Training pathologists to assess stromal tumour-infiltrating lymphocytes in breast cancer synergises efforts in clinical care and scientific research.

A growing body of research supports stromal tumour-infiltrating lymphocyte (TIL) density in breast cancer to be a robust prognostic and predicive biomarker. The gold standard for stromal TIL density quantitation in breast cancer is pathologist visual assessment using haematoxylin and eosin-stained slides. Artificial intelligence/machine-learning algorithms are in development to automate the stromal TIL scoring process, and must be validated against a reference standard such as pathologist visual assessment. Visual TIL assessment may suffer from significant interobserver variability. To improve interobserver agreement, regulatory science experts at the US Food and Drug Administration partnered with academic pathologists internationally to create a freely available online continuing medical education (CME) course to train pathologists in assessing breast cancer stromal TILs using an interactive format with expert commentary. Here we describe and provide a user guide to this CME course, whose content was designed to improve pathologist accuracy in scoring breast cancer TILs. We also suggest subsequent steps to translate knowledge into clinical practice with proficiency testing.

Embracing the (r)evolution of social media and digital scholarship in pediatric nephrology education.

Free Open-Access Medical Education (FOAMed) has transformed medical education in the past decade by complementing and substituting for traditional medical education when needed. The attractiveness of FOAMed resources is due to their inexpensive nature, wide availability, and user ability to access on demand across a variety of devices, making it easy to create, share, and participate. The subject of nephrology is complex, fascinating, and challenging. Traditional didactic lectures can be passive and ineffective in uncovering these difficult concepts and may need frequent revisions. Active teaching methods like flipped classrooms have shown some benefits, and these benefits can only be multifold with current social media tools. Social media will inspire the involvement of students and allow them to create and share educational content in a "trendy way," encouraging the participation of their peers and thus building an educational environment more conducive to them while promoting revision and retainment. FOAMed also promotes asynchronous learning, spaced learning, microlearning, and multimodal presentation with a meaningful variation. This article discusses the evolution of digital education, social media platforms, tools for creating and developing FOAMed resources, and digital scholarship.

Multisource solid waste development of low-carbon ultra-light foamed insulation materials: A feasibility study.

The continuous increase in building energy consumption, and the increasing types and quantities of solid waste have seriously hindered the rapid development of social economy. Therefore, reducing building energy consumption while realizing the recycling of waste has become the mainstream topic of environmental protection construction in the new era. An alkali-activated ultra-light foamed insulation material (AFIM) for building walls was prepared using EPS particles as lightweight aggregates. The effects of EPS dosage, particle size, and gradation on the compressive strength, dry density, thermal conductivity, and volumetric water absorption of AFIM were studied. The results showed that while ensuring good mechanical properties of AFIM, EPS particles can significantly reduce the dry density, thermal conductivity, and volumetric water absorption of AFIM. Excitingly, the optimal thermal conductivity and dry density of AFIM were 0.0408 W/(m·K) and 127.03 kg/m3, respectively. The microscopic morphology results showed that there was good compatibility between EPS particles and AFIM slurry, and the interface transition zone (ITZ) between them was dense and without obvious cracks. In addition, the feasibility of AFIM was evaluated from four aspects: performance, energy consumption, carbon emissions, and life cycle cost (LCC). It was encouraged that the performance of AFIM was comparable to that of traditional insulation materials, and showed significant advantages in energy conservation, emission reduction and economic benefits compared to traditional insulatin materials.

Utility of a Novel Trainee-Level Hematology/Oncology Podcast in Graduate Medical Education: a Pilot Study.

Asynchronous learning continues to gain popularity in medical education. One medium to facilitate asynchronous learning is the podcast. Currently, there are a limited number of hematology/oncology (H/O) podcasts geared towards residents and fellows ("trainees"). To address this need, we created a series of podcasts covering fundamental H/O topics for H/O fellows and internal medicine residents rotating on H/O services. We evaluate the effectiveness of this approach in this pilot study. Between September 2022 and February 2023, residents received recommended episodes via email prior to their rotation. Following their rotation, they received a survey. H/O fellows were encouraged to listen to any available episodes during the study period, after which they also received a survey. The survey collected baseline user information and included a 5-point Likert scale to determine if the podcast episodes were effective educational tools. Summary description was performed by the authors. In total 7 internal medicine residents (27 eligible) and 13 H/O fellows (18 eligible) completed the survey, for a total group of 20 respondents. The trainees found that the podcast helped with inpatient and outpatient management, was clinically relevant, and helped with clinical decision-making. They also agreed that the fundamentals of H/O are amenable to the podcast platform and are likely to continue to use podcasts as learning tools in H/O. This pilot study suggests that podcasts are an effective supplemental learning tool for the fundamentals of H/O in graduate medical education. The use of podcasts as educational tools should be encouraged for trainees.

Efficient removal of Cr(VI) from contaminated kaolin and anolyte by electrokinetic remediation with foamed iron anode electrode and acetic acid electrolyte.

Combined electrokinetic remediation employing reducing agents represents an extensively utilized approach for the remediation of hexavalent chromium (Cr(VI))-contaminated soil. In this investigation, electrokinetic remediation of artificially contaminated kaolin was conducted utilizing a separate circulation system for the anolyte, with a 0.5M solution of acetic acid (HAc) as the electrolyte and foamed iron serving as the anode. The experimental outcomes demonstrated that employing HAc as the electrolyte enhances the electromigration of Cr(VI) and establishes an acidic milieu conducive to the reduction of Cr(VI) by foamed iron, thereby facilitating the rapid reduction of Cr(VI) accumulated in the anolyte through electrokinetic remediation. In the self-prepared contaminated kaolin, the initial concentration of Cr(VI) was 820.26 mg/L. Following the remediation process under optimal experimental conditions, the concentration was significantly reduced to 11.6 mg/L, achieving a removal efficiency of Cr(VI) in the soil of 98.59%. In the optimal experimental setup, the Cr(VI) concentration in the anolyte was reduced to 0.05 mg/L, which is below the EPA's Safe Drinking Water Act standard for Cr(VI) content of 0.1 mg/L. The removal mechanism of Cr(VI) from the electrolyte primarily involves reduction, precipitation, and co-precipitation, with the foamed iron playing a predominant role. HAc and foamed iron exhibit a synergistic effect. The findings of this study substantiate that the integration of foamed iron with HAc is efficacious for the electrokinetic remediation of soil contaminated with Cr(VI).

Foamed Carbon-Supported Nickel-Iron Oxides Interspersed with Bamboo-Like Carbon Nanotubes for High-Performance Rechargeable Zinc-Air Batteries.

The development of multi-component bi-functional electrocatalysts is necessary for commercialization of high-performance zinc-air batteries. Herein, foamed carbon-supported nickel-iron oxides interspersed with bamboo-like carbon nanotubes are prepared as bi-functional electrocatalysts for this battery type. During high temperature synthesis, edges of carbon sheets comprising the foamed carbon structure become involuted to form short carbon nanotubes. The composite of carbon nanotubes and network carbon confer high specific surface area and high electrical conductivity on the newly prepared materials. The supported NiFe2 O4 phase improves the oxygen reduction reaction (ORR) activity by fixing more N atoms, and high-valent Ni oxide (Ni2 O3 ) promotes the formation of OO bonds, which is conducive to the oxygen evolution reaction (OER). The optimized material exhibits excellent bi-functional electrocatalytic activity toward both ORR and OER, and its use in the assembled zinc-air battery cell results in a high power density of 150 mW cm-2 with long discharge stability.

Online urological educational material for medical students: can search engines be trusted?

OBJECTIVES: To determine the credibility of online urological information that medical students are likely to encounter, determine possible discrepancies between the credibility of information pertaining to different areas within urology (especially those less relevant to patients), and assess trends in the sponsorship of online urological educational material. MATERIALS AND METHODS: Health on the Net (HON) principles were used as a validated benchmark to assess the reliability of websites that appeared in the first 150 results of a search using the Google search engine. A variety of urological search terms were used, grouped into three broad categories with varying relevance to patients and medical students. Further analysis focussed on the sponsorship of assessed websites. RESULTS: A total of 5400 websites were assessed for validation over a set of 36 search terms. Only 843/5400 (15.6%) of these were HONcode accredited, indicating a large proportion of unverified and potentially unreliable information. Search engine rankings usually favoured accredited websites (P = 0.009), and accreditation peaked at 51.1% (184/360) in the first page of results, but sorting became weaker outside the highest search results. The percentage of accredited websites varied significantly between different subcategories of search terms such as conditions (18.3% [329/1800], P = 0.003) and procedures (13.5% [243/1800], P = 0.043). Governmental/educational and commercial sources supported the majority of websites assessed for sponsorship (21% [31/150] and 33% [49/150], respectively), and the former were more likely to rank highly in search results. CONCLUSION: Online urological information frequently lacks validation and is often of indeterminate credibility. There is a marked decrease in the proportion of accredited websites beyond the highest-ranked results and when considering search categories more relevant to students and less relevant to patients. Students cannot necessarily rely on free online sources for accurate information and could benefit from the development of more rigorous novel tools and platforms.

Alteration of Fractured Foamed Cement Exposed to CO2-Saturated Water: Implications for Well Integrity.

Geologic CO2 storage (GCS) is a method to mitigate the adverse impact of global climate change. Potential leakage of CO2 from fractured cement at the wellbore poses a risk to the feasibility of GCS. Foamed cement is widely applied in deepwater wells where fragile geologic formations cannot support the weight of conventional cement. Thus, it is critical to know whether fractures in foamed cement self-seal in a similar manner as conventional cement systems. This study is the first to investigate the changes in physical and chemical attributes of foamed cement under dynamic flow conditions using CO2-saturated water. Self-sealing of fractures in the cement was observed at a solution flow rate of 0.1 mL/min and a pressure of 6.9 MPa. The formation of CaCO3 precipitates in pore spaces and fractures led to a decrease in permeability by 1 order of magnitude. The extents of self-sealing in foamed cement samples, specifically the 20 and 30% air volume formulations, were similar to that of conventional cements. We attribute this to the greater alteration depth in the foamed cement, which compensated for the reduced availability of Portlandite and higher initial porosity. The results can be used to evaluate the risk of leakage associated with foamed cement.

Social-media-enabled learning in emergency medicine: a case study of the growth, engagement and impact of a free open access medical education blog.

BACKGROUND: Clinicians are increasingly using social media for professional development and education. In 2012, we developed the St.Emlyn's blog, an open access resource dedicated to providing free education in the field of emergency medicine. OBJECTIVE: To describe the development and growth of this international emergency medicine blog. METHOD: We present a narrative description of the development of St.Emlyn's blog. Data on scope, impact and engagement were extracted from WordPress, Twitter and Google Analytics. RESULTS: The St.Emlyn's blog demonstrates a sustained growth in size and user engagement. Since inception in 2012, the site has been viewed over 1.25 million times with a linear year-on-year growth. We have published over 500 blog posts, each of which attracts a mean of 2466 views (range 382-69 671). The site has been viewed in nearly every country in the world, although the majority (>75%) of visitors come from the USA, UK and Australia. SUMMARY: This case study of an emergency medicine blog quantifies the reach and engagement of social-media-enabled learning in emergency medicine.

Preliminary Evidence for the Emergence of a Health Care Online Community of Practice: Using a Netnographic Framework for Twitter Hashtag Analytics.

BACKGROUND: Online communities of practice (oCoPs) may emerge from interactions on social media. These communities offer an open digital space and flat role hierarchy for information sharing and provide a strong group identity, rapid flow of information, content curation, and knowledge translation. To date, there is only a small body of evidence in medicine or health care to verify the existence of an oCoP. OBJECTIVE: We aimed to examine the emergence of an oCoP through the study of social media interactions of the free open access medical education (FOAM) movement. METHODS: We examined social media activity in Twitter by analyzing the network centrality metrics of tweets with the #FOAMed hashtag and compared them with previously validated criteria of a community of practice (CoP). RESULTS: The centrality analytics of the FOAM community showed concordance with aspects of a general CoP (in terms of community, domain, and practice), as well as some specific traits of a health care community, including social control, common purpose, flat hierarchy, and network-based and concrete achievement. CONCLUSIONS: This study demonstrated preliminary evidence of an oCoP focused on education and based on social media interactions. Further examination of the topology of the network is needed to definitely prove the existence of an oCoP. Given that these communities result in significant knowledge translation and practice change, further research in this area appears warranted.

Growth and by-product profiles of Kluyveromyces marxianus cells immobilized in foamed alginate.

The aim of this research was to study how the yeast cell immobilization technique influences the growth and fermentation profiles of Kluyveromyces marxianus cultivated on apple/chokeberry and apple/cranberry pomaces. Encapsulation of the cells was performed by droplet formation from a foamed alginate solution. The growth and metabolic profiles were evaluated for both free and immobilized cells. Culture media with fruit waste produced good growth of free as well as immobilized yeast cells. The fermentation profiles of K. marxianus were different with each waste material. The most varied aroma profiles were noted for immobilized yeast cultivated on apple/chokeberry pomace.

Effects of oil on aqueous foams: electrical conductivity of foamed emulsions.

Three-phase foams containing dispersed oils (also called foamed emulsion) are usually encountered in such areas as enhanced oil recovery, food foams, and in foams containing antifoams. The presence of oil causes these complex fluids to exhibit extraordinary properties in contrast to aqueous foams. We experimentally investigated, for the first time, the conductive properties of the foamed emulsions and found that the electrical conductivity increases monotonically with the volumetric liquid fraction, presenting a linear relationship. Combined with the analysis on the foaming capacity and microstructure of this complex fluid, the conductive mechanism is revealed. In these foamed emulsions, the whole conductive network is comprised of two levels of structural hierarchy, which displays a different mechanism from those of the conventional aqueous foams. The lamella of emulsions is taken as primary electrical channel, whereas the secondary electrical channel occurs in the lamella between two bubbles. This conductive behaviour is attributed to the microstructure properties of the foamed emulsions. We believe that such findings are potentially important for a better understanding of the fundamentals of these tri-phase dispersion systems.

Optimization of Foams-Polypropylene Fiber-Reinforced Concrete Mixtures Dedicated for 3D Printing.

The continued global urbanization of the world is driving the development of the construction industry. In order to protect the environment, intensive research has been carried out in recent years on the development of sustainable materials and ecological construction methods. Scientific research often focuses on developing building materials that are renewable, energy-efficient, and have minimal impact on the environment throughout their life cycle. Therefore, this article presents research results aimed at developing a concrete mixture using cement with reduced CO2 emissions. In the context of increasing ecological awareness and in line with European Union policy, the development of a mixture based on environmentally friendly cement is of key importance for the future development of the construction industry. The article compares the physical properties of two mixtures, their foaming possibilities, and the influence of the added polypropylene (PP) fibers on the strength properties of the produced composites. It was found that bending strength and compressive strength were highest in the material with silica fume and aluminum powder at 5.36 MPa and 28.76 MPa, respectively. Microscopic analysis revealed significant pore structure differences, with aluminum foamed samples having regular pores and hydrogen peroxide foamed samples having irregular pores. Optimizing aluminum powder and water content improved the materials' strength, crucial for maintaining usability and achieving effective 3D printing. The obtained results are important in the development of research focused on the optimization of 3D printing technology using concrete.

Microstructure evolution and mechanical behavior of foamed cement-based tail backfills under varying fiber types and concentrations.

Industrial solid waste (mine tailings) management has emerged as the key universal ecological challenge as a result of the unceasing creation of rising waste by-products. Employing tailings makes mine fill production economical and assists resolve disposal problems. Foamed cement-based tailings backfill (FCTB) is a mine fill consisting of tailing, cement, water, and foaming agents. It provides certain advantages such as lightweight, good fluidity, and thermal insulation yet is relatively weak in strength. Additionally, FCTB's strength properties can be intensely improved by adding fibers. A total of three diverse fibers: polypropylene (PP), glass (G), and basalt (B) as well as dodecyltrimethylammonium bromide (DTAB) as a foaming agent were used to prepare fiber-reinforced foamed cementitious tailings backfill (FR-FCTB). The mechanical properties, energy evolution, ductility, and microstructure of FR-FCTB were elaborately investigated by uniaxial compression tests (UCS) and SEM. Laboratory findings demonstrate the reinforcing effect of three fibers on FCTB specimens: glass > polypropylene > basalt. FR-FCTB showed the best strength features as a fiber content of 0.3% was adopted in FCTB. At this time, the UCS performance of glass fiber-reinforced FCTBs was 0.85 MPa increased by 18.1%. The addition of fibers can increase the fill's energy storage limit, slow down the discharge of elastic strain energy within the backfill, and enhance the fill's ductility and toughness. The ductility factor evaluates the degree of deterioration of filling in terms of post-peak drop, with all FR-FCTB values being greater than CTB. FR-FCTB's chief hydration product is the C-S-H gel. Fiber's bridging effect significantly rallies crack extension and thus fill's strength features. Lastly, the study's main results are instructive for the industrial application of FR-FCTB used in metallic mines.

Effects of Mixing Techniques and Material Compositions on the Compressive Strength and Thermal Conductivity of Ultra-Lightweight Foam Concrete.

The research focuses on ultra-lightweight foam concrete with a dry density below 200 kg/m3, primarily used as insulation material. Factors that may affect material properties are categorized into mixing techniques and material composition, and experimental investigations were conducted on the impact of these factors on the rheological properties of cement slurry, density at different time intervals, compressive strength, and thermal conductivity of foam concrete samples. The experimental results indicate the influence of mixing speed and mixing duration on the instrument during the cement slurry production and mixing process with foam. Additionally, variations in foam concrete sample properties are observed due to the water-to-cement ratio, foam content, and foam density in the selected material compositions. By analyzing the material density at different time intervals, the relationship between the ambient air trapped during the mixing process and the viscosity of the material can be indirectly observed. This analysis can also reveal the correlation between the unplanned air content and the properties of the material.

Colonization and Biodegradation Potential of Fungal Communities on Immersed Polystyrene vs. Biodegradable Plastics: A Time Series Study in a Marina Environment.

Plastic pollution of the ocean is a major environmental threat. In this context, a better understanding of the microorganisms able to colonize and potentially degrade these pollutants is of interest. This study explores the colonization and biodegradation potential of fungal communities on foamed polystyrene and alternatives biodegradable plastics immersed in a marina environment over time, using the Brest marina (France) as a model site. The methodology involved a combination of high-throughput 18S rRNA gene amplicon sequencing to investigate fungal taxa associated with plastics compared to the surrounding seawater, and a culture-dependent approach to isolate environmentally relevant fungi to further assess their capabilities to utilize polymers as carbon sources. Metabarcoding results highlighted the significant diversity of fungal communities associated with both foamed polystyrene and biodegradable plastics, revealing a dynamic colonization process influenced by the type of polymer and immersion time. Notably, the research suggests a potential for certain fungal species to utilize polymers as a carbon source, emphasizing the need for further exploration of fungal biodegradation potential and mechanisms.

Foam Stabilization Process for Nano-Al2O3 and Its Effect on Mechanical Properties of Foamed Concrete.

Foamed concrete is increasingly utilized in engineering due to its light weight, excellent thermal insulation, fire resistance, etc. However, its low strength has always been the most crucial factor limiting its large-scale application. This study introduced an innovative method to enhance the strength of foamed concrete by using nano-Al2O3 (NA) as a foam stabilizer. NA was introduced into a foaming agent containing sodium dodecyl sulfate (SDS) and hydroxypropyl methylcellulose (HPMC) to prepare a highly stable foam. This approach significantly improved the foam stability and the strength of foamed concrete. Its drainage volume, settlement distance, microstructure, and stabilizing action were investigated, along with the strength, microstructure, and hydration products of foamed concrete. The presence of NA effectively reduced the drainage volume and settlement distance of the foam. NA is distributed at the gas-liquid interface and within the liquid film to play a hindering role, increasing the thickness of the liquid film, delaying the liquid discharge rate from the liquid film, and hindering bubble aggregation, thereby enhancing foam stability. Additionally, due to the stabilizing effect of NA on the foam, the precast foam forms a fine and uniform pore structure in the hardened foamed concrete. At 28 d, the compressive strength of FC0 (0% NAs in foam) is 2.18 MPa, while that of FC3 (0.18% NAs in foam) is 3.90 MPa, increased by 79%. The reason for this is that NA promotes the formation of AFt, and its secondary hydration leads to the continuous consumption of Ca(OH)2, resulting in a more complete hydration reaction. This study presents a novel method for significantly improving the performance of foamed concrete by incorporating NA.