Histopathologic Review of Previously Negative Prostatic Core Needle Biopsies Following a New Diagnosis of Adenocarcinoma of the Prostate by Core Needle Biopsies: Implications for Quality Assurance Programs

Programs for quality assurance are increasingly important in surgical pathology. Many quality assurance (QA) techniques for surgical pathology were adopted from procedures introduced in cytopathology. Surgical pathology specimens have diminished in size such that the majority of diagnostic biopsies of prostatic lesions are now core needle biopsies. These specimens raise issues similar to those of cytology specimens, including concerns regarding adequacy and the representative nature of the biopsy. Due to sample size, some neoplasms may not be diagnosed on initial biopsy, raising concerns regarding false negative results. Cytopathologists have instituted QA procedures including review of all previously negative slides received within five years prior to the new diagnosis of high grade squamous intraepithelial lesion or gynecologic malignancy. No such requirement exists in surgical pathology for review of core biopsies

GUAR GUM: A VERSATILE MATERIAL FOR PHARMACEUTICAL INDUSTRIES

Guar gum (GG) is galactomannan, derived from guar (cyamopsistetragonolobus) kernels which belong to family Leguminosae. The solution of guar gum in water has the highest viscosity amongst all the natural polysaccharide discovered till the date. Further it has better bio-degradability and bio-compatibility. Due to these properties, guar gum finds application in various industries like, Textile, Food, Petrochemical, Mining, Paper, Explosive etc. But due to uncontrollable rate of viscosity, uncontrollable rate of hydration, instability of its solution for a long time and susceptibility to microbial contamination restricts its use in pharmaceutical industries. To overcome these draw back guar gum should be chemically modified. Modified guar gum is widely used in pharmaceutical application due to its viscosity enhancing properties. Guar gum and derivatives are used as binders and disintegrate in tablet and also used as a control-released agent for the drug. In this review article we summarized different pharmaceutical applications of native guar gum and its derivatives

Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams

Academic and nonacademic health informatics (HI) professionals (informaticians) serve on interprofessional health care teams with other professionals, such as physicians, nurses, pharmacists, dentists, and nutritionists. Presently, we argue for investing greater attention to the role health informaticians play on interprofessional teams and the best practices to support this role

Ultrasound-triggered antibiotic release from PEEK clips to prevent spinal fusion infection: Initial evaluations.

Despite aggressive peri-operative antibiotic treatments, up to 10% of patients undergoing instrumented spinal surgery develop an infection. Like most implant-associated infections, spinal infections persist through colonization and biofilm formation on spinal instrumentation, which can include metal screws and rods for fixation and an intervertebral cage commonly comprised of polyether ether ketone (PEEK). We have designed a PEEK antibiotic reservoir that would clip to the metal fixation rod and that would achieve slow antibiotic release over several days, followed by a bolus release of antibiotics triggered by ultrasound (US) rupture of a reservoir membrane. We have found using human physiological fluid (synovial fluid), that higher levels (100–500 μg) of vancomycin are required to achieve a marked reduction in adherent bacteria vs. that seen in the common bacterial medium, trypticase soy broth. To achieve these levels of release, we applied a polylactic acid coating to a porous PEEK puck, which exhibited both slow and US-triggered release. This design was further refined to a one-hole or two-hole cylindrical PEEK reservoir that can clip onto a spinal rod for clinical use. Short-term release of high levels of antibiotic (340 ± 168 μg), followed by US-triggered release was measured (7420 ± 2992 μg at 48 h). These levels are sufficient to prevent adhesion of Staphylococcus aureus to implant materials. This study demonstrates the feasibility of an US-mediated antibiotic delivery device, which could be a potent weapon against spinal surgical site infection. Statement of Significance: Spinal surgical sites are prone to bacterial colonization, due to presence of instrumentation, long surgical times, and the surgical creation of a dead space (≥5 cm 3 ) that is filled with wound exudate. Accordingly, it is critical that new approaches are developed to prevent bacterial colonization of spinal implants, especially as neither bulk release systems nor controlled release systems are available for the spine. This new device uses non-invasive ultrasound (US) to trigger bulk release of supra-therapeutic doses of antibiotics from materials commonly used in existing surgical implants. Thus, our new delivery system satisfies this critical need to eradicate surviving bacteria, prevent resistance, and markedly lower spinal infection rates

Multi-Response Optimization of WEDM Process Parameters for Machining of Superelastic Nitinol Shape-Memory Alloy Using a Heat-Transfer Search Algorithm

Nitinol, a shape-memory alloy (SMA), is gaining popularity for use in various applications. Machining of these SMAs poses a challenge during conventional machining. Henceforth, in the current study, the wire-electric discharge process has been attempted to machine nickel-titanium (Ni55.8Ti) super-elastic SMA. Furthermore, to render the process viable for industry, a systematic approach comprising response surface methodology (RSM) and a heat-transfer search (HTS) algorithm has been strategized for optimization of process parameters. Pulse-on time, pulse-off time and current were considered as input process parameters, whereas material removal rate (MRR), surface roughness, and micro-hardness were considered as output responses. Residual plots were generated to check the robustness of analysis of variance (ANOVA) results and generated mathematical models. A multi-objective HTS algorithm was executed for generating 2-D and 3-D Pareto optimal points indicating the non-dominant feasible solutions. The proposed combined approach proved to be highly effective in predicting and optimizing the wire electrical discharge machining (WEDM) process parameters. Validation trials were carried out and the error between measured and predicted values was negligible. To ensure the existence of a shape-memory effect even after machining, a differential scanning calorimetry (DSC) test was carried out. The optimized parameters were found to machine the alloy appropriately with the intact shape memory effect

Perovskite-perovskite tandem photovoltaics with optimized bandgaps

We demonstrate four and two-terminal perovskite-perovskite tandem solar cells with ideally matched bandgaps. We develop an infrared absorbing 1.2eV bandgap perovskite, $FA_{0.75}Cs_{0.25}Sn_{0.5}Pb_{0.5}I_3$, that can deliver 14.8 % efficiency. By combining this material with a wider bandgap $FA_{0.83}Cs_{0.17}Pb(I_{0.5}Br_{0.5})_3$ material, we reach monolithic two terminal tandem efficiencies of 17.0 % with over 1.65 volts open-circuit voltage. We also make mechanically stacked four terminal tandem cells and obtain 20.3 % efficiency. Crucially, we find that our infrared absorbing perovskite cells exhibit excellent thermal and atmospheric stability, unprecedented for Sn based perovskites. This device architecture and materials set will enable 'all perovskite' thin film solar cells to reach the highest efficiencies in the long term at the lowest costs

A semi-automatic segmentation method for meningioma developed using a variational approach model

Background Meningioma is the commonest primary brain tumour. Volumetric post-contrast magnetic resonance imaging (MRI) is recognised as gold standard for delineation of meningioma volume but is hindered by manual processing times. We aimed to investigate the utility of a model-based variational approach in segmenting meningioma. Methods A database of patients with a meningioma (2007–2015) was queried for patients with a contrast-enhanced volumetric MRI, who had consented to a research tissue biobank. Manual segmentation by a neuroradiologist was performed and results were compared to the mathematical model, using a battery of tests including the Sørensen–Dice coefficient (DICE) and JACCARD index. A publicly available meningioma dataset (708 segmented T1 contrast-enhanced slices) was also used to test the reliability of the model. Results 49 meningioma cases were included. The most common meningioma location was convexity (n = 15, 30.6%). The mathematical model segmented all but one incidental meningioma, which failed due to the lack of contrast uptake. The median meningioma volume by manual segmentation was 19.0 cm3 (IQR 4.9–31.2). The median meningioma volume using the mathematical model was 16.9 cm3 (IQR 4.6–28.34). The mean DICE score was 0.90 (SD = 0.04). The mean JACCARD index was 0.82 (SD = 0.07). For the publicly available dataset, the mean DICE and JACCARD scores were 0.90 (SD = 0.06) and 0.82 (SD = 0.10), respectively. Conclusions Segmentation of meningioma volume using the proposed mathematical model was possible with accurate results. Application of this model on contrast-enhanced volumetric imaging may help reduce work burden on neuroradiologists with the increasing number in meningioma diagnoses

A Visual Interactive Analytic Tool for Filtering and Summarizing Large Health Data Sets Coded with Hierarchical Terminologies (VIADS).

BACKGROUND: Vast volumes of data, coded through hierarchical terminologies (e.g., International Classification of Diseases, Tenth Revision-Clinical Modification [ICD10-CM], Medical Subject Headings [MeSH]), are generated routinely in electronic health record systems and medical literature databases. Although graphic representations can help to augment human understanding of such data sets, a graph with hundreds or thousands of nodes challenges human comprehension. To improve comprehension, new tools are needed to extract the overviews of such data sets. We aim to develop a visual interactive analytic tool for filtering and summarizing large health data sets coded with hierarchical terminologies (VIADS) as an online, and publicly accessible tool. The ultimate goals are to filter, summarize the health data sets, extract insights, compare and highlight the differences between various health data sets by using VIADS. The results generated from VIADS can be utilized as data-driven evidence to facilitate clinicians, clinical researchers, and health care administrators to make more informed clinical, research, and administrative decisions. We utilized the following tools and the development environments to develop VIADS: Django, Python, JavaScript, Vis.js, Graph.js, JQuery, Plotly, Chart.js, Unittest, R, and MySQL. RESULTS: VIADS was developed successfully and the beta version is accessible publicly. In this paper, we introduce the architecture design, development, and functionalities of VIADS. VIADS includes six modules: user account management module, data sets validation module, data analytic module, data visualization module, terminology module, dashboard. Currently, VIADS supports health data sets coded by ICD-9, ICD-10, and MeSH. We also present the visualization improvement provided by VIADS in regard to interactive features (e.g., zoom in and out, customization of graph layout, expanded information of nodes, 3D plots) and efficient screen space usage. CONCLUSIONS: VIADS meets the design objectives and can be used to filter, summarize, compare, highlight and visualize large health data sets that coded by hierarchical terminologies, such as ICD-9, ICD-10 and MeSH. Our further usability and utility studies will provide more details about how the end users are using VIADS to facilitate their clinical, research or health administrative decision making

Portrayal of organ donation and transplantation on American primetime television

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86819/1/j.1399-0012.2011.01427.x.pd