Digital pathology, deep learning, and cancer: a narrative review.

Background and Objective: Cancer is a leading cause of morbidity and mortality worldwide. The emergence of digital pathology and deep learning technologies signifies a transformative era in healthcare. These technologies can enhance cancer detection, streamline operations, and bolster patient care. A substantial gap exists between the development phase of deep learning models in controlled laboratory environments and their translations into clinical practice. This narrative review evaluates the current landscape of deep learning and digital pathology, analyzing the factors influencing model development and implementation into clinical practice. Methods: We searched multiple databases, including Web of Science, Arxiv, MedRxiv, BioRxiv, Embase, PubMed, DBLP, Google Scholar, IEEE Xplore, Semantic Scholar, and Cochrane, targeting articles on whole slide imaging and deep learning published from 2014 and 2023. Out of 776 articles identified based on inclusion criteria, we selected 36 papers for the analysis. Key Content and Findings: Most articles in this review focus on the in-laboratory phase of deep learning model development, a critical stage in the deep learning lifecycle. Challenges arise during model development and their integration into clinical practice. Notably, lab performance metrics may not always match real-world clinical outcomes. As technology advances and regulations evolve, we expect more clinical trials to bridge this performance gap and validate deep learning models' effectiveness in clinical care. High clinical accuracy is vital for informed decision-making throughout a patient's cancer care. Conclusions: Deep learning technology can enhance cancer detection, clinical workflows, and patient care. Challenges may arise during model development. The deep learning lifecycle involves data preprocessing, model development, and clinical implementation. Achieving health equity requires including diverse patient groups and eliminating bias during implementation. While model development is integral, most articles focus on the pre-deployment phase. Future longitudinal studies are crucial for validating models in real-world settings post-deployment. A collaborative approach among computational pathologists, technologists, industry, and healthcare providers is essential for driving adoption in clinical settings.

Recurrence prediction of lung adenocarcinoma using an immune gene expression and clinical data trained and validated support vector machine classifier.

Background: Immune microenvironment plays a critical role in cancer from onset to relapse. Machine learning (ML) algorithm can facilitate the analysis of lab and clinical data to predict lung cancer recurrence. Prompt detection and intervention are crucial for long-term survival in lung cancer relapse. Our study aimed to evaluate the clinical and genomic prognosticators for lung cancer recurrence by comparing the predictive accuracy of four ML models. Methods: A total of 41 early-stage lung cancer patients who underwent surgery between June 2007 and October 2014 at New York University Langone Medical Center were included (with recurrence, n=16; without recurrence, n=25). All patients had tumor tissue and buffy coat collected at the time of resection. The CIBERSORT algorithm quantified tumor-infiltrating immune cells (TIICs). Protein-protein interaction (PPI) network and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted to unearth potential molecular drivers of tumor progression. The data was split into training (75%) and validation sets (25%). Ensemble linear kernel support vector machine (SVM) ML models were developed using optimized clinical and genomic features to predict tumor recurrence. Results: Activated natural killer (NK) cells, M0 macrophages, and M1 macrophages showed a positive correlation with progression. Conversely, T CD4+ memory resting cells were negatively correlated. In the PPI network, TNF and IL6 emerged as prominent hub genes. Prediction models integrating clinicopathological prognostic factors, tumor gene expression (45 genes), and buffy coat gene expression (47 genes) yielded varying receiver operating characteristic (ROC)-area under the curves (AUCs): 62.7%, 65.4%, and 59.7% in the training set, 58.3%, 83.3%, and 75.0% in the validation set, respectively. Notably, merging gene expression with clinical data in a linear SVM model led to a significant accuracy boost, with an AUC of 92.0% in training and 91.7% in validation. Conclusions: Using ML algorithm, immune gene expression data from tumor tissue and buffy coat may enhance the precision of lung cancer recurrence prediction.

Effect of a customized digital adherence tool on retention in care and adherence to antiretroviral treatment in breastfeeding women, children and adolescents living with HIV in Tanzania: a mixed-methods study followed by clinical trials.

BACKGROUND: Adherence to antiretroviral (ARV) treatment for HIV infection is challenging because of many factors. The World Health Organization (WHO) has recommended using digital adherence technologies (DATs). However, there is limited evidence on how DATs improve adherence. Wisepill® is an internet-enabled medication dispenser found feasible and acceptable in several studies. However, limited evidence is available on its effectiveness in improving ART adherence, specifically among children and adolescents. Furthermore, DATs are often developed without involving the target groups. We propose a two-stage project consisting of a formative study to customize an existing Wisepill DAT intervention and a randomized clinical trial to investigate the effectiveness of DAT combined with reminder cues and tailored feedback on adherence to ARV treatment among children and adolescents living with HIV and retention in care among breastfeeding women living with HIV in Kilimanjaro and Arusha Region, Tanzania. METHODS: We will conduct a formative mixed-methods study and three sub-trials in Kilimanjaro and Arusha Regions among (1) children aged 0-14 years and their caregivers, (2) adolescents aged 15-19 years and (3) breastfeeding women and their HIV-negative infants. In the formative study, we will collect and analyse data on needs and contents for DATs, including the contents of short message service (SMS) texts and tailored feedback. The results will inform the customization of the DAT to be tested in the sub-trials. In the trials, participants will be randomized in the intervention arm, where the DAT will be implemented or the control arm, where standard care will be followed. Participants in the intervention arm will take their medication from the Wisepill box and receive daily reminder texts and tailored feedback during clinic visits. DISCUSSION: If the intervention improves adherence to ART and the devices are acceptable, accurate and sustainable, the intervention can be scaled up within the National Aids Control Programmes. TRIAL REGISTRATION: PACTR202301844164954, date 27 January 2023.

Reading a preoperative CT scan to guide complex abdominal wall reconstructive surgery.

Computed tomography (CT) scanning is the imaging modality of choice when planning the overall management and operative approach to complex abdominal wall hernias. Despite its availability and well-recognised benefits there are no guidelines or recommendations regarding how best to read or report such scans for this application. In this paper we aim to outline an approach to interpreting preoperative CT scans in abdominal wall reconstruction (AWR). This approach breaks up the interpretive process into 4 steps-concentrating on the hernia or hernias, any complicating features of the hernia(s), the surrounding soft tissues and the abdominopelvic cavity as a whole-and was developed as a distillation of the authors' collective experience. We describe the key features that should be looked for at each of the four steps and the rationale for their inclusion.

European survey on the current surveillance practices, management guidelines, treatment pathways and heterogeneity of testing of Clostridioides difficile, 2018-2019: results from The Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI).

BACKGROUND: Awareness and compliance with international guidelines for diagnosis and clinical management of Clostridioides difficile infection (CDI) are unknown. AIM: To compare the awareness and compliance with the recommended strategies for diagnosis and clinical management of CDI across Europe in 2018-2019. METHODS: Hospital sites and their associated community practices across 12 European countries completed an online survey in 2018-2019, to report on their practices in terms of surveillance, prevention, diagnosis, and treatment of CDI. Responses were collected from 105 hospitals and 39 community general practitioners (GPs). FINDINGS: Hospital sites of 11 countries reported participation in national surveillance schemes compared with six countries for international schemes. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID)-recommended CDI testing methodologies were used by 82% (86/105) of hospitals, however countries reporting the highest incidence of CDI used non-recommended tests. Over 75% (80/105) of hospitals were aware of the most recent European CDI treatment guidelines at the time of this survey compared with only 26% (10/39) of surveyed GPs. However, up to 15% (16/105) of hospitals reported using the non-recommended metronidazole for recurrent CDI cases, sites in countries with lower awareness of CDI treatment guidelines. Only 37% (39/105) of hospitals adopted contact isolation precautions in case of suspected CDI. CONCLUSION: Good awareness of guidelines for the management of CDI was observed across the surveyed European hospital sites. However, low compliance with diagnostic testing guidelines, infection control measures for suspected CDI, and insufficient awareness of treatment guidelines continued to be reported in some countries.

Increased SERCA2a sub-cellular heterogeneity in right-ventricular heart failure inhibits excitation-contraction coupling and modulates arrhythmogenic dynamics.

The intracellular calcium handling system of cardiomyocytes is responsible for controlling excitation-contraction coupling (ECC) and has been linked to pro-arrhythmogenic cellular phenomena in conditions such as heart failure (HF). SERCA2a, responsible for intracellular uptake, is a primary regulator of calcium homeostasis, and remodelling of its function has been proposed as a causal factor underlying cellular and tissue dysfunction in disease. Whereas adaptations to the global (i.e. whole-cell) expression of SERCA2a have been previously investigated in the context of multiple diseases, the role of its spatial profile in the sub-cellular volume has yet to be elucidated. We present an approach to characterize the sub-cellular heterogeneity of SERCA2a and apply this approach to quantify adaptations to the length-scale of heterogeneity (the distance over which expression is correlated) associated with right-ventricular (RV)-HF. These characterizations informed simulations to predict the functional implications of this heterogeneity, and its remodelling in disease, on ECC, the dynamics of calcium-transient alternans and the emergence of spontaneous triggered activity. Image analysis reveals that RV-HF is associated with an increase in length-scale and its inter-cellular variability; simulations predict that this increase in length-scale can reduce ECC and critically modulate the vulnerability to both alternans and triggered activity. This article is part of the theme issue 'The cardiomyocyte: new revelations on the interplay between architecture and function in growth, health, and disease'.

Intracranial Hemorrhage Secondary to Vitamin K Deficiency Bleeding in a Newborn.

We present a case of a 6-week-old infant who presented with seizure-like activity. Workup revealed abnormal coagulation and imaging confirmed intracranial hemorrhage. Parental refusal of vitamin K treatment at birth suggested vitamin K deficiency bleeding (VKDB) in this newborn. Though VKDB is rare in developed countries, rates have been rising which coincides with an increasing trend of parental refusal of vitamin K prophylaxis at birth.

Effect of early photostimulation at 15-weeks of age and everyday spin feeding on broiler breeder performance.

To prevent broiler breeders from growing too quickly and becoming too large for optimum reproduction, their dietary intake is restricted. While current restricted feeding programs, such as skip-a-day feeding (SAD), improve the economic efficiency of broiler breeder operations, this management practice impacts bird welfare. There is an interest in finding strategies that could reduce the impact of feed restriction during broiler breeder rearing. This research investigated the effects of feeding pullets on an advanced growth curve for early photostimulation at 15 wk (15P) or standard growth curve for photostimulation at 21 wk (21P), using either an every-day-spin feeding program (EDS) or SAD feeding, on the reproductive parameters of broiler breeder hens in a 2 × 2 factorial arrangement. Overall, advancing the growth curve (15P) decreased blood corticosterone levels compared to 21P, but EDS resulted in higher blood corticosterone levels compared to SAD. At the end of rearing in both 15P and 21P, EDS pullets weighed less than SAD pullets. The onset of egg production was 20 and 24 wk of age for the 15P and 21P hens, respectively. Despite an earlier onset, 15P hens did not produce more eggs than 21P hens through 65 wk of age. Egg weight was reduced for 15P compared to 21P until 30 wk of age. The 15P hens had a greater number of double yolk eggs than the 21P hens. Fertility and hatch were not impacted by the advanced growth curve and early photostimulation. Although the current research indicates the potential to reduce feed restriction associated welfare issues by rearing broiler breeder pullets for an earlier photostimulation onset, further research in needed to determine if this management technique can be improved to optimize hen reproductive efficiency.

From policy to practice: An assessment of biosecurity practices in cattle, sheep and goats production, marketing and slaughter in Baringo County, Kenya.

Globally, biosecurity is instrumental in prevention, control and management of livestock diseases and protection of human health. It is defined, prescribed, adopted and enforced through global, regional and national frameworks, laws, policies and strategies. There is more biosecurity practice research conducted in developed countries than developing ones. Consequently, the gap between the ideals recommended in biosecurity frameworks and what is practical in under-resourced rural settings is poorly understood. This anthropological study sought to assess adoption of biosecurity practices across a cattle, sheep and goat value chains continuum to demonstrate where risks lie. The cross-sectional mixed-methods study took place in Baringo County, Kenya. Qualitatively, it utilized 26 focus group discussions with community members and 10 observational interviews with slaughter facility workers. Quantitatively, it included a household survey with 560 community members and a separate survey with 231 livestock traders. Results show that producers, traders and slaughter facility workers did observe some biosecurity practices but not others due but not limited to personal preference, limitations in veterinary service delivery and enforcement of some biosecurity measures, and lack of requisite infrastructure. The study concludes that the implementation of biosecurity measures in rural settings is more complex than envisioned in biosecurity policies and frameworks. It can be hampered by resource limitations, poor enforcement, and contestations with cultural practices. The study recommends that further studies on willingness to adopt biosecurity measures targeting community members in under-resourced settings be conducted to identify possible critical points of intervention at county and national levels.

The Exponentiated Gumbel-Weibull {Logistic} Distribution with Application to Nigeria's COVID-19 Infections Data.

A new flexible univariate probability distribution was defined in this paper. The new distribution is so called the 'exponentiated Gumbel-Weibull {logistic} distribution' and it arose by using the exponentiated Gumbel distribution to generate a generalized Weibull distribution using the logit function or the quantile function of the logistic distribution as a link. The new distribution was observed to be both unimodal and bimodal as well as exhibits various shape and tail properties consistent with data arising from several real life phenomena. A detail study of its statistical properties was carried out and the maximum likelihood method was used in the estimation of its parameters. The new distribution was applied in fitting the reported daily number of infections due to the COVID-19 pandemic in Nigeria. Five other datasets were further used to ascertain the flexibility of the new distribution in fitting data sets with different statistical properties.

Development of a dosimeter prototype with machine learning based 3-D dose reconstruction capabilities.

A 3-D dosimeter fills the need for treatment plan and delivery verification required by every modern radiation-therapy method used today. This report summarizes a proof-of-concept study to develop a water-equivalent solid 3-D dosimeter that is based on novel radiation-hard scintillating material. The active material of the prototype dosimeter is a blend of radiation-hard peroxide-cured polysiloxane plastic doped with scintillating agent P-Terphenyl and wavelength-shifter BisMSB. The prototype detector was tested with 6 MV and 10 MV x-ray beams at Ohio State University's Comprehensive Cancer Center. A 3-D dose distribution was successfully reconstructed by a neural network specifically trained for this prototype. This report summarizes the material production procedure, the material's water equivalency investigation, the design of the prototype dosimeter and its beam tests, as well as the details of the utilized machine learning approach and the reconstructed 3-D dose distributions.

A Community Survey on the Prevalence, Determinants and Socioeconomic Factors associated with Skin Lightening Practices in Benin City, South-South, Nigeria.

BACKGROUND: In Nigeria, many men and women from different socioeconomic classes, commonly incur expenses in the pursuit of lighter skin. This recurrent expenditure and the associated costs of the alternative foregone as well as added costs associated with management of the adverse effects have the capacity to negatively impact on the finances of individuals and households who engage in skin lightening practices. OBJECTIVES: This study aimed to identify the sociodemographic characteristics of respondents in Benin City, Nigeria, determine the prevalence of the skin lightening practices among these respondents and explore the financial implications of these practices. METHODS: A cross-sectional community-based survey using pretested structured questionnaires was conducted on 454 men and women aged 18-70 years selected via multistage sampling in Oredo local government area of Benin city, Edo state, Nigeria. RESULTS: There were 207 males and 247 females included in the survey. Of these 55.3 % were currently using skin lightening products. The average monthly expenditure on cosmetics was significantly higher for users of skin lightening agents (Mean = N==2,183.13, SD = 2,822.91) compared to respondents who did not use skin lightening agents (Mean = =N=1,292.91, SD =1,379.43) (p < 0.001). Cost was the least common factor (2.5%) observed to influence respondents' purchase of skin lightening agents while recommendations from friends and family (59.2%) was the most common factor observed to influence their purchase. Majority of respondents engaged in this practice (77.5%) had seen a doctor or health worker for treatment of a skin problem that occurred during the use of skin lightening agents. CONCLUSION: Engaging in skin lightening practices was done by more than half of the respondents regardless of the cost of the agents and socioeconomic class, with the average monthly expenditure on cosmetics being significantly higher for users of skin lightening agents. This has the potential to negatively impact on the socioeconomic status of the individuals, households and the Nigerian economy over time.

CONTEXTE: Au Nigeria, beaucoup d'hommes et de femmes de différentes classes socio-économiques engagent des dépenses pour obtenir une peau plus claire. Ces dépenses récurrentes et les coûts associés à l'alternative abandonnée ainsi que les coûts supplémentaires associés à la gestion des effets indésirables ont la capacité d'avoir un impact négatif sur les finances des individus et des ménages qui s'engagent dans des pratiques d'éclaircissement de la peau. OBJECTIFS: Cette étude visait à identifier les caractéristiques sociodémographiques des personnes interrogées à Benin City, au Nigeria, à déterminer la prévalence des pratiques d'éclaircissement de la peau parmi ces personnes et à explorer les implications financières de ces pratiques. MÉTHODES: Une enquête communautaire transversale utilisant des questionnaires structurés prétestés a été menée auprès de 454 hommes et femmes âgés de 18 à 70 ans sélectionnés par échantillonnage à plusieurs degrés dans la zone de gouvernement local d'Oredo de la ville de Benin, dans l'État d'Edo, au Nigeria. RÉSULTATS: L'enquête a porté sur 207 hommes et 247 femmes. Parmi eux, 55,3 % utilisaient actuellement des produits d'éclaircissement de la peau. Les dépenses mensuelles moyennes en cosmétiques étaient significativement plus élevées pour les utilisateurs d'agents éclaircissants pour la peau (Moyenne = ¦ 2 183,13, ET = 2 822,91) par rapport aux répondants qui n'utilisaient pas d'agents éclaircissants pour la peau (Moyenne = ¦ 1 292,91, ET = 1 379,43) (p < 0,001). Le coût était le facteur le moins courant (2,5 %) observé pour influencer l'achat d'agents éclaircissants pour la peau par les répondants, tandis que les recommandations des amis et de la famille (59,2 %) étaient le facteur le plus courant observé pour influencer leur achat. La majorité des répondants engagés dans cette pratique (77,5 %) avaient consulté un médecin ou un agent de santé pour le traitement d'un problème de peau survenu lors de l'utilisation d'agents éclaircissants. CONCLUSION: Plus de la moitié des personnes interrogées s'adonnent à des pratiques d'éclaircissement de la peau, indépendamment du coût des agents et de la classe socio-économique, les dépenses mensuelles moyennes en cosmétiques étant significativement plus élevées pour les utilisateurs d'agents d'éclaircissement de la peau. Cela peut avoir un impact négatif sur le statut socio-économique des individus, des ménages et de l'économie nigériane au fil du temps. Mots clés: Agents d'éclaircissement de la peau ; blanchiment de la peau; peau noire; peau ethnique ; socio-économique; économie ; classe; finances; abus; défavorable.

Dietary inclusion of AZOMITE improves feed efficiency in broilers and egg production in laying and broiler breeder hens.

The dietary inclusion of aluminosilicates has been reported to enhance pellet quality, improve feed mill throughput, bind toxins, improve feed efficiency, and promote immunological function across a variety of production systems. AZOMITE is a product marketed as a hydrated sodium calcium aluminosilicate containing macro and trace minerals, and rare earth elements and the potential benefits of its dietary inclusion in broiler, layer, and broiler breeder diets was investigated. In a battery study, broilers were fed diets containing 0, 0.125, 0.250, or 0.500% AZOMITE from 0 to 21 d of age. Laying hens were fed a control diet or this diet supplemented with 0.25% AZOMITE from 54 through 98 wk of age, with the hens fed a standard molting diet or this diet supplemented with 0.25% AZOMITE from 71 to 72 wk of age. Broiler breeder hens were fed a control diet or this diet supplemented with 0.25% AZOMITE from the onset of photostimulation at 21 wk of age through 65 wk of age. All 3 dietary inclusion rates of AZOMITE improved (P < 0.05) the feed to body weight gain ratio in broilers fed these diets relative to broilers fed the control diet. In laying hens total marketable eggs, and in broiler breeder hens total settable eggs were increased (P < 0.05) with the dietary inclusion of AZOMITE by 8 eggs per hen. The inclusion of dietary AZOMITE also improved apparent Ca and P digestibility in broilers and tibia ash content in laying hens. The results indicate the dietary inclusion of AZOMITE in poultry diets improves bird performance.

A machine learning-based prediction of the micropapillary/solid growth pattern in invasive lung adenocarcinoma with radiomics.

BACKGROUND: Micropapillary/solid (MP/S) growth patterns of lung adenocarcinoma are vital for making clinical decisions regarding surgical intervention. This study aimed to predict the presence of a MP/S component in lung adenocarcinoma using radiomics analysis. METHODS: Between January 2011 and December 2013, patients undergoing curative invasive lung adenocarcinoma resection were included. Using the "PyRadiomics" package, we extracted 90 radiomics features from the preoperative computed tomography (CT) images. Subsequently, four prediction models were built by utilizing conventional machine learning approaches fitting into radiomics analysis: a generalized linear model (GLM), Naïve Bayes, support vector machine (SVM), and random forest classifiers. The models' accuracy was assessed using a receiver operating curve (ROC) analysis, and the models' stability was validated both internally and externally. RESULTS: A total of 268 patients were included as a primary cohort, and 36.6% (98/268) of them had lung adenocarcinoma with an MP/S component. Patients with an MP/S component had a higher rate of lymph node metastasis (18.4% versus 5.3%) and worse recurrence-free and overall survival. Five radiomics features were selected for model building, and in the internal validation, the four models achieved comparable performance of MP/S prediction in terms of area under the curve (AUC): GLM, 0.74 [95% confidence interval (CI): 0.65-0.83]; Naïve Bayes, 0.75 (95% CI: 0.65-0.85); SVM, 0.73 (95% CI: 0.61-0.83); and random forest, 0.72 (95% CI: 0.63-0.81). External validation was performed using a test cohort with 193 patients, and the AUC values were 0.70, 0.72, 0.73, and 0.69 for Naïve Bayes, SVM, random forest, and GLM, respectively. CONCLUSIONS: Radiomics-based machine learning approach is a very strong tool for preoperatively predicting the presence of MP/S growth patterns in lung adenocarcinoma, and can help customize treatment and surveillance strategies.

Lyrics and artistic improvisations in health promotion for the COVID-19 pandemic control in East Africa.

News about the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan City, Hubei Province, China in December 2019 diffused gradually to East Africa through mainstream media and social media. The general public construed the pandemic threat as being 'far away' and associated it with foreign practices and behaviours. Social media discourse was initially replete with indifference about the perceived risk. Conflicting views about the possibility of the pandemic spreading to Africa and the complexity of explaining its causes delayed the desired understanding of the reality of the global public health concern. The popular public response to the COVID-19 control discourse is therefore characterised by ambivalence about embracing the pandemic control protocols. Drawing on content and discourse analysis of musical and poetic compositions on COVID-19 by artists in East Africa and shared among WhatsApp users in Kenya, this article describes local perspectives on COVID-19 risk and their health promotion implications. It explores local construction of the meaning of the COVID-19 pandemic and its consequences for effective health promotion. The article considers the spontaneous musical and poetic performances by experienced and amateur artists as local attempts to enhance compliance with the global COVID-19 control protocols and popular participation in local health promotion. The basic premise is that artists' creation and sharing of digital COVID-19 lyrics denote their attempt to go beyond the medical logic of health promotion by including broad aspects of a cultural logic of care. This approach would establish an integrated and sustainable health promotion framework to prevent the spread of COVID-19 and its impact on local societal wellbeing.

Characterization of sperm-associated antigen 6 expression in the reproductive tract of the domestic rooster (Gallus domesticus) and its impact on sperm mobility.

Sperm mobility is a major determinant of sperm quality in the domesticated chicken (Gallus domesticus) and is therefore an area of interest for improving fertility. Sperm-associated antigen 6 (SPAG6) is an important flagellar protein implicated to be necessary for flagellar function but negatively associated with rooster fertility. This study was aimed to characterize the expression of SPAG6 and investigate its utility as a protein biomarker of sperm mobility. By western analysis, relative SPAG6 abundances were compared between the testicular, epididymal, and vasal tissues and in sequentially maturing sperm. Immunocytochemistry techniques were used to detect localization of SPAG6 in chicken sperm. Last, western analysis was used to compare relative SPAG6 abundances in sperm of differing mobility. SPAG6 was found in higher abundance in epididymal tissues and in highest abundance in vasal tissues, relative to that of the testis. SPAG6 was also found to sequentially increase in abundance in maturing sperm. SPAG6 localizes between the axonemal central pair of microtubules in the sperm flagella, but it is also found in lower concentration in the acrosomal region. SPAG6 was not a significant predictor of sperm mobility. SPAG6 abundance, alone, is not a strong predictor of sperm mobility. Its impact on rooster fertility is likely unrelated to its impact on sperm mobility.

Candida auris in the Age of Resistance.

Candida auris (C. auris) is an opportunistic ascomycetous budding yeast that has been emerging as an invasive, multidrug-resistant pathogen over the past 10 years since its discovery. This fungi is the first to be labeled as a public health threat according to the Centers for Disease Control (CDC) and has since become a major problem in the United States. This serves as a detailed overview of the various factors contributing to the pathogenicity of C. auris.

The consensus Immunoscore in phase 3 clinical trial (N0147) and impact on patient management decisions.

The consensus Immunoscore is a routine assay quantifying the adaptive immune response within the tumor microenvironment. It has a prognostic value that has been confirmed in a phase 3 clinical trial (NCCTG N0147) in stage III colon cancers. Moreover, results from another phase 3 randomized trial revealed the predictive value of Immunoscore for response to adjuvant chemotherapy duration. These results highlight the clinical utility of Immunoscore. In its latest edition, the World Health Organization classification of Digestive System Tumors introduced for the first time the immune response as an essential and desirable diagnostic criterion for colorectal cancer. Within the tumor microenvironment, the immune response provides an important estimate of the risk of recurrence and death in colon cancer. The international validation of the prognostic value of the consensus Immunoscore together with its prognostic value in the N0147 trial and its predictive utility for response to chemotherapy in stage III patients provide valuable information for patient management.