Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory condition that may affect any organ. Prostatic involvement is uncommon and under-recognised. The presentation often mimics benign prostatic hyperplasia or prostate carcinoma, causing diagnostic uncertainty. This systematic review synthesises evidence on IgG4-related prostatitis, focusing on clinical manifestations, diagnostic approaches, treatment, and outcomes. Following PRISMA 2020 guidelines, PubMed, Scopus, Web of Science, and Ovid were searched from inception to 12 February 2025. Eligible studies included English-language case reports, case series, and observational studies describing prostatic involvement in IgG4-RD. Data on demographics, clinical and laboratory findings, management, and outcomes were extracted and analysed descriptively. Fifty studies reporting 66 cases were included. Median age was 64 years (range 20-82). Serum IgG4 concentrations were elevated in most (median 832 mg/dL, range 5-4,500), while prostate-specific antigen (PSA) levels varied widely (0.01-180 ng/mL). Multiorgan involvement occurred in 57.8%, isolated disease in 6.2%. Lower urinary tract symptoms were most frequent (39.6%). Glucocorticoids, mainly prednisone, were the main therapy (69.2%), followed by surgery, chiefly transurethral resection of the prostate. Complete and partial responses occurred in 50.9% and 43.4%. Treatment type correlated with outcome (χ²=49.70; p<0.001). Malignancy (18.5%) was associated with higher mortality (p=0.028). IgG4-related prostatitis is a rare and likely under-recognised manifestation of IgG4-RD. Its overlap with benign and malignant prostatic disorders delays diagnosis. Serum IgG4 and PSA are unreliable markers of disease and monitoring. Glucocorticoids remain first-line therapy, with surgery in obstructive cases. Multicentre studies are needed to define prevalence, natural history, and optimal management.

Introduction: In the new ISO 15189:2022 standard, risk management in the clinical laboratory has been hugely emphasized. The purpose of detailed risk analysis and management is to eliminate the known risk factors as much as possible and to minimize the residual risk to an acceptable level. We chose to give precedence to plasma-based tests for Prothrombin time (PT) and activated partial thromboplastin time (aPTT) to conduct a more thorough risk analysis. These tests involve multiple sensitive steps and are overly critical for patient care as test results are self-sufficient to start the treatment. Methods: We applied risk control measures using FMEA (failure mode and effects analysis) based risk analysis process in every step including all phases of the testing process. Results: Many risk factors were identified; control measures and continuous surveillance processes were put in place to avoid recurrence of high-risk events that could affect the test results. Conclusion: It was concluded that with stringent risk management processes in place, risk could be reduced significantly thus minimizing the impact on patient results.

Many andrologists put more attention on the predictive factors of successful sperm extraction in testicular sperm aspiration (TESA) or microdissection testicular sperm extraction (micro-TESE), while the importance of laboratory processing of testicular tissue has been neglected. In fact, for non-obstructive azoospermia (NOA) patients, laboratory procedure of testicular tissue is as important as the surgery itself to find testicular sperm, yet there is no standard procedure for laboratory management of testicular tissue. To establish a laboratory processing for testicular tissue, and to further evaluate the effectiveness of enzymatic digestion and staining for NOA patients with no spermatozoa found after mechanical mincing. We enrolled 811 patients who underwent TESA or micro-TESE from July 2023 to December 2024, among whom 466 were diagnosed with obstructive azoospermia and 345 were diagnosed with NOA. The main outcome measure was the sperm retrieval rate (SRR) after enzymatic digestion and the sperm detection rate (SDR) after staining. In this study, testicular spermatozoa was found after mincing in 466 TESA patients (466/583, 79.9%) and 74 micro-TESE patients (74/228, 32.5%). Of the 237 patients for whom spermatozoa were not identified after mincing, spermatozoa were detected in 55 (23.21%) patients after enzyme digestion and staining. The additional SRR contributed by enzymatic digestion alone was 13.1%, while staining contributed an additional SDR of 10.1%. Using multivariable logistic regression analysis, the seminiferous tubule diameter was the only predictor of identifying spermatozoa in NOA patients after enzymatic digestion and staining. In conclusion, we establish a three-step laboratory processing method for testicular tissue. This study provides strong evidence that enzymatic digestion improves SRR in NOA patients, while staining contributes additional detection value (SDR) when mechanical processing fails, the combined additional value of enzymatic digestion and staining is 23.2%, although only enzymatic digestion contributes to SRR. What is more, the current study showed that seminiferous tubule diameter is a powerful predictor for sperm retrieval, offering real-time, actionable intraoperative guidance. However, the single-center design and lack of live birth outcome data limit the external validity and generalizability of this study.

Indoor air pollution poses serious health risks, especially in enclosed pharmaceutical laboratories due to volatile organic compounds (VOCs). This study evaluates Air Phytoremediation (AP) as a sustainable mitigation strategy using four indoor plant species: Epipremnum aureum, Chlorophytum comosum, Syngonium podophyllum, and Cordyline fruticosa. The removal efficiency of VOCs Benzene, Toluene, Benzaldehyde, and Acetophenone was assessed across various environments, including incubator chambers, laminar airflow cabinets, and a pharmaceutical organic lab. VOC reduction was measured by percentage removal, leaf area, and total weight absorbed. The initial concentration for each VOC was ranged between 10 and 8 ppm for (benzene, toluene, benzaldehyde, and acetophenone). The leaf area per plant species was determined using ImageJ software and ranged between 771.39 and 1471.77 cm2. The exposure duration was standardized at 40 min, corresponding to a realistic laboratory session Cordyline fruticosa showed the highest VOC removal efficiency at 87.5%, reducing the mean VOC concentration from 2.92 ± 0.54 ppm to 0.36 ± 0.14 ppm. Syngonium podophyllum followed with an 81.69% removal efficiency, reducing VOCs to 0.72 ± 0.17 ppm. Epipremnum aureum and Chlorophytum comosum showed removal efficiencies of 77.23% and 62.5%, respectively. Cordyline fruticosa and Syngonium podophyllum can reduce TVOC, CO2, CO, PM2.5, and PM10 levels by 87.5%, 88.23%, 36.78%, 100%, and 100%, respectively .A combined application of Cordyline fruticosa and Syngonium podophyllum in Plant-Based Bio-Filters (PBBFs) significantly improved indoor air quality. These findings highlight the potential of AP as a natural, cost-effective solution for VOC mitigation, offering a practical approach to environmental management and sustainable indoor design in laboratory settings.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-30145-8.

World Health Organization recommends task sharing (TS) for point-of-care testing (POCT) with lay health workers (LHW) to improve access when professional capacity is limited. Despite many benefits of POCT, TS remains underutilized. This study examined uptake of TS for POCT in national policies and the implementation landscape in 19 African countries from November 2024 to March 2025. A mixed-methods approach included an online cross-sectional survey with stakeholders (national ministries of health, medical associations, private laboratories, implementation supporting partners, LHWs); review of national health strategic and policy documents and key informant interviews (KII) with national laboratory directors. Standardized emails recruited participants, whilst documents came from requests and online searches. Quantitative data were analysed descriptively, and KII data with framework analysis. Of 217 policy documents collected, 197 (91%) were relevant. Over half of national health strategic plans (10/19; 53%) recognize LHWs as vital for expansion of primary healthcare services, but fewer (7/19; 37%) mention TS. While 58% (11/19) of national laboratory strategic plans aimed to expand POCT access and quality, 84% did not mention LHW to support TS. Among national HIV/AIDS strategic plans, 53% (9/17) referenced TS for POCT, mainly for HIV diagnosis; with only one addressing POCT for advanced HIV disease. Outside HIV and malaria, LHW POCT was rarely emphasised in disease-specific strategic plans. Seventy-five stakeholders (67% male) completed the online survey, and six KII were conducted. All reported that LHW conduct POCT, mainly with donor-support. HIV rapid testing was cited as having the most structured training program. National laboratory leaders acknowledged implementation challenges but saw opportunities to expand LHW-led POCT. Shifting from fragmented, disease-specific approaches to multi-disease TS model is crucial for sustainable POCT. Coherent policy and implementation reforms are needed to institutionalize TS amid declining resources. National laboratory leadership should drive the adoption of training and quality assurance for TS for multi-disease POCT.

ABSTRACT This ethnographic study examines how anatomical professionals – laboratory managers, technicians, funeral directors, and faculty – navigate the dual status of whole-body donors as both educational tools and enduring persons. Drawing on fieldwork and interviews at a North American medical school, the research explores how donor personhood is sustained, contested, or redefined through daily practices, institutional protocols, and symbolic gestures. Grounded in symbolic interactionism and Mead’s concept of role-taking, the study shows how actions such as covering donor faces, using gendered pronouns, and resisting the placement of bodies on the floor reflect a persistent ethical engagement with the dead. An analysis of an institutional ethics committee further reveals how professionals negotiate the legacy of unconsented remains and evolving standards of dignity. By centring the perspectives of custodians, this work highlights the moral labour behind anatomical education and calls for greater institutional recognition and ethical clarity in the handling of human remains. The study concludes that personhood persists beyond death through relational and ritual practices, and that custodianship is a critical site of ethical meaning-making in medical education.

International mobility and collaborations are a cornerstone of the academic career trajectory, as well as a pathway to better science. The aim of this article is to advocate for enhancing global connections among early career investigators to improve science and accelerate addiction research discovery. Drawing from the author's experiences, we provide specific recommendations to help addiction researchers create international exchange programs for early career investigators. The program consisted of four key components: (1) pre-exchange participant matching of early career investigators at each institution, (2) individualized goal setting for participants, (3) a structured orientation program on the first day of the in-person exchange, and (4) two weeks of research-focused, in-person collaborations and networking activities. Quantitative and qualitative data are presented, including 2-year outcomes from the program (N=8). The exchange program had both immediate and sustained impacts on professional development and research productivity. Participants reported increased confidence in international collaboration, a broadened global perspective, and enhanced scholarly output, with all participants emphasizing the critical importance of in-person interaction. Two years post-exchange, participants reported a more than threefold increase in internationally co-authored publications, a newly awarded international grant, and the establishment of four new formal mentorship relationships. All participants reported a change in their research focus, scientific approach, or lab management practices due to the exchange program. Unexpected benefits included strengthened collaboration within home research teams and the emergence of broader institutional partnerships in both the U.S. and Australia. Understanding and addressing addiction requires a global perspective, and engaging early career researchers in international exchange programs can foster lasting collaborations and encourage globally-focused research. Even short-term exchanges can be cost-effective in promoting long-term productivity in international addiction research.

The implementation of Indonesia’s Government Regulation Number 11 of 2018 concerning Procedures for Organising Remote Sensing Activities (PP 11/2018) is expected to serve as the legal basis to ensure the national availability of remote sensing data through activities such as data acquisition, data processing, data storage and distribution, as well as data utilisation and information dissemination. Governmental institutional changes in Indonesia may introduce dynamics in the implementation of remote sensing. This paper aims to evaluate the effectiveness of the implementation of the regulation concerning procedures for organising remote sensing activities over the past five years. This research employed a qualitative approach by adapting a framework based on the effectiveness dimensions of the Regulation of the Head of Badan Pembinaan Hukum Nasional (BPHN) concerning guidelines for the evaluation of legislative regulations, which were then analysed within three levels of policy hierarchy, namely policy, organisational, and operational. The research findings indicated that the effectiveness of implementation of remote sensing government regulation in Indonesia under the new institutional governance has impacted services to stakeholders. At the organisational level, the strengthening of remote sensing infrastructure management by the Directorate of Laboratory Management through the preparation of special schemes related to remote sensing infrastructure repair is still experiencing obstacles. Meanwhile, at the operational level, the Chairman needs to address the Directorate of Laboratory Management, Research Facilities, and Science and Technology Areas to update the outdated remote sensing data catalogues.

Accurate assay of neonatal bilirubin requires both laboratory and clinical oversight that should be meticulous, comprehensive and continual. Clinicians are provided knowledge resources to engage in an ongoing dialogue with their clinical chemistry laboratory directors to achieve institutional accuracy and optimal performance standards for bilirubin quantification. Clinicians will respond to out-of-range bilirubin values with precision and seek accurate and validated reliability.

TLR8 gain-of-function (GOF) somatic variants were recently identified as causing severe neutropenia, lymphoproliferation, and immune dysregulation. We report the expanded clinical and laboratory phenotype and management of 10 patients, including the original cohort of 6 male patients. We identify the first female patient with TLR8 GOF who presented during infancy with pure red cell aplasia due to a germline TLR8 variant, and two new disease-causing somatic variants in male patients. Eight patients had somatic mosaicism with peripheral blood variant allele fractions of 7-26% and age of disease onset of 9 months to 28 years. All patients had neutropenia, most with severe neutropenia refractory to medical therapy. Anemia and thrombocytopenia were common. Bone marrow characteristically demonstrated severe myeloid hypoplasia and activated T-cell infiltrates and/or aggregates. An increased number of large granular lymphocytes (LGLs) were identified in five patients. Seven patients underwent allogeneic hematopoietic cell transplantation (HCT). High rates of post-HCT cytopenia of unclear etiology and graft-versus-host disease were observed. Five are surviving at 1 to 3 years post-HCT with full donor myeloid and T-cell chimerism and resolution of disease phenotype. The two patients who presented during childhood and did not undergo HCT ultimately died from disease. In conclusion, TLR8 GOF is an X-linked dominant disorder that should be considered in male and female patients with cytopenia, particularly severe neutropenia, lymphoproliferation with immune dysregulation, increased LGLs, and new to this cohort, red cell aplasia. Disease is refractory to medical management, and curative, allogeneic HCT should be considered early after diagnosis. (NCT04339777).

Vocational education in Indonesia is currently experiencing rapid growth due to increasing interest from students. Politeknik Negeri Balikpapan is one of the vocational campuses in Indonesia that emphasizes practical learning over theoretical instruction. Practical learning, of course, requires various equipment and materials to support activities, especially in the Mechanical Engineering laboratory. The laboratory in the Mechanical Engineering Department, currently known as the Workshop, consists of several pieces of equipment inventory, both government-owned and grant-based. The inventory process in the Mechanical Engineering laboratory is still carried out manually by checking each piece of equipment every six months. This manual process is time-consuming and does not provide real-time information about whether the equipment is in good condition or damaged. Based on this issue, the development of an equipment inventory website for the Mechanical Engineering Department Workshop at Politeknik Negeri Balikpapan is crucial to facilitate inventory management. The inventory website is also expected to include updates on equipment condition, quantity, year of procurement, and maintenance history. Additionally, the website is expected to synchronize the data between the Mechanical Engineering laboratory managers and the state-owned asset managers at Politeknik Negeri Balikpapan.

The doctorate in clinical laboratory sciences: current status and outcomes

The history of the University of Puerto Rico (UPR) Surgical Research Laboratory was reviewed from its founding in 1952, by Dr. Francisco Raffucci, to the present. The information for this overview was obtained from the annual reports written by the surgical laboratory directors. Interviews with surgeons who worked in the early facilities, and published works, provided the early history for which no annual reports were available. The history of the laboratory begins at the former School of Tropical Medicine, under the direction of Dr. Francisco Raffucci (1952-1964). The laboratory was housed in a small building on the school grounds. Research in cardiovascular surgery, shock and transplantation was performed and published. The facility was later moved to a wooden building at the Medical Center, a medical complex in San Juan, Puerto Rico and was directed by Dr. Leovigildo Cuello (1964-1967), followed by Dr. Gerhart Ramírez Schon (1969-1972). Under Dr. Eduardo Santiago-Delpín (1972-1977) the laboratory was moved to the tenth floor of the UPR School of Medicine. Subsequent directors of the laboratory at the school of medicine were Dr. Pedro Roselló (1977-1983), Dr. Norma Cruz (1983-2004), Dr. Manuel Más (2000-2015), Dr. Aura Delgado (2015-2017), Dr. Enrique Márquez (2017-2018) and Dr. Anwar Abdul-Hadi (2018-2024), who still leads the laboratory. Currently, the facility is used in collaboration with equipment manufacturers as a surgical simulation center and on various research. The Surgical Research Laboratory continues training surgeons to use new surgical devices and supporting research projects.

The Human Capital Decision Intelligence (HDCI) system integrates human-computer interaction in a microbiology laboratory that uses machine learning and operational research to classify new tasks and then recommend assignments to each person. The models evaluated in building this system are Support Vector Machine, Gaussian Naive Bayes, Multinomial Logistic Regression, and Artificial Neural Network. The results of the research show that the ANN model is the most consistent and reliable across various training ratios, as indicated by the model's goodness parameters. The selected ANN model is combined with a linear programming approach to optimize workload distribution. The integrated system successfully manages new job scenarios and recommends staff based on competencies and availability. It also ensures assignments do not exceed maximum workload limits and finds alternatives when key staff are unavailable. The implementation of the HDCI system has a positive impact on various factors, including the fair distribution of tasks, enhanced staff performance monitoring, and significantly improved operational efficiency and human resource management in the microbiology laboratory. The system is designed to be easy to use and support collaboration between laboratory staff and computational models. The system is not only advanced in supporting personnel management decision-making, but it can also demonstrate how artificial intelligence and operations research systems can be combined to address the needs of the microbiology laboratory environment.

Manual laboratory operation is costly, slow, and difficult to audit. This paper introduces Lab Autonomy, an architecture that combines ESP32‑based edge control, a secure Node.js WebSocket core, and a dual‑database design (PostgreSQL for identity and audit; Influx DB for metrics) behind a Next.js dashboard. We also expose an OPC UA interface to align with industrial interoperability. In evaluations, round‑trip command latency averaged 110 m-s under favorable network conditions, the control loop consistently met a sub‑200 m-s target, and prototype scaling to 50 concurrent devices showed predictable, manageable latency growth with modeling up to 100 devices per server. Scenario modeling further indicates 15–18% energy savings from scheduling, occupancy cues, and closed‑loop verification. These results indicate that low‑cost edge hardware, when paired with persistent messaging and principled data separation, can deliver a secure and extensible platform for lab management.

Background/Objectives: The objective of this study was to analyze the clinical and laboratory features, management, outcomes, and complications of PRES in children with malignancies or following hematopoietic cell transplantation (HCT). Methods: This was a multicenter retrospective analysis of PRES episodes diagnosed between 2014 and 2022 in Polish pediatric hematology and oncology (PHO) centers and HCT units. The study included 438 patients treated for malignancy or post-HCT: 120 with PRES (study group) and 318 without PRES (control group). Results: PRES was diagnosed in children aged 1.7-16.5 years (median = 7.7 years). The most common underlying diagnosis was ALL (76.7%; n = 92). Symptoms of PRES included disturbances of consciousness (84.2%), seizures (80.0%), hypertension (74.2%), apathy (64.2%), abdominal pain (45.0%), visual disturbances (28.3%), and headaches (26.7%). Electrolyte abnormalities were observed in 75.0% of children, most commonly hyponatremia (49.2%) and hypokalemia (37.5%). Children with PRES were more likely to require admission to the intensive care unit (ICU) than controls (50.0% vs. 29.6%, p < 0.001). The most frequent long-term complications of PRES were hypertension (22.5%) and epilepsy (20.8%). Among PHO patients, those with PRES had significantly lower DFS (76.7% vs. 93.7%, p < 0.001) and OS (79.2% vs. 93.4%, p < 0.001). In the HCT group, PRES was also associated with lower DFS (40.0% vs. 83.3%, p = 0.012) and OS (40.0% vs. 77.8%, p = 0.047). Conclusions: PRES is a significant complication of oncological and transplant treatment in children. Its occurrence was associated with worse overall and disease-free survival. We proposed a predictive index for PRES, diagnostic criteria, and a revised name for this syndrome.

Gross anatomy dissection is an essential component of medical and health science education, yet it presents notable occupational hazards, particularly from formaldehyde (FA) exposure and microbial contamination. These risks may be intensified in anatomy dissection halls located in tropical monsoon (Am) climates, where elevated humidity and temperature promote both chemical volatility and microbial persistence. This study assessed the combined effects of such climatic conditions on FA concentrations and microbial ecology within a naturally ventilated dissection hall in southern Thailand. FA levels were measured through personal and area air sampling across seven anatomical regions, while microbial contamination on cadaver-contact surfaces was evaluated using culture-based methods and high-throughput sequencing. Functional prediction of microbial communities was performed using PICRUSt2 to assess their metabolic adaptation to environmental stressors. The results revealed that both personal and indoor FA concentrations (mean 1.17 ± 0.39 ppm and 1.09 ± 0.45 ppm, respectively) exceeded several international occupational exposure limits, with the highest levels observed during dissections involving deep or adipose-rich anatomical regions. Microbial analyses identified stress-tolerant and potentially pathogenic genera, including Bdellovibrio, Aequorivita, and Aspergillus spp., along with enriched pathways involved in aromatic compound degradation and environmental resilience. These findings highlight the limitations of natural ventilation in controlling occupational exposures and microbial contamination in Am climate anatomy laboratories. The study supports the implementation of climate-responsive engineering controls and laboratory management strategies that address chemical safety, thermal regulation, and biosafety to promote healthier and more sustainable dissection environments in similar high-risk settings.

Innovation and Practice of a Student-Operated Simulated Nursing Ward: Transforming Nursing Lab Management via OBE Principles

Gastruloids are embryonic stem cell-derived in vitro models that mimic the axial patterning of the gastrulating embryo. The N2B27 basal medium in which mouse gastruloids are cultured can either be home-made (HM-N2B27), with materials of known origin, or commercially sourced (NDiff227), where the exact formulation is unknown. In their recent publication, Balayo et al. have investigated whether these formulations result in significant differences in gastruloid development. To find out more about their work, we spoke to first author Tina Balayo, and to co-corresponding authors André Dias and David Turner. In the Barcelona team, Tina and André are members of the Martínez Arias lab at the Universitat Pompeu Fabra (Barcelona, Spain), where Tina works as a research technician and lab manager, and André is an EMBO postdoctoral fellow. Heading the Liverpool team, David is a lecturer and group leader of the Development and Stem Cell Lab at the University of Liverpool, UK.

Abstract The role of a CLIA (Clinical Laboratory Improvement Amendments) laboratory director in a community hospital is both challenging and rewarding. It requires a multifaceted approach that combines technical expertise, leadership skills, and emotional resilience—qualities that extend far beyond the theoretical knowledge gained during pathology residency. This abstract reflects on a year of navigating this pivotal role, sharing experiential insights, lessons learned, strategies for success. Transitioning from residency to laboratory directorship highlights the complexities of real-world practice that traditional training often overlooks. The position demands a nuanced approach to decision-making, encompassing regulatory compliance, quality assurance, operational efficiency, and testing stewardship. Successfully navigating these responsibilities requires adaptability, continuous learning, and balancing competing priorities. Key lessons learned include: Leadership as a Core Skill: Leadership in the laboratory extends beyond operational oversight to fostering a collaborative, respectful environment. Emotional intelligence—active listening, empathy, and composure under pressure—is essential for building trust and team cohesion. Strategically delegating responsibilities and maintaining transparent communication empower staff and optimize workflows. Conflict Resolution: Managing conflicts among team members or external stakeholders is a critical skill. Using diplomacy and tact in difficult conversations ensures that differing viewpoints are acknowledged, enabling resolutions that balance individual concerns with organizational goals. Structured approaches, such as facilitated discussions and focusing on common ground, are instrumental in maintaining harmony and productivity. Understanding Financial Management: Financial oversight is a pivotal yet often underappreciated aspect of the laboratory director’s role. Balancing budgetary constraints with the need for quality improvements and technological advancements required developing expertise in cost analysis, resource allocation, and capital investment justification. These skills are crucial for aligning laboratory operations with institutional priorities while safeguarding patient care. The Value of Mentorship and Networks: Mentorship offers practical guidance and emotional support, helping refine regulatory compliance and financial management strategies. Regular consultations with experienced colleagues and involvement in professional networks reinforce the collaborative nature of leadership. Structured Training: Formal leadership training is essential for preparing pathology residents to navigate the complex challenges of administrative roles. Programs offered by organizations such as the College of American Pathologists (CAP) and the American Society for Clinical Pathology (ASCP) could address gaps in conflict resolution, financial management, and strategic planning. Integrating such training into residency curricula would equip future leaders with the tools to manage teams, make informed decisions, ensure smoother transitions into high-responsibility roles, and foster institutional success. This year-long journey underscored the importance of balancing technical expertise with leadership acumen. While the role presents challenges, it also provides profound opportunities to drive meaningful change, enhance operational efficiency, and elevate patient care. By embracing leadership roles and seeking mentorship, future pathologists can navigate the complexities of this high-stakes position with confidence, resilience, and the potential to make a lasting impact.