Anatomic Pathology Research Articles

From intestinal failure to transplantation: Review on the current need for transplant indications under multidisciplinary transplant programs worldwide.

Intestinal failure, defined as the loss of gastrointestinal function to the point where nutrition cannot be maintained by enteral intake alone, presents numerous challenges in children, not least the timing of consideration of intestine transplantation. To describe the evolution of care of infants and children with intestinal failure including parenteral nutrition, intestine transplantation, and contemporary intestinal failure care. The review is based on the authors' experience supported by an in-depth review of the published literature. The history of parenteral nutrition, including out-patient (home) administration, and intestine transplantation are reviewed along with the complications of intestinal failure that may become indications for consideration of intestine transplantation. Current management strategies for children with intestinal failure are discussed along with changes in need for intestine transplantation, recognizing the difficulty in generalizing recommendations due to the high level of heterogeneity of intestinal pathology and residual bowel anatomy and function. Advances in the medical and surgical care of children with intestinal failure have resulted in improved transplant-free survival and a significant fall in demand for transplantation. Despite these improvements a number of children continue to fail rehabilitative care and require intestine transplantation as life-saving therapy or when the burden on ongoing parenteral nutrition becomes too great to bear.

Histopathological Pattern and Audit of Skin Tumors Seen in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria: A 10-year Retrospective Study

Abstract Background: Skin tumors consist of neoplastic lesions that affect the integumentary system which includes skin, hair, nails, and related muscles and glands. Diagnosis of these lesions can be a dilemma for both physicians and pathologists. Tumors of the skin are more heterogeneous than those of any other organ in the body, and this is a result of varying types of cells which can give rise to both benign and malignant skin lesions. Aim and Objectives: The aim of this is to audit the histopathological patterns of skin tumors seen in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-East Nigeria. Materials and Methods: All cases of skin tumors diagnosed in the center within the study period of January 2013 to December 2022 were retrieved from the archives of the Anatomic Pathology Laboratory, NAUTH. Histology slides of the cases that met the inclusion criteria were carefully reviewed. Then, tissue blocks for those diagnosed as malignant skin tumors, were sent for immunohistochemistry. The data obtained were analyzed using the Statistical Package for the Social Sciences version 20.0. Results: There were a total of 206 cases that met the inclusion criteria, 103 males (50.0%) and 103 females (50.0%). The most common tumor as seen in the study is squamous cell carcinoma (SCC) (19%), with the least common being cylindroma, sebaceoma, and trichoepithelioma (1% each). The peak age incidence is in the third decade. The anatomic site most affected by the tumors is the head-and-neck region (78%) followed by the lower-limb region (66%) and the least affected is the anogenital region (25%). Immunohistochemistry showed a 100% correlation for the malignant skin tumors. Conclusion: The overall most common skin tumor is SCC followed by hemangioma, whereas trichoepithelioma, sebaceoma, and cylindroma are the least common. The most common benign tumor is hemangioma, whereas the least common benign tumors are trichoepithelioma and cylindroma. The most common and least common malignant tumors are SCC and Paget’s disease respectively. This study served to generate baseline data for the histopathologic pattern of both benign and malignant skin tumors in NAUTH, Nnewi.

Morphometric studies of the skin of calfs

Relevance. Previously, we conducted comparative morphometric studies of skin samples from different topographic sites in adult cows obtained in winter. At the same time, morphological features of the skin of different topographic areas were established. In this paper, the purpose of our study was to conduct comparative morphometric studies of the skin of different topographic areas in calves.Methods. Morphometric studies of histological preparations were carried out at the Department of Pathological Anatomy and Forensic Veterinary Medicine and at the Department of Biology, Ecology and Histology. Morphometric studies of histological preparations were used to study the thickness of the dermis proper, as well as bundles of collagen fibers of the mesh layer of the dermis. The research results were statistically processed using the "Biostat" program.Results. Morphological features of the skin of different topographic areas in calves have been established, manifested by different thicknesses of skin layers and bundles of collagen fibers of the dermis. The morphometry performed made it possible to supplement the data on the morphological structure of the skin of cattle and can also be used in the study of morpho- and pathogenesis of skin diseases.

G. G. Avtandilov and A. P. Avtsyn: Two Outstanding Pathologists, Two Unique Lives

Academician A.P. Avtsyn and Professor G.G. Avtandilov are generally recognized world authorities in pathological anatomy. Alexander Pavlovich Avtsyn is known as an outstanding scientist, a famous community health administrator, an active public personality, a wonderful teacher, a corresponding member of the USSR Academy of Medical Sciences and a laureate of the USSR State Prize, the founder of the Research Institute of Human Morphology, which was later given his name. Georgy Gerasimovich Avtandilov is an outstanding scientist and educator, a prominent specialist, professor, Doctor of Medical Sciences, Honored Doctor of Kabardino-Balkaria and Honored Scientist of the RSFSR and the Republic of North Ossetia – Alania, as well as an academician of the Russian Academy of Natural Sciences. G.G. Avtandilov specialised in the field of pathological anatomy, mainly in morphometry. The paper describes details of their contribution to the development of pathological anatomy, from both a fundamental and practical point of view. Unique methodological approaches developed by G.G. Avtandilov and A.P. Avtsyn, which are used today by numerous scientists, are presented by the authors. In addition to the scientific life of two outstanding researchers, the article highlights important events from their biographies.

Dedication to Morphology (to the 70th Anniversary of the Birth of Professor I.V. Gaivoronsky)

In February 2024, Professor Ivan Vasilyevich Gaivoronsky, Doctor of Sciences in Medicine, the prominent Russian morphologist, Head of the Department of Normal Anatomy at S.M. Kirov Military Medical Academy, celebrated the 70th anniversary. Ivan Vasilyevich was born on February 2, 1954 in the town of Kadievka, Voroshilovgrad region. In 1979, he graduated with a gold medal from S.M. Kirov Military Medical Academy; within its walls, he came a long way from an adjunct to the Head of the Department of Normal Anatomy, which he has headed for more than 35 years. Ivan V. Gavoronsky is a member of the Presidium of the All-Russian Scientific Medical Society of Anatomists, Histologists and Embryologists and Chairman of its St. Petersburg branch, a member of the Coordinating Council responsible for the field of education “Health and Medical Sciences” and its educational and methodological commission in anatomy and anthropology, Chairman of the dissertation council in the specialties Anatomy and Anthropology, Pathological Anatomy and Forensic Medicine, created at S.M. Kirov Military Medical Academy. Professor Ivan V. Gaivoronsky focused his attention on the development of modern aspects of the collateral circulation issues, the state of various parts of the vascular bed under normal conditions and under the influence of various extreme factors, innovative technologies for preparing and preserving anatomical sections for educational purposes, medical craniology, the study of individual and typological features of the human body, applied issues, dictated by the needs of practical medicine, the history of anatomy, and the improvement of the educational process in the departments of morphological profile. He created a scientific morphological school, which trained 11 doctors and 60 candidates of medical sciences. For significant contribution to the development of Russian science and modernization of the educational process, Professor IvanV. Gaivoronsky was twice awarded the Russian Government Prize in the field of education; he was awarded the honorary titles “Honored Scientist of the Russian Federation” and “Honored Figure of Russian Higher Education”, academician of the Russian Military Medical Academy, Honorary Doctor of the Russian Military Medical Academy; he was awarded the Order of Honor and a medal of the Order for Merits to the Fatherland, II degree.

When to take the primary certification examination: sooner or later?

Most Pathology residents take the Anatomic Pathology and/or Clinical Pathology primary pathology certification examination(s) near the end of their final year of training (i.e., Spring), whereas some postpone the examination(s) to the Fall administration of that year or even later. We compared the Spring and Fall administration pass rates of initial primary certification candidates for those who graduated in the same year they took the examination. We also compared the pass rates of same-year graduates with individuals who postponed the examination for a year or more. We also surveyed the candidates regarding the reasons they chose the Spring or Fall administration. Candidates who chose the earlier (i.e., Spring) administration were more likely to pass compared with those who took the later Fall administration (p = 0.0026 for Anatomic Pathology; p = 0.0004 for Clinical Pathology). Delaying the certifying exams beyond the calendar year of residency graduation was associated with a higher failure rate (p < 0.0001 for both Anatomic and Clinical Pathology). The survey results suggest that residents often take their certification examinations earlier to not interfere with fellowship training, because it coincides with the completion of residency training, or it is expected by their program. Pathology residents are more likely to pass the primary certification examinations when they are taken closer to the end of training, rather than postponing it to a later administration. Pathology residency program directors should encourage residents, who are deemed ready, to take their certification examinations at the earliest possible administration.

Pathology Anatomy and Hemolymph Profile of Spiny Lobster (Panulirus homarus) Infested by Octolasmis sp. on Bottom Cage

Spiny lobster, a fishery commodity with important economic value, is often infested by Octolasmis sp. on their bodies, which causes stress conditions that lead to death. This study aimed to determine the anatomical pathology and hemolymph profile of spiny lobster infested with Octolasmis sp. in bottom cages. The method used was an observation, where 30 lobsters (weight 112.44 ± 24.63 g) were carried out in June–July 2022 at the Pesona Bahari Wongsorejo, Banyuwangi. Hemolymph profile and anatomical pathology data were analyzed, respectively, using the Independent T-Test and Kruskal-Wallis test (α = 95%). The results based on scoring data showed a very significant difference between infected and healthy lobsters (p &lt; 0.01), characterized by the occurrence of tail flakes, lesions on the carapace, gill melanization, and the appearance of ulcers on the ventral abdomen. A very significant change occurred in the hemolymph profile of infected lobsters compared to healthy lobsters (p &lt; 0.01). Total hemocyte count increased with high concentrations of granular cells, respectively 22.1–37.8 ´x 106 cells/mL and 63.75–64.5%, along with lobster damage, while hyaline cells decreased. This study showed that there was a change in anatomic pathology and hemolymph profile between infected and healthy lobsters.

Mesenteric root pseudocyst: finding in an asymptomatic patient—a case report

BackgroundMesenteric cysts are one of the rarest abdominal tumor masses, representing a little-studied pathology. In turn, the variability and non-specificity of clinical manifestations make diagnosis difficult, as it can be reached by imaging findings due to another cause or by non-specific abdominal pain.Case presentationThis article describes the case report of an asymptomatic 28-year-old patient who presented a 6-cm abdominal cystic mass with mixed density, which was found incidentally by computed tomography. Exploratory laparoscopy was performed followed by conversion to conventional surgery to extract the tumor mass. The anatomical pathology diagnosis was pseudocyst of the mesentery root. Mesenteric cysts are one of the rarest abdominal tumor masses, representing a little-studied pathology. In turn, the variability and non-specificity of clinical manifestations make diagnosis difficult, as it can be reached by imaging findings due to another cause or by non-specific abdominal pain.ConclusionsMesenteric cysts are rare, and their nonspecific symptoms often lead to diagnosis based on imaging findings. Complete laparoscopic enucleation is the standard treatment.

Principles, applications, and advancements of the Segment Anything Model

The Segment Anything Model (SAM) is a prominent computer vision model discussed in a review paper focusing on image segmentation. This paper explores the concepts, applications, and advancements of SAM, which excels at accurately separating diverse object types and managing visual data. It leverages convolutional neural networks (CNNs), an encoder-decoder architecture, skip connections, and spatial attention mechanism to capture fine details and contextual information across different scales. SAM finds versatile applications in various domains, including medical imaging for precise anatomical structure delineation and pathology identification. It improves recognition and classification by precise positioning and segmentation. However, the SAM model faces challenges such as complex object shapes and computational requirements for real-time deployment in resource-constrained environments. To tackle these limitations, researchers have proposed advancements like feature enhancement, network architecture modifications, and regularization techniques. Future directions may involve lightweight network designs, optimization strategies, and integration of external information to enhance accuracy, efficiency, and robustness of the SAM model.

Evaluation and Comparison of Tolerance of Ambiguity in Veterinary Pathology Professionals and Trainees

Ambiguity is ubiquitous in veterinary medicine, including in clinical and anatomic pathology. Tolerance of ambiguity (TOA) relates to how individuals navigate uncertainty. It is associated with psychological well-being in health professionals yet has been little investigated in veterinarians or veterinary pathologists. In this study, we used the Tolerance of Ambiguity of Veterinary Students (TAVS) scale and eight previously evaluated items specific to clinical pathology to evaluate and compare TOA in pathology professionals and trainees. We hypothesized that scores would be higher (reflecting greater TOA) for professionals than for trainees, that scores would increase with years of diagnostic experience for professionals and year of study for trainees, and that scores would be higher for clinical than anatomic pathologists due to the frequent ambiguity of clinical pathology practice. One hundred eighty one pathology professionals and trainees participated. TAVS scores were significantly higher for professionals than for trainees, and scores increased significantly with year of experience for professionals but not with year of study for trainees. When comparing disciplines, TAVS scores for all clinical pathologists were significantly lower than scores for all anatomic pathologists. Scores for clinical pathology specific items showed similar trends to TAVS scores, except when comparing disciplines (clinical pathologists tended to have higher scores for these items). Results suggest pathology professionals become more tolerant of ambiguity throughout their careers, independent of increasing TOA with age, and that navigating ambiguity might be more difficult for trainees than for professionals. Educational interventions might help trainees learn to successfully navigate ambiguity, which could impact psychological well-being.

(PM-02) GENITOURINARY TUBERCULOSIS IN MALE PATIENTS: A CASE SERIES FROM A FEDERAL UNIVERSITY HOSPITAL

Abstract Introduction Tuberculosis is a significant global public health threat, causing 1.2 million deaths in 2019. In Brazil, the incidence of the disease in the same year was 46 new cases per 100,000 inhabitants. Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis, resulting from the spread of mycobacteria through hematogenous dissemination from a latent chronic pulmonary infection or by local spread. Objective This study aims to present a case series of genitourinary tuberculosis in male patients from a tertiary university hospital. Method The study conducted a descriptive analysis of a case series using data from the Unit of Pathological Anatomy Laboratory and the Center for Infectious Diseases between 1999 and 2020. Results Four male patients, with a mean age of 32 years (ranging from 23 to 46), were evaluated. Key symptoms reported during medical consultations at the Urology outpatient service included scrotal nodules, increased testicular volume, and orchialgia, with an average symptom duration of six months. Physical examinations revealed a hard nodular mass in the epididymis or upper testicular pole, mostly on the right side (in half of the cases) or the left side (in the other half). Histological examination of biopsies indicated chronic granulomatous inflammation consistent with tuberculoid in all cases, with negative tumor markers. Notably, none of the patients reported contact with tuberculosis or leprosy patients, and only one patient had a positive PPD test (&amp;gt;24mm). Conclusion Genitourinary tuberculosis is a treatable and preventable disease. Understanding its clinical aspects, forms of presentation, dissemination, diagnosis, and treatment is crucial. Drug therapy, including rifampicin, isoniazid, pyrazinamide, and ethambutol, was effective in resolving symptoms in all patients. Surgical intervention in the form of orchidectomy was required for some cases, resulting in positive outcomes. Financing No conflict.

Giant Intrapulmonary Mature Teratoma with Thoracostomy Intervention: A Rare Case Report

Background: Teratoma usually found in mediastinum and rarely found in the lung. Mature teratomas are the most common histological type of germ cell tumours, followed by seminoma. First case reported by Mohr in 1839 and until now only few cases of intrapulmonary teratomas have been reported.&#x0D; Case: A man, 64-years old man, nonsmoker complains of shortness of breath since 6 months and worsened in a week. Patient had history medication for tuberculosis in 2019. Chest Contrast CT-Scan showed hypodense mass and suggestive for benign left lung tumor. TTNA were performed and suggestive for teratoma. Joint conference with several department agree to proceed with thoracostomy. Thoracostomy with wide excision been done to remove the mass and examined for anatomic pathology then confirmed for mature teratoma. During thoracostomy, we cannot removed 100% of the tumor because it adhesive with aorta and parietal pleura. Patient treated in ICU and worsens. Unfortunately, patient passed away four days later.&#x0D; Conclusion: Teratoma is rarely found inside of the lung. Early diagnosis and resection of intrapulmonary teratoma is critical to prevent complications and provide definitive treatment.

Abstract 3511: iQC: machine-learning-driven prediction of surgery reveals systematic confounds in cancer whole slide images from hospitals by protocol

Abstract Problem: This 21st century has produced an eruption of research using AI for the detection and diagnosis of cancer. Yet, an often-unspoken core premise in this field of computational pathology is that a glass slide suitably represents the patient’s disease. Here, we report systematic confounds may dominate slides from a medical center, such that slides are unsuitable for diagnosis. Methods: We mathematically define high quality data as a whole slide image set where the patient’s surgery may be accurately predicted by an automated system. Our system “iQC” accurately distinguished biopsies (i.e. thin strands of tissue) from nonbiopsies, e.g. transurethral resections (TURPs) or prostatectomies, only when the data appeared high quality, e.g. bright histopathology stains and few artifacts. Thus, when the data are of high quality, iQC (i) accurately classifies pixels as tissue, (ii) accurately generates stats that describe the distribution of tissue, and (iii) accurately predicts surgical procedure from those stats. We compare iQC against the published HistoQC tool. Results: iQC holds all data to the same objective quality standard. We validate this standard in five Veterans Affairs Medical Centers (VAMCs) and the public Automated Gleason Grading Challenge (AGGC) dataset. For the surgery prediction task, we report an AUROC of 0.9966-1.000 at VAMCs that produced high quality data and AUROC=0.9824 for AGGC. In contrast, we report AUROC=0.7115 at the VAMC that produced poor quality data. A pathologist found poor quality may be explained by faded histopathology stains and VAMC protocol differences. Supporting this, iQC's novel stain strength statistic finds this VAMC had weaker stains (p &amp;lt; 2.2e-16, two-tailed Wilcoxon rank-sum test; Cohen's d=1.208) than the VAMC that contributed most of the slides. Additionally, iQC recommended only 2 of 3736 (0.005%) VAMC slides for review due to inadequate tissue. In contrast, HistoQC in its default configuration excluded 89.9% of VAMC slides because tissue was not detected, but we reduced this to 16.7% with our custom HistoQC configuration. Conclusion: Our surgery prediction AUROC may be a quantitative indicator positively associated with data quality for a dataset. Unless data are poor quality, iQC accurately locates tissue in slides and excludes few slides. iQC is, to our knowledge, the first automated system in computational pathology that validates quality against objective evidence, e.g. surgical procedure data available in the EHR/LIMS, which requires no efforts or annotations from anatomic pathologists. Citation Format: Andrew J. Schaumberg, Michael S. Lewis, Ramin Nazarian, Ananta Wadhwa, Nathanael Kane, Graham Turner, Purushotham Karnam, Poornima Devineni, Nicholas Wolfe, Randall Kintner, Matthew B. Rettig, Beatrice S. Knudsen, Isla P. Garraway, Saiju Pyarajan. iQC: machine-learning-driven prediction of surgery reveals systematic confounds in cancer whole slide images from hospitals by protocol [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3511.

What's in a Name? Replacing Pejorative Terminology in Anatomic Pathology.

Recent changes to medical terminology and nomenclature have made strides to improve ethical integrity in healthcare. Removing tarnished eponymous namesakes and depreciative descriptions from the medical lexicon is a challenging, but righteous undertaking. In this article, the authors propose replacing the pejorative histologic description of "Indian file" with "Tusken Raider file."

Homeopathy for Chronic Non-specific Low Back Pain: Study Protocol for a Randomized, Double-Blind, Crossover, Placebo-Controlled Clinical Trial Investigating the Efficacy of the Biotherapic Lumbar Vertebra (The BIOVERT Trial).

Chronic non-specific low back pain (CNSLBP) lacks identifiable anatomical pathology and effective pharmacological treatment. Alternative approaches in homeopathy, specifically clinical homeopathy, utilize ultra-diluted (potentized) biological products. In Brazil, standardized biotherapics from sheep tissues, particularly fifty-millesimal (LM) potencies of sheep Lumbar Vertebra, have shown promise in alleviating CNSLBP. Our objective is to present the study protocol of a clinical trial that will assess the efficacy and safety of the biotherapic Lumbar Vertebra LM2 in the short-term management of CNSLBP and to estimate its therapeutic duration. A randomized, double-blind, crossover, placebo-controlled clinical trial spanning 8 weeks per participant was designed. Participants will include 120 individuals (aged 20 to 60 years) with clinically diagnosed CNSLBP by the study's physiotherapist. Exclusion criteria are radicular pain, signs of radiculopathy, specific lumbar spine disorders, pregnancy, or puerperium (up to 60 days after delivery). The medical intervention includes participants being randomly assigned to one of two treatment sequences: homeopathy-placebo or placebo-homeopathy. The treatments will consist of Lumbar Vertebra LM2 oral solution, topical cream, and indistinguishable placebos. Each treatment period will span 2 weeks, with a 4-week washout interval between them. Primary outcome is the assessment of changes in self-reported pain levels using the numeric rating scale (NRS) score, analyzed with a random effects model across both treatment periods. Secondary outcomes are assessment of changes in self-reported disability levels using the Oswestry Disability Index (ODI), analyzed with a random effects model across both treatment periods, and pain and disability variations, evaluated by the NRS score and ODI respectively, after the first and second treatment periods. Adverse events will be assessed at weeks 2 and 8. Pain medications will be used concomitantly. Adherence will be evaluated by the weight of medication returned/standard weight. The BIOVERT (Bioactive Vertebra) trial protocol is designed to investigate a homeopathic strategy for short-term CNSLBP treatment. Favorable outcomes for homeopathy could prompt subsequent studies evaluating the long-term effectiveness of LM potencies of Lumbar Vertebra for CNSLBP. UMIN Clinical Trials Registry - ID: UMIN000051957.

Clinicopathological Analysis of Skin Adnexal Tumours: Four Year Retrospective Study

Background: Cutaneous adnexal tumours are rare, heterogeneous, benign, or malignant tumours that differentiate into one or more types of skin appendages. Methods: This is a retrospective study of 68 cases of cutaneous adnexal tumours diagnosed in our anatomical pathology department over 4 years period from September 2019 to September 2023. Results: Benign adnexal tumours are the most common, accounting for an estimated 97% of cases. These tumours are more frequent in male patients aged between 51 and 70 years. The head and neck region is the most affected area (51% of cases). Tumours originating from the sweat glands were the most frequent. Follicular and sebaceous tumours came second and third. Conclusion: Adnexal tumours are a very diverse group of rare neoplasms. Accurate diagnosis is a challenge for the dermatologist and usually requires the histological study.

The accuracy of fine needle aspiration biopsy (FNAB) in diagnosing musculoskeletal lesion

Fine needle aspiration biopsy (FNAB) is a relatively non-invasive diagnosis of musculoskeletal lesions that is very challenging in some musculoskeletal cases. This study aimed to evaluate the diagnostic utility of FNAB in musculoskeletal lesions. This was a retrospective cross-sectional study involving 180 musculoskeletal patients who underwent FNAB procedure, with or without ultrasound-guided in the Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta between 2018 and 2021. The obtained data were then statistically analyzed for sensitivity, specificity, and accuracy. Of 180 cases, 90 (50%) were confirmed with histopathology examination. Further analysis revealed that 33 cases were confirmed positive, 45 patients were true negative, 2 cases were false positive, and 10 were cases false negative. The overall diagnostic sensitivity, specificity, and accuracy of FNAB in musculoskeletal lesions were 76.8, 95.7, and 83%, respectively. FNAB can lead to misinterpretation in cases that show similar morphologic features. Therefore, clinical information and imaging results are necessary to be correlated. In conclusion, FNAB is an efficient and effective technique for early diagnosis in musculoskeletal cases. FNAB can be used to establish the diagnosis of an inoperable tumor because of its high accuracy.

A 21-day safety evaluation of biotechnologically produced 3-fucosyllactose (3-FL) in neonatal farm piglets to support use in infant formulas

3-Fucosyllactose (3-FL) is one of the most abundant fucosylated oligosaccharides in human breast milk and is an approved infant formula ingredient world-wide. 3-FL functions as a prebiotic to promote early microbial colonization of the gut, increase pathogen resistance and modulate immune responses. To investigate safety and potential gut microbiota effects, 3-FL was fed for 21-days to farm piglets beginning on Postnatal Day (PND) 2. Fructooligosaccharide (FOS), an approved infant formula ingredient, was used as a reference control. Standard toxicological endpoints were evaluated, and the gut microbiota were assessed. Neither 3-FL (245.77 and 489.72 mg/kg/day for males and 246.57 and 494.18 mg/kg/day for females) nor FOS (489.44 and 496.33 mg/kg/day males and females, respectively) produced any adverse differences in growth, food intake or efficiency, clinical observations, or clinical or anatomic pathology changes. Differences in the gut microbiota after 3-FL consumption (versus control and FOS groups) included the absence of Bifidobacterium species from the piglets, enrichment of Prevotellamassilia timonensis, Blautia species, Mediterranea massiliensis, Lachnospiraceae incertae sedis, and Eubacterium coprostanoligens and lower relative abundance of Allisonella histaminiformans and Roseburia inulinivorans. This study further supports the safe use of 3-FL produced using biotechnology as a nutritional ingredient in foods.

Reliability Model of Medical Equipment in University of Port Teaching Hospital

In this research, on medical equipment maintainability and reliability we conducted basic statistics analysis using University of Port Harcourt Teaching Hospital as the case study; the data collected covered 18 departments, namely; Anatomical Pathology, Micro Biology, Chemical Pathology Laboratory, Radiography Department, Pediatrics, Hemodialialysis, Hematology and Blood Transfusion, Physiotherapy, Dental Department, MDR-TB unit, Pharmacy, ICU, Assisted Conception Unit, Orthopedic Ward, Care for Elderly Laboratory, Family Planning Unit, Community Medicine and Labour Ward. The results of the parametric Weibull distribution percentile suggested that the reliability of the devices tends to fail every 21 days. The reliability plot of the model indicated that the devices tend to decrease its life span with age, the Weibull model was adequately fitted following the results of Anderson adjust test of goodness of fit and the probability plot. In comparison, the Probability value of goodness of fit P(0.0000) of Weibull distribution model was compared with that of exponential distribution model P(0.034), the outcome showed that Weibull distribution is better to model the data of medical equipment in University of Port Harcourt Teaching Hospital.

The die-hards, negotiators and migrants: Portraits of doctors' career pathways through specialisation.

Global workforce shortages in medical specialties strain healthcare systems, jeopardising patient outcomes. Enhancing recruitment strategies by supporting professional identity (PI) development may be one way to address this workforce gap-yet little research has explored this topic. The goal of the current study was to explore specialty-specific recruitment through considering PI. As proposed causes of workforce shortages in anatomical pathology (AP) bear similarities to many other specialties, this study uses the field of AP as a model for specialist PI development and asks: (1) why, how and when do doctors choose to pursue AP training and (2) what can be learned from this for recruitment to AP and other specialties? A qualitative research approach was undertaken using narrative inquiry. Interviews with junior doctors interested in AP, AP registrars and AP consultants from Australia and New Zealand were interpreted as stories via 're-storying'. Narrative synthesis of participants' collective stories identified chronological key events (i.e. 'turning points') in choosing AP. Narrative synthesis resulted in identification of three portraits entering medical specialist training: (1) die-hards, deciding upon initial exposure; (2) negotiators, choosing after comparing specialties; and (3) migrants, seeking to move away from non-pathology specialties. The negotiators and migrants cemented their decision to pursue AP as a postgraduate doctor, whereas the die-hards made this decision during medical school. Given the similarities in portrait traits between AP and other specialties across the literature, our results suggest ways to support specialty recruitment using PI development. We propose a medical specialist recruitment framework to support the PI development of doctors with die-hard, negotiator and migrant traits. Use of this framework could enhance current specialty-specific recruitment approaches, particularly in fields challenged by workforce shortages.