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Record W4410050911 · doi:10.1093/clinchem/hvaf026

Autoverified Chocolate-Colored Plasma Samples

2025· article· en· W4410050911 on OpenAlexaff
Janet R. Zhou, Albert K.Y. Tsui

Bibliographic record

VenueClinical Chemistry · 2025
Typearticle
Languageen
FieldNursing
TopicBiochemical Analysis and Sensing Techniques
Canadian institutionsUniversity of Alberta
Fundersnot available
KeywordsColoredFood scienceChromatographyChemistryMaterials science

Abstract

fetched live from OpenAlex

A 37-year-old female with a history of acute intermittent porphyria (AIP) and hemochromatosis presented to the emergency department after experiencing intense abdominal and back pain with nausea. She was admitted to hematology and bloodwork was monitored periodically. Centrifugation of the lithium heparin samples revealed chocolate-colored plasma (Fig 1). However, chemistry results autoverified, without serum indices flags on Roche Cobas c503. Her urinary porphobilinogen/creatinine ratio was >34 µmol/mmol (reference interval <1.7 µmol/mmol). The patient’s lithium heparin plasma samples after centrifugation upon (A) admission, (B) 6 h post-treatment, (C) 24 h post-treatment, (D) 36 h post-treatment, (E) 48 h post-treatment, and (F) 72 h post-treatment. Color figure available at https://academic.oup.com/clinchem. Questions What investigations would be helpful in determining the cause of chocolate-colored plasma? What is the treatment for acute intermittent porphyria? Which assays would be affected by chocolate-colored plasma? The answers are below. Upon ruling out in vivo hemolysis and methemoglobinemia as common causes of brown plasma (1), chart review revealed that the patient was treated for the AIP flare with a hematin infusion. Hematin is brown in color and led to the discolored plasma at 6 h post-treatment (Fig 1B) and persisted at 72 h post-treatment (Fig 1F). Further investigations should be performed to determine whether hematin interferes with any spectrophotometric assays (2–4). The corresponding author takes full responsibility that all authors on this publication have met the following required criteria of eligibility for authorship: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; (c) final approval of the published article; and (d) agreement to be accountable for all aspects of the article thus ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved. Nobody who qualifies for authorship has been omitted from the list. Janet Zhou (Conceptualization-Equal, Data curation-Equal, Formal analysis-Equal, Investigation-Equal, Methodology-Equal, Project administration-Equal, Validation-Equal, Visualization-Equal, Writing—original draft-Equal, Writing—review & editing-Equal), and Albert Tsui (Conceptualization-Equal, Formal analysis-Equal, Investigation-Equal, Methodology-Equal, Project administration-Equal, Supervision-Equal, Validation-Equal, Visualization-Equal, Writing—original draft-Equal, Writing—review & editing-Equal). Upon manuscript submission, all authors completed the author disclosure form. None declared. A.K.Y. Tsui has served on an advisory board for Novo Nordisk.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Bench or experimental · Consensus signal: Bench or experimental
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.251
Threshold uncertainty score0.631

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.037
GPT teacher head0.359
Teacher spread0.322 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designBench or experimental
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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