bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Influence in Leadership
Authors: Rast III David E. , Kershaw Christine
Published: October 2020

Although social influence and leadership are inextricably intertwined, with a few notable exceptions, they are typically discussed in isolation from one another. The overlap of methods of social influence and theories of leadership, however, makes it clear these topics should be discussed together. Furthermore, the involvement of group norms, which are group-based social constructs related to values within the group, clearly link leadership and social influence research. Group norms are involved in social influence via such group-oriented influences as conformity, and they are involved in leadership by setting the values used to determine the group’s leader. Understanding the relationship between and the potential limitations of social influence and leadership will provide researchers in both fields with a stronger foundation for future areas of inquiry.
Global Commercial and Sexual Exploitation of Children
Authors: Laser-Maira Julie Anne , Hounmenou Charles E. , Peach Donna
Published: October 2020

The term commercial sexual exploitation of children (CSEC) refers to the for-profit sexual exploitation of children and youth through buying, trading, or selling sexual acts. CSEC is a subset of children and youth who are victims of human trafficking or trafficking in persons (TIP). The Stockholm Declaration defines CSEC as a form of coercion and violence against children that amounts to forced labor and a contemporary form of slavery; there are many forms of CSEC, including child prostitution, child marriage, early marriage, forced marriage, temporary marriage, mail-order brides, child labor, child servitude, domestic servitude, begging, massage, sex tourism, child pornography, online streaming of sexual abuse, sexual extortion of children, and sexual solicitation of children. Not all experiences of sexual servitude are globally recognized. It is critical to explore the concepts of race, inequality, power, culture, and globalization and how they impact the commercial sexual exploitation of children.
Human Trafficking: Women, Children, and Victim-Offender Overlap
Authors: Aronowitz Alexis A. , Chmaitilly Mounia
Published: October 2020

Human trafficking involves exploitation in prostitution and other forms of sexual exploitation, forced labor, domestic service, and for the purpose of organ removal. The dominant narrative in human trafficking discourse on victims is that of “a young woman and naïve innocent lured or deceived into a life of lurid horror from which escape is nearly impossible,” according to Jo Doezema. This conflicts with the reality of victims who may have exercised agency and been voluntarily involved in the initial stages of the process or those agreeing to work in prostitution. Identifying victims of human trafficking is complex when their very existence in a country as undocumented migrants or their forced participation in activities deemed illegal (prostitution, participation in armed conflict or child soldiering, or criminal offenses) results in their being criminalized rather than protected.

The existence of prior victims becoming traffickers, particularly in the sexual exploitation of other women, has been documented by numerous researchers. Here, and in other situations where victims are forced to participate in criminal activities, the victim-offender overlap becomes blurred.

This presents a number of ethical and operational problems, in terms of how we recognize victims of human trafficking and how we discern them from offenders. Based upon a number of case studies involving women and children forced into prostitution, participation in armed conflict and terrorism, and criminal activities, the reader begins to understand the complexities of the victim-offender overlap and what measures are available to identify and protect victims of human trafficking from criminal prosecution.
Preparing Student Social Workers to Support Inclusive Education in an Indian Context
Authors: Limaye Sandhya
Published: October 2020

Children with disabilities have a variety of needs that require the expertise of several individuals. Multidisciplinary teams include professionals such as teachers, psychologists, social workers, physiotherapists, and resource teachers, who provide support services that help children with disabilities in inclusive educational environments. These teams often include social workers, but in India the role of the social worker is often overlooked and social workers have to struggle to prove their value. Historically, very few social worker education programs have offered specializations or training in inclusive education, and most social workers who worked with children with disabilities in inclusive settings learn the requisite knowledge, attitudes, and skills on the job. Many used the traditional model of social work rehabilitation, which focuses on the individual without relating to social and environmental contexts. The Center for Disability Studies and Action at the Tata Institute of Social Sciences in Mumbai, India, designed a full-time master’s program in Social Work in Disability Studies and Action, which trains social work professionals to work holistically with people with disabilities, including children with disabilities in inclusive educational settings. The master’s program combines the professional skills and knowledge components for social workers with the core values of inclusive education.
History of Curriculum Development in Schools
Authors: Tanner Daniel
Published: October 2020

The evolution of curriculum development in schools reflects the evolution of knowledge and civilization itself. What knowledge is of most worth? How shall it be codified, structured, and transformed into curriculum for the acculturation and growth of successive generations so that the future is better than the past? How can the school be designed and equipped as a productive and democratic learning environment? These are some of the questions that intersect with the fundamental factors of the education process, namely the learner, the curriculum, and the society. When these fundamental factors are set in opposition or isolation, the possibility for educational progress is impeded or set back.

Embracing the idea of progress and the science of education, the experimentalist movement over the first half of the 20th century sought to dissolve the dualisms carried from ancient Greece (e.g., mind/body, intellect/emotion, abstract/concrete knowledge) in endeavoring to create new designs and structures for curriculum synthesis to meet the democratic prospect and the universal educational needs of the rising generation. In sum, the experimentalists reconstructed curriculum development into a process of problem solving for educational progress, holding to the paradigmatic principle that the structure and function of the school curriculum must be in congruence with the nature and needs of the learner for effective living in the democratic society. The paradigm holds the fundamental factors in the education process as necessarily interdependent and in harmony. The curriculum paradigm explains why so many reforms imposed on the schools predictively are destined for failure simply because they set the fundamental factors in conflict with each other.

The march of democracy in global affairs will require a resurgence of the progressive vision for the curriculum of the democratic classroom and school in which students are engaged openly with each other and with the teacher in investigative cooperation, collaboration, and consultation.
Justice Against the Epistemicide: Itinerant Curriculum Theory and the Struggle to Decanonize Curriculum Studies
Authors: Paraskeva João M.
Published: October 2020

The article places the itinerant curriculum theory at the core of the struggle against the curriculum epistemicide and occidentosis. It unpacks the current contemporary global havoc as a result of the exhausted coloniality of power matrix of Modern Western Eurocentric modernity. In doing so, the piece dissects the challenges faced by a specific radical critical curriculum river framed by particular counter hegemonic approaches in the struggle against the curriculum epistemicide. It claims how counter hegemonic movements and groups, in such struggle against the epistemicide they ended up provoking a reversive epistemicide, by not pay attention to the validity and legitimacy of crucial onto-epistemological perspectives beyond Modern Western Eurocentric platform. Also, the article challenges such counter approaches to deterritorialize and delink from coloniality power matric, in order to open up their own Eurocentric canon and seek an itinerant curriculum theoretical commitment.
Gender, Education, and Immigrant Children in the United States
Authors: Ngo Bic , Abdi Nimo , Chandara Diana
Published: October 2020

Education research has long highlighted gender disparities in the academic achievement of women and men. At the dawn of the 20th century, men attained higher levels of education than women. By the 21st century, women from all racial groups achieved higher levels of education than men. Likewise, among the children of post-1965 “new immigrants,” female students have higher levels of educational attainment than male students. While gender has remained important as a domain of analysis for understanding disparities in education, analyses of the significance of gender in the education of immigrant children have focused primarily on differences in gender norms and expectations of immigrant groups from those of dominant culture in the United States. Such an emphasis disregards the social, cultural, and political dynamics of acculturation and adaptation where gender is shaped by the ethnic family, race and racialization, and religion, among other things. The “caring,” translational work that Mexican American girls do for parents, the racialized gender construction of Southeast Asian American male students as Other (not male), and the Islamophobia faced by Somali American female students wearing hijabs make salient family obligations, race, and religious identity, respectively, in the educational experiences and outcomes of female and male immigrant students. Considerations of gender in the education of immigrant children in the United States necessitate an intersectional analysis that puts gender in conversation with social factors and institutions.
Sociocultural Factors and the Global Goals of Education for All
Authors: Hurley Eric A.
Published: October 2020

All over the world, nations have spent much of the last 20 years scrambling to increase and improve access to basic education. Globally, the number of people without access to a basic education has fallen significantly in the years since the goals of Education For All (EFA) were announced in 2000 at the World Education Forum in Dakar, Senegal, and extended at Incheon, South Korea, in 2016. This is ostensibly very good news. While universal access to a basic education is certainly a worthy goal, one can raise significant questions about the orientation of these efforts and the manner in which they are being pursued. For example, very little attention seems to have been paid to what the schools are or will be like, or to how the nations and people they must serve may be different from those for whom they were designed.

To understand the inevitable problems that flow from this potential mismatch, it is useful to examine education in nations that have achieved more or less universal access to basic education. Many of the educational, social, economic, and social justice disparities that plague those nations are today understood as natural effects of the educational infrastructures in operation. Examination of recent empirical research and practice that attends to the importance of social and cultural factors in education may allow nations that are currently building or scaling up access to head off some predictable and difficult problems before they become endemic and calcified on a national scale. Nations who seize the opportunity to build asset-based and culturally responsive pedagogies into their educational systems early on may, in time, provide the rest of the world with much needed leadership on these issues.
Africans in the Indian Ocean World
Authors: Allen Richard B.
Published: October 2020

The African diaspora in the Indian Ocean is inextricably intertwined with slavery and slave trading in an oceanic world that encompasses southern and eastern Africa, the Red Sea, the Persian (or Arabian) Gulf, South Asia, the Indonesian archipelago, and parts of East Asia. A combination of factors, including the cost of free labor, high morbidity and mortality rates from diseases such as malaria and smallpox, and the perceived attributes of different African peoples spurred the exportation by Arab, Muslim, and Swahili merchants of an estimated 2.9–3.65 million men, women, and children from diverse populations in southern and eastern Africa, Madagascar, and the Horn of Africa to Arabia, the Persian Gulf, South Asia, and Southeast Asia between 800 and c.1900. European involvement in this transoceanic slave trade began during the early 16th century and continued well into the 19th century. This diaspora’s legacy includes the presence of communities of African descent in modern Iran, India, Sri Lanka, and Indonesia.
The Archaeology of Khami and the Butua State
Authors: Mukwende Tawanda
Published: October 2020

The Butua state was one of the largest pre-colonial state systems, established in southern Africa in the early 15th century. The state was initially centered at Khami but the capital moved to Danamombe in the 17th century. A defining characteristic of the Butua state was its architecture, which is predominantly made up of terraced platforms built using the technology of dry-stone masonry. The state covered a large area that includes modern-day southern and south-western parts of Zimbabwe, north-east Botswana, and northern South Africa. The Butua state thrived on a number of key economic activities that included mining of various minerals, including gold, which was in high demand from Portuguese and Swahili traders on the Indian Ocean coast. Various metals were also processed to provide a range of utilitarian or ornamental objects made of gold, copper, iron, or alloys of more than one metal. Other economic pillars of the Butua state included cattle farming, agriculture, and local exchange of commodities as well as participation in global exchange networks through the Indian Ocean.
Three Traditions of International Theory
Authors: Keene Edward
Published: October 2020

The English School conceived “international theory” as a way to approach the political philosophy and political speculation by examining historical traditions of international relations. The starting point for this line of inquiry was to organize the wide range of material contained in the history of ideas about international politics into a much simpler, and thus more intelligible, scheme, in the event comprising three traditions. Martin Wight called them realism, rationalism, and revolutionism, but they are also known as Hobbesianism (or Machiavellianism), Grotianism, and Kantianism. The fundamental difference between the three traditions is that each represents an idea of what international society is, from which they derive various propositions about more specific topics such as how to deal with peoples from different cultures, how to conduct diplomacy and wage war, or what obligations under international law are. For realists, international society is the state of nature, and since they see the state of nature as a state of war, the answer to the question “What is international society?” is “nothing.” Rationalists agree that international society is the state of nature, but for them it is a state of “goodwill, mutual assistance and preservation,” and so “international society is a true society, but institutionally deficient; lacking a common superior or judiciary.” Revolutionists, by contrast, reject the analogy with the state of nature. Instead, they have an immanent conception of international society, in the sense that they look beyond the apparent or present reality of a society of sovereign states and see behind it a true international society in the form of a community of mankind. Ultimately, these three traditions has exercised a profound influence on the ways in which international relations scholars think about the history of ideas.
Design Anthropology
Authors: Miller Christine
Published: October 2020

Design anthropology and the factors that converged to facilitate its emergence are examined. Design anthropology has been alternately described as a “fast-developing academic field” and “distinct style of knowing” (Otto and Smith), “an emerging transdisciplinary field” (Miller), and “as a distinct subfield of interdisciplinary research” (Clark). These descriptions have in common an agreement that design anthropology is a distinct form of knowledge production that integrates design and anthropological practice and theory that is supported by a growing network of proponents, both academic and practitioner. Design anthropology’s origins have been traced to several factors: the emergence of the participatory design movement in Scandinavia toward the end of the 1990s, the introduction of ethnography in design in the late 1970s, and the earlier influence of the work of designer and educator Victor Papanek in the early 1960s. In the United States, it is often categorized as a subdiscipline of business anthropology. Within Europe and Scandinavia, it is accepted as a field in its own right with a “distinct style and practice of knowledge production.” In spite of these differences and amidst the creative tension resulting from the convergence of anthropological and design methods, concepts, theory, and practice, design anthropology has emerged as a new form of naturalistic inquiry that is based on rigorous empirical research and critical inquiry, a transdisciplinary field that is intentionally interventionist, participatory, and transformative.

Design anthropology reflects shifting attitudes and changing modes of engagement in its parent fields. Within anthropology, the concept of an interventionist, transformative, and future-oriented practice runs counter to deeply embedded attitudes around passive observation research and ethics. Likewise, in design where craft, “doing,” and “making” have dominated, there is a renewed surge of interest in more scholarly-based design research, emphasizing empirical research and a designerly version of theoretical reflection. Theory in design has traditionally been related to various aspects of form. Design theory is also “made through” design. Johan Redström refers to this form of theory as “transitional theory,” “a kind of design theory that is inherently unstable, fluid, and dynamic in nature.” This conceptualization of theory is similar to the grounded theory approach in the social sciences in which theory emerges from original data and is developed from the ground up.

Beginning with a summary of the conditions and forces that engendered the emergence of design anthropology, the field is described as evolving in ways that are provoking change in traditional forms of design and anthropology. Beyond the influence on its parent disciplines, design anthropology represents an evolving trajectory of emerging fields that open to the possibility of imagining, designing, and co-creating sustainable futures based on social justice and virtuous cycles of growth.
Indian Gaming
Authors: Arnold Laurie
Published: October 2020

Indian gaming, also called Native American casino gaming or tribal gaming, is tribal government gaming. It is government gaming built on sovereignty and consequently is a corollary to state gambling such as lotteries rather than a corollary to corporate gaming. While the types of games offered in casinos might differ in format from ancestral indigenous games, gaming itself is a cultural tradition in many tribes, including those who operate casino gambling. Native American casino gaming is a $33.7 billion industry operated by nearly 250 distinct tribes in twenty-nine states in the United States. The Indian Gaming Regulatory Act (IGRA) of 1988 provides the framework for tribal gaming and the most important case law in Indian gaming remains Seminole Tribe of Florida v. Butterworth, in the US Fifth Circuit Court of Appeals, and the US Supreme Court decision over California v. Cabazon Band of Mission Indians.
The Rise of the Sunbelt South
Authors: Jewell Katherine R.
Published: October 2020

The term “Sunbelt” connotes a region defined by its environment. “Belt” suggests the broad swath of states from the Atlantic coast, stretching across Texas and Oklahoma, the Southwest, to southern California. “Sun” suggests its temperate—even hot—climate. Yet in contrast to the industrial northeastern and midwestern Rust Belt, or perhaps, “Frost” Belt, the term’s emergence at the end of the 1960s evoked an optimistic, opportunistic brand. Free from snowy winters, with spaces cooled by air conditioners, and Florida’s sandy beaches or California’s surfing beckoning, it is true that more Americans moved to the Sunbelt states in the 1950s and 1960s than to the deindustrializing centers of the North and East.

But the term “Sunbelt” also captures an emerging political culture that defies regional boundaries. The term originates more from the diagnosis of this political climate, rather than an environmental one, associated with the new patterns of migration in the mid-20th century. The term defined a new regional identity: politically, economically, in policy, demographically, and socially, as well as environmentally. The Sunbelt received federal money in an unprecedented manner, particularly because of rising Cold War defense spending in research and military bases, and its urban centers grew in patterns unlike those in the old Northeast and Midwest, thanks to the policy innovations wrought by local boosters, business leaders, and politicians, which defined politics associated with the region after the 1970s. Yet from its origin, scholars debate whether the Sunbelt’s emergence reflects a new regional identity, or something else.
Juneteenth and Emancipation Celebrations
Authors: Blanck Emily
Published: October 2020

Emancipation celebrations in the United States have been important and complicated moments of celebration and commemoration. Since the end of the slave trade in 1808 and the enactment of the British Emancipation Act in 1834 people of African descent throughout the Atlantic world have gathered, often in festival form, to remember and use that memory for more promising futures. In the United States, emancipation celebrations exploded after the Civil War, when each local community celebrated their own experience of emancipation. For many, the commemoration took the form of a somber church service, Watch Night, which recognized the signing of the Emancipation Proclamation on January 1, 1863. Juneteenth, which recognized the end of slavery in Texas on June 19, 1865, became one of the most vibrant and longstanding celebrations.

Although many emancipation celebrations disappeared after World War I, Juneteenth remained a celebration in most of Texas through the late 1960s when it disappeared from all cities in the state. However, because of the Second Great Migration, Texans transplanted in Western cities continued the celebration in their new communities far from Texas. In Texas, Juneteenth was resurrected in 1979 when state representative, later Congressman, Al Edwards successfully sponsored a bill to make Juneteenth a state holiday and campaigned to spread Juneteenth throughout the country. This grassroots movement brought Juneteenth resolutions to forty-six states and street festivals in hundreds of neighborhoods. Juneteenth’s remarkable post-1980 spread has given it great resonance in popular culture as well, even becoming a focus of two major television episodes in 2016 and 2017.
Phonetic Correlates of Sex, Gender and Sexual Orientation
Authors: Simpson Adrian P. , Weirich Melanie
Published: October 2020

Speech carries a wealth of information about the speaker aside from any verbal message ranging from emotional state (sad, happy, bored, etc.) to illness (e.g., cold). Central features are a speaker’s gender and their sexual orientation. In part this is an inevitable product of differences in speakers’ anatomical dimensions, for example on average males have lower pitched voices than females due to longer, thicker vocal cords that vibrate more slowly. Arguably much more information has been learned by a speaker as they construct their gender or identify with a particular sexual orientation. Differences in speech already begin in young children, before any marked gender-related anatomical differences develop, emphasizing the importance of behavioral patterns. Gender, gender identity, and sexual orientation are encoded in speech in a range of different phonetic parameters relating to both phonation (activity of the vocal folds) and articulation (dimensions and configuration of the supraglottal cavities), as well as the use of pitch patterns and differences in voice quality (the way in which the vocal folds vibrate). Differences in the size and configuration of the supraglottal cavities give rise to differences in the size of the acoustic vowel space as well as subtle differences in the production of individual sounds, such as the sibilant [s]. Furthermore, significant and systematic gender-specific differences have been found in the average duration of utterances and individual sounds, which in turn have been found to have a complex relationship to the perception of tempo.
Health Profession Centrism
Authors: Pecukonis Edward
Published: October 2020

The concept of health profession centrism and its effects on interprofessional education is important to Social Work practice. Profession centrism is concerned with a student’s professional socialization and their ability to work effectively with other health professionals and clients. This cultural frame determines the salience of curriculum content, core values, practice rituals and customs. It determines the meaning and etiology of symptoms and what constitutes health and treatment success. The interprofessional education (IPE) agenda is often seen as “soft curriculum” content and put to the side for the rigors of health sciences. Paradoxically, it is these issues of communication, ethics, role definition, and working as a team that creates problems among health professionals which compromise safety and efficiency in patient/client care. Learning to minimize profession centrism is a critical education and training objective for health social workers.
TRUU-Lab: Methods for Optimization of Test Names for Understanding and Utilization
Authors: Wang Julia , Garnett Emily , Bierl Charlene , Jackson Brian , Singh Ila
Published: October 2020

Poor understandability of laboratory test names increases risk for inappropriate test utilization and medical errors. Yet, human understandability has not been a major consideration in existing laboratory test names or naming guidelines. TRUU-Lab (Test Renaming for Understanding and Utilization for Laboratory Test Names) is a national initiative that now has more than 45 members representing more than 20 academic and industry organizations, the CDC, the FDA, and organizations outside of the US. The goals of the initiative include: 1) Identify root causes and challenges in understanding and using laboratory test names; 2) Share resources related to potential solutions; 3) Develop consensus guidelines for laboratory test naming; 4) Establish consensus names for existing laboratory tests; and 5) Promote the adoption and implementation of consensus laboratory test names. Previous studies have addressed the first two goals of this initiative by identifying problematic test names and features of test names that contribute to misutilization. We also identified advantages and limitations of current test naming guidelines and previous standardization efforts. This study addresses goals 3 and 4 of the TRUU-Lab initiative. We have adopted an iterative process of guideline development, to make use of feedback from establishing consensus names to improve guidelines and vice versa. Preliminary work in this area has focused on definition of optimal laboratory test names from a human understandability perspective. By analysis of test characteristics through the process of test name redefinition, we found that the requirements for optimal understandability vary with respect to clinical scenario and provider background. This highlights the need for naming guidelines to permit flexibility in the components and presentation format for laboratory test display names. We are using results from this work to construct idealized candidate test names given an appropriate clinical scenario. Candidate names will be evaluated by survey studies through the Brand Institute, which offers expertise in pharmaceutical name and brand identity development. We are assessing different laboratory test names under controlled conditions, with studies conducted in two phases. The first phase, conducted through pilot surveys sent to primary care providers, assesses intuitive name preferences given a short and specific prompt. The second phase will use a simulated electronic medical record environment to present mock clinical scenarios, which surveyed physicians will use to select an appropriate test. We expect that results from survey studies will directly inform the development of TRUU-Lab naming guidelines, in turn permitting development of better optimized laboratory test names. This process represents a new strategy for intentional design of laboratory test names that are understandable and promote correct provider utilization.
Coagulation Testing Gone Awry; Effect of Direct Oral Anticoagulant (DOAC) Removal on Lupus Anticoagulant Assays
Authors: Casa Daniel , Gil Morayma Reyes
Published: October 2020

Background

Direct oral anticoagulants (DOACs) such as apixaban and rivaroxaban are widely used to treat those with or at risk for thromboembolic disease. However, DOACs have been shown to interfere with coagulation assays making their interpretations challenging. Importantly, lupus anticoagulant (LA) assays using the dilute Russell Viper Venom Time (dRVVT) to screen for patients at increased risk of thrombosis are particularly affected by DOACs leading to inaccurate results. DOAC removal agents are available to improve dRVVT specificity for LA and eliminate assay interferences.

Aims

To evaluate the performance of DOAC-Remove to accurately measure LA in patient plasma.

Methods

10 LA positive and 10 LA negative samples without DOAC as well as normal pool plasma (NPP) were used as controls. We assessed 64 patient plasma samples including 39 patients on apixaban and 25 patients on rivaroxaban (anticoagulation was confirmed by chart review). LA testing by dRVVT was performed using Staclot® DRVV Screen and Staclot® DRVV Confirm reagents on STA R Max analyzer. DRVVT testing was performed before and after DOAC removal (DOAC-Remove, Aniara). DOAC plasma concentrations were measured using STA Liquid Anti-Xa assay. Acceptable DOAC removal was defined as an anti Xa level <0.03 IU/mL. Positive LA was defined as a screen ratio and mix ratio greater than 1.15.

Results

Positive and negative samples without DOAC remained the same after DOAC removal treatment. Factor levels in NPP were not affected by DOAC removal treatment. DOAC removal resulted in shortening of the dRVVT in 91% of the samples. Surprisingly, 6 cases showed prolongation in the dRVVT after DOAC removal. Before DOAC removal, 47 cases (24 apixaban and 23 rivaroxaban) tested positive and 17 tested negative (15 apixaban and 2 rivaroxaban). Following DOAC removal, 28 cases tested positive and 36 tested negative. As expected, many samples of patients on DOAC were found to be falsely positive (27/64; 15 on apixaban and 12 on rivaroxaban). Interestingly, 8 of 64 tests were found to be falsely negative. Of the 8 samples that were falsely negative, 7 were on apixaban and 1 on rivaroxaban. 9 samples that were negative before DOAC removal remained negative after DOAC removal, and 20 tests that were positive before DOAC removal remained positive after DOAC removal for a total of 29 results (45%) that remained unchanged. It was found that DOACs caused inaccurate results in 55% of cases.

Conclusions

Our study was able to demonstrate the effectiveness of DOAC-Remove to eliminate DOACs from patient plasma and provide accurate LA results. DOAC interference on LA assays predictably creates many false positive results, however, presence of DOACs can produce false negative results as well, underlying the importance of pretest screening for presence of anticoagulants in plasma samples.
Donor Engraftment of a HSC-Transplanted CLL Patient Experiencing Richter’ Transformation to DLBCL
Authors: Li Ping , Li Tian , McKirenan Sara , Mapara Markus , Vlad George
Published: October 2020

A patient diagnosed with Chronic Lymphocytic Leukemia (CLL) received HSC transplantation, and displayed stable donor engraftment. Three years after transplantation, the patient experienced a relapse in the form of Diffuse Large B cell Lymphoma (DLBCL). Total blood, bone marrow, lymph node (LN) and lineage specific Chimerism measurements were performed using AmpFlSTR+ (Applied Biosystems) kit.

The patient showed full myeloid engraftment and mixed T and B Chimerism immediately after transplant. Within 6–12 weeks all lineages studied (T, B, NK, myeloid and erythroid) were fully donor (99–100%), which remained stable for over 3 years. A miniscule drop in the B cell lineage Chimerism was noted (97.3%) 42 months after transplantation. Concurrent clinical status (lymphadenopathy, abdominal pain) suggested relapse. Histopathology and flow cytometry studies showed that the patient was experiencing Richter’s transformation (RT) to DLBCL. Molecular oncology testing demonstrated that the DLBCL IgH rearrangement was identical to the original CLL disease. Leftover LN tissue which had been submitted for flow cytometry studies and demonstrated the presence of immunophenotypically aberrant monotypic B cells (>50% of cellularity) was processed for Chimerism and showed 21% donor cells.

RT is defined as transformation from CLL into a more aggressive lymphoma, typically DLBCL, with a reported incidence ranging from 1 to 9%. The median time to RT is 1.9 years after diagnosis. Importantly, RT changes the nature of the hematological neoplasm from leukemia, residing mostly in the blood and bone marrow, to lymphoma, a disease which mainly affects secondary lymphoid organs. Therefore, this patient displayed complete or near complete donor engraftment in the peripheral blood (including in lymphoid lineages) by routine Chimerism testing. The reemergence of neoplastic cells of recipient origin was clearly evident when the test was applied to an affected lymph node. In conclusion RT from leukemia to lymphoma may represent a significant challenge to monitoring disease relapse by Chimerism.
An Unusual Presentation of Pleomorphic Lipoma
Authors: Smith F , Martinez Duarte E
Published: October 2020

Introduction/Objective

Pleomorphic lipomas are benign tumors that typically occur in the shoulder, posterior neck, and back. Here, we present a case of a pleomorphic lipoma arising in an unusual location.

Methods

A 63-year-old male presented with a 1.3 x 1.3 x 0.9 cm enhancing slightly heterogeneous mass in the subcutaneous tissue superficial to the right parotid tail. The mass was biopsied and then excised.

Results

Histopathologic examination of the biopsy and resection specimens revealed an adipocytic neoplasm composed of mature adipose tissue with admixed spindle cells within a myxoid stroma. Lipoblasts, cellular atypia or increased mitotic figures were absent. Numerous floret-like cells were identified. These floret cells are characteristic of pleomorphic lipoma. The tumor cells were diffusely positive for CD34 and negative for desmin, smooth muscle actin, MyoD1, keratin, SOX10, and Melan-A by immunohistochemistry, consistent with pleomorphic lipoma.

Conclusion

Pleomorphic lipomas arising from the periparotid adipose tissue are rare. They tend to have a favorable prognosis with low incidence of recurrence if excised with clear margins. Following complete excision, the patient is doing well.
Cribriform Adenocarcinoma of the Minor Salivary Gland (CAMSG); A Separate and Malignant Entity
Authors: Laharwani H , Woods T , Jackson J , Manucha V , Velasco I
Published: October 2020

Introduction/Objective

Cribriform adenocarcinoma of the minor salivary gland (CAMSG) is a recently described salivary gland neoplasm (SGN) that WHO includes under the polymorphous adenocarcinoma (PAC) subheading. CAMSG is reported to occur mostly in the base of the tongue and lingual tonsils.

Methods

We present a case of CAMSG of buccal mucosa in a 48-year old woman who presented with pain and swelling on the left side of the face that started after tooth extraction. Imaging revealed a large expansile mass (5.8 x 4.3 x 6.1 cm) originating in the left mandibular angle extending into masticator space, maxillary sinus, pterygopalatine fossa, sphenoid, middle cranial fossa, orbit and skull base. Ameloblastoma, primary intraosseous carcinoma, and squamous cell carcinoma were considered. Incisional biopsy revealed a tumor comprised of round to ovoid cells with clear to vesicular nuclei (ground-glass appearance) and occasional mitosis present in irregular solid, cribriform, and microcystic patterns in a hyalinized stroma with the presence of abundant mucin within lobules and stroma.

Results

Differential diagnosis of secretory carcinoma, hyalinizing clear cell carcinoma, and less likely PAC and mucoepidermoid carcinoma were considered, all inconsistent with the imaging findings. The tumor cells were positive for S100 and negative for CD117, ki67, p63, CD117, and TTF-1. Based on a prominent cribriform pattern, vesicular nuclei, and S-100 expression, a diagnosis of cribriform adenocarcinoma of minor salivary gland origin was rendered. The patient subsequently underwent left partial maxillectomy, left partial mandibulectomy, and resection of the skull base and left neck dissection and was staged as pT4bN0, with negative margins and vascular invasion. The patient underwent radiation therapy and at 6- month follow up was alive and healthy. Clinically and histologically CAMSG overlaps with tumors of both salivary and non-salivary gland origin.

Conclusion

Recognition of CAMSG as a distinct entity will help in accurate diagnosis and categorization in the WHO classification of SGNs.
Pulmonary Capillaritis: The Breakdown of the Histologic Features
Authors: Gupta A , Fatemi A , Ducatman B , Khayyata S , Iftikhar H , Nair G
Published: October 2020

Introduction/Objective

Capillary inflammation (capillaritis) is rarely the primary pathologic cause of pulmonary hemorrhage. It may coexist with vasculitis. The aim of this study is to investigate the specificity of five histologic features of pulmonary capillaritis previously described by Mark and Ramirez (discussed below). They are usually treated with corticosteroids and cyclophosphamide or azathioprine.

Methods

A retrospective review of patients with a pathologic diagnosis of capillaritis in open lung biopsies was done. The diagnosis was confirmed by two expert pulmonary pathologists. The slides were reviewed and compared to a control group, who also underwent open lung biopsies for clinical suggestion of pulmonary hemorrhage and no pathologic diagnosis of capillaritis. Cases with malignant neoplasms, large and medium size vasculitis syndromes, and diffuse alveolar damage (DAD) were excluded. The five pathologic features of capillaritis were evaluated and scored as negative (0), focal (1+) and moderate to diffuse (2+) in both groups.

Results

Five cases of pulmonary capillaritis and five cases in control group were identified. The etiology of pulmonary capillaritis in the five identified cases included autoimmune diseases, pulmonary hypertension, non-specific interstitial pneumonia, and idiopathic capillaritis. The average score for the morphologic features of capillaritis versus the control group were as follows: Interstitial erythrocytes and/or hemosiderin (2+ vs 2+), fibrinoid necrosis of capillary walls (2+vs 0), intraalveolar septal capillary occlusion by fibrin thrombi (1+ vs 0), neutrophils and nuclear dust in the interstitium, in the fibrin, and in the adjacent alveolar spaces (2+ vs 1+), and fibrin clots attached to interalveolar septa in a sessile manner (2+ vs 1+).

Conclusion

In this small study, we can conclude that fibrinous necrosis is the most specific finding for pulmonary capillaritis while interstitial erythrocytes and/or hemosiderin is least specific. Therefore, in the presence of fibrinous necrosis; in addition to other supporting features; a pathologist is more inclined to communicate a diagnosis of pulmonary capillaritis to the clinicians.
Extra-nodal Rosai-Dorfman Disease Confined to Breast
Authors: Ozluk E , Shackelford R
Published: October 2020

Introduction/Objective

First described by Rosai and Dorfman in 1969, Rosai-Dorfman Disease (RDD) is an uncommon, idiopathic, reactive lymph node process with an unknown etiology. It may involve extra-nodal organs including the skin, bone, soft tissue, and eyes. However, breast involvement is rare and RDD confined to breast without nodal involvement is extremely uncommon.

Methods

Here we present a case of RDD confined to breast. The patient was a 51-year-old African American woman who was found to have an irregular, solid left breast mass on routine mammogram, which had speculated irregular margins and measured of 37.0 x 32.0 x 32.0 mm. She did not have any symptoms, nor any palpable lymph nodes.

The clinician stated that the lesion was highly suspicious for a breast malignancy and requested a fine needle aspiration (FNA) of the mass, followed by total excision.

Results

An FNA was interpreted as atypical histiocytic cells in a mixed lymphoid background. Histopathologic examination revealed an ill-defined mass with sheets of histiocytes, plasma cells, and a mixed lymphocytic population, with occasional germinal centers. Some of the histiocytes were spindle shaped and associated with storiform collagen deposition. The histiocytes had single and multiple nuclei and exhibited occasional emperipolesis.

Immunohistochemical staining with S100 diffusely highlighted the histiocytes, whereas CD1a was negative. CD3 and CD20 immunostains were positive for mixed-type lymphocytic infiltration. Cytokeratin staining was performed and reassuringly stained only the benign ductal cells. A diagnosis of RDD of the breast was made, based on these histopathologic findings.

Conclusion

We report an example of an extra-nodal RDD involving the mammary gland that was initially suspected to be breast carcinoma. RDD may still be a diagnostic challenge, especially in a patient with suspected carcinoma. It is the pathologist’s role to lead the clinician to the proper diagnosis and render a correct histopathologic diagnosis.
Pediatric Pancreatic Teratoma: A Rare Case Report
Authors: Sameeta F , Anderson S A , Manci E , Haque M
Published: October 2020

Introduction/Objective

Teratomas are germ cell neoplasms arising from three germinal layers. They are classified as mature or immature. Mature cystic teratomas (MCTs), also known as dermoid cysts, are benign lesions. Common locations include the sacrococcygeal region, ovaries, testes, brain, mediastinumand retroperitoneum. MCT is extraordinarily rare in the pediatric pancreas; only 11 such cases have been reported in the English literature.

Methods

This eleven-month-old female presented for evaluation of two cystic masses in the body and tail of the pancreas. These masses were initially imaged as anechoic cysts in utero by ultrasound at 19 weeks gestational age and followed carefully over the interval. Her past medical history included a left upper lobectomy for congenital lobar emphysema. The pancreatic cysts were excised by laparoscopy.

Results

Grossly, the two tan-pink cysts measured 2.5 cm and 3.1 cm in greatest dimensions, had smooth inner linings and contained clear fluid. Microscopically, the cyst linings included low cuboidal, columnar, ciliated pseudostratified columnar respiratory or fundal gastric epithelia with underlying serous/mucous glands and smooth muscle. These findings were diagnosed as MCT.

Typically, MCT of pancreas have nonspecific clinical presentations, serum markers and imaging; all depending on the tissue types present; so, the diagnosis is primarily made postoperatively by pathological evaluation. Previously reported cases presented as single cysts, ranged 4 months to 16 years in age and measured 8 to 18 cm in greatest dimension. Complete surgical excision and careful follow-upare the mainstay of therapy

Conclusion

Pediatric pancreatic MCTs are extraordinarily rare, so the preoperative diagnosis and treatment is difficult. This case of MCT is the first reported multicystic presentation, the first documented fetal imaging and the smallest size in the English literature. This report shows that MCT must be considered in the differential diagnoses of fetal abdominal cysts and in multicystic pediatric pancreatic masses.
Apply Molecular Method To Diagnosis A Very Rare Bone Primary Myoepithelial Tumor: A Case Report
Authors: Chen F , Syed H
Published: October 2020

Introduction/Objective

A 38-year-old female without a history of trauma and malignancy presented with left knee pain and swelling for two weeks. MRI and PET scan find a left knee mass arising from the bone along the medial metaphysis of the distal femur. She underwent femur resection, and the specimen was sent for pathology evaluation.

Methods

Grossly, the cut surface of the sample revealed a 4.5 x 2 cm area of hemorrhagic softening of the bone with adjacent soft tissue nodules. Microscopically, the tumor showed biphasic or multiphase morphologic features, prominently presented with areas showing well-differentiated epithelial features and other areas with spindling and sheets of tumor cells. Areas suspicious for a vascular invasion were seen at the periphery of the soft tissue extension of the tumor. Immunohistochemistry stains showed the tumor cells are positive for vimentin, AE1/3, EMA, CK7, CK19, GATA3, and BRST2; and are negative for S100, HMB45, GFAP, Calponin, CDX2, PAX8, WT1, P63, CD34, and ER. The molecular test showed positive for the ESWR1 gene but negative for SYT gene translocation.

Results

A diagnosis of primary myoepithelial carcinoma of bone extension into surrounding soft tissue was made.

Conclusion

The most challenging differential diagnosis for this case is metastatic breast cancer. Many of the positive epithelial stains distinctly highlight the epithelial featured geographic areas sparing the background spindled stroma. The positive staining of GATA3 and BRST2, two commonly used breast linage markers, is unusual and not known in myoepithelial carcinoma. In light of the EWSR1 positive and SYT FISH negative results, combined with the morphologic features, locations as well as negative PET scan against its breast origins. Although many myoepithelial markers, such as S100, Calponin, P63, and GFAP were negative, make this case very unique. The molecular diagnosis is the mainstay for this final diagnosis.