"Forget about comfort zones."

http://www.ncbi.nlm.nih.gov/pubmed/23627449

Arch Pathol Lab Med. 2013 May;137(5):603-5. doi: 10.5858/arpa.2012-0301-ED.

Transformation of pathologists: responding in a volatile, uncertain, complex, and ambiguous environment.

Hernandez JS, Allen TC.

“[T]oday's VUCA environment is now a permanent condition.”¹² Pathologists need to be ready to do things that chafe. “It's going to be a zigzag path. You have to learn how to fail early, fail often, and fail cheaply, as a way of developing your strategy as you go… . [Be] very clear about where you're going, but very flexible in how you get there.”¹³

Forget about comfort zones. “Get used to being uncomfortable.”¹¹ “Be curious. Uncertain times bring opportunities for bold moves. Seize the chance to innovate.”¹¹ “Resist the temptation to cling on to outdated, inadequate processes and behaviors. Take leaps of faith and enjoy the adventure.”¹¹ As Mark Twain famously wrote, in Eve's Diary, “If there wasn't anything to find out, it would be dull. Even trying to find out and not finding out is just as interesting as trying to find out and finding out; and I don't know but more so.”¹⁴

Pain in Cystic Fibrosis

http://www.ncbi.nlm.nih.gov/pubmed/23628511

J Cyst Fibros. 2013 Apr 26. pii: S1569-1993(13)00044-1. doi: 10.1016/j.jcf.2013.04.001. [Epub ahead of print]

Pain in CF: Review of the literature.

Havermans T, Colpaert K, De Boeck K, Dupont L, Abbott J.

Source

Cystic Fibrosis Centre, University Hospital Leuven, Belgium. Electronic address: trudy.havermans@uzleuven.be.

Abstract

BACKGROUND:

This review evaluated pain research in cystic fibrosis (CF).

METHODS:

OVID MEDLINE, CINAHL, AMED, Web of Science, Pubmed, PsychINFO and PsychARTICLES were searched from January 1995-December 2012 to locate papers assessing pain in CF. A proforma was used to record the rationale for the study, characteristics of the sample, pain assessment tools, pain location, frequency and severity, treatment/self-management, coping and the impact on daily activities and quality of life.

RESULTS:

All studies (n=13) were retrospective. Chest and abdominal pains were most commonly reported. Pain was negatively associated with pulmonary exacerbations, quality of life and treatment adherence. Approximately 50% of patients do not consult their GP or CF team about pain, with many patients reporting self-management.

CONCLUSION:

A high incidence of pain is reported in CF although there is little standardization of CF pain measurement. The way forward is to develop guidelines on how to assess pain and provide adequate treatment for pain in CF.

http://www.ncbi.nlm.nih.gov/pubmed/23632101

Respir Med. 2013 Apr 27. pii: S0954-6111(13)00138-8. doi: 10.1016/j.rmed.2013.04.009. [Epub ahead of print]

Factors associated with aerobic fitness in adolescents with asthma.

Berntsen S, Lødrup Carlsen KC, Anderssen SA, Mowinckel P, Carlsen KH.

Source

Department of Paediatrics, Oslo University Hospital, Oslo, Norway. Electronic address: sveinung.berntsen@uia.no.

Abstract

BACKGROUND:

In adolescents with asthma, information on factors associated with cardiorespiratory fitness levels is limited. The present study aimed to determine if objectively measured physical activity as well as potential relevant factors such as lung function, asthma exacerbations, use of inhaled corticosteroids or skin fold thickness are associated with direct measurements of peak oxygen uptake (V˙O₂peak) in adolescents with asthma.

METHODS:

From a nested case-control study at 13-years in the Environment and Childhood Asthma birth cohort study in Oslo, Norway, 86 13-years old adolescents with and 76 without asthma performed maximal running on a treadmill with V˙O₂peak measured. The sum of four skin fold thicknesses was recorded, followed by wearing an activity monitor for four consecutive days. Lung function was measured by maximum forced expiratory flow-volume curves and body plethysmography. Asthma exacerbations and use of medication were registered by parental structured interview. Data were analysed using multiple regression analysis.

RESULTS:

Vigorous physical activity (coefficients with 95% confidence intervals; 1.73 (0.32, 3.14)) and skin fold thickness -0.35 (-0.41, -0.28)) were significantly associated with V˙O₂peak in adolescents with asthma. Neither use of inhaled corticosteroids, lung function nor number of asthma exacerbations was associated with V˙O₂peak when taking physical activity and skin fold thickness into account. In the adolescents without asthma only skin fold thicknesses was negatively associated with V˙O₂peak -3.5 (-4.1, -2.8).

CONCLUSIONS:

V˙O₂peak appears to be determined by vigorous physical activity level in Norwegian adolescents with asthma and not by asthma-related factors such as use of inhaled corticosteroids, lung function nor number of asthma exacerbations.

http://www.ncbi.nlm.nih.gov/pubmed/23632566

Curr Opin Anaesthesiol. 2013 Jun;26(3):382-90. doi: 10.1097/ACO.0b013e328360dc87.

Donation after circulatory death: current status.

Neyrinck A, Van Raemdonck D, Monbaliu D.

Source

aDivision of Anesthesiology and Algology bDivision of Experimental Thoracic Surgery, Katholieke Universiteit Leuven cChair of the Transplant Center, University Hospitals Leuven dDepartment of Abdominal Transplant Surgery, University Hospitals Leuven eDepartment of Microbiology and Immunology, Abdominal Transplant Surgery Lab, Katholieke Universiteit Leuven, Leuven, Belgium.

Abstract

PURPOSE OF REVIEW:

Donor shortage has forced transplant teams to explore new methods to increase the potential donor pool. Donation after circulatory death (DCD) has opened new perspectives and could be a valuable option to expand the brain-dead donors. The purpose of this review is to provide an overview of current practice and to identify remaining questions related to ethical and medical issues that should be further addressed in the future.

RECENT FINDINGS:

Recent findings demonstrate acceptable outcomes after DCD kidney and lung transplantation but inferior graft survival for liver transplantation. The impact and importance of the agonal phase following withdrawal of treatment in controlled DCD is increasingly recognized. Premortem interventions are currently under debate related to preservation strategies or comfort therapy. New preservation strategies using in-situ/in-vivo extracorporeal membrane oxygenation or ex-vivo machine perfusion have large potential in the future. Finally, organizations and institutions are reporting more uniform guidelines related to declaration of death and DCD organ procurement.

SUMMARY:

DCD donation has regained much attention during the last decade and is now part of standard clinical practice albeit this type of donation should not be regarded as an equally acceptable alternative for donation after brain death. It will be important to further explore the potential of DCD, to monitor the long-term outcomes and to further optimize the quality of these grafts. Development and implementation of uniform guidelines will be necessary to guarantee the clinical use of these donor pools.

http://www.ncbi.nlm.nih.gov/pubmed/23632815

Cancer Epidemiol Biomarkers Prev. 2013 Apr 30. [Epub ahead of print]

Natural history of colorectal adenomas: Birth cohort analysis among 3.6 million participants of screening colonoscopy.

Brenner H, Altenhofen L, Stock C, Hoffmeister M.

Source

1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center.

Abstract

BACKGROUND:

Most colorectal cancers (CRCs) develop from adenomas. Knowledge of the natural history of colorectal adenomas, which is not directly observable for ethical reasons, is crucial for designing cost-effective CRC screening strategies.

METHODS:

We derived transition rates from carriage of non-advanced adenoma to carriage of advanced adenoma to carriage of CRC by sex and age in birth cohort analyses among 3,593,420 participants in the German screening colonoscopy program in 2003-2010.

RESULTS:

Transition rates from advanced adenoma to CRC carriage were similar in men and women, but monotonically and significantly increased with age. Estimated annual transition percentages (95% CI) in age groups 55-59, 60-64, 65-69, 70-74 and 75-79 were 2.6 (2.4, 2.9), 3.1 (2.8, 3.3), 3.8 (3.5, 4.1), 5.1 (4.8, 5.5) and 5.2 (4.6, 5.8) among men, and 2.5 (2.2, 2.7), 2.7 (2.4, 3.0), 3.8 (3.5, 4.1), 5.0 (4.5, 5.4) and 5.6 (4.9, 6.3) among women. Estimated annual transitions from carriage of non-advanced to carriage of advanced adenoma were in a narrow range from 3.6 to 4.7% for all age and sex groups.

CONCLUSIONS:

Despite low annual transition rates, cumulative transition rates from advanced adenoma to CRC carriage are expected to exceed 60%, 50% and 40% for age intervals 55-80, 65-80 and 70-80 years, respectively, in both sexes. Cumulative transition rates from non-advanced adenoma to CRC carriage are expected to be close to 30% for age interval 55-80, but less than 2% for age interval 75-80. Impact: Our results enhance the empirical basis for modelling CRC screening strategies.

http://www.bizjournals.com/austin/blog/morning_call/2013/05/peloton-may-get-second-shot-at-cprit.html

Peloton may get another shot at CPRIT funding

Dallas-based startup Peloton Therapeutics Inc. may get a chance to be reconsidered for full funding from Texas' cancer-fighting agency based on two factors.

The company, whose $11 million grant is at the center of the controversy surrounding the Cancer Prevention and Research Institute of Texas, would need to receive a favorable review and not be implicated in the criminal investigation of CPRIT, theAustin American-Statesman reports.

The biomedical company's proposal was approved without first going through the proper peer review channels, lawmakers have said.

CPRIT is under investigation by the Texas attorney general's office and is facing a probe by the National Cancer Institute.

http://www.ncbi.nlm.nih.gov/pubmed/23627748

J Pers Soc Psychol. 2013 Apr 29. [Epub ahead of print]

Paradoxical Consequences of Prohibitions.

Sheikh S, Janoff-Bulman R.

Abstract

Explanations based in attribution theory claim that strong external controls such as parental restrictiveness and punishment undermine moral internalization. In contrast, 3 studies provide evidence that parental punishment does socialize morality, but of a particular sort: a morality focused on prohibitions (i.e., proscriptive orientation) rather than positive obligations (i.e., prescriptive orientation). Study 1 found young adults' accounts of parental restrictiveness and punishment activated their sensitivity to prohibitions and predicted a proscriptive orientation. Consistent with the greater potency of temptations for proscriptively oriented children, as well as past research linking shame to proscriptive morality, Study 2 found that restrictive parenting was also associated with greater suppression of temptations. Finally, Studies 3A and 3B found that suppressing these immoral thoughts is paradoxically harder for those with strong proscriptive orientations; more specifically, priming a proscriptive (versus prescriptive) orientation and inducing mental suppression of "immoral" thoughts led to the most ego depletion for those with restrictive parents. Overall, individuals who had restrictive parents had the lowest self-regulatory ability to resist their "immoral" temptations after prohibitions were activated. In contrast to common attributional explanations, these studies suggest that harsh external control by parents does not undercut moral socialization but rather undermines individuals' ability to resist temptation.

From Ann Moriarty and colleagues: The College of American Pathologists' First 3 Years' Experience With High-Risk Human Papillomavirus Proficiency Testing for Cytology and Other Laboratories

http://dx.doi.org/10.5858/arpa.2012-0149-CP

Article Citation:

Ann T. Moriarty, Joel S. Bentz, Barbara Winkler, Andrew H. Fischer, Rodolfo Laucirica, Rhona J. Souers, Nicole Thomas, and Chengquan Zhao (2013) The College of American Pathologists' First 3 Years' Experience With High-Risk Human Papillomavirus Proficiency Testing for Cytology and Other Laboratories. Archives of Pathology & Laboratory Medicine: May 2013, Vol. 137, No. 5, pp. 606-609.

CAP LABORATORY IMPROVEMENT PROGRAMS

The College of American Pathologists' First 3 Years' Experience With High-Risk Human Papillomavirus Proficiency Testing for Cytology and Other Laboratories

Ann T. Moriarty , MD; Joel S. Bentz , MD; Barbara Winkler , MD; Andrew H. Fischer , MD; Rodolfo Laucirica , MD; Rhona J. Souers ,MS; Nicole Thomas , MPH, CT(ASCT); Chengquan Zhao , MD

From the Department of Esoteric Testing, AmeriPath Indiana, Indianapolis (Dr Moriarty); the Pathology Department, Laboratory Medicine Consultants, Las Vegas, Nevada (Dr Bentz); the Pathology Department, Mt Kisco Medical Group, Mt Kisco, New York (Dr Winkler); the Department of Pathology, University of Massachusetts Memorial Health Care, Worcester (Dr Fischer); Anatomic Pathology, Baylor College of Medicine, Houston, Texas (Dr Laucirica); Biostatistics (Ms Souers) and Survey (Ms Thomas), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao).

Context.—The College of American Pathologists (CAP) Human Papillomavirus (High-Risk) Survey for Cytopathology and Other Laboratories (CHPV) meets the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) requirements for 5 proficiency testing challenges analyzed 3 times per year. This study reports laboratory performance for CHPV from 2008 through 2010.

Objective.—To identify trends in proficiency testing performance for subscribers to the CAP CHPV.

Design.—CHPV responses were evaluated by using a nonlinear mixed model (significance level of .05) with a 2-factor interaction term and repeated measures component, comparing year, media, method, and intended response. Media types included Digene transport, SurePath, ThinPrep media, or a mixture of media types. Proficiency testing challenges validated at 80% consensus.

Results.—All challenges validated; 476 laboratories submitted 14 911 responses with 14 620 correct responses (98%). There were no differences between positive or negative challenges, or rate of correct responses; significant differences existed between media types by year and methods. Digene and ThinPrep media performed better than SurePath (P < .001;P = .03). There was a statistically significant difference between methods (P < .001); “other commercial kits,” “other (noncommercial)” tests, and Third Wave performed more poorly than others.

Conclusions.—Laboratories performed well when testing for human papillomavirus in CHPV during a period of 3 years. All challenges performed to the 80% threshold. Significant differences were found between methods and media. The CAP CHPV survey provides useful information for laboratories choosing human papillomavirus testing methods.

http://dx.doi.org/10.5858/arpa.2012-0430-OA

Angela M. Wright, Debora Smith, Bakula Dhurandhar, Todd Fairley, Miriam Scheiber-Pacht, Subhendu Chakraborty, Blythe K. Gorman, Dina Mody, and Donna M. Coffey (2013) Digital Slide Imaging in Cervicovaginal Cytology: A Pilot Study. Archives of Pathology & Laboratory Medicine: May 2013, Vol. 137, No. 5, pp. 618-624.

ORIGINAL ARTICLES

Digital Slide Imaging in Cervicovaginal Cytology: A Pilot Study

Angela M. Wright , MD; Debora Smith , CT(ASCP); Bakula Dhurandhar , CT(ASCP); Todd Fairley , CT(ASCP); Miriam Scheiber-Pacht , CT(ASCP); Subhendu Chakraborty , MS; Blythe K. Gorman , MD; Dina Mody , MD; Donna M. Coffey , MD

From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas.

Context.—Digital whole slide imaging is the anticipated future of anatomic pathology, where sign-out of glass slides will be replaced by scanned images. Whole slide imaging has been successfully used in surgical pathology, but its usefulness and clinical application have been limited in cytology for several reasons, including lack of availability of z-axis depth focusing and large file size. Recently, several systems have become available in the United States for whole slide imaging with z-axis technology.

Objective.—To determine the accuracy and efficiency of whole slide imaging, as compared with traditional glass slides, for use in cervicovaginal diagnostic cytology.

Design.—Eleven cervicovaginal cytology cases (ThinPrep and SurePath) scanned at ×20, ×40, and ×40 z-stack magnifications using the BioImagene iScan Coreo Au 3.0 scanner were evaluated by 4 cytotechnologists and 3 pathologists in a blinded study. Different magnification scans were recorded as separate cases and presented in a randomized sequence. Corresponding glass slides were also reviewed. For each case, the diagnoses and total time to reach each diagnosis were recorded.

Results.—Diagnostic accuracy was higher and average time per case was lower with glass slides as compared with all digital images. Among the digital images, the ×40 or ×40 z-stack had the highest diagnostic accuracy and lowest interpretation time.

Conclusions.—Whole slide imaging is a viable option for the purposes of teaching and consultations, and as a means of archiving cases. However, considering the large file size and total time to reach diagnosis on digital images, whole slide imaging is not yet ready for daily cervicovaginal diagnostic cytology screening use.

http://dx.doi.org/10.5858/arpa.2013-0125-SA

Liron Pantanowitz, Alexander C. Mackinnon, Jr, and John H. Sinard (2013) Tracking in Anatomic Pathology. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Tracking in Anatomic Pathology

Liron Pantanowitz , MD; Alexander C. Mackinnon, Jr , MD, PhD; John H. Sinard , MD, PhD

From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Pantanowitz); the Department of Pathology, Medical College of Wisconsin, Milwaukee (Dr Mackinnon); and the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Sinard).

Bar code–based tracking solutions, long present in clinical pathology laboratories, have recently made an appearance in anatomic pathology (AP) laboratories. Tracking of AP “assets” (specimens, blocks, slides) can enhance laboratory efficiency, promote patient safety, and improve patient care. Routing of excess clinical material into research laboratories and biorepositories are other avenues that can benefit from tracking of AP assets. Implementing tracking is not as simple as installing software and turning it on. Not all tracking solutions are alike. Careful analysis of laboratory workflow is needed before implementing tracking to assure that this solution will meet the needs of the laboratory. Such analysis will likely uncover practices that may need to be modified before a tracking system can be deployed. Costs that go beyond simply that of purchasing software will be incurred and need to be considered in the budgeting process. Finally, people, not technology, are the key to assuring quality. Tracking will require significant changes in workflow and an overall change in the culture of the laboratory. Preparation, training, buy-in, and accountability of the people involved are crucial to the success of this process. This article reviews the benefits, available technology, underlying principles, and implementation of tracking solutions for the AP and research laboratory.

Pediatricians, social media and blogs: Ethical considerations

http://www.cps.ca/documents/position/ethics-social-media-blogs

Paediatricians, social media and blogs: Ethical considerations

Posted: May 1 2012  

T St-Laurent-Gagnon, KW Coughlin; Canadian Paediatric Society, Bioethics Committee

Abridged version: Paediatr Child Health 2012;17(5):267-9

Abstract

The use of blogs, Facebook and similar social networking sites is rapidly expanding and, when compared with e-mail, may be having a significantly different impact on the traditional doctor-patient relationship. Characteristics specific to these online platforms have major implications for professional relationships, including the ‘Facebook effect’ (the relative permanence of postings) and the ‘online disinhibition effect’. The present practice point illustrates relevant ethical considerations and provides guidance to paediatricians and others concerning the prudent professional and personal use of social networking media.

"... the peril of a field that relies too heavily on the notion that if something is statistically likely, it can be counted on"

http://www.newyorker.com/online/blogs/elements/2013/05/the-crisis-in-social-psychology-that-isnt.html

MAY 1, 2013

THE CRISIS IN SOCIAL PSYCHOLOGY THAT ISN’T

POSTED BY GARY MARCUS

According to the headlines, social psychology has had a terrible year—and, at any rate, a bad week. The New York Times Magazine devoted nearly seven thousand words to Diederik Stapel, the Dutch researcher who committed fraud in at least fifty-four scientific papers, while Nature just published a report about another controversy, questioning whether some well-known “social-priming” results from the social psychologist Ap Dijksterhuis are replicable. Dijksterhuis famously found that thinking about a professor before taking an exam improves your performance, while thinking about a soccer ruffian makes you do worse. Although nobody doubts that Dijksterhuis ran the experiment that he says he did, it may be that his finding is either weak, or simply wrong—perhaps the peril of a field that relies too heavily on the notion that if something is statistically likely, it can be counted on.

May 1st has had quite a few names...

http://www.dailyfinance.com/2013/05/01/may-day-labor-patriotic-holidays-loyalty-law/

Everywhere Else, May Day Honors Workers; Here, It Salutes 'Loyalty'

by Eamon Murphy  May 1st 2013 3:15PM

"International Workers' Day is a big deal around the world, marked by demonstrations and officially recognized in more than 80 countries.

In the U.S., however, the holiday has been subverted by official decree. In 1921, during the Red Scare, an alternative designation for May 1 was created: "Americanization Day." According to the Veterans of Foreign Wars' database of Patriotic Days, "On May 1, 1930, 10,000 VFW members staged a rally at New York's Union Square to promote patriotism." In 1949, Americanization Day morphed into Loyalty Day, and in 1958 –- during the waning days of McCarthyism -- Congress made Loyalty Day official.

As if that weren't enough, the government also made May 1 "Law Day, U.S.A." -- a special moment for the reaffirmation of Americans' loyalty to the United States, and the cultivation of respect for the law. To be fair, the language of the relevant act does mention in particular "the ideals of equality and justice under the law" that should guide relations between citizens and countries, and President Eisenhower in his proclamation spoke of law's importance "in the settlement of international disputes.""

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2013-0093-CP

Liron Pantanowitz, John H. Sinard, Walter H. Henricks, Lisa A. Fatheree, Alexis B. Carter, Lydia Contis, Bruce A. Beckwith, Andrew J. Evans, Christopher N. Otis, Avtar Lal, and Anil V. Parwani (2013) Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

Liron Pantanowitz , MD; John H. Sinard , MD, PhD; Walter H. Henricks , MD; Lisa A. Fatheree , BS, SCT(ASCP); Alexis B. Carter ,MD; Lydia Contis , MD; Bruce A. Beckwith , MD; Andrew J. Evans , MD, PhD; Christopher N. Otis , MD; Avtar Lal , MD, PhD; Anil V.Parwani , MD, PhD

From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Drs Pantanowitz, Contis, and Parwani); the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Dr Sinard); the Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dr Henricks); the College of American Pathologists, Northfield, Illinois (Ms Fatheree); the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (Dr Carter); the Department of Pathology, North Shore Medical Center, Salem, Massachusetts (Dr Beckwith); the Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada (Dr Evans); the Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts (Dr Otis); and University Hospital, London Health Science Center, London, Ontario, Canada (Dr Lal).

Context.—There is increasing interest in using whole slide imaging (WSI) for diagnostic purposes (primary and/or consultation). An important consideration is whether WSI can safely replace conventional light microscopy as the method by which pathologists review histologic sections, cytology slides, and/or hematology slides to render diagnoses. Validation of WSI is crucial to ensure that diagnostic performance based on digitized slides is at least equivalent to that of glass slides and light microscopy. Currently, there are no standard guidelines regarding validation of WSI for diagnostic use.

Objective.—To recommend validation requirements for WSI systems to be used for diagnostic purposes.

Design.—The College of American Pathologists Pathology and Laboratory Quality Center convened a nonvendor panel from North America with expertise in digital pathology to develop these validation recommendations. A literature review was performed in which 767 international publications that met search term requirements were identified. Studies outside the scope of this effort and those related solely to technical elements, education, and image analysis were excluded. A total of 27 publications were graded and underwent data extraction for evidence evaluation. Recommendations were derived from the strength of evidence determined from 23 of these published studies, open comment feedback, and expert panel consensus.

Results.—Twelve guideline statements were established to help pathology laboratories validate their own WSI systems intended for clinical use. Validation of the entire WSI system, involving pathologists trained to use the system, should be performed in a manner that emulates the laboratory's actual clinical environment. It is recommended that such a validation study include at least 60 routine cases per application, comparing intraobserver diagnostic concordance between digitized and glass slides viewed at least 2 weeks apart. It is important that the validation process confirm that all material present on a glass slide to be scanned is included in the digital image.

Conclusions.—Validation should demonstrate that the WSI system under review produces acceptable digital slides for diagnostic interpretation. The intention of validating WSI systems is to permit the clinical use of this technology in a manner that does not compromise patient care.

Accepted: March 12, 2013 ;Published Online: May 1, 2013

http://www.ncbi.nlm.nih.gov/pubmed/23278523

Bioethics. 2012 Dec 20. doi: 10.1111/bioe.12009. [Epub ahead of print]

A Framework to Link International Clinical Research to the Promotion of Justice in Global Health.

Pratt B, Loff B.

Abstract

How international research might contribute to justice in global health has not been substantively addressed by bioethics. Theories of justice from political philosophy establish obligations for parties from high-income countries owed to parties from low and middle-income countries. We have developed a new framework that is based on Jennifer Ruger's health capability paradigm to strengthen the link between international clinical research and justice in global health. The 'research for health justice' framework provides direction on three aspects of international clinical research: the research target, research capacity strengthening, and post-trial benefits. It identifies the obligations of justice owed by national governments, research funders, research sponsors, and investigators to trial participants and host communities. These obligations vary from those currently articulated in international research ethics guidelines. Ethical requirements of a different kind are needed if international clinical research is to advance global health equity.

© 2012 B

UT Regent Wallace Hall Updates Lawsuit Disclosures (HT:DF)

http://www.texastribune.org/2013/04/30/wallace-hall-updates-lawsuit-disclosures/?utm_source=texastribune.org&utm_medium=alerts&utm_campaign=News%20Alert:%20Subscriptions

UT Regent Wallace Hall Updates Lawsuit Disclosures

• by Jay Root

University of Texas System Regent Wallace Hall, who was criticized for not disclosing all of his lawsuits when he applied to join the board, has provided Gov. Rick Perry’s office with an updated list. 

Texas Senate Votes to Let Students Keep Guns in Cars on Campus (HT:DF)

http://www.texastribune.org/2013/05/01/senate-votes-to-let-students-keep-guns-in-/?utm_source=texastribune.org&utm_medium=alerts&utm_campaign=News%20Alert:%20Subscriptions

Senate Votes to Let Students Keep Guns in Cars on Campus

• by Veronica Zaragovia, KUT News

The Texas Senate on Tuesday passed a bill that would allow students with concealed handgun licenses to keep firearms locked inside their cars on college campuses.

Standardized Test Proposal for Texas Colleges Stalls (HT:DF)

http://www.texastribune.org/2013/05/01/critical-thinking-test-mandate-colleges-stalls/?utm_source=texastribune.org&utm_medium=alerts&utm_campaign=News%20Alert:%20Subscriptions

Standardized Test Proposal for Texas Colleges Stalls

• by Reeve Hamilton

A proposal requiring Texas public universities to administer a standardized test, one that has been the subject of significant national debate, appears to be stalled, but the debate over the assessment appears to be far from over.

The Collegiate Learning Assessment, launched in 2000 and run by the Rand Corporation's Council for Aid to Education, purports to measure the critical thinking, writing and analytical skills gained in college by testing students as entering freshmen and exiting seniors. It has been a major flashpoint in higher-education circles since the 2011 release of Academically Adrift: Limited Learning on College Campuses, a book by social scientists Richard Arum and Josipa Roksa. They found that more than one-third of those who took the test did not show significant improvement in these areas over four years in college.

From U Arizona: Recruiting hospitalized Mexican American elder adults and caregivers: challenges and strategies

http://www.ncbi.nlm.nih.gov/pubmed/23244443

Res Gerontol Nurs. 2013 Jan;6(1):22-8. doi: 10.3928/19404921-20121205-01. Epub 2012 Dec 13.

Recruiting hospitalized Mexican American elder adults and caregivers: challenges and strategies.

Crist JD, Ruiz MR, Torres-Urquidy OH, Pasvogel A, Hepworth JT.

Source

ENCASA Telenovela Research Study, College of Nursing, The University of Arizona, Tucson, Arizona 85721-0203, USA. j.crist@nursing.arizona.edu

Abstract

Minority group members' participation in clinical research is essential for eliminating health disparities. Early recruitment procedures for a randomized control trial involving minority elder adults at local hospitals were unsuccessful, with challenges at the hospital and individual levels. These challenges included referrals for home health care being written late during hospitalization, hospital staff being reluctant to assist recruiters, ill minority elder adults, and protective or unavailable caregivers. We met these challenges with evidence-based strategies, including changing inclusion criteria, increasing study staff, branding our study, using a consistently respectful manner, and pacing our process. After revising our approaches in various ways, we recruited close to our goal, with relatively good retention. Participants reported that benefiting the community, rather than monetary reward, was a strong motivator to join the study. Unexpected recruitment expenditures exceeded the recruitment budget. Our experiences include strategies that can be more cost effective in future studies at both hospital and individual levels.

From Stanford: Ethical, Legal, Social, and Policy Implications of Behavioral Genetics

http://www.ncbi.nlm.nih.gov/pubmed/23452225

Annu Rev Genomics Hum Genet. 2013 Feb 28. [Epub ahead of print]

Ethical, Legal, Social, and Policy Implications of Behavioral Genetics.

Berryessa CM, Cho MK.

Source

Stanford Center for Biomedical Ethics, Stanford University, Stanford, CA 94305; email: cmberry@stanford.edu.

Abstract

The field of behavioral genetics has engendered a host of moral and social concerns virtually since its inception. The policy implications of a genetic basis for behaviors are widespread and extend beyond the clinic to the socially important realms of education, criminal justice, childbearing, and child rearing. The development of new techniques and analytic approaches, including whole-genome sequencing, noninvasive prenatal genetic testing, and optogenetics, has clearly changed the study of behavioral genetics. However, the social context of biomedical research has also changed profoundly over the past few decades, and in ways that are especially relevant to behavioral genetics. The ever-widening scope of behavioral genetics raises ethical, legal, social, and policy issues in the potential new applications to criminal justice, education, the military, and reproduction. These issues are especially critical to address because of their potentially disproportionate effects on vulnerable populations such as children, the unborn, and the incarcerated. Expected final online publication date for the Annual Review of Genomics and Human Genetics Volume 14 is . Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.

From Georgtown U Law: Tobacco endgame strategies: challenges in ethics and law

http://www.ncbi.nlm.nih.gov/pubmed/23591513

Tob Control. 2013 May;22 Suppl 1:i55-i57. doi: 10.1136/tobaccocontrol-2012-050839.

Tobacco endgame strategies: challenges in ethics and law.

Thomas BP, Gostin LO.

Source

O'Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Avenue, NW, Washington, DC 20001, USA. bpt11@law.georgetown.edu.

Abstract

There are complex legal and ethical tradeoffs involved in using intensified regulation to bring smoking prevalence to near-zero levels. The authors explore these tradeoffs through a lens of health justice, paying particular attention to the potential impact on vulnerable populations. The ethical tradeoffs explored include the charge that heavy regulation is paternalistic; the potentially regressive impact of heavily taxing a product consumed disproportionately by the poor; the simple loss of enjoyment to heavily addicted smokers; the health risks posed by, for example, regulating nicotine content in cigarettes-where doing so leads to increased consumption. Turning to legalistic concerns, the authors explore whether endgame strategies constitute a form of 'regulatory taking'; whether endgame strategies can be squared with global trade/investment laws; whether free speech rights are infringed by aggressive restrictions on the advertisement and marketing of cigarettes.

http://www.ncbi.nlm.nih.gov/pubmed/23625737

J Med Ethics. 2013 Apr 26. [Epub ahead of print]

Cultural sensitivity in paediatrics.

Bock GL.

Abstract

In a recent Journal of Medical Ethics article, 'Should Religious Beliefs Be Allowed to Stonewall a Secular Approach to Withdrawing and Withholding Treatment in Children?', Joe Brierley, Jim Linthicum and Andy Petros argue for rapid intervention in cases of futile life-sustaining treatment. In their experience, when discussions of futility are initiated with parents, parents often appeal to religion to 'stonewall' attempts to disconnect their children from life support. However, I will argue that the intervention that the authors propose is culturally insensitive.

http://www.ncbi.nlm.nih.gov/pubmed/23627453

Arch Pathol Lab Med. 2013 May;137(5):632-636.

p16 Deletion in Sarcomatoid Tumors of the Lung and Pleura.

Tochigi N, Attanoos R, Chirieac LR, Allen TC, Cagle PT, Dacic S.

Source

From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Drs Tochigi and Dacic); the Department of Histopathology, University Hospital Llandough, Cardiff, United Kingdom (Dr Attanoos); the Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts (Dr Chirieac); the Department of Pathology, The University of Texas Health Science Center at Tyler, Texas (Dr Allen); and the Department of Pathology & Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Cagle).

Abstract

Context.-The diagnosis of sarcomatoid neoplasms of the lung and pleura can be challenging. Homozygous deletion of 9p21, the locus harboring the p16 gene, has been reported as the most common genetic alteration in malignant mesotheliomas that is of potential diagnostic and prognostic significance. 

Objectives.-To evaluate the frequency of 9p21 deletion by fluorescence in situ hybridization in the primary sarcomatoid neoplasms of the lung and pleura and to determine its potential diagnostic utility. Design.-Ninety-two sarcomatoid neoplasms of the lung and pleura (32 sarcomatoid mesotheliomas, 15 sarcomatoid carcinomas, 32 solitary fibrous tumors, and 13 high-grade sarcomas) were examined for 9p21 deletion by fluorescence in situ hybridization. 

Results.-Deletion of 9p21 was most frequently seen in malignant mesotheliomas (81%), followed by sarcomatoid carcinomas (53%), sarcomas (25%), and solitary fibrous tumors (12.5%). Malignant mesotheliomas showed mostly homozygous deletion, whereas sarcomatoid carcinomas showed either homozygous or hemizygous deletion. None of the sarcomas showed homozygous deletion. There was a trend toward more frequent occurrence of 9p21 deletion in recurrent solitary fibrous tumors, but this did not reach statistical difference. 

Conclusions.-Deletion of 9p21 is common in sarcomatoid tumors of the lung and pleura. Despite statistically significant differences in the frequency of 9p21 deletion, and because of the large overlap among the study groups, this genetic abnormality cannot be used as a reliable diagnostic tool in the assessment of sarcomatoid lesions of the lung and pleura. A potential use of p16 deletion in predicting the biology of solitary fibrous tumors should be further explored.