Pathology Laboratory Research Articles

Epidemiological features and psychoneurological consequences of infection of people with the Nipah virus

The lecture outlines modern ideas about the etiology, features of the epidemic process, mechanisms of damage to the human body, clinical manifestations, diagnosis, treatment and prevention of infection caused by the Nipah virus. Particular attention is paid to the characteristics of individual outbreaks of the infectious process in various geographical regions of the world, early and long-term psychopathological, neurological and cognitive consequences due to human infection with the Nipah virus. The risk factors for the emergence and rapid spread of infection with a very high mortality rate, reaching 100%, are emphasized, which determines the high pandemic potential and hidden threats to human society. Recommendations are outlined for the prevention of transmission of infection caused by the Nipah virus at all levels: from animals to humans, from humans to humans, in medical institutions, which, in the absence of effective vaccine prevention and specific antiviral treatment, are the basis for containing the spread of the infectious process. In this regard, measures taken and planned to provide patients and contact persons with adequate medical and psychological care, features of the development and implementation of effective anti-epidemic, clinical diagnostic algorithms, timely and high-quality social and hygienic monitoring of environmental objects against the backdrop of increasing biological threats from outside, and within the country will minimize the risks of biological threats. The lecture is intended for doctors of various specialties, including infectious disease specialists, epidemiologists, general practitioners, neurologists, psychiatrists, laboratory diagnosticians, radiologists etc.

The healing effect of nano emulsified Plantago major L extract on oral wounds in a wistar rat model

IntroductionOral lesions are a common clinical symptom arising from various etiologies and disrupt the patient’s quality of life. However, no definite treatment is not yet possible, due to the constantly changing environment of the mouth. In recent years, herbal treatments have gained popularity among patients and physicians due to their availability, safety, affordability, and antimicrobial properties. This research aims to investigate the therapeutic effects of a nano-emulsion of Plantago major standardized extract (PMSE) on oral ulcers in a Wistar rat model using histomorphometry and stereological parameters.Materials and MethodsThe study involved 72 Wistar rats divided randomly into 24 groups of 3 each: groups A1 to A4 received one dose to 4 doses of 5% PMSE nano emulsion, groups B1 to B4 received one dose to 4 doses of 10% PMSE nano emulsion, and groups C1 to C4 received one dose to 4 doses of 20% PMSE nano emulsion, groups D1 to D4 received one dose to 4 doses of nano-emulsion without PMSE, groups E1 to E4 received one dose to 4 doses of PMSE, and group F served as the control group. An incision measuring 2 mm in diameter was made in the animals’ hard palate using a biopsy punch. A swab containing the necessary material was used to administer the medication orally to the wound. Histological samples were collected on days 2, 4, 6, and 8 and sent to the pathology laboratory for examination. Data analysis was performed using SPSS 26 and setting statistical significance at p < 0.05.ResultsGroup A showed a high rate of complete and normal re-epithelialization of the wound at 66.7%, compared to the other groups. Group D had a re-epithelialization rate of 50%, while groups C, E, and F had rates of 7.41% and group B had 7.16%. In terms of inflammation reduction, 23.88% of group A had no inflammation, a higher percentage compared to the other groups. Group B and D had no inflammation in 3.33% of cases, lower than the other groups. The study evaluated frequency of re-epithelialization and inflammation levels in different groups on days 2, 4, 6, and 8 after four doses of the drug with no significant differences found among the groups.ConclusionNone of the nano emulsions or PMSE enhanced the healing rate of oral ulcers. However, a 5% PMSE nano emulsion displayed an increase in lesion re-epithelialization.

Digital transition in pathology lab: a survey from the Lombardy region.

Digital pathology is an opportunity to revise the routine and old artisanal workflow, moving to standard operating procedures, quality control and reproducibility. Here the results of a survey promoted by the Coordinamento della Medicina di Laboratorio (CRC Med Lab) of the Lombardy region in Italy are reported to shed light on the current situation of digital adoption in the country. The survey composed of 58 questions was sent to 60 pathology laboratories. The results were collected and most significant answers were reported and discussed. Answers were received from 57 (95%) laboratories, a minority organized in spoke-hub networks (16%) with a centralized processing phase (11%). Hybrid manual/computer-assisted traceability was prevalent (36%), with QR/barcode labeling starting within the pathology lab (23%). Different laboratory information systems (LIS) were employed, mostly with alert functions and/or multimedial file attachments (56% and 46%, respectively). The majority opted for a semi-automated tracking management (44, 77%) and 18 centers (32%) were partly digitizing the routine (¾ scanning < 25% of slides). Whole slide images were retained for 3.7 years in average; in-house blocks/slides archiving was still preferred (30, 53%), with 1838 (±1551) and 1798 (±1950) days (5 years) internal permanence for blocks and slides that are stored in out-source (mean turnaround time for return on-demand 3.7±2.1, range 1-10 days). The advantages of digital pathology must be balanced against the challenges faced in the structural revision of the pathology workflow. This regional scouting can represent the foundation to build an efficient and connected digital pathology system in the territory.

567. EPIDEMIOLOGY OF BARRETT'S ESOPHAGUS IN ICELAND; INCIDENCE AND PROGRESSION TO NEOPLASM FROM A LARGE POPULATION-BASED STUDY

Abstract Background Barrett’s esophagus (BE) is the known precursor to esophageal adenocarcinoma (EAC). Previous studies have demonstrated a wide variety of progression rate whereas no nationwide data regarding the progression has been reported. The aims of the study were to evaluate the prevalence of BE and neoplasms in BE, and progression to those in a large population based and nationwide. Methods This was a retrospective study and patients from 7 institutions who were identified through a database of centralized pathology laboratory in an expert center. Demographics and relevant clinicopathological features were obtained from medical records of patients with a pathologically confirmed BE by presence of intestinal metaplasia between 1990 and 2022. Results A total of 811 patients were identified with BE, 551 men (67.9%), male to female ratio 2.1:1, and with a median age at diagnosis of 63 years (IQR 53-73). At the time of BE diagnosis, the prevalence of neoplasm was 13.9%, (56 LGD, 14 HGD, and 43 EAC). Out of 56 LGD, 16.1% progressed to HGD (n=6) or EAC (n=3). Among 698 BE patients without neoplasm at the time of BE diagnosis, the cumulative incidence of neoplasm was 6.9% (29 LGD, 7 HGD, and 12 EAC) with median observation-period of 7 years (IQR: 4-9). In total, 161 cases of neoplasm (65.8% in long-segment, 34.2% in short-segment BE) were diagnosed in this BE cohort; 67.2% at time of BE diagnosis; and 32.8% without dysplasia at diagnosis progressed to neoplasm during follow-up. Conclusion In this large population-based study of patients with BE, around 14% were diagnosed as harboring neoplasm concomitantly with BE, which accounted for approximately 67% of all neoplasms. During the median follow-up of 7 years, about 7% of BE showed dysplastic or malignant progression.

Determinants of Safe Behavior among Clinical Pathology Assistants at Dr. Soebandi Regional Hospital Jember, Indonesia

Introduction: Every workplace has potential hazards that can threaten work safety, including clinical pathology laboratories. Work accidents in clinical pathology at Dr. Soebandi Regional Hospital Jember have decreased every year. This study aims to examine the determinants of safety behavior among clinical pathology assistants at Dr. Soebandi Regional Hospital, Jember. Methods: This research was a quantitative descriptive study with a cross-sectional approach. The study's respondents were 32 clinical pathology assistants. We collected data using a questionnaire. We analyzed this research using frequency, crosstab, and logistic regression tests. Results: The majority of clinical pathology assistants were under 40 years old, had completed occupational health and safety training, possessed competencies suitable for their work, maintained a positive attitude, and demonstrated high motivation at work. Almost all respondents stated that supervision was good, they had good knowledge, and their most recent level of education was Diploma-III. Most clinical pathology assistants behave safely. Clinical pathology assistants who are under 40 years old, have completed occupational health and safety training, exhibit competence, a positive attitude, and high motivation, report good supervision, possess good knowledge, and hold the latest Diploma-III education level are more likely to behave safely. Conclusion: Several clinical pathology assistants have demonstrated safe behavior while working in the clinical pathology laboratory. Several factors, including superior supervision and reasonable supervision efforts in the clinical pathology laboratory, contribute to the safe behavior of clinical pathology assistants.

Optimization of Complete Blood Count Results with Variations in Specimen Handling and Whole Blood Secondary Homogenization Techniques

Specimen homogenization and the addition of anticoagulants are pre-analytical steps that influence the accuracy of the test results. Complete blood count (CBC) is a screening test that supports disease diagnosis and aids in determining the appropriate therapy for patients. Inadequate specimens are inappropriate for subsequent testing, as they can lead to inaccurate results in the CBC examination. This study aims to determine the optimization of complete blood count results with variations in specimen handling and secondary homogenization techniques for whole blood. The type of research used is quantitative analysis using laboratory experimental methods. The study was conducted in May 2024 in the Clinical Pathology Laboratory of the Diploma-4 Medical Laboratory Technology Study Program, Faculty of Health Sciences, Muhammadiyah University of Sidoarjo, using 48 blood samples. The results of the MANOVA test indicate that the type of anticoagulant has a significant effect on the erythrocyte count (p=0.041) but does not have a significant impact on the leukocyte count (p=0.844) and platelet count (p=0.920). Meanwhile, the homogenization technique does not significantly affect the erythrocyte count (p=0.959), leukocyte count (p=0.991), or platelet count (p=0.867). This study concludes that the secondary homogenization technique has no significant effect. In contrast, the type of anticoagulant significantly impacts the results of the Complete Blood Count (CBC) test. This research suggests collecting whole blood specimens using Ethylene Diamine Tetra Acetate (EDTA) vacutainers as the anticoagulant and applying a secondary homogenization technique before performing the CBC analysis.

Phytotoxic effect of Carica papaya extract on seed-borne fungus of African Yam Bean (Sphenostylis stenocarpa Hochst ex. A. Rich. Harms) seeds

Extracts of many higher plants have been reported to exhibit antifungal properties under laboratory experiments. This study was therefore carried out to investigate the effect of Carica papaya plant extracts on the African Yam Bean seed-borne pathogen. The seed health test of African Yam Bean was carried out using the blotter paper method. The experiment was conducted at the Plant Pathology Laboratory of the Department of Crop Science and Horticulture, Nnamdi Azikiwe University, Awka. Test of plant extract for inhibition of radial growth of seed-borne pathogen of African yam bean was studied under in vitro experiment at 0%, 50%, 75% and 100% concentrations with 0% as the control. The design was a Completely Randomized Design (CRD) with three replications. The test plant extracts of different concentrations were added into Petri dishes containing molten-sterilized Sabouraud Dextrose Agar (SDA) and swayed gently on the laboratory bench to allow an even mixture These were allowed to gel. Then nine millimeter discs of a seven-day pure culture of Aspergillus flavus were aseptically placed on the centre of the Petri dishes containing the SDA-extract mixture. Records on the radial inhibition effect of the test plant extract were kept for further analysis. Data on radial inhibition of fungus were subjected to Analysis of Variance (ANOVA). Results showed that Aspergillus niger, Aspergillus flavus and Aspergillus terreus were isolated from incubated African Yam Bean seeds. Carica papaya leaf extract used was very effective and the higher the concentrations of extract, the more effective in the inhibition of radial growth of the test fungus. It could therefore be recommended that farmers should always conduct viability tests on procured seeds before planting. Farmers should rather use plant extract such as the one used in this experiment in controlling seed-borne fungal pathogens of African Yam Bean seeds than synthetic fungicides.

Evaluation of Pathology Resources for Cervical Cancer Detection Between 2018 & 2022: a Retrospective Study at Moi Teaching and Referral Hospital, Western Kenya.

Cervical cancer cases are increasing in sub-Saharan Africa, particularly in Kenya, exacerbated by inadequate histopathology resources, posing a significant barrier to timely diagnosis and treatment. There has been little research on the availability and evolution of histopathology resources for diagnosing cervical cancer over the years. This retrospective study evaluated this evolution at Moi Teaching and Referral Hospital in Kenya between 2018 and 2022. We used a mixed-methods approach. An in-depth interview was conducted with one of MTRH's pathology laboratory staff to assess the equipment, personnel, and quality control trends between 2018 and 2022. A thematic analysis was conducted in NVivo. We also retrospectively conducted a comprehensive inventory review of laboratory resources from 2018-2022 via purposive sampling. Microsoft Excel and Stata version 17 were utilized for descriptive statistical analysis. Turnaround time (TAT) was assessed against the UK's National Health Service Cervical Screening Program guidelines. The number of histopathology laboratory personnel at MTRH increased from 2018 to 2022, during which the facility included two pathologists, one records person, and one office administrator. Patient annual visits increased from approximately 350,000 in 2018 to approximately 500,000 in 2022. However, the histopathology personnel-to-population ratio decreased from 1.5 pathologists and 2.7 histo-technicians per 100,000 in 2018 to 1.4 pathologists and 1.8 histo-technicians per 100,000 in 2022. Despite this decrease, lab equipment, automatic tissue processors and embedding machines were added, and an average 14-day turnaround time was maintained for pathology reports. Despite a decreased personnel-to-patient ratio, the addition of crucial histopathology equipment mirrors the operational commitment of the Moi Teaching and Referral Hospital. The 14-day TAT is commendable, contributes to operational effectiveness and significantly contributes to timely detection. The hospital's dedication to upgrading its infrastructure underscores a proactive approach to addressing growing healthcare demands and improving patient outcomes, even with limited human resources. The decline in the personnel-to-patient ratio underscores challenges in diagnosis, emphasizing the need to address workforce and infrastructure gaps to improve patient care within similar low-resource settings.

Influence of a New Generation Fungicide on Fusarium Head Blight in Spring Barley

Fusarium head blight is a serious problem in both traditional and intensive agriculture. The way to solve this problem is to use combined systemic fungicides. We therefore studied the effect of the new-generation fungicides Alto Super and KE (Propiconazole 250 g/l and Ciproconazole 80 g/l) combined with the foliar fertilizer Ultramag Super Sulphur-900. Laboratory studies were carried out at the Plant Pathology Laboratory of the People&amp;apos;s Friendship University of Russia (RUDN), and field experiments were carried out in 2022 at the experimental field station of the Federal Research Centre &amp;quot;Nemchinovka.&amp;quot; Fusarium head blight appeared in late July and early August. The application of the new-generation fungicide Alto Super, KE, alone and in combination with the new foliar fertilizer Ultramag Super Sulphur considerably reduced the development of the epiphytotic fungal disease. Their biological efficacy was 44.53–83.36%. The yield of Nur Spring barley in the experimental variants was higher than in the control variant. The yield gain of spring barley increased by 5.85% for Alto Super, KE, 9.40% for Ultramag Super Sulphur-900, and 12.85% for Alto Super, KE, and Ultramag Super Sulphur-900.

Nutritional status and related factors in inpatient pressure ulcer patients at Ho Chi Minh City Hospital Rehabilitation – Professional Diseases in 2023

A cross-sectional study was conducted at the Ho Chi Minh City Hospital Rehabilitation – Professional Diseases from February to May 2023 to describe nutritional status and related factors in inpatient pressure ulcer patients at Ho Chi Minh City Hospital Rehabilitation – Professional Diseases in 2023. The study focus on the prevalence of malnutrition and the relationship between malnutrition status based on SGA with demographic characteristics, pathology, and clinical laboratory parameters in inpatients with pressure ulcers at the hospital. The study results showed that the prevalence of malnutrition using the SGA method was 92.7%, while using anthropometric BMI was 15.6%. There was a statistically significant difference in the prevalence of malnutrition according to SGA with age groups, length of hospital stays, and stage of pressure ulcers (p &lt; 0.05). Malnutrition is a common issue among patients with pressure ulcers, thus early detection of nutritional status is crucial for developing intervention plans, counseling, and individualized nutritional care for patients.

Matrix Metalloproteinases 9 Expresion of Thyroid Follicular Neoplasm FNAB and Its Relationship with Thyroid Malignancy Histopathology

Background Fine-Needle Aspiration Biopsy (FNAB) thyroid nodules is not easy to distinguish betwen follicular malignancy and follicular benign lession. Malignancy diagnosis can only be made from histopathology examination by examing tumor invation to capsule and vaskular. Matrix Metalloproteinase 9 (MMP-9) examination can be added to help making initial diagnois. MMP-9 is a proteolytic enzyme that plays important role in cancer progressivity, especially in thyroid. High MMP-9 expression will lead to earlier degradation of thyroid and its will make the cell metastasist easier. This study is to examine MMP-9 expression of thyroid follicular neoplasm related tomalignancy through histopathology examination and the diagnostic test of FNAB MMP-9 expression and histophatologic examination. Methods We used 42 sample FNAB follicular thyroid in Anatomic Pathology laboratories RSUP M Djamil Padang and histopathologic examination was performed. Immunohistochemical was staining with primary antibody MMP-9 then its expression were assessed in stroma and cytoplasmic cell tumour. Results MMP-9 expression was found positive in malignancy histopathologic (80.9%). Expression of MMP-9 at FNAB folikullar neoplasm thyroid is significant in malignant histopathologic thyroid (p=0.017). MMP-9 Sensitivity in thyroid follicular noduleFNAB is quite good (88.575) and its specificity is 51.14%. Conclusion Increased MMP-9 expression of FNAB follicular thyroid neoplasm is associated with histopathologic malignancy.

Performance Evaluation of Commonly Used Portable Hemoglobin Sensors in Comparison to Clinical Test Results.

Telehealth systems in underserved countries leverage various low-cost portable medical sensors to transmit patients' vital information to remote doctors, facilitating timely diagnoses and interventions. However, the potential risks associated with inaccurate data pose considerable threats to the health of individuals. This study focuses on identifying high-quality portable hemoglobin sensors, employing the Japanese clinical pathology laboratory as a gold standard. Out of the eight sensors evaluated in this study, four were found to be highly erroneous.

Description of Bacterial RNA Transcripts Detected in Mycobacterium tuberculosis - Infected Cells from Peripheral Human Granulomas using Single Cell RNA Sequencing.

Mycobacterium tuberculosis (Mtb) remains a global human health threat and a significant cause of human morbidity and mortality. We document here the capture of Mtb transcripts in libraries designed to amplify eukaryotic mRNA. These reads are often considered spurious or nuisance and are rarely investigated. Because of early literature suggesting the possible presence of polyadenylated transcripts in Mtb RNA, we included the H37Rv Mtb reference genome when assembling scRNA seq libraries from fine needle aspirate samples from patients presenting at the TB clinic, Port Moresby General Hospital, Papua New Guinea. We used 10X Genomics single-cell RNA sequencing transcriptomics pipeline, which initiates mRNA amplification with poly-T primers on ~30-micron beads designed to capture, in this case, human mRNA associated with individual cells in the clinical samples. Utilizing the 10X Genomics Cell Ranger tool to align sequencing reads, we consistently detected bacterial small and large ribosomal subunit RNA sequences (rrs and rrl, respectively) and other bacterial gene transcripts in the cell culture and patient samples. We interpret Mtb reads associated with the host cell's unique molecular identifier (UMI) and transcriptome to indicate infection of that individual host cell. The Mtb transcripts detected showed frequent sequence variation from the reference genome, with greater than 90% of the rrs or rrl reads from many clinical samples having at least 1 sequence difference compared to the H37Rv reference genome. The data presented includes only bacterial sequences from patients with TB infections that were confirmed by the hospital pathology lab using acid-fast microscopy and/or GeneXpert analysis. The repeated, non-random nature of the sequence variations detected in Mtb rrs and rrl transcripts from multiple patients, suggests that, even though this appears to be a stochastic process, there is possibly some selective pressure that limits the types and locations of sequence variation allowed. The variation does not appear to be entirely artefactual, and it is hypothesized that it could represent an additional mechanism of adaptation to enhance bacterial fitness against host defenses or chemotherapy.

Influence of Temperature and Relative Humidity on Spore Germination and Early Blight Disease Development of Tomato Caused by Alternaria solani

Early blight of tomato caused by Alternaria solani is one of the most important and devastating disease of tomato which causing extensive yield losses to the crop. Environmental factors play an important role in the development of disease. To investigate the congenial conditions to develop the disease and germination of fungal spores an experiment was conducted in the year 2019 and 2020 at vegetable pathology laboratory of Dr Yashwant Singh Parmar University of Horticulture and Forestry Nauni Solan, Himachal Pradesh, India. Under investigations effect of temperature and relative humidity (RH) on conidial germination and early blight diseases development of tomato caused by Alternaria solani was studied under in vitro and in vivo conditions. Under in vitro conditions, maximum germination of conidia (75.54%) was recorded at 30°C after 24 hours and minimum (23.24%) was recorded at 15°C. length of germ tube (129.55 µm) was maximum at 25°C, whereas, minimum (67.09 µm) was observed at 15°C. In case of relative humidity maximum conidial germination (95.18%) and germ tube length of 238.95 µm was observed at 100% level. Under in vivo conditions disease severity was maximum (81.48%) at 30°C followed by 25°C (78.21%), whereas, minimum (18.88%) was recorded at 40°C. Similarly, the maximum (88.09%) disease severity was observed at 100% RH level while, it was minimum at 38% level of humidity. Overall, the relative humidity of more than 90% and temperature range of 25–30°C was found most congenial for the development of disease.

Cardiac Histopathology Alterations Induced by Subchronic Mangosteen Rind Extract in Wistar Rats

Mangosteen (Garcinia mangostana L.) is renowned for its potent antioxidant characteristics, including free radical scavenging, and its antibacterial, antifungal, anti-inflammatory, and antidiabetic properties. This study aims to assess the subchronic toxicity effects of ethanol extract from mangosteen rind on the cardiac histopathology of male and female Wistar rats. This research was a posttest-only control group design. Forty biological specimens from 40 Wistar rats were divided into four groups, a control group, and three treatment groups, which were given ethanol extract of mangosteen rind with doses of 250 mg/kg, 500 mg/kg, and 1,000 mg/kg for 28 days. Cardiac specimens were prepared and examined using hematoxylin-eosin (HE) staining at the Anatomical Pathology Laboratory of Universitas Jenderal Achmad Yani in December 2021. The findings indicated that prolonged ingestion of large amounts of ethanol extract from mangosteen rind can cause toxic effects characterized by an inflammatory response in cardiac tissue. No fibrosis or hypertrophy was detected; however, inflammatory changes such as the presence of inflammatory cells, vacuolar changes, and neovascularization were observed. The inflammation observed might be due to excessive antioxidant administration leading to oxidative stress. Inflammatory cells may trigger fibrotic remodeling in the heart. The difference in the quantity of inflammatory cells between male and female rats suggests that gender influences the inflammatory response. Overall, administration of ethanol extract from mangosteen rind at doses of 250 mg/kg, 500 mg/kg, and 1,000 mg/kg cause subchronic toxicity effects on the heart histopathology of Wistar rats, marked by inflammation.

Globalization of a telepathology network with artificial intelligence applications in Colombia: The GLORIA program study protocol

In Colombia, cancer is recognized as a high-cost pathology by the national government and the Colombian High-Cost Disease Fund. As of 2020, the situation is most critical for adult cancer patients, particularly those under public healthcare and residing in remote regions of the country. The highest lag time for a diagnosis was observed for cervical cancer (79.13 days), followed by prostate (77.30 days), and breast cancer (70.25 days). Timely and accurate histopathological reporting plays a vital role in the diagnosis of cancer. In recent years, digital pathology has been globally implemented as a technological tool in two main areas: telepathology (TP) and computational pathology. TP has been shown to improve rapid and timely diagnosis in anatomic pathology by facilitating interaction between general laboratories and specialized pathologists worldwide through information and telecommunication technologies. Computational pathology provides diagnostic and prognostic assistance based on histopathological patterns, molecular, and clinical information, aiding pathologists in making more accurate diagnoses. We present the study protocol of the GLORIA digital pathology network, a pioneering initiative, and national grant-approved program aiming to design and pilot a Colombian digital pathology transformation focused on TP and computational pathology, in response to the general needs of pathology laboratories for diagnosing complex malignant tumors. The study protocol describes the design of a TP network to expand oncopathology services across all Colombian regions. It also describes an artificial intelligence proposal for lung cancer, one of Colombia's most prevalent cancers, and a freely accessible national histopathological image database to facilitate image analysis studies.

A Retrospective Review: Our Experience With an Adhesive-Based Pigmented Lesion Assay Used to Evaluate Cutaneous Lesions Suspicious for Melanoma.

Being one of the largest dermatology groups in the country with an in-house pathology laboratory, we have seen a significant increase in the number of adhesive-based pigmented lesion assays (ABPLAs) in addition to biopsies and excisions following a moderate-risk or high-risk result with this test. To report our clinical experience and independently confirm that our results with this ABPLA (Pigmented lesion assay, DermTech. San Diego, CA) are consistent with the results of the validation studies completed by the test manufacturer. A retrospective review of our electronic medical records for results of ABPLAs, corresponding histopathologic results and available clinical follow-up, along with their statistical analysis was completed. After reviewing our electronic medical records, we found that 893 ABPLAs for pigmented lesions concerning for melanoma were obtained in a period of 14 months. Of the 893 ABPLAs completed, 161 biopsies and excisions were performed after the initial results of these assays. Additional clinical follow-up data were recorded and used for the statistical analysis of the performance and accuracy of this test. The small number of lesions reported as low risk for melanoma with corresponding histopathologic results limits our evaluation of the performance of this test. In addition, there may have been some melanomas that were not identified because the duration of the clinical follow-up was insufficient or because some patients were lost to follow-up. In our experience this ABPLA has a sensitivity of 92.0%, a specificity of 79.5%, a positive predictive value of 16.9%, and a negative predictive value of 99.5% for the detection of melanoma.

Pathology students' perceptions of virtual learning: A case study of students in Saudi Arabia.

Pathology laboratory classes are traditionally conducted using a conventional light microscope. The Coronavirus Disease 2019 (COVID-19) pandemic and recent technological advances necessitated remote learning through online classes using virtual slides (VS) instead of glass slides (GS). The purpose of this study was to gauge the perception of learning pathology using virtual slides (VS) as opposed to glass slides (GS) for medical students in Saudi Arabia. This study would help modify teaching methods with the advancement of the application of newer methods in online teaching. This two-phased study evaluated learning outcomes and perceptions in pathology online education for medical students. Using a questionnaire, Phase one analyzed second and third-year students' perceptions of the teaching methods after an online pathology course. Phase Two assessed the learning outcomes of third-year students during online practical sessions using a pretest and post-test design. Statistical data were collected using a simple additive approach. Statistical tools were used to determine the factors affecting students' perceptions. The accessibility of VS at any possible time, location, or device was the most advantageous trait of virtual learning (mean = 2.94±0.9). Students agreed the least with virtual slides as the only optimal method of learning pathology (mean = 2.25±0.9). Most enjoyed the virtual lab experience (51.7%) but still prefer both laboratory-GS and virtual-VS classes (83.5%). VS had the benefit of accessibility and efficiency. The acceptance of VS was significantly affected by the orientation prior to the online class. Findings showed that VS cannot completely replace GS and more aspects such as technical difficulties and prior VS experience should be explored.

How to Develop an Online Video for Teaching Health Procedural Skills: Tutorial for Health Educators New to Video Production.

Clinician educators are experts in procedural skills that students need to learn. Some clinician educators are interested in creating their own procedural videos but are typically not experts in video production, and there is limited information on this topic in the clinical education literature. Therefore, we present a tutorial for clinician educators to develop a procedural video. We describe the steps needed to develop a medical procedural video from the perspective of a clinician educator new to creating videos, informed by best practices as evidenced by the literature. We also produce a checklist of elements that ensure a quality video. Finally, we identify the barriers and facilitators to making such a video. We used the example of processing a piece of skeletal muscle in a pathology laboratory to make a video. We developed the video by dividing it into 3 phases: preproduction, production, and postproduction. After writing the learning outcomes, we created a storyboard and script, which were validated by subject matter and audiovisual experts. Photos and videos were captured on a digital camera mounted on a monopod. Video editing software was used to sequence the video clips and photos, insert text and audio narration, and generate closed captions. The finished video was uploaded to YouTube (Google) and then inserted into open-source authoring software to enable an interactive quiz. The final video was 4 minutes and 4 seconds long and took 70 hours to create. The final video included audio narration, closed captioning, bookmarks, and an interactive quiz. We identified that an effective video has six key factors: (1) clear learning outcomes, (2) being engaging, (3) being learner-centric, (4) incorporating principles of multimedia learning, (5) incorporating adult learning theories, and (6) being of high audiovisual quality. To ensure educational quality, we developed a checklist of elements that educators can use to develop a video. One of the barriers to creating procedural videos for a clinician educator who is new to making videos is the significant time commitment to build videography and editing skills. The facilitators for developing an online video include creating a community of practice and repeated skill-building rehearsals using simulations. We outlined the steps in procedural video production and developed a checklist of quality elements. These steps and the checklist can guide a clinician educator in creating a quality video while recognizing the time, technical, and cognitive requirements.

AnNoBrainer, An Automated Annotation of Mouse Brain Images using Deep Learning.

Annotation of multiple regions of interest across the whole mouse brain is an indispensable process for quantitative evaluation of a multitude of study endpointsin neuroscience digital pathology. Prior experience and domain expert knowledge are the key aspects for image annotation quality and consistency. At present, image annotation is often achieved manually by certified pathologists or trained technicians, limiting the total throughput of studies performed at neuroscience digital pathology labs. It may also mean that simpler and quicker methods of examining tissue samples are used by non-pathologists, especially in the early stages of research and preclinical studies. To address these limitations and to meet the growing demand for image analysis in a pharmaceutical setting, we developed AnNoBrainer, an open-source software tool that leverages deep learning, image registration, and standard cortical brain templates to automatically annotate individual brain regions on 2D pathology slides. Application of AnNoBrainer to a published set of pathology slides from transgenic mice models of synucleinopathy revealed comparable accuracy, increased reproducibility, and a significant reduction (~ 50%) in time spent on brain annotation, quality control and labelling compared to trained scientists in pathology. Taken together, AnNoBrainer offers a rapid, accurate, and reproducible automated annotation of mouse brain images that largely meets the experts' histopathological assessment standards (> 85% of cases) and enables high-throughput image analysis workflows in digital pathology labs.