Medical Pathology Research Articles

Total Neoadjuvant Treatment for Locally Advanced Rectal Cancer Patients: Where Do We Stand?

The therapeutic landscape in locally advanced rectal cancer (LARC) has undergone a significant paradigm shift in recent years with the rising adoption of total neoadjuvant treatment (TNT). This comprehensive approach entails administering chemotherapy and radiation therapy before surgery, followed by optional adjuvant chemotherapy. To establish and deliver the optimal tailored treatment regimen to the patient, it is crucial to foster collaboration among a multidisciplinary team comprising healthcare professionals from various specialties, including medical oncology, radiation oncology, surgical oncology, radiology, and pathology. This review aims to provide insights into the current state of TNT for LARC and new emerging strategies to identify potential directions for future research and clinical practice, such as circulating tumor-DNA, immunotherapy in mismatch-repair-deficient tumors, and nonoperative management.

Autistic Consumer Audit of UC Davis MIND Institute’s Mutant Angelman Mice and Their Translational Value Toward the Human Autistic Experience

On March 10, 2022, six researchers in affiliation with the UC Davis MIND Institute published a mouse gait study in the Autism Research journal, the official journal of the International Society for Autism Research (INSAR). Our team of Autistic scientists set about conducting this consumer audit to evaluate any conflict(s) of interest between the study topic, choice of journal publication, and grant award agenda. To evaluate the impact factor of translational research, we investigated the researchers’ strident claims that genetically modified mutant Angelman syndrome mice (“AS mice models”) may contribute to the advancement of discoveries of behavioral and cognitive abnormalities in intellectually disabled and developmentally disabled (ID/DD) people, such as Autistics. As a result of our exhaustive review of both broad and narrow claims, a full redaction request is made in our recommendation to the publishers of the Autism Research journal, John Wiley & Sons. In conclusion, we strongly recommend that speculative claims about rodent models and translational research for Autism should not be considered meritorious of funding from the National Institutes of Health. Our grassroots initiative is aimed at ameliorating the damaging stereotypes within the medical pathology paradigm under which Autistic people are studied as abnormal human variants under the disease model. Finally, we ask that UC Davis’ MIND Institute cease and desist all rodent model research with the aims of investigating the pathogenic mechanism that is presumed to be underlying Autistic behavioral expression.

Interprofessional Interviewing in Intraprofessional Athletic Training Student Pairs: A Multi-Institutional Educational Technique

Context The Commission on Accreditation of Athletic Training Education 2020 Standards for Professional Programs highlight the need to further incorporate interprofessional education components into the curricula for athletic training programs. Interprofessional education can be a challenging component to integrate into the curriculum on an ongoing and routine basis, especially when access, quantity, and quality of interprofessional education resources are limited at individual universities. Objective To promote professional socialization between athletic training students of different universities while also promoting teamwork and collaboration values and skills through the use of shared interprofessional resources. Background This educational technique was developed as a means to address the lack of access to interprofessional resources faced by 3 professional athletic training programs in order to help meet compliance with 2020 Commission on Accreditation of Athletic Training Education standards 8, 57, and 79. Description Athletic training students from 3 professional athletic training programs were paired with one athletic training student from another institution to research a nonorthopaedic, general medical condition. They were assigned a 3-part project: (1) review the existing literature for peer-reviewed articles on their assigned pathology, (2) interview a non–athletic trainer health care provider who has worked with the pathology, and (3) create an education infographic of the information to use as an educational tool for patients. The project helped to promote collaborative and team-based skills critical to interprofessional and intraprofessional success as a health care provider. Clinical Advantage(s) Students learned with, from, and about how non–athletic trainer health care professionals manage their assigned nonorthopaedic, general medical pathologies in clinical practice. Conclusion(s) This collaborative project allowed athletic training students to develop intraprofessional and interprofessional skills by working with both athletic training students and non–athletic training health care professionals. Informative feedback on how the students perceived their interactions was received at the conclusion of the assignments.

The effects of the (fentanyl-fueled) drug overdose epidemic on medicolegal death investigation in the United States.

The evolving opioid epidemic in the United States, fueled by illicit fentanyl, has greatly increased deaths from illicit drug use. These nonnatural deaths require formal death investigation. The National Association of Medical Examiners states in its Forensic Autopsy Performance Standards that autopsy remains a necessary component for proper investigation of suspected acute overdose deaths. If a death investigation office lacks adequate resources to investigate all deaths under its jurisdiction while meeting expected standards, then that office may be forced to consider altering its protocols for investigation by changing the types of deaths investigated or the extent of its investigations. Drug death investigations take longer to complete because novel illicit drugs and mixtures of drugs complicate toxicological analyses, prolonging a family's wait for completion of a death certificate and autopsy report. Public health agencies must also wait for results, but some agencies have developed mechanisms for rapid notification of preliminary results to allow timely deployment of public health resources. The increased deaths have strained the resources of medicolegal death investigation systems throughout the United States. Given the significant workforce shortage of forensic pathologists, newly trained forensic pathologists are too few to meet the demand. Nevertheless, forensic pathologists (and all pathologists) must make time to present their work and themselves to medical students and pathology trainees to encourage an understanding of the importance of quality medicolegal death investigation and autopsy pathology and to provide a model that can encourage interest in a career in forensic pathology.

The Impact of Updated ACGME Program Requirements for Radiation Oncology Residencies

Background In 2022, the Accreditation Council for Graduate Medical Education (ACGME) made several changes to the common program requirements for radiation oncology, which may be difficult for some residency programs to meet in their current state. Now, programs are expected to have 1.5 clinical physician faculty members per resident. Plus, the sponsoring institution must sponsor at least one medical oncology program and sponsor or have affiliations with ACGME-accredited surgical oncology and pathology programs. We sought to investigate if radiation oncology programs would presently be able to meet these requirements. Methods We compiled a list of accredited radiation oncology residency programs from the ACGME website. We visited the webpage of each program to count the number of radiation oncology physician residents and clinical physician faculty to calculate the corresponding ratio. We included clinical faculty from main campus and select satellite sites and affiliate sites, if residents definitely or probably rotated there. We also searched the websites of each sponsoring institution for sponsored pathology, medical oncology, and surgical oncology programs. Results We identified 90 ACGME-accredited radiation oncology residency programs. At least 9 programs appear to currently have a ratio of clinical physician faculty to residents of less than 1.5:1, ranging from 0.85 to 1.38. Additionally, 1 sponsoring institution does not have its own hematology and medical oncology or medical oncology program, 61 do not have a surgical oncology fellowship, and 5 do not have a pathology residency; however, this does not include affiliated programs. Discussion Approximately 10% of radiation oncology residency programs seem to have an insufficient number of clinical faculty to accommodate their residents, per new ACGME requirements. Furthermore, almost 70% of sponsoring institutions do not sponsor a medical oncology, pathology, or surgical oncology program, though this does not include potentially affiliated programs. A primary limitation of our study is that we collected information from publicly available information, which may be inaccurate. Nevertheless, based on our findings, it is likely that the new requirements may impose challenges on several programs, and failing to achieve them can risk program accreditation. In 2022, the Accreditation Council for Graduate Medical Education (ACGME) made several changes to the common program requirements for radiation oncology, which may be difficult for some residency programs to meet in their current state. Now, programs are expected to have 1.5 clinical physician faculty members per resident. Plus, the sponsoring institution must sponsor at least one medical oncology program and sponsor or have affiliations with ACGME-accredited surgical oncology and pathology programs. We sought to investigate if radiation oncology programs would presently be able to meet these requirements. We compiled a list of accredited radiation oncology residency programs from the ACGME website. We visited the webpage of each program to count the number of radiation oncology physician residents and clinical physician faculty to calculate the corresponding ratio. We included clinical faculty from main campus and select satellite sites and affiliate sites, if residents definitely or probably rotated there. We also searched the websites of each sponsoring institution for sponsored pathology, medical oncology, and surgical oncology programs. We identified 90 ACGME-accredited radiation oncology residency programs. At least 9 programs appear to currently have a ratio of clinical physician faculty to residents of less than 1.5:1, ranging from 0.85 to 1.38. Additionally, 1 sponsoring institution does not have its own hematology and medical oncology or medical oncology program, 61 do not have a surgical oncology fellowship, and 5 do not have a pathology residency; however, this does not include affiliated programs. Approximately 10% of radiation oncology residency programs seem to have an insufficient number of clinical faculty to accommodate their residents, per new ACGME requirements. Furthermore, almost 70% of sponsoring institutions do not sponsor a medical oncology, pathology, or surgical oncology program, though this does not include potentially affiliated programs. A primary limitation of our study is that we collected information from publicly available information, which may be inaccurate. Nevertheless, based on our findings, it is likely that the new requirements may impose challenges on several programs, and failing to achieve them can risk program accreditation.

Big data in oncology: Challenges and solutions.

6513 Background: Oncology care is complex and often multimodal. With recent technological advances, only a fraction of data is structured feasibly for research. Here we present a step-by-step method of building a novel comprehensive pan-cancer oncology data model using standard data definitions and industry-standard benchmarks. Methods: A team of 133 members was assembled including a project manager, bioinformatic engineers, business analysts, biostatisticians, data stewardship experts, clinical curators, and quality assurance (QA) managers. We first identified data domains that capture a comprehensive patient journey, leveraging existing oncology data models as a starting point, including NAACCR, PRISSMM (Deb Schrag & Eva Lepisto), and mCODE (ASCO). A common data model was developed using standard terms plus 5-10 disease specific elements (DSE). REDCap was used as the database platform, as it is HIPAA compliant and allows customizations. The data was stored in AuroraDB using an architecture and products that provide scalability from both an integration and consumption perspective. Results: We identified 10 data domains, including 186 distinct elements: demographics (20), comorbidities (2); cancer diagnosis & staging (27), pathology (45), imaging (18), medications (11), oncology responses (11), radiation treatments (14), cancer surgeries (11), cancer genomic (19), tumor markers (8), and vitals (8). Standard ontologies were used, including ICD-0-3 histology codes, ICD-10 comorbidities codes, CPT cancer surgeries codes, and CTCAE 5.0 for toxicities. We identified a data steward for each tumor type across medical oncology, surgery, pathology, radiology, and radiation oncology domains who aided curator training and the identification of DSE. QA managers and analysts performed 20% source data verification. In addition, we built REDCap rules (applicable across a form), and complex queries (applicable across multiple forms). To support QA and clinical engagement, interactive Tableau dashboards were constructed. In addition, timing and quality errors were monitored via Tableau dashboards at the individual curator level to provide timely feedback, leading to improved data quality and curation efficiency in real time. The Medical oncology and radiology domains were the most time-consuming, whereas Cancer diagnosis was the most difficult to curate. Conclusions: We collected genomic and phenomic data for 15,579 patients across six tumor types to date. Collecting comprehensive oncology data across tumor types is possible but requires institutional support, collaboration between clinical & informatics teams, and a dedicated QA team. [Table: see text]

Efficacy of Neoadjuvant Chemotherapy on Locally Advanced Gastric Adenocarcinoma in Terms of Downstaging and Resectability in a Tertiary Cancer Hospital

Background: Neoadjuvant chemotherapy (NACT) in carcinoma stomach was introduced in an effort to eliminate micro-metastasis and to improve resectablity before surgery which improves R0 resection rates. The aim of the current study was to evaluate the effect of neoadjuvant chemotherapy on downstaging and resectability rate in locally advanced gastric cancer. Material & Methods: This was a single-center quasi-experimental study conducted in the Department of Surgical Oncology in collaboration with the Departments of Medical Oncology, Radiation oncology, and Pathology at the National Institute of Cancer Research and hospital, Dhaka, which is a tertiary care cancer hospital in Bangladesh, between January 2021 and June 2022.Patients with locally advanced adenocarcinoma stomach staged by contrast-enhanced computed tomography (CECT) were randomly included in this study by purposive sampling. Patients in Group I underwent upfront surgery Patients in Group II were started on neoadjuvant chemotherapy, either XELOX or FLOT regimen. Surgery was done following the response assessment CECT. We assessed R0 resection rate, age, sex, comorbidities, tumour size, TNM stage and complications were compared between the two groups. Response to NACT was assessed in Group II. Results: The mean age of patients in groups 1 & 2 was 56 ± 11.06 and 55.70 ± 10.46 years of age respectively (p > 0.05). Majority of the respondents (55/74) were male and 19 patients (26%) were female. Male to female ratio was (24/37 &31/37) in group 1 and (31/37 & 6/37) groups respectively (p > 0.05). Out of 37 patients who received NACT, in 9 patients (24.32%) complete response was noted. Partial response was found in 20 cases (54.05%), p-value (<.0001) while a stable disease was reported in three (8.1%) cases. 5 patients (13.51%) had progressive disease. In the upfront surgery group, R0 resection was feasible in 16 (43.2%) cases, and in the NACT plus surgery group, R0 resection was done in 29 (78.4%) cases. In group 1, R1 resection was done in considerable numbers (19/37) compared to group 2 (5/37), P=0.001. Three patients (8.1%) in group 2 and one (2.7) in group 1 had irresectable lesions. Conclusion: In this study it can be concluded that neoadjuvant chemotherapy could downstage tumour and increase tumor resectability rate in patients with locally-advanced gastric adenocarcinoma. However, further studies are necessary to confirm the effect of this modality on patients’ overall survival. We await survival analysis to further validate the role of NACT.

Predictive Factors of Mortality in a Surgical Intensive Care Unit: A Retrospective Study about 100 Cases

Despite major advances that were made in intensive care unit, mortality rate remains high. The objective of our study was to analyze the incidence and predictive factors of mortality in a surgical intensive care unit, in order to apprehend these factors for an optimal management. We have conducted a retrospective study about 100 consecutive cases of patients admitted to the surgical intensive care unit of Ibn Sina University Hospital in Rabat, during a 3-month period (02/01/2021-02/04/2021). Nearly 20 parameters were collected, analyzed and compared between the group of survivors and the group of deceased. The results shows that the mean age of the patients was 56.86 years, and the sex ratio of men to women was 1,56. Medical comorbidities were dominated by hypertensive and/or ischemic heart disease (38%), diabetes (22%), smoking (27%), neoplasia (17%). 61% of patients were admitted for a surgical pathology, 30% for a medical pathology, and 9% for a traumatic reason. The average APACHE II score at admission was 14,61. On the therapeutic level: 39% of the patients had recourse to vasoactive drugs, 49% had recourse to mechanical ventilation, 6% benefited from extra-renal purification, and 46% from a transfusion of blood derivatives. The average length of stay was 6,46 days. Multivariate analysis using binary logistic regression identified the following factors as independent mortality factors: the existence of neoplastic comorbidities, admission for a medical reason, the elevated APACHE II score, the need for vasoactive drugs, the prolonged mechanic ventilation, the need for transfusion, and the elevated length of stay, all of them were significant. Knowing the predictive factors of mortality will allow us to improve the quality of the care provided, and to target an eventual preventive action to improve the prognosis and to decrease mortality in intensive care unit.

Alcohol use disorder treatment delivered outside hepatology clinic.

Alcohol use disorder treatment delivered outside hepatology clinic.

ACUTE SURGICAL ABDOMEN: UNEXPECTED MEDICAL CAUSE

Acute surgical abdomen is a diagnostic and therapeutic emergency, manifested by a generalized contracture of the abdominal muscles following a peritoneal irritation. In the majority of cases, acute peritonitis is the most common etiology requiring urgent surgical intervention. Nevertheless, some medical pathologies, notably acute adrenal deficiency and inflammatory colitis, can mimic this surgical situation, leading to an aberrant surgical intervention. Through a clinical case, we report the diagnostic and therapeutic modalities of a multifocal tuberculosis initially admitted for an acute surgical abdomen.

Abstract CT068: CASCADE-LUNG: validation of a blood-based assay that evaluates cell-free DNA fragmentation patterns to detect lung cancer

Abstract Rationale: Despite longstanding national recommendations for lung cancer screening by low-dose computed tomography (LDCT), annual participation rates are below 15%. Cost, access, and uncertainty over individual-level benefits and harms of screening preclude greater uptake. The development of a low-cost initial blood test that detects lung cancer with high sensitivity could boost LDCT screening rates and improve screening efficiency, by identifying within the screening-eligible population those at relatively higher risk of lung cancer. DELFI (DNA evaluation of fragments for early interception) is a technology that uses low-coverage, whole-genome sequencing and machine learning to detect cancer signals in the blood. In an early study, DELFI demonstrated high sensitivity to detect stage I/II lung cancers [PMID 34417454]. CASCADE-LUNG (NCT05306288) is an ongoing study to clinically validate a DELFI-based test to detect lung cancers that would be found by chest LDCT. Study Design and Methods: CASCADE-LUNG is an event-driven, multisite, prospective, cross-sectional, observational, blood specimen collection study. Eligible individuals are ≥50 years old with ≥20 pack-years history of smoking who are scheduled for a first-time or annual lung cancer screening by chest CT scan within ~30 days after enrollment. Individuals are excluded for any history of hematologic malignancy or organ transplantation, prior cancer diagnosis or prior cancer treatment within 2 years before enrollment, and blood transfusion within 120 days before enrollment. Blood samples are collected within 30 days after enrollment for DELFI analysis. Medical record reviews are conducted at 4 months and 12 months post-enrollment, during which medical history (including social and family history and cancer screening history), demographics, imaging reports, diagnostic reports, surgery reports, pathology reports, and other diagnostic information are collected. Objectives are to evaluate the sensitivity and specificity of a DELFI-based test to detect lung cancer (primary), including within clinically relevant subgroups such as stage, nodule size, age, and race/ethnicity (secondary). Clinical endpoints include the presence or absence of histopathologically confirmed lung cancer diagnosed between the time of the enrollment chest CT scan and the 4-month follow-up visit (primary) and the 12-month follow-up visit (secondary), and adverse events associated with blood specimen collection (secondary). About 15,000 participants are expected to enroll to reach ~70 lung cancers that are suitable for analysis. Enrollment began in April 2022 and is expected to close in 2023. Citation Format: Julie A. Barta, Stephen Freedland, Peter J. Mazzone, Amy E. Isaacson, Alisa M. Hewitt, Debbie Jakubowski, Peter B. Bach, Victor E. Velculescu. CASCADE-LUNG: validation of a blood-based assay that evaluates cell-free DNA fragmentation patterns to detect lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr CT068.

Serological Analysis of HBsAg and Anti-HCV Antibody in Patients Received at the Mali Hospital Laboratory

Introduction: Viral hepatitis is a public health threat that has long been underestimated. This infectious disease is the seventh cause of death in the world and even ahead of HIV in terms of epidemiological prevalence. Objective: highlight the seroprevalence of hepatitis B and C viral infections in patients seen in the medical analysis and pathology laboratory department of the Mali hospital. Method: This is a prospective and retrospective study that took place from July 2021 to August 2022. This study included 1540 samples from eligible patients with HBsAg, Anti HBe IgG Antibody, Anti HBc Antibody, HBe Ag, Antibody Anti HBs and/or anti-HCV antibodies. Results: These different methodologies allowed us to have the results of 1540 samples concerning this study. The female sex was more represented with 62.92% compared to the male sex or 37.08%. The HBSAg was mainly found positive in the male sex with 5.45%. The average age was 38 ± 17 years with extremes ranging from 2 to 92 years. The age group 21-39 years was the most represented with 47.47% and the most affected by the positivity of the HBSAg with 5.65%. 64.03% of our patients were married and also with increasing positivity for HBS Ag and anti-HCV Ac with 5.91% and 0.91% respectively. The seroprevalence of HBV, HCV and HVB/HCV co-infection were 10.06, 0.9% and 0.84% respectively. Conclusion: Hepatitis B remains largely unknown to the general public but also to many medico-social actors. This lack of knowledge represents a major obstacle to prevention and screening. It also has as a corollary the stigmatization of people who are affected, in romantic encounters or at work in particular. A high seroprevalence of HBsAg obtained indicates the spread of hepatitis B in the Malian population.

Pathology education project (PEP): A pilot program to spark student understanding in pathology as a career

According to the National Resident Matching Program in 2022, 631 pathology positions were offered. In total, 248 senior applicants from United States (US) allopathic schools filled 36.6% of these positions. To bolster medical student understanding of pathology, a medical school pathology interest group organized a multi-day activity to introduce rising second-year medical students to pathology as a career. Five students completed both pre- and post-activity surveys assessing their knowledge of the specialty. All five students had a BA/BS degree as their highest level of education. Only one student indicated that he or she had previously shadowed a pathologist as a medical laboratory scientist for a duration of four years. Two students indicated that they were interested in internal medicine, one indicated radiology, one forensic pathology or radiology, and one was undecided. During the activity, students biopsied tissue from cadavers in the gross anatomy lab. Thereafter, students participated in the standard tissue processing by shadowing a histotechnologist. Under the guidance of a pathologist, students microscopically examined slides and discussed the clinical findings. Post-activity survey results indicated that participation increased their knowledge of pathology as a career with a median increase of 0.8 points (range: 0.2 to 1.6) on a 5-point Likert scale. Students also indicated that their participation increased their knowledge of pathology skills and techniques—median increase of 1.2 (range: 0.8 to 1.8). This activity can be implemented by medical educators to expose medical students to pathology as a career with the benefit of increasing student knowledge in the specialty.

Immobilization syndrome and iatrogenic dependence of hospitalized elderly people

In the hospital, the geriatric missions of nurses and paramedical and medical teams are essential in order to benefit elderly patients and to fight against the immobilization syndrome through responsiveness and quality care. This care takes place in parallel with the specific medical care of the medical pathologies treated. In 2017, the High Authority for Health advocated good professional practices to avoid iatrogenic dependence of hospitalized elderly people. Through this article, we carry out a focus on the immobilization syndrome and its deleterious consequences: we must not do in the place of the elderly subject!

Panorama of Medical Diseases in Pregnant and Postpartum Women in Internal Medicine at the University Hospital Center of the Point G

The description of the epidemiological aspects of all medical pathologies associated with pregnancy and postpartum would provide relevant anamnestic orientation indices that could be taken into account in the global diagnostic and therapeutic approach in internal medicine. Panoramic studies of medical pathologies associated with pregnancy and postpartum have rarely been carried out in Africa, particularly in Mali. The objective of this observational cross-sectional and descriptive study with retrospective data collection for 5 years was to describe the epidemiological and clinical aspects of all medical pathologies associated with pregnancy and postpartum in internal medicine at the University Hospital Center of the Point G in Bamako. Globally, 1846 patients were admitted among which 49 pregnant or postpartum women presented a medical pathology (2.65%). The average age was 27.29 ± 5.84 years. The medical pathologies frequently associated with pregnancy and postpartum in our study were: cardiovascular pathologies (peripartum cardiomyopathy, pulmonary embolism); infectious pathologies (esophageal candidiasis on HIV infection and cerebral toxoplasmosis on HIV infection; digestive pathologies (hepatic cirrhosis).

Complex cerebrovascular diseases in Roberts syndrome caused by novel biallelic ESCO2 variations.

Roberts syndrome (RBS), also known as Roberts-SC phocomelia syndrome, is a rare autosomal recessive developmental disorder caused by mutations in the ESCO2 gene. Cardinal clinical manifestations are pre- and postnatal growth retardation and craniofacial and limb malformations. Here, we report RBS in a Chinese adolescent with novel biallelic ESCO2 variations and complex cerebrovascular diseases. Medical history, neurological examinations, neuroimaging, and pathology were collected in the proband and the family. Whole exome sequencing (WES) with copy number variation analysis was performed to screen for genetic variations. The clinical features of the proband were craniofacial and limb malformations together with complex cerebrovascular diseases. She suffered ischemic stroke at 6 years old and died of cerebellar hemorrhage secondary to an aneurysm at 13 years old. Besides, neuroimaging showed the triad of leukoencephalopathy, calcifications, and cysts. Brain histopathology revealed angiomatous changes and perivascular cysts suggesting chronic small cerebral vasculopathy. Whole exome sequencing (WES) identified novel biallelic variations in the ESCO2 gene (c.1220A>T, p.H407L and c.1562delC, p.A521fs). We describe complex cerebrovascular diseases in Roberts syndrome caused by novel ESCO2 biallelic variations. This case expands not only the cerebral involvement in Roberts syndrome but also the disease spectrum of the neuroimaging triad with leukoencephalopathy, calcifications, and cysts.

Root cause analysis (RCA), a little-known tool for medical errors pathology during the COVID-19 pandemic

Root cause analysis (RCA), a little-known tool for medical errors pathology during the COVID-19 pandemic

New proteins in the differentiation of papillary renal cell carcinoma from clear cell renal cell carcinomas; Importance of DARS2, Reelin and Enkurin

Purpose: The purpose of the present study was to examine the roles of new proteins DARS2, Reelin, and Encurin in the differentiation of Clear-Cell Renal Cell Carcinoma (RCC) and Papillary Renal Cell Carcinoma (RCC). Clear-cell RCC is the most common malignancy of the kidney, and papillary RCC is the second most common malignant malignancy in this respect. They are neoplasms and show similarity to each other, both histologically and morphologically, in some cases. Differential diagnosis is important because treatment approaches and prognoses are different. Although careful histopathological examination and specific immunohistochemical markers are important for diagnosis, there are no specific antibodies that can be used reliably and the search for biomarkers continues in this regard.
 Materials and Methods: A total of 30 Clear-Cell RCC and 30 Papillary RCC cases were included in the present study. Patients were identified retrospectively by reviewing the hospital database and pathological reports. Pathological data were obtained from hospital medical archives and pathology reports.
 Results: It was found that DARS2, Reelin, and Encurin proteins were significantly higher in papillary RCC when compared to clear-cell RCC.
 Conclusion: It was concluded that DARS2, Reelin, and Encurin proteins may be potential biomarkers for the differentiation of Papillary RCC and Clear-Cell RCC.

Super, social, medical: Person-first and identity-first representations of disabled people in Australian newspapers, 2000–2019

This paper provides an interdisciplinary, corpus-based study of naming practices for disabled people in a collection of Australian newspaper articles spanning 20 years. We analyse head nouns, modifiers, and coordinating structures for both person-first and identity-first language, drawing on social actor analysis as well as previously-identified models of media representation. Overall, we find similar usage of both naming practices with respect to the types of social actors that occur, the categorisations of disabilities that are referenced, and the associations that are established, with only minor differences. Additionally, both naming practices are strongly associated with the medical and social pathology models of media representation, which emphasise disadvantage, with almost a total absence of ‘progressive’ models, which represent people as multifaceted agents. We conclude by emphasising the need for the news media to incorporate the voices and preferences of disabled people themselves.

Diagnosing Desire: Imaginative Experiments with Sexuality and the Nerves.

American fiction often tells us that there is something sick about romantic desire. But the writers who I discuss in this article told their readers this even as they critiqued the medical profession's pathologization of women's desires and non-normative sexual subjectivities. In particular, this article looks at two literary responses to the medical notion that marriage was a cure for hysteria and other nervous disorders: Oliver Wendell Holmes's A Mortal Antipathy (1885) and Elizabeth Stuart Phelps's Doctor Zay (1886). While the medical rhetoric of nervous pathology could be repressive and stigmatizing, these fictions sought to reclaim and reimagine the medical treatment of nervous desire in subversive ways.