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\"This book provides applications of soft computing techniques related to healthcare systems and can be used as a reference guide for assessing the roles that various techniques such as machine learning, fuzzy logic, and statistical mathematics play in the advancements of smart healthcare systems. The book presents the basics as well as the advanced concepts to help beginners, as well as industry professionals get up to speed on the latest developments in healthcare systems. The book will examine descriptive, predictive, and social network techniques, as well as provide a discussion on analytical tools and the important role they play in finding solutions to problems in healthcare systems\"-- Provided by publisher.

Background Traditionally, the training of medical laboratory science students has taken place in the laboratory and has been led by academic and pathology experts in a face-to-face context. In recent years, budgetary pressures, increasing student enrolments and limited access to laboratory equipment have resulted in reduced staff-student contact hours in medical laboratory science education. While this restructure in resources has been challenging, it has encouraged innovation in online blended learning. Methods Blended learning histology lessons were implemented in a face-to-face and e-Learning format in a medical laboratory science program to teach tissue morphology and technical procedures outside of the traditional laboratory classroom. Participating students were randomly allocated to either the ‘video’ group ( n  = 14) or the ‘control’ group ( n  = 14). After all students attempted the e-Learning lessons and viewed expert-led video recordings online, students demonstrated their hands-on practical skills in the laboratory. Technical skills, demonstration of safety awareness, and use of histology equipment was captured by video through first person ‘point of view’ recordings for the ‘video’ group only. The ‘control’ group performed the same activities but were not recorded. Prior to summative assessment, the ‘video’ group students had a digital resource portfolio that enabled them to review their skills, receive captured feedback and retain a visual copy of their recorded procedure. Results Results showed that students who participated in the online video format had statistically better practical examination scores and final grades compared to the control group. Conclusion Findings from this study suggest that students are engaged and motivated when being taught in a blended learning format and respond positively to the use of video recordings with expert feedback for the initial learning of hands-on techniques. For the academic, developing a blended learning medical laboratory science program, which includes annotated virtual microscopy, video demonstrations, and online interactive e-Learning activities, provides an effective and economic approach to learning and teaching.

The role of laboratory medicine is essential in healthcare, since in vitro diagnostic testing represents now an unavoidable part of reasoning and clinical decision making. Laboratory tests are an essential part of most care pathways, aimed at optimizing resource utilization and improving patient outcome. The activity of laboratory professionals is interconnected with all medical disciplines, and provides a crucial support for ordering the right test, for the right patient and at the right time, but also helps interpreting and using laboratory data. Although recent advancement in laboratory medicine, catalyzed by technical innovations and development of innovative tests, have promoted a substantial revolution in the organization of clinical laboratories, the future of this profession seems still ambiguous. We have hence developed a “manifesto” of laboratory medicine, meant to promote an innovative prospect of our discipline and encouraging the establishment of a new generation of laboratory professionals and managers.

Clinical metagenomic next-generation sequencing (mNGS), the comprehensive analysis of microbial and host genetic material (DNA and RNA) in samples from patients, is rapidly moving from research to clinical laboratories. This emerging approach is changing how physicians diagnose and treat infectious disease, with applications spanning a wide range of areas, including antimicrobial resistance, the microbiome, human host gene expression (transcriptomics) and oncology. Here, we focus on the challenges of implementing mNGS in the clinical laboratory and address potential solutions for maximizing its impact on patient care and public health.Clinical metagenomic next-generation sequencing (mNGS) is rapidly moving from bench to bedside. This Review discusses the clinical applications of mNGS, including infectious disease diagnostics, microbiome analyses, host response analyses and oncology applications. Moreover, the authors review the challenges that need to be overcome for mNGS to be successfully implemented in the clinical laboratory and propose solutions to maximize the benefits of clinical mNGS for patients.

• The Archives of Pathology & Laboratory Medicine was first published in 1926 as a specialty journal of the American Medical Association. It became the official journal of the College of American Pathologists in 1995. Under the dynamic leadership of its most recent editor-in-chief, Philip T. Cagle, MD, the Archives has dramatically increased its impact factor and become the most widely read general pathology journal. Dr. Cagle has consistently added leading pathologists to the editorial board, and the collective expertise of these individuals is clearly evident in new, cutting-edge journal masthead sections. The Archives has featured innovative content in the field of digital pathology, including articles on the utilization of smart phones in pathology and the incorporation of whole-slide images and videos into the content of articles. During the current editorial board's tenure, special sections were introduced and have proven immensely popular with the journal's readership. As the Archives celebrates its 94th anniversary, its editorial board remains committed to providing insightful and relevant medical knowledge. The journal's open access Web site (www.archivesofpathology.org) allows the dissemination of this information to every corner of the globe at no expense to those who wish to expand their knowledge or improve their medical practice. Dr. Cagle, with support from the editorial board and journal staff, has worked tirelessly during his tenure as Archives editor-in-chief to greatly enhance the content of the journal and its stature within pathology and laboratory medicine.

The first quantitative reverse transcriptase-based polymerase chain reaction (RT-PCR) was designed and distributed in January by the World Health Organization (WHO), soon after the virus was identified. Plastic tubes should be sterile, hydrophobic, and not handled with ungloved hands as RNases are present on skin and hair. Because quality at each level is necessary in a molecular lab, a quality control program is a must. Only few viral RNA extraction kits have been approved by the US Food and Drug Administration (FDA) and Centers for Disease Control and Prevention for RNA extraction.

Background: There is limited data on results of central re-testing of samples from patients with invasive breast cancer categorised in their local hospital laboratories as oestrogen receptor (ER) positive and human epidermal growth factor receptor homologue 2 (HER2) negative. Methods: The Optimal Personalised Treatment of early breast cancer usIng Multiparameter Analysis preliminary study (OPTIMA prelim) was the feasibility phase of a randomised controlled trial to validate the use of multiparameter assay-directed chemotherapy decisions in the UK National Health Service (NHS). Eligibility criteria included ER positivity and HER2 negativity. Central re-testing of receptor status was mandatory. Results: Of the 431 patients tested centrally, discrepant results between central and local laboratory results were identified in only 19 (4.4%; 95% confidence interval 2.5–6.3%) patients (with 21 tumours). On central review, seven patients had cancers that were ER-negative (1.6%) and 13 (3.0%) patients with 15 tumours had HER2-positive disease, including one tumour discrepant for both biomarkers. Conclusions: Central re-testing of receptor status of invasive breast cancers in the UK NHS setting shows a high level of reproducibility in categorising tumours as ER-positive and HER2-negative, and raises questions regarding the cost effectiveness and clinical value of central re-testing in this sub-group of breast cancers in this setting.

Key Points UTIs are increasingly caused by multidrug-resistant organisms as a result of the overuse of empirical, broad-spectrum antibiotic therapy Antimicrobial susceptibility, determined by the phenotypic response to antibiotic exposure, is key for clinical decision making for treating the wide variety of uropathogens and identifying resistance markers Existing technologies (such as PCR, fluorescence in situ hybridization, and mass spectrometry) and new technologies (such as droplet microfluidic and biosensor platforms) need to focus on direct urine testing to expedite objective diagnoses Integrated biosensor–microfluidic platforms have the most potential for point-of-care testing, as they facilitate direct urine analysis and can encompass all assay steps in a compact device New technologies are a key step towards improved antimicrobial stewardship Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs and antimicrobial stewardship. In this Review, Davenport and colleagues discuss emerging technologies including biosensors, microfluidics, and other integrated platforms that could improve UTI diagnosis and treatment choice. Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs. Urine dipsticks are fast and amenable to point-of-care testing, but do not have adequate diagnostic accuracy or provide microbiological diagnosis. Urine culture with antimicrobial susceptibility testing takes 2–3 days and requires a clinical laboratory. The common use of empirical antibiotics has contributed to the rise of multidrug-resistant organisms, reducing treatment options and increasing costs. In addition to improved antimicrobial stewardship and the development of new antimicrobials, novel diagnostics are needed for timely microbial identification and determination of antimicrobial susceptibilities. New diagnostic platforms, including nucleic acid tests and mass spectrometry, have been approved for clinical use and have improved the speed and accuracy of pathogen identification from primary cultures. Optimization for direct urine testing would reduce the time to diagnosis, yet these technologies do not provide comprehensive information on antimicrobial susceptibility. Emerging technologies including biosensors, microfluidics, and other integrated platforms could improve UTI diagnosis via direct pathogen detection from urine samples, rapid antimicrobial susceptibility testing, and point-of-care testing. Successful development and implementation of these technologies has the potential to usher in an era of precision medicine to improve patient care and public health.