Monday, May 27, 2019
"National forgetting doesn’t bode well for the future." #MemorialDay
Remember the Fallen, and Their Cause
Memorial Day pays tribute to those who gave their lives for their country—but we should know more about why.May 24, 2019
"Of the 16 million Americans who fought in World War II, just under 500,000 remained alive in 2018. World War II veterans are dying at a rate of 350 per day. The last surviving World War II vet will likely die sometime in 2044.
Before that happens, we owe these soldiers a display of national gratitude—but a holiday commemorating World War II will be even more important when they’re gone. Tomorrow’s children will be born into a country that has forgotten the legacy of the war, and not just because those who fought it are no longer with us. The idea of the “Greatest Generation” has gone from honorific to punchline. Today, we’re quick to criticize America’s wartime decisions, whether the firebombing of Dresden or the decision to drop atomic bombs on Hiroshima and Nagasaki. Even the photo of the sailor and nurse, once the jubilant symbol of a triumphant nation, is viewed by some as a depiction of sexual assault.
National forgetting doesn’t bode well for the future. Today, too many Americans deride any opposing viewpoint as beyond the pale. Political opponents are casually smeared as “Nazis.” We fail to take seriously the evils of twentieth-century fascism, in part because we no longer acknowledge the moral rectitude of the Allies. We’re less equipped now to defeat fascism in its resurgent cultural manifestations.
Those living in the Eastern European countries that bore the brunt of Hitler’s murderous campaigns understand this well. Their countries still mark the end of World War II with pageantry and parades. Nothing less than the fate of the world hung in the balance during those six long years. Had things gone the other way, humanity would have taken an unimaginably dark turn. That is well worth celebrating, now and forever."
Sunday, May 26, 2019
"The word ‘monster’ comes from the Latin monere, to warn. We need monsters..."
Susan Sontag was a monster
"This is how I see her monstrosity: residing not in whether she was or was not likeable, but in her relentlessness, and her refusal to pander. The word ‘monster’ comes from the Latin monere, to warn. We need monsters like Sontag because they aren’t afraid to speak a certain kind of truth: cutting through cant, received opinion, nationalist rote, the efforts of alt-Right bot farms. We need critics who insist on hierarchies of thought and output, instead of buying into marketing hype that makes everyone really, really good, critics who don’t lunge straight for content, for what a book is ‘about’ or what it ‘says’, but who stop to consider form, and style – which, as Sontag shows us, are inextricably bound up in content. We need critics to keep us on our toes, to question authority, sweeping claims, totalising world views. We need Sontag to help us think for ourselves, and be unafraid to speak our minds. And we need her for these things now, more than ever. Maintaining a lively critical capability isn’t just about snark. It’s how we’re going to make it out of these dark days of nationalism and populism with our democracy intact."
Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group
Arch Pathol Lab Med. 2018 Jan;142(1):89-108. doi: 10.5858/arpa.2017-0124-RA. Epub 2017 Jul 7.
Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group.
Husain AN1, Colby TV1, Ordóñez NG1, Allen TC1, Attanoos RL1, Beasley MB1, Butnor KJ1, Chirieac LR1, Churg AM1, Dacic S1, Galateau-Sallé F1, Gibbs A1, Gown AM1, Krausz T1, Litzky LA1, Marchevsky A1, Nicholson AG1, Roggli VL1, Sharma AK1, Travis WD1, Walts AE1, Wick MR1.
Author information
- 1
- From the Department of Pathology, University of Chicago Medical Center, Chicago, Illinois (Drs Husain and Krausz); the Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona (Dr Colby, emeritus); the Department of Pathology, University of Texas, MD Anderson Cancer Center, Houston (Dr Ordóñez); the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen); the Department of Cellular Pathology, University Hospital of Wales and Cardiff University, Cardiff, South Glamorgan, Wales (Dr Attanoos); the Department of Pathology, Mount Sinai Medical Center, New York, New York (Dr Beasley); the Department of Pathology, University of Vermont College of Medicine, Burlington (Dr Butnor); the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Dr Chirieac); the Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada (Dr Churg); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Dacic); Centre National Référent MESOPATH Departement de Biopathologie, Lyon Cedex, France (Dr Galateau-Sallé); the Department of Pathology, University Hospital of Wales, Penarth, South Glamorgan, Wales (Dr Gibbs); the Department of Pathology, PhenoPath Laboratories, Seattle, Washington (Dr Gown); the Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, (Dr Litzky); the Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California (Drs Marchevsky and Walts); the Department of Histopathology, Royal Brompton & Harefield National Health Service Foundation Trust and the National Heart and Lung Institute, Imperial College, Chelsea, London, England (Dr Nicholson); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Roggli); the Department of Pathology, University of Pittsburgh, and the VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (Dr Sharma); the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Travis); and the Department of Pathology, University of Virginia Medical Center, Charlottesville (Dr Wick).
Abstract
CONTEXT:
- Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose.
OBJECTIVE:
- To provide updated, practical guidelines for the pathologic diagnosis of MM.
DATA SOURCES:
- Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks.
CONCLUSIONS:
- There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.
0.2086 of a second
PAGENAUD HOLDS OFF ROSSI TO WIN INDY 500
By INDYCAR | Published: May 26, 2019
INDIANAPOLIS – Simon Pagenaud swept the month of May at Indianapolis Motor Speedway and extended Team Penske’s Indianapolis 500 legacy in thrilling fashion, holding off Alexander Rossi to win the biggest race of them all, the 103rd Indianapolis 500 presented by Gainbridge on Sunday.
Pagenaud pushed the No. 22 Menards Team Penske Chevrolet across the finish line by 0.2086 of a second ahead of Rossi, the 2016 Indy 500 winner. It was Pagenaud’s first win at “The Greatest Spectacle in Racing” and extended Team Penske’s record for Indianapolis 500 victories to 18.
HT:MC
#MemorialDay "It’s a day for remembering, and honoring, the men and women who have died while serving their country in the U.S. armed forces."
OUR VIEW: Memorial Day a time to contemplate, remember
"It’s a day for remembering, and honoring, the men and women who have died while serving their country in the U.S. armed forces.
The latest compilation pegs that number at nearly 1.355 million since 1775 — roughly half of them combat deaths — and it includes some pretty esoteric conflicts that only history buffs would recognize."
Saturday, May 25, 2019
Rural obesity an increasing concern
Rural obesity an increasing concern
“Access to healthy and affordable food is also limited in many rural communities. Further, the distance that many rural residents must travel to access health care facilities, physical activity facilities and healthy food is an ongoing barrier.”
Thursday, May 23, 2019
Burden or Opportunity? Parent Experiences When Approached for Research in a Pediatric Intensive Care Unit
Ethics Hum Res. 2019 May;41(3):2-12. doi: 10.1002/eahr.500014.
Burden or Opportunity? Parent Experiences When Approached for Research in a Pediatric Intensive Care Unit.
Author information
- 1
- Assistant professor of pediatrics at Northwestern University Feinberg School of Medicine and an adjunct professor of law at the Northwestern University Pritzker School of Law.
- 2
- Research assistant at the Ann & Robert H. Lurie Children's Hospital of Chicago.
- 3
- Medical student and research assistant at Northwestern University Feinberg School of Medicine.
- 4
- Senior statistician at the Ann & Robert H. Lurie Children's Hospital of Chicago.
- 5
- Professor and the vice chair of the Department of Pediatrics at Northwestern University Feinberg School of Medicine and the senior vice president of community health transformation at the Ann & Robert H. Lurie Children's Hospital of Chicago.
Abstract
Despite an ongoing need for pediatric research, low study enrollment may impede study completion, particularly in critical care. We conducted a prospective cross-sectional survey and chart review study to assess parent experiences with research in a pediatric intensive care unit (PICU). Of the 80 parents who completed the study survey, 54% were approached to participate in a research study in the PICU, and 93% agreed to participate. Motivators included altruism, low burden, low risk, and research that would benefit the child. Barriers included risks to the child, the child's being too sick to participate, feeling overwhelmed, not having enough time to participate, the research's being burdensome, and the research's not being explained well. PICU parents had mostly favorable attitudes toward research participation. Compared with non-Hispanic survey respondents, respondents of Hispanic ethnicity less often reported having been approached for research, which further evidences the need to track research recruitment processes to help avoid underinclusion of members of minority populations.
Keep Calm and Tweet On: Legal and Ethical Considerations for Pathologists Using Social Media
Arch Pathol Lab Med. 2019 Jan;143(1):75-80. doi: 10.5858/arpa.2018-0313-SA. Epub 2018 Aug 22.
Keep Calm and Tweet On: Legal and Ethical Considerations for Pathologists Using Social Media.
Author information
- 1
- From the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner); and Department of Pathology, University of Mississippi Medical Center, Jackson (Dr Allen).
Abstract
Recent privacy breaches by a major social media company have again raised questions from some pathologists regarding the legality and ethics of sharing pathology images on social media. The authors examined ethical principles as well as historic and legal precedents relevant to pathology medical photography. Taking and sharing photographs of pathology specimens is embedded into the culture of the specialty of pathology and has been for more than a century. In general, the pathologist who takes the photograph of a gross or microscopic specimen owns the copyright to that photograph. Patient consent is not legally or ethically required to take or use deidentified photographs of pathology specimens. Current US privacy laws (Health Insurance Portability and Accountability Act [HIPAA] of 1996) permit public sharing of deidentified pathology photographs without specific patient consent, even on social media. There is no case law of action taken against pathologists for sharing deidentified pathology images on social media or elsewhere. If there is any legal risk for pathologists or risk of patient harm in sharing pathology photographs, it is very small. The benefits of professional social media use for pathologists, patients, and society are numerous and well documented in the literature.
Many 'Dehumanize' People with Obesity
Many 'Dehumanize' People with Obesity
"In general, we know that people tend to see other groups they're not part of as lesser than them," Kersbergen said. "We've not been able to find any experiment expanding on what's causing it, based on the literature. Obviously, we need a culture change rather than a few slaps on the wrist here and there."
Body acceptance groups and "fat activists" are working to change perceptions toward people with obesity, she added. But shaming those carrying many extra pounds, or even pointing out the health risks associated with the condition, has the opposite effect than intended, Kersbergen said.
"The science is actually pretty straightforward; we know that feeling stigmatized because of your weight actually leads to weight increases," she said. "Telling people to lose weight is a very poor way of getting people to lose weight."
Sunday, May 19, 2019
Centralization of the IARC Biobank: Combining Multiple Sample Collections into a Common Platform
Biopreserv Biobank. 2019 May 15. doi: 10.1089/bio.2018.0036. [Epub ahead of print]
Centralization of the IARC Biobank: Combining Multiple Sample Collections into a Common Platform.
Author information
- 1
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, Lyon, France.
Abstract
The International Agency for Research on Cancer (IARC) is the World Health Organization's (WHO) cancer research agency. The agency conducts research on cancer with worldwide collaborations, adopting a multidisciplinary approach of epidemiology and laboratory-based studies on cancer causes, as well as preventive interventions. The IARC Biobank stores multiple collections of samples and conducts preanalytical services for studies conducted worldwide in support of the research activities. Traditionally, the multiple collections from these studies were managed by the individual research groups in different project-specific databases. In 2010, a program to centralize sample collections into a single platform was initiated by adopting a common database with the introduction of a minimum dataset for sample collections received at IARC. The process involved checking data files, verifying the storage location of samples, conducting data harmonization, and importing or migrating existing data from project-specific spreadsheets and databases into the common database. In addition to the creation of a common biobank database and an up-to-date inventory of IARC's biological resources, a governance structure was established. The creation of the Biobank Steering Committee and the adoption of an access policy is to facilitate and guide the sharing of IARC's resources in a transparent manner, while taking into account Ethical, Legal, and Social Issues.
Twitter is a virus of the mind
Twitter is a virus of the mind
If you log off, you lose your influence: An Encounter Ideas essay
"But in public influence Twitter punches far above its weight. Why? Because it’s where cultural kingmakers congregate, and thus where conventional wisdom is formed and shaped — often instantly and thoughtlessly."
"It used to be incredibly rare to see anyone under age 40 come in with a heart attack — and some of these people are now in their 20s and early 30s."
Death Rates Increasing for Younger Adults Due to Heart Disease
"The rates of heart attacks are declining overall in the U.S. — but not among all groups of Americans. According to a new study, heart attack rates are increasing in what may seem like an unlikely group: adults in their 20s and 30s. What’s more, despite their relatively young age, 20- and 30-somethings have the same rate of bad outcomes after a heart attack — including death — as those who are about 10 years older, the study found.
It used to be incredibly rare to see anyone under age 40 come in with a heart attack — and some of these people are now in their 20s and early 30s."
"In the end, health care is more than a political issue; it is also deeply personal."
Health Care Voters May Surprise Us
"In the end, health care is more than a political issue; it is also deeply personal. Health problems can make anyone physically vulnerable, and many people financially so. For Americans with less education and financial means, navigating the system to get what they need is challenging, and many do not even bother to try. Apathy or lack of engagement in health care decision-making parallels their political disengagement.
The politics of health care reform, therefore, requires understanding differences in consumer priorities and designing policies to meet their most pressing needs."
Fruit juice may increase death risk as much as sugary drinks
Fruit juice may increase death risk as much as sugary drinks
"The researchers found that those who drank the most sugar-sweetened beverages -- including 100 percent fruit juice -- had higher odds of dying during the study, compared with those who drank the least of these."
Saturday, May 18, 2019
"...slow walkers were twice as likely to have a heart-related death as fast walkers..."
Fast walkers more likely to live longer: Study
"'In other words, the findings suggest that perhaps physical fitness is a better indicator of life expectancy than body mass index (BMI), and that encouraging the population to engage in brisk walking may add years to their lives,' said Yates, lead author of the study published in the journal Mayo Clinic Proceedings.
.............
The study showed that slow walkers were twice as likely to have a heart-related death as fast walkers, even when other risk factors such as smoking and body mass index were taken into account."
Exploring the relationship of digital information sources and medication adherence
Comput Biol Med. 2019 Apr 30;109:303-310. doi: 10.1016/j.compbiomed.2019.04.023. [Epub ahead of print]
Exploring the relationship of digital information sources and medication adherence.
Author information
- 1
- (a)Chapman University, Schmid College of Science and Technology, Mathematics and Computer Science, Orange, CA, 92866, USA.
- 2
- Chapman University, School of Pharmacy, Department of Biomedical and Pharmaceutical Sciences, Irvine, CA, 92618, USA.
- 3
- University of Minnesota, College of Pharmacy, Department of Pharmaceutical Care and Health Systems, Minneapolis, MN, 55455, USA.
- 4
- University of California, Los Angeles, Fielding School of Public Health, Department of Community Health Sciences, Los Angeles, CA, 90095-1772, USA.
- 5
- (a)Chapman University, Schmid College of Science and Technology, Mathematics and Computer Science, Orange, CA, 92866, USA. Electronic address: linstead@chapman.edu.
Abstract
We present a retrospective analysis of data collected in the United States from the 2015 National Consumer Survey on the Medication Experience and Pharmacists' Role in order to model the relationship between health information sources and medication adherence and perception. Our results indicate that while the digital age has presented prescription users with many non-traditional alternatives for health information, the use of digital content has a significant negative correlation with pharmaceutical adherence and attitudes toward medication. These findings along with previous research suggest that in order to fully realize the potential benefits of the digital age in regards to patient health, positive patient-provider discussions regarding information found online, efforts to improve general health literacy and improvements in the quality and accuracy of the information found are key. Given that higher reliance on digital content is correlated with younger age, the analysis suggests that proactive measures should be taken to educate younger prescription users about the merits and pitfalls of information seeking techniques as they pertain to health literacy.
"Previous research has suggested that urbanization is a primary factor in the rise in obesity around the world. However, a new large-scale study contradicts this, indicating that the increase in obesity rates is more significant among people in rural areas."
Do we have the wrong idea about the global obesity 'epidemic?'
Published
The Legal Aspects of Diversity in Academic Pathology
Acad Pathol. 2018 Nov 14;5:2374289518811142. doi: 10.1177/2374289518811142. eCollection 2018 Jan-Dec.
The Legal Aspects of Diversity in Academic Pathology.
Allen TC1.
Author information
- 1
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA.
Abstract
Diversity and inclusion in academic pathology center on building a diverse, inclusive pathology faculty. Understanding the basics of federal law, and the US Supreme Court cases that interpret those laws, allows one to consider good practices in diversity hire recruitment and retention that protects the pathology chair, the pathology department, and the institution. Consideration of inclusion and unconscious bias are helpful in building and sustaining robust, valuable academic pathology faculty diversity.
The Comma Queen and the Internet’s Copy Chief on What Matters to a Copyeditor #OxfordComma
The Comma Queen and
the Internet’s Copy Chief on What Matters to a Copyeditor
Mary Norris and Benjamin Dreyer Talk Grammar and Style
By Literary Hub
May 1, 2019
"The term “house style” refers to mechanics: use of italics or quotes for titles, adherence to the serial comma, how to handle numerals consistently. For example, it’s house style at The New Yorker to write out round numbers, but increasingly we have come to regard all numbers as round—or so it would seem. Numerals jump off the page; numbers written as words lie on the page and don’t interrupt the flow. New Yorker house style is for readers who have the leisure to savor what they read."
Impact of the rise of artificial intelligence in radiology: What do radiologists think?
Diagn Interv Imaging. 2019 May 6. pii: S2211-5684(19)30090-7. doi: 10.1016/j.diii.2019.03.015. [Epub ahead of print]
Impact of the rise of artificial intelligence in radiology: What do radiologists think?
Author information
- 1
- Department of Musculoskeletal Radiology, University Hospital of Lille, 59037 Lille, France.
- 2
- Department of Musculoskeletal Radiology, University Hospital of Lille, 59037 Lille, France; Lille Medical School, University of Lille, 59045 Lille, France.
- 3
- Department of Musculoskeletal Radiology, University Hospital of Lille, 59037 Lille, France; Lille Medical School, University of Lille, 59045 Lille, France. Electronic address: thibaut.jacques@chru-lille.fr.
Abstract
PURPOSE:
The purpose of this study was to assess the perception, knowledge, wishes and expectations of a sample of French radiologists towards the rise of artificial intelligence (AI) in radiology.
MATERIAL AND METHOD:
A general data protection regulation-compliant electronic survey was sent by e-mail to the 617 radiologists registered in the French departments of Nord and Pas-de-Calais (93 radiology residents and 524 senior radiologists), from both public and private institutions. The survey included 42 questions focusing on AI in radiology, and data were collected between January 16th and January 31st, 2019. The answers were analyzed together by a senior radiologist and a radiology resident.
RESULTS:
A total of 70 radiology residents and 200 senior radiologists participated to the survey, which corresponded to a response rate of 43.8% (270/617). One hundred ninety-eight radiologists (198/270; 73.3%) estimated they had received insufficient previous information on AI. Two hundred and fifty-five respondents (255/270; 94.4%) would consider attending a generic continuous medical education in this field and 187 (187/270; 69.3%) a technically advanced training on AI. Two hundred and fourteen respondents (214/270; 79.3%) thought that AI will have a positive impact on their future practice. The highest expectations were the lowering of imaging-related medical errors (219/270; 81%), followed by the lowering of the interpretation time of each examination (201/270; 74.4%) and the increase in the time spent with patients (141/270; 52.2%).
CONCLUSION:
While respondents had the feeling of receiving insufficient previous information on AI, they are willing to improve their knowledge and technical skills on this field. They share an optimistic view and think that AI will have a positive impact on their future practice. A lower risk of imaging-related medical errors and an increase in the time spent with patients are among their main expectations.