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For molecular classification of endometrial carcinoma, testing for mismatch repair (MMR) status is becoming a routine process. Mismatch repair deficiency (MMR-D) is caused by loss of expression in one or more of the 4 major MMR proteins: MLH1, MSH2, MSH6, PHS2. Over 30% of patients with endometrial cancer have MMR-D. Determining the MMR status holds significance as individuals with MMR-D are potential candidates for immunotherapy. Pathological whole slide image (WSI) of endometrial cancer with immunohistochemistry results of MMR proteins were gathered. Color normalization was applied to the tiles using a CycleGAN-based network. The WSI was divided into tiles at three different magnifications (2.5 × , 5 × , and 10 ×). Three distinct networks of the same architecture were employed to include features from all three magnification levels and were stacked for ensemble learning. Three architectures, InceptionResNetV2, EfficientNetB2, and EfficientNetB3 were employed and subjected to comparison. The per-tile results were gathered to classify MMR status in the WSI, and prediction accuracy was evaluated using the following performance metrics: AUC, accuracy, sensitivity, and specificity. The EfficientNetB2 was able to make predictions with an AUC of 0.821, highest among the three architectures, and an overall AUC range of 0.767 – 0.821 was reported across the three architectures. In summary, our study successfully predicted MMR classification from pathological WSIs in endometrial cancer through a multi-resolution ensemble learning approach, which holds the potential to facilitate swift decisions on tailored treatment, such as immunotherapy, in clinical settings. [ABSTRACT FROM AUTHOR]

Simple Summary: This study included 227 patients, among whom 27.7% (63/227) were diagnosed with tumors spread through air spaces (STASs), which have been shown to be associated with shorter recurrence-free survival and poor prognosis. A prediction model was developed to forecast tumor STAS in early-stage lung adenocarcinoma pathology images. The radiomics prediction model demonstrated good performance, with an AUC value of 0.83. This prediction model can assist pathologists in the diagnostic processes of clinical practice. The presence of spread through air spaces (STASs) in early-stage lung adenocarcinoma is a significant prognostic factor associated with disease recurrence and poor outcomes. Although current STAS detection methods rely on pathological examinations, the advent of artificial intelligence (AI) offers opportunities for automated histopathological image analysis. This study developed a deep learning (DL) model for STAS prediction and investigated the correlation between the prediction results and patient outcomes. To develop the DL-based STAS prediction model, 1053 digital pathology whole-slide images (WSIs) from the competition dataset were enrolled in the training set, and 227 WSIs from the National Taiwan University Hospital were enrolled for external validation. A YOLOv5-based framework comprising preprocessing, candidate detection, false-positive reduction, and patient-based prediction was proposed for STAS prediction. The model achieved an area under the curve (AUC) of 0.83 in predicting STAS presence, with 72% accuracy, 81% sensitivity, and 63% specificity. Additionally, the DL model demonstrated a prognostic value in disease-free survival compared to that of pathological evaluation. These findings suggest that DL-based STAS prediction could serve as an adjunctive screening tool and facilitate clinical decision-making in patients with early-stage lung adenocarcinoma. [ABSTRACT FROM AUTHOR]

Simple Summary: This review highlights the profound impact of digital pathology (DP) and artificial intelligence (AI) on advancing cancer diagnosis and treatment. DP enables pathologists to access, analyze, and share high-resolution images, enhancing diagnostic accuracy and fostering remote collaboration. AI further refines cancer diagnosis by automating tasks and facilitating spatial analysis of the tumor microenvironment (TME), leading to the discovery of novel biomarkers. Immunoscore (IS), an AI-assisted immune assay, exhibits robust potential in improving cancer diagnosis, prognosis, and treatment selection, surpassing traditional staging systems. Integrating DP and AI, particularly the IS biomarker, into clinical practice promises to enhance personalized cancer therapy. The research underscores a pivotal leap forward in pathology, stressing the imperative of incorporating AI-driven technologies for improved cancer patient care and outcomes. This exploration aims to provide insights into the transformative potential of DP in cancer management, influencing the clinical community towards more effective diagnostic and therapeutic strategies. (1) Background: Digital pathology (DP) is transforming the landscape of clinical practice, offering a revolutionary approach to traditional pathology analysis and diagnosis. (2) Methods: This innovative technology involves the digitization of traditional glass slides which enables pathologists to access, analyze, and share high-resolution whole-slide images (WSI) of tissue specimens in a digital format. By integrating cutting-edge imaging technology with advanced software, DP promises to enhance clinical practice in numerous ways. DP not only improves quality assurance and standardization but also allows remote collaboration among experts for a more accurate diagnosis. Artificial intelligence (AI) in pathology significantly improves cancer diagnosis, classification, and prognosis by automating various tasks. It also enhances the spatial analysis of tumor microenvironment (TME) and enables the discovery of new biomarkers, advancing their translation for therapeutic applications. (3) Results: The AI-driven immune assays, Immunoscore (IS) and Immunoscore-Immune Checkpoint (IS-IC), have emerged as powerful tools for improving cancer diagnosis, prognosis, and treatment selection by assessing the tumor immune contexture in cancer patients. Digital IS quantitative assessment performed on hematoxylin–eosin (H&E) and CD3+/CD8+ stained slides from colon cancer patients has proven to be more reproducible, concordant, and reliable than expert pathologists' evaluation of immune response. Outperforming traditional staging systems, IS demonstrated robust potential to enhance treatment efficiency in clinical practice, ultimately advancing cancer patient care. Certainly, addressing the challenges DP has encountered is essential to ensure its successful integration into clinical guidelines and its implementation into clinical use. (4) Conclusion: The ongoing progress in DP holds the potential to revolutionize pathology practices, emphasizing the need to incorporate powerful AI technologies, including IS, into clinical settings to enhance personalized cancer therapy. [ABSTRACT FROM AUTHOR]

* Context.--Photobleaching artifact occurs when fluorescence intensity decreases following light exposure. Slides stained with fluorescent techniques may be stored in the dark until primary diagnostics. Experimental evidence suggesting the rate of photobleaching and necessity of dark storage is lacking. Objective.--To compare photobleaching rate on direct immunofluorescence and Thioflavin T slides stored in ambient room light conditions and exposed to excitatory wavelengths. Design.--During 2 iterations of the experiment, 45 slides were prepared, 42 with immunofluorescent antibodies plus 3 with thioflavin, from skin and kidney biopsies. The experimental group was stored in room light conditions in comparison to the control in the dark, at room temperature. Further, 1 immunofluorescence slide and 1 thioflavin slide were exposed to excitatory fluorescent light for several hours. Significant photobleaching was defined as an integer decrease in score (scale, 0-3). Results.--Exposure times ranged from 152 to 3034 hours. Nine of the 42 immunofluorescence slides (21%) photobleached after a minimum exposure of 152 hours to room light, with no significant difference between the experimental and control groups (all P values >.05). The immunofluorescence slide exposed to fluorescent light for 4 hours showed marked photobleaching in the exposed field but not elsewhere. No thioflavin slides showed clinically significant photobleaching under any conditions. Conclusions.--Clinically significant photobleaching of slides exposed to room light may occur after a few days, but not a few hours (unless exposed to excitatory fluorescent light). Conversely, thioflavin-stained slides did not photobleach when exposed to ambient room air and photobleached only negligibly when exposed to excitatory fluorescent light. [ABSTRACT FROM AUTHOR]

Introduction. Digital microscopy transformation, the basis for the virtual microscopy applications, is a challenge but also a requirement in modern Medical Education. This paper presents the scope, background, methods, and results of the project "Digital Transformation of Histology and Histopathology by Virtual Microscopy (VM) for an Innovative Medical School Curriculum", VM3.0, funded by the European Union under the Erasmus+ framework (ref.no.2022-1-RO01-KA220-HED-000089017). The project was initiated at Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania, with the support of Euroed Foundation, Iași, and cooperation of University partners from Gdansk (Poland), Plovdiv (Bulgaria), Alicante (Spain), and Patras (Greece) aimed to implement digital histology and histopathology teaching in a common network. Materials and methods. The backbone of the project was the development of a Digital Slide Platform based on the scans of histological slides collected from all the partners of the participating universities and the creation of a simple and fast digital/internet communication tool that could be used to improve histology and histopathology teaching of medical and natural sciences students. The construction of a Virtual Microscopy Library (VML) has been based on the acquisition of whole scans of high-quality histological slides stained by hematoxylin and eosin (H&E) and other classical staining methods and description of various organs' details in English as well as respective languages of the project's partners. The VML can be used for different approches, both for students' instruction in classes as well as for individual students' work and self-testing. Universities from other countries could use the modal structure of the developed VML system on the condition that more slides are provided and the implementation of national language(s) is implemented. Conclusions. The combined efforts of all university partners allowed to establish the dynamic low-cost virtual microscopy educational system. The VM system could help unify the standards of cytology, histology, and histopathology teaching in a quest for the digital transformation of the European educational system. [ABSTRACT FROM AUTHOR]

Introduction. Cytological specimens, such as fine needle aspirations (FNAs) and exfoliative cytology samples, are minimally invasive options for diagnostic purposes. Liquid-based cytology (LBC), originally designed for cervical cytology, has gained prominence as an alternative technique for non-gynecological cytology. Immunocytochemistry (ICC) is an ancillary method used when diagnosis becomes challenging due to morphological overlap or the need for cellular origin clarification. This study aims to assess the diagnostic utility of ICC when applied to LBC slides and evaluate its effectiveness in relation to the waiting (lag) time of residual material. Materials and methods. A total of 74 cases in which ICC was applied to LBC slides were studied over one year in a reference pathology laboratory (Prof. Dr. Cemil Tascioglu, Pathology Laboratory, City Hospital, Istanbul, Turkey). Cases in which immunohistochemistry (IHC) was performed on formalin-fixed paraffin-embedded cell blocks were excluded. The SurePath PAP method was used for the main LBC cytology slides. For the ICC study, 1-4 PAP-stained LBC slides were obtained from each case’s residual material and stained with a primary antibody. Results. The positive immunostaining was obtained in 81% of cases. The samples were categorized into groups based on the waiting time of residual LBC material for ICC analysis: 1-5 days, 6-10 days, 11-20 days, and 21-38 days. Comparative analysis revealed a decline in ICC efficacy as the waiting (lag) time increased. Additionally, a statistically significant difference was observed between the 11-20 days and 21-38 days groups (P < 0.05). An analysis of 142 LBC slides stained by ICC revealed that nuclear markers exhibited higher positivity compared to non-nuclear markers, although no significant difference was detected between the two groups. Conclusions. High positivity rates can be obtained in ICC studies performed on additional slides obtained from residual LBC material within the first 20 days. ICC applied to LBC slides is an important and useful alternative for diagnostic and prognostic markers in cases without a cell block or with a cell block without sufficient number of cells. [ABSTRACT FROM AUTHOR]

Simple Summary: This study developed an interpretable scoring system using artificial intelligence and bladder tissue images. It identified two distinct risk groups with different outcomes in high-grade bladder cancer. The scoring system was associated with various molecular features and gene mutations. This system can save shared clinical decision making and cost by identifying patients who need further molecular testing. Muscle-invasive bladder cancer (MIBC) is a highly heterogeneous and costly disease with significant morbidity and mortality. Understanding tumor histopathology leads to tailored therapies and improved outcomes. In this study, we employed a weakly supervised learning and neural architecture search to develop a data-driven scoring system. This system aimed to capture prognostic histopathological patterns observed in H&E-stained whole-slide images. We constructed and externally validated our scoring system using multi-institutional datasets with 653 whole-slide images. Additionally, we explored the association between our scoring system, seven histopathological features, and 126 molecular signatures. Through our analysis, we identified two distinct risk groups with varying prognoses, reflecting inherent differences in histopathological and molecular subtypes. The adjusted hazard ratio for overall mortality was 1.46 (95% CI 1.05–2.02; z: 2.23; p = 0.03), thus identifying two prognostic subgroups in high-grade MIBC. Furthermore, we observed an association between our novel digital biomarker and the squamous phenotype, subtypes of miRNA, mRNA, long non-coding RNA, DNA hypomethylation, and several gene mutations, including FGFR3 in MIBC. Our findings underscore the risk of confounding bias when reducing the complex biological and clinical behavior of tumors to a single mutation. Histopathological changes can only be fully captured through comprehensive multi-omics profiles. The introduction of our scoring system has the potential to enhance daily clinical decision making for MIBC. It facilitates shared decision making by offering comprehensive and precise risk stratification, treatment planning, and cost-effective preselection for expensive molecular characterization. [ABSTRACT FROM AUTHOR]

Background: Low-friction slide sheets (SS) are designed to reduce compression loads on the body during manual handling tasks, such as boosting patients. Using SS has been shown to decrease muscle activity in the lower back and upper extremities. However, it is unclear if this effect varies with different bed positions. To investigate this, we studied the effects of SS use, bed height, and their combination on muscle activity during a simulated patient boost. Methods: Thirty-three Japanese undergraduate students (age 21.0 ± 1.1 years; 14 men, 19 women) participated. Participants were asked to boost a dummy figure on the bed three times each using four conditions. During the repositioning task, electromyography of eight muscles of the lower back and upper and lower extremities, hip and knee joint flexion angles, pelvic forward tilt angle, and position of the center of mass based on the posterior superior iliac spine were evaluated. Findings: Electrophysiological activities of muscles of lower back and upper extremities were significantly lower with SS than without it in both bed positions (30% and 40% of body height); the reduction in muscle activities with SS use was 20% to 40%. Lowering the bed did not affect the SS effect magnitude on reducing muscle activities, although postural changes, including hip and knee joint flexion, were observed. Conclusions/Application to Practice: SS reduced muscle activities in the back, upper, and lower extremities when the bed was in the low position, and this effect persisted at a bed height of ≥30% of the participant's height. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aims to compare the performance of the standardized consensus Immunoscore (IS) digital pathology assay to an evaluation of the immune response via visual examination of hematoxylin–eosin (H&E) slides and CD3+/CD8+ stained slides, achieved by expert pathologists. Herein, we report the evaluation of 540 stained images by multi-institutional pathologists to determine the concordance between pathologist assessment before and after training. The results show that the IS assay outperformed expert pathologists' T-score evaluation in the clinical setting. This reveals the potential of the IS as an immune pathology tool, critical for reproducible quantitative analysis of tumor-infiltrated immune cells. These findings can contribute to a better diagnosis, allowing one to stratify cancer patients into reliable prognostic groups, based on the immune parameters quantified by IS. This work will likely impact the management of colon cancer patients as it raises the importance of the implementation of digital pathology in cancer diagnosis to provide appropriate personalized therapeutic decisions. Background: The Immunoscore (IS) is a quantitative digital pathology assay that evaluates the immune response in cancer patients. This study reports on the reproducibility of pathologists' visual assessment of CD3+- and CD8+-stained colon tumors, compared to IS quantification. Methods: An international group of expert pathologists evaluated 540 images from 270 randomly selected colon cancer (CC) cases. Concordance between pathologists' T-score, corresponding hematoxylin–eosin (H&E) slides, and the digital IS was evaluated for two- and three-category IS. Results: Non-concordant T-scores were reported in more than 92% of cases. Disagreement between semi-quantitative visual assessment of T-score and the reference IS was observed in 91% and 96% of cases before and after training, respectively. Statistical analyses showed that the concordance index between pathologists and the digital IS was weak in two- and three-category IS, respectively. After training, 42% of cases had a change in T-score, but no improvement was observed with a Kappa of 0.465 and 0.374. For the 20% of patients around the cut points, no concordance was observed between pathologists and digital pathology analysis in both two- and three-category IS, before or after training (all Kappa < 0.12). Conclusions: The standardized IS assay outperformed expert pathologists' T-score evaluation in the clinical setting. This study demonstrates that digital pathology, in particular digital IS, represents a novel generation of immune pathology tools for reproducible and quantitative assessment of tumor-infiltrated immune cell subtypes. [ABSTRACT FROM AUTHOR]

Objective: Education reflecting fundamental knowledge is required for competent health care providers, but often lectures are not available for this purpose. This study aimed to evaluate the dental hygiene learning outcomes following the presentation of web‐based slides on a smartphone to dental hygienists. Methods: A two‐group nonblinded quasi‐experimental design was used for this study. Forty‐six dental hygienists were assigned to a study (n = 31) or control group (n = 15). The study group viewed 22 slides on fundamental oral health knowledge using smartphones. Pre and postviewing tests (score range: 1–13) and a questionnaire were conducted to evaluate knowledge acquisition and to receive feedback from participants. Differences between the study and control group and intrastudy group differences were statistically evaluated. Results: The fundamental knowledge of dental hygienists improved after viewing the slides: the study group had a significantly higher mean score than the control group (10.87 vs. 6.60; p < 0.001). Study group participants also had substantially higher post‐test than pretest knowledge scores (mean 10.87 vs. 6.26, p < 0.001). In the questionnaire, more than 85% of the participants answered that the content of the slides would be useful in their clinical practice. Conclusion: Smartphone‐based educational slides were beneficial for conveying fundamental and recent oral health knowledge to dental hygienists. [ABSTRACT FROM AUTHOR]

This review article examines the use of seductive details in nursing education activities. Seductive details are irrelevant images that are placed into educational material. Although seductive details may be found in any type of educational material and at any academic level, this article focuses on the placement of seductive details in electronic slide presentations used in nursing education activities. Educators optimistically place seductive details in educational material to engage learners or provide a momentary break from the presentation. Although engaging the learner is important, educators must use methods that do not derail how the learner's brain remembers information. Added visuals should be relevant to the material needed to be understood. Using seductive details may adversely affect learning by overloading the working memory with extraneous cognitive information, affecting the ability of the learner to create a coherent mental model needed to store a long-term memory. Evidence-based information about seductive detail use is nonexistent in nursing education literature. Professional nurse educators must carefully consider the use of seductive details in electronic slide presentations. [J Contin Educ Nurs. 2023;54(6):261–267.] [ABSTRACT FROM AUTHOR]

Simple Summary: Identifying biomarkers of survival from a large-scale cohort of Glioblastoma Multiforme (GBM) pathology images is hindered by heterogeneity of tumor signature compounded by age being the single most important confounder in predicting survival in GBM. The main contributions of this manuscript are to define (i) metrics for identifying tumor subtypes of tumor heterogeneity and (ii) relevant statistics for incorporating age for evaluating competing hypotheses. As a result, the GBM cohort are stratified based on interpretable morphometric features with or without preconditioning on published genomic subtypes. Tumor Whole Slide Images (WSI) are often heterogeneous, which hinders the discovery of biomarkers in the presence of confounding clinical factors. In this study, we present a pipeline for identifying biomarkers from the Glioblastoma Multiforme (GBM) cohort of WSIs from TCGA archive. The GBM cohort endures many technical artifacts while the discovery of GBM biomarkers is challenged because "age" is the single most confounding factor for predicting outcomes. The proposed approach relies on interpretable features (e.g., nuclear morphometric indices), effective similarity metrics for heterogeneity analysis, and robust statistics for identifying biomarkers. The pipeline first removes artifacts (e.g., pen marks) and partitions each WSI into patches for nuclear segmentation via an extended U-Net for subsequent quantitative representation. Given the variations in fixation and staining that can artificially modulate hematoxylin optical density (HOD), we extended Navab's Lab method to normalize images and reduce the impact of batch effects. The heterogeneity of each WSI is then represented either as probability density functions (PDF) per patient or as the composition of a dictionary predicted from the entire cohort of WSIs. For PDF- or dictionary-based methods, morphometric subtypes are constructed based on distances computed from optimal transport and linkage analysis or consensus clustering with Euclidean distances, respectively. For each inferred subtype, Kaplan–Meier and/or the Cox regression model are used to regress the survival time. Since age is the single most important confounder for predicting survival in GBM and there is an observed violation of the proportionality assumption in the Cox model, we use both age and age-squared coupled with the Likelihood ratio test and forest plots for evaluating competing statistics. Next, the PDF- and dictionary-based methods are combined to identify biomarkers that are predictive of survival. The combined model has the advantage of integrating global (e.g., cohort scale) and local (e.g., patient scale) attributes of morphometric heterogeneity, coupled with robust statistics, to reveal stable biomarkers. The results indicate that, after normalization of the GBM cohort, mean HOD, eccentricity, and cellularity are predictive of survival. Finally, we also stratified the GBM cohort as a function of EGFR expression and published genomic subtypes to reveal genomic-dependent morphometric biomarkers. [ABSTRACT FROM AUTHOR]

Background and aims: After liquid-based cytology (LBC) technique developed for cervical cytology, it has been used for nongynecological samples and has been very successful. It offers having extra slides of the samples for further examination and ancillary tests. Moreover, cell blocks can be formed from the residue material. The study aimed to evaluate the importance of preparing a second LBC slide or a cell block from the residue material of thyroid fine needle aspiration (FNA) samples to reach a definitive diagnosis in cases diagnosed as nondiagnostic (ND) after the first slide. Material and methods: Seventy five cases diagnosed as ND after the first slide were included in study. For 50 cases, the second LBC slides were prepared (LBC group); for 25 cases, cell block was performed from residue material (CB group). Two groups were compared in terms of reaching a definitive diagnosis. Results: At the end of secondary procedures, a definitive diagnosis was reached in a total of 24 cases (32%). Twenty of 50 cases (40%) in LBC group reached a definitive diagnosis while four cases (16%) in the CB group reached a definitive diagnosis. Achieving a definitive diagnosis was found statistically higher in the LBC group in which the second slide was formed compared to the CB group (P =0.036). Conclusion: Preparing a second slide with LBC method is more purposive than preparing a cell block from the residue material of thyroid FNA samples. Reducing the percentage of ND cases will protect patients from complications and morbidity that may arise from repeated FNA. [ABSTRACT FROM AUTHOR]

Slide decks are a ubiquitous form of communication in both academia and business, and business communication instructors must be able to model and teach multimedia design principles. The literature regarding multimedia design has traditionally fallen into two camps: the cognitive school, focused on designing multimedia messages that accommodate human cognitive architecture, and the graphic design school, focused on using visual appeal as a tool for conceptual organization. I synthesize representative models from each school to provide theoretically derived and empirically supported principles for designing slide decks that are both well-organized and visually appealing. [ABSTRACT FROM AUTHOR]

Over the last decade, 35mm slide libraries that were used to support art history teaching in higher education in Europe and North America have been widely dismantled and dispersed. This article examines the cultural values that have been illuminated by debates about their decline and disposal, and the contexts and practices for their afterlife. Drawing on auto-ethnographic research, interviews with former slide librarians and surviving slide library material, the article pays special attention to one case study, formerly held at the University of Brighton, UK, to trace the slide library's establishment and demise, examine the cultural labour of its production and maintenance, and evaluate its particularities and idiosyncrasies. Through this, the article outlines the values and meanings that were established and contested during the slide library's working life and its 2011 dismantling, and considers how these have been repositioned in the intervening years. The slide library's devaluation contrasts sharply with slides' recent revaluation in scholarly interests in photographic materialities and media archaeologies, in the retro marketplace and in contemporary art practice. Together, these reflections and frameworks provide fresh perspectives on dismantled slide libraries and their remains. [ABSTRACT FROM AUTHOR]

This article casts a retrospective glance at the technological continuum from which the art history slide lecture springs. The article focuses specifically on the copy apparatuses widely used to make transparencies for art-historical consumption, circa 1930 to the early 2000s. The ways in which these once prevalent technologies developed to frame and disseminate visual materials by means of light was instrumental in shaping the widespread illusion of epistemological transparency in the world's art history classrooms. In reference to the work of Martin Heidegger (1889–1976) on technological determinism, the author provides a chronology of slide reproduction technologies in which artworks ultimately appear as self-luminous technological 'images', or simulated entities that speak as if beyond history. [ABSTRACT FROM AUTHOR]

An introduction is presented in which editor discusses various articles within the issue on topics including Heidegger's work on technological determinism; Charles Piazzi Smyth's slides of the Great Pyramid of Giza and pedagogical revolution caused by the adoption of the slide lecture.

The article presents the case of a 53-year-old male with nephrotic syndrome and diabetes who developed progressively worsening memory and responsiveness, ultimately diagnosed with Talaromyces marneffei infection in the central nervous system (CNS), a rare occurrence of this opportunistic fungal infection. Topics include the clinical presentation of CNS T. marneffei infection, diagnostic approaches involving imaging and fungal culture, and the treatment challenges associated with this condition.

* Context.--The rapid recognition of fetal nucleated red blood cells (fNRBCs) presents considerable challenges. Objective.--To establish a computer-aided diagnosis system for rapid recognition of fNRBCs by convolutional neural network. Design.--We adopted density gradient centrifugation and magnetic-activated cell sorting to extract fNRBCs from umbilical cord blood samples. The cell-block method was used to embed fNRBCs for routine formalin-fixed paraffin sectioning and hematoxylin-eosin staining. Then, we proposed a convolutional neural network--based, computer- aided diagnosis system to automatically discriminate features and recognize fNRBCs. Extracting methods of interested region were used to automatically segment individual cells in cell slices. The discriminant information from cellular-level regions of interest was encoded into a feature vector. Pathologic diagnoses were also provided by the network. Results.--In total, 4760 pictures of fNRBCs from 260 cell-slides of 4 umbilical cord blood samples were collected. On the premise of 100% accuracy in the training set (3720 pictures), the sensitivity, specificity, and accuracy of cellular intelligent recognition were 96.5%, 100%, and 98.5%, respectively, in the test set (1040 pictures). Conclusions.--We established a computer-aided diagnosis system for effective and accurate fNRBC recognition based on a convolutional neural network. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we trained deep learning models to classify TUR-P WSIs into prostate adenocarcinoma and benign (non-neoplastic) lesions using transfer and weakly supervised learning. Overall, the model achieved good classification performance in classifying whole-slide images, demonstrating the potential benefit of future deployments in a practical TUR-P histopathological diagnostic workflow system. The transurethral resection of the prostate (TUR-P) is an option for benign prostatic diseases, especially nodular hyperplasia patients who have moderate to severe urinary problems that have not responded to medication. Importantly, incidental prostate cancer is diagnosed at the time of TUR-P for benign prostatic disease. TUR-P specimens contain a large number of fragmented prostate tissues; this makes them time consuming to examine for pathologists as they have to check each fragment one by one. In this study, we trained deep learning models to classify TUR-P WSIs into prostate adenocarcinoma and benign (non-neoplastic) lesions using transfer and weakly supervised learning. We evaluated the models on TUR-P, needle biopsy, and The Cancer Genome Atlas (TCGA) public dataset test sets, achieving an ROC-AUC up to 0.984 in TUR-P test sets for adenocarcinoma. The results demonstrate the promising potential of deployment in a practical TUR-P histopathological diagnostic workflow system to improve the efficiency of pathologists. [ABSTRACT FROM AUTHOR]

Context.--: Wide adoption of digital pathology requires efficient visualization and navigation in Web-based digital slide viewers, which is poorly defined. Objective.--: To define and quantify relevant performance metrics for efficient visualization of cases and slides in digital slide viewers. Design.--: With a universal slide viewer used in clinical routine diagnostics, we evaluated the impact of slide caching, compression type, tile, and block size of whole slide images generated from Philips, Leica, and 3DHistech scanners on streaming performance on case, slide, and field of view levels. Results.--: Two hundred thirty-nine pathologists routinely reviewed 60 080 whole slide images over 3 months. The median time to open a case's slides from the laboratory information system was less than 4 seconds, the time to change to a slide within the case was less than 1 second, and the time to render the adjacent field of view when navigating the slide was less than one-quarter of a second. A whole slide image's block size and a viewer tile size of 1024 pixels showed best performance to display a field of view and was preferrable over smaller tiles due to fewer mosaic effects. For Philips, fastest median slide streaming pace was 238 ms per field of view and for 3DHistech, 125 ms. For Leica, the fastest pace of 108 ms per field of view was established with block serving without decompression. Conclusions.--: This is the first study to systematically assess user-centric slide visualization performance metrics for digital viewers, including time to open a case, time to change a slide, and time to change a field of view. These metrics help to improve the viewer's configuration, leading to an efficient visualization baseline that is widely accepted among pathologists using routine digital pathology. [ABSTRACT FROM AUTHOR]

Evaluation of the mechanical behavior of the microstructure of cancellous bone seems important for the understanding of the mechanical behavior of bone. Prevention and treatment of fragility fractures due to osteoporosis is a major challenge according to ageing population. A bone model might help to assess fracture risk. Measurement of single trabeculae of bone should give further information compared with bone densitometry alone. This study measures the mechanical properties of single cancellous trabeculae derived from human proximal humerus. 34 single trabeculae dissected from human humeral heads were measured and evaluated mechanically. Trabeculae were fixed on microscope slides and geometrical data were reported during axial rotation of the specimens to measure the transverse section using computer aided design (CAD). The samples were subjected to a two-point bending test and were loaded with a measure-stamp at a defined distance. Force and deflection were measured by high-resolution sensors. The E-modulus was then calculated in combination with finite elements method simulation (FEM), using the previously obtained CAD-Data. The average E-modulus from 34 valid measurements of human humeral trabeculae was 1678 MPa with a range from 829 to 3396 MPa, which is consistent with existing literature. The planned additional validation of the measurement method using manufactured three-dimensional synthetic trabeculae with known mechanical properties showed an average elastic modulus of single trabeculae of 51.5 MPa, being two dimensions lower than the value reported in the datasheet of the plastic. This newly developed, time and cost-efficient procedure allows the measurement of E-modulus in single trabeculae. Measurement of mechanic parameters of single trabeculae might give insights on mechanic behavior of bone and be relevant for the research of systemic bone diseases, complementing the existing data on bone-mineral-density. Further examination of single trabeculae of human cancellous bone should give an insight on the mechanical behavior of bone also considering systemic bone diseases. [ABSTRACT FROM AUTHOR]

Simple Summary: Inducible T-cell COStimulator (ICOS) is a biomarker of interest in checkpoint inhibitor therapy, and as a means of assessing T-cell regulation as part of a complex process of adaptive immunity. The aim of our study is to segment the ICOS positive cells using a lightweight deep-learning segmentation network. We aim to assess the potential of a convolutional neural network and transformer together that permits the capture of relevant features from immunohistochemistry images. The proposed study achieved remarkable results compared to the existing biomedical segmentation methods on our in-house dataset and surpassed our previous analysis by only utilizing the Efficient-UNet network. In this article, we propose ICOSeg, a lightweight deep learning model that accurately segments the immune-checkpoint biomarker, Inducible T-cell COStimulator (ICOS) protein in colon cancer from immunohistochemistry (IHC) slide patches. The proposed model relies on the MobileViT network that includes two main components: convolutional neural network (CNN) layers for extracting spatial features; and a transformer block for capturing a global feature representation from IHC patch images. The ICOSeg uses an encoder and decoder sub-network. The encoder extracts the positive cell's salient features (i.e., shape, texture, intensity, and margin), and the decoder reconstructs important features into segmentation maps. To improve the model generalization capabilities, we adopted a channel attention mechanism that added to the bottleneck of the encoder layer. This approach highlighted the most relevant cell structures by discriminating between the targeted cell and background tissues. We performed extensive experiments on our in-house dataset. The experimental results confirm that the proposed model achieves more significant results against state-of-the-art methods, together with an 8× reduction in parameters. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of pancreatic lesions remains a clinical challenge. Early and accurate diagnosis is extremely important for improving the therapeutic usefulness of pancreatic cancers and Endoscopic ultrasonography - fine needle aspiration (EUS-FNA) cytology has come up with this advantage. For current study the authors evaluated the diagnostic accuracy of EUS-FNAC by applying PSC system for reporting pancreaticobiliary cytology and Calculated the malignancy risk associated with the diagnostic categories. Material and Methods: A retrospective study over the period of 2.5 years (April 2017 to Oct 2019) 60 patients in our cohort EUS-FNAC guided unstained fixed and unfixed slides received of pancreatic lesion and were stained with Papanicolau and Giemsa using standard technique and immunocytochemistry, where required Application of Papanicolaou Society of Cytopathology system for reporting pancreaticobiliary cytology Histopathological and clinical follow-up were retrieved. Results: Our study has comparable results with sensitivity, specificity, PPV, and NPV of 92.8%, 100%, 100%, and 92.59%, respectively. Fuurthermore, a diagnostic accuracy of 96.2%. Risk of malignancy is lower for benign and indeterminate category whereas it is higher for suspicious and malignant categories. Conclusion: The application of the new proposed terminology for pancreaticobiliary cytology brings standardization. Final diagnosis can be reached by the multidisciplinary approach of EUS-FNA cytology, cell block preparation, immunocytochemistry, and immunohistochemistry; if required, can be adopted as an alternative approach to biopsy. The present study showed high sensitivity and specificity for EUS-FNA in the diagnosis of pancreatic carcinoma, which may influence the treatment plans of both surgeons and oncologists. [ABSTRACT FROM AUTHOR]

Purpose: To validate prostate tissue composition measured using hybrid multi-dimensional MRI (HM-MRI) by comparing with reference standard (ground truth) results from pathologists' interpretation of clinical histopathology slides following whole mount prostatectomy. Materials and methods: 36 prospective participants with biopsy-confirmed prostate cancer underwent 3 T MRI prior to radical prostatectomy. Axial HM-MRI was acquired with all combinations of echo times of 57, 70, 150, 200 ms and b-values of 0, 150, 750, 1500 s/mm2 and data were fitted using a 3-compartment signal model using custom software to generate volumes for each tissue component (stroma, epithelium, lumen). Three experienced genitourinary pathologists independently as well as in consensus reviewed each histology image and provide an estimate of percentage of epithelium and lumen for regions-of-interest corresponding to MRI (n = 165; 64 prostate cancers and 101 benign tissue). Agreement statistics using total deviation index (TDI0.9) was performed for tissue composition measured using HM-MRI and reference standard results from pathologists' consensus. Results: Based on the initial results showing typical variation among pathologists TDI0.9 = 25%, we determined we will declare acceptable agreement if the 95% one-sided upper confident limit of TDI0.9 is less than 30%. The results of tissue composition measurement from HM-MRI compared to ground truth results from the consensus of 3 pathologists, reveal that ninety percent of absolute paired differences (TDI0.9) were within 18.8% and 22.4% in measuring epithelium and lumen, respectively. We are 95% confident that 90% of absolute paired differences were within 20.6% and 24.2% in measuring epithelium and lumen, respectively. These were less than our criterion of 30% and inter-pathologists' agreement (22.3% for epithelium and 24.2% for lumen) and therefore we accept the agreement performance of HM-MRI. The results revealed excellent area under the ROC curve for differentiating cancer from benign tissue based on epithelium (HM-MRI: 0.87, pathologists: 0.97) and lumen volume (HM-MRI: 0.85, pathologists: 0.77). Conclusion: The agreement in tissue composition measurement using hybrid multidimensional MRI and consensus of pathologists is on par with the inter-raters (pathologists) agreement. [ABSTRACT FROM AUTHOR]

Aims and Objectives: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a precise modality for tissue sampling of mediastinal and hilar lesions adjacent to the proximal airway. This study aims to determine the diagnostic efficacy, sensitivity, and specificity of rapid-on site evaluation (ROSE) in EBUS-TBNA. Materials and Methods: This is a retrospective study that included 100 patients who underwent EBUS-TBNA of paratracheal and mediastinal lymph nodes in a tertiary care hospital in South India between March 2018 and March 2020. After the procedure, the diagnostic yield from the nodes sampled was transferred to slides that were stained with rapid hematoxylin and eosin (H and E), and then onsite evaluation was done. The tissue derived was also processed for histopathologic examination in all cases. ROSE was performed to assess sample adequacy and to arrive at a preliminary diagnosis. In patients suspected of tuberculosis, the sample was collected for GeneXpert evaluation as well. Results: Of the 100 cases studied, 51 were males and 49 were females. The age distribution was between 3 and 78 years. Forty-seven cases were diagnosed as granulomatous lymphadenitis, 13 as metastatic malignancies, 33 as reactive lymphadenitis, 3 as atypical cells, and 1 case was diagnosed as a cystic lesion. The diagnostic yield was not adequate for evaluation in three cases. Diagnostic yield was obtained in the first two passes where the lymph nodes were more than 2 cm in size. More diagnostic passes were required in lymph nodes less than 2 cm and those located between and adjacent to major vessels. The onsite diagnosis was correlated with the final histopathologic diagnosis. Conclusion: ROSE serves as a useful adjunct to reduce procedure time and enhance sample collection and triaging, and reduces the need for further invasive testing. [ABSTRACT FROM AUTHOR]

Breast cancer diagnosis is a critical step in clinical decision making, and this is achieved by making a pathological slide and gives a decision by the doctors, which is the method of final decision making for cancer diagnosis. Traditionally, the doctors usually check the pathological images by visual inspection under the microscope. Whole-slide images (WSIs) have supported the state-of-the-art diagnosis results and have been admitted as the gold standard clinically. However, this task is time-consuming and labour-intensive, and all of these limitations make low efficiency in decision making. Medical image processing protocols have been used for this task during the last decades and have obtained satisfactory results under some conditions; especially in the deep learning era, it has exhibited the advantages than those in the shallow learning period. In this paper, we proposed a novel breast cancer region mining framework based on deep pyramid architecture from multilevel and multiscale breast pathological WSIs. We incorporate the tissue- and cell-level information together and integrate these into a LSTM model for the final sequence modelling, which successfully keeps the WSIs' integration and is not mentioned by the prevalence frameworks. The experiment results demonstrated that our proposed framework greatly improved the detection accuracy than that only using tissue-level information. [ABSTRACT FROM AUTHOR]

Clients and employers are asking for infographics and visually appealing slides because they see infographics everywhere, and slides at conferences and meetings are looking different than in years past. They want graphical elements, short phrases, connections between ideas to be made clear, and to get to the point right away. Putting together these new deliverables means incorporating a few key elements and thinking differently about how you present data. The elements needed are visual (color coding, graphics, and icons), content (timeframes and timelines, statistics, and references), and knowledge (facts and deductions). Infographics come in different sizes: they can be an image of any size or shape, 1 or 2-page 8.5 by 11 sizes, or rolling infographics that are a standard screen width but any length (meant to be scrolled on a website). When creating visually appealing slides, use templates, icons, colors, and images to bring visual interest; put words into boxes, SmartArt, circles, shapes, charts, and graphics; and pare down the words and showcase certain words (often numbers or shorter phrases) with color, size, or space. Create infographics and visually appealing slides using sites or templates available from these sites and from PowerPoint Office 365 to make this process easier. Getting comfortable with these new visual formats might take some time, research, and exposure, but it can be a worthwhile addition to your skillset. [ABSTRACT FROM AUTHOR]

* Context.--Invasive micropapillary carcinoma (IMPC) is a rare variant of breast carcinoma, composed of avascular morula-like tumor clusters surrounded by stromal spaces, which can affect the HER2 immunohistochemical (IHC) staining pattern. The 2013 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) HER2 testing guideline suggests moderate to intense but incomplete (basolateral) staining be considered equivocal. Objectives.--To perform a detailed assessment of HER2 IHC staining patterns in IMPC. Design.--Hematoxylin-eosin and HER2 IHC slides were retrospectively reviewed to assess the morphology and HER2 IHC characteristics of IMPC. The 2018 ASCO/CAP guideline was applied. Results.--The cohort consisted of 187 IMPCs from 181 patients with median age of 58 years. Homogeneous (≥90%) micropapillary component was found in 40% (75 of 187) of cases. Receptor profile was as follows: 75% (140 of 187) ER+ HER2-, 19% (37 of 187) ER+ HER2+, 4% (7 of 187) ER- HER2+, and 2% (3 of 187) ER- HER2-. Of 26 cases with HER2 IHC 3þ, 65% (17 of 26) showed a basolateral staining pattern with strong intensity. HER2 fluorescence in situ hybridization (FISH) showed amplification in 26% (17 of 66) of HER2 IHC equivocal cases: 76% (13 of 17) showed basolateral staining pattern and 24% (4 of 17) complete staining, with weak to moderate (2), moderate (14), or moderate to strong (1) intensity. Conclusions.--The most frequent staining pattern was basolateral, seen in 49% of cases, including 65% HER2 IHC positive and 76% HER2 IHC equivocal/FISH amplified. If a basolateral pattern and weak to moderate staining is observed in IMPC, alternative testing should be performed to confirm the HER2 status. [ABSTRACT FROM AUTHOR]

Clinicians and pathologists traditionally use patient data in addition to clinical examination to support their diagnoses. We investigated whether a combination of histologic whole slides image (WSI) analysis based on convolutional neural networks (CNNs) and commonly available patient data (age, sex and anatomical site of the lesion) in a binary melanoma/nevus classification task could increase the performance compared with CNNs alone. We used 431 WSIs from two different laboratories and analysed the performance of classifiers that used the image or patient data individually or three common fusion techniques. Furthermore, we tested a naive combination of patient data and an image classifier: for cases interpreted as 'uncertain' (CNN output score <0.7), the decision of the CNN was replaced by the decision of the patient data classifier. The CNN on its own achieved the best performance (mean ± standard deviation of five individual runs) with AUROC of 92.30% ± 0.23% and balanced accuracy of 83.17% ± 0.38%. While the classification performance was not significantly improved in general by any of the tested fusions, naive strategy of replacing the image classifier with the patient data classifier on slides with low output scores improved balanced accuracy to 86.72% ± 0.36%. In most cases, the CNN on its own was so accurate that patient data integration did not provide any benefit. However, incorporating patient data for lesions that were classified by the CNN with low 'confidence' improved balanced accuracy. • Pathologists incorporate patient data in addition to clinical examination. • They put more emphasis on patient data if they are uncertain. • We investigated fusing histologic image/patient data within CNN-based classifiers. • State-of-the-art fusing approaches in general did not yield a performance benefit. • Mimicking humans by fusing patient data only if CNN was uncertain raised accuracy. [ABSTRACT FROM AUTHOR]

The author offers insights on scholarship and the collaboration between art historians and artists. Topics discussed include the impact of digital photography on the operations of the art history department slide library, the way art exhibitions and catalogues serve as models of collaboration between art scholars, curators, and conservators, and the need for more collaborative publications in the art industry.

Background: Medical students need problem-solving skills because these are crucial in diagnosing cases in the future. This study aimed to improve medical students' problemsolving abilities through analysis, reasoning, and application. Methods: A four-month prospective cross-sectional study was conducted at MNR Medical College and Hospital (March to June 2021). Six case scenarios were developed and created in PowerPoint. Each scenario was broken down into the following sections: title, history, clinical findings, investigations, and treatment. The slides were arranged randomly to produce a medley which was then shown to the students. They were tasked with sorting the slides and diagnosing each case. Student responses were gathered using a Google Forms questionnaire. Results: The number of participants who completed the activity within the stipulated time was 132. The majority of students (85%) scored over 80% in the activity. The activity was interesting (63.6%), promoted active learning (65.2%), helped students correlate the different aspects of the case scenario and make a diagnosis (69.7%), helped build problembased skills, and activated prior knowledge (71.2%), improved clinical orientation to the curriculum (65.2%), exposed students to aspects of the diseases not dealt with in the classroom (40.9%), students felt such an activity should be required of future students (68.2%). Conclusion: This novel learning method of integrating case scenarios using a digital platform provided multiple opportunities for testing and developing skills necessary for clinical practice. The fact that the activity was well received by students strengthens the argument to create additional activities of this type that may be applied to any topic. [ABSTRACT FROM AUTHOR]

Educators are increasingly invited to present via webinars rather than in-person. Webinars offer multiple advantages over in-person presentations, including the ability to speak to participants across a wide geographic area and the possibility of reduced financial and time costs for the webinar organizer, speakers, and participants. To capitalize on these advantages, educators need strategies to present effectively using this medium. Here we provide 12 tips for effective webinar presentations based upon best practices identified in the literature and the authors' experience organizing educational webinars. The 12 tips are: (1) Learn webinar logistics, (2) Conduct a needs assessment, (3) Write specific learning objectives, (4) Attend a webinar, (5) Create clear, engaging slides, (6) Develop interactive learning activities, (7) Familiarize yourself with the technology, (8) Practice your presentation, (9) Be organized, prepared, and energetic, (10) Evaluate participant learning, (11) Learn from feedback, and (12) Share your experience with the organizer. We hope these tips help presenters improve the quality and effectiveness of their webinars. [ABSTRACT FROM AUTHOR]

Context.--Mitotic count is an important histologic criterion for grading and prognostication in phyllodes tumors (PTs). Counting mitoses is a routine practice for pathologists evaluating neoplasms, but different microscopes, variable field selection, and areas have led to possible misclassification. Objective.--To determine whether 10 high-power fields (HPFs) or whole slide mitotic counts correlated better with PT clinicopathologic parameters using digital pathology (DP). We also aimed to find out whether this study might serve as a basis for an artificial intelligence (AI) protocol to count mitosis. Design.--Representative slides were chosen from 93 cases of PTs diagnosed between 2014 and 2015. The slides were scanned and viewed with DP. Mitotic counting was conducted on the whole slide image, before choosing 10 HPFs and demarcating the tumor area in DP. Values of mitoses per millimeter squared were used to compare results between 10 HPFs and the whole slide. Correlations with clinicopathologic parameters were conducted. Results.--Both whole slide counting of mitoses and 10 HPFs had similar statistically significant correlation coefficients with grade, stromal atypia, and stromal hypercellularity. Neither whole slide mitotic counts nor mitoses per 10 HPFs showed statistically significant correlations with patient age and tumor size. Conclusions.--Accurate mitosis counting in breast PTs is important for grading. Exploring machine learning on digital whole slides may influence approaches to training, testing, and validation of a future AI algorithm. [ABSTRACT FROM AUTHOR]

Introduction: Automated slidemakers and stainers and digital microscopes are coupled with haematology analysers to achieve better efficiency and cost‐effectiveness. This study evaluates the integrated performance of slidemakers and digital microscopes commonly available on the market. Methods: We compared the percentage of neutrophils for five slidemakers (two Siemens Advia Autoslides, a SysmexSP‐10 and SP‐50 and an Abbot Alinity hs) and a Horiba Hemaprep to the corresponding haematology analyser data (Siemens Advia 2120i, Sysmex XN and Abbot Alinity hq). Differential leucocyte counting (DLC) was performed on three different CellaVision digital microscopes (DM96, DM1200 and DI‐60) and manually. The quality of the smears was assessed using a CellaVision SmearChecker. Results: We observed a significant positive absolute bias (P <.05) for the percentage of neutrophils with the Autoslide and Alinity hs smears on the digital microscopes, but not when DLC was performed manually. The SP‐10 and SP‐50 showed no bias regardless of the DLC method. No bias was observed for the Hemaprep smears. All the smears had an acceptable monolayer quality, stain intensity and colour. All smears, except those from Sp‐10, were of an acceptable length. Conclusion: Users should be aware of a potential lack of accuracy that can be encountered when using some slidemakers and digital microscopes. All laboratories should validate or verify the differential counts from slidemakers and digital microscope with automated cell differential counters. Manual count validation should only be considered if a significant proportion of clinically relevant abnormal cells are present. Otherwise, haematology analyser results should be favoured. [ABSTRACT FROM AUTHOR]

A variable affecting the success of behavioral training workshops is the degree to which workshop instructors promote attentiveness among trainees. This study represented a preliminary assessment of trainee attentiveness associated with different types of workshop instructor behavior. Attentiveness among 298 people attending 21 training workshops was observed as instructors engaged in different categories and subcategories of behavior. Results indicated a decreasing trend in trainee attentiveness as instructors spent more time exclusively talking and talking with a slide presentation. Relatedly, trainee attentiveness was lowest when instructors were talking with and without a slide presentation relative to engaging in these plus other behaviors (asking a question, telling a story, changing instructors, showing a video, providing a participant activity, and/or expressing humor). Results are discussed in terms of behavior analysts conducting workshops in light of instructional behavior associated with high levels of trainee attentiveness and exerting caution with time spent exclusively talking and talking with slide presentations. Future research areas discussed focus on ways to further specify workshop instructor behavior that promotes or impedes trainee attentiveness. [ABSTRACT FROM AUTHOR]

* Context.--Repair is a challenging diagnosis and a significant source of false-positive (FP) interpretations in cervical cytology. No large-scale study of performance of repair in the liquid-based era has been performed. Objective.--To evaluate the performance of repair in the College of American Pathologists Pap Education and Proficiency Testing (PT) programs. Design.--The FP rate for slides classified as repair was evaluated by preparation type, participant type (cytotechnologist, pathologist, or laboratory), and program. The specific misdiagnosis category and individual slide performance were also evaluated. The rate of misclassification of slides as repair by participants for other diagnostic categories in the Pap Education program was assessed. Results.--The overall FP rate was 1700 of 12 715 (13.4%). There was no significant difference by program or preparation type. Within the Education program there was no difference by participant type, but pathologists' FP rate in the PT program (47 of 514, 9.1%) was significantly better than cytotechnologists in the PT program (51 of 380, 13.4%) and pathologists in the Education program (690 of 4900, 14.1%). High-grade squamous intraepithelial lesions/cancers (HSIL+) accounted for 1380 of 1602 FP interpretations (86%) in Education, but 43 of 98 (43.9%) in PT. Most slides had a low rate of misclassification, but a small number were poor performers. False-negative diagnosis of HSIL+ as repair was less common, ranging from 0.7% to 1.8%. Conclusions.--Despite initial indications that liquidbased cytology might reduce the rate of misclassification of repair, FP interpretations remain common and are no different by preparation type. Misclassification is most commonly as HSIL or carcinoma, potentially resulting in significant patient harm. [ABSTRACT FROM AUTHOR]

Context.--Digital pathology (DP) implementations vary in scale, based on aims of intended operation. Few laboratories have completed a full-scale DP implementation, which may be due to high overhead costs that disrupt the traditional pathology workflow. Neither standardized criteria nor benchmark data have yet been published showing practical return on investment after implementing a DP platform. Objective.--To provide benchmark data and practical metrics to support operational efficiency and cost savings in a large academic center. Design.--Metrics reviewed include archived pathology asset retrieval; ancillary test request for recurrent/metastatic disease; cost analysis and turnaround time (TAT); and DP experience survey. Results.--Glass slide requests from the department slide archive and an off-site surgery center showed a 93% and 97% decrease, respectively. Ancillary immunohistochemical orders, compared in 2014 (52%)--before whole slide images (WSIs) were available in the laboratory information system--and 2017 (21%) showed $114 000/y in anticipated savings. Comprehensive comparative cost analysis showed a 5-year $1.3 million savings. Surgical resection cases with prior WSIs showed a 1-day decrease in TAT. A DP experience survey showed 80% of respondents agreed WSIs improved their clinical sign-out experience. Conclusions.--Implementing a DP operation showed a noteworthy increase in efficiency and operational utility. Digital pathology deployments and operations may be gauged by the following metrics: number of glass slide requests as WSIs become available, decrease in confirmatory testing for patients with metastatic/recurrent disease, long-term decrease in off-site pathology asset costs, and faster TAT. Other departments may use our benchmark data and metrics to enhance patient care and demonstrate return on investment to justify adoption of DP. [ABSTRACT FROM AUTHOR]

Context: The opportunity to deliver a professional presentation to an international audience is a privilege. As with all other presentations, preparation and planning are essential components for a successful outcome. The difference between a diverse international audience and a homogeneous audience of the same background as the speaker requires consideration of additional factors associated with relevant delivery of the content matter. Recognition and integration of cultural differences, language barriers, and delivery expectations are critical to the creation and conveyance of one's presentation. Objective: This article will share advice for preparing for and delivering presentations to an international audience. Data Source: Factors to consider when preparing a platform-style presentation include knowing the cultural background of audience members, the speed and tone of one's delivery, the appearance of slides, the use of hand gestures, and the integration of appropriate terminology. The process of speaking through an interpreter and additional methods that have been proven to be effective in the delivery of an international presentation will also be identified. Conclusion: One can never have enough experience, as each presentation to a diverse international audience may be vastly different. [ABSTRACT FROM AUTHOR]

Comments on the review of manuscript and presentation of slides at scientific meetings. Importance of time and energy in reviewing manuscripts; Flaws of the peer-review process; Purpose of the PowerPoint slide format.