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Ki‐67, a nuclear protein expressed in all stages of cellular proliferation, is a valuable tool to assess tumor proliferation and has been linked to more aggressive tumor behavior. However, interlaboratory staining heterogeneity and inter‐observer variability challenge its reproducibility. Round Robin tests are a suitable tool to standardize and harmonize immunohistochemical and molecular analyses in histopathology. The study investigates the interrater and interlaboratory reproducibility of Ki‐67‐scoring using both manual and automated approaches. Unstained TMA slides comprising diverse tumor types (breast cancer, neuroendocrine tumors, lymphomas, and head and neck squamous cell carcinoma) were distributed to six pathology laboratories, each employing their routine staining protocols. Manual and automated scoring methods were applied, and interrater and interlaboratory agreement assessed using intraclass correlation coefficients (ICC). The results highlight good‐to‐excellent reliability overall, with automated scoring demonstrating higher consistency (ICC 0.955) than manual scoring (ICC 0.871). Results were more variable when looking at the individual entities. Reliability remained good for lymphomas (ICC 0.878) and breast cancer (ICC 0.784) and was poor in well‐differentiated neuroendocrine tumors (ICC 0.354). This study clearly advocates standardized practices and training to ensure consistency in Ki‐67‐assessment, and it demonstrates that this can be achieved in a peer‐to‐peer approach in local quality‐circles. [ABSTRACT FROM AUTHOR]

The summative assessment approach of all level three Business and Technology Education Council (BTEC) qualifications is changing away from a purely teacher-based, criterion-referencing internal assessment approach to a mixture of internal and external assessments including exams for core units. As this is a shift away from what teachers may be familiar with, the question of whether teachers are cognisant of how to effectively prepare students for high-stake exams arises. This paper reports on a pilot study preparing such an investigation by developing questionnaires with relevant techniques recommended in the literature and then comparing responses of two groups of teachers. One group is BTEC lecturers who may be unfamiliar with exam preparation. The other group routinely prepare further education students for General Certificate of Secondary Education (GCSE) exams and, therefore, is familiar with exam preparation techniques and serves as a control group. One aspect of the research outcomes pertains to the refinement of the research method and suggests incorporating a formal interview. The other aspect relates to the tentative research results, which found that the responses of both groups have a high degree of agreement. However, there are some differences when it comes to detailed assessment preparation planning, student motivation and parental involvement. As the number of participants was very small, any conclusions suggested here need to be substantiated by a larger sample involving more than one college.

Habitat degradation and fragmentation are two of the main drivers for biodiversity loss. To mitigate the negative impact of fragmentation in forests, conservation targets are increasingly addressing connectivity to facilitate the independent movement of species between habitat fragments to ensure genetic diversity and adaptation to climate change. In this article, we present a novel approach to identifying and prioritizing stepping stones for preserving connectivity based on national and regional biodiversity data for Austrian forest ecosystems. Our study identified forest areas where conservation measures should be taken to ensure future habitat connectivity by combining four indicator values with different requirements of a stepping stone habitat into a prioritization value. The four compounded indicators are: (i) the Protect Value, which includes distances to patches of protected areas with restricted management for the undisturbed development of retention areas, (ii) the Connect Value, which combines datasets of designated habitat corridors and connectivity areas in Austria based on landscape models and expert validation, (iii) the Species Value identifying species‐rich areas, and (iv) the Habitat Value identifying biotopes of high ecological value, key biodiversity areas, and sites of favorable protection status. Nonparametric tests revealed significant differences in prioritization value among the ecoregions of Austria and therefore encourage the consideration of stepping stone prioritization at local and regional context. Building upon the insights from this case study on Austrian forest ecosystems, we developed a robust framework derived from our methodology. This framework is designed to facilitate future implementations in diverse study regions, accounting for factors beyond connectivity crucial for identifying high value stepping stone habitats. We encourage adaptation of this framework to local data availability, species requirements, and local conditions. The compiled framework provides decision support for managers and conservationists for prioritizing areas to conserve and improve connectivity of forest habitats. However, it does not substitute on‐the‐ground field assessments of habitat quality and measures of functional connectivity. [ABSTRACT FROM AUTHOR]

Aims Simplified ablation technologies for pulmonary vein isolation (PVI) are increasingly performed worldwide. One of the most common complications following PVI are vascular access-related complications. Lately, venous closure systems (VCSs) were introduced into clinical practice, aiming to reduce the time of bed rest, to increase the patients' comfort, and to reduce vascular access-related complications. The aim of the present study is to compare the safety and efficacy of using a VCS to achieve haemostasis following single-shot PVI to the actual standard of care [figure-of-eight suture and manual compression (MC)]. Methods and results This is a prospective, multicentre, randomized, controlled, open-label trial performed at three German centres. Patients were randomized 1:1 to undergo haemostasis either by means of VCS (VCS group) or of a figure-of-eight suture and MC (F8 group). The primary efficacy endpoint was the time to ambulation, while the primary safety endpoint was the incidence of major periprocedural adverse events until hospital discharge. A total of 125 patients were randomized. The baseline characteristics were similar between the groups. The VCS group showed a shorter time to ambulation [109.0 (82.0, 160.0) vs. 269.0 (243.8, 340.5) min; P < 0.001], shorter time to haemostasis [1 (1, 2) vs. 5 (2, 10) min; P < 0.001], and shorter time to discharge eligibility [270 (270, 270) vs. 340 (300, 458) min; P < 0.001]. No major vascular access-related complication was reported in either group. A trend towards a lower incidence of minor vascular access-related complications on the day of procedure was observed in the VCS group [7 (11.1%) vs. 15 (24.2%); P = 0.063] as compared to the control group. Conclusion Following AF ablation, the use of a VCS results in a significantly shorter time to ambulation, time to haemostasis, and time to discharge eligibility. No major vascular access-related complications were identified. The use of MC and a figure-of-eight suture showed a trend towards a higher incidence of minor vascular access-related complications. [ABSTRACT FROM AUTHOR]

Aims Pulmonary vein isolation (PVI) for catheter ablation of atrial fibrillation (AF) is a time-demanding procedure. High-power short-duration (HPSD) ablation protocols and high-density mapping catheters have recently been introduced to clinical practice. We investigated the impact of high-density mapping and HPSD ablation protocols on procedural timing, efficacy, and safety by comparing different standardized set-ups. Methods and results Three electrophysiology (EP) laboratory set-ups were analysed: (i) circular catheter for mapping and HPSD ablation with 30/35 W guided by an ablation index (AI); (ii) pentaspline catheter for mapping an HPSD ablation with 50 W guided by an AI; and (iii) pentaspline catheter for mapping and HPSD ablation with 90 W over 4 s using a novel ablation catheter. All patients underwent PVI without additional left atrial ablation strategies. Procedural data and operating intervals in the EP laboratory were systematically analysed. Three hundred seven patients were analysed (30/35 W AI: n = 102, 50 W AI: n = 102, 90 W/4 s: n = 103). Skin-to-skin times [105.3 ± 22.7 (30/35 W AI) vs. 81.4 ± 21.3 (50 W AI) vs. 69.5 ± 12.2 (90 W/4 s) min, P ≤ 0.001] and total laboratory times (132.8 ± 42.1 vs. 107.4 ± 25.7 vs. 95.2 ± 14.0 min, P < 0.001) significantly differed among the study groups. Laboratory interval analysis revealed significant shortening of mapping and ablation times. Arrhythmia-free survival after 12 months was not different among the study groups (log-rank P = 0.96). Conclusion The integration of high-density mapping and HPSD protocols into an institutional AF ablation process resulted in reduced procedure times without compromising safety or efficacy. [ABSTRACT FROM AUTHOR]