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Context: Decreased trunk neuromuscular control is a risk factor for both upper- and lower-extremity injuries, yet there are few reliable and valid clinical tests to identify deficits. Objective: The purpose of this study was to determine the reliability and known-groups validity of a novel clinical test, the seated trunk control test (STCT). Design: Cross-sectional reliability and known-groups validity study. Setting: Laboratory. Participants: 89 unique participants: 34 were 3 months postoperative anterior cruciate ligament reconstruction (ACLR) and 55 healthy controls. Methods: For the STCT, participants sat on a balance board with their eyes closed for three 30-second trials while investigators counted balance errors. Intraclass correlations (ICCs) were used to assess interrater reliability (N = 20) and test–retest reliability (N = 40). To assess known-groups validity, independent t tests were used to compare STCT errors at 3 months post-ACLR with healthy matched controls (N = 34/group). Area under a receiver operating characteristic curve identified an optimal cutoff for distinguishing between groups. Results: The STCT had perfect interrater reliability (ICC2,3 = 1.00) and good test–retest reliability (ICC3,3 =.79; 95% confidence interval =.61–.89). The ACLR group made significantly more errors on the STCT (mean [SD] = 15.5 [5.4]) than controls (mean [SD] = 8.2 [4.1]; P <.001, Cohen d = 1.52). The STCT's ability to distinguish between groups was excellent (area under a ROC curve = 0.86). A cutoff of 12 errors maximized sensitivity (76%) and specificity (85%). Conclusions: The STCT is reliable between raters and across days. It also has excellent ability to distinguish between individuals with a recent ACLR and healthy matched controls, which provides initial evidence to suggest that the STCT may be clinically useful for identifying deficits in trunk neuromuscular control. [ABSTRACT FROM AUTHOR]

Laser Thomson scattering is a minimally intrusive diagnostic technique for determining electron temperature, density, and bulk velocity in plasma systems. Advances in technology have made possible the application of Thomson scattering to electric propulsion-relevant plasma systems, with reported electron number-density detection limits as low as 1 × 10 16 m − 3 , and electron temperatures from one-to-tens eV. However, the implementation of laser Thomson scattering in large vacuum testing facilities, wherein electric propulsion devices are tested, remains a challenge. This work presents the implementation of a laser Thomson scattering system in a large vacuum test facility at the Georgia Tech High Power Electric Propulsion Laboratory. The diagnostic was optimized for maximum light-collection efficiency and ease of re-alignment while the facility is at vacuum. The high light-collection efficiency allowed reduced accumulation times to achieve the target detection limit of 1 × 10 17 m − 3 . The diagnostic is used to measure axial electron property profiles in the near-field plume of a lanthanum hexaboride hollow cathode operating at 25 A on krypton at a background pressure of 1.3 × 10 − 6 Torr—Kr. The diagnostic is quantitatively compared to similar systems in the literature. The resulting axial points, collected from 2 to 8 mm downstream of the cathode keeper orifice, are qualitatively and quantitatively compared with simulations and experimental measurements made with electrostatic probes and laser-induced fluorescence. The main quantitative difference between measured values and results is the one to two order of magnitude difference in the peak electron density, being attributed to the relative size and location of the external anode with respect to the cathode keeper. [ABSTRACT FROM AUTHOR]

Among the numerous fields permeated by Virtual Reality (VR), this review focuses on education and specifically, engineering education. VR allows engineering students to safely and cost-efficiently experience realistic yet simulated environments otherwise inaccessible, costly and/or dangerous. The feelings of presence and immersion generated by VR help motivate and engage students both in the theoretic and the hands-on laboratory parts of their studies. In this systematic review, 104 journal publications are selected and analyzed to cover research questions along five major axes (VR popularity; VR technology; VR-based intervention features; educational methods and assessment of learning outcomes; open research issues). Results reveal an increasing interest in this field, with equal usage of 2D and 3D VR systems. Active and experiential learning methods dominate on the pedagogical axis and aim to develop cognitive and metacognitive skills. Positive effects of VR on student learning across multiple domains verify the potential of VR to improve engineering education. [ABSTRACT FROM AUTHOR]

Organic photovoltaic (OPV) technology has recently achieved remarkable progress in academia, attaining power conversion efficiencies exceeding 19%, a breakthrough previously unimaginable. Despite these advancements, the translation of high‐efficiency OPV cells into the commercialization of OPV modules has been limited, impeding the market penetration of OPV technology. Upon careful examination, various challenges emerge, including disparities between laboratory research and industrial production in device architecture, influenced by considerations of cost and manufacturability. Additionally, the incorporation of high‐efficiency materials requires careful consideration not only of the compatibility between the photoactive layer and interface layers or transparent electrodes but also of the associated synthetic complexity of chemical structures and cost implications. While these issues are crucial, they may not be widely discussed in current mainstream research. In this article, the purpose is to identify bottlenecks from a material techniques perspective, with the aim of promoting increased resources in the research of pertinent module technologies. This effort is intended to propel OPV technology toward greater success and bring it into closer alignment with the goals of commercialization. [ABSTRACT FROM AUTHOR]

Three-dimensional magneto-optical traps (3D-MOTs) are an integral component of atomic clocks, quantum computers, and other cold-atom science applications. Due to the dependence on bulk optics and lasers, conventional 3D-MOTs occupy a large volume, limiting their portability. Efforts to build 3D-MOTs using integrated photonics promise to reduce the size and weight of these systems allowing applications beyond the lab. However, the need for counterpropagating beams to facilitate 4- and 6-beam geometries necessitates free-space mirrors and quarter wave plates (QWPs) that limit integration. Replacing these mirrors and QWPs with planar retroreflecting metasurfaces provides a route to achieving a complete 3D-MOT within an integrated package. Here, we report on the design and demonstration of a retroreflecting metasurface for 3D-MOTs that operates at large angles and preserves circular polarization. Specifically, we utilize Bayesian optimization to design an amorphous silicon (a-Si) on gold metasurface for high efficiency polarization-insensitive retroreflection of 780 nm circularly polarized light at 54.7°. Numerical simulations demonstrate maintenance of circular polarization after highly efficient retroreflection ( ϵ − 1 = 1.10 , R − 1 = 0.86). Experimentally, we demonstrate similarly excellent performance at 736 nm at 50.3 ° ( ϵ − 1 = 1.04 , R − 1 = 0.73) and show that deviation from the target design is due to oxidation of the a-Si metaelements. We conclude by discussing mitigation strategies for future devices and propose a corrective optic for the currently fabricated device. This work represents a step toward the miniaturization of 3D-MOTs and expansion of cold-atom science beyond the laboratory. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India's 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients. Methodology: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed. Results: Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality. Conclusions: Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups. [ABSTRACT FROM AUTHOR]

Today, the world is affected by a COVID-19 epidemic. Early diagnosis can play an important role in the control and prevention of this disease, so the study and practice of biosafety among staff of diagnostic laboratories have a key role in the healthiness of health fighters against COVID-19. In this study, we will review laboratory biosafety considerations for the diagnosis process of SARS-CoV-2 in three phases: (1) the preanalytical phase, (2) the analytical phase, and (3) the postanalytical phase. It should be noted that employees with high-risk underlying health conditions, like lung or heart disease or diabetes, should be moved to lower-risk environments. We believe that this review will help to restrict the risk of developing COVID-19, while working in clinical laboratories. [ABSTRACT FROM AUTHOR]

Virtual Reality (VR) laboratories are a new pedagogical approach to support psychomotor skills development in undergraduate programmes to achieve practical competency. VR laboratories are successfully used to carry out virtual experiments in science courses and for clinical skills training in professional courses. This paper describes the development and evaluation of a VR-based microbiology laboratory on Head-Mounted Display (HMD) for undergraduate students. Student and faculty perceptions and expectations were collected to incorporate into the laboratory design. An interactive 3-dimensional VR laboratory with a 360° view was developed simulating our physical laboratory setup. The laboratory environment was created using Unity with the (created) necessary assets and 3D models. The virtual laboratory was designed to replicate the physical laboratory environment as suggested by the students and faculty. In this VR laboratory, six microbiology experiments on Gram staining, bacterial streaking, bacterial motility, catalase test, oxidase test and biochemical tests were placed on the virtual platform. First-year biomedical science students were recruited to evaluate the VR laboratory. Students' perception of the virtual laboratory was positive and encouraging. About 70% of the students expressed they felt safe using the VR laboratory and that it was engaging. They felt that the VR laboratory provided an immersive learning experience. They appreciated that they could repeat each experiment multiple times without worrying about mistakes or mishaps. They could personalise their learning by concentrating on the specific experiments. Our in-house VR-based microbiology laboratory was later extended to other health professions programmes teaching microbiology. [ABSTRACT FROM AUTHOR]

Introduction: ST-segment elevation myocardial infarction (STEMI) represents the most harmful clinical manifestation of coronary artery disease. Risk assessment plays a beneficial role in determining both the treatment approach and the appropriate time for discharge. Hierarchical agglomerative clustering (HAC), a machine learning algorithm, is an innovative approach employed for the categorization of patients with comparable clinical and laboratory features. The aim of the present study was to investigate the role of HAC in categorizing STEMI patients and to compare the results of these patients. Methods: A total of 3205 patients who were diagnosed with STEMI at the university hospital emergency clinic between 2015 and 2023 were included in the study. The patients were divided into 2 different phenotypic disease clusters using the HAC method, and their outcomes were compared. Results: In the present study, a total of 3205 STEMI patients were included; 2731 patients were in cluster 1, and 474 patients were in cluster 2. Mortality was observed in 147 (5.4%) patients in cluster 1 and 108 (23%) patients in cluster 2 (chi-square P value < 0.01). Survival analysis revealed that patients in cluster 2 had a significantly greater risk of death than patients in cluster 1 did (log-rank P < 0.001). After adjustment for age and sex in the Cox proportional hazards model, cluster 2 exhibited a notably greater risk of death than did cluster 1 (HR = 3.51, 95% CI = 2.71–4.54; P < 0.001). Conclusion: Our study showed that the HAC method may be a potential tool for predicting one-month mortality in STEMI patients. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the feasibility of an online self-sampling pilot intervention for HIV testing addressed to gay, bisexual, and other men who have sex with men (GBMSM) and trans women (TW) users of dating apps in Spain. The website https://www.testate.org/ was designed to offer self-sampling kits for HIV testing and online consultation of the results. It was advertised on gay dating apps. Participants requested the delivery of a saliva self-sampling kit by mail and a postage-paid envelope to send the sample to the reference laboratory. An anonymous acceptability survey was conducted. The cascade of care was estimated. From November 2018 to December 2021, 4623 individual users ordered self-sampling kits, 3097 returned an oral fluid sample to the reference laboratory (67.5% return rate). 87 reactive results were detected. 76 were confirmed to be HIV-positive, we estimated an HIV prevalence of 2.45% (95% CI 1.9–3.0%). 100% of those referred to specialized care are in treatment. 45.8% of participants took more than one test. 23 incident cases were detected among repeat testers, of which 20 were confirmed. The estimated incidence was 1.00 confirmed case per 100 individual-years of follow-up. 98.01% of participants would recommend it to a friend. The most identified advantages were convenience and privacy. We demonstrated that the online offer of oral self-sampling kits for HIV detection and reporting results online among GBMSM and TW users of dating apps is feasible. The intervention counted with a high acceptability and high efficacy (in terms of reactivity, confirmation and linkage to care rates). [ABSTRACT FROM AUTHOR]

Animal welfare has evolved during the past decades to improve not only the quality of life of laboratory rodents but also the quality and reproducibility of scientific investigations. Bibliometric analysis has become an important tool to complete the current knowledge with academic databases. Our objective was to investigate whether scientific research on cannibalism/infanticide is connected with maternal aggression towards the offspring in laboratory rodents. To carry out our research, we performed a specific search for published articles on each concept. Results were analyzed in the open-source environment RStudio with the package Bibliometrix. We obtained 253 and 134 articles for the first search (cannibalism/infanticide) and the second search (maternal aggression towards the pups) respectively. We observed that the interest in infanticide/cannibalism started in the 1950s, while researchers started showing interest in maternal aggression towards the pups 30 years later. Our analyses indicated that maternal aggression had better citations in scientific literature. In addition, although our results showed some common features (e.g. oxytocin or medial preoptic area in the brain), we observed a gap between cannibalism/infanticide and maternal aggression towards the pups with only 14 published articles in common for both the searches. Therefore, we recommend researchers to combine both concepts in further investigations in the context of cannibalism for better dissemination and higher impact in laboratory rodents' welfare research. [ABSTRACT FROM AUTHOR]

Background: The application of the Six Sigma (σ) metric in biochemical laboratories is a powerful tool for reducing the occurrence of errors and prioritizing important improvements in laboratory quality control. The National Accreditation Board for Testing and Calibration Laboratories (NABL) is an accreditation body with an accreditation system established in accordance with ISO/IEC 17011, providing specialty- or scope-based certification based on the conformance of quality indices to medical laboratories. In this context, a study has been designed that considers the quality guidelines set by NABL as well as the sigma metric rule in the assessment of analytical performance. Aims and Objectives: The aims of this study were to identify the gaps and need for strategy modification for quality improvement by assessing the performance of two NABL-accredited medical testing laboratories on a Sigma metric scale. Materials and Methods: A retrospective analytical study was conducted over 6 months (January-June 2021). Internal quality control (IQC) and EQAS data were obtained from third-party QC providers (Bio-Rad, India) and analyzed by calculating sigma (σ) values based on the coefficient of variation, bias, and total error allowable in two NABL-accredited medical testing laboratories. To identify potential problems for analytes with poor sigma values, a quality goal index (QGI) analysis was performed. Results: By analyzing the sigma values obtained by both NABL-accredited laboratories, we can see that laboratory 2 performed better than laboratory 1. After calculating the QGI, there was a problem of inaccuracy and imprecision in laboratory 1, and laboratory 2 had QGI values that indicated only imprecision. Conclusion: Diagnostic laboratories should incorporate Six Sigma metrics to identify gaps in their performance to ensure better quality control and patient safety. [ABSTRACT FROM AUTHOR]

Context.--In 2014, the College of American Pathologists developed an evidence-based guideline to address analytic validation of immunohistochemical assays. Fourteen recommendations were offered. Per the National Academy of Medicine standards for developing trustworthy guidelines, guidelines should be updated when new evidence suggests modifications. Objective.--To assess evidence published since the release of the original guideline and develop updated evidence-based recommendations. Design.--The College of American Pathologists convened an expert panel to perform a systematic review of the literature and update the original guideline recommendations using the Grading of Recommendations Assessment, Development and Evaluation approach. Results.--Two strong recommendations, 1 conditional recommendation, and 12 good practice statements are offered in this updated guideline. They address analytic validation or verification of predictive and nonpredictive assays, and recommended revalidation procedures following changes in assay conditions. Conclusions.--While many of the original guideline statements remain similar, new recommendations address analytic validation of assays with distinct scoring systems, such as programmed death receptor-1 and analytic verification of US Food and Drug Administration approved/cleared assays; more specific guidance is offered for validating immunohistochemistry performed on cytology specimens. [ABSTRACT FROM AUTHOR]

Context.--In the United States, review of digital whole slide images (WSIs) using specific systems is approved for primary diagnosis but has not been implemented for intraoperative consultation. Objective.--To evaluate the safety of review of WSIs and compare the efficiency of review of WSIs and glass slides (GSs) for intraoperative consultation. Design.--Ninety-one cases previously submitted for frozen section evaluation were randomly selected from 8 different anatomic pathology subspecialties. GSs from these cases were scanned on a Leica Aperio AT2 scanner at X20 magnification (0.25 μm/pixel). The slides were deidentified, and a short relevant clinical history was provided for each slide. Nine board-certified general pathologists who do not routinely establish primary diagnoses using WSIs reviewed the WSIs using Leica Aperio ImageScope viewing software. After a washout period of 2--3 weeks, the pathologists reviewed the corresponding GSs using a light microscope (Olympus BX43). The pathologists recorded the diagnosis and time to reach the diagnosis. Intraobserver concordance, time to diagnosis, and specificity and sensitivity compared to the original diagnosis were evaluated. Results.--The rate of intraobserver concordance between GS results andWSI results was 93.7%. Mean time to diagnosis was 1.25 minutes for GSs and 1.76 minutes for WSIs (P < .001). Specificity was 91% for GSs and 90% for WSIs; sensitivity was 92% for GSs and 92% for WSIs. Conclusions.--Time to diagnosis was longer with WSIs than with GSs, and scanning GSs and uploading the data to whole slide imaging systems takes time. However, review of WSIs appears to be a safe alternative to review of GSs. Use of WSIs allows reporting from a remote site during a public health emergency such as the COVID-19 pandemic and facilitates subspecialty histopathology services. [ABSTRACT FROM AUTHOR]

Context.--In 2018 the College of American Pathologists Diagnostic Immunology and Flow Cytometry Committee designed and implemented a new plasma cell neoplasia flow cytometry proficiency testing program--PCNEO--to allow clinical flow cytometry laboratories to monitor and assess their performance compared with a peer group. Objective.--To report the results from the first 4 years of the PCNEO program. Design.--Program participants were sent 2 sets of challenges per year, each including 1 wet challenge and 2 dry challenges, with associated clinical and laboratory findings. The wet challenges were composed of myeloma cell line specimens (with or without dilution in preserved whole blood) for flow cytometric analysis. The dry (paper) challenges were composed of clinical case summaries and images of flow cytometric test results from various flow cytometry laboratories of committee members. Results.--A total of 116 to 145 laboratories from 17 countries enrolled in the proficiency testing program. For the wet challenges, almost all participants (97%--100%; cumulative, 98.2%) correctly identified the presence of neoplastic plasma cell populations based on flow cytometric analysis of undiluted myeloma cell lines. Slightly fewer participants (89.0%--97.4%; cumulative, 95.2%) correctly identified the presence of neoplastic plasma cell populations based on flow cytometric analysis of diluted myeloma cell lines (10% or 50% dilutions into peripheral blood) intended to better represent a typical clinical sample. There was generally agreement among 80% or more of participants for positive or negative staining for CD38, CD138, CD19, CD20, and surface and cytoplasmic K and λ light chains. Similarly, 84% to 100% of participants were able to correctly identify the presence of neoplastic plasma cell populations in paper challenges, including the presence of small, neoplastic plasma cell populations (0.01%--5.0% clonal plasma cells) and the presence of nonneoplastic plasma cell populations (correctly identified by 91%--96% of participants). Conclusions.--Participant performance in the new proficiency testing program was excellent overall, with the vast majority of participants able to perform flow cytometric analysis and identify neoplastic plasma cell populations and to identify small plasma cell clones or expanded populations of reactive plasma cells in dry challenge flow cytometry results. This program will allow laboratories to verify the accuracy of their testing program and test interpretations for the assessment of patients suspected of having a plasma cell neoplasm. [ABSTRACT FROM AUTHOR]

Context.--Clinician feedback is an important source of information for laboratory quality improvement programs. Objective.--To pilot a program for nearly real-time solicitation and analysis of physician feedback regarding clinical laboratory services. Design.--Laboratories distributed either electronic or paper survey forms to physicians. Results were tabulated by College of American Pathologists staff. Free-text comments were shared promptly with the participating laboratories to facilitate follow-up. Results.--Forty-seven clinical laboratories participated in the study and submitted results for 987 physician surveys, including both paper and electronic forms. Of 694 responses submitted electronically within the study period, 460 (66.3%) included at least 1 free-text entry, for a total of 951 free-text comments. Conclusions.--Point-of-service solicitation of physician feedback regarding clinical laboratory services is feasible and can provide a substantial quantity of potentially useful information regarding laboratory performance from the customer perspective. [ABSTRACT FROM AUTHOR]

Context.--Misdiagnosis of antiphospholipid syndrome can occur owing to the wide diversity of antiphospholipid (aPL) assays and a lack of international calibrators and harmonized reference intervals. Objective.--To assess laboratory practices regarding reporting and establishing reference intervals for immuno-globulin (Ig) G/IgM anti-cardiolipin (aCL) and anti--beta-2 glycoprotein I (anti-β2GPI) assays. Design.--Supplemental questions related to reporting and establishing reference ranges for aPL assays were sent as part of the Antiphospholipid Antibody (ACL)-B 2019 College of American Pathologists (CAP) proficiency testing survey. The response rate and methods assessment details were determined, as well as qualitative and quantitative results for 3 test samples. Results.--The number of participants reporting results for IgG aCL (n = 489), IgM aCL (n = 476), IgG anti-β2GPI (n = 354), and IgM anti-β2GPI (n = 331) varied by antibody type. The enzyme-linked immunosorbent assay (ELISA) (up to 58.6%, 260 of 444) was the most used method; others included multiplex (from 18.9%to 23.9%), fluorescence enzyme immunoassay (14.4%--17.6%), and chemiluminescence immunoassay (6.5%--9.0%). More respondents reported quantitative than qualitative results, and manufacturer cutoff ranges were used by 92.9% and 94.2% of respondents for aCL and anti-β2GPI, respectively. Despite variation in the use of semiquantitative ranges, qualitative negative/positive reporting of the test samples achieved almost 100% consensus. Qualitative consensus was met in contrast to the wide range of quantitative results obtained for each analyte across different kits. Conclusions.--ELISA remains the most used method for detecting aPL antibodies, with most laboratories reporting quantitative results based on manufacturers' suggested reference ranges. The categorization of quantitative results as equivocal, weak positive, or positive for responders using kits from the same manufacturer was variable. [ABSTRACT FROM AUTHOR]

Context.--The College of American Pathologists (CAP) surveys provide national benchmarks of pathology practice. Objective.--To investigate pancreaticobiliary cytology practice in domestic and international laboratories in 2021. Design.--We analyzed data from the CAP Pancreaticobiliary Cytology Practice Supplemental Questionnaire that was distributed to laboratories participating in the 2021 CAP Nongynecologic Cytopathology Education Program. Results.--Ninety-three percent (567 of 612) of respondent laboratories routinely evaluated pancreaticobiliary cytology specimens. Biliary brushing (85%) was the most common pancreaticobiliary cytology specimen evaluated, followed by pancreatic fine-needle aspiration (79%). The most used sampling methods reported by 235 laboratories were 22-gauge needle for fine-needle aspiration (62%) and SharkCore needle for fine-needle biopsy (27%). Cell block was the most used slide preparation method (76%), followed by liquid-based cytology (59%) for pancreatic cystic lesions. Up to 95% (303 of 320) of laboratories performed rapid on-site evaluation (ROSE) on pancreatic solid lesions, while 56% (180 of 320) performed ROSE for cystic lesions. Thirty-six percent (193 of 530) of laboratories used the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology in 2021. Among all institution types, significant differences in specimen volume, specimen type, ROSE practice, and case sign-out were identified. Additionally, significant differences in specimen type, slide preparation, and ROSE practice were found. Conclusions.--This is the first survey from the CAP to investigate pancreaticobiliary cytology practice. The findings reveal significant differences among institution types and between domestic and international laboratories. These data provide a baseline for future studies in a variety of practice settings. [ABSTRACT FROM AUTHOR]

Context.--Increased band neutrophils in blood smear differential counts ("bandemia") are entrenched in medicine as a flag for sepsis. However, laboratory hematology experts have long advocated for discontinuation of reporting bands separately from segmented neutrophils because of poor sensitivity and specificity, poor interobserver agreement, and availability of alternative biomarkers for sepsis. Objective.--To describe band neutrophil reporting practices and reproducibility of band classification among laboratories participating in the College of American Pathologists (CAP) proficiency testing (PT) program. Design.--A survey questionnaire was distributed to hematology PT participants. A subsequent morphologic challenge included 12 preselected cell identifications of segmented neutrophils, bands, and metamyelocytes, and a 100-cell manual differential count of a digitally scanned blood smear. Results.--Among laboratories that reported manual differentials, most respondents reported bands (4554 of 5268; 86.4%). Only 3222 of 4412 respondents (73.0%) provided band reference ranges. Though participants classified "easy" band neutrophils well (78.0%-98.3%), categorization of cell identifications for "moderate" and "difficult" bands was poor (3.1%-39.0% of laboratories), with classification instead as segmented neutrophils. This pattern was seen regardless of laboratory demographic characteristics. Marked variability in band counts was observed on the 100-cell differential count for both CAP PT participants and CAP Hematology and Clinical Microscopy Committee (HCMC) members (coefficients of variation, 55.8% and 32.9%, respectively). Variability was significantly improved when segmented and band neutrophils were grouped together (coefficients of variation, 6.2% and 5.0%, respectively). Conclusions.--Most CAP PT-participating laboratories report band counts, many without reference ranges. The survey confirms significant interlaboratory variability of band enumeration when bands are separately identified from segmented neutrophils. This study reaffirms the CAP Hematology and Clinical Microscopy Committee's strong recommendation to group segmented and band neutrophils together in manual differential counts. [ABSTRACT FROM AUTHOR]

Purpose: The MAST® D72C test is a phenotypical test which can detect ESBL and AmpC production in Enterobacterales. It can also identify the suspected presence of carbapenemase. The aim of the present study was to assess the sensitivity and specificity of this test and to discuss its usefulness in laboratories, especially those that use only an automated AST system. Method: The performance of the MAST® D72C test was assessed against a collection of 119 non-redundant Enterobacterales isolates characterized for their content in β-lactamases, and compared with that of the reference double disk synergy test. β-lactamase content was established from phenotypic and genotypic analyses to collect a broad diversity of resistance mechanisms and bacterial strains, including 30 ESBL-producing strains, 32 strains overproducing chromosomal AmpC, 10 strains producing plasmid-encoded AmpC, 12 carbapenemase-producing strains, 13 strains combining the production of several β-lactamases, and 22 strains that produced other β-lactamases. Results: The sensitivity and specificity for ESBL-detection were comparable with those of the synergy test, 75 versus 72.5%, and 94.9 versus 93.7%, respectively. The sensitivity and specificity for AmpC-detection were 71.7% and 100%, respectively, and sensitivity reached 78.7% if we excluded carbapenem-resistant isolates. Carbapenemase-detection sensitivity was 90%. Conclusion: These results show that the MAST® D72C test can be a useful tool for the detection of ESBL- and AmpC-production in clinical laboratories. [ABSTRACT FROM AUTHOR]

Purpose: Rapid, reliable identification of mycobacteria from positive cultures is essential for patient management, particularly for the differential diagnosis of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM) species. The aim of the present study was to evaluate a new "In-Vitro-Diagnostic"-certified PCR kit, FluoroType®-Mycobacteria VER 1.0 (Hain Lifescience GmbH) for NTM and MTBC identification from cultures. Methods: Mycobacteria identification isolated from positive cultures during routine practice at the Lyon university hospital mycobacteria laboratory obtained by hsp65 amplification/sequencing were compared retrospectively and prospectively to those obtained by and the FluoroType®-Mycobacteria VER 1.0 kit. Results: The overall agreement between hsp65 amplification/sequencing and the FluoroType®-Mycobacteria VER 1.0 kit was 88.4% (84/95); 91.2% (52/57) for the retrospective period and 84.2% (32/38) for the prospective period. There were 9 (9.5%) minor discrepancies (species in the FluoroType®-Mycobacteria VER 1.0 database and identified at genus level): 4 during the retrospective period, 5 during the prospective period; and 2 (2.1%) major discrepancies (species in the FluoroType®-Mycobacteria VER 1.0 database and identified incorrectly to species level): 1 during the retrospective period (M. kumamotonense identified as M. abscessus subsp massiliense by the kit) and 1 during the prospective period (M. chimaera identified as M. smegmatis by the kit). Including concordant results at genus level and minor discrepancies, 17.9% (17/95) of strains were identified as Mycobacterium sp. by the FluoroType®-Mycobacteria-VER 1.0 kit. Conclusion: The good performance of the FluoroType®-Mycobacteria-VER 1.0 kit with few major discrepancies could enable its use for first-line identification of positive mycobacteria cultures. However, an alternative identification method at least for reference laboratories is needed owing to the non-negligible proportion of NTM strains were identified at genus level. [ABSTRACT FROM AUTHOR]

From 2019 (pre-COVID-19) to 2022 (COVID-19 years), three tertiary Greek hospitals monitored MDRO bloodstream infection (BSI) and hospital acquisition relying on laboratory data. Surveillance covered carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), Pseudomonas aeruginosa (CRPA), vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA), in intensive care units (ICUs) and non-ICUs. Non-ICUs experienced significant increases in CRE, CRAB and VRE during the pandemic. In ICUs, CRE increased in 2021, CRAB in 2020 and 2021, and VRE in 2021 and 2022. KPC predominated among CRE. MDRO BSI and hospital acquisition incidence rates increased, driven by CRE and CRAB. [ABSTRACT FROM AUTHOR]

This review aims to gather the current state of the art on the encapsulation methods using alginate as the main polymeric material in order to produce hydrogels ranging from the microscopic to macroscopic sizes. The use of alginates as an encapsulation material is of growing interest, as it is fully bio-based, bio-compatible and bio-degradable. The field of application of alginate encapsulation is also extremely broad, and there is no doubt it will become even broader in the near future considering the societal demand for sustainable materials in technological applications. In this review, alginate's main properties and gelification mechanisms, as well as some factors influencing this mechanism, such as the nature of the reticulation cations, are first investigated. Then, the capacity of alginate gels to release matter in a controlled way, from small molecules to micrometric compounds, is reported and discussed. The existing techniques used to produce alginates beads, from the laboratory scale to the industrial one, are further described, with a consideration of the pros and cons with each techniques. Finally, two examples of applications of alginate materials are highlighted as representative case studies. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, scientists investigated how pathologists test for a protein called HER2 in a type of cancer called endometrial cancer (EC). They checked samples from 180 patients tested over the first two years following approval of the test in the clinic. They found that 28% of the samples had HER2 overexpression, which makes them eligible for HER2-targeted therapies. They also noticed that in some cases, the test results were different depending on the method used. This study shows that there are challenges in testing for HER2 in endometrial cancer and suggests that we need standardized guidelines to help doctors make better decisions about endometrial cancer treatment. HER2-targeted therapies have transformed the management of advanced or recurrent serous endometrial cancer (EC), leading to an increased clinical demand for HER2 testing. Despite its adoption in select academic centers, the global extent of such tumor testing is unclear. In this study, we report on the initial two-year experience of HER2 testing at a major academic center with a reference gynecologic oncology service and biomarker reference laboratory. All patients who underwent HER2 testing based on physician discretion, reflex HER2 testing, and reference laboratory requests were included. From February 2021 to October 2023, HER2 testing was performed on 192 tumor tissue samples from 180 EC patients. Serous carcinoma constituted 52% of samples, reflecting diagnostic challenges and limited therapeutic options for advanced EC. HER2 positivity was found in 28% of all cases and 30% of p53-aberrant cases. An immunohistochemistry (IHC) score of 3+ was found in 15% of samples, while IHC 2+ was found in 45% (13% IHC 2+/ISH+ and 32% IHC 2+/ISH−). The newly identified 'HER2-low' category comprised 46% of the samples. Heterogeneity was noted in 42% of HER2-positive cases, with complex patterns in 3%. NGS and HER2 IHC-FISH showed a 24% discordance, attributed to intratumoral heterogeneity, tumor cellularity, a small number of amplified cells, and the HER2/CEP17 ratio near the cut-off. This study offers real-world insights into HER2 testing in EC, highlighting the challenges and underscoring the need for standardized guidelines in specimen handling, proficiency testing, and scoring criteria to enhance patient management and therapeutic decision-making. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic continues to pose a global zoonotic disease threat, highlighting the importance of developing strategies to combat new viruses and variants stemming from climate change and animal populations. A multidisciplinary approach is needed to address dis/misinformation surrounding such research. Collaborations across disciplines aid in actual responses to public health emergency events as well, easing the transition to a new equilibrium and impacting planning for future events. Russian disinformation regarding the joint work of Americans and Ukrainians as part of the Biological Threat Reduction Program is evidence of the need to educate the public about the real risks and benefits of zoonotic disease research. As seen in the recently released National Biodefense Strategy, political leaders in the United States are becoming more explicit about embracing a One Health framework for biodefense and public health emergency preparedness. This has significant benefits in terms of policy making by helping to dispel dis/misinformation, build trust in disease surveillance data, and give frontline workers such as those in the agricultural sector a voice in the conversation with which to share their expertise. A communication complex perspective applied through a culture‐centered approach to a One Health model aims to improve risk and crisis communication. This unique strategy will help government leaders as well as those in relevant sectors to speak to the unique questions and concerns of a particular population. Among other things, this helps to avoid an ineffective "cookie‐cutter" approach messaging. In this manuscript, we argue that coconstructing a cultural understanding of human, animal, and environmental health practices within a unique culture will lead to a specialized risk and crisis communication plan accepted by local communities. Key points: The increasing spread of mis/disinformation in the area of infectious disease research necessitates that facilities like biosafety level 4 (BSL‐4) labs more actively and productively engage with the public.The One Health model is a useful way to frame engagement because it provides opportunities for members of the public to directly engage in activities like surveillance which can increase buy‐in regarding public health preparedness and response activities.When engaging with the public it is important to remember that, particularly on issues like infectious disease, a culture‐centered approach that takes into account existing perceptions, attitudes, and knowledge is important to establish a relationship of trust. [ABSTRACT FROM AUTHOR]

The experimental data of core flow distribution are indispensable for obtaining licensing and facilitating the design of fluid systems of nuclear reactors. In this study, an Advanced power reactor Core flow and Pressure (ACOP) test facility was established to experimentally simulate the internal flow of the Advanced Power Reactor 1000 (APR1000) on a reduced length scale of 1/5. The core region was simulated by using 177 core simulators representing the fuel assemblies of the APR1000. The APR1000 flow distributions were synthetically identified by accurately measured parameters: the core inlet flow rate and outlet pressure under the four-pump balanced and unbalanced flow conditions. The overall inlet flow rates ranged from 87.7% to 112.0% relative to the averaged flow rate. Here, we scrutinize the flow distributions considering the flow conditions and internal structures and briefly describe the applied scaling method and design concept of the test facility. [ABSTRACT FROM AUTHOR]

Ball mills are widely used for size reduction in mineral processing, but effective scaling from laboratory to industrial scale remains challenging. This study introduces a novel scaling constant approach to replicate energy transfer to ore during milling across different scales by adjusting rotational speed and grinding medium size distribution. The scaling constant encapsulates parameters like the number of balls per working area, rotational speed, and an average ball's maximum potential and kinetic energies. Experiments were conducted using a laboratory ball mill with interchangeable drum sizes (300, 400, and 500 mm) and a Design of Experiments methodology. Statistical analysis revealed that the scaling constant was more effective at maintaining consistent specific energy and energy per rotation across scales than size reduction, especially in dry milling. Wet milling results showed no significant differences in all metrics across scales. The dominant charge motion shifted from centrifuging to cascading as the mill diameter increased, highlighting the complex scaling dynamics. While the scaling constant shows promise for maintaining energy utilization, additional factors like charge motion and particle breakage mechanisms should be considered. The findings provide insights for improving ball mill design and optimization in mineral processing. [ABSTRACT FROM AUTHOR]

Generally, chemical engineering students get well acquainted with the batch synthesis of various active pharmaceutical ingredients, however, only tiny focus is provided to undergraduates on the topic of flow chemistry. In this paper, we report that students participating in the chemical engineering BSc course at the Budapest University of Technology and Economics were encouraged to perform the flow synthesis of paracetamol, a common pain painkiller. Two different synthetic routes for the continuous production of paracetamol were investigated and compared the batch and flow methods. Thus, these experiments allowed the students to discover flow chemistry for themselves under supervision: how to set up a flow system, how to carry out a reaction continuously, and to experience the advantages of flow chemistry over batch synthesis. In addition, students also got familiar with in-line Fourier transform infrared spectroscopy, as one of the reactions was monitored in real-time. [ABSTRACT FROM AUTHOR]

Introduction: Proactive esophageal cooling has been FDA cleared to reduce the likelihood of ablation‐related esophageal injury resulting from radiofrequency (RF) cardiac ablation procedures. Data suggest that procedure times for RF pulmonary vein isolation (PVI) also decrease when proactive esophageal cooling is employed instead of luminal esophageal temperature (LET) monitoring. Reduced procedure times may allow increased electrophysiology (EP) lab throughput. We aimed to quantify the change in EP lab throughput of PVI cases after the introduction of proactive esophageal cooling. Methods: EP lab throughput data were obtained from three EP groups. We then compared EP lab throughput over equal time frames at each site before (pre‐adoption) and after (post‐adoption) the adoption of proactive esophageal cooling. Results: Over the time frame of the study, a total of 2498 PVIs were performed over a combined 74 months, with cooling adopted in September 2021, November 2021, and March 2022 at each respective site. In the pre‐adoption time frame, 1026 PVIs were performed using a combination of LET monitoring with the addition of esophageal deviation when deemed necessary by the operator. In the post‐adoption time frame, 1472 PVIs were performed using exclusively proactive esophageal cooling, representing a mean 43% increase in throughput (p <.0001), despite the loss of two operators during the post‐adoption time frame. Conclusion: Adoption of proactive esophageal cooling during PVI ablation procedures is associated with a significant increase in EP lab throughput, even after a reduction in total number of operating physicians in the post‐adoption group. [ABSTRACT FROM AUTHOR]

Recent emphasis on learning biology through scientific investigations has focused instruction on understanding and using scientific evidence. To unpack the complexities of evidentiary reasoning, here we present a novel laboratory investigation for teaching the Hardy Weinberg Equilibrium (HWE) in an introductory biology laboratory course that was informed by the Conceptual Analysis of Disciplinary Evidence (CADE) framework. This HWE laboratory investigation highlights evidentiary reasoning with scaffolding questions to target reasoning with and about scientific evidence and it provides students with detailed disciplinary knowledge underpinning their investigation and evidentiary reasoning. To indicate how CADE influenced instruction on evidentiary reasoning during the investigation, changes in one instructor's laboratory discussion questions before and after implementing CADE are provided. Also, our CADE-informed HWE laboratory investigation is compared to other published activities for engaging students with HWE. Findings show that with CADE, the instructor implemented more scaffolds for directing students to consider multiple aspects of evidentiary reasoning and encouraged students' epistemic considerations about the nature, scope and quality of scientific evidence. These changes suggest that CADE can be a practical pedagogical tool to inform improvements in HWE laboratory investigations and to help instructors develop and implement scaffolds to guide students' evidentiary reasoning during a scientific investigation. [ABSTRACT FROM AUTHOR]

We examined whether mimicking an interaction partner is universally advantageous or, provided the mimicry is particularly strong, whether it has detrimental impacts on interpersonal and negotiation outcomes. Participants interacted with a confederate who engaged in no, subtle, or strong mimicry and then negotiated. In laboratory Experiment 1 (N = 71) and Experiment 2 (N = 149), subtly (vs. not) mimicked participants liked the confederate more, while strongly (vs. subtly) mimicked participants liked and trusted less. In Experiment 2, strongly (vs. subtly) mimicked participants were less susceptible to the first-offer anchor. The online Experiment 3 (N = 180) corroborated the too-much-mimicry effect: When participants became aware of mimicry, it exerted detrimental effects on liking and trust irrespective of the experimental condition. Experiment 1 and Experiment 3 found no too-much-mimicry effect on anchoring susceptibility. These findings show that (a) sufficiently subtle mimicry positively influences interpersonal outcomes and (b) too much mimicry backfires. [ABSTRACT FROM AUTHOR]

Nitrogen (N) management is a key component to maintaining high productivity of northern highbush blueberry (Vaccinium corymbosum L.) and nitrogen is often supplied by applying ammonium-based fertilizers. It can also be supplied through mineralization of soil organic matter (SOM), although the amount released by SOM is difficult to predict and not always considered in the development and implementation of N fertility programs. Laboratory and field experiments were conducted to estimate the timing and magnitude of net N mineralization from SOM throughout the growing season, identify soil properties that can be measured commercially and used to predict net N mineralization across a range of SOM, and determine whether N requirements for maximizing yield and fruit quality of blueberry vary across soils with different amounts of SOM. The laboratory experiment was conducted for 6 months using soil samples collected from 10 representative commercial blueberry fields in northwest Washington. The soils contained 2% to 42% soil organic carbon (SOC). The mean net N mineralization rates were fastest during the first 3 to 4 months of incubation, corresponding to the period during which N uptake reaches its maximum in blueberry. Results indicated that the soil total N may be a useful predictor of the N supply from SOM (6.34 ± 1.13 kg-ha21 increase in net N mineralization with each 0.1% increase in total N), but there was substantial variability in the N supply that could not by explained by the total N (P < 0.001; r2 5 0.433). The field experiment was conducted from 2019 to 2021 and included four mature, regionally representative, commercial fields of 'Duke' blueberry. The fields contained 3% to 28% SOC and were each fertilized with low, medium (control), or high N rates, corresponding to 33 to 50, 67 to 84, or 102 to 118 kg-ha21 N per year, respectively. Although soil inorganic N levels suggested that N mineralization was substantial at sites with higher SOM, sites with lower SOM did not require more fertilizer N than those with higher SOM. Under the conditions of this experiment, even the lowest N rates were sufficient to sustain production for at least 3 years at each site. The findings of this study indicate that SOM may be an important contributor to N fertility in managed blueberry systems, and that yield and fruit quality can be maintained across various N fertilizer rates, including at rates <50 kg-ha21 N. However, the long-term impacts of reducing N application rates remain unclear, and future research should monitor long-term changes in plant health and soil fertility associated with reduced N applications across diverse soils and production systems. [ABSTRACT FROM AUTHOR]