Powassan virus is a tick-borne flavivirus that can cause severe neuroinvasive disease, with areas of endemicity in the Northeast and Midwest United States, Canada, and Russia. Diagnosis is challenging and relies on a high index of suspicion and choosing the right test based on duration of infection and the patient\'s immune status. This review covers laboratory testing for Powassan virus, including historical considerations, modern options, and methods being developed in the research space.

For antinuclear antibody (ANA) screening, the gold standard method is an indirect immunofluorescence assay (IIFA) using HEp-2 cells, and a serial dilution test is needed to determine the endpoint titer. We aimed to evaluate the accuracy of the estimated endpoint titer (eEPT) by the NOVA View system, by comparing it with the EPT by the serial dilution method (dEPT). The endpoint titers of a total of 1518 ANA positive cases with five major patterns including speckled, homogeneous, centromere, nucleolar, and nuclear dots patterns were determined using both the estimation function and the serial dilution method by the NOVA View system. A significant correlation between the light intensity unit (LIU) values and dEPTs was identified in all five patterns with high ρ values, ranging from 0.666 to 0.832. However, the overall exact match rate between dEPT and eEPT was 22.1% (336/1518), with the ±one-titer match rate being highest in the centromere pattern (62.8%, 81/129), and lowest in the homogeneous pattern (37.6%, 200/532). This suggests that while LIU values correlate well with dEPT, there are discrepancies in numerical agreement. Most cases that did not show an exact match, showed one-to-three-titer overestimations by eEPT. Therefore, adjusting eEPT downward significantly improved the concordance rates with dEPTs. Further investigation for an appropriate cutoff of LIU values for determining eEPT should be performed for clinical application and contribution to the standardization of the ANA titer.

Domestic rabbits (Oryctolagus cuniculus) are commonly kept as pets or bred for laboratory investigation, meat, fur production, or a combination of these purposes. We conducted a retrospective study to assess the prevalence of diseases in domestic rabbits according to purpose. We retrieved results of autopsies, biopsies, and cytologies from 2,583 cases received at 4 diagnostic laboratories in California from 2013-2022. Rabbits were classified as pets (2,241; 86.8%), laboratory animals (92; 3.6%), meat-production animals (60; 2.3%), or multipurpose animals (190; 7.4%). A final diagnosis was reached in 2,360 (91.4%) cases and was classified by system, etiology, and type of process. Pet rabbits had the highest median age (5.9 y; vs. 3 y, 0.67 y, and 0.25 y in meat, multipurpose, and laboratory rabbits, respectively), and most of the neoplasms were diagnosed in this group (872 of the total 896 neoplasms in the study; 97.3%), with tumors of the skin, female reproductive tract, and hematolymphoid system being the most common. Laboratory rabbits had a high prevalence of infectious enterotyphlocolitis (40 of 92; 43.4%), and ~45% of those cases were due to opportunistic colibacillosis. Infectious and parasitic pneumonias were common in meat rabbits (18 of 60; 30%); pneumonic pasteurellosis accounted for >60% of those cases. Infectious cholangiohepatitides were common in multipurpose rabbits (61 of 110; 55.5%), with rabbit hemorrhagic disease representing the most common etiology (82.4% of those cases). Our results demonstrate that purpose of use can predict prevalence of disease in rabbits submitted to diagnostic laboratories.

Direct oral anticoagulants (DOACs) have significant advantages over vitamin K antagonists including lack of need for routine laboratory monitoring. However, assessment of DOAC effect and concentration may be important to guide clinical management including need for DOAC reversal, particularly in acute or emergent situations. In this manuscript, the authors describe tests to screen for DOAC presence and tests that have demonstrated equivalence to gold standard testing for quantifying DOAC exposure. They also discuss the effect of DOACs on other coagulation assays and strategies for monitoring unfractionated heparin in patients with concomitant DOAC exposure.

BACKGROUND: Several indexes based on clinical and laboratory tests to identify frailty and to predict mortality have been produced. Only two studies, mixing clinical and laboratory parameters were made about a frailty index made of laboratory tests (FI-Lab) and mortality in older patients hospitalized for COVID-19. The aim of this study was to explore the accuracy and precision of an FI-Lab constructed with some common bio-humoral tests and mortality in a cohort of patients hospitalized for COVID-19.
METHODS: The FI-Lab was constructed using 40 different bio-humoral tests during the first four days of hospitalization, with a score from 0 to 1. The association between FI-Lab and mortality was assessed using a multivariate Cox\'s regression analysis, reported as hazard ratios (HRs) and 95% confidence intervals (CIs). The accuracy of the FI-Lab was reported as area under the curve (AUC) and the precision with the C-Index.
RESULTS: 376 patients (mean age: 65 years; 53.7% males) were initially included. During the follow-up period, 41 deceased. After adjusting for five different factors, an FI-Lab value >0.54, the median value of our cohort, was associated with a relative risk about five times greater than lower values. Modeling FI-LAB as a continous variable, each increase in 0.01 points was associated with an increased risk in mortality of 8.4% (HR=1.084; 95%CI: 1.039-2.044). The FI-Lab was highly accurate (AUC=0.91; 95%CI: 0.87-0.95) and precise (C-Index=0.81) in predicting death.
CONCLUSIONS: A simple index based on common laboratory tests can be used to predict mortality among older people hospitalized for COVID-19.

Accurately characterizing permanent deformation in granular materials subjected to cyclic loading is crucial for pavement design. This paper introduces an alternative approach to characterizing permanent deformation in a framework that reduces the number of load cycle repetitions by applying an alternative analytical strategy based on plastic strain rate variation over time. The methodology uses a cycle-hardening approach to establish correlations between short-term (post-compaction) and long-term (shakedown state) plastic strain accumulation. This alternative approach provides an efficient means to accelerate the characterization of permanent deformation, ensuring the integrity and validity of the assessment in a more time-efficient and resource-optimized way.

BACKGROUND: The integration of augmented reality (AR) in spine surgery marks a significant advancement, enhancing surgical precision and patient outcomes. AR provides immersive, three-dimensional visualizations of anatomical structures, facilitating meticulous planning and execution of spine surgeries. This technology not only improves spatial understanding and real-time navigation during procedures but also aims to reduce surgical invasiveness and operative times. Despite its potential, challenges such as model accuracy, user interface design, and the learning curve for new technology must be addressed. AR\'s application extends beyond the operating room, offering valuable tools for medical education and improving patient communication and satisfaction.
METHODS: A literature review was conducted by searching PubMed and Scopus databases using keywords related to augmented reality in spine surgery, covering publications from January 2020 to January 2024.
RESULTS: In total, 319 articles were identified through the initial search of the databases. After screening titles and abstracts, 11 articles in total were included in the qualitative synthesis.
CONCLUSIONS: Augmented reality (AR) is becoming a transformative force in spine surgery, enhancing precision, education, and outcomes despite hurdles like technical limitations and integration challenges. AR\'s immersive visualizations and educational innovations, coupled with its potential synergy with AI and machine learning, indicate a bright future for surgical care. Despite the existing obstacles, AR\'s impact on improving surgical accuracy and safety marks a significant leap forward in patient treatment and care.

This article explores the growing prominence of nature-inspired design philosophies in the context of sustainability and human well-being within the built environment and focuses on their application within laboratory buildings. Biomimicry and biophilic design are highlighted as key nature-inspired design approaches, with biomimicry drawing inspiration from nature for innovations and biophilic design promoting human health through enhancing the connection with the surrounding natural elements. This paper further discusses living building strategy as an emerging method for creating dynamic and adaptable spaces by prioritizing user experience through co-creation and focusing on sustainable and regenerative structures. The potential of integrating these approaches is emphasized using laboratory buildings as an example, with nature-inspired and living laboratories serving as models for future built environments that promote both environmental responsibility and a positive human experience. Accordingly, this work aims to investigate the design and construction of laboratory buildings based on nature-inspired design strategies and the living building concept. Moreover, the paper discusses the application of biomimicry and living building concepts within laboratory buildings as a novel contribution to the body of knowledge, and concludes by proposing the Nature-inspired & Living Laboratory (NILL 1.0)TM Building Assessment index to serve as a guideline for the design and construction of laboratory buildings using nature as an inspiration and the analogy of human body systems.

Laboratory stress tasks are necessary to closely investigate the stress response in a controlled environment. However, to our knowledge, no study has tested whether participating in such tasks can pose any daily life adverse effect. Fifty-three healthy participants (46 women) took part in a laboratory session where stress was induced using a typical psychosocial stressor: the repeated Montreal Imaging Stress Task (rMIST). Average levels of negative affect (NA), heart rate (HR), root mean square of successive differences (RMSSD), and skin conductance level (SCL), as well as reactivity across all these parameters as measured with the experience sampling method (ESM) in the four days prior to the laboratory session were compared with the four days following the session. We also assessed whether vulnerability to psychopathology moderated these associations. Findings showed that the task did not pose any significant adverse effect on participants. However, there was an unexpected increase in average RMSSD and a decrease in average SCL pre- to post- task. In addition, more vulnerable individuals were more likely to experience an increase in average levels of NA in the days following the task compared to the days preceding it. Our findings suggest that laboratory stress tasks may pose a significant risk to more vulnerable individuals.

BackgroundThe COVID-19 pandemic and the emergence of Candida auris have changed the epidemiological landscape of candidaemia worldwide.AimWe compared the epidemiological trends of candidaemia in a Greek tertiary academic hospital before (2009-2018) and during the early COVID-19 (2020-2021) and late COVID-19/early post-pandemic (2022-2023) era.MethodsIncidence rates, species distribution, antifungal susceptibility profile and antifungal consumption were recorded, and one-way ANOVA or Fisher\'s exact test performed. Species were identified by MALDI-ToF MS, and in vitro susceptibility determined with CLSI M27-Ed4 for C. auris and the EUCAST-E.DEF 7.3.2 for other Candida spp.ResultsIn total, 370 candidaemia episodes were recorded during the COVID-19 pandemic. Infection incidence (2.0 episodes/10,000 hospital bed days before, 3.9 during the early and 5.1 during the late COVID-19 era, p < 0.0001), C. auris (0%, 9% and 33%, p < 0.0001) and fluconazole-resistant C. parapsilosis species complex (SC) (20%, 24% and 33%, p = 0.06) infections increased over time, with the latter not associated with increase in fluconazole/voriconazole consumption. A significant increase over time was observed in fluconazole-resistant isolates regardless of species (8%, 17% and 41%, p < 0.0001). Resistance to amphotericin B or echinocandins was not recorded, with the exception of a single pan-echinocandin-resistant C. auris strain.ConclusionCandidaemia incidence nearly tripled during the COVID-19 era, with C. auris among the major causative agents and increasing fluconazole resistance in C. parapsilosis SC. Almost half of Candida isolates were fluconazole-resistant, underscoring the need for increased awareness and strict implementation of infection control measures.