Impact of conflict/war disasters on blood banks and transfusion services in low- and middle-income countries in the Eastern Mediterranean region.

Background And Objectives: Different countries in the Eastern Mediterranean region face significant challenges resulting from man-made disasters. This survey aimed to assess the experiences of blood bank and transfusion services in the Eastern Mediterranean region in managing their operations during conflict/war disasters.

Materials And Methods: A survey was distributed to medical directors in 61 blood banks and transfusion services in low- and middle-income countries with conflict/war disasters.

A Review of Program Signaling Effects, Perceptions, and Trends for Medical Residencies.

Program signaling is a relatively new tool in the residency application process, introduced to help applicants express genuine interest in programs amid rising application numbers. While its use has rapidly expanded across specialties, the number and type of signals vary. Limited cross-specialty analysis hinders identification of best practices, leaving applicants and programs without standardized guidance about how to use signaling to achieve specific goals.

Analysis of anatomic pathology and laboratory medicine diagnostic services and infrastructure available at a sample of institutions in Kenya.

Objective: There is a paucity of data regarding the anatomic and clinical pathology capabilities at hospitals and laboratories across much of Africa, including in Kenya. We aimed to sample institutions in Kenya to identify the available pathology and laboratory diagnostic services.

Methods: Subject matter experts developed 2 individual surveys assessing anatomic pathology (AP) and clinical pathology (CP), respectively.

Re-visioning intercultural relational empathy.

We have previously argued that empathy is a multidimensional, context-modulated attribute, and that the Western unidimensional 'one size fits all' approach to empathy is inadequate particularly in intercultural settings. We called for relational empathy characterized by qualities such as curiosity; cultural and epistemic humility; bidirectional engagement; relational consciousness/ubuntu. In a paradigm shift from dominant models of ego-based empathy as projected content, here we describe a model of empathies or multiple 'local stories' that are process-based, fluid and context-dependent.

A Descriptive 5-Year Analysis of the Demographics and Therapies for Patients With Immune Thrombotic Thrombocytopenic Purpura in the USA: A Multicenter Study of 390 Disease Episodes From 2017 to 2021.

Immune thrombotic thrombocytopenic purpura (iTTP) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and microvascular occlusion secondary to acquired ADAMTS13 deficiency. Contemporary data regarding iTTP treatment practices in the US, including the use of caplacizumab, are lacking. We aimed to characterize the demographics and therapies, including medications and apheresis practices, in patients with iTTP in the US.

Survey of anatomic and clinical pathology services and infrastructure in Nigeria.

Objectives: The paucity of data regarding the availability and extent of diagnostic medical services across sub-Saharan Africa hinders appropriate allocation of resources to improve health care in these regions. We assessed anatomic pathology (AP) and clinical pathology (CP) services in Nigeria, one of the most populous and fastest-growing countries in the world.

Methods: Two individual surveys (AP focused and CP focused) were developed by subject matter experts and administered to individuals involved in pathology and laboratory medicine diagnostic services at hospitals and laboratories across Nigeria between June and August 2022 using the American Society for Clinical Pathology email listserv.

Survey of clinical microbiology and infectious disease testing capabilities among institutions in Africa.

Objectives: Inadequate laboratory infrastructure and testing capabilities are a major impediment to addressing the infectious disease burden in Africa. Therefore, the aims of this study were to characterize the clinical microbiology/infectious disease laboratory capabilities among countries in Africa.

Methods: A survey to assess the microbiological testing capabilities at hospitals, government laboratories, and free-standing public and private laboratories in African countries was developed by subject matter experts.

Physician perspectives about the diagnosis and management of acute chest syndrome.

Background: Acute chest syndrome (ACS) is the leading cause of mortality, accounting for 25% of all deaths among individuals with sickle cell disease (SCD). There is a lack of evidence-based laboratory and clinical risk stratification guidelines for the diagnosis and management of ACS.

Study Design And Methods: To better understand physician practices for the management of ACS in the United States, we created an ACS Working Group including hematology and transfusion medicine physicians from four different SCD treatment centers in the United States.

The seasonal distribution of immune thrombotic thrombocytopenic purpura is influenced by geography: Epidemiologic findings from a multi-center analysis of 719 disease episodes.

Prior studies have suggested that immune thrombotic thrombocytopenic purpura (iTTP) may display seasonal variation; however, methodologic limitations and sample sizes have diminished the ability to perform a rigorous assessment. This 5-year retrospective study assessed the epidemiology of iTTP and determined whether it displays a seasonal pattern. Patients with both initial and relapsed iTTP (defined as a disintegrin and metalloprotease with thrombospondin type motifs 13 activity <10%) from 24 tertiary centers in Australia, Canada, France, Greece, Italy, Spain, and the US were included.

How do I manage a blood product shortage?

Background: The demand for blood products sometimes exceeds the available inventory. Blood product inventories are dependent upon the availability of donors, supplies and reagents, and collection staff. During prolonged extreme shortages, blood centers and transfusion services must alter practices to meet the needs of patients.

Anatomic and clinical pathology services and infrastructure in Zambia.

Objectives: Pathology services are limited across most of sub-Saharan Africa. We sought to ascertain the availability of anatomic and clinical pathology services and diagnostic resources in Zambia.

Methods: Two individual surveys-one for anatomic pathology and one for clinical pathology/laboratory medicine-were developed by subject matter experts.

Survey of blood collection and transfusion practices among institutions in Africa.

Introduction: Dramatic improvements in blood transfusion have occurred during the last two decades. Transfusion medicine services and practices in Africa remain underexplored.

Methods: A survey of blood bank/transfusion medicine (BBTM) practices, available blood products, blood product source(s), pre-transfusion testing, and blood donor infectious disease testing methodologies across Africa was performed using the American Society for Clinical Pathology (ASCP) listserv.

A multidisciplinary comparison of transfusion and perioperative support for high-risk cardiac surgery at three large academic centres in North America.

Cardiac surgery is associated with numerous peri- and post-operative haemostatic complications and blood transfusion requirements. Complex procedures such as redo-sternotomy heart transplantation or type A aortic dissection repairs are at high-risk for severe coagulopathy and significant transfusion requirements. However, current practice guidelines do not specifically address high-risk surgeries, resulting in variable practice.

Transfusion medicine research in Africa: Insights from investigators in the field.

Background And Objectives: Research in low-resource settings is inherently challenging. We sought to assess the factors that have impeded or facilitated transfusion medicine (TM) research in various African settings.

Materials And Methods: A qualitative case study was conducted of selected investigators in Africa; selection was based on productivity-spanning publication, leadership and research in TM.

Object recognition ability predicts category learning with medical images.

We investigated the relationship between category learning and domain-general object recognition ability (o). We assessed this relationship in a radiological context, using a category learning test in which participants judged whether white blood cells were cancerous. In study 1, Bayesian evidence negated a relationship between o and category learning.

Blood utilization in liver transplantation (BUILT): A multidisciplinary survey of transfusion practices.

Background: The purpose of this study was to survey liver transplant centers in the United States to assess baseline practices in blood utilization and identify opportunities for standardization to optimize blood use in these complex cases.

Study Design And Methods: Two surveys, one for transfusion medicine physicians and the other for anesthesiologists, were distributed to high-volume liver transplant centers.

Results: The response rate was 52% for both surveys.

COVID-19 Pandemic Impact on Academic Global Health Programs: Results of a Large International Survey.

Background: The COVID-19 pandemic caused significant disruptions in international communications and travel for academic global health programs (AGHPs) in both high-income countries (HICs) and low- and middle-income countries (LMICs). Given the importance of international travel and communication to AGHPs, the pandemic has likely had considerable impact on the education, research, and administrative components of these programs. To date, no substantive study has determined the impacts of the COVID-19 pandemic on AGHPs in HICs and LMICs.

Empathy across cultures - one size does not fit all: from the ego-logical to the eco-logical of relational empathy.

Empathy is extolled in Western healthcare and medical education as an exemplary quality to cultivate in trainees and providers. Yet it remains an elusive and inadequately understood attribute. It posits a "one size fits all" unidimensional attribute applicable across contexts with scant attention given to its multifaceted dimensions in intercultural contexts.

Global health education in high-income countries: confronting coloniality and power asymmetry.

Contemporary global health education is overwhelmingly skewed towards high-income countries (HICs). HIC-based global health curricula largely ignore colonial origins of global health to the detriment of all stakeholders, including trainees and affected community members of low- and middle-income countries. Using the Consortium of Universities for Global Health's , we analyse the current structure and content of global health curricula in HICs.

Status of hospital-based blood transfusion services in low-income and middle-income countries: a cross-sectional international survey.

Objectives: Blood transfusion is life-saving for patients experiencing acute blood loss and severe anaemia. In low-income and middle-income countries (LMICs), low blood donation rates and unavailability of whole blood and blood components (blood products) impairs timely blood transfusion. To fulfil patient-specific blood orders, a hospital blood transfusion service (HBTS) receives orders from a prescriber for blood transfusion, tests and prepares blood products for the patient.

COVID-19 and the impact on blood availability and transfusion practices in low- and middle-income countries.

Background/case Studies: The coronavirus disease 2019 (COVID-19) pandemic disrupted the global blood supply. Low- and middle-income countries (LMICs) already experienced blood supply deficits that preceded the pandemic. We sought to characterize the challenges experienced during the pandemic, and adaptations, such as COVID-19 convalescent plasma (CCP).

Improving Medical Image Decision-Making by Leveraging Metacognitive Processes and Representational Similarity.

Improving the accuracy of medical image interpretation can improve the diagnosis of numerous diseases. We compared different approaches to aggregating repeated decisions about medical images to improve the accuracy of a single decision maker. We tested our algorithms on data from both novices (undergraduates) and experts (medical professionals).