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The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http//journals.sagepub.com/doi/10.1177/2374289517715040. 1.The rapidly spreading COVID-19 pandemic demanded immediate organizational pivots in departments of laboratory medicine and pathology, including development and implementation of severe acute respiratory syndrome coronavirus 2 diagnostics in the face of unprecedented supply chain shortages. Laboratory medicine and pathology educational programs were affected in numerous ways. Here, we overview the effects of COVID-19 on the large, academic Department of Laboratory Medicine and Pathology educational practice at Mayo Clinic, highlighting lessons learned for the post-pandemic era and planning for the possibility of a future pandemic.

The impact of ABO incompatibility (ABO-I) on hematopoietic stem cell transplant outcomes is still debated.

We retrospectively investigated 432 consecutive transplants performed at our center (2012-2020). All patients but 6 were affected by hematologic malignancies. The effect of different ABO match combinations on engraftment rate, transfusion support, acute and chronic graft-versus-host disease incidences, nonrelapse mortality (NRM), disease-free survival, and overall survival was assessed in univariate and multivariate analysis. Significance was set at

 < 0.05.

ABO match distribution among transplants was as follows 223 ABO-compatible, 94 major ABO-I, 82 minor ABO-I, and 33 bidirectional ABO-I. At univariate analysis, major ABO-I delayed the engraftment of neutrophils, platelets, and erythroid cells. At multivariate analysis, major ABO-I transplants displayed delayed erythroid engraftment (odds ratio [OR], 0.51; 95% confidence intervals [CIs], 0.38-0.70;

 < 0.0001) and hindered transfusion independence for both red blood cells (OR, 0.52; 95% CI, 0.37-0.72;

 = 0.0001) and platelets (0.60; 95% CI, 0.45-0.86;

 = 0.0048). Moreover, major ABO-I transplants received greater amounts of blood products (

 < 0.0001 for red blood cells and

 = 0.0447 for platelets). In comparison with other ABO matches, major ABO-I was associated with an increased NRM (OR, 1.67; 95% CI, 1.01-2.75;

 = 0.0427). No effects of ABO-mismatch were found on graft-versus-host disease, disease-free survival, and overall survival.

Major ABO mismatch delays multilineage engraftment hinders transfusion independence and increases NRM. The prognostic impact of transfusion burden in hematopoietic stem cell transplantation deserves to be explored.

Major ABO mismatch delays multilineage engraftment hinders transfusion independence and increases NRM. The prognostic impact of transfusion burden in hematopoietic stem cell transplantation deserves to be explored.Plasma cell disorders are one of the most common hematologic malignancies. Monoclonal gammopathy of undetermined significance (MGUS) is defined by a serum monoclonal protein less then 3 g/dL, bone marrow plasma cell infiltration less then 10%, and most importantly absence of end-organ damage. The prevalence of MGUS in general population is estimated to be 1%-4% and its frequency increases with age with 3% among people above 50 y of age. The risk of progression to clinically significant plasma cell dyscrasia is estimated to be 1% per year. With aging population and increasing use of transplantation for the management of kidney disease in older adults, MGUS is being identified during the evaluation for kidney transplant candidacy or during the postkidney transplant follow-up. MGUS in patients with end-stage renal disease (ESRD) undergoing evaluation for kidney transplant can pose a complex management dilemma. In this article, we review the current state of knowledge about the prevalence of MGUS in ESRD population and the impact of kidney transplantation on the progression of MGUS to clinically significant plasma cell disorder. We make recommendations for the screening of ESRD patients undergoing kidney transplant evaluation and the management of MGUS after renal transplant.

Immunosuppression with calcineurin inhibitors (CNIs) is reportedly associated with risk of renal impairment in liver transplant recipients. It is believed that this can be mitigated by decreasing initial exposure to CNIs or delaying CNI introduction until 3-4 d posttransplantation. The ADVAGRAF studied in combination with mycophenolate mofetil and basiliximab in liver transplantation (DIAMOND) trial evaluated different administration strategies for prolonged-release tacrolimus (PR-T).

DIAMOND was a 24-wk, open-label, phase 3b trial in de novo liver transplant recipients randomized to PR-T 0.2 mg/kg/d (Arm 1); PR-T 0.15-0.175 mg/kg/d plus basiliximab (Arm 2); or PR-T 0.2 mg/kg/d delayed until day 5 posttransplant plus basiliximab (Arm 3). In a 5-y follow-up, patients were maintained on an immunosuppressive regimen according to standard clinical practice (NCT02057484). Primary endpoint graft survival (Kaplan-Meier analysis).

Follow-up study included 856 patients. Overall graft survival was 84.6% and 73.5%ment arms at 5 y posttransplant.

Research in genetics and infectious diseases (ID) presents novel configurations of ethical, legal, and social issues (ELSIs) related to the intersection of genetics with public health regulations and the control of transmissible diseases. Such research includes work both in pathogen genetics and on the ways that human genetics affect responses to ID. This paper identifies and systematizes the unique issues at this intersection, based on an interdisciplinary expert review.

This paper presents results of a formal issue-spotting exercise among twenty experts in public health, law and genomics, biobanking, genetic epidemiology, ID medicine and public health, philosophy, ethics and ID, ethics and genomics, and law and ID. The focus of the exercise was on the collection, storage, and sharing of genetic information relating to ID.

The issue-spotting exercise highlighted the following ELSIs risks in reporting to government authorities, return of individual research results, and resource allocation - each taking on specific configurations based on the balance between public health and individual privacy/protection.

The public health implications of interactions between genomics and ID frame considerations for equity and justice. In the context of the COVID-19 pandemic, these issues are especially pressing.

The public health implications of interactions between genomics and ID frame considerations for equity and justice. In the context of the COVID-19 pandemic, these issues are especially pressing.The effects of in-feed probiotics on growth performance, haematological parameters, gut microbial content, and morphological changes to pangasius fish were assessed. The trial had three phases, i.e., larvae to fry (20 days), fry to fingerlings (45 days), and grow-out phase from fingerlings to marketing (90 days). The stocking densities were 400 m-3, 200 m-3, and 12 m-3 for phases 1, 2, and 3, respectively. Phases 1 and 2 were conducted in hapas in the same pond, whereas phase 3 was performed in concrete tanks. The in-feed probiotic was administered at a rate of 0.2 g kg-1 of feed three times per day in phases 1 and 2 only. In phase 3, in-feed probiotics was not applied to any groups. The treated group exhibited higher growth performances (p less then 0.05) than the control in all three phases of experiment. The survival % in phase 1 and 2 were found significantly (p less then 0.05) higher in treatment groups. This indicates that pangasius nurserers would benefit from using probiotics as a safeguard to increase fry survival to a greater extent. Two haematological parameters including red blood cells (RBC) and white blood cells (WBC) levels were found significantly (p less then 0.05) higher in treated groups in phase 2 and 3, while glucose and hemoglobin level were found significantly (p less then 0.05) higher in the treated groups during phases 2 and 3, respectively. The gut microbiota content was relatively higher in the treated groups in phase 2 and 3. Histological findings indicate that the use of probiotics during the nursing phases of pangasius induced a positive change in the intestinal morphological structures. The positive impacts of probiotics on the phase 3 confirmed an immediate and long-term growth performance and health of pangasius.Humans can reason about other minds, comprehend language and imagine. These abilities depend on association regions that exhibit evolutionary expansion and prolonged postnatal development. Precision maps within individuals reveal these expanded zones are populated by multiple specialized networks that each possess a spatially distributed motif but remain anatomically separated throughout the cortex for language, social and mnemonic / spatial functions. Rather than converge on multi-domain regions or hubs, these networks include distinct regions within rostral prefrontal and temporal association zones. To account for these observations, we propose the expansion-fractionation-specialization (EFS) hypothesis evolutionary expansion of human association cortex may have allowed for an archetype distributed network to fractionate into multiple specialized networks. Human development may recapitulate fractionation and specialization when these abilities emerge.The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.About 1 billion stunted school-aged children are growing up with impaired mental development which can lead to low cognitive performance, reduced school achievement, and low productivity. But there is scarce evidence on cognitive function, school performance and their associated factors among school aged children. The main aim of this study was to assess cognitive function, school performance and determine their association with nutritional status among school children aged 7 to 10 years at Soddo Town and Soddo Zuriya Woreda, Wolaita Zone, Southern Ethiopia. Institutional comparative cross-sectional study was conducted on a total sample of 178 primary school children. The Raven's Color Progressive Matrices (RCPM) and selected tests from Kaufman assessment battery for children second edition were used. Mid-year average students' examination result was also used. Data were analyzed by using SPSS version 25, WHO Anthro plus, and independent sample t-test. S961 order Bivariate and multivariate linear regression analyses were also used.