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Federally Qualified Health Centers (FQHCs) provide service to medically underserved areas and communities, providing care to over 32 million patients annually. The burden of diabetes is increasing, but often, the vulnerable communities served by FQHCs lag in the management of the disease due to limited resources and related social determinants of health. With the increasing adoption of technologies in health care delivery, digital tools for continuous glucose monitoring (CGM) are being used to improve disease management and increase patient engagement. In this viewpoint, we share insights on the implementation of a CGM program at an FQHC, the Community-University Health Care Center (CUHCC) in Minneapolis, Minnesota. Our intent is to improve diabetes management through better monitoring of glucose and to ensure that the CGM program enables our organization's overarching digital strategy. Given the resource limitations of our population, we provided Libre Pro devices to uninsured patients through grants to improve health care equity. We used an interdisciplinary approach involving pharmacists, nurses, and clinicians and used hemoglobin A1c (HbA1c) levels as a measure of diabetes management. We assessed the CGM program and noted key aspects to guide future implementation and scalability. We recruited 148 participants with a mean age of 54 years; 39.8% (59/148) self-identified their race as non-White, 9.5% (14/148) self-identified their ethnicity as Hispanic or Latino, and one-third (53/148, 35.8%) were uninsured. Participants had diverse language preferences, with Spanish (54/148, 36.5%), English (52/148, 35.1%), Somali (21/148, 14.2%), and other languages (21/148, 14.2%). Their clinical characteristics included an average BMI of 29.91 kg/m2 and a mean baseline HbA1c level of 9.73%. Results indicate that the CGM program reduced HbA1c levels significantly from baseline to first follow-up (P<.001) and second follow-up (P<.001), but no significant difference between the first and second follow-up (P=.94). We share key lessons learned on cultural and language barriers, the digital divide, technical issues, and interoperability needs. These key lessons are generalizable for improving implementation at FQHCs and refining digital strategies for future scalability., (©Madhur Thakur, Eric W Maurer, Kim Ngan Tran, Anthony Tholkes, Sripriya Rajamani, Roli Dwivedi. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 05.02.2025.)

Background: Pain is a complex condition and affects one's life beyond physical symptoms. National pain management recommendations include a whole-person approach that includes strengths (or resilience)., Purpose: The purpose of this study was to examine de-identified data from the MyStrengths+MyHealth application to examine, Strengths, Challenges, and Needs for the population and a subset of the data for those with and without self-reported Challenges in the Pain concept., Design: This cross-sectional comparative study used de-identified consumer-generated whole-person strengths data from the MyStrengths+MyHealth (MSMH) application., Methods: Data was collected from various community settings between 2019 and 2023 and approved by the University's Institutional Review Board. From the sample population (N=1737), we identified those with self-reported Pain (n=1280) and without self-reported Pain (n=457) and compared Strengths, Challenges, and Needs., Results: The sample population (N=1737) was largely in the age range of 45-64 years (51.2%), Male (56.4%), White (90.5%), non-Hispanic/Latino (86.6%), and Married (74.2%). The Pain group (n=1280) reported significantly fewer Strengths (p<0.001) and more average Challenges and Needs (p<0.001) than the Without Pain Group (n=457) across all concepts. For the Pain Group, the most frequent Strength reported was Role Change (70.5%), the most frequent Challenge Nutrition (96.1%), and the greatest Need was Income (89.9%)., Conclusions: Despite reporting Challenges and Needs, the Pain Group identified many Strengths. The Pain Group identified Role Change (70.5%) as a top Strength was surprising and may suggest adaptability to chronic pain. MSMH has potential to empower individuals to provide a comprehensive whole-person assessment and resilience which may be particularly useful for those living with chronic pain., Clinical Implications: This study has clinical implications for supporting the use of digital health tools such as mobile applications for capturing contextual data directly from patients to enable nurses to provide more accessible and personalized care to patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Hardware support for isolated execution (such as Intel SGX) enables development of applications that keep their code and data confidential even while running on a hostile or compromised host. However, automatically verifying that such applications satisfy confidentiality remains challenging. We present a methodology for designing such applications in a way that enables certifying their confidentiality. Our methodology consists of forcing the application to communicate with the external world through a narrow interface, compiling it with runtime checks that aid verification, and linking it with a small runtime library that implements the interface. The runtime library includes core services such as secure communication channels and memory management. We formalize this restriction on the application as Information Release Confinement (IRC), and we show that it allows us to decompose the task of proving confidentiality into (a) one-time, human-assisted functional verification of the runtime to ensure that it does not leak secrets, (b) automatic verification of the application's machine code to ensure that it satisfies IRC and does not directly read or corrupt the runtime's internal state. We present /CONFIDENTIAL: A verifier for IRC that is modular, automatic, and keeps our compiler out of the trusted computing base. Our evaluation suggests that the methodology scales to real-world applications.

Nonenzymatic template-directed replication would have been affected by co-solutes in a heterogeneous prebiotic soup due to lack of enzymatic machinery. Unlike in contemporary biology, these reactions use chemically activated nucleotides, which undergo rapid hydrolysis forming nucleoside monophosphates ('spent' monomers). These co-solutes cannot extend the primer but continue to base pair with the template, thereby interfering with replication. We, therefore, aimed to understand how a mixture of 'spent' ribonucleotides would affect nonenzymatic replication. We observed the inhibition of replication in the mixture, wherein the predominant contribution came from the cognate Watson-Crick monomer, showing potential sequence dependence. Our study highlights how nonenzymatic RNA replication would have been directly affected by co-solutes, with ramifications for the emergence of functional polymers in an RNA World., (© 2023 Federation of European Biochemical Societies.)

Security-critical applications constantly face threats from exploits in lower computing layers such as the operating system, virtual machine monitors, or even attacks from malicious administrators. To help protect application secrets from such attacks, there is increasing interest in hardware implementations of primitives for trusted computing, such as Intel's Software Guard Extensions (SGX) instructions. These primitives enable hardware protection of memory regions containing code and data, and provide a root of trust for measurement, remote attestation, and cryptographic sealing. However, vulnerabilities in the application itself, such as the incorrect use of SGX instructions or memory safety errors, can be exploited to divulge secrets. In this paper, we introduce a new approach to formally model these primitives and formally verify properties of so-called enclave programs that use them. More specifically, we create formal models of relevant aspects of SGX, develop several adversary models, and present a sound verification methodology (based on automated theorem proving and information ow analysis) for proving that an enclave program running on SGX does not contain a vulnerability that causes it to reveal secrets to the adversary. We introduce Moat, a tool which formally verifies confidentiality properties of applications running on SGX. We evaluate Moat on several applications, including a one time password scheme, off-the-record messaging, notary service, and secure query processing.

Postharvest losses in fruits and vegetables exert substantial economic and environmental repercussions. Chemical interventions are being widely utilized for the past six decades which may lead to significant health complications. Bioprotection of fruits and vegetables is the need of the hour in which use of lactic acid bacteria (LAB) with GRAS status predominantly stands out. Incorporation of LAB in postharvest fruits and vegetables suppresses the growth of spoilage organisms by synthesizing various antimicrobial compounds such as bacteriocins, organic acids, hydrogen peroxide (H 2 O 2 ), exopolysaccharides (EPS), and BLIS. For example, Pediococcus acidilactici, Lactobacillus plantarum, and Limosilactobacillus fermentum convert natural sugars in fruits and vegetables to lactic acid and create an acidic environment that do not favour spoilage organisms. LAB can improve the bioavailability of vitamins and minerals and enrich the phenolic profile and bioactivity components. LAB has remarkable physiological characteristics like resistance towards bacteriophage, proteolytic activity, and polysaccharide production which adds to the safety of foods. They modify the sensory properties and preserve the nutritional quality of fruits and vegetables. They can also perform therapeutic role in the intestinal tract as they tolerate low pH, high salt concentration. Thus application of LAB, whether independently or in conjunction with stabilizing agents as edible coatings, is regarded as an exceptionally promising methodology for ensuring safer consumption of fruits and vegetables. This review addresses the most recent research findings that harness the antagonistic property of lactic acid bacterial metabolites, formulations and coatings containing their bioactive compounds for extended shelf life of fruits and vegetables., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: This study experimentally evaluated how well lay individuals could interpret and use 4 types of electronic health record (EHR) patient-facing immunization visualizations., Materials and Methods: Participants (n = 69) completed the study using a secure online survey platform. Participants viewed the same immunization information in 1 of 4 EHR-based immunization visualizations: 2 different patient portals (Epic MyChart and eClinicWorks), a downloadable EHR record, and a clinic-generated electronic letter (eLetter). Participants completed a common task, created a standard vaccine schedule form, and answered questions about their perceived workload, subjective numeracy and health literacy, demographic variables, and familiarity with the task., Results: The design of the immunization visualization significantly affected both task performance measures (time taken to complete the task and number of correct dates). In particular, those using Epic MyChart took significantly longer to complete the task than those using eLetter or eClinicWorks. Those using Epic MyChart entered fewer correct dates than those using the eLetter or eClinicWorks. There were no systematic statistically significant differences in task performance measures based on the numeracy, health literacy, demographic, and experience-related questions we asked., Discussion: The 4 immunization visualizations had unique design elements that likely contributed to these performance differences., Conclusion: Based on our findings, we provide practical guidance for the design of immunization visualizations, and future studies. Future research should focus on understanding the contexts of use and design elements that make tables an effective type of health data visualization., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

This study identified 22 features that are used and the needs for desired features/data in patient portals that enable online access to medical records. Data collected at a Midwestern state fair indicates that while most participants used patient portals, use and desirability of specific features varied widely. Identified needs for enhanced data access, portal functionality, and usability can be used to inform effective patient portal design., (©Sripriya Rajamani, Robin Austin, Chelsea Richwine, Malin Britt-Lalich, Madhur Thakur, Yasmin Odowa, Ratchada Jantraporn, Jenna Marquard. Originally published in JMIR Formative Research (https://formative.jmir.org), 11.10.2024.)

Malathy Krishnamurthy,1 Margaret M Lemmon,1 Evan M Falcinelli,1 Reuel A Sandy,1 Jennifer N Dootz,1 Tiffany M Mott,1 Sathish Rajamani,1,2 Kurt E Schaecher,3 Allen J Duplantier,1,4 Rekha G Panchal11Department of Target Discovery and Experimental Microbiology, Division of Molecular and Translational Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA; 2General Dynamics Information Technology, Frederick, MD, USA; 3Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD, USA; 4Cherokee Nation Assurance, Frederick, MD, USAPurpose: The rapid emergence of multidrug-resistant (MDR) bacteria and the lack of new therapies to eliminate them poses a major threat to global health. With the alarming rise in antimicrobial resistance (AMR), focus has now shifted to the use of the polymyxin class of antibiotics as the last line of defense for treatment of Gram-negative infections. Unfortunately, the growing resistance of bacteria against polymyxins is threatening the treatment of MDR infections, necessitating the need for novel strategies. The objective of this study was to determine if combination of polymyxin (polymyxin B or colistin) with a nonantibiotic small molecule AR-12, a celecoxib derivative that is devoid of cyclooxygenase 2 (COX-2) inhibitory activities, can be an effective strategy against polymyxin-resistant MDR bacteria.Methods: Growth inhibition studies, time-kill assays and permeability assays were conducted to investigate the effect of AR-12 on the antibacterial activity of polymyxins.Results: Growth studies were performed on a panel of polymyxin-resistant MDR strains using the combination of AR-12 with either colistin or polymyxin B. The combination treatment had no effect on strains that have inherent polymyxin resistance; however, AR-12 was effective in lowering the minimal inhibitory concentration (MIC) of polymyxins by 4–60-fold in several strains that had acquired polymyxin resistance. Time-kill assays using the combination of AR-12 and colistin with select MDR strains suggest rapid killing and bactericidal activity, while the permeability assays using fluorescently labeled dansylated polymyxin and 1-N-phenylnaphthylamine (NPN) in these MDR strains suggest that AR-12 can potentiate the antibacterial activity of polymyxins by possibly altering the bacterial outer membrane via modification of lipopolysaccharide and thereby improving the uptake of polymyxins.Conclusion: Our studies indicate that the combination of AR-12 and polymyxin is effective in targeting select Gram-negative bacteria that have acquired polymyxin resistance. Further understanding of the mechanism of action of AR-12 will provide new avenues for developing narrow-spectrum antibacterials to target select Gram-negative MDR bacteria. Importantly, our studies show that the use of nonantibiotic small molecules in combination with polymyxins is an attractive strategy to counter the growing resistance of bacteria to polymyxins.Keywords: Gram-negative, MDR bacteria, potentiator, antimicrobial resistance

RNA World Hypothesis is centred around the idea of a period in the early history of life's origin, wherein nonenzymatic oligomerization and replication of RNA resulted in functional ribozymes. Previous studies in this endeavour have demonstrated template-directed primer extension using chemically modified nucleotides and primers. Nonetheless, similar studies that used non-activated nucleotides led to the formation of RNA only with abasic sites. In this study, we report template-directed primer extension with prebiotically relevant cyclic nucleotides, under dehydration-rehydration (DH-RH) cycles occurring at high temperature (90 °C) and alkaline conditions (pH 8). 2'-3' cyclic nucleoside monophosphates (cNMP) resulted in primer extension, while 3'-5' cNMP failed to do so. Intact extension of up to two nucleotide additions was observed with both canonical hydroxy-terminated (OH-primer) and activated amino-terminated (NH 2 -primer) primers. We demonstrate primer extension reactions using both purine and pyrimidine 2'-3' cNMPs, with higher product yield observed during cAMP additions. Further, the presence of lipid was observed to significantly enhance the extended product in cCMP reactions. In all, our study provides a proof-of-concept for nonenzymatic primer extension of RNA, using intrinsically activated prebiotically relevant cyclic nucleotides as monomers., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background and Objective: The data modernization initiative (DMI) is a multi-year, multi-billion-dollar endeavor toward a robust public health information infrastructure. The various DMI projects (interoperability, analytics, workforce, governance) present an opportunity for a learning health system (LHS) framework in public health. The objective is to share an academic-practice partnership model between the University of Minnesota (UMN) and the Minnesota Department of Health (MDH) in advancing public health informatics (PHI) and its relationship to an LHS model., Methods: The UMN-MDH partnership was conceptualized in 2018 as a 1-year pilot with annual renewals through a time/cost-sharing faculty position with PHI expertise. The partnership focus was decided based on MDH's needs and mutual interests, with the core collaborating faculty (SR) being an embedded researcher at MDH. Responsibilities included supporting electronic case reporting (eCR), interoperability projects, and assisting MDH staff with PHI presentations/publications. The partnership has expanded to PHI workforce development through a national grant and now includes an interest in applying the LHS framework to MDH-DMI work., Results: The MDH-DMI team has embarked upon 13 projects for assessment through an LHS approach: systems interoperability projects between MDH and healthcare/local public health ( n  = 6); systems modernization for MDH programs ( n  = 5); informatics workforce development ( n  = 1); and program governance ( n  = 1). Each project has been evaluated and/or has current/future assessment plans to synthesize learnings and create a feedback loop for iterative improvement. The partnership has been mutually beneficial as it met agreed upon metrics across both institutions. The program's productivity is showcased with shared authorship in 10 peer-reviewed proceedings/publications, 22 presentations and 16 posters across local/national conferences., Conclusion: The current case report of the UMN-MDH partnership is a relatively recent exemplar to support tangible LHS demonstration in public health. Building LHS momentum at MDH and other public health entities will require LHS champion(s) and continued academic collaboration., Competing Interests: The authors declare that they do not have any competing interests., (© 2024 The Author(s). Learning Health Systems published by Wiley Periodicals LLC on behalf of University of Michigan.)

Background and Objective:  Though public health is an information-intense profession, there is a paucity of workforce with Public Health Informatics and Technology (PHIT) skills, which was evident during the coronavirus disease 2019 (COVID-19) pandemic. This need is addressed through the PHIT workforce program (2021-2025) by the Office of the National Coordinator for training and to increase racial and ethnic diversity in the PHIT workforce. The objective is to share details on the Training in Informatics for Underrepresented Minorities in Public Health (TRIUMPH) consortium, funded by the PHIT workforce program., Methods:  The TRIUMPH consortium is a collaboration between academic and practice partners with a commitment to training 879 students in PHIT. The Schools of Public Health and Nursing at the University of Minnesota, Jiann-Ping Hsu College of Public Health at Georgia Southern University, Morehouse School of Medicine, and Public Health Informatics Institute offer PHIT training through various programs. Academic institutions focus on student recruitment, developing courses/curriculum, and granting degrees/certificates, and the role of practice partners is to support experiential learning through internships/practicums., Results:  The TRIUMPH consortium is progressing toward its goals, with 692 students (79%) already trained in a PHIT modality as of December 2023. The learners comprise diverse race/ethnicity, including White (48%), Black/African American (32%), Asian (10%), White Hispanic (5%), American Indian/Alaska Native (2%), and Black Hispanic (1%). Numerous internships have been completed in settings ranging from state/local public health agencies to health care delivery systems. Diversity initiatives were supported by partnering with existing programs (e.g., the AMIA First Look program and the Nursing Knowledge Big Data Science conference)., Conclusion:  This consortium model is an excellent approach to informatics training and sharing expertise across partners. It provides scalability and broader geographic outreach while presenting opportunities to students from underrepresented backgrounds. Lessons learned have implications for overall informatics training (e.g., partnerships models, promoting racial/ethnic diversity)., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Competing Interests: Declaration of competing interest None of the authors has any conflicts of interest, other than their employment in commercial biopharmaceutical companies or contract research organizations (CROs). No information is presented in this paper that advocates for or promotes commercial products from any of our organizations.

The current work communicates the entropy generation analysis of oscillating flow of magnetohydrodynamic couple stress nanofluid in a vertical channel. The main objective of present study is to examine the entropy analysis of a magnetohydrodynamic couple stress nanofluid. In this study, water and ethylene glycol (50:50) and diamond are used as the base fluid and nanoparticles, respectively. The effects of radiative heat, Ohmic, and viscous dissipation are all considered. By employing the perturbation process, the governing partial differential equations are transformed into the set of ordinary differential equations, which are then deciphered by implementing the Runge-Kutta fourth-order scheme with shooting technique. The obtained outcomes reveal that, amplifying viscous dissipation promising the temperature whereas the reverse is true for the influence of couple stress viscosity and Hartmann number. Heat transfer rate is decelerating with the boost up in Hartmann number at the walls while it is accelerating with the increment in viscous dissipation at the right wall. Entropy is escalating for intensifying viscous dissipation, and thermal radiation whereas the reverse is true for the impression of couple stress viscosity, and volume fraction of nanoparticles. Bejan number is falling for escalating volume fraction of nanoparticles, and viscous dissipation while it is enhancing with escalation in couple stress parameter. [ABSTRACT FROM AUTHOR]

Optical coherence microscopy (OCM) imaging of the Drosophila melanogaster (fruit fly) heart tube has enabled the non-invasive characterization of fly heart physiology in vivo . OCM generates large volumes of data, making it necessary to automate image analysis. Deep-learning-based neural network models have been developed to improve the efficiency of fly heart image segmentation. However, image artifacts caused by sample motion or reflections reduce the accuracy of the analysis. To improve the precision and efficiency of image data analysis, we developed an Attention LSTM U-Net model (FlyNet3.0), which incorporates an attention learning mechanism to track the beating fly heart in OCM images. The new model has improved the intersection over union (IOU) compared to FlyNet2.0 + with reflection artifacts from 86% to 89% and with movement from 81% to 89%. We also extended the capabilities of OCM analysis through the introduction of an automated, in vivo heart wall thickness measurement method, which has been validated on a Drosophila model of cardiac hypertrophy. This work will enable the comprehensive, non-invasive characterization of fly heart physiology in a high-throughput manner., Competing Interests: The authors declare no conflicts of interest., (© 2024 Optica Publishing Group.)

Prebiotic genetic nucleotides (PGNs) often outcompete canonical alphabets in the formation of nucleotides and subsequent RNA oligomerization under early Earth conditions. This indicates that the early genetic code might have been dominated by pre-RNA that contained PGNs for information transfer and catalysis. Despite this, deciphering pre-RNAs' capacity to acquire function and delineating their evolutionary transition to a canonical RNA World has remained under-researched in the origins of life (OoL) field. We report the synthesis of a prebiotically relevant nucleotide (BaTP) containing the noncanonical nucleobase barbituric acid. We demonstrate the first instance of its enzymatic incorporation into an RNA, using a T7 RNA polymerase. BaTP's incorporation into baby spinach aptamer allowed it to retain its overall secondary structure and function. Finally, we also demonstrate faithful transfer of information from the pre-RNA-containing BaTP to DNA, using a high-fidelity RNA-dependent DNA polymerase, alluding to how selection pressures and complexities could have ensued during the molecular evolution of the early genetic code., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

We aimed to assess medical students' use of decision-support medical apps and evaluate their perception of app use. A cross-sectional multi-center observational study was conducted among medical students with and without a medical informatics course as part of their undergraduate medical curriculum. We assessed trust, perceptions, patient impression, reliability, and comfort using an online survey. A total of 439 responses were received. There were significant differences between the two groups when indicating which apps, they trust. Students agreed that using apps enhanced knowledge (91%), saved time (88%), improved patient care (85%), and increased diagnostic accuracy (82%). Students indicated that patients would think that students didn't know what they were doing (63%) or students were fresh out of training (53%) when using apps in the presence of patients. Incorporating medical app usage as part of learning may increase trust and comfort with using medical apps in medical practice.

The critical need for system interoperability and robust information infrastructure in public health was highlighted during the COVID-19 pandemic. An assessment of the evolving interoperability between immunization information system (IIS) in a state-based public health agency and electronic health records (EHRs) including pandemic-driven evolution/use was conducted. The Minnesota Immunization Information Connection (MIIC), the IIS for Minnesota (US) supports interoperability with EHRs using HL7v2.5.1 standards-based queries. Structured interviews were conducted with 28 experts across 12 healthcare systems and public health clinics (n=286 sites) between April - July 2022. Though all reported use of MIIC, most (83%) had MIIC integration within their EHRs, and high EHR queries to MIIC (∼6 million/month), numerous organizational/technical barriers were identified including standard vaccine-naming need in EHRs, app access issues, limited resources and informatics-staff shortage in public health. Results underscore vital role of IIS, on-going interoperability evaluation to address issues and promote standards-based bi-directional EHR-IIS data exchanges.

Aim This study aimed to assess and compare the mechanical properties, including compressive strength, diametral tensile strength, flexural strength, fracture resistance, microhardness, and microleakage, between Cention N (Ivoclar Vivadent, Gurugram, India) and Cention N enriched with titanium dioxide (TiO 2 ) nanoparticles. Methodology A total of 120 samples were involved in the study, which were split into two experimental groups. For evaluation of each mechanical property, 20 samples were included, of which 10 samples were used for evaluating the properties of Cention N and 10 samples were used for TiO 2  nanoparticles-enriched Cention N. Samples, formed using Teflon molds, were filled with Cention N and TiO 2 -enriched Cention N powders mixed per the manufacturer's instructions. The universal testing machine (UTM) was used to assess compressive, flexural, diametral tensile strength, and fracture resistance. Microhardness was evaluated using a diamond indenter, while microleakage was examined utilizing a stereomicroscope. Results The nanotitania-enriched Cention N showed significantly increased mechanical properties and increased microhardness with the least microleakage. Conclusion The inclusion of TiO 2 in Cention N has proved to yield promising results., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Irudayaraj et al.)

Microscopic evaluation of glands in the colon is of utmost importance in the diagnosis of inflammatory bowel disease and cancer. When properly trained, deep learning pipelines can provide a systematic, reproducible, and quantitative assessment of disease-related changes in glandular tissue architecture. The training and testing of deep learning models require large amounts of manual annotations, which are difficult, time-consuming, and expensive to obtain. Here, we propose a method for automated generation of ground truth in digital hematoxylin and eosin (H&E)-stained slides using immunohistochemistry (IHC) labels. The image processing pipeline generates annotations of glands in H&E histopathology images from colon biopsy specimens by transfer of gland masks from KRT8/18, CDX2, or EPCAM IHC. The IHC gland outlines are transferred to coregistered H&E images for training of deep learning models. We compared the performance of the deep learning models to that of manual annotations using an internal held-out set of biopsy specimens as well as 2 public data sets. Our results show that EPCAM IHC provides gland outlines that closely match manual gland annotations (Dice = 0.89) and are resilient to damage by inflammation. In addition, we propose a simple data sampling technique that allows models trained on data from several sources to be adapted to a new data source using just a few newly annotated samples. The best performing models achieved average Dice scores of 0.902 and 0.89 on Gland Segmentation and Colorectal Adenocarcinoma Gland colon cancer public data sets, respectively, when trained with only 10% of annotated cases from either public cohort. Altogether, the performances of our models indicate that automated annotations using cell type-specific IHC markers can safely replace manual annotations. Automated IHC labels from single-institution cohorts can be combined with small numbers of hand-annotated cases from multi-institutional cohorts to train models that generalize well to diverse data sources., (Copyright © 2023 United States & Canadian Academy of Pathology. Published by Elsevier Inc. All rights reserved.)