Association of anti-heparin platelet factor 4 antibody levels and thrombosis in pediatric intensive care patients without thrombocytopenia
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Bibliographic record
Abstract
Anti-heparin platelet factor 4 (anti-HPF4) antibodies have been demonstrated to play a pathogenetic role in the development of heparin-induced thrombocytopenia. In adults, the presence of anti-HPF4 antibodies without thrombocytopenia has been reported not to confer a thrombotic risk. To investigate whether this also holds true for children, we performed a case-control study in heparin-exposed patients from a pediatric intensive care unit. During the 30-month study period, 612 patients received heparin for at least 5 days. Of these, 10 patients developed thrombosis without thrombocytopenia and constituted the study group. These patients were compared with 19 matched control patients with neither thrombosis nor thrombocytopenia. Anti-HPF4 antibody levels were measured using an enzyme-linked immunosorbent assay (Asserachrom HPF4). All thrombosis patients and controls had lower anti-HPF4 antibody levels than the cut-off level recommended by the manufacturer for adults. However, median anti-HPF4 antibody levels were significantly higher in the thrombosis patients [51% of the manufacturer's cut-off; interquartile range (IQR), 47-53%] than in the control group (23%; IQR, 9-36%) (P = 0.004). At an anti-HPF4 cut-off level of 45%, the odds ratio for a thrombotic event amounted to 34 (95% confidence interval, 4.4-261.8), indicating an association between anti-HPF4 antibody levels and thrombosis despite the absence of thrombocytopenia. A role of anti-HPF4 antibodies in the development of catheter-related thrombosis is suggested.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it