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The article discusses the challenges posed by lipemic samples in diagnostic laboratories due to lipid interference in spectrophotometric methods. The study examines the use of high-speed centrifugation to mitigate this interference in anti-Xa activity measurement for patients on anticoagulants. Results show that high-speed centrifugation did not significantly impact anti-Xa activity measurement and was effective in overcoming lipemia for unfractioned heparin and low molecular weight heparin. The study suggests that high-speed centrifugation is a simple and effective method to address lipemia interference in laboratory measurements. [Extracted from the article]

Introduction: This observational study conducted across seven emergency care units compares the efficacy of four D‐dimer detection methods, namely HemosIL D‐dimer HS (HS), HemosIL D‐dimer HS‐500 (HS‐500), VIDAS D‐dimer (VIDAS), and HemosIL AcuStar D‐dimer (ACUSTAR). The primary focus is on patients with a clinical suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE). Methods: A total of 149 samples were collected from patients with suspected DVT or PE. The confirmation of DVT/PE was based on calf ultrasound or computed tomography‐Angiography. Direct comparisons were made between the different detection methods, considering both their analytical performance and clinical utility. Additionally, the impact of an age‐adjusted cut‐off on the diagnostic accuracy of each method was assessed. Results: The results revealed comparable negative predictive value, sensitivity, and specificity across the methods, with a notable exception of increased specificity for HS compared with HS‐500 (50.8% vs. 41.5%, p = 0.03). Further analysis incorporating an age‐adjusted cut‐off demonstrated a significant improvement in specificity for HS. When using the age‐adjusted cut‐off, HS exhibited a substantial increase in specificity compared with HS‐500 (63.1% vs. 49.2%, p = 0.004) and demonstrated significantly higher specificity compared with VIDAS (63.1% vs. 53.8%, p = 0.04). Conclusion: The study emphasizes the nonuniversal effect of an age‐adjusted cut‐off and discusses the potential necessity for different cut‐off values, particularly in the case of HS‐500. These findings contribute to the understanding of D‐dimer detection methods in the context of DVT and PE, providing insights into their relative performances and the potential optimization through age‐adjusted cut‐offs. [ABSTRACT FROM AUTHOR]

Light transmission aggregometry (LTA) is a method used to investigate platelet functions in platelet-rich plasma (PRP), notably when screening for platelet disorders. Various national guidelines and recommendations help in setting up the LTA test in specialized laboratories. However, due to the nature of the sample matrix and its subsequent specificities, more accurate positions are needed to achieve LTA accreditation according to the standard NF EN ISO 15 189. We reviewed guidelines and recommendations as they can be useful in the accreditation process, and we conducted a survey on LTA practice among members of the Société Française de Thrombose et d’Hémostase (SFTH) in 2021. We formulated 28 proposals, which have been approved by vote within the SFTH. All aspects to take into consideration for the proper conduct of LTA assays and their accreditation have been covered. Notably, preanalytical, analytical and postanalytical aspects are depicted, including blood sampling, PRP preparation, instruments, agonists, performance assessment, personnel training and data interpretation. This document, essentially representing a French position paper on the current recommendations and subsequent proposals for LTA accreditation, might prove useful also outside France for relevant laboratories and auditors involved in LTA accreditation.

Introduction: This study aims to evaluate the effectiveness and reliability of the utilization for clinical reporting of the evaluation of digital images of bone marrow aspirates by morphologists and their comparability with the classic microscopic morphological evaluation. Methods: We scanned 180 consecutive bone marrow needle aspirates smears using the "Metafer4 VSlide" whole slide imaging (WSI) digital scanning system. We evaluated the statistical comparability and the risk of bias of the microscopic readings with those performed on the screen on the digitized medullary images. Results: The evaluation of cellularity on the screen was equivalent, with a higher frequency of "normal" than the analysis of digital preparations. The means and medians of the percentage values obtained on the different cell populations with the microscopic and digital reading were comparable as the main categories are concerned, with an average difference equal to 0 for the neutrophilic and eosinophilic granulocytic series, at −0.2% for the total myeloid cells, at 1.2% for the erythroid series, at −0.4% for the lymphocytes and at −0.4% for the blasts. Dysplastic features were consistently identified in 69/71 cell lineages. Conclusion: Our study demonstrated that screen evaluation of digitized bone marrow needle aspirates provides quantitative and qualitative results comparable to traditional microscopic analysis of the corresponding slide smears. Digital images offer significant benefits in reducing the workload of experienced operators, reproducibility and sharing of observations, and image preservation. Even in routine diagnostic activities, their use does not alter the quality of the results obtained in evaluating bone marrow needle aspirates. [ABSTRACT FROM AUTHOR]

This article discusses the measurement and interpretation of vitellogenin (VTG) in fish and amphibians as a biomarker for endocrine activity. The reliability and acceptability of VTG results are important for regulatory assessments of chemicals. The article highlights the variability in VTG measurements and the need for improvement in sampling, quantification, and data handling. It proposes a decision logic to assist in the interpretation of VTG measurements and calls for the development of OECD guidance on best practices for VTG assessment. The article emphasizes the importance of considering other factors and endpoints in conjunction with VTG results to determine endocrine activity. [Extracted from the article]

Curricula related to instrumental analysis aim for competency-based education to promote the development of teaching strategies that encourage students to successfully tackle the problem-solving and tasks inherent to their profession. However, this endeavor is constrained by the complexity of equipment and the lack of time in laboratory classes. The objective of this work is to present an alternative high-performance liquid chromatography (HPLC) practice that adapts the desired competencies to a shorter and more effective timeframe. It seeks more active participation from the student and contextualizes chromatographic analysis within a real-world problem that encompasses the entire analytical process, from sample to final result. In this scenario, the student receives a solid sample of spicy paprika from a supermarket and must report the level of spiciness in terms of the total amount of capsaicinoids. To achieve this, they must first apply different experimental conditions for extracting the analytes of interest (varying temperatures and solvents) and selecting the most optimal condition. This practice is designed for short sessions, specifically conducted in two 2.5 h laboratory sessions, and has been implemented in the subject "Advanced Techniques in Instrumental Analysis (ATIA)" in the fourth year of the Degree in Biotechnology at the University of Cadiz. The results obtained demonstrated a significant increase in student motivation and an improvement in the acquisition of skills; 100% of the students achieved a grade higher than seven in the final evaluation of their learning process. [ABSTRACT FROM AUTHOR]

Efforts to enhance diversity, equity, and inclusion (DEI) can be enabled through remote access to teaching and learning experiences that are normally reserved to in-person attendance. Utilizing a novel technique entitled the Surrogate Avatar Experience (SuAvE), remote learners can adopt agency as offered through volunteer in-person avatars that afford embodied learning experiences. This paper discusses the connection between learning objectives in electrochemical laboratory practice and the ways in which modulation, the agency of the in-class participant, can shift the focus of the embodied learning. When attending to the imparted skills for the remote learner, the prioritization of transferrable skills and ways in which electrochemical practice is evolving is further discussed. [ABSTRACT FROM AUTHOR]

Introduction: Recombinant porcine FVIII (rpFVIII) (Obizur, Susoctcog‐alfa, Takeda, Japan) is licensed for the treatment of bleeding in acquired Haemophilia A (AHA). The summary of product characteristics state that monitoring should be by one stage assay (OSA) rather than chromogenic assay (CSA). CSA have been shown to underestimate activity when rpFVIII is added to plasma in vitro. Methods: Samples from three AHA patients (n = 21) (pre‐ and post rpFVIII) were assessed using FVIII:C assays; OSA methods: Actin, Actin FS, Actin FSL and Pathromtin SL performed on CS5100i (Sysmex, Kobe, Japan); APTT‐SP, SynthASil and SynthAFax performed on ACL TOP (Werfen, Barcelona, Spain). CSA methods on CS5100i: Siemens Chromogenic Assay, Biophen FVIII:C, Technochrom FVIII:C; on ACL TOP: Rox Factor VIII, Coamatic Factor VIII and CRYOcheck Factor VIII. Results: OSA and CSA varied according to reagent used median OSA 61 IU/dL (range 41.5–81 IU/dL (ANOVA p < 0.0001)) median CSA 46.5 IU/dL (range of method specific medians 36.5–84 IU/dL (ANOVA p < 0.0001)). Amongst OSA, Actin FS was associated with the highest FVIII:C, APTT‐SP was associated with the lowest. Variation in CSA results by different methods was also seen with highest FVIII:C levels obtained using the Technochrom FVIII:C and the lowest levels obtained with Siemens Assay. Conclusion: The relationship between OSA and CSA was not consistent between method or patient. Previously there has been reports of underestimation by CSA in in vitro spiked samples. Investigation into concentration of phospholipids in the APTT reagents may explain some of these variations. [ABSTRACT FROM AUTHOR]

Summary: Treatment advances have greatly improved survival, but myeloma is among the worst of all cancers for delayed diagnosis, causing serious morbidities and early deaths. This delay is largely because the symptom profile of myeloma has very low specificity, and in primary care, myeloma is rare. However, initiating the journey to diagnosis simply requires considering myeloma and sending blood to test for monoclonal immunoglobulin. Laboratory tests reliably detect monoclonal immunoglobulin, which is present in 99% of myeloma cases, so why do health care systems have such a problem with delayed diagnosis? The Myeloma UK early diagnosis programme has brought together diverse expertise to investigate this problem, and this article was prepared by the programme's working group for laboratory best practice. It reviews evidence for test requesting, analysis and reporting, for which there is large variation in practice across the United Kingdom. It presents a 'GP Myeloma diagnostic tool' and how it can be integrated into laboratory practice alongside a laboratory best practice tool. It proposes improved requesting and integration with haematology services for reporting and interpretation. Here the laboratory has a central role in creating efficient and cost‐effective pathways for appropriate and timely bone marrow examination for myeloma diagnosis. [ABSTRACT FROM AUTHOR]

Light transmission aggregometry (LTA) is a method used to investigate platelet functions in platelet-rich plasma (PRP), notably when screening for platelet disorders. Various national guidelines and recommendations help in setting up the LTA test in specialized laboratories. However, due to the nature of the sample matrix and its subsequent specificities, more accurate positions are needed to achieve LTA accreditation according to the standard NF EN ISO 15 189. We reviewed guidelines and recommendations as they can be useful in the accreditation process, and we conducted a survey on LTA practice among members of the Société Française de Thrombose et d’Hémostase (SFTH) in 2021. We formulated 28 proposals, which have been approved by vote within the SFTH. All aspects to take into consideration for the proper conduct of LTA assays and their accreditation have been covered. Notably, preanalytical, analytical and postanalytical aspects are depicted, including blood sampling, PRP preparation, instruments, agonists, performance assessment, personnel training and data interpretation. This document, essentially representing a French position paper on the current recommendations and subsequent proposals for LTA accreditation, might prove useful also outside France for relevant laboratories and auditors involved in LTA accreditation.What is the context? Light transmission aggregometry (LTA) is a laboratory test, mainly used to explore the ability of platelets to adhere to each other, which defect could be observed in patients with bleeding. LTA is not well standardized, mostly because platelets are stable only a few hours and subsequent non-existent stable reference material. There are different recommendations for LTA tests, but they all differ in many aspects. French and European laboratories that must obtain accreditation to perform LTA tests need more precise standards. What is new? In this work, we compared all the recommendations and took position on all aspects of LTA tests, based on laboratories’ experience and practice. We made 28 proposals, which have been approved by vote within the members of the French specialists’ society. What is the impact? This document is suitable and should be helpful also outside France for laboratories involved in LTA accreditation. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the potential contribution of structural and dispersion parameters, as well as alarms provided by Sysmex XN9000 haematology analyzer. The objective was to assess the need for a microscopic examination in the context of lymphocytosis. It also aims to contribute in differentiating rapidly lymphoproliferative disorders such as chronic lymphocytic leukaemia (CLL), non‐chronic lymphocytic leukaemia (NON‐CLL) and non‐infectious reactive lymphocytosis (REAC). Methods: We prospectively assessed lymphocyte parameters (Ly‐X, Ly‐Y, Ly‐Z, Ly‐WX, Ly‐WY, Ly‐WZ) provided by the Sysmex XN9000 analyzer; they were measured in the white blood cell differential (WDF) channel which also provides alarms via the precursor/pathological cellular channel (WPC). Blood samples from 71 subjects with CLL, NON‐CLL lymphoproliferative and REAC non‐infectious reactive lymphocytosis, as well as a control (NORM) group of 12 subjects without any abnormalities were analyzed. Results: The most discriminating parameters to distinguish the different groups were Ly‐X, Ly‐Z and Ly‐WZ. The lymphoid structural parameters Ly‐X and Ly‐Z significantly discriminated the CLL group from the other groups (p < 0.001), and the CLL group from the REAC group (p < 0.01), respectively. The Ly‐WZ parameter discriminated the CLL group from the NON‐CLL, REAC (p < 0.001) and NORM (p < 0.01) groups. Alarms were higher in all study groups compared to the NORM group. An algorithm integrating these structural and alarm parameters is proposed. Conclusion: This study demonstrated that Ly‐X, Ly‐Z, and Ly‐WZ lymphocyte parameters are useful for detecting morphological changes in lymphocytes; they provide useful information for the differential diagnosis of lymphocytosis, and this before the examination of the blood smear. An algorithm combining the WDF (parameters) and the WPC (alarms) makes it possible to decide whether or not to use a microscopic examination or flow cytometry immunophenotyping. [ABSTRACT FROM AUTHOR]

United States Food and Drug Administration (FDA)‐approved viscoelastic testing (VET) methodologies have significantly changed in the last 10 years, with the availability of cartridge‐based VET. Some of these cartridge‐based methodologies use harmonic resonance‐based clot detection. While VET has always allowed for the evaluation of real‐time clot formation, cartridge‐based VET provides increased ease of use as well as greater portability and robustness of results in out‐of‐laboratory environments. Here we review the use of VET in a variety of clinical contexts, including cardiac surgery, trauma, liver transplant, obstetrics, and hypercoagulable states such as COVID‐19. As of now, high quality randomized trial evidence for new generation VET (TEG 6s, HemoSonics Quantra, ROTEM sigma) is limited. Nevertheless, the use of VET‐guided transfusion algorithms appears to result in reduced blood usage without worsening of patient outcomes. Future work comparing the new generation VET instruments and continuing to validate clinically important cut‐offs will help move the field of point‐of‐care coagulation monitoring forward and increase the quality of transfusion management in bleeding patients. [ABSTRACT FROM AUTHOR]

The optimization of an undergraduate experiment for Organic Chemistry students is described to explore the concept of click chemistry. The preparation of a terminal fluorescent alkyne and an organic azide is reported consisting of simple steps. These are employed in the Cu(I)-catalized azide-alkyne cycloaddition to obtain a novel molecule containing a triazole ring whose characterization allows the students to practice a variety of techniques: NMR (1H, 13C, COSY and HSQC), melting point, thin layer chromatography, IR, fluorescence spectroscopy and mass spectrometry to confirm the structure of their obtained product. An alternative methodology in a one-pot reaction is also explored and a full laboratory manual provided. [ABSTRACT FROM AUTHOR]

Curricula related to instrumental analysis aim for competency-based education to promote the development of teaching strategies that encourage students to successfully tackle the problem-solving and tasks inherent to their profession. However, this endeavor is constrained by the complexity of equipment and the lack of time in laboratory classes. The objective of this work is to present an alternative high-performance liquid chromatography (HPLC) practice that adapts the desired competencies to a shorter and more effective timeframe. It seeks more active participation from the student and contextualizes chromatographic analysis within a real-world problem that encompasses the entire analytical process, from sample to final result. In this scenario, the student receives a solid sample of spicy paprika from a supermarket and must report the level of spiciness in terms of the total amount of capsaicinoids. To achieve this, they must first apply different experimental conditions for extracting the analytes of interest (varying temperatures and solvents) and selecting the most optimal condition. This practice is designed for short sessions, specifically conducted in two 2.5 h laboratory sessions, and has been implemented in the subject “Advanced Techniques in Instrumental Analysis (ATIA)” in the fourth year of the Degree in Biotechnology at the University of Cadiz. The results obtained demonstrated a significant increase in student motivation and an improvement in the acquisition of skills; 100% of the students achieved a grade higher than seven in the final evaluation of their learning process.

Laboratory practices, which represent a vital part of electrical engineering education, have especially in the last few years been subjected to numerous challenges. The paper presents a concept of upgrading the laboratory practice curriculum in power electronics by introducing computer simulations. Due to the recognized shortcomings of the previous approach, the curriculum was closely reviewed, compared to the concepts from existing literature, and intensively upgraded by the introduction of the Ansys Simplorer computer program. The intensity of the process upgrade was enhanced by the COVID‐19 pandemic and related lockdowns. The introduced curriculum changes enabled the students to approach individual topics more gradually, reducing the gaps between the behavior of ideal and real power electronics circuits. The results of student feedback, obtained by a web‐based survey and a pre‐exam quiz, demonstrate that students recognize the new approach as being more gradual and beneficial, enabling them to improve their understanding of specific phenomena and to master the topics of power electronics with ease and satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Non‐parallelism in factor assays can lead to incorrect factor activities. Parallelism can be assessed by calculating the coefficient of variation (CV) of results obtained on 3 dilutions of the same sample. Some authors have proposed that if there is <15% then the average activity is reportable. Some analysers use a slope ratio (SR) to calculate parallelism, with an acceptance range of approximately 0.9–1.1. Methods: We evaluated CV and SR in one stage FII–FXII assays on Sysmex CS5100i using Innovin or Actin FS. Frozen normal and pathological plasmas, plasmas containing Direct Oral Anticoagulants, Direct Thrombin Inhibitors or Lupus Anticoagulant were analysed to assess possible non‐parallelism. Results: In plasmas with factor levels >25 IU/dl (plus no interfering substances) all CVs were < 15%. One sample (low factor activities 10–15 IU/dl), had CVs > 15% in FII, FVII and FXII assays only. SR outside of 0.9–1.1 were seen in FII and FXII assays at different levels of clotting factor including some within the normal range. Non‐parallelism was detected more frequently with SR than CV for those with interfering substances. Conclusions: SR outside of 0.9–1.1 were seen in different levels of clotting factors, including samples which did not contain interfering substances. The target of 15% CV was a better discriminator than a SR for acceptance. When factor levels were reduced to around 10–15 IU/dl, a target 20 %CV was more appropriate than 15%. It might be appropriate for laboratories to assess locally whether their acceptance criteria need to be wider at low levels of clotting factors. [ABSTRACT FROM AUTHOR]

Myeloproliferative neoplasms (MPN) are clonal hematopoietic stem cell-derived disorders characterized by uncontrolled proliferation of differentiated myeloid cells. Two main groups of MPN, BCR::ABL1-positive (Chronic Myeloid Leukemia) and BCR::ABL1-negative (Polycythemia Vera, Essential Thrombocytosis, Primary Myelofibrosis) are distinguished. For many years, cytomorphologic and histologic features were the only proof of MPN and attempted to distinguish the different entities of the subgroup BCR::ABL1-negative MPN. World Health Organization (WHO) classification of myeloid neoplasms evolves over the years and increasingly considers molecular abnormalities to prove the clonal hematopoiesis. In addition to morphological clues, the detection of JAK2, MPL and CALR mutations are considered driver events belonging to the major diagnostic criteria of BCR::ABL1-negative MPN. This highlights the preponderant place of molecular features in the MPN diagnosis. Moreover, the advent of next-generation sequencing (NGS) allowed the identification of additional somatic mutations involved in clonal hematopoiesis and playing a role in the prognosis of MPN. Nowadays, careful cytomorphology and molecular biology are inseparable and complementary to provide a specific diagnosis and to permit the best follow-up of these diseases. [ABSTRACT FROM AUTHOR]

During ICTAC2020, a workshop was held on "Good laboratory practice in thermal analysis and calorimetry" for young researchers and beginners under the aegis of the Education Committee of ICTAC. Thermal analysis (TA) covers relationship between large number of sample properties and the temperature. Naturally, there is some technique for each property of the sample bringing versatility in TA. This review is devoted to the Workshop and has been refined for the benefit of the readers so that it helps them in obtaining useful qualitative and quantitative information about the effects of heat treatments on materials of all kinds. Recent trends in DSC, TG-FTIR, TG-MS, DMA, kinetics and nanocalorimetry have also been covered in this article. [ABSTRACT FROM AUTHOR]

This study investigates the diagnostic practices for mucormycosis among 30 French University Hospital mycology laboratories, in 2024. All laboratories perform both direct examination and culture, with fluorescent brighteners being the most commonly used method for direct examination. While 77 % of the participating laboratories routinely identify Mucorales to the species level, with 70 % having adopted Mucorales-specific quantitative PCR, primarily for the diagnosis of invasive fungal infections. Antifungal susceptibility testing practices varied between centers, with 36.7 % of laboratories consistently performing these tests, primarily using gradient concentration strips. Amphotericin B, posaconazole, and isavuconazole were the most frequently tested antifungals. These findings highlight variations in laboratory practices and emphasize the importance of establishing uniform diagnostic and susceptibility testing methods to optimize mucormycosis management. [ABSTRACT FROM AUTHOR]

Introduction: The Yumizen H2500 (YH2500) cell analyser was compared to the Pentra DX Nexus (both from HORIBA Medical) to evaluate the efficiency of the new YH2500 technology for the WBC‐differential in samples from oncology patients with WBC‐diff abnormalities. Material and Methods: The 220 samples with slide review criteria on the Nexus were systematically analysed on the YH2500. The WBC‐diff was compared to flow cytometry (FCM). The 100 additional samples with Monocyte/Neutrophil separation flags were evaluated. The flagging performance and the accuracy of the WBC‐diff were analysed. Results: The YH2500 generated fewer flags than the Nexus (47.73% vs 66.64%; p <.0001), except for Monocyte/Neutrophil flag (15.5% vs. 2.7%; p < 0.0001). Overall performances were higher on the YH2500 (Sensitivity, 100 vs. 89.6%; Specificity 81.0% vs. 50.9%; PPV, 74.3% vs. 62.9%; NPV, 100% vs. 69.5%; Efficiency, 87.7% vs. 69.5%). YH2500 showed a statistically significant better correlation with FCM for the 6‐part differential than the Nexus. On 134 samples with Monocyte/Neutrophil separation flag, it was shown that, in samples with less than 10% monocytes on the YH2500, the results of monocyte and neutrophil counts were comparable to the manual count, and that these samples did not need a slide review if no other main criterion for review was present. Conclusion: The YH2500 demonstrated better performance characteristics than the previous cell counter, the Nexus. Its implementation in our laboratory routine work significantly improved the practice workflow, decreased the number of manual cell counts and increased the pertinence of slide review and reporting of the microscopic count. [ABSTRACT FROM AUTHOR]

Why did German physicists not build an atomic bomb during the Second World War? This question has long been controversial. This essay provides a new perspective through a focus on the everyday practice of the physicists in their laboratories. The study of everyday research work has long been obscured by the question of the bomb. To this end, the research of the Viennese group in the German Uranverein, or "Uranium Club," will be analyzed in detail. What breaks and continuities were there in everyday laboratory practice? Were the physicists able to acquire new resources? Did they at least come close to the scale of Big Science or did their research remain tied to the academic laboratory? [ABSTRACT FROM AUTHOR]

This study investigates the diagnostic practices for mucormycosis among 30 French University Hospital mycology laboratories, in 2024. All laboratories perform both direct examination and culture, with fluorescent brighteners being the most commonly used method for direct examination. While 77 % of the participating laboratories routinely identify Mucorales to the species level, with 70 % having adopted Mucorales-specific quantitative PCR, primarily for the diagnosis of invasive fungal infections. Antifungal susceptibility testing practices varied between centers, with 36.7 % of laboratories consistently performing these tests, primarily using gradient concentration strips. Amphotericin B, posaconazole, and isavuconazole were the most frequently tested antifungals. These findings highlight variations in laboratory practices and emphasize the importance of establishing uniform diagnostic and susceptibility testing methods to optimize mucormycosis management., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Eric Dannaoui has received research grants from Biomérieux: travel grants from Gilead, Mundipharma, and Pfizer; speaker's fee from Mundipharma, Pfizer, and Gilead. Kévin Brunet has received travel grants from Pfizer and Gilead and speaker's fee from Gilead. Laurence Millon has received travel grants from Gilead and Pfizer; speaker's fee from Gilead and Pfizer. Marjorie Cornu received travel grants and speaker's fee from Gilead and Pfizer. The other authors have no conflicts of interest to disclose., (Copyright © 2024 SFMM. Published by Elsevier Masson SAS. All rights reserved.)

Brewing beer is one of the most popular food processes in the current society, and it has been widely used as a learning course at many universities. However, most laboratory experiences take a very long time to develop. In this work, we discuss the brewing process from malt extract as an intelligent way to reduce the timing for implementation by simplifying some of its stages, such as malting or mashing, but maintaining the same core process. During brewing with malt extract, the students deal with this multidisciplinary process, enhancing primary learning outcomes related to the unit operations of chemical engineering applied to the food industry. At the university level, the addition of brewing as a laboratory experiment might directly affect the productive fabric of the area through the development of new beer-related businesses. [ABSTRACT FROM AUTHOR]

Background: Statistical analyses are embedded as critical functions in the routine haematology laboratory. Aim: This educational article is aimed at providing an overview of these topics and practical application examples. Materials, Methods, and Results: Topics covered include mathematical conversion between units, maintaining a quality control (QC) system, statistical methods for reagent validation, and determining uncertainty of measurement (UoM). Discussion: Additional considerations may be required when a regional laboratory program is in place, such as the harmonization of INR results and determination of therapeutic reference intervals for unfractionated heparin therapy. Conclusion: The coauthors of this manuscript are fortunate to be part of regional network of hospital laboratories, the Eastern Ontario Regional Laboratory Association (EORLA). [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the status of laboratory practice of organic acid (OA) analysis using gas chromatography–mass spectrometry in China.

Nursing professors must constantly interact with students, maintain a high level of professional performance, and meet targets and deadlines, even during a pandemic. Considering the changing educational environment, it is essential to identify contemporary limitations and problems to provide feedback for improvement. This study aimed to explore the laboratory and clinical teaching experiences of nursing professors during the COVID-19 pandemic. Focus group interviews were conducted with professors from the nursing departments of universities in Korea. In total, 19 professors who had laboratory and clinical experience participated in this study. The collected data were analyzed using thematic analysis. The analysis identified four themes. The themes included feeling helpless in the infection management system, uncertainty about the effectiveness of alternative practice training, acceptance of changes, and preparation for future practice training. As the necessity and possibility of non-face-to-face education have been confirmed by the pandemic, it is expected that classes using technology will be actively developed in nursing practice education. The roles and attitudes of teachers and educational institutions also need to change. Nursing professors should reflect upon and evaluate challenges to prepare for post-pandemic practical education.

Higher education in evolutionary anthropology involves providing students with in‐depth knowledge of biological and cultural heritage sites and collections that are frequently inaccessible. Indeed, most sites, fossils, and archaeological remains can be visited or manipulated only rarely and solely by specialists with extensive experience. Owing to the development of 3D and medical imaging techniques, this fragile heritage is now more widely accessible, and in a dynamic way. However, exclusive adoption of virtual teaching and learning has a negative impact on student engagement and, naturally, on exchanges with instructors, and thus cannot be used without some reservations. In the ITAP (Immersion dans les Terrains de l'Anthropologie biologique et de la Préhistoire) project of the higher education STEP (Soutien à la Transformation et à l'Expérimentation Pédagogiques) transformation program at the University of Bordeaux, we combine student‐active teaching with Master's students fully immersed in ongoing fieldwork, laboratory study, and dissemination of research results in order to develop more individually shaped learning curricula and to foster both professional and new interdisciplinary skills. Here, we present examples of experiments conducted in the ITAP project using both authentic and virtual collections of archaeological, experimental, and reference materials that help to break down the barriers between research activities and higher education, as well as providing a more general appraisal of the appropriate use of virtual tools in higher education by combining them with real‐life situations. [ABSTRACT FROM AUTHOR]

This research is a descriptive study that describes the learning of chemistry during the Covid-19 pandemic. The respondents in this study were 127 high school students from the West Java and Banten provinces. A Google Form questionnaire was used to collect the data. The results showed that the most widely used online class applications were WhatsApp Group feature, Google Classroom, and Zoom. Students also used printed textbooks, e-books, and student worksheets as learning media. Students did laboratory practice at home using easily found tools and materials. However, a small portion of the respondents ( 11 %) used materials purchased from a chemical store, and another small portion of the respondents ( 14 %) used virtual laboratories. They reported the results of their practice by making a laboratory practice report as well as through video activities and Microsoft PowerPoint for presentation. Students learn from home with varying durations. Most students experienced obstacles during the learning process so that they prefer learning face-to-face in class as usual. Therefore, the teacher must prepare a variety of strategies for distance learning so that the students can learn chemistry from home with fun. Some strategies that can be applied are providing audio-visual learning media or computer/android-based games for chemistry, using the online class application that accommodates interactions similar to face-to-face learning, providing laboratory practice using tools and materials that can be easily found around the house, providing virtual lab application, and providing more opportunities for students to ask questions about chemistry topics that they do not understand.

IntroductionQuality-assured antimicrobial susceptibility testing (AST) depends upon the knowledge and skills of laboratory staff. In many low- and middle-income countries (LMICs), including Pakistan, such types of knowledge and skills are limited. Therefore, the objective of this study was to use openaccess online courses to improve the knowledge of laboratory staff involved in the detection and reporting of antimicrobial resistance (AMR).MethodologySeven online modules comprising 22 courses aimed at strengthening the laboratory detection of Antimicrobial resistance (AMR) were developed. The courses were uploaded onto the website www.parn.org.pk. Participants had an option of selecting courses of their interest. Online registration and completion of a pre-course assessment (pre-test) were essential for enrolment. However, participation in post-course assessment (post-test) was optional. The number of registered participants and the proportion of participants who completed each course were computed. A paired t-test was used to assess the increase between mean pre- and post-test scores. The association between the participants working in public vs. private laboratories and course completion rates were determined using the chi-square test.ResultsA total of 227 participants from Pakistan (March 2018 to June 2020) were registered. The largest number of registered participants and the highest completion rate were noted for AST and biosafety courses, while quality-related courses attracted a lower interest. A comparison of pre- and post-test performance using the paired mean score for the individual courses showed a statistically significant (the value of p < 0.05) improvement in 13/20 assessed courses. A higher course completion rate was observed in participants from public vs. private sector laboratories (56.8 vs. 30.8%, the value of p = 0.005).ConclusionsOur study suggests a promising potential for open online courses (OOCs) toward addressing knowledge gaps in laboratory practice in resource limited settings.

Introduction: Thrombin generation assays assess overall coagulation system and are widely used in research; however, they still need standardization and clinical validation. The new ST Genesia is a benchtop, automated analyzer that normalizes each thrombin generation parameter using a reference plasma. The ThromboScreen reagent kit has two triggers, one of which contains thrombomodulin to assess the effect of the protein C pathway. This study aimed to make a pilot approach to the ThromboScreen reference range in children and evaluate the impact of sex, age, and pro‐ and anticoagulant plasma proteins on thrombin generation parameters. Methods: This study included 55 healthy children from the following age groups: 1‐6 years (n = 14), 7‐11 years (n = 15), and 12‐17 years (n = 26). Children younger than 1 year were excluded from the study. We measured thrombin generation using ThromboScreen, coagulation routine and test, pro‐ and anticoagulant proteins. Results: Age did not influence ThromboScreen results. Males showed significantly lower endogenous thrombin potential and peak height values than females. The strongest determinants of endogenous thrombin potential were von Willebrand factor parameters, whereas for endogenous thrombin potential inhibition, the strongest determinants were protein C and protein S. No statistically significant differences were found between groups on temporal parameters. Conclusions: For the ThromboScreen reagent kit, it may not be necessary to subdivide reference ranges according to age for children (>1 year). [ABSTRACT FROM AUTHOR]

Background: The antithrombotic effect of direct oral anticoagulants (DOAC) in specific clinical scenarios is difficult to assess. Objective: This study aimed to evaluate the effect of DOAC on thrombin generation (TG) in relation to their plasma level. Methods: Eighty patients newly started on anticoagulation were included, 20 patients for each DOAC—apixaban, edoxaban, rivaroxaban, and dabigatran. Plasma was sampled before DOAC (baseline), at plasma peak time, 6 and 12 hours after starting DOAC for quantification of drug levels and TG. Results: The baseline TG before DOAC intake showed inter‐individual variability. All DOACs significantly prolonged lag time (LT) and time to peak (TTP), but did not change endogenous thrombin potential (ETP). Anti‐Xa inhibitors but not dabigatran reduced thrombin peak, but the effect of apixaban at plasma peak was less pronounced (factor 1.6). LT and TTP prolongation of dabigatran was lower compared to anti‐Xa inhibitors. All DOACs showed a nonlinear dose‐response relationship, with the greatest antithrombotic effect at lower DOAC plasma levels. The inhibition of TG parameters between baseline and peak was parallel between individual patients but the coefficient of variation of TG was lower compared to drug levels. Conclusion: The antithrombotic effect at DOAC peak plasma level measured by TG depends on the patient‐specific baseline TG level and the drug‐specific inhibition by the particular DOAC. Although peak plasma levels have a high variability, the variation of TG is lower compared to drug levels. Therefore, TG assays may be superior to plasma levels in the assessment of the intensity of anticoagulation. [ABSTRACT FROM AUTHOR]

The article presents case of early detection of Candida parapsilosis sepsis in peripheral blood as a result of cytografic changes on the Sysmex XN-3000 hematology analyzer. It mentions diagnostic support tools such as microscopic blood smear reviews (MBSR) and cytographic changes caused by yeasts in the counting channels of the automated hematology analyzers; and also mentions spurious automated counts are observed along with abnormal leukocyte scatter plots.

Objectives: Clinical laboratory testing provides essential data for making medical diagnoses. Generating accurate and timely test results clearly communicated to the treating clinician, and ultimately the patient, is a critical component that supports diagnostic excellence. On the other hand, failure to achieve this can lead to diagnostic errors that manifest in missed, delayed and wrong diagnoses. Content: Innovations that support diagnostic excellence address: 1) test utilization, 2) leveraging clinical and laboratory data, 3) promoting the use of credible information resources, 4) enhancing communication among laboratory professionals, health care providers and the patient, and 5) advancing the use of diagnostic management teams. Integrating evidence-based laboratory and patient-care quality management approaches may provide a strategy to support diagnostic excellence. Professional societies, government agencies, and healthcare systems are actively engaged in efforts to advance diagnostic excellence. Leveraging clinical laboratory capabilities within a healthcare system can measurably improve the diagnostic process and reduce diagnostic errors. Summary: An expanded quality management approach that builds on existing processes and measures can promote diagnostic excellence and provide a pathway to transition innovative concepts to practice. Outlook: There are increasing opportunities for clinical laboratory professionals and organizations to be part of a strategy to improve diagnoses. [ABSTRACT FROM AUTHOR]

The aim of this research was to investigate whether there was a predictive effect of the frequency of laboratory use of students, their academic success and attending various opportunities to learn science outside the classroom on the fifth and sixth grade students’ scientific process skills performance (SPSP). Also, it was investigated whether there was a significant relationship between the students’ SPSP and the grade level in which the concepts included in the test items were appropriate. The quantitative research methods were used in this study. Data were collected from 458 fifth and sixth grade students. Regression analysis was conducted to determine the effects of the frequency of laboratory use of students, their academic success and attending various opportunities to learn science outside the classroom on students’ SPSP. As a result, it was determined that students’ academic success was important predictor variables that affect the fifth and sixth grade students’ SPSP. It was also determined that the frequency of laboratory use of students had an important predictive effect on students’ causal scientific process skills performance (C-SPSP). Additionally, it was determined that various opportunities to learn science outside the classroom such as attending in science fairs and reading scientific journals had an important predictive effect on students’ SPSP. Although, it was also determined that the students’ SPSP differs according to the grade level, statistically significant relationship was not found between the students’ SPSP and the grade level in which the concepts included in the test items were appropriate.

There are many preanalytical variables (PAV) that are known to affect coagulation testing. The more commonly acknowledged PAV addressed by the clinical laboratory tend to start with their influence on blood collection, but realistically coagulation PAV starts with the patient, where the laboratory has less influence or control. Patient selection and appropriate timing for blood collection may be integral for assuring proper diagnosis and management. Laboratory control and assurance for ideal phlebotomy practice would mitigate most PAVs related to blood collection to minimize suboptimal sample collection. Laboratory oversight of sample transportation, processing and storage will assure sample integrity until testing can be facilitated. The purpose of this document is to review common PAV that should be taken into consideration when ordering, performing and interpreting a coagulation test result, with additional attention to the effect of direct oral anticoagulants (DOACs). [ABSTRACT FROM AUTHOR]

Heparin- induced thrombocytopenia (HIT) is a prothrombotic condition resulting from pathogenic antibodies to complexes of heparin and platelet factor 4 (PF4). The diagnosis of HIT can be challenging due to the widespread use of heparin and the frequency of thrombocytopenia in hospitalized patients. Laboratory testing for HIT typically includes an immunoassay to detect antibodies to PF4- heparin and a functional assay. Current HIT diagnostic algorithms recommend using the 4Ts score to determine the need for HIT laboratory testing. Automated calculation of HIT clinical prediction scores in the electronic health record may improve the identification of patients who should undergo HIT testing. Another challenge in the management of patients with suspected HIT is the turnaround time of the laboratory testing needed to confirm the diagnosis. Due to the high daily thrombotic risk of HIT, clinicians must treat patients with intermediate to high pretest likelihood of HIT empirically while awaiting the test results. Treatment for HIT often involves alternative anticoagulants that lack reversal agents, which may increase bleeding risk, prolong hospital stays, and increase costs for patients suspected of having HIT. Rapid immunoassays hold promise to improve the speed of HIT diagnosis. These assays must retain a very high sensitivity for this “can't miss” diagnosis, yet have sufficient specificity to be of diagnostic value. A Bayesian approach has been proposed using two rapid immunoassays in succession, which decreased analytic turnaround time to 60 minutes. Such an approach has the potential to be a much- needed clinical advance in improving accuracy and speed in the diagnosis of HIT. [ABSTRACT FROM AUTHOR]

Anemia is a global health problem in all age groups. According to World Health Organization (WHO), approximately 40% of pregnant women are anemic. Iron deficiency anemia (IDA) due to nutritional deficiency is the most common cause. The incidence of IDA varies worldwide depending on the socioeconomic status, but it remains the leading cause even in developed countries. Physiologic anemia of pregnancy due to relatively higher expansion of blood volume in comparison with elevated red blood cell mass also occurs frequently. Complete blood count (CBC) in the first trimester is recommended for all pregnant women to screen for anemia. The screening of pregnant women for IDA in absence of anemia is still debatable. If IDA is suspected, ferritin level of <30 ng/ml is diagnostic. Iron supplementation is recommended for all pregnant women to compensate the increased demand. [ABSTRACT FROM AUTHOR]

Introduction: Examination of a blood film is the second most common hematology test, after the complete blood count. Interpretation of a peripheral blood film by trained laboratory professionals provides valuable diagnostic information. The Institute for Quality Management in Healthcare (IQMH) Hematology Scientific Committee developed a questionnaire to gather information regarding current practices for manual blood film review and reporting from laboratories participating in IQMH Morphology proficiency testing (PT) surveys. Methods: An online survey was distributed to 174 laboratories, 97% submitted results. Results: Of the respondents, the majority (82%) indicated affiliation with small‐ or medium‐sized hospitals (<500 beds). 80% of respondents had core laboratory technologists performing manual blood film reviews, while only 2% utilized dedicated hematology technologists with morphology expertise. All respondents had a policy for manual blood film review by a technologist, 70% did not have blood films reviewed by a senior/charge technologist prior to review by a physician. The majority (88%) of participants included morphological findings in their critical result list; of these, 98% include malaria and 88% include the first‐time finding of blasts as critical results. 59% of participants indicated that they have a procedure in place to ensure that interpretation and confirmation of first‐time potentially significant morphological findings are available from a physician at all times. Conclusion: This survey identified significant variation in blood film review and reporting practices across participating laboratories. The IQMH Hematology Scientific Committee will develop best practice recommendations to guide and standardize practice. [ABSTRACT FROM AUTHOR]

The article deals with the possibilities of formation of professional and general culturalcompetencies of students in the process of independent work, which is now becoming more relevant due to the competence approach and turns into one of the main components of professional training of future specialists. Studies were conducted in the field of organizing independent work for students. Particular attention is paid to that part of the independent work that is realized in the course of auditorium lessons - at lectures, seminars and at the performance of laboratory work. There are methodological recommendations for increasing the proportion of independent work of students in mastering the basic educational programs of higher professional education.

Introduction: In daily practice in haematology laboratories, red blood cell (RBC) abnormalities are frequent and their management is a real challenge. The aim of this study is to establish a "decision tree" using RBC and reticulocyte parameters from the SYSMEX XN‐10 analyser to distinguish between patients with a hereditary RBC disease from iron deficiency anaemia and other patients. Methods: We analysed results of complete RBC counts in a cohort composed of 8217 adults divided into 5 different groups: iron deficiency anaemia (n = 120), heterozygous haemoglobinopathy (n = 92), sickle cell disease syndrome (n = 56), hereditary spherocytosis (n = 18) and other patients (n = 7931). A Classification And Regression Tree (CART) analysis was used to obtain a two‐step decision tree in order to predict these previous groups. Results: Five parameters and the calculated RBC score were selected by the CART method: mean corpuscular haemoglobin concentration, percentage of microcytes, distribution width of the RBC histogram, percentage of nucleated red blood cells, immature reticulocytes fraction and finally RBC Score. When applying the tree and recommended flowchart, 158/166 of the RBC hereditary disease patients and 114/120 iron deficiency anaemia patients are detected. Overall, the correct classification rate reached 99.4%. Sensitivity and specificity for RBC disease detection were 95.2% and 99.9%, respectively. These results were confirmed in an independent validation cohort. Conclusion: Based on the XN‐10 RBC and reticulocyte parameters, we propose a two‐step decision tree delivering a good prediction and classification of hereditary RBC diseases. These results can be used to optimize additional reticulocyte analysis and microscopy review. [ABSTRACT FROM AUTHOR]

The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) initiated the CArdiac MARker Guidelines Uptake in Europe (CAMARGUE) Study to survey if current biomarker testing for heart failure (HF) in Europe is in accordance with up-dated guidelines. A web-based questionnaire was distributed to clinical laboratories via European biochemical societies in 2019. Questions covered the type of natriuretic peptide (NP) assays performed, decision limits for HF, and opinion concerning requirement of different thresholds in patients with renal failure or obesity. There were 347 participating laboratories mostly from European countries with 266 offering NP testing. NP testing was increased from 67% to 77% between 2013 and 2019. NT-proBNP remained the preferred biomarker. Recommended decision limits were implemented for BNP (85%) and better focused for NT-proBNP (40%) than in the previous survey. The survey revealed that laboratorians are willing to support the translation of adjusted cut-off values for age, gender and for patients with conditions like renal insufficiency. Guidelines stimulate clinical laboratories to offer NP testing with high value for the diagnosis and management of HF, and to present adjusted medical decision limits. Future guidelines should encourage the use of personalized cut-offs for some confounding factors. [ABSTRACT FROM AUTHOR]