Manual Section Research Articles

Assessment of dental age estimation using dentinal translucency in ground sections of single rooted teeth: a digital image analysis.

Human dentition is unique to individuals and helps in identification of individuals in forensic odontology. This study proposes to study the manually ground sections of single rooted teeth using digital methods for dental age estimation. To assess the dentinal translucency from the scanned digital images of manually ground section of teeth using commercially available image edition software. Corroborating the root dentinal translucency length and region of interest (ROI) of translucency zone in pixels (as a marker of dental age) with the chronological age of the subject, as stratified by different age groups. Twenty single-rooted extracted teeth from 20 patients each from 6 groups divided as per age. Manual sectioning of the teeth followed by scanning the sections was done. Root area in pixels and ROI of translucency zone were measured. From the observed values, translucency length percentage (TLP) and percentage of ROI in pixels (TPP) was calculated and tabulated. Pearson's correlation coefficients were obtained for age with TLP and TPP. Positive correlation existed between age and TLP and also between age and TPP. With the obtained data, multilinear regression equations for specific age groups based on 10-year intervals were derived. By a step-down analysis method, age was estimated with an average error of around ±7.9 years. This study gives a novel method for age-estimation that can be applied in real-time forensic sciences.

EXPLORING THE POTENTIAL OF MORINGA OLEIFERA EXTRACT AS A NATURAL TISSUE FIXATIVE FOR HISTOPATHOLOGICAL APPLICATIONS

Histopathology, crucial for disease diagnosis, heavily relies on effective tissue fixation to maintain cellular architecture. However, the carcinogenic nature of formalin has spurred interest in safer alternatives. Moringa oleifera, renowned for its medicinal properties, presents a promising natural fixative candidate. This study aimed to assess Moringa oleifera extract's viability as a fixative for histopathological applications, specifically focusing on its compatibility with subsequent histological analyses. Distilled water and normal saline solutions of Moringa extract were prepared at varying concentrations. Kidney tissue samples from euthanized rats were treated with these solutions alongside formalin. Tissue sections underwent manual processing, embedding, sectioning, and staining using Hematoxylin and Eosin (H&E) technique. Microscopic examination revealed varying degrees of tissue preservation across Moringa concentrations and solvents. Higher concentrations (15%) in distilled water exhibited optimal preservation, akin to formalin-fixed tissues, while lower concentrations and normal saline solutions showed suboptimal fixation. These findings highlight Moringa oleifera's potential as a tissue fixative, particularly at higher concentrations in distilled water. Further research is recommended to isolate active components and explore alternative Moringa extracts for enhanced tissue preservation. Comparative studies would elucidate the efficacy of Moringa-derived fixatives and inform their utilization in histopathological practice.

Communicative and linguistic translation tools for academic adaptation of educational migrants in crisis conditions

The article is devoted to solving the urgent scientific and methodological problem of adaptation of migrants to living conditions in a new socio-cultural space, which is caused by the current crisis conditions that have developed in Europe and the world and pose a threat not only to the health, but also to the lives of millions of people. A significant part of migration flows is made up of students who master their future profession at foreign universities, in particular in Polish higher education institutions. Modern approaches to determining the structure of communicative competence of an educational migrant, types of adaptation, and tasks of language training are analyzed. The level of proficiency in the language of instruction is the main factor of the success of the educational process. It has been found that todayʼs conditions require clarification of the composition of participants of the academic adaptation of foreign students. The authors believe that at the initial stage of the adaptation process, the role of translators increases significantly. The requirements for the structure of communicative competence of an educational migrant and the professional and communicative competence of a translator have been clarified. A list of actual communicative situations in the domestic, educational, professional, administrative, socio-cultural spheres of communication is determined, examples of lexical units that will ensure the implementation of communicative tasks are provided. For the formation of professional translation competence, the development of communicative and linguistic tools is proposed: the creation of an educational complex consisting of a syllabus of an elective discipline, a manual, the theoretical and practical sections of which will provide linguistic and methodical guidelines for the formation of interpretation and translation skills in situations of adaptation of educational migrants. It is also proposed to add a complex dictionary of a new type to the toolkit, which will combine the characteristics of different types of lexicographic works and perform the task of interpreting and explaining current lexical units. The developed linguomethodical principles for the creation of an educational complex for the formation of professional and communicative competence of translators can become an invariant model for the creation of variable methodical materials for teaching translation from/into other languages.

The value of artificial intelligence in the diagnosis of lung cancer: A systematic review and meta-analysis.

Lung cancer is a common malignant tumor disease with high clinical disability and death rates. Currently, lung cancer diagnosis mainly relies on manual pathology section analysis, but the low efficiency and subjective nature of manual film reading can lead to certain misdiagnoses and omissions. With the continuous development of science and technology, artificial intelligence (AI) has been gradually applied to imaging diagnosis. Although there are reports on AI-assisted lung cancer diagnosis, there are still problems such as small sample size and untimely data updates. Therefore, in this study, a large amount of recent data was included, and meta-analysis was used to evaluate the value of AI for lung cancer diagnosis. With the help of STATA16.0, the value of AI-assisted lung cancer diagnosis was assessed by specificity, sensitivity, negative likelihood ratio, positive likelihood ratio, diagnostic ratio, and plotting the working characteristic curves of subjects. Meta-regression and subgroup analysis were used to investigate the value of AI-assisted lung cancer diagnosis. The results of the meta-analysis showed that the combined sensitivity of the AI-aided diagnosis system for lung cancer diagnosis was 0.87 [95% CI (0.82, 0.90)], specificity was 0.87 [95% CI (0.82, 0.91)] (CI stands for confidence interval.), the missed diagnosis rate was 13%, the misdiagnosis rate was 13%, the positive likelihood ratio was 6.5 [95% CI (4.6, 9.3)], the negative likelihood ratio was 0.15 [95% CI (0.11, 0.21)], a diagnostic ratio of 43 [95% CI (24, 76)] and a sum of area under the combined subject operating characteristic (SROC) curve of 0.93 [95% CI (0.91, 0.95)]. Based on the results, the AI-assisted diagnostic system for CT (Computerized Tomography), imaging has considerable diagnostic accuracy for lung cancer diagnosis, which is of significant value for lung cancer diagnosis and has greater feasibility of realizing the extension application in the field of clinical diagnosis.

Using the Homosaurus in a Public Library Consortium: A Case Study

Library of Congress Subject Headings (LCSH) on LGBTQIA+ topics have not evolved alongside the frequently changing vernacular vocabulary used to access resources on the topics. To rectify this issue, libraries can choose to use an alternative controlled vocabulary, like The Homosaurus: An International LGBTQ+ Linked Data Vocabulary. This case study provides an overview of how Cooperative Computer Services (CCS), a public library consortium in Illinois, made the case to allow the Homosaurus in the CCS catalog, gained approval from the member libraries, and crafted a cataloging manual section. Other libraries can follow the recommendations in this article on how to properly make the case for the approval of a policy to allow an alternative controlled vocabulary in their catalog.

A Statistical Study on Some Micromorphological Characters

In this study, the micromorphological features of 19 Salvia L. taxa belonging to the Lamiaceae family were compared statistically. For micromorphological studies, the manual cross sections were prepared. The sections were colored using safranin and fast-green dyes and after that, photographed by different magnification of light microscope. The data obtained from the micromorphological features of the investigated samples were turned into tables and were used for statistical studies. Significance level of the differences between the taxa and micromorphological characters were evaluated by Analysis of variance (Regression Analysis) and Pearson’s correlation. The differences were also assessed by the one–way ANOVA test. As the results of this study show that the quantitative micromorphological characters such as lower epidermis width and lower epidermis length are the most appropriate taxonomical characters that can be used to separate taxa. By this study, it has been found that the results from numerical analysis of micromorphological characters can provide additional evidence for the recognition of the taxa. In addition, the results showed that the investigated taxa also could be distinguished from each other not only by their morphological features but numerical micromorphological anatomical characters as well. Statistical analyses were performed using the MINITAB software package.

Efficient 3D observation of steel microstructure using serial sectioning with precision cutting and on-site etching

This paper describes a fast and precise 3D observation method for steel microstructures using a cutting-based serial sectioning system with on-site etching. The method employs automated 3D internal structure microscopy for ferrous materials and on-site manual etching without detaching the specimen during the process. A notable feature of this system is that it uses precision cutting instead of polishing for surface fabrication, which has advantages in the fabrication speed, applicability in dry conditions, and controllability of the fabrication depth. The precision cutting of a dual-phase (DP) steel achieved a low roughness comparable to polishing. Furthermore, the on-site etching process by dropping etchant yielded sufficient contrast between ferrite and martensite phases. Observation of DP steel cross sections at 1 μm intervals afforded a 3D image in the range of 690 × 518 × 103 μm3 with a resolution of 0.144 × 0.144 × 1.0 μm3. The processing time was approximately five minutes for each cross section and almost half a day for the whole image, which was much more efficient than manual serial sectioning that requires a few weeks. The microstructures were also visible in reconstructed lateral cross sections of the 3D image, which proved the sufficient quality of our imaging. In addition, the segmented volume revealed the non-uniform martensite distribution among cross sections quantitatively. Most of them were connected in 3D, while they seemed to be separated in 2D. These results demonstrated the usefulness of our method with precision cutting and on-site etching.

A new complete color normalization method for H&E stained histopatholgical images

The popularity of digital histopathology is growing rapidly in the development of computer aided disease diagnosis systems. However, the color variations due to manual cell sectioning and stain concentration make the process challenging in various digital pathological image analysis such as histopathological image segmentation and classification. Hence, the normalization of these variations are needed to obtain the promising results. The proposed research intends to introduce a reliable and robust new complete color normalization method, addressing the problems of color and stain variability. The new complete color normalization involves three phases, namely enhanced fuzzy illuminant normalization, fuzzy-based stain normalization, and modified spectral normalization. The extensive simulations are performed and validated on histopathological images. The presented algorithm outperforms the existing conventional normalization methods by overcoming the certain limitations and challenges. As per the experimental quality metrics and comparative analysis, the proposed algorithm performs efficiently and provides promising results.

La fabbrica delle parole. Tecniche e sistemi di produzione del libro a stampa tra xv e xix secolo. By Andrea De Pasquale

The present book is a good idea, though precisely what readership it is targeting is far from clear. At one level—the best one—it is a simple pictorial history of the book‐making trades; it could also plausibly serve as a manual for university students which through contemporary illustrations—165 of them—illustrates the said processes with a modicum of commentary. Certainly it has been added to the printing/Bibliography manual section of my own bookcase. It is puzzling, however, to discover that none of the images is sourced, and so recognizing where they are from and the historical period they belong to is largely a matter of guesswork and the reader's own knowledge. Just under a quarter stem from the Diderot‐D' Alembert Encyclopédie (1751‐72), whose large plates, in order to accommodate them in a small volume such as this (21 cm), lose a lot of detail; the three earliest originate in the woodcuts of Jost Amman for the 1568 Eygentliche Beschreibung (or Panoplia in the Latin version), albeit, rather strangely, omitting those showing the papermaking and printing processes (too famous perhaps?); and a handful of others derive from the Hoepli manual by Salvadore Landi (1892). Otherwise the bulk of the nineteenth‐century images are taken from the periodical literature of the age—most of them unfamiliar to the present writer—and it would be valuable to know their original date and context of publication.

Whole-Mount Immunofluorescence Staining, Confocal Imaging and 3D Reconstruction of the Sinoatrial and Atrioventricular Node in the Mouse.

The electrical signal physiologically generated by pacemaker cells in the sinoatrial node (SAN) is conducted through the conduction system, which includes the atrioventricular node (AVN), to allow excitation and contraction of the whole heart. Any dysfunction of either SAN or AVN results in arrhythmias, indicating their fundamental role in electrophysiology and arrhythmogenesis. Mouse models are widely used in arrhythmia research, but the specific investigation of SAN and AVN remains challenging. The SAN is located at the junction of the crista terminalis with the superior vena cava and AVN is located at the apex of the triangle of Koch, formed by the orifice of the coronary sinus, the tricuspid annulus, and the tendon of Todaro. However, due to the small size, visualization by conventional histology remains challenging and it does not allow the study of SAN and AVN within their 3D environment. Here we describe a whole-mount immunofluorescence approach that allows the local visualization of labelled mouse SAN and AVN. Whole-mount immunofluorescence staining is intended for smaller sections of tissue without the need for manual sectioning. To this purpose, the mouse heart is dissected, with unwanted tissue removed, followed by fixation, permeabilization and blocking. Cells of the conduction system within SAN and AVN are then stained with an anti-HCN4 antibody. Confocal laser scanning microscopy and image processing allow differentiation between nodal cells and working cardiomyocytes, and to clearly localize SAN and AVN. Furthermore, additional antibodies can be combined to label other cell types as well, such as nerve fibers. Compared to conventional immunohistology, whole-mount immunofluorescence staining preserves the anatomical integrity of the cardiac conduction system, thus allowing the investigation of AVN; especially so into their anatomy and interactions with the surrounding working myocardium and non-myocyte cells.

How to run a repository: Open documentation of 15 years’ experience

To better coordinate a repository ecosystem of over 20 individual systems and synthesise decades of staff knowledge and expertise, a team at the Cornell University Library created an open manual of repository principles and strategies to support both new and existing repository managers. This case study will document the process of creating this manual, describing the identification of strategic areas of repository management; the composition and revision of manual sections in conjunction with experts throughout the library system; the development of both best practices and action steps for implementing them; and the publication of the manual in both an open wiki and an open access repository under a CC-BY-NC 4.0 licence to facilitate use, feedback and further revision. As the manual itself is intended to fill a gap in the existing repository manual toolset and engender a larger conversation about repository management practices, this case study can serve as the basis for a similar conversation about the openly shared documentation of those practices.

Mechanism of floral scent production in Osmanthus fragrans and the production and regulation of its key floral constituents, \u03b2-ionone and linalool

Sweet osmanthus (Osmanthus fragrans Lour.) is among the top ten most well-known flowers in China and is recognized as both an aromatic plant and ornamental flower. Here, manual sectioning, scanning electron microscopy, and transmission electron microscopy of sweet osmanthus petals revealed that large amounts of lipids are present inside the petal cells and on the cell surfaces. However, no secretory structures were observed. Instead, the petal cells protrude slightly outward, and the surfaces of the cells are adorned with highly regular brush-shaped hairs. The surfaces of the ‘Yingui’ petals possessed mostly curled and more numerous hairs, whereas the ‘Dangui’ petals possessed fewer brush-shaped and more sparsely arranged hairs. In addition, many granular substances were attached to the brush-shaped hairs, and the granules were denser on the hairs of the ‘Yingui’ petals compared to the hairs on the ‘Dangui’ petals. Furthermore, 35 aromatic components in the ‘Yingui’ petals and 30 aromatic components in the ‘Dangui’ petals were detected via GC-MS. The main aromatic component of the ‘Yingui’ petals was β-ionone, whereas that of the ‘Dangui’ petals was linalool and its oxides. Transcriptome sequencing and qRT-PCR indicated that the high β-ionone content in the ‘Yingui’ petals was due to the overexpression of CCD1 and CCD4 and that the high linalool content in the ‘Dangui’ petals was due to the overexpression of MECS, HDR, IDI1, and LIS1, which function upstream of the linalool synthetic pathway. In particular, the expression levels of CCD4 and LIS1 were upregulated by 5.5- and 5.1-fold in the ‘Yingui’ and ‘Dangui’ petals, respectively. One transcription factor (ERF61) was cloned and named, and the expression pattern of ERF61 in sweet osmanthus petals was found to be generally consistent with that of CCD4. Tobacco transformation experiments, yeast one-hybrid experiments, and electrophoretic mobility shift assays indicated that ERF61 binds to the CCD4 promoter and stimulates CCD4 expression, thereby regulating the synthesis of β-ionone in sweet osmanthus petals.

P13. Effect of intraoperative steroid treatment on spinal fusion capacity in rat spinal arthrodesis model

BACKGROUND CONTEXT Local steroid administration during cervical spine surgery has been shown to improve postoperative dysphagia. Due to concerns for complications like pseudarthrosis, however, widespread acceptance of intraoperative local steroid administration has not been adopted for such procedures. Previous literature in a rabbit posterolateral lumbar fusion (PLF) model demonstrated inhibition of graft incorporation and consequent pseudarthrosis following postoperative intramuscular dexamethasone administration. Nevertheless, the potential complications of intraoperative local steroid administration on bone healing and spine fusion have yet to be directly investigated. PURPOSE This study aims to evaluate the effect of intraoperative local steroid administration on spinal fusion capacity in a rat model. STUDY DESIGN/SETTING Preclinical. PATIENT SAMPLE Female Sprague-Dawley rats, ages 12-16 weeks. OUTCOME MEASURES The outcome measures for this pre-clinical study are radiography, manual palpation fusion scoring, microCT and histological sectioning. METHODS Forty-five female Sprague-Dawley rats underwent bilateral posterolateral lumbar spinal fusion at L4-L5 using 0.5 mg recombinant human BMP-2 (rhBMP-2) delivered on an absorbable collagen sponge (INFUSE™; 1 mg rhBMP-2 per animal). Either no steroid (vehicle control), 0.5mg triamcinolone (low-dose steroid), or 2.5mg triamcinolone (high-dose) was added directly to the implant. (The sub-therapeutic 1 mg dose of rhBMP-2 per animal was chosen in order to avoid saturation of the fusion response and capture any potential inhibitory effect that might exist. Rats were radiographed alive at four weeks, and after euthanasia at eight weeks post-operative. Spines were then harvested and underwent manual palpation-based fusion scoring, microCT imaging, and histological sectioning. Fusion scoring was performed by three blinded observers using an established scoring system whereby 0 = no bridging bone, 1 = unilateral bridging bone, and 2 = bilateral bridging bone, with an average score of >1 considered fused. Mean fusion scores were compared using one-way ANOVA. Fusion rates were compared using Fischer's exact test. RESULTS The mean fusion scores of the control, low-dose steroid, and high-dose steroid groups were 0.61 (SD=0.59), 1.09 (SD=0.81), and 0.58 (SD=0.58), respectively. Fusion rates of the three groups were 38%, 57%, and 33%, respectively. At p>0.05, neither fusion scores nor rates were significantly different among groups (Figure 1). Data processing from MicroCT images to quantify the volume of new bone growth in fusion masses is in progress, as is histological analysis of fusion beds. CONCLUSIONS The results demonstrate that steroid delivered intraoperatively within the INFUSE™ implant during spinal fusion surgery had no adverse impact on fusion capacity in the clinically relevant rat model. Considering that intraoperative steroid use during human cervical spine surgery has been shown to minimize dysphagia, these results open the door for higher-order investigations into the potential for similar steroid use in human spine surgery patients. FDA DEVICE/DRUG STATUS Unavailable from authors at time of publication.

Comparison of the seventh and eighth editions of the American Joint Committee on Cancer (AJCC) staging for oropharyngeal squamous cell carcinomas (OPSCC): A Surveillance, Epidemiology and End Results Program (SEER) database analysis.

e17538 Background: The recently released eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, incorporates significant changes to the prior seventh edition. The changes reflect the improved understanding of tumor biology, prognostic factors and molecular markers that effect outcomes in Head and Neck cancers. A key update restages OPSCC by human papilloma virus (HPV) positive and negative cancers as data demonstrated that these tumors have significantly different biology and outcomes. Methods: Using SEER data from 2004 – 2014, we identified male patients with squamous cell carcinomas of the tonsil, base of tongue and soft palate aged between 21 and 64 years old (those clinical characterizes were considered as surrogate markers for HPV positive status). We classified them by the AJCC 8th edition staging for HPV positive OPSCC and by AJCC 7th edition staging. The prediction performance by two staging editions were compared regarding overall survival (OS) and Disease free survival (DFS). Kaplan-Meier method and Cox proportional hazard model were applied, and the discrimination performance was measured by the concordance statistics (C-statistics). Results: A total of 8202 eligible patients were included in the analysis with a median follow up period of 51 months. 7415 (90.4%) patients had previously received radiation and 7038 (85.8%) patients had previously received chemotherapy. The median age of patients was 56 years. Distribution of stage I disease increased from 2% to 19.6% in AJCC 8th edition. 10-year overall survival (OS) for AJCC 8th stages I (74%), II (78%), III (55%) and IV (32%). Using Stage I as reference, the hazard ratio for stage II, III, and IV is 0.98 (95%CI: 0.87-1.09), 2.29 (95%CI: 2.04-2.57), and 5.88 (95%CI: 4.96-6.98). Similar results were noted for ten year disease free survival. The C-statistics measured overall discrimination for 8th edition is 0.68 and 0.63 for the 7th edition (P < 0.001). Conclusions: Based on this SEER analysis, the overall performance of discrimination improved from AJCC 7th to 8th edition; but in this study population, AJCC 8th edition does not distinguish stage I and II sufficiently as expected as it does for stages III and IV disease. Limitations of the SEER database include the surrogate for P16 status and under reported and incomplete data.

Novel Color Normalization Method for Hematoxylin & Eosin Stained Histopathology Images

With the advent of computer-assisted diagnosis (CAD), the accuracy of cancer detection from histopathology images is significantly increased. However, color variation in the CAD system is inevitable due to the variability of stain concentration and manual tissue sectioning. The small variation in color may lead to the misclassification of cancer cells. Therefore, color normalization is a very much essential step prior to segmentation and classification in order to reduce the inter-variability of background color among a set of source images. In this paper, a novel color normalization method is proposed for Hematoxylin and Eosin stained histopathology images. Conventional Reinhard algorithm is modified in our proposed method by incorporating fuzzy logic. Moreover, mathematically, it is proved that our proposed method satisfies all three hypotheses of color normalization. Furthermore, several quality metrics are estimated locally for evaluating the performance of various color normalization methods. The experimental result reveals that our proposed method has outperformed all other benchmark methods.

Modifications and recent updates in the 8th edition of tumor node metastasis staging pertaining to oropharynx and oral cavity.

Modifications and recent updates in the 8th edition of tumor node metastasis staging pertaining to oropharynx and oral cavity.

Relation between Manual Dexterity and the Accuracy of Cavity Preparation

Background: Manual dexterity is important for dentists. However, few studies have investigated the relation between dental skills and manual dexterity. The hypothesis of the present study is that an association exists between manual dexterity and the accuracy of cavity preparation.Methods: Fifty-two dental students (25 males, 27 females) participated in this study. All subjects completed manual dexterity tasks (i.e., grip strength, pinch force, and number of taps made by fingers of the right hand) and a preparation accuracy test using Virtual Reality Systems (VRS, Simodont®). For the preparation test, the cross-block body in Simodont's Manual Dexterity section was used. The associations between erroneous preparations (i.e., errors in the lateral and vertical directions) and the results of manual dexterity tasks were then analyzed and examined.Result: The results revealed that grip strength and number of taps made by the fingers correlated with lateral direction errors. In particular, the number of taps in the first 10 s from the start of tapping made by the third finger, which the participants used as a finger rest during preparation, demonstrated a significant correlation with lateral direction errors.Conclusion: In this work, tapping was revealed to be associated with manual dexterity by quantifying the accuracy of preparation. In addition, the agility of the third finger used as a finger rest appeared to affect accuracy in the lateral direction. VRS is useful not only in developing teaching strategy but also in research on cavity preparation. DOI: 10.21276/aohdr.1828

Knife-Edge Scanning Microscopy for Bright-Field Multi-Cubic Centimeter Analysis of Microvasculature

Modern light microscopy has benefited from the use of serial section microscopy such as in the Allen Brain Atlas and the creation of new rodent models for Alzheimer’s disease research [1, 2]. Typically, slides are prepared in the conventional manner, where images are collected using traditional light microscopy and digitally scanned. The resulting images then must be computationally registered to one another to create a 3D image. However, numerous issues have inhibited widespread adoption of this method. These include the manual nature of slide preparation and staining, the introduction of artifacts from manual sectioning and mounting on slides, the time taken for whole-slide scanning an entire sample, the difficult nature of image registration and data handling, and the simple fact that it results in too much data for modern infrastructures to handle. The knife-edge scanning microscope (KESM) combines sectioning and imaging into a single step, automates a large part of the traditional pathology workflow, and allows for a greater speed, precision, throughput, and scale at which tissues are digitized (Figure 1). The KESM achieves tissue data collection at a resolution of submicron pixels with a maximum sample volume of over 100 cm3, exceeding the depth offered by confocal or 2-photon microscopy. To handle high-resolution data of over a terabyte per cm3, sophisticated data processing software is applied to model 3D tissue reconstructions, provide interactive image views, and apply quantitative analytics. This allows quantitative analysis to be performed on 3D image stacks of whole mouse organs, which is extremely difficult, expensive, and time-consuming with traditional manual techniques.

Head and neck cancers—major changes in the American Joint Committee on cancer eighth edition cancer staging manual

Answer questions and earn CME/CNE The recently released eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, introduces significant modifications from the prior seventh edition. This article details several of the most significant modifications, and the rationale for the revisions, to alert the reader to evolution of the field. The most significant update creates a separate staging algorithm for high-risk human papillomavirus-associated cancer of the oropharynx, distinguishing it from oropharyngeal cancer with other causes. Other modifications include: the reorganizing of skin cancer (other than melanoma and Merkel cell carcinoma) from a general chapter for the entire body to a head and neck-specific cutaneous malignancies chapter; division of cancer of the pharynx into 3 separate chapters; changes to the tumor (T) categories for oral cavity, skin, and nasopharynx; and the addition of extranodal cancer extension to lymph node category (N) in all but the viral-related cancers and mucosal melanoma. The Head and Neck Task Force worked with colleagues around the world to derive a staging system that reflects ongoing changes in head and neck oncology; it remains user friendly and consistent with the traditional tumor, lymph node, metastasis (TNM) staging paradigm. CA Cancer J Clin 2017;67:122-137. © 2017 American Cancer Society.

Heterogeneous genomic locations within NS3, NS4A and NS4B identified for genotyping and subtyping of Hepatitis C virus: A simple genome analysis approach

Hepatitis C virus (HCV) displays excessive genetic heterogeneity and exists in several genotypes and subtypes. Characterizing these genotypes and subtypes becomes extremely important for diagnostic and epidemiological reasons. Present study analyzed HCV genome using a simple genome analysis approach. We combined manual sectioning of a reference genome alignment (RA) followed by a comprehensive comparative phylogenetic analysis. The main aim was to identify heterogeneous locations on HCV genome suitable for genotyping/subtyping. HCV reference dataset, comprising of whole genome sequences from all HCV genotypes and subtypes, was aligned into an RA. The RA was manually clipped into overlapping sections of 500 bases, each 50 bases apart. Phylogeny for each section and RA was estimated using neighbor-joining phylogenetic method. Clustering pattern between section phylogenies and RA phylogeny was compared for similarity. Sections (locations on genome) with clustering similar to whole genome were selected since it displays comparable genetic heterogeneity making these sections suitable for genotyping/subtyping. Based on this conception, we identified new genomic locations on NS3, NS4A and NS4B suitable for genotyping and subtyping. Exact genomic positions for known genotyping locations, core and NS5B were also identified. Furthermore, phylogenetic analyses at such small genomic scale provided opportunities to explore evolutionary relationships usually overlooked.