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Most current predictive models for risk of readmission were primarily designed from non-surgical patients and often utilize administrative data alone. Models built upon comprehensive data sources specific to colorectal surgery may be key to implementing interventions aimed at reducing readmissions. This study aimed to develop a predictive model for risk of 30-day readmission specific to colorectal surgery patients including administrative, clinical, laboratory, and socioeconomic status (SES) data. Patients admitted to the colorectal surgery service who underwent surgery and were discharged from an academic tertiary hospital between 2017 and 2019 were included. A total of 1549 patients met eligibility criteria for this retrospective split-sample cohort study. The 30-day readmission rate of the cohort was 19.62%. A multivariable logistic regression was developed (C = 0.70, 95% CI 0.61–0.73), which outperformed two internationally used readmission risk prediction indices (C = 0.58, 95% CI 0.52–0.65) and (C = 0.60, 95% CI 0.53–0.66). Tailored surgery-specific readmission models with comprehensive data sources outperform the most used readmission indices in predicting 30-day readmission in colorectal surgery patients. Model performance is improved by using more comprehensive datasets that include administrative and socioeconomic details about a patient, as well as clinical information used for decision-making around the time of discharge. [ABSTRACT FROM AUTHOR]

Understanding the risk factors associated with COVID-19 infection among healthcare workers is crucial for infection prevention and control. The aim of this study was to examine the risk of testing positive for COVID-19 among a multicenter cohort of workers, taking into account their occupational roles (medical professionals, staff in operational and administrative roles, or laboratory personnel) in healthcare settings. The data analyzed in this study included 2163 individuals with suggestive COVID-19 symptoms who underwent laboratory testing. The incidence rate in the study sample was calculated to be 15.3 cases per 10,000 person-days. The results from the multiple regression model indicated that job roles were not significantly associated with the risk of testing positive. However, age and the duration of the pandemic were identified as significant risk factors, with increasing age and longer pandemic duration being associated with a higher risk of testing positive. Additionally, vaccination was found to reduce the risk of testing positive. These findings provide valuable insights into COVID-19 transmission among indoor healthcare workers, highlighting the influence of age, pandemic duration, and vaccination on infection risk. Further research is needed to develop evidence-based strategies aimed at protecting healthcare workers and preventing virus spread in healthcare settings. [ABSTRACT FROM AUTHOR]

Importance of laboratory diagnosis has come to the spotlight once again with the COVID-19 pandemic caused by Sars-Cov-2 and significant changes have taken place in terms of laboratory operation. A global effort has emerged when all healthcare professionals faced a biological threat. Interlaboratory collaboration and multidisciplinary approach contributed to this effort. This study aims to explain step-by-step establishment of a fully capable laboratory for Sars-Cov-2 diagnosis to support local and global fight for the COVID-19 pandemic. Several precautions were taken, and disaster plans were updated because of the changes in employee health and workload distribution. Some of these are setting up a laboratory from scratch for microorganism diagnostic tests performed in pandemic cases, measures for healthcare workers, personnel assignment planning, changes in the variety and number of tests, innovations in quality standards and the contribution of laboratories to scientific studies. Ankara Molecular Diagnostic Laboratory has become one of the laboratories in Türkiye where Sars-Cov-2 and its mutations have been studied the most with 1,710,856 samples between 01 October 2020 and 01 May 2022 since its establishment and it has become the laboratory with the highest number of equipment and technical personnel in the capital. This study summarizes all the phases of Ankara Molecular Diagnostic Laboratory beginning with its establishment from the scratch and covers all the steps to render this facility fully operational. [ABSTRACT FROM AUTHOR]

COVID-19 testing is an important risk mitigation strategy for COVID-19 prevention in school settings, where the virus continues to pose a public health challenge for in-person learning. Socially vulnerable school communities with the highest proportion of low-income, minority, and non-English speaking families have the least testing access despite shouldering a disproportionate burden of COVID-19 morbidity and mortality. Through the Safer at School Early Alert (SASEA) program, we investigated community perceptions of testing in San Diego County schools, with a focus on barriers and facilitators from the perspective of socially vulnerable parents and school staff. Using a mixed-methods approach, we administered a community survey and conducted focus group discussions (FGDs) with staff and parents from SASEA-affiliated schools and childcares. We recruited 299 survey respondents and 42 FGD participants. Protecting one's family (96.6%) and protecting one's community (96.6%) were marked as key motivators to testing uptake. School staff in particular reported that the reassurance of a negative status mitigated concerns about COVID-19 infection in schools. Participants expressed that COVID-19-related stigma, loss of income as a result of isolation/quarantine requirements, and lack of multilingual materials were the most significant barriers to testing. Our findings suggest that the testing barriers faced by school community members are predominantly structural. Testing uptake efforts must provide support and resources to manage the social and financial consequences of testing while continuously communicating its benefits. There is a clear need to continue to incorporate testing as a strategy to maintain school safety and facilitate access for vulnerable community members. [ABSTRACT FROM AUTHOR]

Myocarditis is a condition caused by acute or chronic inflammation of the cardiac myocytes, resulting in associated myocardial edema and myocardial injury or necrosis. The exact incidence is unknown, but is likely underestimated, with more mild cases going unreported. Diagnosis and appropriate management are paramount in pediatric myocarditis, as it remains a recognized cause of sudden cardiac death in children and athletes. Myocarditis in children is most often caused by a viral or infectious etiology. In addition, there are now two highly recognized etiologies related to Coronavirus disease of 2019 (COVID-19) infection and the COVID-19 mRNA vaccine. The clinic presentation of children with myocarditis can range from asymptomatic to critically ill. Related to severe acute respiratory syndrome-Coronavirus 2 (SARs-CoV-2), children are at greater risk of developing myocarditis secondary to COVID-19 compared to the mRNA COVID-19 vaccine. Diagnosis of myocarditis typically includes laboratory testing, electrocardiography (ECG), chest X-ray, and additional non-invasive imaging studies with echocardiogram typically being the first-line imaging modality. While the reference standard for diagnosing myocarditis was previously endomyocardial biopsy, with the new revised Lake Louise Criteria, cardiac magnetic resonance (CMR) has emerged as an integral non-invasive imaging tool to assist in the diagnosis. CMR remains critical, as it allows for assessment of ventricular function and tissue characterization, with newer techniques, such as myocardial strain, to help guide management both acutely and long term. [ABSTRACT FROM AUTHOR]

Introduction: Hemolysis is a common pre‐analytical factor that can influence test results. Here, we explored the influence of hemolysis on nucleated red blood cells (NRBCs) count and tried to illustrate the mechanisms underlying this interference. Methods: From July 2019 to June 2021, 20 preanalytical hemolytic peripheral blood (PB) samples from inpatient at Tianjin Huanhu Hospital were evaluated using Sysmex XE‐5000 automated hematology analyzer. When NRBC enumeration was positive and a flag was triggered, a 200‐cell differential count was performed by experienced technologists on microscopic review. When the manual count was inconsistent with automated enumeration, samples will be re‐collected. Plasma exchange test was performed to verify the influence factors of hemolyzed samples and the mechanical hemolysis experiment mimicking hemolysis that might occur during blood collection was performed to illustrate the underlying mechanisms. Results: Hemolysis led to false‐positive NRBC count and the value of NRBC was positively correlated with the degree of hemolysis. Hemolysis specimen shared a common scatter diagram: a "beard" on WBC/ basophil (BASO) channel and a "blue scatter line" on immature myeloid information (IMI) channel. Lipid droplets were found above the hemolysis specimen after centrifugation. Plasma exchange experiment confirmed that these lipid droplets interfered with NRBCs count. Mechanical hemolysis experiment implied further that broken red blood cells (RBCs) released lipid droplets causing the false‐positive NRBCs count. Conclusion: In the present study, we firstly found that hemolysis could lead to false‐positive NRBCs enumeration, which was associated with lipid droplets released from broken RBCs during hemolysis. [ABSTRACT FROM AUTHOR]

This study describes outcomes and lessons learned providing JYNNEOS vaccine for laboratory workers exposed to orthopoxviruses such as mpox. The findings are instructive for occupational health professionals seeking to implement an occupational vaccine program for a commercially unavailable vaccine. Objective: The aim of the study is to identify lessons learned implementing JYNNEOS vaccination for laboratory workers exposed to orthopoxviruses such as mpox. Methods: Workers at risk of laboratory exposure were offered vaccine in a carefully planned occupational health program. Vaccine was procured from the Centers for Disease Control and Prevention (CDC) Drug Service, which has special requirements. Reasons for accepting or declining vaccine and adverse effects were obtained by survey. Results: Most workers accepted JYNNEOS, and occupational risk was the most commonly cited reason for acceptance. Most experienced mild local adverse effects. The administrative requirements of the Centers for Disease Control and Prevention Drug Service are documented. Conclusions: Occupational health programs caring for laboratory workers handling unusual biological agents require careful planning and coordination to facilitate access to vaccines that are not commercially available, anticipate and mitigate barriers to vaccination, and comply with special Centers for Disease Control and Prevention requirements. [ABSTRACT FROM AUTHOR]

(1) Background: The incidence proportion of SARS-CoV-2 infection among healthcare workers (HCWs) in Poland is not exactly known. This study aims to present secondary epidemiological data identifying the scale of the spread of novel coronavirus infection and the estimation of vaccination coverage in selected professional groups of HCWs in Poland. (2) Methods: The secondary epidemiological data included both the number of infections and infection fatality rate (IFR) in individual occupational groups, which occurred throughout the observation period (January 2021–July 2022), both in the country and in individual voivodeship (administrative area). (3) Results: The incidence proportion of SARS-CoV-2 infections among HCWs was 16.48%. The highest percentage of infected workers concerned laboratory scientists (21.62%) and paramedics (18%). The highest frequency of infections among HCWs occurred in the province of Zachodnio-Pomorskie (18.9%). Due to COVID-19, 558 healthcare workers died during the analysed period, mostly nurses (n = 236) and doctors (n = 200). The results regarding the vaccination coverage of HCWs against COVID-19 indicate the highest percentage of vaccinated were among doctors (83.63%) and the lowest among physiotherapists (38.2%). (4) Conclusions: In general, the percentage of infections was high in Poland during the pandemic (16.48%). Significant territorial differences were observed in the frequency of infections, deaths, and percentage of vaccinated workers in individual voivodeships. [ABSTRACT FROM AUTHOR]

Standardized laboratory exercise testing is common in sport settings and rehabilitation. The advantages of laboratory-based compared to field testing include the use of calibrated equipment and the possibility of keeping environmental conditions within narrow limits, making test results highly comparable and reproducible. However, when using different equipment (e.g., treadmills), the results might deviate and impair comparability. The aim of this study was to compare the biomechanical properties (rolling resistance, speed, inclination) of two treadmills regularly used for exercise testing in elite wheelchair athletes. During the experiment, speed and inclination of two treadmills (same model and producer, different manufacturing year and belt material) were verified. Standardized drag tests were performed to assess rolling resistance. Power output conducted by the athlete during later exercise tests was calculated based on the results. Speed and inclination deviated only slightly from the values indicated by the producer. Rolling resistance caused by different belt material was mainly accountable for the differences in power output between the treadmills. In general, athletes had to deliver 10% more power output on one of the treadmills compared to the other. Concluding from these results: if different treadmills are used for testing, a proper validation is recommended to avoid misleading interpretations of test results. [ABSTRACT FROM AUTHOR]

This mixed methods study retrospectively assessed attitudes and participation of employees, occupational health personnel, and key personnel regarding the rollout of a pilot COVID-19 workplace vaccination program in five German companies in May/June 2021 in Baden-Württemberg (Southern Germany) by combining survey data and qualitative interviews. A total of 652 employees completed a standardized questionnaire and we conducted ten interviews with occupational health personnel and key personnel with other professional backgrounds organizing the pilot workplace vaccination program. Survey data were analyzed descriptively and interviews were audio recorded, transcribed verbatim, and analyzed using qualitative content analysis. Employees participated widely in COVID-19 vaccinations at their workplaces, and most employees (n = 608; 93.8%) had a full COVID-19 immunization at the time of the survey. The main advantages of the pilot COVID-19 workplace vaccination program were seen in the flexible and time-saving vaccination offer as well as the trust in and long-standing relationship with occupational health physicians. The main disadvantage of the pilot vaccination offer was increased workload for occupational health personnel, especially during the roll-out phase of the program. The pilot COVID-19 workplace vaccination program was predominantly positively assessed, and the important role of occupational health services in managing the COVID-19 pandemic was highlighted. The main criticisms of the COVID-19 workplace vaccination program related to the high organizational and administrative burden. Findings from our study can support the development of future programs for the administration of generally recommended vaccination in the workplace setting in Germany. [ABSTRACT FROM AUTHOR]

Introduction. Antiretroviral therapy (ART) has reduced mortality and improved life expectancy among HIV patients but does not provide a cure. Patients must remain on lifelong medications and deal with drug resistance and side effects. This underscores the need for HIV cure research. However, participation in HIV cure research has risks without guaranteed benefits. We determined what HIV healthcare providers know about HIV cure research trials, the risks involved, and what kind of cure interventions they are likely to recommend for their patients. Methods. We conducted in-depth qualitative interviews with 39 HIV care providers consisting of 12 physicians, 8 counsellors, 14 nurses, 2 pharmacists, 2 laboratory scientists, and 1 community advocate from three hospitals. Interviews were transcribed verbatim and coded, and thematic analysis was performed independently by two investigators. Results. Participants were happy about the success of current treatments and hopeful that an HIV cure will be found in the near future, just as ART was discovered through research. They described cure as total eradication of the virus from the body and inability to test positive for HIV or transmit the virus. In terms of risk tolerance, respondents would recommend to their patients' studies with mild to moderate risks like what patients on antiretroviral therapy experience. Participants were reluctant to recommend treatment interruption to patients as part of a cure study and wished trials could be performed without stopping treatment. Healthcare providers categorically rejected death or permanent disability as an acceptable risk. The possibility of finding a cure that will benefit the individual or future generations was strong motivations for providers to recommend cure trials to their patients, as was transparency and adequate information on proposed trials. Overall, the participants were not actively seeking knowledge on cure research and lacked information on the various cure modalities under investigation. Conclusion. While hopeful for an HIV cure, healthcare providers in Ghana expect a cure to be definitive and pose minimal risk to their patients. [ABSTRACT FROM AUTHOR]

The design of a hybrid Hematology I course (prepandemic) was adopted for Hematology II and facilitated our conversion of Hematology II into a fully remote course by fall 2020, after the university went into remote instruction. When the university suspended face-to-face (F2F) classes in March 2020, only the laboratory final exam was pending for Hematology I, and it was therefore administered remotely. Because students had taken another F2F practical exam before lockdown, we were able to compare the two. There was a significant difference between the practical examination grades for the online versus F2F exams: 94% vs. 77% mean scores, respectively. However, there was no difference between the written portion of the exams. In this article, we report the final lab and lecture grades for both courses. In spring 2021, our students completed their clinical practicums with our hospital affiliates and received scores of > 90%. We also report the performance of students who sat for the American Society of Clinical Pathology Board of Certification (BOC) examination for medical laboratory scientists. All students who appeared in the BOC examination performed satisfactorily in the hematology subdiscipline. These external assessments are positive objective benchmarks for our courses and students. [ABSTRACT FROM AUTHOR]

Objective Diversity is integral for an effective learning environment and pedagogy. In this study, we aim to determine the student and faculty diversity in the Clinical Laboratory Sciences programs at Stony Brook University. Methods We retrospectively analyzed data over 20 years for the traditional program and 8 years for the hybrid program. Results Over 20 years, 502 students graduated from the traditional program, and 96 students graduated from the hybrid program. In the traditional program, an average of 25 students enrolled with 75% female and 25% male and in the hybrid program, an average of 12 students with 8.5 female and 3.5 male enrolled. The traditional program had the highest proportion of Asian students (50%), with White students making up 24.5%, whereas the highest proportions in the hybrid program were 35% White students and 24% Hispanic students. Among the 5 boroughs of New York City, the highest proportion of student representation was from Queens and Manhattan in both traditional (24.1%) and hybrid programs (16.7%). There were 30% male and 70% female faculty served in the traditional program whereas the current representation of fulltime faculty is 100% female. Conclusion Our data show the diversity of students and faculty in clinical laboratory sciences programs at Stony Brook University institution. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is now considered one of the greatest global health threats. This is further compounded by a lack of new antibiotics in development. Antimicrobial stewardship programmes can improve and optimize the use of antibiotics, thereby increasing the cure rates of antibiotic treatment and decreasing the problem of AMR. In addition, diagnostic and antimicrobial stewardships in the pathology laboratories are useful tools to guide clinicians on patient treatment and to stop the inappropriate use of antibiotics in empirical treatment or narrow antibiotics. Medical Laboratory Scientists are at the forefront of performing antibiotics susceptibility testing in pathology laboratories, thereby helping clinicians to select the appropriate antibiotics for patients suffering from bacterial infections. Methods: This cross-sectional study surveyed personal antimicrobial usage, the knowledge and awareness on AMR, and antimicrobial stewardship, as well as barriers to antimicrobial susceptibility testing among medical laboratory scientists in Nigeria using pre-tested and validated questionnaires administered online. The raw data were summarized and exported in Microsoft Excel and further analyzed using IBM SPSS version 26. Results: Most of the respondents were males (72%) and 25–35 years old (60%). In addition, the BMLS degree was the highest education qualification most of the respondents (70%) achieved. Of the 59.2% of the respondents involved in antibiotics susceptibility testing, the disc diffusion method was the most commonly used (67.2%), followed by PCR/Genome-based detection (5.2%). Only a small percentage of respondents used the E-test (3.4%). The high cost of testing, inadequate laboratory infrastructure, and a lack of skilled personnel are the major barriers to performing antibiotics susceptibility testing. A higher proportion of a good AMR knowledge level was observed in male respondents (75%) than females (42.9%). The knowledge level was associated with the respondent's gender (p = 0.048), while respondents with a master's degree were more likely to possess a good knowledge level of AMR (OR: 1.69; 95% CI: 0.33, 8.61). Conclusion: The findings of this study indicate that Nigerian medical laboratory scientists had moderate awareness of AMR and antibiotic stewardship. It is necessary to increase investments in laboratory infrastructure and manpower training, as well as set up an antimicrobial stewardship programme to ensure widespread antibiotics susceptibility testing in hospitals, thereby decreasing empirical treatment and the misuse of antibiotics. [ABSTRACT FROM AUTHOR]

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Letter to the Editor

Is it appropriate for scientists to engage in political advocacy? Some political critics of scientists argue that scientists have become partisan political actors with self-serving financial agendas. However, most scientists strongly reject this view. While social scientists have explored the effects of science politicization on public trust in science, little empirical work directly examines the drivers of scientists' interest in and willingness to engage in political advocacy. Using a natural experiment involving the U.S. National Science Foundation Graduate Research Fellowship (NSF-GRF), we causally estimate for the first time whether scientists who have received federal science funding are more likely to engage in both science-related and non-science-related political behaviors. Comparing otherwise similar individuals who received or did not receive NSF support, we find that scientists' preferences for political advocacy are not shaped by receiving government benefits. Government funding did not impact scientists' support of the 2017 March for Science nor did it shape the likelihood that scientists donated to either Republican or Democratic political groups. Our results offer empirical evidence that scientists' political behaviors are not motivated by self-serving financial agendas. They also highlight the limited capacity of even generous government support programs to increase civic participation by their beneficiaries.

International initiatives to strengthen national health laboratory systems in resource-poor countries are often hampered by unfamiliarity with the country's health laboratory environment and turnover of international partners during the initiative. This study provides an overview of, and lessons learned from, the use of a laboratory long-term partnership approach (ie, "twinning") to strengthen the national public health laboratory system in an international setting. We focused on the partnering of the Uganda Ministry of Health Central Public Health Laboratory (CPHL) with the New Mexico State Public Health Laboratory to help the CPHL become Uganda's national public health reference laboratory (Uganda National Health Laboratory Services [UNHLS] Institute) and leader of its nascent Uganda National Health Laboratory Network (UNHLN). Via twinning, CPHL leadership received training on laboratory leadership and management, quality systems, facility management, and the One Health environmental strategy (ie, that the health of persons is connected to the health of animals and the environment), and drafted a National Health Laboratory Policy, UNHLS Institute business plan, and strategic and operating plans for the UNHLS Institute and UNHLN. The CPHL is now responsible for the UNHLS Institute and coordinates the UNHLN. Lessons learned include (1) twinning establishes stable long-term collaborations and (2) success requires commitment to a formal statement of activities and objectives, as well as clear and regular communication among partners.

The text discusses the evolution of conservation efforts since the inception of Oryx in 1950, highlighting changes in framing, scientific rigor, and the Eurocentric nature of conservation practices. While there has been progress in diversifying authorship and focusing on social dimensions, the conservation gaze still centers on charismatic megafauna and lacks comprehensive exploration of human societies. The text emphasizes the need for broader communication strategies and diverse forms of conservation writing to engage a wider audience effectively. [Extracted from the article]

This article reports the discovery of a novel allele, HLA-A*24:618, during routine sequencing-based HLA typing of a 5-year-old Ecuadorian female patient with hemophagocytic lymphohistocytosis residing in New York City. The allele was identified through next-generation sequencing (NGS) and verified by laboratory personnel. The HLA haplotypes of the patient were inferred from her parents' HLA types. The novel allele, A*24:618, had a single base substitution resulting in an amino acid substitution of Serine to Tyrosine. The sequence of the allele was submitted to the GenBank and IPD-IMGT/HLA databases and assigned the accessions number OR762265 and HWS10068247, respectively. The name A*24:618 was officially assigned by the WHO Nomenclature Committee for Factors of the HLA System. The authors declare no conflicts of interest, and no datasets were generated or analyzed during the study. [Extracted from the article]

This article reports the discovery of a novel HLA allele, HLA-A*02:1135, in a 44-year-old Mandarin-speaking Chinese individual from New York City. The allele was identified through next-generation sequencing (NGS) typing and was verified by laboratory personnel. The HLA haplotypes of the donor were also inferred from a family study. The novel allele, A*02:1135, had a single base substitution resulting in an amino acid substitution. The sequence of the allele is available in the GenBank database and has been officially assigned the name A*02:1135 by the WHO Nomenclature Committee. The authors declare no conflicts of interest, and the data supporting the findings are openly available in the IPD-IMGT/HLA database. [Extracted from the article]

Background: In autumn 2021 in Finland, a recommendation to use face masks was implemented nationwide in schools for pupils ages 12 years and above. While national guidelines were in form of recommendations, cities implemented mandatory masking in schools. Some cities extended this mandate for younger pupils as well. Our aim was to compare COVID-19 incidence among 10–12-year-olds between cities with different recommendations on the use of face masks in schools. Methods: COVID-19 case numbers, defined as positive laboratory verified SARS-CoV-2 test results, were obtained from the National Infectious Disease Registry (NIDR) of the Finnish Institute for Health and Welfare. Helsinki, Turku and Tampere were selected for comparison since the baseline COVID-19 incidence in the cities had been similar in August and September 2021. Helsinki and Tampere implemented the national recommendation on face mask use at schools, while Turku extended this to include those 10 years old and above, starting from the beginning of semester in early August. Age groups of 7–9-year-olds, 10–12-year-olds and 30–49-year-olds were included in the statistical analysis and moving averages of 14-day incidences per 100 000 inhabitants were used as a dependent variable. Joinpoint regression was used to estimate average percent changes (APC) and average daily percent changes (ADPC) in the 14-day incidences. Differences in the ADPC values between the cities were compared in one-month periods. We also calculated cumulative incidences from the beginning of August to the end of November in the cities by age group. Results: In August, the ADPC was highest in Turku (3.9) and lowest in Tampere (2.0), while in September, the ADPC was highest in Turku (-0.3) and lowest in Helsinki (-3.2) among 10–12-year-olds. In October, the ADPC was highest in Helsinki (2.1) and lowest in Turku (-0.2) and in November, the ADPC was highest in Turku (4.1) and lowest in Tampere (-0.5) among 10–12-year-olds. We also calculated cumulative incidences from the beginning of August to the end of November in the cities by age groups of 7–9 years, 10–12 years, and 30–49 years. The cumulative incidence was highest in Turku in all age groups and lowest in Tampere. Conclusions: According to our analysis, no additional effect was gained from mandating face masks, based on comparisons between the cities and between the age groups of the unvaccinated children (10–12 years versus 7–9 years). [ABSTRACT FROM AUTHOR]

Background: Follicular cell-derived thyroid carcinoma represents the vast majority of paediatric thyroid cancers (TCs). Papillary thyroid carcinoma (PTC) accounts for over 90% of all childhood TC cases, and its incidence in paediatric patients is increasing. The objective of this follow-up study was to present the outcome of ultrasound (US) and laboratory monitoring of paediatric patients with autoimmune thyroiditis (AIT) prior to the development of PTC. Patients and methods: This prospective study included 180 children and adolescents (132 females; 73.3%) with a suspicion of thyroid disorder referred to the Outpatient Endocrine Department. The patients were divided into four groups: 1) 28 patients with a mean age of 10.7 [standard deviation (SD), 3.1] y, in whom PTC was detected during the active surveillance of AIT [AIT(+), PTC(+) follow up (F)]; 2) 18 patients with a mean age of 12.8 (SD, 3.4) y, in whom PTC and AIT were detected upon admission (A) [AIT(+), PTC(+) A]; 3) 45 patients with a mean age of 13.0 (SD, 3.4) y, in whom PTC was detected upon admission and AIT was excluded [AIT(-), PTC(+) A]; and 4) an age- and sex-matched control group of 89 patients with AIT and with a mean age of 9.4 (SD, 3.0) y. The analysis included clinical, US, and laboratory assessment results of children on admission (groups 1--4) and during follow-up (groups 1 and 4) in the Paediatric Endocrine Outpatient Department. Results: Upon admission of those in group 1, the US evaluation revealed a hypoechogenic thyroid gland in 12 and an irregular normoechogenic gland in 16 patients. US monitoring revealed an increase in thyroid echogenicity and an increased irregularity of the thyroid structure during the follow-up period of all of the patients from group 1. Such changes were not noticed in group 4. PTC was diagnosed at the mean time of 3.6 y (3mo--9 y) since AIT confirmation in group 1. The mean maximum PTC diameter as per the US was significantly smaller in group 1 than in groups 2 and 3 [13.2 (10.8) mm vs. 22.2 (12.8) and 22.05 (15.4) mm]. Fewer patients in group 1 were referred to 131I than in groups 2 and 3 (71.4% vs. 94.4 and 93.3%). Interestingly, significant differences were observed in the thyroglobulin antibody (TgAb)/thyroid peroxidase antibody (TPOAb) ratio between groups 2 and 3, as opposed to group 4, at the beginning of observation [15.3 (27.6) and 3.5 (8.8] vs. 0.77 (1.9)]. In group 1, after the followup, an increase in the TgAb/TPOAb ratio was observed [1.2 (9.8) to 5.2 (13.5)]. There were no significant differences between groups 1--3 in labeling index Ki67, lymph nodes metastasis, extrathyroidal extension, and angioinvasion. There were no associations between thyroid-stimulating hormone, TgAb, and the extent of the disease. Conclusion: The use of thyroid US focused on the search for developing tumours in the routine follow-up of patients with AIT may not only help in the early detection of thyroid malignancies that are not clinically apparent but may also influence the invasiveness of oncological therapy and reduce the future side effects of 131I therapy. We propose that the repeat evaluation of TPOAb and TgAb warrants further exploration as a strategy to determine TC susceptibility in paediatric patients with AIT in larger multicentre studies. [ABSTRACT FROM AUTHOR]

Clinical outcomes for many childhood brain tumours remain poor, despite our increasing understanding of the underlying disease biology. Advances in molecular diagnostics have refined our ability to classify tumour types and subtypes, and efforts are underway across multiple international paediatric neuro-oncology consortia to take novel biological insights in the worst prognosis entities into innovative clinical trials. Whilst for the first time we are designing such studies on the basis of disease-specific biological data, the levels of preclincial evidence in appropriate model systems on which these trials are initiated is still widely variable. We have considered these issues between CONNECT, PNOC and ITCC-Brain, and developed a framework in which we can assess novel concepts being brought forward for possible clinical translation. Whilst not intended to be proscriptive for every possible circumstance, these criteria provide a basis for self-assessment of evidence by laboratory scientists, and a platform for discussion and rational decision-making prior to moving forward clinically. [ABSTRACT FROM AUTHOR]

The knowledge, attitude, and practice (KAP) of healthcare workers (HCW) toward the COVID-19 pandemic influence their preparedness to accept the preventative measures. This study investigates KAP toward COVID-19 among the HCWs working in two designated COVID hospitals. It was a cross-sectional study. The overall KAP scores were calculated, and the difference in mean scores among various demographic and other variables was tested using t-test and one-way ANOVA. The participants were knowledgeable about transmission modes and disease symptoms and were aware of the preventive measures like hand sanitisations for 96% and 91% for wearing masks. Among the knowledgeable group, 87% were aware of the control measures of COVID-19 infection like isolation and treatment of the infected; quarantine of their close contacts; and 92% had the acquaintance about the avoidance of public transport and crowded places as a safety measure. The HCWs also showed a positive attitude toward keeping distance and staying at home (81.13% strongly agreed) and regularly washing hands (agreed 91%). The mean knowledge, attitude, and practice scores of the study participants were 19.67(±1.85), 27.95(1.81) and 4.61(0.51), respectively. Nurses were found to have significantly better knowledge, attitude, and practice toward COVID-19 than laboratory technicians and pharmacists. HCWs having higher education levels were also found to have better knowledge about COVID-19. The majority of the HCWs who participated in the study also strongly agreed that the referred hospitals are well prepared for infection prevention and control (IPC). Better knowledge, attitude and practices toward COVID-19 may considerably decrease the risk of getting the disease. [ABSTRACT FROM AUTHOR]

Purpose : Emerging data suggests improved obstetric outcomes with frozen embryo transfer (FET) in an ovulatory or natural cycle (NC-FETs), as compared to programmed endometrial preparation. The objective of this study is to better understand practice patterns and provider attitudes regarding the use of NC-FETs in the United States (U.S.). Methods : In this cross-sectional study, an anonymous 22-question survey was emailed to 441 U.S. Assisted Reproductive Technology (ART) clinics to assess the utilization of NC endometrial preparation for FET, protocols used, restrictions to offering NC-FET, and providers' perspectives on advantages and disadvantages of NC-FET. Descriptive statistics were used to analyze survey responses. Result(s): The survey response rate was 49% (216/441). Seventeen percent of responding clinics did not offer NC-FET. Of the clinics that did not offer NC-FET, 65% had only 1–2 physicians in their practice. Common reasons for not offering NC-FET included "lack of timing predictability for transfer" (81%) and "increased burden on staff/laboratory personnel on holidays and weekends" (54%). Of clinics offering NC-FET, 76% reported < 25% of cycles used the NC for endometrial preparation. Over half (52%) of clinics that offered NC-FET reported having eligibility restrictions for NC-FET. Reported benefits of NC-FET were "patient satisfaction" (18%), "decreased cost of medications" (18%), and "avoidance of intramuscular progesterone" (17%). The attitude towards NC-FET in their clinics was reported as positive by 65% of respondents. Conclusion: NC-FETs are offered by most U.S. ART clinics but are used only in the minority of FET cycles for endometrial preparation, and use is often restricted. [ABSTRACT FROM AUTHOR]

Drug-resistant tuberculosis is a substantial health-care concern worldwide. Despite culture-based methods being considered the gold standard for drug susceptibility testing, molecular methods provide rapid information about the Mycobacterium tuberculosis mutations associated with resistance to anti-tuberculosis drugs. This consensus document was developed on the basis of a comprehensive literature search, by the TBnet and RESIST-TB networks, about reporting standards for the clinical use of molecular drug susceptibility testing. Review and the search for evidence included hand-searching journals and searching electronic databases. The panel identified studies that linked mutations in genomic regions of M tuberculosis with treatment outcome data. Implementation of molecular testing for the prediction of drug resistance in M tuberculosis is key. Detection of mutations in clinical isolates has implications for the clinical management of patients with multidrug-resistant or rifampicin-resistant tuberculosis, especially in situations when phenotypic drug susceptibility testing is not available. A multidisciplinary team including clinicians, microbiologists, and laboratory scientists reached a consensus on key questions relevant to molecular prediction of drug susceptibility or resistance to M tuberculosis , and their implications for clinical practice. This consensus document should help clinicians in the management of patients with tuberculosis, providing guidance for the design of treatment regimens and optimising outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effect of antibiotics on pregnancy outcomes in different risk groups of intrauterine infection of threatened abortion. METHODS: Using a retrospective survey, 146 cases of threatened abortion from May 2020 to May 2021 were extracted from hospital records and divided into 2 groups according to laboratory indicators and high risk factors of intrauterine infection, those with elevated laboratory indicators and no high risk factors of intrauterine infection were set as class Ⅰ infected, those with elevated laboratory indices and high risk factors of intrauterine infection were set as class Ⅱ infected, and then they were divided into non-medication group and medication group according to whether antibiotics were applied or not. The effects of antibiotics on pregnancy outcomes were estimated by comparing the length of stay, gestational weeks of delivery, prolonged gestational weeks, perinatal infection rate, neonatal survival rate and infection rate. RESULTS: Among class Ⅰ infected, the mean length of stay was longer in the medication group than that in the non-medication group, with statistically significant difference (P<0. 05); the gestational weeks of delivery and prolonged gestational weeks were longer in the medication group than those in the non-medication group, but the difference was not statistically significant ( P > 0. 05); there was no statistically significant difference in the perinatal infection rate, neonatal survival rate and neonatal infection rate between the medication group and the non-medication group (P>0. 05). Among class Ⅱ infected, the mean length of stay was longer in the medication group than that in the non-medication group, with statistically significant difference (P<0. 05); the gestational weeks of delivery and prolonged gestational weeks were shorter in the medication group than those in the non-medication group, but the difference was not statistically significant (P>0. 05); there was no statistically significant difference in the perinatal infection rate, neonatal survival rate and neonatal infection rate between the medication group and the non-medication group (P>0. 05). CONCLUSIONS: The application value of antibiotics for patients with threatened abortion is limited, which may not be beneficial in improving pregnancy outcomes, regardless of the combination of elevated laboratory indicators or high-risk factors of intrauterine infection. [ABSTRACT FROM AUTHOR]

(1) Background: Semen analysis is a poor predictor of the fertilization potential of spermatozoa and a male factor may contribute to poor outcomes of the IVF procedure, despite a normal semen analysis. The microfluidic sperm selection (ZyMot-ICSI) is based on the selection of the spermatozoa with the lowest DNA fragmentation rate, but studies do not prove better clinical outcomes after this method. (2) Methods: We conducted a retrospective trial comparing 119 couples that were allocated to the classic gradient centrifugation sperm method (control group), and 120 couples that were allocated with the microfluidic technique being used (study group) at our university-level clinic, to go through IVF. (3) Results: The statistical analysis showed that there is no significant difference between the fertilization rate (study vs. control p = 0.87), but regarding blastocyst rate (study vs. control p = 0.046) and clinical pregnancy (p = 0.049), there is quite a significant statistical difference. Microfluidic preparation of spermatozoa seems to improve the results and it may be utilized more broadly for ICSI, and could also improve the workflow in standard IVF, decrease intervention by laboratory personnel and provide more consistent incubation conditions. (4) Conclusions: The patients that had the sperm preparation for ICSI with the microfluidic sperm selection had slightly better results compared with the gradient centrifugation selection. [ABSTRACT FROM AUTHOR]

Dr. Wolf Singer (b. 1943) is one of Germany's most renowned brain researchers and neurophysiologists. His accomplishments in the creation of new research centers for neuroscience as well as his commitment to European scientific organizations for integrative brain research are highly valued as significant moments of advancement in the neurosciences. Before his appointment as a scientific member of the Max Planck Society and director at the Frankfurt Max Planck Institute for Brain Research, he gained deep insight into the chances and pitfalls of translational initiatives at the Max Planck Institute of Psychiatry in Munich. From the late 1950s onward, the institute adapted to emerging international trends and successfully integrated neurochemistry, neurophysiology, and neuroanatomy into the fledgling interdisciplinary field of neuroscience. This agenda of reorientation was an undertaking of Otto Detlev Creutzfeldt, Detlev Ploog, Gerd Peters, and Horst Jatzkewitz, among others. In the 1970s, Munich's laboratories attracted scientists from several countries in Europe and abroad. This article examines whether specific styles of conducting (neuro)science research existed in the Max Planck Society. [ABSTRACT FROM AUTHOR]

Medical laboratory scientists (MLS) often begin their careers employed in a hospital or public health laboratory, where employment qualifications and standards are dictated by the accrediting body. MLS who specialize in clinical microbiology have multiple career paths that can lead to a very successful and satisfying career. This review covers some details of the educational requirements and certifications required for employment within various hospital laboratory work environments and opportunities for career advancement. Alternative career paths are also highlighted, opening first with hospital departments adjacent to the clinical microbiology laboratory, such as quality assurance and infection prevention and control. In addition, careers in public health laboratories, research laboratories, scientific communication, project management, government, and the food industry, as well as foundation and non-profit work, are highlighted. Various technical career pathways within the industry and biotechnology sectors are described. The review concludes by acknowledging that for some individuals, career goals may not be fully realized without the pursuit of higher education, and it provides some overarching career advice for taking the next step toward a new career pathway. [ABSTRACT FROM AUTHOR]

In 2023, Seminars in Thrombosis and Hemostasis will be celebrating its 50 th anniversary, and similarly this will also mark my 5 th decade of working in, or association with, laboratories that perform hemostasis testing. My career started at a large military medical center, but I also worked at several other facilities, including military dispensaries, community hospitals, and a large academic institution. The difference between each type of hemostasis laboratory was as expected, with larger facilities having better instrumentation and more prolific test menus. However, whether one worked in a large academic center, or a small rural hospital, regulatory changes affected every clinical laboratory to the same degree. Advances in technology also eventually affected every hemostasis laboratory, but these salient changes were more likely to occur earlier at the larger institutions. As Seminars in Thrombosis and Hemostasis celebrates its 50 th anniversary, that milestone triggered recollection about those salient events that occurred during my own career in hemostasis testing. As such, I describe (my impression) the top ten landmark changes that altered laboratory practice at the facilities where I worked during the past 5 decades. [ABSTRACT FROM AUTHOR]

Looking at scientists (in the life sciences), we focus on the sense of meaninglessness associated with bureaucratization. We define the sense of meaninglessness as a perception of meaning deficit or meaning conflict in particular situations that can be associated with frustration, irritation, and/or boredom. We show that it can be caused by identity disturbance – particularly the incongruence between the ideal self as a researcher and the imposed self as a bureaucrat. We claim that the sense of meaninglessness is more likely to emerge in those activities that are further from an individual's core identity, and more identity work is needed to make them meaningful. We also claim that processes of rationalization imposed by external agendas, particularly transitions from substantive to formal rationality (predictability, control and calculability, efficiency) contribute to the proliferation of meaninglessness in academia. The sense of meaninglessness is, therefore, ignited by the external forces colonizing academic life and constitutes an instance of the 'irrationality of rationality'. It is an outcome or side effect of the collision between two incompatible logics of practice: bureaucratic and scientific. To show the incongruence of those competing logics, we analyze the data derived from a mixed-method study conducted between 2013 and 2014 among beneficiaries of an international research grant project. As a supplementary source of reference, we use our research on academic boredom and laboratory scientists' work and careers. [ABSTRACT FROM AUTHOR]

Rodents are the predominant species used for scientific research and must be humanely killed upon completion of the work. In the UK this is regulated by Schedule 1 of the Animals Scientific Procedures Act 1986, which lists permitted methodologies considered capable of humane killing, including overdose of an anaesthetic, exposure to carbon dioxide (CO2) gas, dislocation of the neck and concussion of the brain by striking the cranium. Although all are permitted, operator motivations behind method selection and individual operator preference remain unknown. The views of 219 laboratory animal personnel on institutional availability and use of Schedule 1 killing methods for laboratory rodents were obtained. Only 10% of participants reported that all four methods were available at their institution with 57.5% of respondents preferring cervical dislocation. For CO2, only 18.6% of participants reported using the recommended flow rate, while 45.5% did not know the flow rate employed. We highlight the urgent requirement for the development of quality-controlled training programmes, to improve knowledge and confidence in the selection and application of killing methods. We advocate for continuous review of killing practices to ensure best practice is reflected in legislation and achieve optimal protection of the welfare of laboratory rodents during killing. [ABSTRACT FROM AUTHOR]

Indoor and outdoor noise is renowned for its ability to negatively affect children's health and performance. However, the possible restorative benefits of everyday soundscapes in children are still poorly understood. This study aimed to explore the role of everyday soundscapes in children's restorative experiences in frequented indoor (classroom) and outdoor (urban park) environments. In stage one, 335 children (7-12 years old) were interviewed using a questionnaire survey to investigate their restoration needs, restorative experience, and potential restorative sounds. In stage two, 61 children participated in a laboratory study to assess the perceived restorativeness of different soundscapes, which were combinations of potential restorative sounds and background noise, under signal-to-noise ratios (SNRs) from -5 to 15 dB. The findings denoted that the children's need for restoration increased with age significantly. Younger children reported that the role of the sound environment was more important in their classroom experiences than in urban parks. Although the types of music displayed in surveyed parks were generally not preferred by the children, music was assessed as the most restorative sound in the laboratory study. Additionally, natural sounds were perceived to be more restorative than background noise in the context. In particular, birdsong showed more restorativeness in the classroom context, whereas fountain sounds showed more restorativeness in the park context. Additionally, an SNR of at least 5 dB is desirable when considering the restorative experiences of children in classrooms and urban parks. [ABSTRACT FROM AUTHOR]

The article focuses on the issue of compassion fatigue in the community of lab animal workers, who are responsible for the care of animals used in biomedical research. Topics include how the profession is critical to medical advancement work in the field suffer from mental, emotional, and physical exhaustion due to their deep bond with the animals; and how compassion fatigue is a significant problem that leads to a high attrition rate from animal rights groups.

A 48-question survey was developed and disseminated to laboratory professionals. This survey sought the perspective of clinical educators on a variety of topics, including two open-ended questions on the impact COVID-19 had on student clinical rotations and the ensuing policy changes. Of 207 clinical sites that participated in the survey., Some terminated student clinical rotations without offering any other training alternative. Others employed a number of strategies such as shortening the length of clinical rotations, taking fewer students, transitioning to an online learning platform, or delaying training until a future date. Some mandated regular illness checks, symptom checks, and COVID-19 testing when available. Clinical educators expressed concern over the lack of continuity of student clinical training, policy changes related to COVID-19 and student training that were deemed to diminish the quality of the students' clinical education. With terminated, delayed or shortened clinical rotations at many sites, in combination with staff and supply shortages, clinical educators were concerned about the overall quality of clinical education the students were receiving. In addition to these concerns, the reduction of student graduates during the pandemic decreased the number of applicants for job vacancies exasperating a pre-pandemic problem. [ABSTRACT FROM AUTHOR]

The goal of this study was to analyse the influence of the antecedents of patient experience, namely staff appearance, laboratory staff attitude, information clarity, staff responsiveness, laboratory ambience, phlebotomy process, laboratory technology, and report results, which furtherly generate customer delight and drive favourable intentions such as revisit intentions to the laboratory and willingness to share and post on social media. By extending earlier studies and using data from a leading private clinical laboratory service, this study suggests a new insight. A quantitative study with a survey is used with a cross-sectional data approach. The sample was taken purposively from customers who have had laboratory services at the laboratory, particularly from customers who have undergone the phlebotomy process. The 186 samples that complied with the criteria were examined using the PLS-SEM method. The findings demonstrated that the eight antecedents show a high probability of influencing the patient experience, with the phlebotomy process found as the predominant antecedent, followed by laboratory staff attitude and patient perception of laboratory technology. Further, this study found strong evidence that patient experience could generate customer delight, which drives the revisit intention and willingness to share and post positive things on social media. Openness is found to strengthen that process. The results of this study revealed that the higher the patient's experience through their journey, the higher the probability of delight could exist in the context of service provided in the private clinical laboratory. Thus, it is worth considering by the clinic management to develop a more effective business. [ABSTRACT FROM AUTHOR]

Laboratory Medicine is a crucial discipline that contributes to the diagnosis, management and monitoring of patients. This branch of medicine faces two major challenges: New technologies and increased demand. There is limited information available of the state of affairs in Laboratory Medicine in Spain. This study provides a picture of clinical laboratories and clinical laboratory professionals. The Spanish Society of Laboratory Medicine distributed a questionnaire among the 250 most representative centers (the ones with the largest volume of determinations and training programs), of which 174 (69.6%) returned the questionnaire providing data for 2019. Laboratories were classified according to the number of determinations. In total, 37% identified themselves as small (<1 million determinations per year); 40% considered themselves medium-sized (1–5 million determinations per year) and 23% considered they were large laboratories (>5 million determinations). The level of specialization of laboratory physicians and laboratory performance were higher in large laboratories. Most requests (87%) and determinations (93%) corresponded to biochemistry and hematology. As many as 63% of physicians had an indefinite contract, and 23% were older than 60 years. Laboratory medicine is a consolidated discipline that is gaining relevance in Spain. It adds value to the diagnosis, prognosis and follow-up of diseases, and to treatment response monitoring. The results of this study will help us address challenges such as the need for specialized training for laboratory professionals; the emergence of technological innovations; exploitation of Big Data; optimization of quality management systems and patient safety. [ABSTRACT FROM AUTHOR]

Background and Objectives: The global trend toward increased protection of medical personnel from occupational radiation exposure requires efforts to promote protection from radiation on a societal scale. To develop effective educational programs to promote radiation protection, we clarify the actual status and stage of behavioral changes of spine surgeons regarding radiation protection. Materials and Methods: We used a web-based questionnaire to collect information on the actual status of radiation protection and stages of behavioral change according to the transtheoretical model. The survey was administered to all members of the Society for Minimally Invasive Spinal Treatment from 5 October to 5 November 2020. Results: Of 324 members of the Society for Minimally Invasive Spinal Treatment, 229 (70.7%) responded. A total of 217 participants were analyzed, excluding 12 respondents who were not exposed to radiation in daily practice. A trunk lead protector was used by 215 (99%) participants, while 113 (53%) preferred an apron-type protector. Dosimeters, thyroid protector, lead glasses, and lead gloves were used by 108 (50%), 116 (53%), 82 (38%), and 64 (29%) participants, respectively. While 202 (93%) participants avoided continuous irradiation, only 120 (55%) were aware of the source of the radiation when determining their position in the room. Regarding the behavioral change stage of radiation protection, 134 (62%) participants were in the action stage, while 37 (17%) had not even reached the contemplation stage. Conclusions: We found that even among the members of the Society for Minimally Invasive Spinal Treatment, protection of all vulnerable body parts was not fully implemented. Thus, development of educational programs that cover the familiar risks of occupational radiation exposure, basic protection methods in the operating room, and the effects of such protection methods on reducing radiation exposure in actual clinical practice is warranted. [ABSTRACT FROM AUTHOR]

Background: In response to the global Mpox outbreaks, this survey aimed to assess the knowledge, perceptions, and advocacy of Mpox vaccines among solid organ transplant healthcare workers (HCWs) in Saudi Arabia. Methods: A cross-sectional survey was conducted among solid organ transplant HCWs in Saudi Arabia from 15 August to 5 September 2022. A total of 199 responses were received from participants primarily working in the kidney (54.8%) and liver (14.6%) transplant units. Results: The survey found that most participants were aware of the 2022 Mpox outbreak, but the majority were more concerned about COVID-19 than Mpox. While the majority of participants thought laboratory personnel and HCWs in direct contact with Mpox patients should receive the vaccine, less than 60% believed that all HCWs should be vaccinated. Additionally, over half of the participants lacked knowledge of animal–human transmission of the virus. Conclusion: The results highlight the need for increased education on Mpox among transplant HCWs in Saudi Arabia, particularly regarding the virus's transmission dynamics and vaccines. This education is crucial to improve HCWs' understanding of this emerging disease, especially given their vulnerability during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers' (HCWs) knowledge of multi-stranded cholera interventions (including case management, water, sanitation, and hygiene (WASH), surveillance/laboratory methods, coordination, and vaccination) is crucial to the implementation of these interventions in healthcare facilities, especially in conflict-affected settings where cholera burden is particularly high. We aimed to assess Nigerian HCWs' knowledge of cholera interventions and identify the associated factors. Methods: We conducted a cross-sectional study using a structured interviewer-administered questionnaire with HCWs from 120 healthcare facilities in Adamawa and Bauchi States, North-East Nigeria. A knowledge score was created by assigning a point for each correct response. HCWs' knowledge of cholera interventions, calculated as a score, was recoded for ease of interpretation as follows: 0–50 (low); 51–70 (moderate); ≥ 71 (high). Additionally, we defined the inadequacy of HCWs' knowledge of cholera interventions based on a policy-relevant threshold of equal or lesser than 75 scores for an intervention. Multivariable logistic regression was used to identify the factors associated with the adequacy of knowledge score. Results: Overall, 490 HCWs participated in the study (254 in Adamawa and 236 in Bauchi), with a mean age of 35.5 years. HCWs' knowledge score was high for surveillance/laboratory methods, moderate for case management, WASH, and vaccination, and low for coordination. HCWs' knowledge of coordination improved with higher cadre, working in urban- or peri-urban-based healthcare facilities, and secondary education; cholera case management and vaccination knowledge improved with post-secondary education, working in Bauchi State and urban areas, previous training in cholera case management and response to a cholera outbreak—working in peri-urban areas had a negative effect. HCWs' knowledge of surveillance/laboratory methods improved with a higher cadre, 1-year duration in current position, secondary or post-secondary education, previous training in cholera case management and response to a cholera outbreak. However, HCWs' current position had both positive and negative impacts on their WASH knowledge. Conclusions: HCWs in both study locations recorded a considerable knowledge of multi-stranded cholera interventions. While HCWs' demographic characteristics appeared irrelevant in determining their knowledge of cholera interventions, geographic location and experiences from the current position, training and involvement in cholera outbreak response played a significant role. [ABSTRACT FROM AUTHOR]

Background and Objectives: Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. Materials and Methods: We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. Results: A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Conclusions: Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings. [ABSTRACT FROM AUTHOR]

Personnel who work in laboratories and directly deal with detecting and examining pathogenic biological agents (PBA) in human biomaterials have to face high risks of becoming infected. At present, working conditions at workplaces of personnel in such laboratories are to be analyzed and checked thoroughly with subsequent implementation of relevant correction measures. We performed qualitative analysis of infection risks in clinical and diagnostic laboratories using a reason tree and event tree analysis and determined a risk probability range for an ending event considering combined effects produced by preconditions. We revealed basic reasons why personnel in medical laboratories became infected when working with PBA. The events were considered at three levels and four directions in their development. We performed mathematical calculation of possible event combinations and determined the whole probability range for occurrence of the events. Quantitative risk analysis showed that a probability of a person becoming infected remained within 0.9∙10–4–0.9∙10–3 range even in case of the most unfavorable outcome. The study provides a well-substantiated conclusion about peculiarities of work tasks accomplished in laboratories; we established that laboratory personnel who were involved in determining drug resistance of microbacteria had the highest risks of infection. The most hazardous scenarios of emergencies were identified; they made the highest contribution to the analyzed risk. We established that a probability of personnel becoming infected that starts with the value being 1.3∙10–6 occurs when immune prevention is neglected and a disease is revealed too late. It is advisable to analyze ways how emergencies develop in medical laboratories since this helps to make necessary amendments in the system and influence factors of its functioning. This analysis procedure gives an opportunity to select the most relevant measures for protection and prevention of emergencies involving PBA leakage out of all the available ones. These measures can reduce risks of infection for personnel down to their acceptable levels.