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The article discusses the evolution of dermatopathology education at Harvard Medical School, particularly focusing on the contributions of Dr. Martin C. Mihm, Jr. The program was established in 1975 and has since expanded to two training programs at different Harvard-affiliated institutions. Graduates have excelled in various fields, including academia, research, and commercial enterprises. The legacy of Dr. Mihm continues to inspire excellence in teaching, investigation, and patient care within the field of dermatopathology. [Extracted from the article]

Background: Medical diagnostic laboratories as high‐risk environments are often exposed to unpredictable situations such as patient fainting, blood pressure drops, chemical spills, and burns. These life‐threatening events defined as medical emergencies and necessitate urgent actions. Hence, determining the most common medical emergencies in medical laboratories, so understanding and planning strategies to effective management seems to be crucial. Objective: This study aimed to investigate medical crises in Iranian medical laboratories. Methods: In this cross‐sectional study, data collection was performed by a simple random sampling method through electronic and paper questionnaires filled by personnel in private and hospital laboratories in different provinces. Results: The most frequent medical emergencies were patient fainting, staff needle stick, and patient's blood pressure dropping. The occurrence of medical emergencies was 24% and 76% in men and women, respectively. Out of all, treatment was administered at the scene of the accident in 37.1% of cases, and 28.1% were discharged after sampling. Moreover, 51% of the medical diagnostic laboratories had a trolley code, with injection devices and angiocaths as available tools. In 81% of the laboratories, practicing for probable medical emergencies was not possible. A significant relationship was found between the type of client (laboratory personnel or the referring person) and the type of emergency event (p < 0.05). Conclusions: Considering the prevalence and importance of handling medical emergencies in a short time, it is necessary to design training courses for laboratory personnel and expert them to encountering with unpredictable threats in order to help affected individuals. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Trichophyton mentagrophytes ITS genotype VII (TMVII) has recently been identified in France as the causative agent of dermatophyte infections transmitted during sexual activity among men who have sex with men (MSM).Our objective was to provide new insights into the epidemiology, clinical presentation and treatment of TMVII infections based on cases diagnosed from October 2022 to September 2023 in three medical mycology laboratories in Paris. Additionally, we aimed to perform molecular characterization of TMVII strains collected in Paris, as well as in Switzerland.We identified all isolates from skin and hair belonging to the T. mentagrophytes complex by sequencing the ITS region. For isolates corresponding to TMVII, clinical data were retrieved from medical records. For all available TMVII strains that we isolated since January 2021, we sequenced tef1α and tubb and determined the MAT locus idiomorph.We identified 32 cases of TMVII Infections. All cases occurred in men, 30 of whom reported having sex with men. Fifteen cases were sporadic cases including four among sex workers. The other 17 cases belonged to a single cluster involving a tantric masseur who infected 15 clients and his roommate. The median time from massage to lesion onset was 16 [2–52] days. Except for one patient, all other patients received systemic antifungal treatment with terbinafine. We observed five patients whose cultures remained positive even after 3–4 weeks of treatment and five patients experienced a relapse of the infection after discontinuing antifungal treatment. All French isolates exhibited identical tef1α and tubb sequences, as well as the same MAT idiomorph locus. They displayed variations in the tef1α sequence compared to isolates from Switzerland and the Czech Republic.We confirm the active circulation of TMVII among MSM in France, which is associated with challenges in diagnosis, treatment and prevention. [ABSTRACT FROM AUTHOR]

Down syndrome (DS) is defined by an extra copy of chromosome 21 and confers an increased susceptibility to hematological disorders. Transient abnormal myelopoiesis (TAM) and myeloid‐leukemia associated with Down syndrome (ML‐DS) are two conditions that need to be accurately diagnosed to provide appropriate management. Both TAM and ML‐DS are characterized by proliferation of megakaryoblasts carrying a mutation in the GATA1 gene. Here, we report four cases with educational significance, highlighting typical diagnostic features that facilitate the differentiation between these two conditions, thereby assisting clinicians and medical laboratory professionals in effectively managing and monitoring these patients. [ABSTRACT FROM AUTHOR]

Introduction: In 2018, the Australasian College for Emergency Medicine (ACEM) and the Royal College of Pathologists of Australasia (RCPA) produced a guideline to encourage appropriate pathology requesting in the Emergency Department (ED). Objective: To assess adherence to the ACEM/RCPA pathology testing guideline in a regional ED. Methods, Design, Setting and Participants: This was a retrospective observational study conducted at a regional Australian ED over 7 days. Adults with a presenting complaint encompassed by the guideline were included. All blood tests were audited against the guideline recommendations and classified as indicated or non‐indicated. Chi‐squared analyses were performed to explore the association between presenting complaint and non‐indicated testing. Main Outcome Measure: The primary outcome was the number of non‐indicated blood tests. Results: Forty percent of tests ordered were not clinically indicated, with non‐indicated testing occurring during 87% of encounters. The C‐reactive protein (CRP) was the test most frequently ordered outside of guidelines (94% non‐indicated). Patients presenting with lower abdominal pain accounted for nearly one‐quarter of all non‐indicated tests. Conclusions: Blood tests were commonly requested outside of the guideline recommendations and interventions to improve pathology stewardship are required. [ABSTRACT FROM AUTHOR]

This guidance document has been prepared on behalf of the International Council for Standardization in Haematology (ICSH). The aim of the document is to provide guidance and recommendations for the performance and interpretation of activated partial thromboplastin time (APTT) and prothrombin time (PT) plasma mixing tests in clinical laboratories in all regions of the world. The following areas are included in this document: preanalytical, analytical, postanalytical, and quality assurance considerations as they relate to the proper performance and interpretation of plasma mixing tests. The recommendations are based on good laboratory practice, published data in peer‐reviewed literature, and expert opinion. [ABSTRACT FROM AUTHOR]

Background: Medical laboratories play crucial roles in healthcare, and effective enterprise risk management (ERM) is necessary to ensure business continuity, patient safety, and quality of care. In medical laboratories, ERM is important for enhancing patient safety, regulatory compliance and accreditation, quality management, business continuity, and cyber security. By following ERM principles and approaches, the medical laboratories can proactively manage their risks, improve patient safety, and maintain a high level of quality and reliability of outcomes. However, implementing ERM in medical laboratories faces unique challenges. This study explored the specific challenges and offers practical solutions for overcoming them to ensure successful ERM implementation in Harare, Zimbabwe. Methodology: A cross‐sectional survey was done through 41 self‐administered questionnaires and interviews with medical laboratory staff from the six main medical laboratories in Harare. Data were analyzed using the Statistical Package for Social Sciences version 22. Quantitative data were analyzed using descriptive statistics such as frequencies and percentages. Qualitative data were analyzed using mean scores of Likert scale responses. Results: The main challenges identified in the study included increased workload, staffing, organizational structures, timeliness of information, inadequate information technology support, and insufficient financial support in ERM. These can be addressed by portfolio management of risks, leveraging on cutting edge technology, restructuring to ensure swift responses to issues and redistributing staff workload, and training personnel to avoid burnouts and ensure maximum efficiency. Conclusion: Implementing ERM in medical laboratories requires understanding and addressing these challenges. By following the ERM principles and approaches the medical laboratories can proactively manage their risks, improve patient safety and maintain a high level of quality and reliability of outcomes ERM is still a new approach in the sector and needs further research. [ABSTRACT FROM AUTHOR]

Introduction: Direct oral anticoagulants (DOACs) reflect anticoagulation agents given to treat or prevent thrombosis, having largely replaced vitamin K antagonists (VKAs) such as warfarin. DOACs are given in fixed daily doses and generally do not need monitoring. However, there may be a variety of reasons that justify measurement of plasma DOAC levels in individual patients. Methods: We report updated findings for DOAC testing in our geographic region, using recent data from the RCPAQAP, an international external quality assessment (EQA) program, currently with some 40–60 participants in each of the different DOAC (rivaroxaban, apixaban, dabigatran) modules, to assess laboratory performance in this area. Data has been assessed for the past 5 years (2019–2023 inclusive), with 20 samples each per DOAC. Results: Data shows a limited repertoire of assays in use, and mostly consistency in reported numerical values when assessing proficiency samples. Available assays mostly comprised reagents from four manufacturing suppliers. There was good consistency across what participants identified as 'DOAC detected', but some variability when participants attempted to grade DOAC levels as low vs moderate vs high. Inter‐laboratory/method coefficient of variation (CVs) were generally <15% for each DOAC, when present at >100 ng/mL. Conclusion: We hope our findings, reflecting on mostly consistent reporting of DOAC levels and interpretation provides reassurance for clinicians requesting these measurements, and helps support their implementation in regions where there is a paucity of test availability. [ABSTRACT FROM AUTHOR]

Introduction: Thorough assessment of the antiphospholipid syndrome (APS) includes retesting of positive antiphospholipid antibody (aPL) tests after at least 12 weeks, and a full antiphospholipid antibody profile. To what extent this work‐up is done in clinical practice is unknown. Methods: Data on 25 116 in‐ and out‐hospital patients tested for the presence of lupus anticoagulant (LA), the aPL which most strongly correlates with thrombosis, was extracted from the laboratory information system of the only laboratory that performs LA tests in the Capital Region, Denmark. We estimated fraction of repeated tests, tests repeated within the recommended time span, and fraction with a full aPL profile. Results: Out of 25 116 patients, 843 were positive for LA (3.3%), and 3948 results were inconclusive (16%). Only 51% (95% CI of the proportion: 48%–54%) (n = 431) of positive tests were repeated. The proportion of inconclusive LA test results increased from 13% (12%–15%) in 2009 to 20% (19%–22%) in 2020. Out of the positive tests repeated within the first year, only 60/353 (17%; 13%–21%) were repeated within 12–16 weeks; 177/353 (50%; 45%–55%) were re‐tested within the first 12 weeks of first positive test result. The proportion of patients with a full antiphospholipid antibody profile increased from 161/1978 (8%) in 2010 to 1041/1978 (43%) in 2020. Conclusion: We found several issues with the laboratory workup of APS. This indicates a need for increased awareness of comprehensive laboratory assessment of possible APS as well as a closer collaboration between the laboratory and clinicians. [ABSTRACT FROM AUTHOR]

Quality is an indispensable requirement in medical laboratories, where controls are performed at different phases of the laboratory processes. In the following, we consider the internal quality control activities during the analytical phase of medical laboratories for verifying the test results prior to their release. To monitor the measurement process for errors in the test results, one approach that is considerably attracting the health professionals is patient‐based real‐time quality control. In this respect, real‐time patient test results are monitored, commonly by implementing the Moving Average (MA) control chart with truncation limits. A usual practice is the use of truncation limits to exclude abnormal patient test results from the MA calculations. However, an open issue in the literature is how to determine the width of the truncation limits and the window size in the MA calculations. Furthermore, the distributions of the test results are often nonnormal and difficult to model by personnel having insufficient training in statistics. Consequently, robustness of the performance of the MA control chart to non‐normal distributions of test results is another open topic in the literature. In this study, a detailed robustness analysis is performed by considering various distributions having different shapes. Performance of several MA control chart designs constructed by altering the truncation limits and window sizes are investigated. Based on our simulation results with selected distributions, we conclude that the truncation limits should not be used and a window size of 20 is recommended. Under such a setting, the MA control chart performs similar to its intended performance in terms of false alarms and in detecting systematic errors, hence being robust to non‐normality of the test results. [ABSTRACT FROM AUTHOR]

Introduction: Across the globe, nurses and midwives play a crucial role in providing care to patients in healthcare facilities. They often contact the patient, providing direct care as directed by medical doctors or clinical officers. Traditionally, the role of nurses and midwives in the clinical diagnosis process is to coordinate the clinical diagnosis process—which includes laboratory diagnosis requests—from diagnosticians to the clinical laboratory. In these settings, these diagnosticians are general or specialist medical doctors. However, in some regions in sub‐Saharan Africa (SSA), nurses and midwives are primary diagnosticians in healthcare facilities. Methodology: We present a perspective on the role of nurses and midwives in medical laboratory investigations in SSA. We highlight how, on top of nursing and midwifery roles, nurses take up the role of diagnosticians in facilities where doctors are few or are absent and what key issues are worth consideration. Furthermore, we present how efficient collaboration between nursing midwifery and medical laboratory diagnostic systems facilitates effective patient management. Conclusion: Emphasizing training on laboratory test utilization for nurses and midwives in SSA is vital for enhancing healthcare outcomes. [ABSTRACT FROM AUTHOR]

The laboratory practice "Primary culture and directional differentiation of rat bone marrow mesenchymal stem cells (BMSCs)" is part of a required course for sophomore medical students at Tongji university, which has been conducted since 2012. Blended learning has been widely applied in medical courses. Based on a student‐centered teaching philosophy, we reconstructed a comprehensive stem cell laboratory module with blended learning in 2021, aiming to facilitate students in enhancing their understanding of the multi‐lineage differentiation potential of stem cells and improve their experimental skills, self‐directed learning ability, and innovative thinking. First, we constructed in‐depth online study resources, including videos demonstrating laboratory procedures, a PowerPoint slide deck, and published literature on student self‐learning before class. In class, students performed a primary culture of BMSCs, freely chose among adipogenic, osteogenic, or chondrogenic differentiation, and used cytochemical or immunofluorescence staining for identification. After class, the extracurricular part involved performing quantitative polymerase chain reaction to examine the expression of multi‐lineage differentiation marker genes, which was designed as an elective. After 2 years of practice, positive feedback was obtained from both students and faculty members who achieved, the learning goal as expected. The reconstructed stem cell laboratory module provides comprehensive practice opportunities for students. Students have a better understanding of BMSC at the molecular, cellular, and functional levels and have improved their experimental skills, which forms a basis for scientific research for medical students. Introducing blended learning into other medical laboratory practices thus seems valuable. [ABSTRACT FROM AUTHOR]

Objectives. Drug utilization evaluation (DUE) studies aim to survey the appropriateness of drug use. DUE is an executive approach used to improve the use of medications as well as reduce the cost of treatment, ensure drug adequacy, and improve patient safety. The aim of this study was to evaluate the pattern of erythropoietin use, according to standard guidelines, in patients admitted to Namazi Hospital in Shiraz, Iran. Methods. In this descriptive, retrospective study, 230 patients were assessed. All patients who were hospitalized in different wards of Namazi Hospital, affiliated to Shiraz University of Medical Sciences, and received at least three doses of erythropoietin from September 2019 to March 2020 participated in this study. The following standard indicators of erythropoietin use were evaluated through reviewing medical charts of the cohort: drug dose, dosing intervals, route of administration, indication, monitoring of laboratory parameters, drug dose adjustment based on the response rate as well as target hemoglobin ≥12 g/dl, attention to major drug interactions, and administration of injectable or oral iron supplementation during treatment. Results. Most (65.2%) of the participants were male. The mean ± SD age of the patients was 47.55 ± 22.71 years. More than half (51.3%) of the included subjects were hospitalized in the nephrology ward. PDpoetin® and Cinnapoietin® were given to 52.6% and 47.4% of the study participants, respectively. Treatment of anemia due to chronic kidney disease was the most frequent indication of erythropoietin. The time interval of erythropoietin administration was three times a week for 68.3% of the patients. The most frequently administered weekly dose of erythropoietin was 12,000 units. The weekly dose, dose interval, and route of administration of erythropoietin were appropriate in 52.6%, 77.4%, and 100% of the patients, respectively. Dose adjustment based on the response rate, attention to major drug interactions as well as absolute-relative contraindications, and attention to the target hemoglobin ≥12 g/dl to decide whether or not to continue treatment were based on standard guideline in 98.1%, 98.7%, and 93% of the patients, respectively. The sum indexes of erythropoietin use were in line with standard guidelines in 75.84% of the cases. Conclusion. According to our results, in the setting of erythropoietin use in hospitals, physicians need more attention and education in areas such as selecting the proper dose of medication, correct indication of the drug, temporal arrangement of monitoring laboratory items, and the patient's need for iron supplements. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic placed unprecedented stress on laboratories in the Eastern Mediterranean Region. Building on existing capacity for influenza diagnostics, countries introduced COVID‐19 diagnostic support to ~100% regional coverage. A key challenge during the expansion was maintaining quality testing in laboratories, ensuring that correct results were shared with medical facilities. Methods: WHO organized two rounds of independently monitored severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) external quality assurance programs (EQAP). The Public Health Laboratory (PHL) division of WHO supplied external quality assurance (EQA) panels, from the Royal College of Pathologists of Australasia Quality Assurance Programme (RCPAQAP) Australia to laboratories not enrolled in recurring Global Influenza Surveillance and Response System (GISRS) quality assurance programs, in which national influenza centers routinely participate. Results: Fifteen and 14 countries participated in PHL/EQAP for SARS‐CoV‐2 between 2020 and 2022. Concordance was consistent between rounds, reaching 96.4% and 89.9%. A separate assessment of GISRS/EQAP to national‐level laboratories identified high levels of response and concordance for SARS‐CoV‐2 (100% response, 93% concordance), which was reduced for influenza (50% response rate, 80% concordance), reflecting the challenge of prioritizing pathogens during outbreaks. Conclusion: The proliferation of laboratories in response to COVID‐19 was a success story from the pandemic. However, monitoring the quality of laboratories was challenging via existing EQAP. The addition of PHL/EQAP provided a mechanism to monitor performance of laboratories that were not designated as national influenza centers. While a high proportion of laboratories attained good results, continual emphasis on quality and enrollment in EQAP is key to ensuring sustainability of laboratory testing in future. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic measures forced students to stay home and confined them to remote learning. This had a large impact on laboratory experiments, which are often impossible to complete from home. This article is a resource for instructors/educators to introduce the topic of structural biology and crystallographic methods. The main focus is to describe a hands-on crystallization laboratory exercise that can be carried out remotely at home with safe household products. X-ray crystallography is a vital technique for determining protein structure and function. This information can be used to understand fundamental biological processes and to help in the design of life-saving medications. Here, a method was developed to teach crystallography using reagents and equipment that can be found in grocery stores. The steps involved in a crystallography experiment are detailed with links and references to additional resources. [ABSTRACT FROM AUTHOR]

Healthcare in the United States has become increasingly digital since the passage of the HITECH Act in 2009. As a result, there is a growing need to optimize healthcare IT to allow for the interoperable exchange of data. As a result, the Office of the National Coordinator for Health IT has implemented their Final Rule for the 21st Century Cures Act. This requires certified health IT systems to use modernized messaging standards for the safe and secure exchange of data within health information networks and also requires the use of terminology standards including LOINC, SNOMED CT, and UCUM for coding clinical and laboratory data. Given the critical importance of laboratory results in the delivery of healthcare, laboratorians must become familiar with these principles of interoperability. Their clinical laboratory expertise is needed to appropriately structure and code test results to safeguard against improper aggregation or misinterpretation by downstream users and systems. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii, using microscopic and molecular methods in Jahrom city (Fars Province), south of Iran. Stool samples were collected from 360 outpatients referred to the medical laboratories in Jahrom city. Standard parasitological methods, including direct wet mount examination, formalin–ether sedimentation technique, and trichrome staining techniques, were used for detection of Entamoeba complex. Nested polymerase chain reaction (PCR) was used to identify the genus/species of Entamoeba. Entamoeba complex cysts were detected in 2.5% (9/360) of samples by microscopic methods, while 11 isolates were considered positive for the Entamoeba complex by nested PCR. Among them, 2 (18.18%) out of 11 samples were E. histolytica, 5 (45.45%) were E. dispar, and 4 (36.36%) were E. moshkovskii. Molecular positivity was more prevalent among females (4.16%), people living in rural areas (3.44%), and people over 60 years old (13.33%). Considering the clinical manifestations, the Entamoeba complex infection in patients with fever (7.69%), severe diarrhea (5.10%), and nausea (5%) was high. This study reported the presence of E. histolytica, E. dispar, and E. moshkovskii in Jahrom city. Therefore, we suggest more public health interventions in Jahrom city. [ABSTRACT FROM AUTHOR]

The positive relationship between lecture attendance and academic outcomes may be changing in the era of lecturing recordings. The objective of the study was to test this and to determine whether it varied between student cohorts. Consenting students in biochemistry from pharmacy, biomedical science, medical laboratory science, and nutrition programs, which had access to lecture recordings, signed in when attending lectures. Attendance was related to academic outcomes by regression analysis. Average attendance was low (≤19%) and declined significantly between years for most weeks. The students who attended ≥50% of lectures (≤17%) had higher marks than those that attended <50%. Overall regression analysis showed there were positive associations between most academic outcomes and lecture attendance or engagement (attendance and lecture recording access). However, these associations were weak or moderate for students in the pharmacy and biomedical science programs and were not apparent for students in the medical laboratory science and nutrition programs. In a separate survey, the most common reason for attending lectures was "I think I learn more by attending" and for not attending, was "Work commitments made it difficult to get to lectures." The main conclusion is that students of biochemistry should be encouraged to attend lectures, as the limited evidence suggests that attendance may still be associated with better academic outcomes and that some students find them beneficial. [ABSTRACT FROM AUTHOR]

After the COVID‐19 pandemic, there was an increasing demand for remote learning and an expansion in the substitution of traditional practical sessions with lab‐based virtual tools. This study aimed to assess the effectiveness of virtual labs in practicing biochemical experiments and to examine the student's feedback regarding this tool. Virtual and traditional labs training were compared in teaching qualitative analysis of proteins and carbohydrates experiments for first‐year medical students. Students' achievements were assessed, and their satisfaction regarding virtual labs was estimated using a questionnaire. A total of 633 students were enrolled in the study. There was a significant increase in the average scores of students performing the virtual lab of protein analysis compared with those trained in a real lab and those who watched videos explaining the experiment (p < 0.001). The opposite was noticed in the qualitative analysis of carbohydrates with significantly high grades of students trained conventionally compared with those who practiced with virtual labs (p < 0.001). Students' feedback rates on the virtual labs were high (>70% satisfaction rate). Most students believed virtual labs were supported with a clear explanation, yet they thought it did not give a realistic experience. Students accepted virtual labs, but they still prefer using them as preparatory to classic labs. In conclusion, virtual labs can offer good laboratory practice in the Medical Biochemistry course. Their impact on students' learning might be increased if selected cautiously and implemented properly in the curriculum. [ABSTRACT FROM AUTHOR]

Background: Achievement of ISO15189 accreditation demonstrates competency of a laboratory to conduct testing. Three programmes were developed to facilitate achievement of accreditation in low‐ and middle‐income countries: Strengthening Laboratory Management Towards Accreditation (SLMTA), Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) and Laboratory Quality Stepwise Implementation (LQSI). Objective: To determine the level of accreditation and associated barriers and facilitators among medical laboratories in the WHO‐AFRO region by 2020. Methods: A desk review of SLIPTA and SLMTA databases was conducted to identify ISO15189‐accredited medical laboratories between January 2013 and December 2020. Data on access to the LQSI tool were extracted from the WHO database. Facility and country characteristics were collected for analysis as possible enablers of accreditation. The chi‐square test was used to analyse differences with level of significance set at <0.05. Results: A total of 668 laboratories achieved accreditation by 2020 representing a 75% increase from the number in 2013. Accredited laboratories were mainly in South Africa (n = 396; 55%) and Kenya (n = 106; 16%), two countries with national accreditation bodies. About 16.9% (n = 113) of the accredited laboratories were registered for the SLIPTA programme and 26.6% (n = 178) for SLMTA. Approximately 58,217 LQSI users were registered by December 2020. Countries with a higher UHC index for access to HIV care and treatment, higher WHO JEE scores for laboratory networks, a larger number of registered LQSI users, with national laboratory policy/strategic plans and PEPFAR‐priority countries were more likely to have an accredited laboratory. Of the 475 laboratories engaged in the SLIPTA programme, 154 attained ≥4 SLIPTA stars (ready to apply for accreditation) and 113 achieved ISO 15189 accreditation, with 96 enrolled into the SLMTA programme. Lower‐tier laboratories were less likely to achieve accreditation than higher‐tier laboratories (7.7% vs. 30%) (p < 0.001). The probability of achieving ISO 15189 accreditation (19%) was highest during the first 24 months after enrolment into the SLIPTA programme. Conclusion: To sustainably anchor quality improvement initiatives at facility level, national approaches including access to a national accreditation authority, adoption of national quality standards and regulatory frameworks are required. [ABSTRACT FROM AUTHOR]

Background: While studies have shown that antibody detection may be delayed if an antibody identification (ABID) is not performed every 3 days, little data exist on the potential major risk of an acute hemolytic transfusion reaction (aHTR). Study Design and Methods: At our institution, if no change in the screen, or a positive crossmatch, ABIDs are performed every 30 days. Between January 1, 2015 and May 31, 2019, all new antibodies detected within 28 days of a prior transfusion were identified. Testing results and patient charts were reviewed for evidence of hemolysis. The $211 patient charge was used to determine the cost for ABIDs performed during the studied time period. Results: For 36 patients, a new clinically significant alloantibody was detected within 28 days of an antigen‐positive transfusion. Only one of these patients had a history of prior alloimmunization and put at possible risk due to the ABID policy. For this patient, while there was less than the expected increment to an antigen‐positive unit, there was no clinical or laboratory evidence of an aHTR. During this same time, 6095 ABIDs were performed, at a cost of approximately $1.29 million, and 72,665 red cell transfusions occurred. Conclusion: With an ABID every 30 days, only one patient, over 4.5 years, was put at potential risk for hemolysis from one transfusion (0.001% of the total units transfused during the time period). While antibody detection may be delayed, performing ABIDs every 30 days saves money and medical laboratory scientist time and should be balanced against potential patient harm. [ABSTRACT FROM AUTHOR]

Environmental microbiota are becoming more conventional components of restoration ecology studies due to their functional importance in ecosystems. Studying these microbiota offers insight into how they respond to, and potentially drive, ecosystem restoration. However, microbes are everywhere and therefore they pose a risk to sample integrity via uncontrolled contamination, and many of these risks are introduced before entering a molecular facility. Field ecologists who have limited experience in microbial and/or molecular studies may lack the knowledge on how to mitigate microbial contamination risks and, accordingly, may find rigorous collection of microbial samples a daunting task. Here, we present a practical guide that builds on our previous paper to help manage the risks of microbial contamination when undertaking a microbiota restoration study prior to entering a molecular facility. We cover study design and planning, undertaking field sampling, and sample transport and storage. We hope to provide a useful and practical guide to restoration ecologists who wish to include a microbiota component in their studies. If done well, this inclusion offers improved research quality and ultimately enhanced restoration outcomes. [ABSTRACT FROM AUTHOR]

The correction notice in the Health Science Reports journal addresses the role of nurses and midwives in medical laboratory investigations in sub-Saharan Africa. It emphasizes the crucial role these healthcare professionals play in patient care, especially in regions where doctors are scarce. The correction also includes the proper affiliation and name suffix for one of the authors, Don Eliseo Lucero-Prisno III. The article highlights the importance of training nurses and midwives in laboratory test utilization to enhance healthcare outcomes in SSA. [Extracted from the article]

Introduction: There may be clinically relevant differences between results of different FIX assays in samples containing extended half life FIX concentrates requiring regular surveillance of assay results through proficiency testing exercises. Control materials used in proficiency testing must be commutable, that is have the same inter‐assay properties as those demonstrated by authentic clinical samples when measured by different analytical methods. Methods: We assessed relationships between results with different FIX assays and commutability of UK National External Quality Assessment Scheme (NEQAS) materials containing rIX‐FP (Idelvion) or rFIXFc (Alprolix) by comparing results obtained using widely used one‐stage and chromogenic assays during a proficiency testing exercise with results obtained when analysing a series of individual patient samples using the same assay systems. NEQAS samples prepared by addition of either Idelvion or Alprolix to FIX deficient plasma were sent to 76 haemophilia centres in Europe. A total of 18 Idelvion and 22 Alprolix patient samples were assayed in a single centre. Two chromogenic and two one‐stage assays were compared. Results: The pattern of results obtained for NEQAS samples and patient samples was similar. In all cases, the NEQAS sample data point was within the scatter of patient sample data in plots of patient sample results showing one‐stage assay results using Synthasil or Actin FS plotted against chromogenic assay results with Biophen or Rox chromogenic FIX kits. Conclusion: This indicates that the NEQAS samples containing Idelvion or Alprolix were commutable and therefore suitable for use in proficiency testing exercises. [ABSTRACT FROM AUTHOR]

Introduction: Hemoglobinopathies are major public health problems worldwide. Accurate laboratory diagnosis of the carrier is essential, which includes initial screening, Hb analysis, and DNA analysis. For the first time, we have developed a single‐tube quality control (QC) sample for these laboratory tests. Methods: The QC sample was made from a lyophilized mixture of the stabilized hemolysate with carbon monoxide saturation and the white blood cells of known thalassemia mutations. Homogeneity and stability were examined by Hb and DNA analyses on day 0 and every month for 12 months, at room temperature, 4°C, and −20°C. A preliminary proficiency testing (PT) program for hemoglobinopathies using this single QC material was developed. Results: Hemoglobin (Hb) and DNA analyses of a single‐tube QC sample demonstrated satisfactory results of Hb analysis for at least five months and DNA analysis for at least one year of storage at −20°C. The results obtained from a preliminary PT program on five expert laboratories confirmed that a single tube QC sample prepared could be used as a PT item with various Hb and DNA analyses methods. Conclusion: A single lyophilized control sample has been generated for use in hemoglobinopathies' internal and external quality control program. Unlike other available control materials, which are used for individual testing, a single‐tube QC sample generated can be used to control the pre‐analytical and analytical processes of both Hb and DNA analyses and is suitable for use in the PT program of hemoglobinopathies. [ABSTRACT FROM AUTHOR]

Dengue virus (DENV) infection results mostly from the bites of virus‐carrying Aedes mosquitoes, which results in dengue fever (DF) with or without warning signs, severe dengue, or asymptomatic infections in humans. For point‐of care identification of DENV‐infected patients, a rapid diagnostic test (RDT) for DENV nonstructural protein 1 (NS1) has been developed to achieve early diagnosis and timely clinical management. We evaluated the performance of a new commercially available dengue NS1 RDT AsiaGen Dengue NS1 Antigen Rapid Diagnosis Test using real‐time qRT‐PCR as a reference method and compared the results with SD BIOLINE Dengue NS1 Ag using a single acute‐phase serum panel collected during the largest dengue outbreak in the history of Taiwan in 2015. The results suggested that the sensitivity and specificity of AsiaGen Dengue NS1 Antigen RDT (96.9% and 100%) were similar to those of SD BIOLINE Dengue NS1 RDT (100% and 100%) for detection in the acute phase of DENV‐2 infection. The results suggested that the sensitivity of both RDTs was similar (95.4% ~ 100%) for the sera collected at less than or equal to three days postsymptom onset (PSO). Our results suggested that the two DENV NS1 RDTs used in this study were promising for the timely diagnosis of DENV infection during dengue outbreaks, at least for DENV‐2 in areas where authorized medical laboratories are not available or medical resources are limited. However, the performance of AsiaGen DENV NS1 RDTs in the detection of primary/secondary infections and infection by serotypes of DENV other than DENV‐2 requires further investigation. [ABSTRACT FROM AUTHOR]

The pandemic caused major shifts in the delivery of education worldwide. In the teaching of medical biochemistry, the greatest impact was towards the delivery of traditional laboratory simulations. In this study, we highlight the benefits and barriers encountered in the use of virtual laboratories (vLABs) to substitute traditional laboratory practicals. The subjects were a class of 271 medical students at the Faculty of Medicine, Hasanuddin University, all freshman undergoing the Biomedicine Block. The study assessed the use of a commercial vLAB on antibodies and blood typing procedures, which were implemented using our four‐step model of vLAB implementation. Collected data include the lecturer‐assigned pre‐ and post‐test result, built‐in vLAB assessment result of the student first and best attempts, a student perception questionnaire based on a 5‐point Likert scale, and an open ended questionnaire regarding student perceptions of the advantages and disadvantages of the vLAB. We observed a remarkable increase of lecturer assigned pre‐ and post‐test scores and built‐in first and best attempt scores (p < 0.0001, Wilcoxon signed rank test). A majority of students reported increased motivation when using the vLABs, and favored the ability of mastery through repetition. However, technical and language barriers were highlighted by students during the vLAB implementation. We demonstrate a successful implementation of commercial vLABs in a cohort of non‐native English speakers using our four‐step approach. Implementation requires strong support from faculty to address technical and language barriers that arise during use of vLABs. [ABSTRACT FROM AUTHOR]

In order to cultivate the ability of independent learning and lifelong learning of medical students, improve the ability of students to analyze and solve problems, improve the competence of medical talents and cultivate high‐level and innovative talents, we have constructed the blended teaching model of "Clinical Case Investigation—Online Open Course Learning—Classroom PBL Seminar—After‐Class Health Education". At the same time, an ability‐oriented performance evaluation system improved the teaching quality feedback system has also established. This article introduces the construction and application of the blended teaching model, as well as the problems it faces, provides a theoretical basis for the optimization and improvement of this model. It also provides a model theory and practical basis for creating a blended online and offline "golden course" for the professional courses of medical laboratory technology. [ABSTRACT FROM AUTHOR]

Specific scope: This guideline includes specific quality management requirements for laboratories preparing for accreditation according to the ISO/IEC Standard 17025 General requirements for the competence of testing and calibration laboratories (2017, references to relevant parts of ISO/IEC Standard 17025 are included1). It should be noted that in EPPO Standards the verb 'should' carries the highest level of obligation and is the equivalent of 'shall' in the ISO Standard. This Standard should be used in conjunction with PM 7/76 Use of EPPO diagnostic protocols. Specific approval and amendment: First approved in 2009–09. First revision approved in 2014–04. A second revision was prepared to incorporate the conclusions and recommendations of the Workshop on Flexible Scope 2017–06‐26/28. Second revision approved 2018–09. Third revision approved 2019–09. Fourth revision approved in 2021–09. Authors and contributors are given in the Acknowledgements section. [ABSTRACT FROM AUTHOR]

Specific scope: This Standard specifies the general quality management requirements needed to perform diagnostic tests for plant pests in a laboratory. Another Standard, PM 7/98, includes specific quality management requirements for laboratories preparing for accreditation according to the ISO/IEC Standard 17025 General requirements for the competence of testing and calibration laboratories (references to relevant parts of ISO/IEC Standard 17025 are included). Specific approval and amendment: This Standard was first approved in 200‐09. First revision approved in 2018‐09. This first revision was prepared to incorporate the conclusions and recommendations of the Workshop on Flexible Scope 2017‐06‐26/28. Second revision approved in 2021‐09. This second revision was prepared to align different sections with PM7/98 (5). [ABSTRACT FROM AUTHOR]

The mixing of uses in a single building or collection of buildings can function as an urban catalyst, activating regenerations to the city fabric around it. Doojin Hwang Architects' Choonwondang Hospital of Korean Medicine, Seoul, is a good example. The hospital accommodates a medical centre, museum of traditional Korean medicine and pharmaceutical herbal laboratory with back‐of‐house functions clearly visible to visitors. Doojin Hwang takes us through it. [ABSTRACT FROM AUTHOR]

Introduction: Hemoglobin (Hb) analysis is a key testing for diagnosis of hemoglobinopathies. Accurate analysis, interpretation of results, and genetic risk assessment are important. We report on 8 years of the proficiency testing (PT) program for hemoglobinopathies in Thailand. Methods: Laboratory participants were required to test two simulated PT items in each cycle using capillary electrophoresis, one was a husband and another was his pregnant wife. Related hematological parameters were provided. The participants also provide interpretation and evaluate the risk of having three severe thalassemia diseases in an expected fetus. Three cycles were operated per year in accordance with the ISO17043 and ISO13528 guidelines. A total of 84 laboratories throughout Thailand were participated. Results: A total of 24 PT cycles were performed during 2012‐2019. Most participants had Excellent performance for the PT items with normal, β‐thalassemia trait, hemoglobin E trait, hemoglobin E trait with α‐thalassemia, and Hb H disease. However, when the PT items with homozygous Hb E and Hb E‐β‐thalassemia were tested, an increase in a Needs improvement performance was noted. From 24 PT cycles, the performance with Excellent, Good, Fair, and Needs improvement was ranging from 10.5%‐95.8%, 0%‐11.3%, 0%‐77.2%, and 2.3%‐37.0%, respectively. Conclusion: Most participants have proven their performance to be reliable and demonstrated their abilities to provide interpretation and genetic risk assessment on most of the PT items. For complex thalassemia however, a need to improve the interpretation and risk assessment skills is required which is essential for effective prevention and control of severe thalassemia diseases in Thailand. [ABSTRACT FROM AUTHOR]

Background: Recently revisited products like low‐titer group O whole blood (LTOWB) and novel applications of group A as a universal donor of plasma are being used for trauma resuscitation. A survey of American Level 1 trauma centers was performed to elucidate the extent to which these products are currently employed. Methods: A survey was written that probed into the current use of blood products in trauma resuscitation with specific emphasis on LTOWB and group A plasma. A list of adult civilian Level 1 trauma centers in the continental USA was obtained from two public surgery and trauma focused websites. An email was then sent to each center's transfusion service medical director or laboratory manager providing them with a link to the online survey. Results: Responses were received from 103/187 (55%) adult civilian Level 1 trauma centers. For the resuscitation of trauma patients, group A plasma was used at 94/103 (91%) centers, while LTOWB was used at 43/103 (42%) centers. There were 39/103 (38%) centers that used both products. At 62/94 (66%) of the centers that used group A plasma, there was no limit on the number of units that could be administered, while an unlimited number of LTOWB units could be used at 5/43 (12%) of the centers that used LTOWB. RhD‐positive LTOWB could be transfused to RhD‐negative or RhD‐type unknown females of childbearing potential at 22/43 (51%) of centers. Conclusion: The use of group A plasma and LTOWB in trauma is increasing at American Level 1 trauma centers. [ABSTRACT FROM AUTHOR]

The emerging pandemic of coronavirus disease 2019 (COVID‐19) has affected over 200 countries and resulted in a shortage of diagnostic resources globally. Rapid diagnosis of COVID‐19 is vital to control the spreading of the disease, which, however, is challenged by limited detection capacity and low detection efficiency in many parts of the world. The pooling test may offer an economical and effective approach to increase the virus testing capacity of medical laboratories without requiring more laboratory resources such as laboratory workers, testing reagents, and equipment. In this study, the sample pools of 6 and 10 were detected by a real‐time reverse transcription‐polymerase chain reaction assay targeting ORF1ab and N genes of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Each pool consisted of five or nine negative SARS‐CoV‐2 samples and one positive counterpart with varying viral loads. Two different strategies of sample pooling were investigated and the results were compared comprehensively. One approach was to pool the viral transport medium of the samples in the laboratory, and the other was to pool swab samples during the collection process. For swab pooling strategy, qualitative results of SARS‐CoV‐2 RNA, specific tests of ORF1ab and N genes, remained stable over the different pool sizes. Together, this study demonstrates that the swab pooling strategy may serve as an effective and economical approach for screening SARS‐CoV‐2 infections in large populations, especially in countries and regions where medical resources are limited during the pandemic and may thus be potential for clinical laboratory applications. [ABSTRACT FROM AUTHOR]

Over the last decade, European countries faced several emerging and re‐emerging animal diseases as well as zoonotic diseases. During these episodes, the laboratory diagnostic capabilities were a key factor to rapidly control and/or eradicate them. Because of the associated socio‐economic and health consequences, it is crucial to react rapidly and efficiently, not only during crisis but also in peacetime (i.e. preparedness). However, to date, there is no published method to identify diseases with diagnostic gaps and to prioritize assays to be implemented. This study was conducted based on the outcome of a prioritization exercise in which 29 epizootic and exotic diseases with high risk of emergence or re‐emergence in Belgium (Bianchini et al., [2020] Transboundary and Emerging Diseases, 67(1), 344‐376) were listed. Knowledge mapping was used to visualize and identify gaps in the diagnostic procedures for different epidemiological scenarios at national level. To fill these gaps, an overview of diagnostic capabilities at national and international level (laboratories and kits providers or manufacturers) as well as the published assays in the scientific literature and the prescribed assays by international institutions and kits providers was carried out. The outcome of this study revealed the usefulness of knowledge mapping as a tool to identify gaps and ultimately gain insight on alternatives for better preparedness and responsiveness. While this exercise was limited to Belgium, we believe this exercise can benefit other countries and thereby enhancing knowledge sharing and collaboration to increase diagnostic capabilities for a common list of (re‐) emerging diseases in crisis situation. [ABSTRACT FROM AUTHOR]

Many factors predict academic performance at university but accessing lecture recordings has not been established as one. Our aims were to quantify how and why biochemistry students accessed lecture recordings and to determine any association between accessing lecture recordings and academic outcomes. Lecture recording access data was collected and related to academic outcomes. On average, students accessed 46% of lecture recordings and each recording was accessed 2.3 times, but not to completion. After lecture delivery, students were slow to access lecture recordings, and the number of accesses was still increasing prior to the examinations. For the entire cohort, there were weak positive associations between accessing lecture recordings and academic outcomes for the semester, and between the access to lecture recordings in weeks 1–5 and 6–11 with the mid‐semester and final examination, respectively. For programs, the weak association for the semester was only apparent for the pharmacy and biomedical science students, and not for the medical laboratory or nutrition students. The most common reason for accessing lecture recording was to "Revise lecture concepts for assessment purposes." For students, who did not attend lectures, lecture recordings were accessed predominantly as "I prefer the flexibility of online recordings." Flexibility was also the theme of the positive additional feedback on accessing lecture recordings. In conclusion, consideration needs to be given on how to persuade students to access lecture recordings in a timelier way. As accessing lecture recordings is weakly associated with positive academic outcomes for some program cohorts, this supports their continued availability. [ABSTRACT FROM AUTHOR]

This document is titled "PM 7/131 (2) Guidelines on the main tasks of Reference Laboratories for official plant pest diagnostics" and was published in the EPPO Bulletin in December 2023. It describes the main tasks of Reference Laboratories for official plant pest diagnostics. These laboratories are established in countries to coordinate and harmonize activities of laboratories performing official plant pest diagnostics. The tasks of Reference Laboratories include establishing diagnostic protocols, performing validation of tests, collaborating with other laboratories, providing training, organizing proficiency tests, and providing information on new developments in diagnostics. Additionally, Reference Laboratories may provide technical-scientific support to the NPPO, participate in research projects, and establish international cooperation networks. The document also includes information on how to provide feedback on the diagnostic protocol and the protocol revision process. [Extracted from the article]

VALITEST is an EU‐funded project built to improve the reliability of diagnostic tests performed in plant health laboratories across the European and Mediterranean region. The project is undertaken by a consortium of 16 partners composed of research institutions, private companies (such as diagnostic kit providers), national plant protection organizations and one intergovernmental organization (EPPO). Current harmonized procedures for the validation and organization of test performance studies will be improved based on the experience gained from the project and by including appropriate statistical approaches, by adapting the process for new promising technologies (e.g. high‐throughput sequencing) and by providing new guidelines for the production of reference materials for validation studies. The project will provide a more complete and precise description of the performance of 82 diagnostic tests targeting 11 pests of interest for stakeholders of the region. It will also tackle the need for proficient users by developing a horizontal approach for the evaluation of laboratories' proficiency and by organizing training activities on the concept of validation. The outcomes of the project will stimulate, optimize and strengthen the interactions between stakeholders in plant health for better diagnostics and lay the foundations for structuring the quality and the commercial offers for plant health diagnostics tools thanks to the creation of a dedicated association and a quality charter. [ABSTRACT FROM AUTHOR]

Medical laboratory wastewaters arising from diagnosis and examination units show highly toxic characteristic. Within the scope of the study, removal of the wastewater's toxicity and increasing BOD5/COD ratio of the medical laboratory wastewaters through electro‐Fenton (EF) process were investigated. In the study, central composite design was applied to optimize the process parameters of EF for COD, BOD5, and toxicity unit (TU) removal. Based on ANOVA, H2O2/COD was found to be significant parameter for COD removal, whereas current, reaction time, and H2O2/COD were determined to be significant parameters for BOD5 and TU removal. Optimum conditions (pH value of 3.4, current 3 A, reaction time 33.9 min, and H2O2/COD of 1.29) were determined, and predicted removals of COD, BOD5, and TU were found to be 55.1%, 42.5%, and 99.7% and experimental removals were found to be 53.4%, 41.2%, and 99.5%, respectively. TU value of the wastewater decreased from the value of 163–0.815, and BOD5/COD value increased from the value of 0.32–0.39. The results of the study indicate that EF process is an effective treatment option for COD, BOD5, and especially toxicity removal from medical laboratory wastewater. Practitioner points: Electro‐Fenton process was applied medical laboratory wastewater with highly toxic characteristic.Response surface methodology approach using central composite design was employed for modeling.53.4%, 41.2%, and 99.5% of COD, BOD5, and toxicity removals were achieved under statistically optimized conditions.TU value of the wastewater decreased from the value of 163–0.815.BOD5/COD value increased from the value of 0.32–0.39. [ABSTRACT FROM AUTHOR]

Not all obstetric care facilities offer sufficient genetic counseling in Japan. When necessary, patients are referred to tertiary perinatal care centers for genetic counseling and further testing. Because each facility typically has an exclusive contract with a laboratory, the additional testing required may be performed at a different laboratory. With no reporting standards for normal chromosomal variants, differences between laboratories impede result interpretation, and clinical errors may occur. We present a case of a patient diagnosed with 46,XX,?dup (4)(p12p12) variant over two pregnancies. During the first pregnancy, the variant was determined to be a de novo, leading the parents to terminate the pregnancy. During the second pregnancy, further analysis revealed no 4p duplication, and we diagnosed as a normal variant, 4cenh+, inherited from the mother. Differences in reporting standards for a normal variant made evaluation of this patient difficult. Medical staff should be aware of this issue, and reporting standards should be standardized. [ABSTRACT FROM AUTHOR]

Background. Malaria remains a major cause of morbidity and mortality worldwide and particularly in sub-Saharan Africa where it is endemic. As such, it is important that a proper diagnosis is made before treatment is initiated. Malaria parasite count plays a key role in the diagnosis and management of malaria. Variations in ratings by laboratory personnel can impact negatively on the treatment regimen for malaria-infected patients. The study is thus aimed at evaluating and comparing the proficiency and parasitaemia counts by two different categories of laboratory staff at the LEKMA Hospital, Ghana. Materials and Methods. A total of 200 confirmed malaria-positive samples were used in the study. Six thick and thin films were prepared from each sample and uniquely labelled. Two of the six slides were given to two WHO-accredited malaria microscopists to examine and report their respective parasite count/μl (parasite count / WBC × 8000). These were used as the reference for the two categories of laboratory staffs: rater A being diploma holders (Technical Officers referred to as untrained rater) and rater B being degree holders (Medical Laboratory Scientist referred to as trained rater) at the LEKMA Hospital. Results. In comparison to the expected outcome, the parasite count by the rater group A (190 (151-239)]) and the rater group B (177 (140-224)) demonstrated significant positive correlation (r = 0.995 , p < 0.0001 vs. r = 0.995 , p < 0.0001 , respectively) with the expected outcome in the cases of heavy parasitaemia. A statistically significant difference (p < 0.05) between counts by the different raters in low parasitemia was observed in this study. A persistent nosedive inter-rater agreement from k = 0.82 to k = 0.40 with increasing density cutoff was observed in this study. Conclusion. The study observed that the degree of inter-rater agreement of parasite density count by various categories of laboratory personnel is almost perfect. However, the parasite count between raters varied significantly with very low levels of parasitemia but better correlated with heavy parasitemia. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance among community-acquired uropathogens is an emerging concern over the past decades that warrants a continuing reevaluation of the appropriateness of recommended empiric antimicrobial regimens for treatment of urinary tract infections (UTIs).Aims: To describe the microbial spectrum and resistance profile of community-acquired uropathogens and predictors of isolation of resistant strains.Methods: Between October 2017 and June 2019, individuals who visited the outpatient clinics for diagnosis of UTIs or screening of asymptomatic bacteriuria were included in the study if they were tested for urine culture in one of the three main medical diagnostic laboratories of Mashhad, Iran. The standard disk diffusion antimicrobial susceptibility testing was used, with the Clinical and Laboratory Standards Institute (CLSI) threshold cutoffs for susceptibility of isolated uropathogens.Results: Three hundred thirty cases were included with a median age of 47 years. Two hundred seventy-six (83.6%) were female. The most common isolated uropathogens were Escherichia coli in 201 (60.9%) cases and Klebsiella species in 46 (13.9%) cases. E. coli isolates showed the highest rates of susceptibility to nitrofurantoin (89.3%), cefixime (75%), and gentamicin (72.4%). Exposure to antibiotics in the past 3 months was a predictor of resistance to ciprofloxacin (OR: 2.8, 95% CI: 1.33-6.28), and older age was a predictor of resistance to TMP-SMX (OR: 2.1, 95% CI: 1.07-3.97) among E. coli isolates. Conclusion. E. coli and Klebsiella species accounted for about two-thirds of community-acquired uropathogens. In regard to the high susceptibility rates, nitrofurantoin was identified as the first-choice agent for empiric treatment of community-acquired cystitis, while cefixime and gentamicin might be the second-choice alternatives. Ciprofloxacin and TMP-SMX, on the other hand, cannot be considered appropriate agents for empiric therapy of community-acquired UTIs, particularly in those who had exposure to antibiotics in the past 3 months and the elderly. [ABSTRACT FROM AUTHOR]

Metal sulfide catalysts for ultra‐deep hydrodesulfurization of diesel generally lose a fraction of their catalytically active sites during reactor startup. The underlying mechanisms are discussed. A laboratory diagnostic tool consisting of three probe molecules is developed for testing metal sulfide catalysts' start‐of‐run (SOR) activity maintenance. It is found that a significant fraction of the active sites on a commercial supported catalyst are deactivated permanently, but this is not the case with a bulk metal sulfide catalyst. The SOR deactivation of the bulk catalyst is completely reversible, while that of the supported catalyst is partially reversible. The diagnostic tool may provide a basis for developing a high‐throughput approach for evaluating and enhancing catalyst SOR stability, thereby increasing plant productivity. [ABSTRACT FROM AUTHOR]

Background. Multidrug-resistant Enterobacteriaceae particularly extended-spectrum beta-lactamase producers have become a major public health threat. Despite efforts to limit their spread, rates of multidrug-resistance members of the Enterobacteriaceae continue to increase throughout the world causing increased morbidity and mortality and raised costs for medical care. Objective. The aim of this study was to determine the prevalence of multidrug resistance and extended-spectrum β-lactamase-producing Enterobacteriaceae. Methods. Four hundred forty Enterobacteriaceae isolates from outpatients referred to Arsho Advanced Medical Laboratory were identified and assessed for their antimicrobial resistance pattern by using the automated VITEK 2 compact system. Extended-spectrum β-lactamase production was determined by the VITEK 2 automated compact system using the extended-spectrum β-lactamase test panel as per the instruction of the manufacturer. Results. The overall resistance rates of Enterobacteriaceae against cephalosporins, aminoglycosides, and fluoroquinolones were high. Nitrofurantoin with a resistance rate of 14.3% and piperacillin/tazobactam combination with a resistance rate of 17.3% were better active against this group of Gram-negative bacteria. Out of 440 isolates of Enterobacteriaceae, 42.1% were multidrug-resistant of which 34.3% and 8.95% were extensively drug-resistant and pan-drug resistant, respectively. Among 185 multidrug-resistant Enterobacteriaceae, 63.9% of the isolates produced extended-spectrum β-lactamase of which 75.4%, 19.5%, 1.7%, 2.5%, and 0.8% were E. coli, K. pneumoniae, C. freundii, E. cloacae, and P. mirabilis, respectively. Conclusions. The present study demonstrated high prevalence rates of multidrug-resistant and extended-spectrum-beta-lactamase-producing Enterobacteriaceae. In order to combat these problems, infection control strategy and proper antibiotic policies should be formulated. [ABSTRACT FROM AUTHOR]

Istanbul Medical Faculty, Department of Medical Biology, as the first EFI‐accredited HLA laboratory in Turkey since 1999 has been organizing both national and international quality control tests for HLA typing under the banner of the "Balkan external proficiency testing (BEPT)" encompassing countries from EFI regions 8. The first round of BEPT in 2004 was organized for low‐resolution HLA‐A,‐B typing by molecular methods and 12 centres participated in the exercise. In 2005, low‐resolution HLA‐DR typing was added, and in 2007, low‐resolution HLA‐C and DQ typing were added to the exercise and 28 centres participated. In 2015, high‐resolution (four digits or higher typing) HLA‐A,‐B,‐C,‐DR and –DQ typing added to the exercise and 40 centres participated. In the last 2 years, 2017 and 2018, the number of participating centres increased to 48 and 52, respectively. When the distribution of low‐resolution typing methods applied in the exercises were investigated, it was found that 82% of the centres in the first round of BEPT in 2004 used PCR‐SSP, whereas in the last round in 2018, 26% of the centres preferred SSP, while the rest used SSO (50%) or SSP and SSO (24%) methods. Methods for high‐resolution typing were SBT (41%), NGS (18%), SSO (18%), SSP (6%), SBT + NGS (6%) and SBT + SSP (11%). In 15th trial for BEPT, nomenclature mistake rate was 12%, and erroneous result rate was 6% for HLA samples. The most common mistakes in the exercises were nomenclature mistakes. The EFI Standards Version 7.0 is stated "HLA type can be reported using a hyphen if homozygosity is not proven by family studies." In order to provide standard results among HLA laboratories and since accurate HLA typing leads to significant increase of graft and patient survival, quality control exercises should be performed in all HLA‐based tests periodically. [ABSTRACT FROM AUTHOR]

Anatomic pathology (AP) laboratories provide critical diagnostic information that help determine patient treatments and outcomes, but the risks of AP operations and their impact on patient safety and quality of care remain poorly recognized and undermanaged. Hospital‐based laboratories face an operational and risk management challenge because clinical work of unknown quantity and complexity arrives with little advance notice, which results in fluctuations in workload that can push operations beyond planned capacity, leading to diagnostic delays and potential errors. Modeling the dynamics of workload and complexity in AP offers the opportunity to better use available information to manage risks. We developed a stock‐and‐flow model of a typical AP laboratory operation and identified key exogenous inputs that drive AP work. To test the model, we generated training and validations data sets by combining data from the electronic medical records and laboratory information systems over multiple years. We demonstrate the implementation of 10‐day AP work forecast generated on a daily basis, and show its performance in comparison with actual work. Although the model somewhat underpredicts work as currently implemented, it provides a framework for prospective management of resources to ensure quality during workload surges. Although full implementation requires additional model development, we show that AP workload largely depends on few and accessible clinical inputs. Recognizing that level loading of work in a hospital is not practical, predictive modeling of work can empower laboratories to triage, schedule, or mobilize resources more effectively and better manage risks that reduce the quality or timeliness of diagnostic information. [ABSTRACT FROM AUTHOR]

Specific scope: This guideline includes specific quality management requirements for laboratories preparing for accreditation according to the ISO/IEC Standard 17025 General requirements for the competence of testing and calibration laboratories (2017, references to relevant parts of ISO/IEC Standard 17025 are included1). It should be noted that in EPPO Standards the verb 'should' carries the highest level of obligation and is the equivalent of 'shall' in the ISO Standard. Specific approval and amendment: First approved in 2009–09. First revision approved in 2014–04. A second revision was prepared to incorporate the conclusions and recommendations of the Workshop on Flexible Scope 2017‐06‐26/28. Second revision approved 2018‐09. Third revision approved 2019‐09. [ABSTRACT FROM AUTHOR]

The scientific and clinical interest in extracellular vesicles (EV) has grown exponentially during the past 15 years. As most research indicates that EVs can be utilised in diagnostics, prognostics and therapeutics, we may be on the brink of establishing the clinical utility of EV measurement, but how can we make this a reality? If we are to introduce EVs as biomarkers into clinical laboratories, it will be necessary to offer fully validated, International Organization for Standardization (ISO) standard 15189 assays. ISO 15189 defines the quality management system requirements particular to medical laboratories and is used internationally to determine accreditation. In order for a clinical laboratory to offer an accredited test for EVs, this assay must have been subjected to a thorough assay validation process. This process requires the generation of data related to defined performance characteristics, to ensure that an assay is performing in accordance with the needs of its clinical users. Each of the defined performance characteristics will be discussed in this review, along with the issues that specifically affect EV analysis. Accreditation is increasingly important for all clinical laboratories and the standards required to achieve this are becoming more and more stringent. Therefore, as companies seek to develop the best assays to detect EVs and their molecular contents for clinical utility, and as we move rapidly towards our goal of offering EV analysis in the diagnosis and monitoring of disease, it is timely to highlight the requirements for the clinical accreditation of such assays. It is essential to consider these parameters to ensure that we develop the highest quality assays possible and ultimately the best outcomes for patients. [ABSTRACT FROM AUTHOR]