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Lee S, Arffman RK, Komsi EK, Lindgren O, Kemppainen JA, Metsola H, Rossi HR, Ahtikoski A, Kask K, Saare M, Salumets A, Piltonen TT. AI-algorithm training and validation for identification of endometrial CD138+ cells in infertility-associated conditions; polycystic ovary syndrome (PCOS) and recurrent implantation failure (RIF). J Pathol Inform 2024; 15:100380. [PMID: 38827567 PMCID: PMC11140811 DOI: 10.1016/j.jpi.2024.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/20/2024] [Accepted: 04/26/2024] [Indexed: 06/04/2024] Open
Abstract
Background Endometrial CD138+ plasma cells serve as a diagnostic biomarker for endometrial inflammation, and their elevated occurrence correlates positively with adverse pregnancy outcomes. Infertility-related conditions like polycystic ovary syndrome (PCOS) and recurrent implantation failure (RIF) are closely associated with systemic and local chronic inflammatory status, wherein endometrial CD138+ plasma cell accumulation could also contribute to endometrial pathology. Current methods for quantifying CD138+ cells typically involve laborious and time-consuming microscopic assessments of only a few random areas from a slide. These methods have limitations in accurately representing the entire slide and are susceptible to significant biases arising from intra- and interobserver variations. Implementing artificial intelligence (AI) for CD138+ cell identification could enhance the accuracy, reproducibility, and reliability of analysis. Methods Here, an AI algorithm was developed to identify CD138+ plasma cells within endometrial tissue. The AI model comprised two layers of convolutional neural networks (CNNs). CNN1 was trained to segment epithelium and stroma across 28,363 mm2 (2.56 mm2 of epithelium and 24.87 mm2 of stroma), while CNN2 was trained to distinguish stromal cells based on CD138 staining, encompassing 7345 cells in the object layers (6942 CD138- cells and 403 CD138+ cells). The training and performance of the AI model were validated by three experienced pathologists. We collected 193 endometrial tissues from healthy controls (n = 73), women with PCOS (n = 91), and RIF patients (n = 29) and compared the CD138+ cell percentages based on cycle phases, ovulation status, and endometrial receptivity utilizing the AI model. Results The AI algorithm consistently and reliably distinguished CD138- and CD138+ cells, with total error rates of 6.32% and 3.23%, respectively. During the training validation, there was a complete agreement between the decisions made by the pathologists and the AI algorithm, while the performance validation demonstrated excellent accuracy between the AI and human evaluation methods (intraclass correlation; 0.76, 95% confidence intervals; 0.36-0.93, p = 0.002) and a positive correlation (Spearman's rank correlation coefficient: 0.79, p < 0.01). In the AI analysis, the AI model revealed higher CD138+ cell percentages in the proliferative phase (PE) endometrium compared to the secretory phase or anovulatory PCOS endometrium, irrespective of PCOS diagnosis. Interestingly, CD138+ percentages differed according to PCOS phenotype in the PE (p = 0.03). On the other hand, the receptivity status had no impact on the cell percentages in RIF samples. Conclusion Our findings emphasize the potential and accuracy of the AI algorithm in detecting endometrial CD138+ plasma cells, offering distinct advantages over manual inspection, such as rapid analysis of whole slide images, reduction of intra- and interobserver variations, sparing the valuable time of trained specialists, and consistent productivity. This supports the application of AI technology to help clinical decision-making, for example, in understanding endometrial cycle phase-related dynamics, as well as different reproductive disorders.
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Affiliation(s)
- Seungbaek Lee
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu 90220, Finland
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu 50406, Estonia
| | - Riikka K. Arffman
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu 90220, Finland
| | - Elina K. Komsi
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu 90220, Finland
| | - Outi Lindgren
- Department of Pathology, Oulu University Hospital, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu 90220, Finland
| | - Janette A. Kemppainen
- Department of Pathology, Oulu University Hospital, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu 90220, Finland
| | - Hanna Metsola
- Department of Pathology, Oulu University Hospital, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu 90220, Finland
| | - Henna-Riikka Rossi
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu 90220, Finland
| | - Anne Ahtikoski
- Department of Pathology, Turku University Hospital, Turku 20521, Finland
| | - Keiu Kask
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu 50406, Estonia
- Competence Centre on Health Technologies, Tartu 51014, Estonia
| | - Merli Saare
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu 50406, Estonia
- Competence Centre on Health Technologies, Tartu 51014, Estonia
| | - Andres Salumets
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu 50406, Estonia
- Competence Centre on Health Technologies, Tartu 51014, Estonia
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm 14152, Sweden
| | - Terhi T. Piltonen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu 90220, Finland
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Coudry RA, Assis EA, Frassetto FP, Jansen AM, da Silva LM, Parra-Medina R, Saieg M. Crossing the Andes: Challenges and opportunities for digital pathology in Latin America. J Pathol Inform 2024; 15:100369. [PMID: 38638195 PMCID: PMC11025004 DOI: 10.1016/j.jpi.2024.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 04/20/2024] Open
Abstract
The most widely accepted and used type of digital pathology (DP) is whole-slide imaging (WSI). The USFDA granted two WSI system approvals for primary diagnosis, the first in 2017. In Latin America, DP has the potential to reshape healthcare by enhancing diagnostic capabilities through artificial intelligence (AI) and standardizing pathology reports. Yet, we must tackle regulatory hurdles, training, resource availability, and unique challenges to the region. Collectively addressing these hurdles can enable the region to harness DP's advantages-enhancing disease diagnosis, medical research, and healthcare accessibility for its population. Americas Health Foundation assembled a panel of Latin American pathologists who are experts in DP to assess the hurdles to implementing it into pathologists' workflows in the region and provide recommendations for overcoming them. Some key steps recommended include creating a Latin American Society of Digital Pathology to provide continuing education, developing AI models trained on the Latin American population, establishing national regulatory frameworks for protecting the data, and standardizing formats for DP images to ensure that pathologists can collaborate and validate specimens across the various DP platforms.
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Affiliation(s)
| | | | | | | | | | - Rafael Parra-Medina
- National Cancer Institute (INC), Bogotá, Colombia
- Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | - Mauro Saieg
- Grupo Fleury, São Paulo, Brazil
- Santa Casa Medical School, São Paulo, SP, Brazil
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Simsek E, Sunguroglu A, Kilic A, Özgültekin N, Ozensoy Guler O. Effects of thymoquinone and the curcumin analog EF-24 on the activity of the enzyme paraoxonase-1 in human glioblastoma cells U87MG. J Enzyme Inhib Med Chem 2024; 39:2339901. [PMID: 38864175 PMCID: PMC11172254 DOI: 10.1080/14756366.2024.2339901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/01/2024] [Indexed: 06/13/2024] Open
Abstract
The spices and aromatic herbs were used not only in cooking to add flavour and smell to dishes but also for medicinal use. Nigella sativa, also called black cumin, is one of the species that contains an important bioactive component, thymoquinone (TQ), which has antioxidant, anti-inflammatory, antimicrobial, and antidiabetic effects. Curcuma longa, which also includes curcumin, has numerous anti-cancer properties. However, the bioavailability of curcumin is lower than that of its analogs. An analog of curcumin (EF-24), which has better bioavailability than curcumin, is capable of exerting a high anti-cancer effect. In our study, we determined the effects of PON1 enzyme activity on the proliferation and aggressiveness of glioblastoma cancer treated with TQ and EF-24 from lysates of the glioblastoma cell line U87MG. The results were determined as increased PON1 activity after treatment with TQ and EF-24 in the U87MG cell line (p < 0.0001).
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Affiliation(s)
- Ender Simsek
- Department of Medical Biology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | | | - Ahmet Kilic
- Department of Medical Biology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Nurbanu Özgültekin
- Multiscale Thermofluids School of Engineering, The University of Edinburg Edinburg, UK
| | - O. Ozensoy Guler
- Department of Medical Biology, Ankara Yildirim Beyazit University, Ankara, Turkey
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4
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Lopes A, Ward AD, Cecchini M. Eye tracking in digital pathology: A comprehensive literature review. J Pathol Inform 2024; 15:100383. [PMID: 38868488 PMCID: PMC11168484 DOI: 10.1016/j.jpi.2024.100383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/28/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024] Open
Abstract
Eye tracking has been used for decades in attempt to understand the cognitive processes of individuals. From memory access to problem-solving to decision-making, such insight has the potential to improve workflows and the education of students to become experts in relevant fields. Until recently, the traditional use of microscopes in pathology made eye tracking exceptionally difficult. However, the digital revolution of pathology from conventional microscopes to digital whole slide images allows for new research to be conducted and information to be learned with regards to pathologist visual search patterns and learning experiences. This has the promise to make pathology education more efficient and engaging, ultimately creating stronger and more proficient generations of pathologists to come. The goal of this review on eye tracking in pathology is to characterize and compare the visual search patterns of pathologists. The PubMed and Web of Science databases were searched using 'pathology' AND 'eye tracking' synonyms. A total of 22 relevant full-text articles published up to and including 2023 were identified and included in this review. Thematic analysis was conducted to organize each study into one or more of the 10 themes identified to characterize the visual search patterns of pathologists: (1) effect of experience, (2) fixations, (3) zooming, (4) panning, (5) saccades, (6) pupil diameter, (7) interpretation time, (8) strategies, (9) machine learning, and (10) education. Expert pathologists were found to have higher diagnostic accuracy, fewer fixations, and shorter interpretation times than pathologists with less experience. Further, literature on eye tracking in pathology indicates that there are several visual strategies for diagnostic interpretation of digital pathology images, but no evidence of a superior strategy exists. The educational implications of eye tracking in pathology have also been explored but the effect of teaching novices how to search as an expert remains unclear. In this article, the main challenges and prospects of eye tracking in pathology are briefly discussed along with their implications to the field.
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Affiliation(s)
- Alana Lopes
- Department of Medical Biophysics, Western University, London, ON N6A 3K7, Canada
- Gerald C. Baines Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Aaron D. Ward
- Department of Medical Biophysics, Western University, London, ON N6A 3K7, Canada
- Gerald C. Baines Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Department of Oncology, Western University, London, ON N6A 3K7, Canada
| | - Matthew Cecchini
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada
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Gonzalez R, Saha A, Campbell CJ, Nejat P, Lokker C, Norgan AP. Seeing the random forest through the decision trees. Supporting learning health systems from histopathology with machine learning models: Challenges and opportunities. J Pathol Inform 2024; 15:100347. [PMID: 38162950 PMCID: PMC10755052 DOI: 10.1016/j.jpi.2023.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/06/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
This paper discusses some overlooked challenges faced when working with machine learning models for histopathology and presents a novel opportunity to support "Learning Health Systems" with them. Initially, the authors elaborate on these challenges after separating them according to their mitigation strategies: those that need innovative approaches, time, or future technological capabilities and those that require a conceptual reappraisal from a critical perspective. Then, a novel opportunity to support "Learning Health Systems" by integrating hidden information extracted by ML models from digitalized histopathology slides with other healthcare big data is presented.
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Affiliation(s)
- Ricardo Gonzalez
- DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada
- Division of Computational Pathology and Artificial Intelligence, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Ashirbani Saha
- Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Escarpment Cancer Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Clinton J.V. Campbell
- William Osler Health System, Brampton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peyman Nejat
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Cynthia Lokker
- Health Information Research Unit, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Andrew P. Norgan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
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Boza JM, Amirali A, Williams SL, Currall BB, Grills GS, Mason CE, Solo-Gabriele HM, Erickson DC. Evaluation of a field deployable, high-throughput RT-LAMP device as an early warning system for COVID-19 through SARS-CoV-2 measurements in wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 944:173744. [PMID: 38844223 PMCID: PMC11249788 DOI: 10.1016/j.scitotenv.2024.173744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/02/2024] [Accepted: 06/01/2024] [Indexed: 06/16/2024]
Abstract
Quantification of SARS-CoV-2 RNA copies in wastewater can be used to estimate COVID-19 prevalence in communities. While such results are important for mitigating disease spread, SARS-CoV-2 measurements require sophisticated equipment and trained personnel, for which a centralized laboratory is necessary. This significantly impacts the time to result, defeating its purpose as an early warning detection tool. The objective of this study was to evaluate a field portable device (called MINI) for detecting SARS-CoV-2 viral loads in wastewater using real-time reverse transcriptase loop-mediated isothermal amplification (real-time RT-LAMP). The device was tested using wastewater samples collected from buildings (with 430 to 1430 inhabitants) that had known COVID-19-positive cases. Results show comparable performance of RT-LAMP against reverse transcriptase polymerase chain reaction (RT-qPCR) when detecting SARS-CoV-2 copies in wastewater. Both RT-LAMP and RT-qPCR detected SARS-CoV-2 in wastewater from buildings with at least three positive individuals within a 6-day time frame prior to diagnosis. The large 96-well throughput provided by MINI provided scalability to multi-building detection. The portability of the MINI device enabled decentralized on-site detection, significantly reducing the time to result. The overall findings support the use of RT-LAMP within the MINI configuration as an early detection system for COVID-19 infection using wastewater collected at the building scale.
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Affiliation(s)
- J M Boza
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14850, USA
| | - A Amirali
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - S L Williams
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - B B Currall
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - G S Grills
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - C E Mason
- Department of Physiology and Biophysics, Weill Cornell Medical College, New York City, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - H M Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
| | - D C Erickson
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14850, USA; Division of Nutritional Science, Cornell University, Ithaca, NY 14850, USA.
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Usuzaki T, Inamori R, Shizukuishi T, Morishita Y, Takagi H, Ishikuro M, Obara T, Takase K. Predicting isocitrate dehydrogenase status among adult patients with diffuse glioma using patient characteristics, radiomic features, and magnetic resonance imaging: Multi-modal analysis by variable vision transformer. Magn Reson Imaging 2024; 111:266-276. [PMID: 38815636 DOI: 10.1016/j.mri.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES To evaluate the performance of the multimodal model, termed variable Vision Transformer (vViT), in the task of predicting isocitrate dehydrogenase (IDH) status among adult patients with diffuse glioma. MATERIALS AND METHODS vViT was designed to predict IDH status using patient characteristics (sex and age), radiomic features, and contrast-enhanced T1-weighted images (CE-T1WI). Radiomic features were extracted from each enhancing tumor (ET), necrotic tumor core (NCR), and peritumoral edematous/infiltrated tissue (ED). CE-T1WI were split into four images and input to vViT. In the training, internal test, and external test, 271 patients with 1070 images (535 IDH wildtype, 535 IDH mutant), 35 patients with 194 images (97 IDH wildtype, 97 IDH mutant), and 291 patients with 872 images (436 IDH wildtype, 436 IDH mutant) were analyzed, respectively. Metrics including accuracy and AUC-ROC were calculated for the internal and external test datasets. Permutation importance analysis combined with the Mann-Whitney U test was performed to compare inputs. RESULTS For the internal test dataset, vViT correctly predicted IDH status for all patients. For the external test dataset, an accuracy of 0.935 (95% confidence interval; 0.913-0.945) and AUC-ROC of 0.887 (0.798-0.956) were obtained. For both internal and external test datasets, CE-T1WI ET radiomic features and patient characteristics had higher importance than other inputs (p < 0.05). CONCLUSIONS The vViT has the potential to be a competent model in predicting IDH status among adult patients with diffuse glioma. Our results indicate that age, sex, and CE-T1WI ET radiomic features have key information in estimating IDH status.
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Affiliation(s)
- Takuma Usuzaki
- Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Miyagi Cancer Center, Miyagi, Japan
| | - Ryusei Inamori
- Radiological Imaging and Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shizukuishi
- Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Yohei Morishita
- Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hidenobu Takagi
- Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Department of Advanced MRI Collaborative Research, Graduate School of Medicine, Sendai, Japan
| | - Mami Ishikuro
- Tohoku University Graduate School of Medicine, Division of Molecular Epidemiology, Sendai, Japan
| | - Taku Obara
- Tohoku University Graduate School of Medicine, Division of Molecular Epidemiology, Sendai, Japan; Tohoku University Graduate School of Medicine, Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Sendai, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
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Wu RI, Torous VF. Cytopathology fellowship match: Pros and cons. Diagn Cytopathol 2024; 52:460-465. [PMID: 38642074 DOI: 10.1002/dc.25324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
A cytopathology fellowship match would create an enforced and structured recruitment timeline for the benefit of applicants and programs. Major benefits would include delaying fellowship applications to allow residents to explore different subspecialty areas, a standardized application process for administrative ease, and optimization of matches between applicants and programs based on ranked preferences rather than use of time-limited "exploding offers." The overall gains in efficiency and achieving the primary goals of supporting trainees and recruiting in an equitable and inclusive manner outweigh any downsides to instituting a cytopathology fellowship match. We aim to review the major discussions around this ongoing debate, arriving at the same conclusion as others in the literature that a pan-pathology fellowship match is ideal and that leadership from the Association of Pathology Chairs will be essential in unifying the fractured fellowship recruitment process.
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Affiliation(s)
- Roseann I Wu
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Vanda F Torous
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Fitzhugh VA. Cytopathology fellowship and practice: Are our trainees and cytopathologists diverse? Diagn Cytopathol 2024; 52:433-439. [PMID: 38660884 DOI: 10.1002/dc.25330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
Over the last several years, there has been increased focus on diversity, equity, and inclusion within all areas of pathology and laboratory medicine. Many of the specialty societies within pathology have taken up the mantle of diversity. While there is little research into the diversity of cytopathologists in practice, the Accreditation Council for Graduate Medical Education (ACGME) has been collecting diversity data on pathology and laboratory medicine trainees since 2011. This data are an opportunity to explore how diverse our trainees in cytopathology are, and by extrapolation, allows us to develop some ideas as to how diverse attending level cytopathologists are. The author will also share personal observations from her own training and career regarding diversity in cytopathology.
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Affiliation(s)
- Valerie A Fitzhugh
- Department of Pathology, Immunology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Pathology Service Line, Robert Wood Johnson Barnabas Health, West Orange, New Jersey, USA
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Yurtsever N, Jacobs JW, Booth GS, Schwartz J, Park YA, Woo JS, Lauro D, Torres S, Ward DC, Stephens LD, Allen ES, Tormey CA, Adkins BD. A multi-institutional survey of apheresis services among institutions in the United States. J Clin Apher 2024; 39:e22138. [PMID: 38979705 DOI: 10.1002/jca.22138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Apheresis practices in the United States (US) have not been comprehensively characterized to date. This study aimed to address this gap by evaluating apheresis therapy through a national survey. METHODS A multi-institutional survey was conducted between April and July 2023. The survey, comprising 54 questions, focused on institutional demographics, procedures, equipment, staffing, training, and impacts of the Coronavirus Disease 2019 (COVID-19) pandemic. Responses from 22 institutions, primarily academic medical centers, were analyzed. RESULTS Therapeutic plasma exchange (TPE) was the most common procedure, followed by hematopoietic progenitor cell collection (HPC-A) and red blood cell exchange (RCE). CAR-T cell collections were widespread, with some institutions supporting over 30 protocols concurrently. Most sites used the Spectra Optia Apheresis System, were managed by a transfusion medicine service, and employed internal apheresis providers. Insufficient staffing levels, exacerbated by the COVID-19 pandemic, were common and most often addressed using overtime. DISCUSSION The survey highlighted the ubiquity of TPE, expanding cellular collections and staffing challenges. The role of apheresis in supporting cellular therapy, particularly in newly developing cell and gene therapies and clinical trials, was evident. Staffing issues during the pandemic emphasized the need for innovative recruitment strategies. CONCLUSION This nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.
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Affiliation(s)
- Nalan Yurtsever
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jeremy W Jacobs
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Garrett S Booth
- Department of Pathology, Microbiology, & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Joseph Schwartz
- Department of Pathology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Yara A Park
- Department of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Jennifer S Woo
- Department of Pathology, City of Hope National Medical Center, Irvine, California, USA
| | - Deisen Lauro
- Division of Transfusion Medicine, City of Hope National Medical Center, Duarte, California, USA
| | - Sarina Torres
- Division of Transfusion Medicine, City of Hope National Medical Center, Duarte, California, USA
| | - Dawn C Ward
- Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Laura D Stephens
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Elizabeth S Allen
- Department of Pathology, University of California, San Diego, La Jolla, California, USA
| | - Christopher A Tormey
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brian D Adkins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Alkhasawneh A, Baskovich B, Gopinath A, Allan R, Mohamed A, Quan W. Interactive Pathology Tutorial in Neoplastic Hematology Disorders for Medical Hematology-Oncology Fellows. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:413-417. [PMID: 38520477 DOI: 10.1007/s13187-024-02427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Abstract
Hematology-oncology (HO) fellows receive limited instruction in the process of establishing a diagnosis for hematologic neoplasms, and learning neoplastic hematology often occurs in limited encounters. In the current study, we developed a web-based interactive pathology tutorial in neoplastic hematologic disorders for HO fellows to work up simulated cases and establish the diagnosis. An online system ("Pathology Playground") was utilized to load case materials including microscopic images and ancillary studies. Twelve high-yield simulated cases of common leukemias and lymphoma were included. At the beginning of each case, trainees review the clinical history and slide images, and then, they are given the option to request additional pathology work-up. Based on the results, they can enter their diagnostic impression. If the diagnosis is correct, the user is shown a short educational presentation. If the diagnosis is not correct, the user gets notified by the message "Incorrect." The tutorial was integrated in the educational curriculum of our HO fellowship program, and bimonthly teaching sessions were held to review two cases each time. During the sessions, trainees request ancillary studies to complete the diagnostic work-up using the software and interpret the findings. As the case is being worked up by the trainee, the hematopathologists and HO fellowship program director discuss the findings, the appropriate work-up tools, and the implications on management. All of our six HO fellows attended the sessions, and a survey from the trainees showed high ease of use of the system and they viewed it as a very useful educational tool. A pre-test and post-test were administered for one of the sessions, and the result showed improvement in the average from 62 to 73%. Expanding the use of this online interactive tutorial and incorporating additional cases would enhance its value as a learning resource.
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Affiliation(s)
- Ahmad Alkhasawneh
- Department of Pathology and Laboratory Medicine, College of Medicine, UF Health Jacksonville, 655 W 8thStreet, C-506, Jacksonville, FL, 32209, USA.
| | - Brett Baskovich
- Department of Pathology, Mount Sinai Hospital, New York, NY, USA
| | - Arun Gopinath
- Department of Pathology and Laboratory Medicine, College of Medicine, UF Health Jacksonville, 655 W 8thStreet, C-506, Jacksonville, FL, 32209, USA
| | - Robert Allan
- Department of Pathology, Malcom Randall Veterans Affairs Medical Center, University of Florida, Gainesville, FL, USA
| | - Abdullah Mohamed
- Department of Pathology and Laboratory Medicine, College of Medicine, UF Health Jacksonville, 655 W 8thStreet, C-506, Jacksonville, FL, 32209, USA
| | - Walter Quan
- Department of Medicine, UF Health Jacksonville, Jacksonville, FL, USA
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Das K. COVID and cytopathology training: Impact and innovations. Diagn Cytopathol 2024; 52:413-423. [PMID: 38323803 DOI: 10.1002/dc.25280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/02/2024] [Accepted: 01/18/2024] [Indexed: 02/08/2024]
Abstract
Graduate medical education and training in Cytopathology faced numerous unexpected challenges during the COVID-19 pandemic of 2020. It was caused by the SARS-Co-V2 coronavirus and transmitted by breathing droplets or aerosol particles containing the virus and less commonly by contact with infected surfaces and fomites. To mitigate the rapid spread of disease non-essential services were closed, surgical procedures were prioritized, and "social distancing" was implemented. These measures led to a marked decline in the volume of specimens, number of fine needle aspiration (FNA) and rapid on-site evaluation procedures performed. The trainees in Pathology were required to stay at home either entirely or partly during the early period of the pandemic. This led to re-designing of the cytopathology training program nationwide. Many innovative methods and protocols were put in place to overcome the challenges faced and adjustments made in creating the virtual training program in Cytopathology. On May 5th, 2023, the WHO declared that COVID-19 was no longer a global emergency. Regulations were lifted and healthcare services returned to pre-pandemic era. Graduate medical education and training returned to normal however many changes were incorporated into the training program moving forward. Herein the impacts and innovations that COVID-19 had on Cytopathology training are described.
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Affiliation(s)
- Kasturi Das
- Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York, USA
- Division of Cytopathology, Northwell Health Laboratories, Greenvale, New York, USA
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Taillandier A, Avry F, Miquelestorena-Standley E, Samimi M, de la Fouchardière A, Macagno N, Kervarrec T. Impact of the adjunction of a short video to an original article for the recognition of newly described tumor entities in pathology: An interventional prospective study. J Cutan Pathol 2024. [PMID: 39014546 DOI: 10.1111/cup.14685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024]
Abstract
CONTEXT Merkel cell carcinoma diagnosis is often based on microscopic examination by pathologists. While histopathologic diagnosis primarily hinges on conscious and analytical cognition, the pathologist's decision-making process is also influenced by a rapid "gist" or "gestalt" approach. In this study, using cases of Merkel cell carcinoma as a model, we aim to assess how pathologists' viewing short videos containing conceptual clues and visual aids, in conjunction with reading an original article as a reference, may enhance their diagnostic performance. METHOD Sixteen pathologists were included in the present work. After participants had read the original article, their ability to distinguish Merkel cell polyomavirus (MCPyV)+ and MCPyV- Merkel cell carcinoma cases was evaluated on a first preliminary series of 20 cases. Following this test, the participants watched the video and then evaluated a second "experimental" series of 20 independent cases. RESULTS After reading the original article, for each case, a median number of 12 participants (75%, Q1-Q3: 10-13) classified the specimen in the correct category (92 incorrect answers in the whole series). An important interobserver variability was observed in this setting (Kappa coefficient = 0.465). By contrast, following the video, all cases were correctly classified by most of the participants, with only 12 incorrect answers on the whole series and excellent interobserver reproducibility (Kappa coefficient = 0.846). CONCLUSION Our study demonstrated that providing a short video together with an original article may enhance pathologists' performance in diagnosing Merkel cell carcinoma.
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Affiliation(s)
- Antoine Taillandier
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Chambray-les-tours, France
| | - François Avry
- Pharmacie à usage Intérieur, Université de Tours, Centre Hospitalier Universitaire de Tours, Chambray-les-tours, France
| | - Elodie Miquelestorena-Standley
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Chambray-les-tours, France
- «Transplantation, Immunologie, Inflammation», EA4145, Université de Tours, Tours, France
| | - Mahtab Samimi
- "Biologie des infections à polyomavirus" team, UMR INRA ISP 1282, Université de Tours, Tours, France
- Department of Dermatology, Université de Tours, Centre Hospitalier Universitaire de Tours, Chambray-les-tours, France
| | | | - Nicolas Macagno
- Department of Pathology, AP-HM, Timone University Hospital, Marseille, France
- Aix-Marseille University, INSERM U1251, MMG, Marseille, France
| | - Thibault Kervarrec
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Chambray-les-tours, France
- "Biologie des infections à polyomavirus" team, UMR INRA ISP 1282, Université de Tours, Tours, France
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Chang MF, Yeh CC, Lue JH, Liao ML. Medical students' preferences for asynchronous online or face-to-face learning strategies in learning gross anatomy and neuroanatomy during the COVID-19 pandemic. Clin Anat 2024. [PMID: 38994925 DOI: 10.1002/ca.24202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/15/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
Gross anatomy and neuroanatomy are fundamental subjects in medical education. However, learning different anatomical terms and understanding the complexity of the subjects are often challenging for medical students. At National Taiwan University, the 2020-2021 cohort adopted a face-to-face (F2F) learning strategy for gross anatomy and neuroanatomy lecture and laboratory courses until May 17, 2021. After the aforementioned date, the same cohort learned the rest of the gross anatomy and neuroanatomy courses via asynchronous online learning. This study aimed to evaluate the benefits of and students' preferences for F2F and asynchronous online learning strategies in learning gross anatomy and neuroanatomy. A survey with closed-ended and open-ended questions was used to quantitatively and qualitatively explore medical students' learning preferences for two teaching strategies in gross anatomy and neuroanatomy. The results identified different learning preferences among students in learning gross anatomy and neuroanatomy-satisfied with both learning strategies, satisfied with only F2F learning strategy, satisfied with only asynchronous online learning strategy, and satisfied with neither learning strategy. The survey results with closed-ended and open-ended questions showed that medical students preferred F2F learning for anatomical laboratory courses but favored asynchronous online learning for neuroanatomical laboratory courses. In addition, medical students considered peer discussion more critical in learning gross anatomy than neuroanatomy. These findings provide valuable information about medical students' preference for gross anatomy and neuroanatomy courses, which anatomy teachers can consider when planning to enhance their curriculum in the future.
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Affiliation(s)
- Ming-Fong Chang
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Chuan Yeh
- Department of Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - June-Horng Lue
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meng-Lin Liao
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
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15
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Meltzer K, Yang M, Rossmann A, Kinsey EW, Cronholm PF, Morgan AU. Patient-Portal Compared with Supplemental In-Office Tablet Screening for Health-Related Social Needs in Primary Care. J Gen Intern Med 2024:10.1007/s11606-024-08929-x. [PMID: 38981941 DOI: 10.1007/s11606-024-08929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 06/28/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Screening for health-related social needs (HRSN) has become more widespread but the best method of delivering the screening tool is not yet known. OBJECTIVE Describe HRSN screening completion rate, specifically portal-based and in-person tablet-based screening. DESIGN Cross-sectional retrospective observational study. PARTICIPANTS Adults age 18 or older who had a non-acute primary care visit at one of three internal medicine primary care clinics at a large, urban, academic medical center between July 2022 and July 2023. MAIN MEASURES We identified the proportion of individuals who were screened using the HRSN questionnaire, whether screening was completed by patient-portal or tablet, as well as the degree of burden of HRSN. Using the electronic health record, we explored associations between sociodemographic characteristics and HRSN attributes. KEY RESULTS Our study included 24,597 patients, of whom 37% completed the HRSN questionnaire. A smaller proportion of Black/African American patients and those with Medicaid insurance completed the questionnaire, yet they comprised a greater percentage of those who screened positive for unmet HRSN (p ≤ 0.001). Most patients completed the questionnaire by patient-portal (86.1%) compared with in-office tablets (14.0%). A larger proportion of those who completed screening by tablet screened positive for HRSN. Of all patients screened, 21.8% were positive for an unmet HRSN and 11.5% had more than one unmet HRSN. CONCLUSIONS A majority of patients are not being screened for HRSN and results illustrate disparities when screening patients for HRSN through portal-based compared with supplemental in-office tablet-based screening. Prevalence of unmet HRSN varied by demographics such as race and insurance status.
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Affiliation(s)
- Kerry Meltzer
- National Clinician Scholars Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
| | - Max Yang
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Rossmann
- Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eliza W Kinsey
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter F Cronholm
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Public Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Anna U Morgan
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Soranno DE, Amaral S, Ashoor I, Atkinson MA, Barletta GM, Braun MC, Carlson J, Carter C, Chua A, Dharnidharka VR, Drake K, Erkan E, Feig D, Goldstein SL, Hains D, Harshman LA, Ingulli E, Kula AJ, Leonard M, Mannemuddhu S, Menon S, Modi ZJ, Moxey-Mims M, Nada A, Norwood V, Starr MC, Verghese PS, Weidemann D, Weinstein A, Smith J. Responding to the workforce crisis: consensus recommendations from the Second Workforce Summit of the American Society of Pediatric Nephrology. Pediatr Nephrol 2024:10.1007/s00467-024-06410-9. [PMID: 38976042 DOI: 10.1007/s00467-024-06410-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/23/2024] [Accepted: 05/11/2024] [Indexed: 07/09/2024]
Abstract
IMPORTANCE Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care. OBJECTIVE To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce. EVIDENCE REVIEW Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN members. Working groups met prior to the Summit to conduct an organized literature review and establish key questions to be addressed. The Summit was held in-person in November 2023. During the Summit, work groups presented their preliminary findings, and the at-large group developed the key action statements and future directions. FINDINGS A holistic appraisal of the effort required to cover inpatient and outpatient sub-specialty care will help define faculty effort and time distribution. Most pediatric nephrologists practice in academic settings, so work beyond clinical care including education, research, advocacy, and administrative/service tasks may form a substantial amount of a faculty member's time and effort. An academic relative value unit (RVU) may assist in creating a more inclusive assessment of their contributions to their academic practice. Pediatric sub-specialties, such as nephrology, contribute to the clinical mission and care of their institutions beyond their direct billable RVUs. Advocacy throughout the field of pediatrics is necessary in order for reimbursement of pediatric sub-specialist care to accurately reflect the time and effort required to address complex care needs. Flexible, individualized training pathways may improve recruitment into sub-specialty fields such as nephrology. CONCLUSIONS AND RELEVANCE The workforce crisis facing the pediatric nephrology field is echoed throughout many pediatric sub-specialties. Efforts to improve recruitment, retention, and reimbursement are necessary to improve the care delivered to pediatric patients.
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Affiliation(s)
- Danielle E Soranno
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Bioengineering, Purdue University Weldon School of Engineering, 1044 W. Walnut Street, West Lafayette, IN, R4-42146202, USA.
| | - Sandra Amaral
- Departments of Pediatrics and Biostatistics, Epidemiology and Informatics, Children's Hospital of Philadelphia and University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Isa Ashoor
- Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Meredith A Atkinson
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gina-Marie Barletta
- Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Michael C Braun
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Joann Carlson
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Caitlin Carter
- Rady Children's Hospital, University of California San Diego, San Diego, CA, USA
| | - Annabelle Chua
- Duke Children's Hospital and Health Center, Durham, NC, USA
| | | | - Keri Drake
- University of Texas Southwestern Medical Center, St. Louis, MO, USA
| | - Elif Erkan
- Department of Pediatrics, University of Cincinnati College of Medicine, Indianapolis, IN, USA
| | - Dan Feig
- Department of Pediatrics, University of Alabama, Heersink School of Medicine, Birmingham, AL, USA
| | - Stuart L Goldstein
- Department of Pediatrics, University of Cincinnati College of Medicine, Indianapolis, IN, USA
| | - David Hains
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lyndsay A Harshman
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Elizabeth Ingulli
- Rady Children's Hospital, University of California San Diego, San Diego, CA, USA
| | | | - Mary Leonard
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | | | - Shina Menon
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Zubin J Modi
- Department of Pediatrics and Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, MI, USA
| | - Marva Moxey-Mims
- Department of Pediatrics, Children's National Hospital/George Washington University SOM, Washington, D.C, USA
| | - Arwa Nada
- Department of Pediatrics, Le Bonheur Children's Hospital, UTHSC, Memphis, TN, USA
| | - Victoria Norwood
- Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
| | - Michelle C Starr
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Darcy Weidemann
- Department of Pediatrics, Division of Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Adam Weinstein
- Department of Medical Sciences and Pediatrics, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Jodi Smith
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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Ihara K, Dumkrieger G, Zhang P, Takizawa T, Schwedt TJ, Chiang CC. Application of Artificial Intelligence in the Headache Field. Curr Pain Headache Rep 2024:10.1007/s11916-024-01297-5. [PMID: 38976174 DOI: 10.1007/s11916-024-01297-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE OF REVIEW Headache disorders are highly prevalent worldwide. Rapidly advancing capabilities in artificial intelligence (AI) have expanded headache-related research with the potential to solve unmet needs in the headache field. We provide an overview of AI in headache research in this article. RECENT FINDINGS We briefly introduce machine learning models and commonly used evaluation metrics. We then review studies that have utilized AI in the field to advance diagnostic accuracy and classification, predict treatment responses, gather insights from various data sources, and forecast migraine attacks. Furthermore, given the emergence of ChatGPT, a type of large language model (LLM), and the popularity it has gained, we also discuss how LLMs could be used to advance the field. Finally, we discuss the potential pitfalls, bias, and future directions of employing AI in headache medicine. Many recent studies on headache medicine incorporated machine learning, generative AI and LLMs. A comprehensive understanding of potential pitfalls and biases is crucial to using these novel techniques with minimum harm. When used appropriately, AI has the potential to revolutionize headache medicine.
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Affiliation(s)
- Keiko Ihara
- Department of Neurology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Japanese Red Cross Ashikaga Hospital, Ashikaga, Tochigi, Japan
| | | | - Pengfei Zhang
- Department of Neurology, Rutgers University, New Brunswick, NJ, USA
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA
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Kim J, Bae S, Yoon SM, Jeong S. Roadmap for providing and leveraging annotated data by cytologists in the PDAC domain as open data: support for AI-based pathology image analysis development and data utilization strategies. Front Oncol 2024; 14:1346237. [PMID: 39035745 PMCID: PMC11258423 DOI: 10.3389/fonc.2024.1346237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/31/2024] [Indexed: 07/23/2024] Open
Abstract
Pancreatic cancer is one of the most lethal cancers worldwide, with a 5-year survival rate of less than 5%, the lowest of all cancer types. Pancreatic ductal adenocarcinoma (PDAC) is the most common and aggressive pancreatic cancer and has been classified as a health emergency in the past few decades. The histopathological diagnosis and prognosis evaluation of PDAC is time-consuming, laborious, and challenging in current clinical practice conditions. Pathological artificial intelligence (AI) research has been actively conducted lately. However, accessing medical data is challenging; the amount of open pathology data is small, and the absence of open-annotation data drawn by medical staff makes it difficult to conduct pathology AI research. Here, we provide easily accessible high-quality annotation data to address the abovementioned obstacles. Data evaluation is performed by supervised learning using a deep convolutional neural network structure to segment 11 annotated PDAC histopathological whole slide images (WSIs) drawn by medical staff directly from an open WSI dataset. We visualized the segmentation results of the histopathological images with a Dice score of 73% on the WSIs, including PDAC areas, thus identifying areas important for PDAC diagnosis and demonstrating high data quality. Additionally, pathologists assisted by AI can significantly increase their work efficiency. The pathological AI guidelines we propose are effective in developing histopathological AI for PDAC and are significant in the clinical field.
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Affiliation(s)
- Jongkwang Kim
- Department of Medical Informatics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sumok Bae
- Department of Medical Informatics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seong-Mi Yoon
- Department of Pathology at the Medical Center, Medical Research Institute, ORTHOTECH, Daegu, Republic of Korea
| | - Sungmoon Jeong
- Department of Medical Informatics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Youssef A, Rosenwald A, Rosenfeldt MT. TelePi: an affordable telepathology microscope camera system anyone can build and use. Virchows Arch 2024; 485:115-122. [PMID: 37935902 DOI: 10.1007/s00428-023-03685-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023]
Abstract
Telepathology facilitates histological diagnoses through sharing expertise between pathologists. However, the associated costs are high and frequently prohibitive, especially in low-resource settings, where telepathology would paradoxically be of paramount importance due to a paucity of pathologists.We have constructed a telepathology system (TelePi) with a budget of < €120 using the small, single-board computer Raspberry Pi Zero and its High-Quality Camera Module in conjunction with a standard microscope and open-source software. The system requires no maintenance costs or service contracts, has a small footprint, can be moved and shared across several microscopes, and is independent from other computer operating systems. TelePi uses a responsive and high-resolution web-based live stream which allows remote consultation between two or more locations. TelePi can serve as a telepathology system for remote diagnostics of frozen sections. Additionally, it can be used as a standard microscope camera for teaching of medical students and for basic research. The quality of the TelePi system compared favorable to a commercially available telepathology system that exceed its cost by more than 125-fold. Additionally, still images are of publication quality equal to that of a whole slide scanner that costs 800 times more.In summary, TelePi is an affordable, versatile, and inexpensive camera system that potentially enables telepathology in low-resource settings without sacrificing image quality.
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Affiliation(s)
- Almoatazbellah Youssef
- Institute of Pathology and Comprehensive Cancer Centre Mainfranken, Julius Maximilian University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.
| | - Andreas Rosenwald
- Institute of Pathology and Comprehensive Cancer Centre Mainfranken, Julius Maximilian University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
| | - Mathias Tillmann Rosenfeldt
- Institute of Pathology and Comprehensive Cancer Centre Mainfranken, Julius Maximilian University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
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Bedekovics J, Madarász K, Mokánszki A, Molnár S, Mester Á, Miltényi Z, Méhes G. Exploring p53 protein expression and its link to TP53 mutation in myelodysplasia-related malignancies-Interpretive challenges and potential field of applications. Histopathology 2024; 85:143-154. [PMID: 38571438 DOI: 10.1111/his.15185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/28/2024] [Accepted: 03/16/2024] [Indexed: 04/05/2024]
Abstract
AIMS TP53 alterations have a significant prognostic effect in myeloid neoplasms. Our objective was to investigate the TP53 gene mutation status, p53 protein expression and their relationship in dysplasia-related myeloid neoplasms with varying levels of myeloblast counts. METHODS AND RESULTS A total of 76 bone marrow biopsy samples with different blast counts were analysed. Total and strong (3+) p53 expression was determined. Dual immunohistochemical staining was performed to determine the cell population associated with p53 expression. NGS analysis was performed using the Accel-Amplicon Comprehensive TP53 panel. Both p53 expression and TP53 VAF showed a significant correlation with the myeloblast ratio (P < 0.0001); however, p53 expression was also present in other cell lineages. The VAF value exhibited a significant correlation with p53 expression. A high specificity (0.9800) was observed for TP53 mutation using the ≥ 10% strong (3+) p53 cut-off value, although the sensitivity (0.4231) was low. CONCLUSIONS Strong (3+) p53 expression using a ≥ 10% cut-off value accurately predicts TP53 mutation but does not reveal the allelic state. The p53 expression is significantly influenced by myeloblast count, and histological interpretation should consider the presence of intermixed non-neoplastic marrow cells with varying physiological p53 expression.
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Affiliation(s)
- Judit Bedekovics
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Kristóf Madarász
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Mokánszki
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Sarolta Molnár
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ágnes Mester
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsófia Miltényi
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Asri R, Baquerizo H, Padilla-Register M, Soto-Greene ML, Grachan JJ. Comfort levels and experiences of middle school and high school age children in anatomical donor-based anatomy outreach sessions. ANATOMICAL SCIENCES EDUCATION 2024; 17:1026-1037. [PMID: 38679942 DOI: 10.1002/ase.2430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024]
Abstract
Many health professions schools host anatomy outreach sessions for high school students that utilize anatomical donors. However, teaching with anatomical donors for younger learners is uncommon. This study aimed to assess the comfort levels and experiences of students who attended the anatomy sessions as part of summer programs at Rutgers New Jersey Medical School. Younger learners (students entering grades 7-10; n = 25) and older learners (students entering grades 11-12; n = 33) completed pre- and post-session surveys about their comfort using a 5-point Likert scale. Before the sessions, most students felt comfortable or very comfortable learning from isolated organs (μ = 2.7, SD = 1.3) or full-body donors (μ = 2.4, SD = 1.4), even though most have never been to an anatomical donor lab before. After the sessions, the comfort level significantly increased for both isolated organs (μ = 3.3, SD = 1.1; p = 0.02) and full-body donors (μ = 3.1, SD = 1.2; p = 0.004). For isolated organs, there was no significant difference in the comfort level between younger and older learners before (p = 0.50) or after (p = 0.56) the sessions. Similarly, for full-body donors, there was no significant difference in the comfort level between younger and older learners before (p = 0.95) or after (p = 0.75) the sessions. Most students expressed that the experience was unique and positive. In conclusion, most students entering grades 7-12 felt comfortable learning from isolated organs and full-body anatomical donors prior to the sessions and felt more comfortable after the sessions. With this, anatomy outreach programs that utilize anatomical donors could be expanded to include younger learners to provide more dynamic teaching experiences for students of various ages.
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Affiliation(s)
- Rijul Asri
- Office of Education, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Humberto Baquerizo
- Office of Primary Care, Diversity and Community Engagement, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | | | - Maria L Soto-Greene
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jeremy J Grachan
- Office of Education, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Sriraman S, Saadoon R, Bochner R, Khandakar S. Improving Patient Portal Activation for Newborns in the Well Baby Nursery. Pediatrics 2024; 154:e2023063274. [PMID: 38867690 DOI: 10.1542/peds.2023-063274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 02/27/2024] [Accepted: 03/11/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Patient portals provide parents access to their child's health information and direct communication with providers. Our study aimed to improve portal activation rates of newborns during nursery hospitalization to >70% over 6 months. Secondarily, we describe the facilitators and barriers to portal use. METHODS The study design used a mixed-methodology framework of quality improvement (QI) and cross-sectional analyses. The Model for Improvement guided QI efforts. The primary outcome was the proportion of portals activated for newborns during nursery hospitalization. Interventions included portal activation algorithm, staff huddles, and documentation templates. Telephone interviews were conducted with a randomized sample of mothers of infants who activated the portal. These mothers were divided into portal "users" and "nonusers." We examined sociodemographic variables and health care utilization outcomes in the 2 groups. RESULTS Portal activation increased from 12.9% to 85.4% after interventions. Among 482 mothers with active portals, 127 (26.3%) were interviewed. Of those, 70% (89 of 127) reported using the portal, and 85.4% (76 of 89) found it useful. Reasons for accessing the portal included checking appointments and reviewing test results. Lack of knowledge of portal functionality was the main barrier to portal use (42.1%). Portal users were less likely to have a no-show to primary care appointments compared with nonusers (44.9% versus 78.9%, P < .001). CONCLUSIONS Portal activation rates increased after QI interventions in the nursery. Most parents accessed the portal and found it useful. Portals can improve health care delivery and patient engagement in the newborn period.
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Affiliation(s)
- Sheetal Sriraman
- Department of Pediatrics, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York
- Department of Pediatrics, New York City Health and Hospital, Kings County, Brooklyn, New York
| | - Reem Saadoon
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois
| | - Risa Bochner
- Department of Pediatrics, New York City Health and Hospital, Harlem, New York, New York
| | - Saema Khandakar
- Department of Pediatrics, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York
- Department of Pediatrics, New York City Health and Hospital, Kings County, Brooklyn, New York
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23
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Gimenez C, Balassanian R, Banet N, Barkan G, DeRobbio K, Henderson-Jackson E, Jenkins E, Kilic A, Lai L, Lura T, Morgenstern N, Mito J, Reid MD, Rivera-Colon G, Stewart J, Lowe ACY. Science, Medicine, and Cytology: an educational program of the Diversity, Equity, and Inclusion Committee of the American Society of Cytopathology. J Am Soc Cytopathol 2024; 13:244-253. [PMID: 38834386 DOI: 10.1016/j.jasc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/01/2024] [Accepted: 04/10/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION As our field of pathology continues to grow, our trainee numbers are on the decline. To combat this trend, the ASC Diversity, Equity, and Inclusion Committee established the Science, Medicine, and Cytology SumMer Certificate program to improve exposure to pathology/cytopathology with a focus on diversity, equity, and inclusion. Herein, we report our findings of the first 2 years of the program. MATERIALS AND METHODS An online course was developed targeting students who are underrepresented in medicine at the high school and college level. It consisted of several didactic sessions, presenting the common procedures involving cytopathologists and cytologists. Interviews with cytopathologists were also included. Participants were surveyed for demographic information and provided course evaluations. RESULTS In the first year of the program (2021), 34 participants completed the program, which increased to 103 in 2022. In both years there was a diversity in participant demographic backgrounds; however, only a minority of participants self-identified as being underrepresented in medicine. A vast majority (>85%) of participants in both years were high school or college students. In 2021, 100% of participants stated that the program format was effective and 94% thought the content was appropriate for their level of education; in 2022 the results were similar. In 2021, 66% considered health care as a potential career; this value increased in 2022 to 83%. In 2021 and 2022, 31% and 38%, respectively, considered cytology as a career. CONCLUSIONS Evaluations were excellent, generating interest in cytopathology. Barriers in reaching underrepresented minorities exist and additional work is needed. Expansion to a wider audience may increase outreach.
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Affiliation(s)
- Cecilia Gimenez
- Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York; Division of Cytopathology, Northwell Health Laboratories, Greenvale, New York.
| | - Ronald Balassanian
- Department of Pathology, University of California, San Francisco, San Francisco, California
| | - Natalie Banet
- Department of Pathology, Cleaveland Clinic Community Oncology Group, Cleaveland, Ohio
| | - Guliz Barkan
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Kristen DeRobbio
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Elizabeth Jenkins
- Department of Pathology, American Society of Cytopathology, Wilmington, Delaware
| | - Ayse Kilic
- Department of Pathology, Loyola University Chicago, Maywood, Illinois
| | - Lisa Lai
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Theresa Lura
- James H Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Nora Morgenstern
- Department of Pathology, NYC Health and Hospitals Elmhurst, Queens, New York
| | - Jeffrey Mito
- Department of Pathology, Harvard Medical School, Boston, Massachusetts
| | - Michelle D Reid
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia
| | - Glorimar Rivera-Colon
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jimmie Stewart
- Department of Pathology, Regents of The University of Minnesota, Minneapolis, Minnesota
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Huang SS, Huang AY, Lin YF, Lin SM, Webster CS, Lin JY, Yang YY, Yang SJH, Lirng JF, Chen CH, Yang AC, Lin CH. Learning pathways composed of core subjects with features of reducing cognitive load have better learning outcomes. J Chin Med Assoc 2024; 87:714-721. [PMID: 38829990 DOI: 10.1097/jcma.0000000000001116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Changing the course duration or timing of subjects in learning pathways would influence medical students' learning outcomes. Curriculum designers need to consider the strategy of reducing cognitive load and evaluate it continuously. Our institution underwent gradual curricular changes characterized by reducing cognitive load since 2000. Therefore, we wanted to explore the impact of this strategy on our previous cohorts. METHODS This cohort study explored learning pathways across academic years of more than a decade since 2000. Eight hundred eighty-two medical students between 2006 and 2012 were included eventually. Learning outcomes included an average and individual scores of subjects in different stages. Core subjects were identified as those where changes in duration or timing would influence learning outcomes and constitute different learning pathways. We examined whether the promising learning pathway defined as the pathway with the most features of reducing cognitive load has higher learning outcomes than other learning pathways in the exploring dataset. The relationship between features and learning outcomes was validated by learning pathways selected in the remaining dataset. RESULTS We found nine core subjects, constituting four different learning pathways. Two features of extended course duration and increased proximity between core subjects of basic science and clinical medicine were identified in the promising learning pathway 2012, which also had the highest learning outcomes. Other pathways had some of the features, and pathway 2006 without such features had the lowest learning outcomes. The relationship between higher learning outcomes and cognitive load-reducing features was validated by comparing learning outcomes in two pathways with and without similar features of the promising learning pathway. CONCLUSION An approach to finding a promising learning pathway facilitating students' learning outcomes was validated. Curricular designers may implement similar design to explore the promising learning pathway while considering potential confounding factors, including students, medical educators, and learning design of the course.
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Affiliation(s)
- Shiau-Shian Huang
- Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Anna YuQing Huang
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Yu-Fan Lin
- Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Sheng-Min Lin
- Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Craig S Webster
- Department of Anaesthesiology and Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Ji-Yang Lin
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Stephen J H Yang
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Jiing-Feng Lirng
- Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chen-Huan Chen
- Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | | | - Chi-Hung Lin
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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25
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Teles MS, Mamidanna S, Mattes MD. Assessment of Student Perceptions of Aspects of a Career in Radiation Oncology. J Am Coll Radiol 2024; 21:1079-1089. [PMID: 38369041 DOI: 10.1016/j.jacr.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE To determine medical students' views of various aspects of a career in radiation oncology (RO) to identify areas that may benefit from reform and to guide initiatives to stimulate broader and more diverse student interest in the specialty. METHODS AND MATERIALS An electronic survey was sent to student oncology interest group members at seven US medical schools. The survey asked students to rate 19 aspects of RO on a 5-point bipolar Likert-type scale. Descriptive statistics are reported, along with subgroup analyses based on participants' demographics. RESULTS The response rate was 51.1% (n = 275 of 538). The most favorably rated aspects of RO were outpatient working hours (mean ± SD Likert-type rating of 4.51 ± 0.82), routinely working with other physicians (4.45 ± 0.76), and use of advanced technology to treat patients. The most unfavorably rated aspects of RO were less geographic flexibility for residency or employment (1.98 ± 1.04), spending a lot of time on a computer doing treatment planning (2.80 ± 1.21), and having a job that is not well understood by most doctors and the general public (2.89 ± 1.02). Gender was associated with significant differences in 8 of 19 questions in how each aspect of RO was viewed. Few differences were observed based on race or ethnicity, though Asian participants had a significantly more favorable view of RO being a more science-oriented specialty compared with White or underrepresented students, respectively (3.50 versus 3.21 versus 2.84, P = .01). CONCLUSIONS These findings inform the RO community in the development of more effective initiatives to encourage students to fully explore the specialty.
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Affiliation(s)
| | - Swati Mamidanna
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; Member ASTRO Communications and Education Committees.
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26
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Matthews A, Fenu E, Skuli SJ, Harris JC, Bagg A, Lai C. Immunohistochemistry-based detection of TP53 mutations in acute myeloid leukemia: a promising high sensitivity diagnostic approach. Leuk Lymphoma 2024; 65:1012-1015. [PMID: 38535517 DOI: 10.1080/10428194.2024.2332505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/13/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Andrew Matthews
- Hematology Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Elena Fenu
- Pathology, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Sarah J Skuli
- Hematology Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jaryse C Harris
- Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam Bagg
- Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Catherine Lai
- Hematology Oncology, University of Pennsylvania, Philadelphia, PA, USA
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27
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Schukow CP, Punjabi LS, Abdul-Karim FW. #PathX: #PathTwitter's Transformation and a Discussion on Different Social Media Platforms Used by Pathologists in 2024. Adv Anat Pathol 2024; 31:275-277. [PMID: 38047394 DOI: 10.1097/pap.0000000000000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
#PathTwitter is a well-known virtual community that has historically been positive for pathologists, trainees, and medical students worldwide to communicate, collaborate, and connect for free. However, in 2023, the popular social media platform Twitter (parent company: X Corp.) transitioned to "X" and, with this, #PathTwitter evolved into #PathX. Although the overall user experience of X and Twitter has not changed significantly, this transition brought much anecdotal hesitancy from the online virtual pathology community early on. Thus, the purpose of this review is to discuss the background of Twitter's importance in pathology, the implications of this transition to the online pathology community, current views from this community regarding Twitter versus X, and to provide an overview of pertinent changes in the platform, as well as of different popular social media platforms that may be used by pathologists in 2024.
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Affiliation(s)
- Casey P Schukow
- Department of Pathology, Corewell Health's Beaumont Hospital, Royal Oak, MI
| | - Lavisha S Punjabi
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Fadi W Abdul-Karim
- Professor Emeritus, Pathology, Case Western Reserve University and Cleveland Clinic Lerner College of Medicine, Cleveland, OH
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28
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Bouhouita-Guermech S, Haidar H. Scoping Review Shows the Dynamics and Complexities Inherent to the Notion of "Responsibility" in Artificial Intelligence within the Healthcare Context. Asian Bioeth Rev 2024; 16:315-344. [PMID: 39022380 PMCID: PMC11250714 DOI: 10.1007/s41649-024-00292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 07/20/2024] Open
Abstract
The increasing integration of artificial intelligence (AI) in healthcare presents a host of ethical, legal, social, and political challenges involving various stakeholders. These challenges prompt various studies proposing frameworks and guidelines to tackle these issues, emphasizing distinct phases of AI development, deployment, and oversight. As a result, the notion of responsible AI has become widespread, incorporating ethical principles such as transparency, fairness, responsibility, and privacy. This paper explores the existing literature on AI use in healthcare to examine how it addresses, defines, and discusses the concept of responsibility. We conducted a scoping review of literature related to AI responsibility in healthcare, searching databases and reference lists between January 2017 and January 2022 for terms related to "responsibility" and "AI in healthcare", and their derivatives. Following screening, 136 articles were included. Data were grouped into four thematic categories: (1) the variety of terminology used to describe and address responsibility; (2) principles and concepts associated with responsibility; (3) stakeholders' responsibilities in AI clinical development, use, and deployment; and (4) recommendations for addressing responsibility concerns. The results show the lack of a clear definition of AI responsibility in healthcare and highlight the importance of ensuring responsible development and implementation of AI in healthcare. Further research is necessary to clarify this notion to contribute to developing frameworks regarding the type of responsibility (ethical/moral/professional, legal, and causal) of various stakeholders involved in the AI lifecycle.
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Affiliation(s)
| | - Hazar Haidar
- Ethics Programs, Department of Letters and Humanities, University of Quebec at Rimouski, Rimouski, Québec Canada
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29
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Schukow CP, Herman MK, Kochanowski J, Hansma PA. Modernizing Forensic Pathology Education on TikTok: Lessons Learned on this "Social Media Frontier". Adv Anat Pathol 2024; 31:278-280. [PMID: 38314570 DOI: 10.1097/pap.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Affiliation(s)
- Casey P Schukow
- Department of Pathology, Corewell Health's Beaumont Hospital, Royal Oak MI
| | | | - Julia Kochanowski
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND
| | - Patrick A Hansma
- Department of Pathology, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
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30
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Ngo TB, Niu W, Fang Z, Gold L. Dermatology residents' perspectives on virtual dermatopathology education. J Cutan Pathol 2024; 51:530-537. [PMID: 38549184 PMCID: PMC11166523 DOI: 10.1111/cup.14618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Dermatopathology education accounts for 30% of U.S. dermatology residency training. The COVID-19 pandemic expedited the implementation of virtual dermatopathology in place of traditional microscopy for resident education. This study examined U.S. dermatology residents' perceptions of virtual dermatopathology, as research in this area is lacking. METHODS An anonymous, confidential, institutional review board-approved survey was electronically distributed to U.S. dermatology residents consisting of 16 questions comparing attitudes towards virtual and traditional dermatopathology education. Responses were n = 59. Statistical analysis was performed using SAS software. RESULTS Participants believe virtual imaging is superior to conventional microscopy in schedule flexibility (96.6% vs. 1.7%, p < 0.0001), lecture convenience (94.8% vs. 0.0%, p < 0.0001), personal review (96.6% vs. 0.0%, p < 0.0001), cost-effectiveness (64.4% vs. 6.8%, p < 0.0001), and board exam preparation (52.5% vs. 16.9%, p = 0.0005). Conventional microscopy was favored for image quality (50.8% vs. 25.4%, p = 0.0127) and overall utility (50.8% vs. 27.1%, p = 0.0195). CONCLUSIONS Our study supports virtual dermatopathology utilization as a valuable tool in dermatology residency training. Also it is shown that conventional microscopy training continues to play a key role. Further studies should examine whether, if ever, virtual dermatopathology could gradually replace conventional microscopy with the advent of newer and more powerful digital and scanning technology.
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Affiliation(s)
- Tram B. Ngo
- Louisiana State University Health Sciences Center at New Orleans, School of Medicine, 433 Bolivar St, New Orleans, LA 70112, USA
| | - Wei Niu
- Louisiana State University Health Sciences Center at New Orleans, Department of Dermatology, 1542 Tulane Ave, New Orleans, LA 70112, USA
| | - Zhide Fang
- Louisiana State University Health Sciences Center at New Orleans, School of Public Health, Biostatistics Program, 2020 Gravier St, New Orleans, LA 70112, USA
| | - Logan Gold
- Louisiana State University Health Sciences Center at New Orleans, School of Medicine, 433 Bolivar St, New Orleans, LA 70112, USA
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Aden D, Zaheer S, Khan S. Possible benefits, challenges, pitfalls, and future perspective of using ChatGPT in pathology. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:198-210. [PMID: 38971620 DOI: 10.1016/j.patol.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/22/2024] [Accepted: 04/16/2024] [Indexed: 07/08/2024]
Abstract
The much-hyped artificial intelligence (AI) model called ChatGPT developed by Open AI can have great benefits for physicians, especially pathologists, by saving time so that they can use their time for more significant work. Generative AI is a special class of AI model, which uses patterns and structures learned from existing data and can create new data. Utilizing ChatGPT in Pathology offers a multitude of benefits, encompassing the summarization of patient records and its promising prospects in Digital Pathology, as well as its valuable contributions to education and research in this field. However, certain roadblocks need to be dealt like integrating ChatGPT with image analysis which will act as a revolution in the field of pathology by increasing diagnostic accuracy and precision. The challenges with the use of ChatGPT encompass biases from its training data, the need for ample input data, potential risks related to bias and transparency, and the potential adverse outcomes arising from inaccurate content generation. Generation of meaningful insights from the textual information which will be efficient in processing different types of image data, such as medical images, and pathology slides. Due consideration should be given to ethical and legal issues including bias.
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Affiliation(s)
- Durre Aden
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sufian Zaheer
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
| | - Sabina Khan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
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Beavis AL, Wethington SL, Yu R, Topel KM, Bielman ML, Olson S, Rositch AF. Differential utilization of the online patient portal for completion of health-related social needs screening during routine gynecologic cancer care. Cancer 2024. [PMID: 38943672 DOI: 10.1002/cncr.35376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/27/2024] [Accepted: 04/12/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Telehealth technologies offer efficient ways to deliver health-related social needs (HRSN) screening in cancer care, but these methods may not reach all populations. The authors examined patient characteristics associated with using an online patient portal (OPP) to complete HRSN screening as part of gynecologic cancer care. METHODS From June 2021 to June 2023, patients in a gynecologic oncology clinic completed validated HRSN screening questions either (1) using the OPP (independently before the visit) or (2) in person (verbally administered by clinic staff). The authors examined the prevalence of HRSN according to activated OPP status and, in a restricted subgroup, used stepwise multivariate Poisson regression to identify associations between patient and visit characteristics and using the OPP. RESULTS Of 1616 patients, 87.4% (n = 1413) had an activated OPP. Patients with inactive OPPs (vs. activated OPPs) more frequently reported two or more needs (10% vs 5%; p < .01). Of 986 patients in the restricted cohort, 52% used the OPP to complete screening. The final multivariable model indicated that patients were less likely to use the OPP if they were Black (vs. White; adjusted relative risk [aRR], 0.70; 95% confidence interval [CI], 0.59-0.83); not employed (vs. employed; aRR, 0.81; 95% CI, 0.68-0.97), or had low measures of OPP engagement (aRR, 0.80; 95% CI, 0.68-0.92). New versus established patients were 21% more likely to use the OPP (aRR, 1.21; 95% CI, 1.06-1.38). CONCLUSIONS Differential use of the OPP suggested that over-reliance on digital technologies could limit the ability to reach those populations that have social factors already associated with cancer outcome disparities. Cancer centers should consider using multiple delivery methods for HRSN screening to maximize reach to all populations.
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Affiliation(s)
- Anna L Beavis
- The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephanie L Wethington
- The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ruoxi Yu
- The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristin M Topel
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marie L Bielman
- The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Olson
- Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Fu CP, Huang CK, Yang YC, Liao WS, Huang SM, Chang WD, Chen YJ, Li MW, Lin YJ, Wu CL, Chi HY, Lee CY, Chiang FM, Chen YL, Tsou CF, Liu TH, Su CT, Yang AL, Kuo NC, Chang WY. Developing an entrustable professional activity for providing health education and consultation in occupational therapy and examining its validity. BMC MEDICAL EDUCATION 2024; 24:705. [PMID: 38943116 PMCID: PMC11214254 DOI: 10.1186/s12909-024-05670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/18/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. METHODS Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. RESULTS The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. CONCLUSION The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings.
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Affiliation(s)
- Chung-Pei Fu
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ching-Kai Huang
- Department of Rehabilitation, Occupational Therapy, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chiun Yang
- Department of Rehabilitation, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Wei-Sheng Liao
- Department of Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shih-Min Huang
- Department of Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Wei-Di Chang
- Department of Rehabilitation, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yi-Ju Chen
- Department of Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Wei Li
- Department of Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Yi-Ju Lin
- Department of Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Chin-Lung Wu
- Department of Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsin-Yu Chi
- Department of Rehabilitation, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Chia-Yi Lee
- Department of Rehabilitation, Cathay General Hospital, Taipei, Taiwan
| | - Fu-Mei Chiang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Lan Chen
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Fen Tsou
- Department of Rehabilitation, Cathay General Hospital, Taipei, Taiwan
| | - Tzu-Hung Liu
- Department of Family Medicine, Taipei Tzu Chi Hospital, New Taipei City, Taiwan
- School of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Chia-Ting Su
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ai-Lun Yang
- Institute of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Nung-Chen Kuo
- Department of Occupational Therapy, Taoyuan General Hospital, Ministry of Health and Welfare,, No. 1492, Zhongshan Rd.,Taoyuan Dist., Taoyuan, 330, Taiwan.
| | - Wan-Ying Chang
- Department of Physical Medicine and Rehabilitation, Taipei Hospital, Ministry of Health and Welfare, No. 127, Su-Yuan Rd., Hsin-Chung Dist., New Taipei City, Taiwan.
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Rashidi HH, Ikram A, Dang LT, Bashir A, Zohra T, Ali A, Tanvir H, Mudassar M, Ravindran R, Akhtar N, Sikandar RI, Umer M, Akhter N, Butt R, Fennell BD, Khan IH. Comparing machine learning screening approaches using clinical data and cytokine profiles for COVID-19 in resource-limited and resource-abundant settings. Sci Rep 2024; 14:14892. [PMID: 38937503 PMCID: PMC11211475 DOI: 10.1038/s41598-024-63707-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/31/2024] [Indexed: 06/29/2024] Open
Abstract
Accurate screening of COVID-19 infection status for symptomatic patients is a critical public health task. Although molecular and antigen tests now exist for COVID-19, in resource-limited settings, screening tests are often not available. Furthermore, during the early stages of the pandemic tests were not available in any capacity. We utilized an automated machine learning (ML) approach to train and evaluate thousands of models on a clinical dataset consisting of commonly available clinical and laboratory data, along with cytokine profiles for patients (n = 150). These models were then further tested for generalizability on an out-of-sample secondary dataset (n = 120). We were able to develop a ML model for rapid and reliable screening of patients as COVID-19 positive or negative using three approaches: commonly available clinical and laboratory data, a cytokine profile, and a combination of the common data and cytokine profile. Of the tens of thousands of models automatically tested for the three approaches, all three approaches demonstrated > 92% sensitivity and > 88 specificity while our highest performing model achieved 95.6% sensitivity and 98.1% specificity. These models represent a potential effective deployable solution for COVID-19 status classification for symptomatic patients in resource-limited settings and provide proof-of-concept for rapid development of screening tools for novel emerging infectious diseases.
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Affiliation(s)
- Hooman H Rashidi
- Computational Pathology and AI Center of Excellence (CPACE), University of Pittsburgh Medical Center, and University of Pittsburgh School of Medicine, Pittsburgh, USA.
| | - Aamer Ikram
- National Institutes of Health, Islamabad, Pakistan
| | - Luke T Dang
- Department of Pathology and Laboratory Medicine, University of California, 4400 V Street, DavisSacramento, CA, 95817, USA
| | - Adnan Bashir
- Health Information Systems Program (HISP), Islamabad, Pakistan
| | | | - Amna Ali
- National Institutes of Health, Islamabad, Pakistan
| | - Hamza Tanvir
- National Institutes of Health, Islamabad, Pakistan
| | | | - Resmi Ravindran
- Department of Pathology and Laboratory Medicine, University of California, 4400 V Street, DavisSacramento, CA, 95817, USA
| | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | - Mohammed Umer
- Rawalpindi Medical University-Rawalpindi, Rawalpindi, Pakistan
| | - Naeem Akhter
- Rawalpindi Medical University-Rawalpindi, Rawalpindi, Pakistan
| | - Rafi Butt
- Isolation Hospital and Infectious Treatment Centre, Islamabad, Pakistan
| | - Brandon D Fennell
- Department of Medicine, University of California, San Francisco, USA
| | - Imran H Khan
- Department of Pathology and Laboratory Medicine, University of California, 4400 V Street, DavisSacramento, CA, 95817, USA.
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Hong SM, Baek DH. Diagnostic Procedures for Inflammatory Bowel Disease: Laboratory, Endoscopy, Pathology, Imaging, and Beyond. Diagnostics (Basel) 2024; 14:1384. [PMID: 39001273 PMCID: PMC11241288 DOI: 10.3390/diagnostics14131384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
Diagnosing inflammatory bowel disease (IBD) can often be challenging, and differentiating between Crohn's disease and ulcerative colitis can be particularly difficult. Diagnostic procedures for IBD include laboratory tests, endoscopy, pathological tests, and imaging tests. Serological and stool tests can be easily performed in an outpatient setting and provide critical diagnostic clues. Although endoscopy is an invasive procedure, it offers essential diagnostic information and allows for tissue biopsy and therapeutic procedures. Video capsule endoscopy and device-assisted enteroscopy are endoscopic procedures used to evaluate the small bowel. In addition to endoscopy, magnetic resonance imaging, computed tomography, and ultrasound (US) are valuable tools for small bowel assessment. Among these, US is noninvasive and easily utilized, making its use highly practical in daily clinical practice. Endoscopic biopsy aids in the diagnosis of IBD and is crucial for assessing the histological activity of the disease, facilitating a thorough evaluation of disease remission, and aiding in the development of treatment strategies. Recent advances in artificial intelligence hold promise for enhancing various aspects of IBD management, including diagnosis, monitoring, and precision medicine. This review compiles current procedures and promising future tools for the diagnosis of IBD, providing comprehensive insights.
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Affiliation(s)
- Seung Min Hong
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea
| | - Dong Hoon Baek
- Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea
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Peyretaillade E, Akossi RF, Tournayre J, Delbac F, Wawrzyniak I. How to overcome constraints imposed by microsporidian genome features to ensure gene prediction? J Eukaryot Microbiol 2024:e13038. [PMID: 38934348 DOI: 10.1111/jeu.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Since the advent of sequencing techniques and due to their continuous evolution, it has become easier and less expensive to obtain the complete genome sequence of any organism. Nevertheless, to elucidate all biological processes governing organism development, quality annotation is essential. In genome annotation, predicting gene structure is one of the most important and captivating challenges for computational biology. This aspect of annotation requires continual optimization, particularly for genomes as unusual as those of microsporidia. Indeed, this group of fungal-related parasites exhibits specific features (highly reduced gene sizes, sequences with high rate of evolution) linked to their evolution as intracellular parasites, requiring the implementation of specific annotation approaches to consider all these features. This review aimed to outline these characteristics and to assess the increasingly efficient approaches and tools that have enhanced the accuracy of gene prediction for microsporidia, both in terms of sensitivity and specificity. Subsequently, a final part will be dedicated to postgenomic approaches aimed at reinforcing the annotation data generated by prediction software. These approaches include the characterization of other understudied genes, such as those encoding regulatory noncoding RNAs or very small proteins, which also play crucial roles in the life cycle of these microorganisms.
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Affiliation(s)
| | - Reginal F Akossi
- LMGE, CNRS, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jérémy Tournayre
- INRAE, UMR Herbivores, Université Clermont Auvergne, VetAgro Sup, Saint-Genès-Champanelle, France
| | - Frédéric Delbac
- LMGE, CNRS, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Ivan Wawrzyniak
- LMGE, CNRS, Université Clermont Auvergne, Clermont-Ferrand, France
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De Silva S, Alli-Shaik A, Gunaratne J. Machine Learning-Enhanced Extraction of Biomarkers for High-Grade Serous Ovarian Cancer from Proteomics Data. Sci Data 2024; 11:685. [PMID: 38918474 PMCID: PMC11199488 DOI: 10.1038/s41597-024-03536-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
Comprehensive biomedical proteomic datasets are accumulating exponentially, warranting robust analytics to deconvolute them for identifying novel biological insights. Here, we report a strategic machine learning (ML)-based feature extraction workflow that was applied to unveil high-performing protein markers for high-grade serous ovarian carcinoma (HGSOC) from publicly available ovarian cancer tissue and serum proteomics datasets. Diagnosis of HGSOC, an aggressive form of ovarian cancer, currently relies on diagnostic methods based on tissue biopsy and/or non-specific biomarkers such as the cancer antigen 125 (CA125) and human epididymis protein 4 (HE4). Our newly developed ML-based approach enabled the identification of new serum proteomic biomarkers for HGSOC. The performance verification of these marker combinations using two independent cohorts affirmed their outperformance against known biomarkers for ovarian cancer including clinically used serum markers with >97% AUC. Our analysis also added novel biological insights such as enriched cancer-related processes associated with HGSOC.
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Affiliation(s)
- Senuri De Silva
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117594, Singapore
| | - Asfa Alli-Shaik
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore
| | - Jayantha Gunaratne
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A*STAR), Singapore, 138673, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117594, Singapore.
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Rodino KG, Luethy PM, Abbott AN, Bender JM, Eberly AR, Gitman M, Leber A, Dien Bard J. Defining the value of medical microbiology consultation. J Clin Microbiol 2024:e0035924. [PMID: 38904385 DOI: 10.1128/jcm.00359-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024] Open
Abstract
Medical microbiologists, defined as doctoral-level laboratory directors with subspecialty training in medical microbiology, lead the clinical laboratory operations through activities such as clinical consultations, oversight of diagnostic testing menu, institutional leadership, education, and scholastic activities. However, unlike their clinical colleagues, medical microbiologists are largely unable to bill for clinical consultations performed within the hospital and, therefore, unable to generate relative value units or a similar quantifiable metric. As hospital budgets tighten and justification of staffing becomes a necessity, this may present a challenge to the medical microbiologist attempting to prove their value to the organization. To aid in providing tangible data, the Personnel Standards and Workforce subcommittee of the American Society for Microbiology conducted a multi-center study across seven medical centers to document clinical consultations and their impact. Consults were generated equally from internal (laboratory-based) and external (hospital-based) parties, with the majority directly impacting patient management. Near universal acceptance of the medical microbiologist's recommendation highlights the worth derived from their expertise. External consults required more time commitment from the medical microbiologist than internal consults, although both presented ample opportunity for secondary value, including impact through stewardship, education, clinical guidance, and cost reduction. This study is a description of the content and impact of consultations that underscore the importance of the medical microbiologist as a key member of the healthcare team. IMPORTANCE Medical microbiologists are invaluable to the clinical microbiology laboratory and the healthcare system as a whole. However, as medical microbiologists do not regularly generate relative value units, capturing and quantifying the value provided is challenging. As hospital budgets tighten, justification of staffing becomes a necessity. To aid in providing tangible data, the Personnel Standards and Workforce subcommittee of the American Society for Microbiology conducted a multi-center study across seven medical centers to document clinical consultations and their impact. To our knowledge, this is the first study to provide detailed evaluation of the consultative value provided by medical microbiologists.
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Affiliation(s)
- Kyle G Rodino
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul M Luethy
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - April N Abbott
- Department of Laboratory Medicine, Deaconess Health System, Evansville, Indiana, USA
| | - Jeffrey M Bender
- Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Allison R Eberly
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Melissa Gitman
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy Leber
- Department of Laboratory Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Jennifer Dien Bard
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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van Enk A, MacDonald G, Hatala R, Gingerich A, Tam J. Not in the file: How competency committees work with undocumented contributions. MEDICAL EDUCATION 2024. [PMID: 38899368 DOI: 10.1111/medu.15457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/25/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Competence committees (CCs) centre their work around documentation of trainees' performance; undocumented contributions (i.e. informal, unrecorded material like personal judgements, experiential anecdotes and contextual information) evoke suspicion even though they may play a role in decision making. This qualitative multiple case study incorporates insights from a social practice perspective on writing to examine the use of undocumented contributions by the CCs of two large post-graduate training programmes, one in a more procedural (MP) speciality and the other in a less procedural (LP) one. METHODS Data were collected via observations of meetings and semi-structured interviews with CC members. In the analysis, conversations were organised into triptychs of lead-up, undocumented contribution(s), and follow-up. We then created thick descriptions around the undocumented contributions, drawing on conversational context and interview data to assign possible motivations and significance. RESULTS We found no instances in which undocumented contributions superseded the contents of a trainee's file or stood in for missing documentation. The number of undocumented contributions varied between the MP CC (six instances over two meetings) and the LP CC (22 instances over three meetings). MP CC discussions emphasised Entrustable Professional Activity (EPA) observations, whereas LP CC members paid more attention to narrative data. The divergent orientations of the CCs-adding an 'advis[ing]/guid[ing]' role versus focusing simply on evaluation-offers the most compelling explanation. In lead-ups, undocumented contributions were prompted by missing and flawed documentation, conflicting evidence and documentation at odds with members' perceptions. Recognising other 'red flags' in documentation often required professional experience. In follow-ups, purposes served by undocumented contributions varied with context and were difficult to generalise; we, therefore, provide deeper analysis of two vignettes to illustrate. CONCLUSIONS Our data suggest undocumented contributions often serve best efforts to ground decisions in documentation. We would encourage CC practices and policies be rooted in more nuanced approaches to documentation.
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Affiliation(s)
- Anneke van Enk
- Centre for Health Education Scholarship, University of British Columbia, Vancouver, BC, Canada
| | - Graham MacDonald
- Rehabilitation Sciences Program, University of British Columbia, Vancouver, BC, Canada
| | - Rose Hatala
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andrea Gingerich
- Division of Medical Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Jennifer Tam
- Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Ngan CBM, Kaur R, Jackson DE. Does high body mass index (>25 kg/m 2) or weight (>80 kg) reduce the effectiveness of anti-D prophylaxis in Rh(D)-negative pregnant women? A systematic review and meta-analysis. Vox Sang 2024. [PMID: 38889996 DOI: 10.1111/vox.13693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Haemolytic disease of the foetus and newborn (HDFN) occurs when maternal antibodies, often triggered by foetal antigens, destroy foetal and neonatal red blood cells. Factors like antibody strength, quantity and gestational age influence HDFN severity. Routine antenatal anti-D prophylaxis (RAADP) has significantly reduced HDFN cases. However, the effect of overweight/obesity (body mass index [BMI] > 25/30 kg/m2) on anti-D prophylaxis efficacy remains unclear. This systematic review will examine the impact of BMI on anti D prophylaxis effectiveness in Rh(D) negative pregnant women. MATERIALS AND METHODS We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. We searched databases from 1996 to 2023, focusing on studies exploring the link between high BMI/weight and anti-D serum levels in Rh(D)-negative pregnant women with Rh(D)-positive foetuses. Ten eligible studies were included, three suitable for meta-analysis. Study quality was assessed using the Strengthening the Reporting Observation Studies in Epidemiology (STROBE) checklist. Statistical analyses included Pearson correlation coefficients and risk differences. RESULTS Our meta-analysis revealed a significant negative correlation (r = -0.59, 95% confidence interval [CI]: -0.83 to -0.35, p = 0.007) between high BMI/weight and serial anti-D levels in in Rh(D)-negative pregnant women with Rh(D)-positive foetuses. High BMI/weight had lower odds of serial anti-D level exceeding 30 ng/mL (arcsine risk difference [ARD] = 0.376, 95% CI: 0.143-0.610, p = 0.002). Heterogeneity among studies was low (I2 = 0). CONCLUSION While our analysis suggests a potential linkage between high BMI/weight and reduced efficacy of anti-D prophylaxis, caution is warranted due to study limitations. Variability in study design and confounding factors necessitate careful interpretation. Further research is needed to confirm these findings and refine clinical recommendations.
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Affiliation(s)
- C B M Ngan
- Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Victoria, Australia
| | - R Kaur
- Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Victoria, Australia
| | - Denise E Jackson
- Thrombosis and Vascular Diseases Laboratory, School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Victoria, Australia
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Verona J, Gülsen Y, Zaninotto M, Munsaka S, Serdarevic N, Datta SK, Wiencek J, Fink N. Ethical Checklists for Clinical Research Projects and laboratory medicine: two tools to evaluate compliance with bioethical principles in different settings. Clin Chem Lab Med 2024; 0:cclm-2024-0604. [PMID: 38881198 DOI: 10.1515/cclm-2024-0604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/30/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES To develop two ethical checklists to evaluate (i) management of ethical concerns in research projects and (ii) awareness of ethical conduct of healthcare laboratory professionals. METHODS Comprehensive discussion among the members of IFCC Task Force on Ethics based on pertinent literature. RESULTS This Checklist for Clinical Research Projects should be useful to evaluate research proposals from an ethical perspective before submitting it to an IRB or its equivalent, thereby diminishing rejection rates and resulting in more time-effective projects. The checklist designed to evaluate the ethical conduct in laboratory medicine could be useful for self evaluation (internal audits) and for certification/accreditation processes performed by third parties. CONCLUSIONS These checklists are simple but powerful tools useful to guide professionals to adhere to ethical principles in their practice, especially in developing countries where accredited ethics committees may be difficult to find.
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Affiliation(s)
- Julián Verona
- Hospital de Balcarce "Dr. Felipe A. Fossati", Balcarce, Buenos Aires, Argentina
| | - Yilmaz Gülsen
- Department of Medical Biochemistry, Ankara Yildirim Beyazit University School of Medicine, Ankara, Türkiye
- Medical Biochemistry Laboratory, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Martina Zaninotto
- Department of Laboratory Medicine, University Hospital, Padova, Italy
| | - Sody Munsaka
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Nafija Serdarevic
- Institute for Biochemistry, University of Sarajevo Clinics Center, Sarajevo, Bosnia and Herzegovina
- Faculty of Health Sciences, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sudip K Datta
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Joesph Wiencek
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Nilda Fink
- Fundación Bioquímica Argentina, Programa PROES, Ciudad Autónoma de Buenos Aires, Argentina
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Zhang S, Yang B, Yang H, Zhao J, Zhang Y, Gao Y, Monteiro O, Zhang K, Liu B, Wang S. Potential rapid intraoperative cancer diagnosis using dynamic full-field optical coherence tomography and deep learning: A prospective cohort study in breast cancer patients. Sci Bull (Beijing) 2024; 69:1748-1756. [PMID: 38702279 DOI: 10.1016/j.scib.2024.03.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/06/2024]
Abstract
An intraoperative diagnosis is critical for precise cancer surgery. However, traditional intraoperative assessments based on hematoxylin and eosin (H&E) histology, such as frozen section, are time-, resource-, and labor-intensive, and involve specimen-consuming concerns. Here, we report a near-real-time automated cancer diagnosis workflow for breast cancer that combines dynamic full-field optical coherence tomography (D-FFOCT), a label-free optical imaging method, and deep learning for bedside tumor diagnosis during surgery. To classify the benign and malignant breast tissues, we conducted a prospective cohort trial. In the modeling group (n = 182), D-FFOCT images were captured from April 26 to June 20, 2018, encompassing 48 benign lesions, 114 invasive ductal carcinoma (IDC), 10 invasive lobular carcinoma, 4 ductal carcinoma in situ (DCIS), and 6 rare tumors. Deep learning model was built up and fine-tuned in 10,357 D-FFOCT patches. Subsequently, from June 22 to August 17, 2018, independent tests (n = 42) were conducted on 10 benign lesions, 29 IDC, 1 DCIS, and 2 rare tumors. The model yielded excellent performance, with an accuracy of 97.62%, sensitivity of 96.88% and specificity of 100%; only one IDC was misclassified. Meanwhile, the acquisition of the D-FFOCT images was non-destructive and did not require any tissue preparation or staining procedures. In the simulated intraoperative margin evaluation procedure, the time required for our novel workflow (approximately 3 min) was significantly shorter than that required for traditional procedures (approximately 30 min). These findings indicate that the combination of D-FFOCT and deep learning algorithms can streamline intraoperative cancer diagnosis independently of traditional pathology laboratory procedures.
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MESH Headings
- Humans
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/surgery
- Breast Neoplasms/pathology
- Tomography, Optical Coherence/methods
- Deep Learning
- Female
- Prospective Studies
- Middle Aged
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Ductal, Breast/pathology
- Aged
- Adult
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Intraoperative Period
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Affiliation(s)
- Shuwei Zhang
- Breast Center, Peking University People's Hospital, Beijing 100044, China
| | - Bin Yang
- China ESG Institute, Capital University of Economics and Business, Beijing 100070, China; Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
| | - Houpu Yang
- Breast Center, Peking University People's Hospital, Beijing 100044, China
| | - Jin Zhao
- Breast Center, Peking University People's Hospital, Beijing 100044, China
| | - Yuanyuan Zhang
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - Yuanxu Gao
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Macao 999078, China
| | - Olivia Monteiro
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Macao 999078, China
| | - Kang Zhang
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University of Science and Technology, Macao 999078, China; College of Future Technology, Peking University, Beijing 100091, China.
| | - Bo Liu
- School of Mathematical and Computational Sciences, Massey University, Auckland 0745, New Zealand.
| | - Shu Wang
- Breast Center, Peking University People's Hospital, Beijing 100044, China.
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Schukow CP, Holmes C, Chambers M, Rayes O, Jackson NR, Deeken AH, Hlavaty LA. How (Cautious) Social Media Use May Improve Education and Pipeline Efforts of a Growing Postpandemic Forensic Pathologist Workforce Shortage. Am J Forensic Med Pathol 2024:00000433-990000000-00195. [PMID: 39018442 DOI: 10.1097/paf.0000000000000960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
ABSTRACT Many subspecialties of pathology have initiated novel methods and strategies to connect with medical students and residents, stimulate interest, and offer mentorship. Emerging concern about the future of forensic pathology has been highlighted in contemporary literature as recruitment of new fellows has stagnated and workforce shortage concerns have blossomed. Amidst these challenges, the potential role of social networking platforms like social media (SoMe) in enhancing autopsy pathology/forensics education has garnered attention, yet literature focusing specifically on its application in autopsy and forensic pathology remains limited. This review aims to provide a comprehensive narrative overview of the current literature on the established uses of SoMe in forensic pathology. It seeks to build upon existing recommendations, introducing a contemporary compilation of online resources designed to facilitate virtual engagement among pathologists, learners, patients, and families. The review supports the idea that strategic, ethical, and conscientious use of SoMe has a place in addressing the growing workforce shortages and closing educational gaps in forensic pathology by enhancing exposure to the field and dispelling antiquated stereotypes.
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Affiliation(s)
- Casey P Schukow
- From the Department of Pathology, Corewell Health William Beaumont University Hospital Royal Oak, MI
| | - Carley Holmes
- From the Department of Pathology, Corewell Health William Beaumont University Hospital Royal Oak, MI
| | - Meagan Chambers
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | | | - Nicole R Jackson
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Amy H Deeken
- Department of Pathology, Summa Health Systems, Akron, OH
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Firouzabadi FD, Hesami M, Sheikhy A, Radmard M, Dabiri M, Ramezanpour S, Yousem DM. Representation of International Medical Graduates Among Diagnostic Radiology Chairs, Neuroradiology Chiefs, and Program Directors. Acad Radiol 2024:S1076-6332(24)00291-5. [PMID: 38871553 DOI: 10.1016/j.acra.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
RATIONALE AND OBJECTIVES The number of international medical graduates (IMGs) entering radiology residencies and neuroradiology fellowships averaged 9.7% and 20.9% from 2021 to 2023, respectively. We aimed to determine whether IMG graduates are populating leadership roles at a proportionate rate in diagnostic radiology (DR) and neuroradiology. MATERIALS AND METHODS We surveyed 191 DR program directors, 94 neuroradiology program directors (PDs), 192 chairs of radiology, and 91 directors of neuroradiology inquiring about their original citizenship and medical school (American Medical Graduates [AMG] vs IMG). We reviewed institutional websites to obtain missing data and recorded H indices for each person using Scopus. RESULTS We confirmed the original citizenship and medical school location in 61-75% and 93-98% of each leadership group. We found that 16.2% of DR program directors, 43.7% of neuroradiology PDs, 28.5% of Chairs, and 40.6% of neuroradiology directors were not originally US citizens. The IMG rate was 18/188 (9.6%), 20/90 (22.2%), 26/186 (14.0%), and 19/85 (22.4%) for the same groups respectively. The most common country of origin and medical school cited was India for all leadership groups. IMGs had a median H index of 14 while AMG 10, significantly different (p = 0.021) CONCLUSION: Compared to the rate of diagnostic and neuroradiology trainees entering from 2021 to 2023, IMGs are proportionately represented at the leadership positions studied. The H index of the IMGs was higher than AMG. We conclude that IMGs have made substantial and proportionate inroads in radiology and neuroradiology leadership.
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Affiliation(s)
| | - Mina Hesami
- Section of Emergency Ultrasound, Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ali Sheikhy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahla Radmard
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
| | - Mona Dabiri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
| | | | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
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45
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Blagg LN. Medical laboratory scientist motivation to pursue graduate education. Lab Med 2024:lmae041. [PMID: 38860483 DOI: 10.1093/labmed/lmae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Medical laboratory staffing shortages have persisted, with challenges in maintaining adequate medical laboratory professionals. The career trajectory for medical laboratory scientists beyond entry level is ambiguous, but advancement opportunities are enhanced with specialist certifications and advanced degrees. OBJECTIVE This study explored the motivation and preferences of medical laboratory scientists in pursuing graduate medical laboratory science education based on the importance of professional development, career advancement, recognition, and employment benefits. METHODS A quantitative, cross-sectional, and descriptive correlational study surveyed American Society for Clinical Pathology Board of Certification-credentialed medical laboratory scientists using an online questionnaire. RESULTS The overall response rate was 2.5%, and 1247 complete surveys were analyzed. Educational preferences varied by respondent age and amount of laboratory experience. Professional development, career advancement, recognition, and employment benefits were all important motivators for seeking graduate degrees, but those who were younger and had less experience indicated they were more important. CONCLUSION This study suggests several areas of improvement for educational programs, health care organizations, and professional organizations to support the motivation of medical laboratory scientists to pursue graduate education.
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Affiliation(s)
- Lorraine N Blagg
- College of Graduate Health Studies, A.T. Still University, Kirksville, MO, US
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Boland PA, Hardy NP, Moynihan A, McEntee PD, Loo C, Fenlon H, Cahill RA. Intraoperative near infrared functional imaging of rectal cancer using artificial intelligence methods - now and near future state of the art. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06731-9. [PMID: 38858280 DOI: 10.1007/s00259-024-06731-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/15/2024] [Indexed: 06/12/2024]
Abstract
Colorectal cancer remains a major cause of cancer death and morbidity worldwide. Surgery is a major treatment modality for primary and, increasingly, secondary curative therapy. However, with more patients being diagnosed with early stage and premalignant disease manifesting as large polyps, greater accuracy in diagnostic and therapeutic precision is needed right from the time of first endoscopic encounter. Rapid advancements in the field of artificial intelligence (AI), coupled with widespread availability of near infrared imaging (currently based around indocyanine green (ICG)) can enable colonoscopic tissue classification and prognostic stratification for significant polyps, in a similar manner to contemporary dynamic radiological perfusion imaging but with the advantage of being able to do so directly within interventional procedural time frames. It can provide an explainable method for immediate digital biopsies that could guide or even replace traditional forceps biopsies and provide guidance re margins (both areas where current practice is only approximately 80% accurate prior to definitive excision). Here, we discuss the concept and practice of AI enhanced ICG perfusion analysis for rectal cancer surgery while highlighting recent and essential near-future advancements. These include breakthrough developments in computer vision and time series analysis that allow for real-time quantification and classification of fluorescent perfusion signals of rectal cancer tissue intraoperatively that accurately distinguish between normal, benign, and malignant tissues in situ endoscopically, which are now undergoing international prospective validation (the Horizon Europe CLASSICA study). Next stage advancements may include detailed digital characterisation of small rectal malignancy based on intraoperative assessment of specific intratumoral fluorescent signal pattern. This could include T staging and intratumoral molecular process profiling (e.g. regarding angiogenesis, differentiation, inflammatory component, and tumour to stroma ratio) with the potential to accurately predict the microscopic local response to nonsurgical treatment enabling personalised therapy via decision support tools. Such advancements are also applicable to the next generation fluorophores and imaging agents currently emerging from clinical trials. In addition, by providing an understandable, applicable method for detailed tissue characterisation visually, such technology paves the way for acceptance of other AI methodology during surgery including, potentially, deep learning methods based on whole screen/video detailing.
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Affiliation(s)
- Patrick A Boland
- UCD Centre for Precision Surgery, School of Medicine, University College Dublin, 47 Eccles Street, Dublin 7, Dublin, Ireland
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - N P Hardy
- UCD Centre for Precision Surgery, School of Medicine, University College Dublin, 47 Eccles Street, Dublin 7, Dublin, Ireland
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Moynihan
- UCD Centre for Precision Surgery, School of Medicine, University College Dublin, 47 Eccles Street, Dublin 7, Dublin, Ireland
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - P D McEntee
- UCD Centre for Precision Surgery, School of Medicine, University College Dublin, 47 Eccles Street, Dublin 7, Dublin, Ireland
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - C Loo
- UCD Centre for Precision Surgery, School of Medicine, University College Dublin, 47 Eccles Street, Dublin 7, Dublin, Ireland
| | - H Fenlon
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - R A Cahill
- UCD Centre for Precision Surgery, School of Medicine, University College Dublin, 47 Eccles Street, Dublin 7, Dublin, Ireland.
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
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Uther P, Thomson J, Bartlett AW, Kennedy SE. Medical student interactions with children in their daily lives. Arch Dis Child Educ Pract Ed 2024:edpract-2022-324750. [PMID: 38862200 DOI: 10.1136/archdischild-2022-324750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 05/27/2024] [Indexed: 06/13/2024]
Abstract
Learning to communicate effectively with children in clinical interactions can be challenging. This study aimed to determine the extent to which medical students are exposed to children in their daily lives, in order to understand the experience students bring when entering paediatric rotations. METHODS A cross-sectional survey of medical students entering paediatric rotations from two medical schools was conducted. Students were asked to rate the frequency of their interactions with infants, preschool-aged and school-aged children and their confidence in doing so. RESULTS 339 out of 476 students participated in this study. Interactions with infants and preschool-aged children were rare, with most students reporting interactions once or two times per year or less (83% and 67%, respectively). Students interacted with school-aged children more frequently (43% most weeks or days). Students who interacted more frequently with children were more confident when entering their paediatric placements. CONCLUSIONS Medical students have limited exposure to infants and preschool-aged children in their daily lives and this affects their confidence. Supervisors should incorporate activities aimed at building confidence interacting with young children early in clinical attachments.
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Affiliation(s)
- Penelope Uther
- Paediatrics, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna Thomson
- Paediatric Learning Initiative, Médecins sans Frontières, Paris, France
| | - Adam William Bartlett
- Infectious Diseases, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- School of Clinical Medicine, Discipline of Paediatrics, UNSW, Sydney, New South Wales, Australia
| | - Sean E Kennedy
- School of Clinical Medicine, Discipline of Paediatrics, UNSW, Sydney, New South Wales, Australia
- Nephrology, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
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Karthika M, Vanajakshy Kumaran S, Beekanahaali Mokshanatha P. Quality indicators in respiratory therapy. World J Crit Care Med 2024; 13:91794. [PMID: 38855272 PMCID: PMC11155503 DOI: 10.5492/wjccm.v13.i2.91794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 06/03/2024] Open
Abstract
Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance, effectiveness, and safety of healthcare services. These indicators provide a systematic way to evaluate the quality of care offered, and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices. Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives. Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care. By systematically tracking and analyzing indicators related to infection control, treatment effectiveness, and adherence to protocols, respiratory care practitioners can identify areas to improve and implement evidence-based changes. This article reviewed how to identify, implement, and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.
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Affiliation(s)
- Manjush Karthika
- Research and Innovation Council, Srinivas Institute of Medical Sciences and Research Center, Srinivas University, Mangalore 574146, India
- Department of Health and Medical Sciences, Liwa College, Abu Dhabi, United Arab Emirates
| | - Sureshkumar Vanajakshy Kumaran
- Healthcare Management, Tata Institute of Social Sciences, Mumbai 400088, India
- Medical Administration, NS Memorial Institute of Medical Sciences, Kollam 691020, India
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Kıyak YS, Emekli E. ChatGPT prompts for generating multiple-choice questions in medical education and evidence on their validity: a literature review. Postgrad Med J 2024:qgae065. [PMID: 38840505 DOI: 10.1093/postmj/qgae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
ChatGPT's role in creating multiple-choice questions (MCQs) is growing but the validity of these artificial-intelligence-generated questions is unclear. This literature review was conducted to address the urgent need for understanding the application of ChatGPT in generating MCQs for medical education. Following the database search and screening of 1920 studies, we found 23 relevant studies. We extracted the prompts for MCQ generation and assessed the validity evidence of MCQs. The findings showed that prompts varied, including referencing specific exam styles and adopting specific personas, which align with recommended prompt engineering tactics. The validity evidence covered various domains, showing mixed accuracy rates, with some studies indicating comparable quality to human-written questions, and others highlighting differences in difficulty and discrimination levels, alongside a significant reduction in question creation time. Despite its efficiency, we highlight the necessity of careful review and suggest a need for further research to optimize the use of ChatGPT in question generation. Main messages Ensure high-quality outputs by utilizing well-designed prompts; medical educators should prioritize the use of detailed, clear ChatGPT prompts when generating MCQs. Avoid using ChatGPT-generated MCQs directly in examinations without thorough review to prevent inaccuracies and ensure relevance. Leverage ChatGPT's potential to streamline the test development process, enhancing efficiency without compromising quality.
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Affiliation(s)
- Yavuz Selim Kıyak
- Department of Medical Education and Informatics, Faculty of Medicine, Gazi University, Ankara 06500, Turkey
| | - Emre Emekli
- Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir 26040, Turkey
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Hof S, Untiedt H, Hübner A, Marcus C, Kuebart A, Herminghaus A, Vollmer C, Bauer I, Picker O, Truse R. Effects of remote ischemic preconditioning on early markers of intestinal injury in experimental hemorrhage in rats. Sci Rep 2024; 14:12960. [PMID: 38839819 PMCID: PMC11153647 DOI: 10.1038/s41598-024-63293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/27/2024] [Indexed: 06/07/2024] Open
Abstract
The maintenance of intestinal integrity and barrier function under conditions of restricted oxygen availability is crucial to avoid bacterial translocation and local inflammation. Both lead to secondary diseases after hemorrhagic shock and might increase morbidity and mortality after surviving the initial event. Monitoring of the intestinal integrity especially in the early course of critical illness remains challenging. Since microcirculation and mitochondrial respiration are main components of the terminal stretch of tissue oxygenation, the evaluation of microcirculatory and mitochondrial variables could identify tissues at risk during hypoxic challenges, indicate an increase of intestinal injury, and improve our understanding of regional pathophysiology during acute hemorrhage. Furthermore, improving intestinal microcirculation or mitochondrial respiration, e.g. by remote ischemic preconditioning (RIPC) that was reported to exert a sufficient tissue protection in various tissues and was linked to mediators with vasoactive properties could maintain intestinal integrity. In this study, postcapillary oxygen saturation (µHbO2), microvascular flow index (MFI) and plasmatic D-lactate concentration revealed to be early markers of intestinal injury in a rodent model of experimental hemorrhagic shock. Mitochondrial function was not impaired in this experimental model of acute hemorrhage. Remote ischemic preconditioning (RIPC) failed to improve intestinal microcirculation and intestinal damage during hemorrhagic shock.
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Affiliation(s)
- Stefan Hof
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany.
| | - Hendrik Untiedt
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Anne Hübner
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Carsten Marcus
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Anne Kuebart
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Anna Herminghaus
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Christian Vollmer
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Inge Bauer
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Olaf Picker
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Richard Truse
- Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
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