratory testing and improved cooperation between blood banks and maternal-fetal medicine services to better manage HDFN risk.
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Background: Normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP) are organ procurement and transport techniques that can improve organ quality, facilitate longer transport, and reduce postoperative complications, increasing organ availability and improving outcomes. NRP and NMP often require allogeneic red blood cells (RBCs). Our academic transfusion service began providing RBCs to support NRP and NMP for adult heart transplant (HT), orthotopic liver transplant (OLT), and multiorgan transplant (MOT) in August 2020.

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Prior studies have suggested that immune thrombotic thrombocytopenic purpura (iTTP) may display seasonal variation; however, methodologic limitations and sample sizes have diminished the ability to perform a rigorous assessment. This 5-year retrospective study assessed the epidemiology of iTTP and determined whether it displays a seasonal pattern. Patients with both initial and relapsed iTTP (defined as a disintegrin and metalloprotease with thrombospondin type motifs 13 activity <10%) from 24 tertiary centers in Australia, Canada, France, Greece, Italy, Spain, and the US were included.

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The actual risk of providing RhD-positive units to RhD-negative recipients remains debatable. There is no standard of care in the United States (US) to guide transfusion decisions regarding RhD type for patients with an unknown blood type, except for women of childbearing age and neonates. The risk of alloantibody formation by an RhD-negative patient exposed to RhD-positive blood is reported to be from 3% to 70%.

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Article Synopsis
  • A study evaluated apheresis practices in the US through a national survey involving 22 academic medical institutions to identify trends and challenges.
  • The survey revealed that therapeutic plasma exchange (TPE) is the most common procedure, with issues in staffing exacerbated by COVID-19 affecting service delivery.
  • Findings emphasized the importance of apheresis in cellular therapies and the need for innovative staffing solutions in the context of ongoing medical advancements and challenges.
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Hematopoietic stem cell transplantation (HSCT) is a cornerstone of modern medical practice, and can only be performed safely and effectively with appropriate transfusion medicine support. Patients undergoing HSCT often develop therapy-related cytopenia, necessitating differing blood product requirements in the pre-, peri-, and post-transplant periods. Moreover, ensuring optimal management for patients alloimmunized to human leukocyte antigens (HLA) and/or red blood cell (RBC) antigens, as well as for patients receiving ABO-incompatible transplants, requires close collaboration with transfusion medicine and blood bank professionals.

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Background: The COVID-19 pandemic affected healthcare delivery across all specialties including apheresis. To describe the changes in apheresis service practices that occurred during the pandemic, the American Society for Apheresis (ASFA) Apheresis Medicine Attending Physician Subcommittee conducted a survey study.

Study Design And Methods: A 32-question survey was designed and distributed to 400 ASFA physician members on September 7, 2022.

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Background: Current Association for the Advancement of Blood & Biotherapies (AABB) standards require transfusion services to have a policy on Rh immune globulin (RhIG) immunoprophylaxis for when RhD-negative patients are exposed to RhD-positive red cells. This is a survey of AABB-accredited transfusion services in the United States (US) regarding institutional policies and practices on RhIG immunoprophylaxis after RhD-negative patients receive RhD-positive (i.e.

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Objectives: Gender equity studies have shown that women are underrepresented in journal editor in chief positions, which confer major professional opportunities and influence. We sought to systematically investigate editor in chief gender and journal attributes within pathology.

Methods: We constructed a journal data set using the Scimago Journal & Country Rank and Clarivate Journal Citation Reports databases.

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Background: Correct classification of transfusion reactions is important not only for effective patient care and donor management but also for accurate tracking of events in hemovigilance systems. We compared the ability of a generative artificial intelligence (AI) system to correctly diagnose hypothetical clinical situations as transfusion reactions in comparison to previous studies reporting the accuracy of transfusion medicine (TM) specialists in assessing these cases.

Methods: An AI system was requested to assess 36 case scenarios to provide a diagnosis, severity, and imputability of the transfusion reactions using the CDC National Healthcare Safety Network (NHSN) criteria.

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Article Synopsis
  • The risk of thrombosis in individuals with hemoglobin C trait (HbAC) or hemoglobin C disease (HbCC) is not well understood, but chronic hemolysis and higher blood viscosity in these individuals may increase this risk.
  • A systematic review analyzed 22 studies involving 782 people with HbAC or HbCC, focusing on venous thromboembolism (VTE) and arterial thrombosis outcomes.
  • Findings indicate a potential increased risk of VTE associated with HbAC, especially in pregnant individuals, suggesting that HbC could be a risk factor for thrombosis, highlighting the need for further research through prospective cohort studies.
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The current recommended testing algorithm for assessing the alloimmunized pregnancy utilized by many obstetricians in the United States (US) fails to consider the most recent evidence, placing fetuses, and mothers at unnecessary risk of poor outcome or death. This narrative review of the current landscape of fetal red blood cell (RBC) antigen testing evaluates the history of hemolytic disease of the fetus and newborn (HDFN) and how its discovery has continued to influence practices in the US today. We compare current US-based HDFN practice guidelines with those in Europe.

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Pure red cell aplasia (PRCA) is a rare hematologic phenomenon that is usually associated with inherited genetic mutations such as in Diamond-Blackfan anemia. However, due to the emergence of allogenic stem cell transplantation in the treatment of various malignant and non-malignant disorders, the incidence of PRCA has increased. PRCA following hematopoietic stem cell transplant (HSCT) is more commonly seen in the setting of a major ABO-incompatible transplant.

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Background: Predicting whether a patient's platelet refractoriness (PR) is due to immune or nonimmune causes can be challenging. This study compared the demographics and clinical history of PR patients with human leukocyte antigen (HLA) antibodies (HLA-PR) versus PR patients without HLA antibodies.

Materials And Methods: A retrospective review of all patients with PR consults at a single institution over a 3-year period was performed.

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