Working Group Research Articles

Prevalence of geriatric impairments and frailty categorization among real-world patients with multiple myeloma: a prospective cohort study (MFRAIL).

There is limited knowledge regarding the prevalence of geriatric impairments and frailty among patients with multiple myeloma (MM) in a real-world setting. This study evaluated the distribution of frailty profiles among 116 patients with newly diagnosed or relapsed MM, using four common frailty scales. The proportion of patients classified as frail varied significantly, ranging from 15.5% to 56.9%, due to differences in how frailty was operationalized between each frailty measure. Functional, cognitive, and mobility impairments were common overall and irrespective of performance status. Analyses between frailty and treatment selection (dose reduction and doublet vs. triplet therapy) demonstrated significant differences in non-steroid MM drug dose reductions between frail vs. non-frail patients, as scored by the International Myeloma Working Group (IMWG) Frailty Index and Simplified Frailty Score (p<.05). A standardized approach to frailty assessment that is practical in application, and beneficial in guiding treatment selection and minimizing treatment related toxicity is necessary to provide optimal tailored care.

Developing tomorrow's leaders: Self‐esteem and teamwork go hand in hand

A new study published in a special issue of Education Sciences by Elena De Prada, Mercedes Mareque, and Margarita Pino‐Juste finds that there is a “relationship between teamwork skills and the successful development of self‐esteem.” Researchers determined that leadership skills aren’t necessarily innate and can be taught, especially when group work is closely managed. The study's subjects were social science students.

Montessori Approach in Chemistry Teaching at the Lower Level of an Eight-Year High School: Possibilities of Implementing Selected Elements in a Classical School

The article presents the concept of teaching chemistry at the Montessori grammar school, including the possible integration of chemistry into the natural sciences class. The goal of the paper is to introduce to teachers elements of Montessori pedagogy that can be implemented in chemistry teaching at classical schools. The described principles are supplemented with examples of specific materials (e.g. StudyGuide, self-assessment, group work assignments), including a summary of the advantages and disadvantages in the implementation of innovations. The next focus is on describing the phases of learning for developing pupils' knowledge and key competencies, individual and group work and providing feedback, working with a heterogeneous group of learners or justifying the sufficient space for practice and learning.

What is Alzheimer's disease? An analysis of nosological perspectives from the 20th and 21st centuries.

Recent US proposals suggest defining Alzheimer's disease (AD) based on β-amyloidosis alone. This sparked debates that echoed historical ones about the significance of brain lesions and clinical phenotype. This review covers debates on AD nosology through three key periods: AD's discovery in German-speaking countries in the early 20th century, its redefinition in Anglo-Saxon countries in the 1960s-1980s, and current debates on the biological or clinicobiological definitions of AD. Key players' opinions are focused on. At the beginning of the 20th century, AD was defined as a clinicopathological entity. Debates arose around the pathological anchor, which included extended neurofibrillary tangles versus neuritic plaques (Alzheimer vs. Fischer) and its association with senile dementia (Kraepelin). In the 1960s-1980s, the debate shifted towards whether AD could be diagnosed using qualitative or quantitative neuropathological features and whether it was a unique process (Terry and Katzman) or had subtypes (Roth). The current definition proposed by the US Alzheimer's Association is based purely on biological β-amyloid abnormalities and represents a double break: from the historical clinicopathological definition of AD and from the historical emphasis on tau or combined tau and β-amyloid high levels of pathology. Conversely, the clinicobiological proposal of the International Working Group remains aligned with historical concepts of AD. This historical perspective illustrates the unresolved questions surrounding AD pathogenesis, role of lesions, and the clinical phenotype, especially for sporadic cases. The intense nosological debates throughout the history of AD also illustrate the diversity of theoretical frameworks for defining disease in medicine.

Usefulness of the serum creatinine/cystatin C ratio as a blood biomarker for sarcopenia components among age groups in community-dwelling older people: The SONIC study.

The serum creatinine/cystatin C ratio (CCR) or sarcopenia index is considered a useful marker of muscle mass. However, its usefulness in late-stage older adults remains unclear. We aimed to determine the usefulness of CCR as an indicator of sarcopenia in community-dwelling Japanese adults aged >75 years. Our study recruited participants aged 70, 80, and 90 ± 1 years during the baseline years, and included a 3-year follow-up in the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians study. From 2015 to 2018, 955 participants were eligible: 367 in their 70s, 304 in their 80s, and 284 in their 90s. The diagnostic components of sarcopenia, including "low muscle mass, plus low muscle strength, and/or low physical performance," were evaluated using the bioelectrical impedance analysis-measured skeletal muscle mass index (SMI), handgrip strength, and short physical performance battery (SPPB) score, respectively, in accordance with the Asia Working Group for Sarcopenia 2019 criteria. Separate analyses were performed between each component and CCR, adjusting for sex, body mass index, and other blood biomarkers in each group. The relationship between CCR and sarcopenia components was significant for handgrip strength (β = 0.21, 0.13, 0.19, and P < 0.0001, =0.0088, <0.0001, for the 70s, 80s, and 90s age groups, respectively); however, it was limited for SMI (β = 0.14; P = 0.0022, only for the 90s) and not significant for the SPPB score. CCR is a limited indicator of sarcopenia in late-stage older adults. Although its association with muscle strength was significant, its relationship with muscle mass and physical performance was less pronounced. Geriatr Gerontol Int 2024; ••: ••-••.

Household Air Pollution Interventions to Improve Health in Low- and Middle-Income Countries: An Official American Thoracic Society Research Statement.

Background: An estimated 3 billion people, largely in low- and middle-income countries, rely on unclean fuels for cooking, heating, and lighting to meet household energy needs. The resulting exposure to household air pollution (HAP) is a leading cause of pneumonia, chronic lung disease, and other adverse health effects. In the last decade, randomized controlled trials of clean cooking interventions to reduce HAP have been conducted. We aim to provide guidance on how to interpret the findings of these trials and how they should inform policy makers and practitioners.Methods: We assembled a multidisciplinary working group of international researchers, public health practitioners, and policymakers with expertise in household air pollution from within academia, the American Thoracic Society, funders, nongovernmental organizations, and global organizations, including the World Bank and the World Health Organization. We performed a literature search, convened four sessions via web conference, and developed consensus conclusions and recommendations via the Delphi method.Results: The committee reached consensus on 14 conclusions and recommendations. Although some trials using cleaner-burning biomass stoves or cleaner-cooking fuels have reduced HAP exposure, the committee was divided (with 55% saying no and 45% saying yes) on whether the studied interventions improved measured health outcomes.Conclusions: HAP is associated with adverse health effects in observational studies. However, it remains unclear which household energy interventions reduce exposure, improve health, can be scaled, and are sustainable. Researchers should engage with policy makers and practitioners working to scale cleaner energy solutions to understand and address their information needs.

“Online Teaching in Times of COVID-19 in India and Palestinian Universities: Challenges and Antidotes"

Purpose&#x0D; Covid-19 pandemic has influenced universities across the world to make an abrupt shift from face-to-face teaching to digital/online teaching. The present paper investigates challenges experienced by Indian and Palestinian universities while teaching online in times of Covid-19 pandemic.&#x0D; Design/methodology/approach&#x0D; Data was collected from instructors of four Palestinian and Indian universities using a semi-tailored electronic questionnaire and analyzed using SPSS.&#x0D; Findings&#x0D; Results showed that unique challenges experienced by four Palestinian and four Indian universities’ instructors when teaching online during the Covid-19 pandemic include difficulty in receiving feedback from students in online classes compared to traditional face-to-face classes; difficulty in categorizing students into sub-groups to facilitate group working; and unfavorable online environment at home because of the presence of other family members and children. On the basis of this study’s findings, universities should prepare for future crises by ensuring instructors are competent and have knowledge in information communication technologies (ICT) as well as take into consideration the development and enhancement of the quality of online (virtual) courses delivered during emergencies.&#x0D; Originality&#x0D; This paper aims to research the implications involved in online teaching and online learning. Through data collection, this research paper was able to measure the impact and suggest recommendations.&#x0D; Practical implications&#x0D; Study in the research will contribute to overcome the challenges of stakeholders involved in education profession. Online teaching and learning, both had its own challenge and discomfort whilst implementing it.&#x0D; Social implications&#x0D; This research will help to strengthen the bond between educators and learners. Online teaching and learning created an unsaid interest and dilution in education world. This research can pave the way to develop better understanding between stakeholders.

Taking action for Athlete wellbeing: strengthening psychosocial support through interactive group work

ABSTRACT This article provides an exploration into the social context of elite sport and details how a participatory action research methodology was used to develop, deliver, and evaluate two interactive group work interventions, “connection workshops” and “mental health literacy training.” Located within a professional Australian National Rugby League (NRL) and designed to strengthen the psychosocial support available to athletes within the high-performance environment, four connection workshops and three mental health literacy training sessions were facilitated within “The Club.” Qualitatively evaluated through seventeen one-on-one semi-structured interviews with athletes, coaches, and support staff, results indicated that these programs had strengthened the presence of psychosocial protective resources within the high-performance environment, with an increase in athletes’ help-seeking behavior resulting from improved accessibility and quality of interpersonal supports.

Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients—Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC)

Adequate medical nutrition therapy for critically ill patients has an impact on their prognoses. However, it requires an individualized approach that takes into account the activity (phases of metabolic stress) and particularity of these patients. We propose a comprehensive strategy considering the patients’ nutritional status and the set of modifiable circumstances in these patients, in order to optimize/support nutritional efficiency: (1) A detailed anamnesis and an adequate initial nutritional assessment must be performed in order to implement medical nutrition therapy that is in line with the needs and characteristics of each patient. Furthermore, risks associated with refeeding syndrome, nutritrauma or gastrointestinal dysfunction must be considered and prevented. (2) A safe transition between nutrition therapy routes and between health care units will greatly contribute to recovery. The main objective is to preserve lean mass in critically ill patients, considering metabolic factors, adequate protein intake and muscle stimulation. (3) Continuous monitoring is required for the successful implementation of any health strategy. We lack precise tools for calculating nutritional efficiency in critically ill patients, therefore thorough monitoring of the process is essential. (4) The medical nutrition approach in critically ill patients is multidisciplinary and requires the participation of the entire team involved. A comprehensive strategy such as this can make a significant difference in the functional recovery of critically ill patients, but leaders must be identified to promote training, evaluation, analysis and feedback as essential components of its implementation, and to coordinate this process with the recognition of hospital management.

The Role of High-Resolution Manometry Prior to and Following Antireflux Surgery: The Padova Consensus.

In the last two decades the development of high-resolution manometry (HRM) has changed and revolutionized the diagnostic assessment of patients complain foregut symptoms. The role of HRM before and after antireflux procedure remains unclear, especially in surgical practice, where a clear understanding of esophageal physiology and hiatus anatomy is essential for optimal outcome of antireflux surgery (ARS). Surgeons and gastroenterologists (GIs) agree that assessing patients following antireflux procedures can be challenging. Although endoscopy and barium-swallow can reveal anatomic abnormalities, physiologic information on HRM allowing insight into the cause of eventually recurrent symptoms could be key to clinical decision making. A multi-disciplinary international working group (14 surgeons and 15 GIs) collaborated to develop consensus on the role of HRM pre- and post- ARS, and to develop a postoperative classification to interpret HRM findings. The method utilized was detailed literature review to develop statements, and the RAND/University of California, Los Angeles Appropriateness Methodology (RAM) to assess agreement with the statements. Only statements with an approval rate >80% or a final ranking with a median score of 7 were accepted in the consensus. The working groups evaluated the role of HRM prior to ARS and the role of HRM following ARS. This international initiative developed by surgeons and GIs together, summarizes the state of our knowledge of the use of HRM pre- and post-ARS. The Padova Classification was developed to facilitate the interpretation of HRM studies of patients underwent ARS.

Recovery Animals in Toxicology Studies: An Innovation and Quality Consortium Perspective on Best Practices With Case Study Examples.

The inclusion of recovery animals in nonclinical safety studies that support clinical trials is undertaken with a wide diversity of approaches even while operating under harmonized regulatory guidance. While empirical evaluation of reversibility may enhance the overall nonclinical risk assessment, there are often overlooked opportunities to reduce recovery animal use by leveraging robust scientific and regulatory information. In the past, there were several attempts to benchmark recovery practices; however, recommendations have not been consistently applied across the pharmaceutical industry. A working group (WG) sponsored by the 3Rs Translational and Predictive Sciences Leadership Group of the IQ Consortium conducted a survey of current industry practice related to the evaluation of reversibility/recovery in repeat dose toxicity studies. Discussion among the WG representatives included member company strategies and case studies that highlight challenges and opportunities for continuous refinements in the use of recovery animals. The case studies presented in this paper demonstrate increasing alignment with the Society of Toxicologic Pathology recommendations (2013) towards (1) excluding recovery phase cohorts by default (include only when scientifically justified), (2) minimizing the number of recovery groups (e.g., control and one dose level), and (3) excluding controls in the recovery cohort by leveraging external and/or dosing phase data. Recovery group exclusion and decisions regarding the timing of reversibility evaluation may be driven by indication, modality, and/or other scientific or strategic factors using a weight of evidence approach. The results and recommendations discussed present opportunities to further decrease animal use without impacting the quality of human risk assessment.

Incorporating equity, diversity, and inclusion into the epidemiology and biostatistics curriculum: A workshop report and implementation strategies recommendations.

There is an obligation among those teaching epidemiology to incorporate principles of equity, diversity, and inclusion (EDI) into the curriculum. While there is a well-established literature related to teaching epidemiology, this literature rarely addresses critical aspects of EDI. To our knowledge, there is no working group or central point of discussion and learning for incorporating EDI into epidemiology teaching in Canada. To address this gap, we convened a workshop entitled "Incorporating EDI into the epidemiology and biostatistics curriculum and classroom." The workshop discussed nine strategies to incorporate EDI in the epidemiology curriculum: positionality (or reflexivity) statements; opportunities for feedback; land acknowledgements; clarifying the purpose of collecting data on race and ethnicity, sex and gender, Indigeneity; acknowledgingthat race/ethnicity is asocial construct, not a biological variable; describing incidence and prevalence of disease; demonstrating explicit bias using directed acyclic graphs (DAGs); critical appraisal of study population diversity; and admission criteria and considerations. Key take-aways from the workshop were the need to be more intentional when determining the validity of evidence, particularly with respect to historical context and the need to recognize that there is no single solution that will address EDI.

Use of Darvadstrocel (Allogenic Stem Cell Therapy) for Crohn's Fistulas in Real Clinical Practice: The National Project to Implement Mesenchymal Stem Cell for the Treatment of Perianal Crohn's Fistula (the PRIME Study).

Perianal fistulas may affect 15-50% of patients with Crohn's disease. Treatment is complex, requiring a multidisciplinary approach. Darvadstrocel (allogenic mesenchymal cells obtained from lipoaspirates) was approved in 2018 by the European and Spanish Agencies of Medicines and Medical Products as a treatment for fistulas in Crohn's disease. Recent European Crohn's and Colitis Organisation and Spanish Working Group on Crohn's Disease and Ulcerative Colitis guidelines state that darvadstrocel is effective with a favorable safety profile and a strong level of evidence (2). Presenting real-world effectiveness data for darvadstrocel in a Spanish population. Observational retrospective cohort study with prospective data gathering. Fourteen institutions. From November 2019-April 2022, all patients (73) treated with darvadstrocel in these institutions were included, fulfilling the following criteria: 1) complex fistula/s in a patient with Crohn's disease; 2) failure of conventional and antitumor necrosis factor treatment; 3) absence of collections >2 cm confirmed by pelvic MRI scan at the time of surgery. Darvadstrocel treatment. Clinical response (closure of ≥50% of external openings), complete clinical closure (100% of external openings) and radiological closure (no fluid collection >2 cm, no edema or inflammation) evaluated 6 months after treatment. Clinical response was observed in 63 patients (86.3%), complete clinical closure in 50 patients (68.5%) and radiological closure in 45 patients (69.2%). Combined clinical and radiological response was observed in 41 patients (63.1%). Not all clinically healed patients had radiological closure and vice versa. No serious adverse events were reported. Retrospective. Study results were consistent with those reported in previous clinical trials, real-world efficacy findings from the INSPIRE study (assessing darvadstrocel effectiveness in Europe, Israel, Switzerland, UK, and Japan) and previously published literature. Darvadstrocel was effective and demonstrated a favorable safety profile when used in normal clinical practice for treatment of fistulas in Crohn's disease. See Video Abstract.

[Update of the German S3 guideline on renal cell carcinoma].

Renal cell carcinoma is the third most common tumor among urological tumors. In Germany more than 14,000 people are affected every year. The sex ratio is 2/3men and 1/3women. The S3guideline is intended to provide all disciplines dealing with renal cell carcinoma with the current status of diagnostics, therapy and follow-up care of the patients with this tumor. The first version of the German guideline on renal cell carcinoma was published in 2015. The development was carried out at S3level, which means that astructured, evidence-based literature search was carried out, recommendations and statements were developed in topic-related working groups and were approved by an interdisciplinary group of officials elected by the different medical societies. The chapters were gradually revised in 2017, 2020 and 2021 to reflect new aspects. This article provides information about the most important innovations of the most recent update from 2023. In the epidemiology subsection, the substance trichlorethene has been added as arisk factor for the development of renal cell carcinoma. While there were no new data on neoadjuvant therapy, the checkpoint inhibitor pembrolizumab was the first substance to demonstrate improved disease-specific and overall survival in the adjuvant situation. The combination nivolumab plus cabozantinib and lenvatinib plus pembrolizumab were included in the chapter on systemic therapy for metastatic clear cell renal cell carcinoma. New are the chapters on non-clear cell renal cell carcinoma and hereditary tumors. The S3guideline provides astructured, evidence-based overview of all aspects of renal cell carcinoma.

Improved Re-Parameterized Convolution for Wildlife Detection in Neighboring Regions of Southwest China

To autonomously detect wildlife images captured by camera traps on a platform with limited resources and address challenges such as filtering out photos without optimal objects, as well as classifying and localizing species in photos with objects, we introduce a specialized wildlife object detector tailored for camera traps. This detector is developed using a dataset acquired by the Saola Working Group (SWG) through camera traps deployed in Vietnam and Laos. Utilizing the YOLOv6-N object detection algorithm as its foundation, the detector is enhanced by a tailored optimizer for improved model performance. We deliberately introduce asymmetric convolutional branches to enhance the feature characterization capability of the Backbone network. Additionally, we streamline the Neck and use CIoU loss to improve detection performance. For quantitative deployment, we refine the RepOptimizer to train a pure VGG-style network. Experimental results demonstrate that our proposed method empowers the model to achieve an 88.3% detection accuracy on the wildlife dataset in this paper. This accuracy is 3.1% higher than YOLOv6-N, and surpasses YOLOv7-T and YOLOv8-N by 5.5% and 2.8%, respectively. The model consistently maintains its detection performance even after quantization to the INT8 precision, achieving an inference speed of only 6.15 ms for a single image on the NVIDIA Jetson Xavier NX device. The improvements we introduce excel in tasks related to wildlife image recognition and object localization captured by camera traps, providing practical solutions to enhance wildlife monitoring and facilitate efficient data acquisition. Our current work represents a significant stride toward a fully automated animal observation system in real-time in-field applications.

&lt;span&gt;&lt;strong&gt;TESOL-major students&amp;rsquo; perceptions and practices on group autonomy at Dong Thap University&lt;/strong&gt;&lt;/span&gt;

For decades, researchers around the world have expressed concern about group autonomy outside the classroom. However, this topic has received little attention in the Mekong Delta of Vietnam. To address this gap, a study was conducted with 107 first-year TESOL-major students in the Foreign Languages Faculty at Dong Thap University. They were invited to complete a set of questionnaires to explore their perceptions and practices regarding group autonomy behind class. The findings revealed that the majority of students understood the importance and role of group autonomy in their learning process. However, the results also indicated that just half of them could learn autonomously without teacher requirements, and group work frequency was quite low. This study provides valuable insights into the literature on autonomous learning in the local context.

More frequent utilization of evidence-based teaching practices leads to increasingly positive student outcomes

IntroductionEvidence-based teaching (EBT) practices benefit students, yet our understanding of how frequently these strategies should be utilized in STEM courses is less established.MethodsIn this study, students (n = 894) of faculty who learned about how to implement EBTs from the Summer Institutes for Scientific Teaching were surveyed. The students rated the frequency of implementation of six types of EBTs after the course and completed a follow-up survey one year later to examine long-term outcomes.ResultsClass and student-level analyses indicated that students who reported being exposed to EBTs every couple of classes also reported that they learned more and had a higher ability to work in groups when compared to students who were exposed to EBTs less frequently.DiscussionThe results will help instructors and faculty development professionals understand how frequently EBTs should be incorporated when designing and modifying courses.

Responsibility of commitment making officials in government procurement of goods/services

The implementation of good governance is the main prerequisite for carrying out state goals, especially in providing public welfare. In line with the large demands of society for the implementation of good governance, the government must provide quality public services. In this regard, development planning is needed that is systematic, directed, comprehensive, and responsive to the dynamics of community needs. In the government's efforts to provide public services, it is necessary to develop and implement a real legal accountability system for the implementation public services, so that the implementation of government and development can take place in an efficient, clean and accountable manner. The responsibility of Commitment Making Officials in the procurement of government goods/services consists of administrative responsibility and criminal responsibility. Administrative responsibility occurs if an administrative violation occurs, and will be subject to administrative sanctions. Meanwhile, criminal liability means the possibility that a criminal act has occurred and can be subject to criminal sanctions.  However, this responsibility can also be imposed on other officials involved in the procurement of goods/services, such as Budget Users, Budget User Proxies, Procurement Officials/Election Working Group, as long as their involvement in the criminal act can be proven.

Association of Performance on Multiple Cognitive Domains with Sarcopenia Among Middle-aged and Older Adults.

The relationship between cognitive function and subsequent sarcopenia remains unclear. Therefore, this study aimed to examine the associations of performance on multiple cognitive domains with sarcopenia in the middle-aged and older adults. This longitudinal analysis (wave 2011-2013) included 2934 participants from the CHARLS study. Sarcopenia was defined by the Asian Sarcopenia Working Group 2019 criteria. Cognitive function was measured by the Chinese version of the Mini-Mental State Examination (MMSE). Three interpretable techniques, namely SHapley Additive exPlanations (SHAP) and two built-in methods (coefficients of logistic regression and Gini importance of random forest), were used to assess the relationship between MMSE, its components (orientation, attention, episodic memory, and visuospatial ability) and sarcopenia. In addition, the association of MMSE score and its components with sarcopenia was further validated using stepwise regression. All interpretable methods showed that MMSE score was important predictors for sarcopenia, especially for SHAP (MMSE score ranked top one). For its components, episodic memory, visuospatial ability, and attention showed high predictive value compared with orientation. Stepwise regression analyses showed that MMSE score and its components of episodic memory and visuospatial ability were correlated with sarcopenia, with their odds ratios of 0.93 (95% CI: 0.91-0.96, p<0.001), 0.87 (95% CI: 0.82-0.93, p<0.001), and 1.32 (95% CI: 1.05-1.65, p=0.016), respectively. Better cognitive function especially episodic memory and visuospatial ability was negatively associated with incident sarcopenia among community middle-aged and older adults.

Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary.

Blood Sampling Guidelines have been developed totarget European emergency medicine-related professionals involved in the blood sampling process (e.g.physicians, nurses, phlebotomists working in the ED), as well as laboratory physicians and other related professionals. Theguidelines population focus on adult patients. The development of these blood sampling guidelines for the EDsetting isbased on the collaboration of three European scientific societies that have a role toplay in the preanalytical phaseprocess: EuSEN, EFLM, and EUSEM. The elaboration of the questions was doneusing the PICO procedure, literature search and appraisal was based on the GRADE methodology. The final recommendations were reviewed by an international multidisciplinary external review group. The document includes the elaborated recommendations for the selected sixteen questions. Three in pre-sampling, eight regarding sampling, three post-sampling, and two focus on quality assurance. In general, the quality ofthe evidence is very low, and the strength of the recommendation in all the questions has been rated as weak. The working group in four questions elaborate the recommendations, based mainly on group experience, rating as good practice. The multidisciplinary working group was considered one of the major contributors to this guideline. The lack of quality information highlights the need for research in this area of the patient care process. The peculiarities of the emergency medical areas need specific considerations to minimise the possibility of errors in the preanalytical phase.