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Mayo Clinic Proceedings. Innovations,... Sep 2018To assess the relationship between bone marrow (BM) biopsy operator experience and both specimen quality and ancillary testing utilization.
OBJECTIVE
To assess the relationship between bone marrow (BM) biopsy operator experience and both specimen quality and ancillary testing utilization.
PATIENTS AND METHODS
We evaluated all referred and in-house (IH) BM biopsy specimens obtained over a contiguous 6-week period from April 3, 2017, to May 19, 2017. The BM specimens were assessed for the length of interpretable marrow, and aspirates were assessed for the presence of spicules. Subgroup comparisons included IH BM obtained by a trained team of nurses within our institution, patients clinically referred (CR) to our institution with outside-obtained BM specimens, and outside pathologist-referred (PR) consultation cases. Ancillary study usage was compared between the first 100 cases of each group.
RESULTS
A total of 1191 BM specimens were analyzed, including 600 IH, 288 CR, and 303 PR cases with biopsies and/or aspirates. The average interpretable biopsy lengths of IH, CR, and PR cases were 16.0 mm, 10.0 mm, and 7.0 mm, respectively (<.001). World Health Organization-recommended length of 15 mm or more was achieved in 61.4%, 26.6%, and 19.1%, respectively (<.001). Of the aspirates analyzed among IH, CR, and PR cases, 93%, 71.3%, and 73.5% contained spicules, respectively (<.001). Use of immunohistochemistry, flow cytometry, karyotype, and fluorescence in situ hybridization was higher in CR and PR cases than in IH cases (all <.05). The IH, CR, and PR cases used on average 1.5, 2.8, and 4.8 immunohistochemistry stains per case (<.001).
CONCLUSION
Having a dedicated team of BM biopsy operators is likely one factor contributing to improved BM biopsy quality and a reduced need for ancillary testing.
PubMed: 30225457
DOI: 10.1016/j.mayocpiqo.2018.06.007 -
Frontiers in Psychology 2023The Padlet interactive platform constitutes a virtual online board on which users can post various types of multimedia content, such as documents, questions, comments,...
INTRODUCTION
The Padlet interactive platform constitutes a virtual online board on which users can post various types of multimedia content, such as documents, questions, comments, images, video clips, and audio clips. This platform has gained popularity in higher education yet remains ancillary in the fields of medical education and medical management.
METHODS
This case study sought to initially design an intervention program that employs online collaborative learning enabled by Padlet and to assess how Health Management students perceived the activity and its ramifications for their learning. 85 students' reflective journals were content analyzed.
RESULTS
five main categories stood out: (1) user experience of the platform; (2) visuality and visibility of the platform; (3) collaborative learning and OCL; (4) active online learning and student engagement; and (5) cognitive flexibility.
DISCUSSION
This study emphasizes the importance of incorporating digital tools in education, particularly the use of the Padlet platform to facilitate collaborative learning and improve the quality of teaching and learning. It demonstrates that Padlet-mediated online collaborative learning can be an effective digital learning tool because of its ease of use and ability to accommodate both pedagogical and technological challenges.
PubMed: 37063539
DOI: 10.3389/fpsyg.2023.1157621 -
Polish Journal of Radiology 2022The liver imaging reporting and data system (LI-RADS) is a structured reporting system that categorizes hepatic observations according to major imaging features and...
PURPOSE
The liver imaging reporting and data system (LI-RADS) is a structured reporting system that categorizes hepatic observations according to major imaging features and lesion size, with an optional ancillary features contribution. This study aimed to evaluate inter-reader agreement of dynamic magnetic resonance imaging (MRI) using LI-RADS v2018 lexicon.
MATERIAL AND METHODS
Forty-nine patients with 69 hepatic observations were included in our study. The major and ancillary features of each hepatic observation were evaluated by 2 radiologists using LI-RADS v2018, and the interreader agreement was allocated.
RESULTS
The inter-reader agreement of major LI-RADS features was substantial; κ of non-rim arterial hyperenhancement, non-peripheral washout appearance, and enhancing capsule was 0.796, 0.799, and 0.772 ( < 0.001), respectively. The agreement of the final LI-RADS category was substantial with κ = 0.651 ( < 0.001), and weighted κ = 0.786 ( < 0.001). The inter-reader agreement of the ancillary features was substantial to almost perfect (k range from 0.718 to 1; < 0.001). An almost perfect correlation was noted for the hepatic lesion size measurement with ICC = 0.977 ( < 0.001).
CONCLUSIONS
The major and ancillary features of the LI-RADS v2018, as well as the final category and lesions size, have substantial to almost perfect inter-reader agreement.
PubMed: 35892071
DOI: 10.5114/pjr.2022.117590 -
Modern Pathology : An Official Journal... Jan 2019Metastatic malignancies of unknown primary site (MUP) is the eighth most common form of malignancy, with an estimated 10-15% of oncology patients having a MUP. Fine... (Review)
Review
Metastatic malignancies of unknown primary site (MUP) is the eighth most common form of malignancy, with an estimated 10-15% of oncology patients having a MUP. Fine needle aspiration cytology (FNA) and core needle biopsy (CNB) are often the first procedures utilized in the work-up of these cases and have a pivotal role for the diagnosis of metastases. There is an increasing emphasis on the precise classification of malignancy and determination of primary site of origin, utilizing smaller specimens. Recent available data suggest that there is a management benefit in identifying the primary site and/or specific cell lineage of MUP. In addition, the pathologists are asked to preserve the limited diagnostic material for potential molecular testing, as selected patients may benefit from targeted therapy. However, these tasks can become extremely challenging, especially if there is no previous history of malignancy, prior pathology is not available for review, or there is an unpredictable pattern of metastasis. In this review, we present a contemporary clinicopathologic approach to the work-up of MUP that includes cytomorphology, ancillary studies, and clinicopathologic correlation. The cytohistologic subclassification of malignancies into specific cell lineages and/or morphologic categories is presented. Knowledge of the various patterns of metastasis to common and unusual sites can help narrow down the location of a primary site. The use of ancillary studies with particular emphasis on IHC utilizing an algorithmic approach and the role of molecular analysis as a diagnostic and theranotic test are also discussed. When the cell block and/or CNB lacks sufficient material for ancillary testing, the cell transfer technique may be utilized.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Humans; Neoplasms, Unknown Primary
PubMed: 30600317
DOI: 10.1038/s41379-018-0149-9 -
Process Biochemistry (Barking, London,... Jun 2023One of the outcomes from the global COVID-19 pandemic caused by SARS-CoV-2 has been an acceleration of development timelines to provide treatments in a timely manner....
One of the outcomes from the global COVID-19 pandemic caused by SARS-CoV-2 has been an acceleration of development timelines to provide treatments in a timely manner. For example, it has recently been demonstrated that the development of monoclonal antibody therapeutics from vector construction to IND submission can be achieved in five to six months rather than the traditional ten-to-twelve-month timeline using CHO cells [1], [2]. This timeline is predicated on leveraging existing, robust platforms for upstream and downstream processes, analytical methods, and formulation. These platforms also reduce; the requirement for ancillary studies such as cell line stability, or long-term product stability studies. Timeline duration was further reduced by employing a transient cell line for early material supply and using a stable cell pool to manufacture toxicology study materials. The development of non-antibody biologics utilizing traditional biomanufacturing processes in CHO cells within a similar timeline presents additional challenges, such as the lack of platform processes and additional analytical assay development. In this manuscript, we describe the rapid development of a robust and reproducible process for a two-component self-assembling protein nanoparticle vaccine for SARS-CoV-2. Our work has demonstrated a successful academia-industry partnership model that responded to the COVID-19 global pandemic quickly and efficiently and could improve our preparedness for future pandemic threats.
PubMed: 37013198
DOI: 10.1016/j.procbio.2023.03.014 -
Indian Journal of Ophthalmology Jun 2024Uveitis and its complications are more common in the developing world, in which the condition occurs in up to 714 per 100,000 in the population and accounts for up to... (Review)
Review
Uveitis and its complications are more common in the developing world, in which the condition occurs in up to 714 per 100,000 in the population and accounts for up to 25% of all blindness. In India, the ophthalmic sub speciality of uveitis greatly evolved in the last four decades. In the early decades most of the studies were epidemiological studies. In recent years, more research has been published due to tremendous advancements in clinical diagnosis, laboratory investigations and ancillary test and treatment modalities. In this review article, we did a medline search with key words 'uveitis' and 'India', and selectively incorporated articles showing the evolution of this sub-speciality in India.
Topics: Humans; India; Uveitis; Biomedical Research; Disease Management; Ophthalmology
PubMed: 38454865
DOI: 10.4103/IJO.IJO_1577_23 -
Cancer Cytopathology Aug 2018Cytology samples obtained from exfoliative sources and fine-needle aspiration (FNA) procedures can all be used to detect microorganisms and/or the associated... (Review)
Review
Cytology samples obtained from exfoliative sources and fine-needle aspiration (FNA) procedures can all be used to detect microorganisms and/or the associated cytopathologic effects (CPE) caused by an infection. There are many advantages to utilizing cytology samples as an adjunct to routine microbiology laboratory methods. For example, cytology samples can be obtained by non-invasive and minimally invasive techniques, and interpretation is affordable, accurate, and fast. Furthermore, routine cytology stains, including the Papanicolaou (Pap) and the Diff-Quik (DQ) stains, can adequately identify a number of microorganisms. Finally, material obtained by these procedures can also be used for cytologic ancillary testing, microbiology culture, and molecular studies. Currently, there are a variety of ancillary diagnostic techniques that are routinely utilized in the cytopathology laboratory. Additionally, the increasing utilization of molecular-based, diagnostic techniques on fluid specimens, as well as FFPE material, is expanding the role of cytopathology for infectious disease diagnostics. In this review, we provide an overview of the most practical ancillary techniques commonly used to identify microorganisms on cytology specimens.
Topics: Animals; Bacteria; Communicable Diseases; Cytodiagnosis; Fungi; Humans; Parasites; Pathology, Clinical; Viruses
PubMed: 30156776
DOI: 10.1002/cncy.22023 -
American Journal of Preventive Medicine Mar 2018Commute time is associated with reduced sleep time, but previous studies have relied on self-reported sleep assessment. The present study investigated the relationships...
INTRODUCTION
Commute time is associated with reduced sleep time, but previous studies have relied on self-reported sleep assessment. The present study investigated the relationships between commute time for employment and objective sleep patterns among non-shift working U.S. Hispanic/Latino adults.
METHODS
From 2010 to 2013, Hispanic/Latino employed, non-shift-working adults (n=760, aged 18-64 years) from the Sueño study, ancillary to the Hispanic Community Health Study/Study of Latinos, reported their total daily commute time to and from work, completed questionnaires on sleep and other health behaviors, and wore wrist actigraphs to record sleep duration, continuity, and variability for 1 week. Survey linear regression models of the actigraphic and self-reported sleep measures regressed on categorized commute time (short: 1-44 minutes; moderate: 45-89 minutes; long: ≥90 minutes) were built adjusting for relevant covariates. For associations that suggested a linear relationship, continuous commute time was modeled as the exposure. Moderation effects by age, sex, income, and depressive symptoms also were explored.
RESULTS
Commute time was linearly related to sleep duration on work days such that each additional hour of commute time conferred 15 minutes of sleep loss (p=0.01). Compared with short commutes, individuals with moderate commutes had greater sleep duration variability (p=0.04) and lower interdaily stability (p=0.046, a measure of sleep/wake schedule regularity). No significant associations were detected for self-reported sleep measures.
CONCLUSIONS
Commute time is significantly associated with actigraphy-measured sleep duration and regularity among Hispanic/Latino adults. Interventions to shorten commute times should be evaluated to help improve sleep habits in this minority population.
Topics: Actigraphy; Adult; Employment; Female; Hispanic or Latino; Humans; Income; Male; Middle Aged; Self Report; Sleep; Sleep Initiation and Maintenance Disorders; Time Factors; Transportation; United States; Young Adult
PubMed: 29338957
DOI: 10.1016/j.amepre.2017.11.006 -
Philosophical Transactions of the Royal... Jun 2017Extreme climatic events (ECEs) have a disproportionate effect on ecosystems. Yet much of what we know about the ecological impact of ECEs is based on observing the... (Review)
Review
Extreme climatic events (ECEs) have a disproportionate effect on ecosystems. Yet much of what we know about the ecological impact of ECEs is based on observing the effects of single extreme events. We examined what characteristics affect the strength of inference that can be drawn from single-event studies, which broadly fell into three categories: opportunistic observational studies initiated after an ECE, long-term observational studies with data before and after an ECE and experiments. Because extreme events occur rarely, inference from such single-event studies cannot easily be made under the usual statistical paradigm that relies on replication and control. However, single-event studies can yield important information for theory development and can contribute to meta-analyses. Adaptive management approaches can be used to learn from single, or a few, extreme events. We identify a number of factors that can make observations of single events more informative. These include providing robust estimates of the magnitude of ecological responses and some measure of climatic extremeness, collecting ancillary data that can inform on mechanisms, continuing to observe the biological system after the ECE and combining observational data with experiments and models. Well-designed single-event studies are an important contribution to our understanding of biological effects of ECEs.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'.
Topics: Animals; Climate Change; Ecosystem; Life History Traits; Plant Physiological Phenomena
PubMed: 28483871
DOI: 10.1098/rstb.2016.0141 -
JAMA Ophthalmology Jul 2021Intimate partner violence (IPV) is a substantial cause of morbidity and mortality in the US. Previous studies indicate gaps in identifying and referring female patients...
Detection and Referral of Orbital and Ocular Injuries Associated With Intimate Partner Violence Following an Educational and Screening Initiative in an Emergency Department.
IMPORTANCE
Intimate partner violence (IPV) is a substantial cause of morbidity and mortality in the US. Previous studies indicate gaps in identifying and referring female patients with IPV-associated orbital and ocular injuries to ancillary services.
OBJECTIVE
To determine the number of IPV-associated orbital floor fractures, zygomaticomaxillary complex (ZMC) fractures, and ruptured globes referred to ancillary services in adult female patients following an educational and screening intervention to health care professionals.
DESIGN, SETTING, AND PARTICIPANTS
This single-center retrospective quality improvement analysis examined electronic medical records of adult female patients seen in a single level 1 trauma center emergency department and ophthalmology clinic between January 2015 and February 2019, after the initiative began. Female adults who sustained orbital floor fractures, ZMC fractures, or ruptured globes were included. Preinitiative data were previously collected between January 1995 and January 2015 on adult female patients and published. Data analysis for this study occurred from May 2020 to September 2020.
INTERVENTIONS
A 2-part, ongoing initiative began January 2015. First, enhancement of IPV screening protocols in the emergency department was conducted. Second, an educational campaign on IPV injury patterns was presented to residents and faculty in ophthalmology, emergency, otolaryngology, and trauma departments.
MAIN OUTCOMES AND MEASURES
Comparison of ancillary service involvement preinitiative (January 1995 to January 2015) and postinitiative (January 2015 to February 2019).
RESULTS
A total of 216 adult female patients (mean [SD] age, 55.0 [22.7] years; age range, 18-99 years) sustained orbital floor or ZMC fractures postinitiative. A total of 22 of 216 (10.2%) sustained fractures from IPV compared with 31 of 405 (7.6%) preinitiative (95% CI, -2.2% to 7.3%; P = .28). Documented social work referrals (11 of 31 preinitiative vs 20 of 22 postinitiative; difference, 55% [95% CI, 35%-76%]; P < .001), homegoing safety assessments (1 of 31 preinitiative vs 18 of 22 postinitiative; difference, 79% [95% CI, 61%-96%]; P < .001), and law enforcement involvement (7 of 21 preinitiative vs 16 of 22 postinitiative; difference, 50% [95% CI, 26%-74%]; P < .001) were higher in patients who presented after the initiative with orbital floor and ZMC fractures. A total of 51 adult female patients (mean [SD] age, 57.7 [20.8] years; age range 20-93 years) sustained ruptured globes postinitiative. A total of 5 of 51 patients (9.8%) sustained injury due to IPV postinitiative, compared with 5 of 141 (3.5%) preinitiative (95% patients, -2.5% to 15.0%; P = .08).
CONCLUSIONS AND RELEVANCE
Following the start of the initiative, referral patterns of adult female patients with IPV-associated orbital fractures improved. Targeted IPV screening of patients with orbital and ocular injuries is essential for effective intervention.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Emergency Service, Hospital; Eye Injuries; Female; Humans; Intimate Partner Violence; Middle Aged; Orbital Fractures; Referral and Consultation; Retrospective Studies; Young Adult
PubMed: 34042949
DOI: 10.1001/jamaophthalmol.2021.1546