bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do we need Diagnostic Decision Support For Pathologists in Anatomic Pathology Laboratory Information System (APLIS)?
Authors: Sonawane S S 
Published: November 2022

Abstract

Introduction/Objective
On a typical day, pathologists spend time not just looking at the slides but have various information needs in order to facilitate the sign-out. This study was performed to find out various resources utilized by pathologists to facilitate the sign-out and if having the diagnostic decision support in APLIS will improve the sign-out experience? To answer these questions a survey was created.

Methods/Case Report
An anonymous Google survey of 10 questions inquiring about practice setting, training level, work experience, various resources utilized to facilitate daily sign-out, time spent to find the information, and ways the sign-out experience can be enhanced was created and distributed among the pathologists via a social media platform.

Results (if a Case Study enter NA)
85 pathologists participated in the survey, and the results showed that 66% of respondents worked in an academic setting while 34% worked in a community practice setting. 37% of respondents had work experience &gt;5 years while 23% had work experience &lt; 5 years and the remainder of them were in training. 44% of them had a subspecialty sign-out system. EPICBeaker (27.3%) was the most commonly utilized APLIS system, followed by Cerner (22%) and Copath(16%), and reminder used Novopath, soft path, Med-tech, and Power path. The pathologists use various resources to facilitate daily sign out which include textbooks, ebooks, PubMed, CAP protocols, WHO books, own notes, and internet searches. Reasons to refer to these resources include finding the grossing guidelines, differential diagnosis, special or immunohistochemical stains, practices guidelines, correct tumor stage, and grade or molecular tests. On a typical day, 41% of the respondents spend 1-2 hours/day, and 25% of the respondents spend 2-3hrs/day finding the correct information to sign out their cases. 81% of the pathologists responded that if all the resources are available in APLIS will increase their productivity.

Conclusion
Having all the resources in one place in APLIS in the form of diagnostic decision support will enhance the sign-out experience for pathologists and will increase productivity.
Digital Pathology, A Cognitively Efficient Teaching Strategy: Current Application and a Glimpse into Future
Authors: Saxena R , Moore N , Johnson J 
Published: November 2022

Abstract

Introduction/Objective
If pathology education is to be efficacious, it must embrace the ramifications of cognitive load of the learners, to optimize the capacity of the working memory. When undergraduate students commence their learning of pathology, they encounter a heap of new data and classifications. Simplifying these intricate systems into assimilable subschemas and items is key for effective transfer of knowledge. The minimization of the profundity of intrinsic cognitive load is essential, considering that its impact on pathology beginners is often left unaccounted, both in active learning as well as in traditional methods of instruction. In today’s digital generation, digital pathology plays a key role by intertwining disease morphology with clinical presentation and fortifying its pathophysiologic basis. We designed a teaching methodology utilizing digital pathology to evaluate its effect on cognitive load.

Methods/Case Report
Active learning was implemented online using digital pathology, molecular pathology, and laboratory data in case-based setting with question-answer sessions. In small groups, students were encouraged to analyze digital pathology slides with the help of annotations and identify areas of histopathological significance. They utilized this information further to make an accurate diagnosis and answer corresponding questions, with access to answers available later, complemented with algorithms and concept maps. A 14-item structured questionnaire was delivered afterwards to evaluate the efficacy and popularity of the exercise.

Results (if a Case Study enter NA)
End-of-term examination results showed that learners developed higher-order comprehension skills along with a greater potential in interpreting histopathological data towards solving case studies. Feedback revealed a higher degree of overall satisfaction and increased ability to retain information.

Conclusion
Digital transformation of pathology education provides the kind of framework where learning happens naturally - developing in small boosts of progress until expertise is achieved, and students appreciate the value of the ‘learned thing’ along with the real utility of that knowledge. The innovative approach utilizing digitization and integration offers the opportunity of decrement in intrinsic cognitive load by invoking students to build better, reliable, long-lasting, supportable and inclusive schemata while correlating the relevant incoming information with previously stabilized knowledge and consolidating the entirety of understanding.
Smooth Muscle Proliferation in Hamartomatous Polyps Mimicking Prolapse in Pediatric Patients with PTEN Hamartoma Tumor Syndrome
Authors: Torres C , Morse P , He M 
Published: November 2022

Abstract

Introduction/Objective
In the field of pediatric pathology, it is vital to find recognize cases that could be associated with cancer predisposition syndromes. PTEN hamartoma tumor syndrome (PHTS) is an inherited set of disorders caused by germline inactivating mutations of the PTEN tumor suppressor gene. In the GI tract, PHTS is associated with hamartomatous polyps that can display smooth muscle overgrowth. We therefore present a series of three cases of colonic polyps with smooth muscle overgrowth, mimicking prolapse, in pediatric patients with PTEN mutations.

Methods/Case Report
The first case is a 19-year-old male with PHTS who underwent colonoscopy due to hematochezia. Two pedunculated polyps were removed from the transverse and descending colon. Both polyps showed prominent smooth muscle and ganglion cells in the lamina propria. In the second case, a 9-year-old male with PHTS also underwent colonoscopy due to hematochezia. At least 20 sessile 2-4mm polyps were present in the colon. Histology showed smooth muscle proliferation and ganglion cells in the lamina propria. The third case is a 13-year-old male with undiagnosed PHTS, but a history of Chron’s disease, trichilemmoma, and plantar wart like lesions. He underwent upper and lower endoscopy for Chron’s disease assessment. Three polyps were removed from the descending colon. One was a juvenile polyp while the other two showed prominent smooth muscle proliferation and ganglion cells in the lamina propria.

Results (if a Case Study enter NA)
NA

Conclusion
Histologically, all hamartomatous polyps had smooth muscle overgrowth, confirmed by SMA immunostain, which could easily be confused with prolapse type changes such as in solitary rectal ulcer syndrome. The key in distinguishing between the two is by recognizing ganglion cells within the lamina propria, confirmed by S100 immunostain. Additional clues include identifying mucosal ganglion cells, disarray of crypt architecture, and fibromuscular proliferation as well as considering the location and number of polyps. It is vital for pathologists to recognize the differential diagnosis of polyps with smooth muscle proliferation, especially in pediatric populations where a diagnosis of cancer predisposition syndromes may not be established. Furthermore, is important to discuss pursuing PTEN genetic testing with clinical colleagues as it has immense medical implications and requires a thorough future medical following.
Primary Epithelioid Pulmonary Angiosarcoma with WAIHA and Thrombocytopenia: A Rare Association
Authors: Lazim A , Alsammak M , Hennawy H 
Published: November 2022

Abstract

Introduction/Objective
Angiosarcomas accounts for approximately 1%-2% of sarcomas, particularly involving the deep soft tissue. As a subtype, primary epithelioid angiosarcoma is an extremely rare neoplasm. Herein, we present an unusual primary epithelioid angiosarcoma of the right upper lung lobe with multiple nodal and bony metastases and associated severe form of autoimmune hemolytic anemia (WAIHA) and thrombocytopenia.

Methods/Case Report
Our case is a 79-year-old female with a recent onset of warm type autoimmune hemolytic anemia with positive coombs test and thrombocytopenia. The patient serum was also positive for EBV (IgG and IgM). On chest CT scan, a right upper lobe, metabolically active lung mass with mediastinal lymphadenopathy was found. Metabolically active bilateral osseous lesions identified within thoracic spine, ribs, bilateral humeri and femurs. A transbronchial core biopsy of the lung mass revealed poorly differentiated epithelioid hemorrhagic neoplasm with extensive necrosis and vascular background. The tumor cells are positive for AE1/AE3, CK7, FLI-1, BRG1 (SMARCA4, retained), and vimentin; and faint weak focal membranous staining for CD31, Factor VIII, and ERG. They are negative for CK20, TTF-1, Napsin-A, p63, p40, SMA, Melan-A, HMB45, GATA3, PAX-8, CDX-2, HepPar, synaptophysin, calretinin, CAMTA1, EBER (EBV) and S100 (Figure-1-A-D, H&E, 10X, CK AE2/AE3, FLI-1, CD31). This immunoprofile and histologic features favor epithelioid angiosarcoma.

Results (if a Case Study enter NA)
NA.

Conclusion
Comprehensive morphological and immunohistochemical findings supported the diagnosis of epithelioid angiosarcoma. The importance of reporting this case was the unusual pulmonary primary presentation, associated nodal and osseous secondary involvement, together with the unique systemic presentation with warm autoimmune hemolytic anemia and thrombocytopenia in a patient with active EBV infection.
Three Cases Highlighting Three Potential Pitfalls in the Platelet Refractory Workup
Authors: Attieh M , Dent E A , Then C E , Barrette E , Alter D N , Duncan A , Roback J D , Sullivan H C , Happney L 
Published: November 2022

Abstract

Introduction/Objective
Platelet refractory (PR) patients do not achieve expected post-transfusion platelet counts. We investigate such patients with a post-transfusion platelet count, indirect Platelet Antibody Screen (ind-PAS), Class I HLA Antibody (HLA-Ab) testing, and platelet crossmatch (PXM). The following three cases highlight potential pitfalls of laboratory investigations for PR patients.

Methods/Case Report
Case #1 (57-year-old male with AML) revealed discrepant predicted and observed donor compatibility. Antibody testing demonstrated no platelet glycoprotein antibodies and HLA-ab to B13, corresponding to 4% calculated PRA (CPRA), indicating 96% predicted donor compatibility. However, PXM revealed that the patient was compatible with 11/14 (79%) screened donors. Communication with the reference laboratory revealed that two PXM incompatible units were ABO incompatible. Case #2 (27-year-old female with aplastic anemia) is a highly sensitized patient (99% CPRA). PXM revealed compatibility with 1/14 screened donors; however, she failed to respond to the compatible donor. To investigate this poor response, patient’s plasma was tested against HLA incompatible donors. Neat serum demonstrated compatibility with all donors, whereas 1:8 dilution resulted in positive crossmatches with half the donors. The false negative crossmatches are likely explained by prozone in the setting of high HLA-ab burden. Case #3 (79-year-old male with AML) demonstrated a discrepancy between the ind-PAS (PakPlus, Immucor), which was negative for HLA-ab, and HLA specificity testing (LABScreen, OneLambda), which revealed Class I antibodies, corresponding to 38% CPRA. Per the ind-PAS package insert, the sensitivity of the assay was 85%-91% compared to selected HLA-ab tests; other sources have demonstrated lower sensitivity of 68%.

Results (if a Case Study enter NA)
NA.

Conclusion
The three cases highlight the importance of investigating incongruent results. Cases #1 and #2 demonstrate pitfalls in the PXM: ABO incompatibility can result in positive PXM and false-negative PXM can occur in the setting of high HLA-ab burden. Case #3 reveals the importance of knowing a test’s limitation, especially sensitivity. Centers that only perform ind-PAS may miss HLA-ab detection.
Workflow Improvement after Implementing Remote Blood Allocation Devices at an Academic Medical Center Blood Bank
Authors: Quach T , Abdelmonem M , Nguyen A , Yoshizuka S , Vukic K , Cai W , Howard E , Kilambi S 
Published: November 2022

Abstract

Introduction/Objective
Patients with hematological cancer routinely receive red blood cell (RBC) transfusions in the outpatient infusion clinical setting as part of their clinical therapy. Typically, RBCs are delivered to the outpatient infusion clinic via the pneumatic tube (P-tube). However, due to the recent expansion of the hospital footprint and the new location of the transfusion services, the P-tube encountered challenges that impacted the reliability of the delivery of RBC, which can delay patient care and affect patient satisfaction. This study’s purpose is to evaluate the pre-and post-implementation of the Haemobank-20 (HB20), remote blood storage and dispensing device, by reviewing the turn-around time (TAT) and the number of orders fulfilled outside of the transfusion service.

Methods/Case Report
Blood products are stocked to the HB in the infusion center. An electronic transfusion schedule is reviewed the night before scheduled transfusions to ensure appropriate inventory. When a patient is ready for the transfusion, the clinical nurse will use the device to retrieve blood products for the patient from the HB20. The average timed delivery time from the transfusion service to the outpatient infusion center is about 11 minutes. Data was retrospectively gathered from a 10-month interval before and after HB20 implementation to evaluate the number of orders fulfilled by the HB20.

Results (if a Case Study enter NA)
The HB has helped maintain nurse-to-patient ratios, reduced traffic at the blood bank issue window, and significantly sped up the turnaround time of RBCs from 11 minutes to less than 60 seconds. Before HB implementation, staff at the blood bank received 2853 units of RBCs through the blood bank window. This has been decreased by 61.2 percent to 1136 RBCs.

Conclusion
Implementing the Haemobank-20 in the outpatient infusion center has successfully reduced the turnaround time and the workload within the Transfusion Services. The current results study demonstrate that the remote blood-release system is safe and helpful in improving the efficiency of blood issue for patients in remote outpatient locations.
Development and Validation of a Strong Cation Exchange Chromatographic Column Coupled with High-Performance Liquid Chromatography Method for Meropenem and Evaluation of Its Stability in Human Plasma: Application to the Therapeutic Drug Monitoring
Authors: Liu Ting , Chen Ling , Yu Panpan , Li Qingyu , Lou Jiang 
Published: November 2022

Abstract
Meropenem is a wide inter-individual variability in the pharmacokinetic, and standard dosing may not be adequate in critically ill patients. Therapeutic drug monitoring is a useful tool to optimize dosing. Meropenem is the amphoteric compound with an isoelectric point of 5.15. The secondary amino group of meropenem is positively charged when pH ≤ 5.4, thus we attempted to separate by strong cation exchange (SCX) column using acetonitrile/25-mM potassium dihydrogen phosphate (pH 3.0; 60:40) as mobile phase, and good peak shape and effective separation obtained. Generally, meropenem were unstable in plasma. We try to investigate stability of plasma samples using the medium QC sample with or without 3-(N-morpholino) propanesulfonic acid (MOPS) as stabilizer solutions at possible conditions during handling and storage. Meropenem showed higher stability at −80°C, and addition of MOPS might increase the short-term and extracted samples stability. This method is suitable for the quantification of meropenem in human plasma from 0.5 to 100 μg/mL. The accuracy was ranged from 96.53 to 101.11% with relative standard deviation ≤ 4.76%. The method has been used for determined 63 critically ill patients treated with meropenem. During the first measurement, 11 patients showed trough levels below the target ranges despite standard dosing. Through continuous or prolonged infusion, 8/11 patients (72.73%) led to adequate trough levels. The described SCX–high-performance liquid chromatography method for meropenem in human plasma is a powerful tool for therapeutic drug monitoring.
On a time-discrete convolution—space collocation BEM for the numerical solution of two-dimensional wave propagation problems in unbounded domains
Authors: Monegato Giovanni 
Published: November 2022

Abstract
For the numerical solution of a classical two-dimensional Dirichlet exterior problem for the wave equation in the time domain, we consider a space-time boundary integral equation approach, based on its discretization by means of the coupling of a time discrete convolution quadrature of order 2, with the classical continuous piecewise linear boundary element method. The latter is either the Galerkin method or the collocation one, this being computationally much cheaper. For the efficient evaluation of most of the integrals generated by these two boundary element methods, but also for the subsequent analysis, we first define a new Gaussian quadrature. After recalling that stability and convergence have been proved for the Galerkin method, while for the collocation one we only have numerical evidences of these properties, to (partially) fill this gap, we first note that collocation can be obtained directly from the Galerkin system, after discretizing its inner product integral by using the composite trapezoidal rule, which in this case turns out to be the Gaussian rule mentioned above with $1$ node. Then, we show that for all (positive) time step-sizes $\varDelta _t$, when we let $h\rightarrow 0$, independently from $\varDelta _t$, the matrix of the linear system produced by the collocation method, properly normalized, converges, in the $\infty $-norm, to the corresponding Galerkin matrix. The behavior of the associated absolute and relative errors in the $\infty $-norm, as $h\rightarrow 0$, are $O\big (h^{\frac {5}{3}}+\varDelta _t^{-(1+\varepsilon )}h^{\frac {5+\varepsilon }{2}}[|\!\ln \varDelta _t|+|\!\ln h|]\big )$ and $O\big (h^{\frac {2}{3}}/|\!\ln \varDelta _t|+\varDelta _t^{-(1+\varepsilon )}h^{\frac {3+\varepsilon }{2}}[1+|\!\ln h|/|\!\ln \varDelta _t|]\big )$, respectively, with $\varepsilon&gt;0$ as close as one likes to $0$ and the $O(\cdot )$ constant independent from $\varDelta _t, h$. Some possible extensions of the investigation we carried out are also mentioned.
Inequalities in the prevalence of skilled birth attendance in Ghana between 1993 and 2014
Authors: Tetteh Justice Kanor , Ameyaw Edward Kwabena , Adu Collins , Agbaglo Ebenezer , Agbadi Pascal , Nutor Jerry John 
Published: November 2022

AbstractBackgroundGlobally, maternal and neonatal health remains a public health priority, particularly for resource-constrained regions like sub-Saharan Africa (SSA). Skilled birth attendance (SBA) is essential in promoting maternal and neonatal health. This study investigated the inequalities in the prevalence of SBA in Ghana using data from the Ghana Demographic and Health Survey (GDHS) between 1993 and 2014.MethodsData were analysed using the World Health Organization's Health Equity Assessment Toolkit software. In analysing the data, we first disaggregated SBA by four inequality stratifiers: wealth index, education, residence, and region. Second, we measured the inequality through summary measures, namely difference, population attributable risk, ratio, and population attributable fraction. A 95% confidence interval was constructed for point estimates to measure statistical significance.ResultsThroughout the period, SBA was highest among women in the highest wealth quintile and those with a secondary or higher level of education. The analysis also indicated that SBA was highly concentrated among urban residents in 1993 (80.78 [95% uncertainty interval {UI} 76.20–84.66]) and persisted to 2014 (91.55 [95% UI 88.80–93.68]). In 1993, Northern region recorded the lowest prevalence of SBA in Ghana (15.69 [95% UI 11.20–21.54]) and the region consistently recorded the lowest SBA prevalence even into 2014 (38.21 [95% UI 27.44–50.27]).ConclusionsThere are significant inequalities in SBA across education, wealth, residence, and region in Ghana. To enhance SBA, there is the need for policymakers and interventionists to design and develop targeted policies and programs that are tailored to the needs of the subpopulations at risk of low SBA: women with no formal education, those within the poorest wealth quintile, rural-dwelling women and women in the Northern region. This will facilitate the uptake of SBA and ultimately translate into the realization of Sustainable Development Goals 3.1 and 3.2.
The Role of Forensic Veterinary Toxicology in Pet Custody Cases
Authors: Turkmen Zeynep , Zengin Simge , Kuloglu Genc Merve , Yayla Murat , Tekin Bulbul Tugba , Mercan Selda 
Published: November 2022

Abstract
Forensic veterinary toxicology has become a popular branch of toxicology, dealing with animal cruelty (e.g., malicious poisoning), regulatory issues (e.g., contamination of the feed supply chain), insurance litigation or wildlife poisoning. The current study highlights the importance of the toxicological aspects of animal health-related disagreements in a pet custody case following a divorce. In this study, the custody case of three dogs and a cat was concluded with the aid of toxicological test results that were obtained from the pets’ blood samples for the first time in Turkey. The results confirmed the presence of benzoylecgonine in one of the blood samples, as alleged by one of the owners. The study also aims to raise the veterinarians’, as well as the judicial system members’, awareness of drug abuse in pets.
Some linguistic features of the dialect of Acre and their possible explanation by the history of the city
Authors: Zuʾbi Amal 
Published: November 2022

Abstract
This paper introduces the main characteristics of a variety of Acre Arabic spoken by local residents in Acre today. The description provided is based on new evidence gathered in 2016–17 through interviews with various people, particularly older people, who grew up in Acre. Throughout the paper I discuss a number of distinctive phonological, morphological and syntactical features and compare them to Palestinian Arabic, especially Galilean Arabic, and also to Old Damascene Arabic and Egyptian Arabic. While some features occur in Palestinian Arabic but under different circumstances, other features do not occur in Palestinian Arabic, but are characteristic of Syrian Arabic and/or Egyptian Arabic dialects. Features of the dialect that are unique to Acre are presented, along with some speculations on how the linguistic evidence reflects the history of the city. Finally, a transcribed and translated text is provided.
Towards a Better Understanding of the Ḥarsusi Language
Authors: Rubin Aaron D 
Published: November 2022

Abstract
The Ḥarsusi texts collected by T.M. Johnstone and published by Harry Stroomer (2004) comprise the only corpus of Ḥarsusi texts published to date, and thus remain an invaluable source for the study of that language. A re-examination of the audio recordings of these texts reveal that the draft manuscripts on which the published edition was based contain numerous discrepancies, including many errors. By using these audio recordings in order to obtain corrected readings, we are able to better analyse and more accurately describe the phonology and morphology of Ḥarsusi, a language for which we as yet have no comprehensive description.