Utilizing perioperative patient positioning to correct intraocular lens implant subluxation.

Purpose: to describe how preoperative and intraoperative positioning techniques can be used to manage subluxed intraocular lenses (IOL) whilst saving patients from pars plana vitrectomy.

Observations: An 88-year-old man with a complex past medical history including mild cognitive decline from early Alzheimer's dementia and pertinent ocular history of pseudoexfoliation syndrome and previous cataract surgery with IOL presented with decreased vision secondary to an inferiorly subluxed IOL/bag complex. The IOL was not visible in the operating room when he was supine but was visible in clinic the next day after he had slept in the prone position the night before.

Incidence of Endogenous Fungal Endophthalmitis in Screening Dilated Exams in Patients with Elevated Beta-D-Glucan Levels versus Positive Fungal Blood Cultures.

Purpose: Endogenous endophthalmitis is a severe intraocular infectious condition requiring rapid diagnosis and treatment. This study examines the incidence of fungal endophthalmitis in patients with elevated beta-D-glucan (BG) levels and those with positive blood culture and the utility of ophthalmology consultation in these patients.

Methods: Single center retrospective consecutive cohort study was conducted on patients at Beaumont Health from 2016-2021 who either had positive fungal blood cultures or an elevated BG level.

Single-cell transcriptome and accessible chromatin dynamics during endocrine pancreas development.

Delineating gene regulatory networks that orchestrate cell-type specification is a continuing challenge for developmental biologists. Single-cell analyses offer opportunities to address these challenges and accelerate discovery of rare cell lineage relationships and mechanisms underlying hierarchical lineage decisions. Here, we describe the molecular analysis of mouse pancreatic endocrine cell differentiation using single-cell transcriptomics, chromatin accessibility assays coupled to genetic labeling, and cytometry-based cell purification.

A machine learning approach to identify barriers in stream networks demonstrates high prevalence of unmapped riverine dams.

Restoring stream ecosystem integrity by removing unused or derelict dams has become a priority for watershed conservation globally. However, efforts to restore connectivity are constrained by the availability of accurate dam inventories which often overlook smaller unmapped riverine dams. Here we develop and test a machine learning approach to identify unmapped dams using a combination of publicly available topographic and geospatial habitat data.

A melanoma patient with macrophage-cancer cell hybrids in the primary tumor, a lymph node metastasis and a brain metastasis.

In 1911 it was proposed that cancer might result from fusion and hybridization between macrophages and cancer cells. Using immunohistochemistry it was determined that essentially all solid tumors expressed macrophage-like molecules on their cell surface. More recently we have used forensic (STR) genetics that allows one to detect DNA from more than one individual in the same sample.

Recent Advances in Studies of Skin Color and Skin Cancer.

The relationship between skin color and skin cancer is well established: the less melanin in one's skin the greater the risk for developing skin cancer. This review is in two parts. First, we summarize the current understanding of the cutaneous pigmentary system and trace melanin from its synthesis in the pigment cell melanosomes through its transfer to keratinocytes.

Leukocyte⁻Cancer Cell Fusion-Genesis of a Deadly Journey.

According to estimates from the International Agency for Research on Cancer, by the year 2030 there will be 22 million new cancer cases and 13 million deaths per year. The main cause of cancer mortality is not the primary tumor itself but metastasis to distant organs and tissues, yet the mechanisms of this process remain poorly understood. Leukocyte⁻cancer cell fusion and hybrid formation as an initiator of metastasis was proposed more than a century ago by the German pathologist Prof.

Trigeminal hypertrophic interstitial neuropathy presenting as unilateral proptosis, ptosis, tearing, and facial neuralgia.

Purpose: To show the utility of MRI and histology in diagnosing rare cases of trigeminal hypertrophic interstitial neuropathy (HIN).

Observations: A 57-year-old African-American woman presented with a 4-year history of right eye proptosis with tearing, headaches, and worsening right-sided trigeminal neuralgia symptoms and jaw pain. HIV and diabetes tests were negative and thyroid function was normal.

A Melanoma Lymph Node Metastasis with a Donor-Patient Hybrid Genome following Bone Marrow Transplantation: A Second Case of Leucocyte-Tumor Cell Hybridization in Cancer Metastasis.

Background: Metastatic disease is the principal cause of mortality in cancer, yet the underlying mechanisms are not fully understood. Macrophage-cancer cell fusion as a cause of metastasis was proposed more than a century ago by German pathologist Prof. Otto Aichel.

Clinical sensitivity of HPV assays for the detection of high grade cervical disease in cervical samples treated with glacial acetic acid.

Background: Lysis of bloody liquid based cytology (LBC) specimens with glacial acetic acid (GAA) is performed to aid cytological interpretation. However, the influence of GAA treatment on HPV detection is not fully understood and in studies designed to assess this, few cases of high-grade disease have been included.

Objectives: To assess the sensitivity of HPV molecular tests for the detection of high grade cervical disease in GAA treated samples

Study Design: A total of 207 specimens associated with high grade dyskaryosis and treated with GAA were collated prospectively.

Effect of levosimendan therapy on myocardial infarct size and left ventricular function after acute coronary occlusion.

Background: Levosimendan is an inotropic agent with cardioprotective and vasodilating properties used for the management of acutely decompensated heart failure. We studied the effects of levosimendan treatment on the size of myocardial infarction (MI) and left ventricular (LV) function in experimental pig model of post MI heart failure.

Methods: After occlusion of the left anterior descending (LAD) coronary artery, animals received levosimendan 5 mg/kg/day orally for 8 weeks (n=7) or no treatment (n=18).

The Effect of Payer Status on Survival of Patients with Stage I/II Non-small Cell Lung Cancer: NCDB 1998-2011.

Background: One of the challenges to improving access to care is identifying disparities in health care. To determine the influence of insurance status on outcome for patients with non-small cell lung cancer (NSCLC), we analyzed data from the National Cancer Data Base (NCDB) from 1998-2011.

Materials And Methods: Data from 299,914 patients diagnosed with NSCLC registered in the NCDB were analyzed.

Clinical and Analytical Performance of the Onclarity HPV Assay Using the VALGENT Framework.

As the demand for human papillomavirus (HPV)-related cervical screening increases, emerging HPV tests must be evaluated robustly using well-annotated samples, such as those generated in the Validation of HPV Genotyping Tests (VALGENT) framework. Through VALGENT, we assessed the performance of the BD Onclarity HPV assay, which detects 14 high-risk (HR) types and resolves six individual types and three groups of types. Consecutive samples from a screening population (n = 1,000), enriched with cytologically abnormal samples (n = 300), that had been tested previously with the GP5+/6+ PCR enzyme immunoassay (EIA) and the GP5+/6+ PCR LMNX assay (Diassay) were tested with the Onclarity assay.

A Melanoma Brain Metastasis with a Donor-Patient Hybrid Genome following Bone Marrow Transplantation: First Evidence for Fusion in Human Cancer.

Background: Tumor cell fusion with motile bone marrow-derived cells (BMDCs) has long been posited as a mechanism for cancer metastasis. While there is much support for this from cell culture and animal studies, it has yet to be confirmed in human cancer, as tumor and marrow-derived cells from the same patient cannot be easily distinguished genetically.

Methods: We carried out genotyping of a metastatic melanoma to the brain that arose following allogeneic bone-marrow transplantation (BMT), using forensic short tandem repeat (STR) length-polymorphisms to distinguish donor and patient genomes.

Sedation scales and measures--a literature review.

The monitoring and assessment of the degree of conscious sedation experienced by patients is important for both clinical practice and in research. Whereas clinical monitoring remains the gold standard for safety in patient care, numerous measures are available to supplement this and to provide quantitative data on level of sedation. This manuscript provides an overview of existing measures of the degree of sedation.

Effect of glacial acetic acid pre-treatment of cervical liquid-based cytology specimens on the molecular detection of human papillomavirus.

Objective: Cytology laboratories routinely treat cervical liquid-based cytology (LBC) specimens that are heavily contaminated with blood with glacial acetic acid (GAA) in order to lyse red blood cells and facilitate assessment. However, the impact on downstream human papillomavirus (HPV) detection is not well understood. This study examines the effect of GAA pre-treatment of ThinPrep(®) Preservcyt(®) specimens on the molecular detection of HPV.

Medical students' approaches to learning over a full degree programme.

Students take three approaches to learning and studying: deep, surface and strategic, influenced by the learning environment. Following the General Medical Council's report "Tomorrow's Doctors," a deep approach was cultivated in Years 1 and 2 of a university undergraduate medical programme by introducing explicit written learning objectives constructed according to Biggs' SOLO taxonomy, problem-based learning and constructively aligned in-course assignments and examinations. The effect of these changes was measured with the Approaches to Study Skills Inventory for Students (ASSIST).

Molecular assay for screening and quantifying DNA in biological evidence: the modified Q-TAT assay.

A method is described for the quantitation of total human and male DNA. Q-TAT utilizes end-point, multiplex polymerase chain reaction (PCR) amplification of the amelogenin and SRY loci to quantify DNA and incorporates a cloned nonhuman template to detect PCR inhibition. Standard curves of fluorescence from amelogenin or SRY amplicons were generated from amplification of known amounts of NIST traceable SRM-female or SRM-male DNA.

A single ThinPrep slide may not be representative in all head and neck fine needle aspirate specimens.

Objectives: Ideally, head and neck aspiration should be performed by trained aspirators within the setting of a one-stop clinic, where smeared material is available for immediate assessment. However, this may not always be possible for practical reasons and the use of liquid-based techniques in head and neck cytology is increasing. Although liquid-based cytology has been extensively validated for use in gynaecological cytology, no studies have investigated whether or not a single ThinPrep slide is representative for head and neck aspirate specimens.

The use of the 'borderline' category in the reporting of cervical cytopathology in the UK: results of a survey conducted under the aegis of the British Society for Clinical Cytology.

Objective: To determine how the 'borderline' category was used by cytopathologists in the UK when reporting cervical smears.

Methods: A questionnaire was sent by email to members of the British Society for Clinical Cytology.

Results: There is wide variation in the use of the 'borderline' category in the UK but the majority of respondents (77.

Relationship between assessment results and approaches to learning and studying in Year Two medical students.

Context: Students can take different approaches to learning and studying: deep (understanding material); surface (memorizing details), and strategic (motivated by assessments). It is important to know how assessments affect student choices of approach.

Methods: Students' learning approaches in Year 2 of the medical programme were measured using the Approaches to Study Skills Inventory for Students.

Using a quality control approach to define an 'adequately cellular' liquid-based cervical cytology specimen.

Objective: To define a minimum acceptable total squamous cellularity for (ThinPrep) liquid-based cervical cytology (LBC) specimens using quality control techniques.

Methods: Two hundred LBC preparations were made containing varying numbers (<200) of severely dyskaryotic squamous cells and with varying total cellularities.

Results: Ninety-eight per cent of the LBC preparations that were missed by one or more of three cytoscreeners had fewer than 16 abnormal objects (single dyskaryotic cells or clumps of cells) and 87 dyskaryotic cells.