RESUMEN
The tissue diagnosis of adenocarcinoma and intraductal carcinoma of the prostate (IDC-P) includes Gleason grading of tumor morphology on the hematoxylin and eosin (H&E) stain, and immunohistochemistry (IHC) markers on the PIN-4 stain (CK5/6, P63, AMACR). In this work, we create an automated system for producing both virtual H&E and PIN-4 IHC stains from unstained prostate tissue using a high-throughput hyperspectral fluorescence microscope and artificial intelligence & machine learning. We demonstrate that the virtual stainer models can produce high-quality images suitable for diagnosis by genitourinary pathologists. Specifically, we validate our system through extensive human review and computational analysis, using a previously-validated Gleason scoring model, and an expert panel, on a large dataset of test slides. This study extends our previous work on virtual staining from autofluorescence, demonstrates the clinical utility of this technology for prostate cancer, and exemplifies a rigorous standard of qualitative and quantitative evaluation for digital pathology.
RESUMEN
Recent discoveries support the principle that palliative care may improve the quality of life of patients with Parkinson's disease and those who care for them. Advance care planning, a component of palliative care, provides a vehicle through which patients, families, and clinicians can collaborate to identify values, goals, and preferences early, as well as throughout the disease trajectory, to facilitate care concordant with patient wishes. While research on this topic is abundant in other life-limiting disorders, particularly in oncology, there is a paucity of data in Parkinson's disease and related neurological disorders. We review and critically evaluate current practices on advance care planning through the analyses of three bioethical challenges pertinent to Parkinson's disease and propose recommendations for each.