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Background: The lip print pattern is a unique among individuals and thus helps in the identification during the forensic investigation. Lip print analysis in the forensic scene may help in the personal identification. Thus, correlating the lip print with the finger print and gender will create a new room in forensic dentistry investigation. Aim: This study aims to identify the lip and finger print pattern and to correlate lip and finger print pattern for gender identification. Materials and Methods: A total of 100 students from dental institution were included in this study. Of which, 50 were male and 50 were female.. Their aged range between 18 and 28 years with a mean age of 21.3 years. The physiological rest position of the lip print was recorded by the application of red or dark pink colored lipstick over the lips and the imprint was transferred over a white chart sheet through a transparent tape. The imprint of the finger was taken directly on a white chart sheet. The lip and finger print pattern was examined with magnifying lens. The results were analyzed using SPSS software 19.0 (Armonk, NY, USA) and presented as a descriptive statistics. A correlation of lip print with finger print and gender variation was analyzed by Pearson correlation test. Results: The study identified higher prevalence of Type II (34%) lip print pattern in the overall study population. In males, Type I lip print (42%) and plain loop finger print pattern (44%) was frequent in the study. In males, the correlation of lip and finger print patter showed weaker correlation and statistically insignificant (P = 0.436). In females, Type II lip print (34%) and plain loop finger print pattern (42%) was frequent in the study. In females, the correlation of the lip and finger print pattern showed weaker correlation with approachable statistical significance (P = 0.083). The correlation of lip and finger print with gender showed weaker correlation and approachable significance (P = 0.07). The association of lip and finger print in the study showed statistically insignificant. However, the association of Type III lip print pattern with loop finger print pattern showed statistical significant association (P = 0.05) by Chi-square analysis. Conclusion: Lip print analysis is a challenging area in the personal identification during forensic dentistry examination. The study revealed the weaker correlation and approachable significance of lip and finger print pattern in gender identification. Future studies should be encouraged in the direction of software based identification for lip and finger print analysis in gender identification. Such studies may benefit this study pattern in more accurate way.

Background: Xylene is a flammable liquid with characteristic petroleum or aromatic odours, it is miscible with most of the organic solvents and paraffin wax. Xylene clears tissues rapidly and renders transparency, facilitating clearing endpoint determination, this made it to be used as a clearing agent in routine histopathological techniques. Even though it is a good clearing agent, it causes damage to the tissues by its hardening effect particularly those fixed in non-protein coagulant fixatives. Apart from these tissue effects, it has severe, long lasting ill effects on health of technicians and pathologists when exposed to longer duration. Hence in order to overcome these effects and replace xylene with a safe alternative agent, the present study was carried out to assess the clearing ability and biofriendly nature of four different natural oils i.e., Carrot oil, Olive oil, Pine oil and Rose oil in comparison with that of Xylene. According to Bernoulli’s principle of fluid dynamics, to decrease viscosity of these oils and increase penetration into tissues for rapid clearing hot-air oven technique was used. Aims: To assess:1) Clearing ability and bio-friendly nature of four different oils i.e., Carrot oil, Olive oil, Pine oil, Rose oil in comparison with that of xylene, 2) Application of Bernoulli’s principle of fluid dynamics in rapid clearing of tissues by using hot-air oven. Materials and Methods: Forty different formalin fixed tissue samples were taken. Each sample of tissue was cut into 5 bits (40x5=200 total bits) which were subjected for dehydration in differential alcohol gradients. Later, each bit is kept in 4 different oils such as Carrot oil, Olive oil, Pine oil, Rose oil and xylene and transferred into hot-air oven. Further routine steps of processing, sectioning and staining were done. Individual sections cleared in four different oils were assessed for cellular architecture, staining quality and a comparison was done between them. Results: Results showed that all the four oils had ability to clear the tissues similar to that of xylene. Pine oil was superior in its physical and clearing properties, which also maintained good cellular architecture and distinct staining quality, when compared with other oils and xylene. Conclusion: Carrot oil, Olive oil, Pine oil, Rose oil, are not only bio friendly and economical but can also be used as clearing agent instead of xylene. In this study stability and longetivity of haematoxyllin and eosin staining was evaluated for over a period of one year and no significant difference in staining quality were observed.

Learner autonomy is an invaluable asset in graduate medical education, preparing the trainee to independently face challenges in the future professional settings. Educational institutions face the difficult task of providing a balance between learner autonomy and supervision. In graduate medical education, trainees often prefer less supervision than what is imparted by their attending physician. This increased supervision comes at the cost of learner autonomy and has not exhibited improvement in patient outcomes or safety. When attendings exhibit control over details, the trainees may label them as "micromanagers". Cardinal features of a micromanager include excessively requesting updates, insisting that the task be done their way, and scrutinizing every detail. This micromanaging behavior is non-conducive to the learning environment and may even contribute to supervisor burnout. The business literature reveals a debate about this very topic. Unfortunately, there is still a lack of literature on micromanagement in graduate medical education. Although a conglomerate of internal factors may lead to excessive supervision in an academic medical institution, we surmise that micromanagement exists because of a complex dynamic between three drivers: accountability, trust, and autonomy. When trainees are held accountable, they learn to take ownership for their actions which leads to establishment of trust which further enables motivation and gaining of autonomy. Supervising attendings should ideally be able to comfortably adjust their level of supervision based on their trust and the trainee's competence, accountability, and autonomy. The micromanaging physician is unable to do so, and this can have a detrimental effect on the learner. Micromanagement can be perceived by some as a beneficial component during the early immersion of the trainee with the rationalization for better patient outcomes and safety. However, in the long term, it threatens the learning environment and erodes the complex relationship between accountability, trust, and autonomy. We recommend an action plan to mitigate micromanagement at three levels-the micromanager, the micromanaged, and the organizational structure-and hope that these solutions enhance the learning environment for both the trainee and supervisor., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mookerjee et al.)

Aims: This project aims to address the question of whether patients were satisfied with using a video visit for prechemotherapy evaluation during the COVID-19 pandemic. Methods & materials: This project used a survey tool with patients undergoing prechemotherapy evaluation that was administered at the time of chemotherapy; 70 surveys were collected. Descriptive statistics of survey questions are presented. Results: 73% of patients reported satisfaction with their video visit experience. 65% of patients reported that they prefer in-person visits as their preferred choice for prechemotherapy evaluation. Conclusion: Patient satisfaction was favorable, but not consistent with results from prior published studies. Patients also mostly preferred an in-person visit for prechemotherapy evaluation. Further research is needed to determine patient attitudes to telemedicine for different types of consultations.

Multiple myeloma (MM) is an aggressive cancer that originates from antibody-secreting plasma cells. Although genetically and transcriptionally well characterized, the aberrant gene regulatory networks that underpin this disease remain poorly understood. Here, we mapped regulatory elements, open chromatin, and transcription factor (TF) footprints in primary MM cells. In comparison with normal antibody-secreting cells, MM cells displayed consistent changes in enhancer activity that are connected to superenhancer (SE)-mediated deregulation of TF genes. MM cells also displayed widespread decompaction of heterochromatin that was associated with activation of regulatory elements and in a major subset of patients' deregulation of the cyclic adenosine monophosphate pathway. Finally, building SE-associated TF-based regulatory networks allowed identification of several novel TFs that are central to MM biology. Taken together, these findings significantly add to our understanding of the aberrant gene regulatory network that underpins MM., (© 2018 by The American Society of Hematology.)

Background: Biliary cancers are highly aggressive tumors that are often diagnosed an advanced disease stage and have a poor outcome with systemic therapy. Recent efforts towards molecular characterization have identified a subset of biliary patients that have HER2/neu amplification or mutation. HER2/neu amplification is associated with response to HER2/neu-directed therapy in breast and gastric cancers. However, the efficacy of HER2/neu-targeted therapy in biliary cancers is unknown., Patients and Methods: We retrospectively reviewed cases of advanced gallbladder cancer and cholangiocarcinoma with HER2/neu genetic aberrations or protein overexpression who received HER2/neu-directed therapy between 2007 and 2014. Clinical data were retrieved from medical records, and imaging studies were independently reviewed., Results: Nine patients with gallbladder cancer and five patients with cholangiocarcinoma had received HER2/neu-directed therapy (trastuzumab, lapatinib, or pertuzumab) during the study period. In the gallbladder cancer group, HER2/neu gene amplification or overexpression was detected in eight cases. These patients experienced disease stability (n = 3), partial response (n = 4), or complete response (n = 1) with HER2/neu-directed therapy. One patient had HER2/neu mutation and experienced a mixed response after lapatinib therapy. The duration of response varied from 8+ to 168 weeks (median 40 weeks), and three patients are still on therapy. One patient developed HER2/neu amplification as a secondary event after FGFR-directed therapy for FGF3-TACC3 gene fusion. The cholangiocarcinoma cases treated in this series had a higher proportion of HER2/neu mutations, and no radiological responses were seen in these patients despite HER2/neu-directed therapy., Conclusions: HER2/neu blockade is a promising treatment strategy for gallbladder cancer patients with gene amplification and deserves further exploration in a multi-center study.

Acquired amegakaryocytic thrombocytopenia (AAT) is a hematologic disorder that presents as thrombocytopenia with absent megakaryocytes in the bone marrow. Causes of AAT include toxins, drugs, viral infections, systemic lupus erythematosus, and cytokine deficiencies. Patients with AAT should be followed for possible progression to aplastic anemia or myelodysplastic syndrome. We present a case of a 61-year-old woman with AAT due to occupational chemical exposure.

Background: The optimal volume of pleural fluid to diagnose a malignant effusion is unknown. Our study was designed to demonstrate if a minimum pleural fluid volume (10 mL) is equivalent to a large volume thoracentesis to make a cytopathologic diagnosis of malignancy., Methods: A total of 121 thoracentesis samples were obtained from 102 patients with suspected or known malignant effusions. Pleural fluid was collected in three aliquots for cytologic examination (10 mL, 60 mL, > or = 150 mL). The pathologist was blinded to patient identifiers and aliquot volume. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated for each volume for the diagnosis of malignancy., Results: Pleural malignancy was diagnosed in 90 patient encounters (74.4%). For direct smear/cytospin, there was increased sensitivity and NPV for 60 mL (P = .0058 and P = .045, respectively) and for > or = 150 mL (P < .001 and P = .009, respectively) compared with 10 mL. For combined direct smear/cytospin and cell block preparations, statistical significance for sensitivity and NPV existed only between the 10 mL and > or = 150 mL specimens (P = .0099 and P = .033, respectively). No statistical difference existed for specificity or PPV for any aliquot volume., Conclusions: The sensitivity for diagnosis of pleural malignancy is dependent on the pleural fluid volume extracted during thoracentesis. Volumes of 10 mL do not perform as well as larger volumes. When both direct smear/cytospin and cell block preparations are used, we recommend > or = 150 mL, whereas when only direct smear/cytospin is used, 60 mL is adequate for the diagnosis a malignant pleural effusion.

Rapid prototyping of microfluidic systems using a combination of double-sided tape and PDMS (polydimethylsiloxane) is introduced. PDMS is typically difficult to bond using adhesive tapes due to its hydrophobic nature and low surface energy. For this reason, PDMS is not compatible with the xurography method, which uses a knife plotter and various adhesive coated polymer tapes. To solve these problems, a PDMS/tape composite was developed and demonstrated in microfluidic applications. The PDMS/tape composite was created by spinning it to make a thin layer of PDMS over double-sided tape. Then the PDMS/tape composite was patterned to create channels using xurography, and bonded to a PDMS slab. After removing the backing paper from the tape, a complete microfluidic system could be created by placing the construct onto nearly any substrate; including glass, plastic or metal-coated glass/silicon substrates. The bond strength was shown to be sufficient for the pressures that occur in typical microfluidic channels used for chemical or biological analysis. This method was demonstrated in three applications: standard microfluidic channels and reactors, a microfluidic system with an integrated membrane, and an electrochemical biosensor. The PDMS/tape composite rapid prototyping technique provides a fast and cost effective fabrication method and can provide easy integration of microfluidic channels with sensors and other components without the need for a cleanroom facility.

It is now apparent that distinction between the so-called malignant histiocytosis and lymphoma can be made using panels of established immunohistochemical markers and/or genotypic analysis. Many, if not all, of the previously diagnosed cases of malignant histiocytosis have been shown to be of lymphoid, rather than histiocytic, lineage. We report a rare case of colonic histiocytic neoplasm accompanied by a lymphoreticular dissemination that mimicked that of malignant histiocytosis. In addition, barium studies and computed axial tomography confirmed an intussusception that subsequently developed. The histiocytic nature of the neoplastic cells was supported by immunohistochemical, ultrastructural, and cytochemical studies. To our knowledge our case may represent the fifth documented case of a histiocytic malignancy reported in the literature. The relationship among the various cases will be discussed as well as the significance of the focal S-100 immunoreactivity observed in the present case.