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Background: Hormonal changes in pregnancy are known to alter melanocytic lesions, with some nevi noted to have increased mitotic figures and increased Ki‐67 proliferation index. Additionally, cytomorphologic changes have also been noted, referred to as superficial micronodules of pregnancy. These changes may alarm the pathologist for malignancy, particularly nevoid melanoma. Immunohistochemistry for p16 has been recently utilized to distinguish benign nevi from melanoma. We assessed the use of p16 immunohistochemistry for distinguishing melanocytic nevi of pregnant patients from nevoid melanomas. Methods: Fourteen nevomelanocytic lesions were obtained from pregnant or postpartum patients along with 20 nevoid melanomas for comparison. Immunohistochemistry with p16 was performed on each melanocytic lesion. The percentage of nuclear p16 staining of dermal melanocytes was grouped on a scale of <5%, 5% to 25%, >25% to 50%, and >50%. Results: The majority of nevi from pregnant patients (81%) showed staining of >5% for p16. In contrast, the majority of nevoid melanomas (65%) had staining of <5% for p16. Conclusion: The application of p16 as a potential immunohistochemistry diagnostic marker to distinguish nevi from pregnant patients vs nevoid melanomas may be useful. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The authors review a model of early medical student education that leverages the strengths of physician educators in curriculum development and small-group instruction in the first year of medical school. OBJECTIVE: The objective of this study was to understand the experience of practicing physicians who helped to design, implement, and deliver the first-year curriculum at a new medical school. METHODS: Survey data were collected for all first-year physician instructors and first-year medical students at the new Kaiser Permanente Bernard J. Tyson School of Medicine during the inaugural 2020-2021 academic year. Physician involvement in curriculum design and implementation, time required for teaching preparation, ratings of collaboration with basic scientists, and confidence and satisfaction of the clinician educators with first-year medical student education, as well as student satisfaction with physician educators, were all explored. RESULTS: Despite extensive time commitment from the physician educators and some reported variability in confidence ratings for course content, physicians rated their experience teaching first-year medical students at the new medical school highly. They rated their collaboration with basic scientists highly as well. Medical students rated their physician educators highly across multiple assessment domains. CONCLUSION: The successful combination of basic scientists with physician educators in first-year medical education may provide a road map for other medical schools seeking to further integrate clinical sciences into basic science education. [ABSTRACT FROM AUTHOR]

We believe the switch to a digital pathology (DP) workflow is imminent and it is essential to understand the economic implications of conversion. Many aspects of the adoption of DP will be disruptive and have a direct financial impact, both in short term costs, such as investment in equipment and personnel, and long term revenue potential, such as improved productivity and novel tests. The focus of this whitepaper is to educate pathologists, laboratorians and other stakeholders about the business and monetary considerations of converting to a digital pathology workflow. The components of a DP business plan will be thoroughly summarized, and guidance will be provided on how to build a case for adoption and implementation as well as a roadmap for transitioning from an analog to a digital pathology workflow in various laboratory settings. It is important to clarify that this publication is not intended to list prices although some financials will be mentioned as examples. The authors encourage readers who are evaluating conversion to a DP workflow to use this paper as a foundational guide for conducting a thorough and complete assessment while incorporating in current market pricing. Contributors to this paper analyzed peer-reviewed literature and data collected from various institutions, some of which are mentioned. Digital pathology will change the way we practice through facilitating patient access to expert pathology services and enabling image analysis tools and assays to aid in diagnosis, prognosis, risk stratification and therapeutic selection. Together, they will result in the delivery of valuable information from which to make better decisions and improve the health of patients. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the decision of the U.S. Centers for Medicare and Medicaid Services (CMS) to lower the technical component of the surgical pathology.

The article focuses on a study conducted to compare the effects of fructose and glucose on cerebral blood flow (CBF) in the area of brain involved in with appetite and reward pathways. The study was conducted on twenty healthy research volunteers who underwent two magnetic resonance imaging sessions in a medical facility at Yale University with administering fructose and glucose drinks to the participants. According to the results, CBF was significantly reduced after glucose and fructose ingestion as fructose is responsible for making a connection between hypothalamus and striatum.

We believe the switch to a digital pathology (DP) workflow is imminent and it is essential to understand the economic implications of conversion. Many aspects of the adoption of DP will be disruptive and have a direct financial impact, both in short term costs, such as investment in equipment and personnel, and long term revenue potential, such as improved productivity and novel tests. The focus of this whitepaper is to educate pathologists, laboratorians and other stakeholders about the business and monetary considerations of converting to a digital pathology workflow. The components of a DP business plan will be thoroughly summarized, and guidance will be provided on how to build a case for adoption and implementation as well as a roadmap for transitioning from an analog to a digital pathology workflow in various laboratory settings. It is important to clarify that this publication is not intended to list prices although some financials will be mentioned as examples. The authors encourage readers who are evaluating conversion to a DP workflow to use this paper as a foundational guide for conducting a thorough and complete assessment while incorporating in current market pricing. Contributors to this paper analyzed peer-reviewed literature and data collected from various institutions, some of which are mentioned. Digital pathology will change the way we practice through facilitating patient access to expert pathology services and enabling image analysis tools and assays to aid in diagnosis, prognosis, risk stratification and therapeutic selection. Together, they will result in the delivery of valuable information from which to make better decisions and improve the health of patients. [ABSTRACT FROM AUTHOR]