Search

Background: Workload measurement is important to help determine optimal staffing and workload distribution for pathology laboratories. The Level 4 Equivalent (L4E) System is the most widely used Anatomical Pathology (AP) workload measurement tool in Canada. However, it was initially not developed with subspecialties in mind. Methods: In 2016, a Pan-Canadian Pediatric-Perinatal Pathology Workload Committee (PCPPPWC) was organized to adapt the L4E System to assess Pediatric-Perinatal Pathology workload. Four working groups were formed. The Placental Pathology Working Group was tasked to develop a scheme for fair valuation of placental specimens signed out by subspecialists in the context of the L4E System. Previous experience, informal time and motion studies, a survey of Canadian Pediatric-Perinatal Pathologists, and interviews of Pathologists' Assistants (PA) informed the development of such scheme. Results: A workload measurement scheme with average L4E workload values for examination and reporting of singleton and multiple gestation placentas was proposed. The proposal was approved by the Canadian Association of Pathologist - Association canadienne des pathologistes Workload and Human Resources Committee for adoption into the L4E System. Conclusion: The development of a workload measurement model for placental specimens provides an average and fair valuation of these specimen types, enabling its use for resource planning and workload distribution. [ABSTRACT FROM AUTHOR]

Glutamine synthetase (GS) is the enzyme responsible for the biosynthesis of glutamine, providing the only source of endogenous glutamine necessary for several critical metabolic and developmental pathways. GS deficiency, caused by pathogenic variants in the glutamate‐ammonia ligase (GLUL) gene, is a rare autosomal recessive inborn error of metabolism characterized by systemic glutamine deficiency, persistent moderate hyperammonemia, and clinically devastating seizures and multi‐organ failure shortly after birth. The four cases reported thus far were caused by homozygous GLUL missense variants. We report a case of GS deficiency caused by homozygous GLUL gene deletion, diagnosed prenatally and likely representing the most severe end of the spectrum. We expand the known phenotype of this rare condition with novel dysmorphic, radiographic and neuropathologic features identified on post‐mortem examination. The biallelic deletion identified in this case also included the RNASEL gene and was associated with immune dysfunction in the fetus. This case demonstrates that total absence of the GLUL gene in humans is viable beyond the embryonic period, despite the early embryonic lethality found in GLUL animal models. [ABSTRACT FROM AUTHOR]

Objectives: While reference limits are foundational to interpreting clinical laboratory tests, they may not correspond to the actual values triggering clinical response. We propose to measure this using clinical action curves, which plot test values against an indicator of clinical action. Methods: We selected repeat test ordering as a quantifiable, objective, useful measure that is readily calculable using available laboratory data. Using all results in Calgary in 2010-2011 for eight analytes, clinical action curves for each analyte were plotted as the relationship between index test value and retesting hazard, modeled using Cox proportional hazards with restricted cubic splines. Clinical action limits were defined where retesting hazard rose 38% above baseline (25%-50% considered). Results: In general, clinical action increased before the reference limits, and clinical action limits were narrower than reference limits. However, some reference limits showed no increased clinical action and may thus be ignored in practice. Conclusions: Clinical action curves and limits provide practical, objective tools for describing physician responses to test values. Results suggest that many normal results are treated as abnormal and vice versa; such discrepancies require further scrutiny and ultimately reconciliation via altered reference ranges or altered practice patterns. [ABSTRACT FROM AUTHOR]

Objectives: While reference limits are foundational to interpreting clinical laboratory tests, they may not correspond to the actual values triggering clinical response. We propose to measure this using clinical action curves, which plot test values against an indicator of clinical action.Methods: We selected repeat test ordering as a quantifiable, objective, useful measure that is readily calculable using available laboratory data. Using all results in Calgary in 2010-2011 for eight analytes, clinical action curves for each analyte were plotted as the relationship between index test value and retesting hazard, modeled using Cox proportional hazards with restricted cubic splines. Clinical action limits were defined where retesting hazard rose 38% above baseline (25%-50% considered).Results: In general, clinical action increased before the reference limits, and clinical action limits were narrower than reference limits. However, some reference limits showed no increased clinical action and may thus be ignored in practice.Conclusions: Clinical action curves and limits provide practical, objective tools for describing physician responses to test values. Results suggest that many normal results are treated as abnormal and vice versa; such discrepancies require further scrutiny and ultimately reconciliation via altered reference ranges or altered practice patterns. [ABSTRACT FROM AUTHOR]

The article focuses on the views from junior residents on the anatomical pathology residency training in Canada. It notes that quality assurance or improvement (QA/QI) is vital to pathology, however, QA/QI training for residents is either minimal or absent in several residency programs in the country. It points that pathologists must embrace new technologies and utilize them to render the optimum patient-centered diagnostic data in a collaborative management with radiologists and physicians.

The recent unprecedented progress in ageing research and drug discovery brings together fundamental research and clinical applications to advance the goal of promoting healthy longevity in the human population. We, from the gathering at the Aging Research and Drug Discovery Meeting in 2023, summarised the latest developments in healthspan biotechnology, with a particular emphasis on artificial intelligence (AI), biomarkers and clocks, geroscience, and clinical trials and interventions for healthy longevity. Moreover, we provide an overview of academic research and the biotech industry focused on targeting ageing as the root of age-related diseases to combat multimorbidity and extend healthspan. We propose that the integration of generative AI, cutting-edge biological technology, and longevity medicine is essential for extending the productive and healthy human lifespan.