[DIAGNOSIS AND TREATMENT OF ELEVATED LIPOPROTEIN(A) IN ISRAEL: CONSENSUS STATEMENT FROM THE ISRAEL SOCIETY FOR RESEARCH, PREVENTION AND TREATMENT OF ATHEROSCLEROSIS AND ISRAEL SOCIETY FOR CLINICAL LABORATORY SCIENCES].

INTRODUCTION: Lipoprotein(a) [Lp(a)] is composed of 2 major protein components, a low-density lipoprotein (LDL) cholesterol-like particle containing apolipoprotein B (apo B) that is covalently bound to apolipoprotein(a). Its level is predominantly genetically determined, and it is estimated that 20% to 25% of the population have Lp(a) levels that are associated with increased cardiovascular risk. Elevated Lp(a) is related to increased vascular inflammation, calcification, atherogenesis and thrombosis, and is considered an independent and potentially causal risk factor for atherosclerotic cardiovascular diseases and calcified aortic valve stenosis. Recent data demonstrate that Lp(a) testing has the potential to reclassify patients' risk and improve cardiovascular risk prediction, and therefore could inform clinical decision-making regarding risk management. Statins and ezetimibe are ineffective in lowering Lp(a) levels, whereas proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have a modest effect on Lp(a) reduction. Nevertheless, RNA interference-based therapies with potent Lp(a)-lowering effects are in advanced stages of development, and clinical trials are underway to confirm their benefit in reducing cardiovascular events. This scientific consensus document was developed by a committee that consisted of representatives from the Israeli Society for the Research, Prevention and Treatment of Atherosclerosis, and the Israeli Society for Clinical Laboratory Sciences, in order to create uniformity in Lp(a) measurement methods, indications for testing and reporting of the results, aiming to improve the diagnosis and management of elevated Lp(a) in clinical practice.

Medical Laboratory Science Student Outcomes Related to Curriculum Changes Made During COVID-19 Pandemic.

The COVID-19 pandemic forced many healthcare education programs to alter teaching methods, leading to a transition from face-to-face learning to distance learning. This study aimed to evaluate how curricular changes made during the COVID-19 pandemic may have influenced student performance in a medical laboratory science (MLS) program. MLS student exam scores, final course grades, and Board of Certification performance data were investigated to determine how changes made to curriculum and delivery influenced program outcomes for students completing the program before and during the COVID-19 pandemic at the University of Nebraska Medical Center. Self-reported responses to faculty survey questions explored curriculum changes and perception of student success. There were 24 instances in which scores between the two cohorts were statistically significant with only two of those demonstrating the COVID-19 cohort performed better. Four of six faculty indicated they felt there was a disconnect between theory and laboratory application for the COVID-19 academic year and students performed better in the pre-COVID-19 academic year. While there are benefits for asynchronous learning, the findings and perceptions of this study suggest that in-person learning and combining theory and laboratory components support the education of introductory courses.

Toolkit for emerging technologies in laboratory medicine.

An emerging technology (ET) for laboratory medicine can be defined as an analytical method (including biomarkers) or device (software, applications, and algorithms) that by its stage of development, translation into broad routine clinical practice, or geographical adoption and implementation has the potential to add value to clinical diagnostics. Considering the laboratory medicine-specific definition, this document examines eight key tools, encompassing clinical, analytical, operational, and financial aspects, used throughout the life cycle of ET implementation. The tools provide a systematic approach starting with identifying the unmet need or identifying opportunities for improvement (Tool 1), forecasting (Tool 2), technology readiness assessment (Tool 3), health technology assessment (Tool 4), organizational impact map (Tool 5), change management (Tool 6), total pathway to method evaluation checklist (Tool 7), and green procurement (Tool 8). Whilst there are differences in clinical priorities between different settings, the use of this set of tools will help support the overall quality and sustainability of the emerging technology implementation.

Medical Laboratory Sciences Student Perceptions of Their Affective Development.

AIMS: The affective and professional development of healthcare professionals, including medical laboratory scientists (MLS), is important for employability, resilience, and provision of effective patient care. Affective domain development is also critical to the quality of care provided in healthcare settings, yet there is limited research about which activities and experiences are perceived by MLS students as beneficial for their affective development. The purpose of this study was to understand, through semi-structured interviews, how MLS students value program learning activities and experiences in support of their affective development within the framework of social cognitive and emotional intelligence (EI) theories. METHODS: Twelve MLS program graduates from one large Midwestern university were interviewed using semi-structured interviews. Data were analyzed using open manual coding to identify emergent themes. RESULTS: Findings indicate that students' affective domain development was influenced by interactions with different types of people through a variety of learning experiences and activities in diverse settings integrated during the program coursework. CONCLUSION: Developing program coursework activities that enhance and are supportive of student affective development may be beneficial to graduate employability, helping reduce the workforce shortage of MLS professionals, and promote a better quality of care for patients in healthcare settings.

Continuing professional development (CPD) training needs assessment for medical laboratory professionals in Ethiopia.

BACKGROUND: Continuing professional development (CPD) is required for health workers in practice to update knowledge and skills regularly to match the changing complexity of healthcare needs. The objective of this study was to identify the training needs of Medical Laboratory professionals in Ethiopia. METHODS: A total of 457 medical laboratory professionals from five regions and two city administrations were involved in the study. Data were collected from August 02 to 21, 2021 with structured self-administered online tool with five-point Likert scale. The tool had consent, demography, cross-cutting issues, and main activity area specific to medical laboratory. RESULTS: Majority of the participants were male (80.1%). Participants from Amhara region 110 (24.1%) were the largest groups in the survey followed by Oromia 105 (23%) and Addis Ababa 101 (22.1%). The study participants comprised 54.7% with a bachelor's degree, 31.3% with a diploma (associate degree), and 14% with a master's degree. The participants had varying years of service, ranging from less than one year to over 10 years of experience. Most of the participants work as generalists (24.1%) followed by working in microbiology (17.5%) and parasitology (16%). The majority (96.9%) were working in a public sector or training institutions and the rest were employed in the private sector. Our study showed that the three most important topics selected for training in the cross-cutting health issues were health and emerging technology, computer skills and medico-legal issues. Topics under microbiology, clinical chemistry and molecular diagnostics were selected as the most preferred technical areas for training. Participants have also selected priority topics under research skill and pathophysiology. When the laboratory specific issues were regrouped based on areas of application as technical competence, research skill and pathophysiology, thirteen topics under technical competence, four topics under research skill and three topics under pathophysiology were picked as priority areas. CONCLUSION: In conclusion, our study identified that CPD programs should focus on topics that address technical competence in microbiology, clinical chemistry and molecular diagnostics. Additionally competencies in research skill and updating knowledge in pathophysiology should also receive due attention in designing trainings.

El laboratorio de los Anales. Peritaje, enseñanza, edición y comercio en el laboratorio de análisis químico de la calle Carretas, Madrid, 1867-1880 / The anales laboratory. Expertise, teaching, publishing and trade in the laboratory of chemical analysis at carretas street, madrid, 1867-1880

El laboratorio de análisis químico abierto, entre 1867 y 1880, en la calle Carretas de Madrid, es estudiado aquí en el contexto de las disputas corporativas por el control de un nuevo espacio de actividad académica y profesional surgido en la segunda mitad del siglo XIX en torno a la determinación de composición química de alimentos, bebidas y productos de la industria, la agricultura y el comercio. Se analiza la ubicación y el diseño de los espacios, la interacción entre las diferentes actividades desarrolladas dentro y fuera del laboratorio, así como las razones y los intereses que atrajeron a los diferentes públicos que hicieron uso de sus servicios. El objetivo es comprender mejor el significado y el funcionamiento de un espacio híbrido en el que actividades diversas y dispersas como el análisis químico, la producción industrial, la enseñanza, la divulgación y la edición interactuaron de forma sinérgica para sustentar la autoridad y la credibilidad que sus promotores necesitaban para conquistar la confianza de quienes estuvieron dispuestos a pagar por sus productos, en su mayoría escritos.(AU)

The laboratory of chemical analysis operating, between 1867 and 1880, at Carretas street in Madrid is studied here in the context of professional disputes over the control of news spaces for academic and professional activities emerging in the second half of the 19th Century on chemical analyses of food beverages and industrial, trade and agriculture products. The paper examines the location and design of the laboratory, the interaction between the different activities carried out inside and outside the lab, and the reasons and interests that attracted different publics requesting a variety of services. The aim is to understand better the meaning and operation of a hybrid space with a large range of activities such as chemical analysis, industrial production, teaching, and popularization interacting synergistically. They were employed by the promoters of the lab to reinforce the authority and credibility required to gain the confidence of those who were willing to pay for their products.(AU)

Students' Perspective on Scientific Training.

How should lab heads train their students and what is the role of degree-granting institutions in this process? Chua, Vandana, and Hsieh discuss the needs of graduate students and ways to cultivate purposeful, personalized mentee training in the lab.

Interprofessional Education in NAACLS MLT and MLS Programs: Results of a National Survey.

BACKGROUND: Interprofessional education is essential for students enrolled in health care professional programs. OBJECTIVES: We assessed the attitudes towards and the beliefs about interprofessional education (IPE) among program directors of medical laboratory science (MLS) and medical laboratory technician (MLT) programs accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). We also investigated the inclusion of IPE in the curricula of such programs. METHODS: We emailed the link to an anonymous 22-item cross-sectional survey to 468 program directors and tabulated the responses. RESULTS: Program directors who support the need to include IPE within the curricula of MLT and MLS programs showed a generally positive attitude towards IPE. The beliefs about IPE among our respondents were not homogeneous. Program directors who have not yet implemented IPE in the curriculum may not have had an opportunity to experience the practical benefits of IPE. CONCLUSION: Although barriers to IPE implementation exist, half of the respondents reported having already implemented IPE within their curricula.

Promoting System Thinking and Professionalism Through Simulated Hospital Experiences for Nursing and Clinical Laboratory Science Students.

ABSTRACT: A simulation laboratory was developed for prelicensure nursing and undergraduate clinical laboratory science students using scripted patient cases with laboratory test results. The experience was guided by TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). Participants ( n = 66) completed the modified Interprofessional Professionalism Assessment pre- and postsimulation. Journal reflections provided qualitative data. All aspects of interprofessional professionalism increased after the simulation; the most significant gain was confidence in working with other health care professionals. Analysis of journal themes indicated the students perceived increased communication and collaboration skills concerning patient care and safety.

Coping with the COVID-19 Pandemic: How a Master's in Clinical Laboratory Sciences Program Adapted Through the Modification of Existing Resources.

OBJECTIVE: Our aim was to describe the rapid adaption of a Master of Clinical Laboratory Sciences (MCLS) program to the abrupt suspension of classroom instruction and laboratory training at affiliated hospitals in compliance with the New York governor's executive order in March 2020. METHODS: Teaching modifications included greater emphasis on Zoom video conferencing, Media Lab assignments, independent self-study, and online testing. RESULTS: Instruction of academic coursework continued uninterrupted using previously established teaching modalities. Clinical training presented 2-fold concerns, credit hours needed for the master's degree and clinical hours required for New York State licensing. The latter was delayed. CONCLUSION: The real-time need to deliver laboratory science education during a time of statewide closure was fulfilled using available teaching modalities. The resulting uninterrupted academic and clinical training ensured the education of the incoming workforce of our clinical laboratories. This teaching strategy may be considered during new curricula development in preparation for times of future crises.

A historical perspective on diversity in Clinical Laboratory Sciences Programs.

OBJECTIVE: Diversity is integral for an effective learning environment and pedagogy. In this study, we aim to determine the student and faculty diversity in the Clinical Laboratory Sciences programs at Stony Brook University. METHODS: We retrospectively analyzed data over 20 years for the traditional program and 8 years for the hybrid program. RESULTS: Over 20 years, 502 students graduated from the traditional program, and 96 students graduated from the hybrid program. In the traditional program, an average of 25 students enrolled with 75% female and 25% male and in the hybrid program, an average of 12 students with 8.5 female and 3.5 male enrolled. The traditional program had the highest proportion of Asian students (50%), with White students making up 24.5%, whereas the highest proportions in the hybrid program were 35% White students and 24% Hispanic students. Among the 5 boroughs of New York City, the highest proportion of student representation was from Queens and Manhattan in both traditional (24.1%) and hybrid programs (16.7%). There were 30% male and 70% female faculty served in the traditional program whereas the current representation of fulltime faculty is 100% female. CONCLUSION: Our data show the diversity of students and faculty in clinical laboratory sciences programs at Stony Brook University institution.

Medical laboratory practice in Malawi ­ Current status

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Nurses' Perceptions of Medical Laboratory Scientists: Mistaken Identity and Misplaced Regard.

INTRODUCTION: The medical laboratory science (MLS) profession is an integral part of the healthcare team, providing diagnostic laboratory results used to determine directives in the treatment and management of disease processes. There is a scarcity of literature describing other healthcare professionals' perceptions of medical laboratory scientists. Research also suggests MLS professionals feel unrecognized for contributions to patient care. PURPOSE: A pilot study to describe intensive care unit (ICU) nurses' perceptions of medical laboratory scientists and their role in healthcare. METHODS: Five ICU nurses were interviewed using open-ended questions. Data were analyzed using phenomenological research inquiry to develop themes. RESULTS: Four themes were identified: professional practice, visibility, professional entry, and interprofessional learning. DISCUSSION: While participants were aware of the medical laboratory, they were unaware of the scope of practice, educational requirements, and professional credentials of medical laboratory scientists. Findings also showed misconceptions of the MLS scope of practice that overlaps with phlebotomists and medical laboratory technicians (MLTs). CONCLUSION: This study found that the intensive care nurse participants demonstrated an overall positive perception of medical laboratory scientists but a low level of knowledge of the MLS profession and expertise. Implications for interdisciplinary education to create a more comprehensive healthcare delivery team were presented.

The Hidden Crisis in the Times of COVID-19: Critical Shortages of Medical Laboratory Professionals in Clinical Microbiology.

The COVID pandemic has put a spotlight on laboratory medicine, showcasing how vital diagnostic testing is for society and the health care system. It has also brought to light and accelerated the critical shortage of trained and experienced laboratory personnel that has been felt for decades. The need for laboratory professionals is expected to grow by 11% between 2020 and 2030, a higher rate of growth than the overall average for all other health care occupations. Here, the background to this workforce shortage is reviewed. Some proposed actions to help address the issue are put forth, including increasing awareness of the medical laboratory science profession along with bolstering training opportunities and awareness of alternate routes to obtaining certification as a medical laboratory scientist. In addition, recent survey data specifically related to the employee shortages in microbiology are presented which demonstrate that 80% of microbiology laboratories have vacant positions and that filling these positions is challenging for a number of reasons, including a lack of qualified applicants.

Improving Youden plots by including analytical performance specifications.

Historically, Youden plots are made of a scatter plot of the results of two EQA samples with an elliptical confidence area around them. Because Youden plots compare individual laboratory results with respect to other laboratories, they intrinsically evaluate with state of the art. In the field of medical laboratory science, analytical performance specifications have been proposed and various EQA providers show these limits on Youden plots by horizontal and vertical lines near the limits of total error. This study shows the weaknesses of these limits of total error and proposes a new approach for drawing acceptance areas on Youden plots. The classical Youden plot is extended with two acceptance areas: A first acceptance area evaluates the reported results with respect to maximum allowed variability, a second acceptance area evaluates the results with respect to maximum allowed variability and bias. The ellipses are calculated using quantiles of the Chi-square and noncentral Chi-square distribution. Results show that the new approach allows evaluating results from individual laboratories and from measurement procedures by comparing the position and overlap of the confidence area and the acceptance areas. It is demonstrated that his approach controls the type I error better than the rectangular limits.

Promotion to Top-Tier Journal and Development Strategy of the Annals of Laboratory Medicine for Strengthening its Leadership in the Medical Laboratory Technology Category: A Bibliometric Study.

BACKGROUND: A bibliometric analysis of the Annals of Laboratory Medicine (ALM) was performed to understand its position in the medical laboratory technology category and to suggest a developmental strategy. METHODS: Journal metrics, including the number of articles by publication type, country of authors, total citations, 2-year impact factor, country of cited authors, journals citing ALM, and Hirsch-index, were obtained from the Journal Citation Report and Web of Science Core Collection. Target data included ALM content in the Web of Science from January 1, 2012, to October 5, 2021. Bibliometric analysis was performed using Biblioshiny. RESULTS: The impact factor increased from 1.481 in 2013 to 3.464 in 2020. Authors belonging to the USA, China, and Korea cited ALM articles the most. Plos One, Scientific Reports, and Frontiers in Microbiology most frequently cited ALM, besides ALM itself. The Hirsch-index was 34. The co-occurrence network of Keyword Plus indicated four clusters: diagnosis, identification, prevalence, and risk. The conceptual structure map of Keyword Plus based on multiple correspondence analysis showed two clusters: bacterial susceptibility at the bench and clinical courses. The co-citation network showed that ALM was in the cluster of the New England Journal of Medicine, The Lancet, JAMA, and the Annals of Internal Medicine. The collaboration network showed that Korean authors collaborated mainly with authors from the USA, Germany, and Italy. CONCLUSIONS: The journal's promotion to an international top-tier journal has been successful. "Principles of transparency and best practice in scholarly publishing" and a preprint policy are yet to be added.