Integrated polarization-free Bragg filters with subwavelength gratings for photonic sensing.

We present polarization-free Bragg filters having subwavelength gratings (SWGs) in the lateral cladding region. This Bragg design expands modal fields toward upper cladding, resulting in enhanced light interaction with sensing analytes. Two device configurations are proposed and examined, one with index-matched coupling between transverse electric (TE) and transverse magnetic (TM) modes and the other one with hybrid-mode (HM) coupling. Both configurations introduce a strong coupling between two orthogonal modes (either TE-TM or HM1-HM2) and rotate the polarization of the input wave through Bragg reflection. The arrangements of SWGs help to achieve two configurations with different orthogonal modes, while expanding modal profiles toward the upper cladding region. Our proposed SWG-assisted Bragg gratings with polarization independency eliminate the need for a polarization controller and effectively tailor the modal properties, enhancing the potential of integrated photonic sensing applications.

Anisotropic leaky-like perturbation with subwavelength gratings enables zero crosstalk.

Electromagnetic coupling via an evanescent field or radiative wave is a primary characteristic of light, allowing optical signal/power transfer in a photonic circuit but limiting integration density. A leaky mode, which combines both evanescent field and radiative wave, causes stronger coupling and is thus considered not ideal for dense integration. Here we show that a leaky oscillation with anisotropic perturbation rather can achieve completely zero crosstalk realized by subwavelength grating (SWG) metamaterials. The oscillating fields in the SWGs enable coupling coefficients in each direction to counteract each other, resulting in completely zero crosstalk. We experimentally demonstrate such an extraordinarily low coupling between closely spaced identical leaky SWG waveguides, suppressing the crosstalk by ≈40 dB compared to conventional strip waveguides, corresponding to ≈100 times longer coupling length. This leaky-SWG suppresses the crosstalk of transverse-magnetic (TM) mode, which is challenging due to its low confinement, and marks a novel approach in electromagnetic coupling applicable to other spectral regimes and generic devices.

High-density integrated delay line using extreme skin-depth subwavelength grating waveguides.

Optical delay lines control the flow of light in time, introducing phase and group delays for engineering interferences and ultrashort pulses. Photonic integration of such optical delay lines is essential for chip-scale lightwave signal processing and pulse control. However, typical photonic delay lines based on long spiral waveguides require extensively large chip footprints, ranging from mm2 to cm2 scales. Here we present a scalable, high-density integrated delay line using a skin-depth engineered subwavelength grating waveguide, i.e., an extreme skin-depth (eskid) waveguide. The eskid waveguide suppresses the crosstalk between closely spaced waveguides, significantly saving the chip footprint area. Our eskid-based photonic delay line is easily scalable by increasing the number of turns and should improve the photonic chip integration density.

Broadband integrated polarization splitter and rotator using subwavelength grating claddings.

We present a broadband integrated photonic polarization splitter and rotator (PSR) using adiabatically tapered coupled waveguides with subwavelength grating (SWG) claddings. The PSR adiabatically rotates and splits the fundamental transverse-magnetic (TM0) input to the fundamental transverse-electric (TE0) mode in the coupler waveguide, while passing the TE0 input through the same waveguide. The SWGs work as an anisotropic metamaterial and facilitate modal conversions, making the PSR efficient and broadband. We rigorously present our design approaches in each section and show the SWG effect by comparing with and without the SWG claddings. The coupling coefficients in each segment explicitly show a stronger coupling effect when the SWGs are included, confirmed by the coupled-mode theory simulations. The full numerical simulation shows that the SWG-PSR operates at 1500-1750 nm (≈250 nm) wavelengths with an extinction ratio larger than 20 dB, confirmed by the experiment for the 1490-1590 nm range. The insertion losses are below 1.3 dB. Since our PSR is designed based on adiabatical mode evolution, the proposed PSR is expected to be tolerant to fabrication variations and should be broadly applicable to polarization management in photonic integrated circuits.

Efficient Visualization of Whole Slide Images in Web-based Viewers for Digital Pathology.

CONTEXT.­: Wide adoption of digital pathology requires efficient visualization and navigation in Web-based digital slide viewers, which is poorly defined. OBJECTIVE.­: To define and quantify relevant performance metrics for efficient visualization of cases and slides in digital slide viewers. DESIGN.­: With a universal slide viewer used in clinical routine diagnostics, we evaluated the impact of slide caching, compression type, tile, and block size of whole slide images generated from Philips, Leica, and 3DHistech scanners on streaming performance on case, slide, and field of view levels. RESULTS.­: Two hundred thirty-nine pathologists routinely reviewed 60 080 whole slide images over 3 months. The median time to open a case's slides from the laboratory information system was less than 4 seconds, the time to change to a slide within the case was less than 1 second, and the time to render the adjacent field of view when navigating the slide was less than one-quarter of a second. A whole slide image's block size and a viewer tile size of 1024 pixels showed best performance to display a field of view and was preferrable over smaller tiles due to fewer mosaic effects. For Philips, fastest median slide streaming pace was 238 ms per field of view and for 3DHistech, 125 ms. For Leica, the fastest pace of 108 ms per field of view was established with block serving without decompression. CONCLUSIONS.­: This is the first study to systematically assess user-centric slide visualization performance metrics for digital viewers, including time to open a case, time to change a slide, and time to change a field of view. These metrics help to improve the viewer's configuration, leading to an efficient visualization baseline that is widely accepted among pathologists using routine digital pathology.

Averting BER Floor with Iterative Source and Channel Decoding for Layered Steered Space-Time Codes.

The widespread development in wireless technologies and the advancements in multimedia communication have brought about a positive impact on the performance of wireless transceivers. We investigate the performance of our three-stage turbo detected system using state-of-the-art high efficiency video coding (HEVC), also known as the H.265 video standard. The system makes use of sphere packing (SP) modulation with the combinational gain technique of layered steered space-time code (LSSTC). The proposed three-stage system is simulated for the correlated Rayleigh fading channel and the bit-error rate (BER) curve obtained after simulation is free of any floor formation. The system employs low complexity source-bit coding (SBC) for protecting the H.265 coded stream. An intermediate recursive unity-rate code (URC) with an infinite impulse response is employed as an inner precoder. More specifically, the URC assists in the prevention of the BER floor by distributing the information across the decoders. There is an observable gain in the BER and peak signal-to-noise ratio (PSNR) performances with the increasing value of minimum Hamming distance (dH,min) using the three-stage system. Convergence analysis of the proposed system is investigated through an extrinsic information transfer (EXIT) chart. Our proposed system demonstrates better performance of about 22 dB than the benchmarker utilizing LSSTC-SP for iterative source-channel detection, but without exploiting the optimized SBC schemes.

Mode-evolution-based ultra-broadband polarization beam splitter using adiabatically tapered extreme skin-depth waveguide.

We present an ultra-broadband silicon photonic polarization beam splitter (PBS) using adiabatically tapered extreme skin-depth (eskid) waveguides. Highly anisotropic metamaterial claddings of the eskid waveguides suppress the crosstalk of transverse-electric (TE) mode, while the large birefringence of the eskid waveguide efficiently cross-couples the transverse-magnetic (TM) mode. Two eskid waveguides are adiabatically tapered to smoothly translate TM mode to the coupled port via mode evolution while keeping the TE mode in the through port. The tapered cross-section of the eskid PBS was designed numerically, achieving a large bandwidth at 1400-1650 nm with extinction ratios >20dB. We experimentally demonstrated the tapered-eskid PBS and confirmed its broad bandwidth at 1490-1640 nm, limited by laser bandwidth. With its mode evolution, the tapered-eskid PBS is tolerant to fabrication imperfections and should be crucial for controlling polarizations in photonic circuits.

SSG-LUGIA: Single Sequence based Genome Level Unsupervised Genomic Island Prediction Algorithm.

BACKGROUND: Genomic Islands (GIs) are clusters of genes that are mobilized through horizontal gene transfer. GIs play a pivotal role in bacterial evolution as a mechanism of diversification and adaptation to different niches. Therefore, identification and characterization of GIs in bacterial genomes is important for understanding bacterial evolution. However, quantifying GIs is inherently difficult, and the existing methods suffer from low prediction accuracy and precision-recall trade-off. Moreover, several of them are supervised in nature, and thus, their applications to newly sequenced genomes are riddled with their dependency on the functional annotation of existing genomes. RESULTS: We present SSG-LUGIA, a completely automated and unsupervised approach for identifying GIs and horizontally transferred genes. SSG-LUGIA is a novel method based on unsupervised anomaly detection technique, accompanied by further refinement using cues from signal processing literature. SSG-LUGIA leverages the atypical compositional biases of the alien genes to localize GIs in prokaryotic genomes. SSG-LUGIA was assessed on a large benchmark dataset `IslandPick' and on a set of 15 well-studied genomes in the literature and followed by a thorough analysis on the well-understood Salmonella typhi CT18 genome. Furthermore, the efficacy of SSG-LUGIA in identifying horizontally transferred genes was evaluated on two additional bacterial genomes, namely, those of Corynebacterium diphtheria NCTC13129 and Pseudomonas aeruginosa LESB58. SSG-LUGIA was examined on draft genomes and was demonstrated to be efficient as an ensemble method. CONCLUSIONS: Our results indicate that SSG-LUGIA achieved superior performance in comparison to frequently used existing methods. Importantly, it yielded a better trade-off between precision and recall than the existing methods. Its nondependency on the functional annotation of genomes makes it suitable for analyzing newly sequenced, yet uncharacterized genomes. Thus, our study is a significant advance in identification of GIs and horizontally transferred genes. SSG-LUGIA is available as an open source software at https://nibtehaz.github.io/SSG-LUGIA/.

Ultra-high extinction ratio polarization beam splitter with extreme skin-depth waveguide.

In this Letter, we present a high extinction ratio and compact on-chip polarization beam splitter (PBS), based on an extreme skin-depth (eskid) waveguide. Subwavelength-scale gratings form an effectively anisotropic metamaterial cladding and introduce a large birefringence. The anisotropic dielectric perturbation of the metamaterial cladding suppresses the TE polarization extinction via exceptional coupling, while the large birefringence efficiently cross-couples the TM mode, thus reducing the coupling length. We demonstrated the eskid-PBS on a silicon-on-insulator platform and achieved an ultra-high extinction ratio PBS (${\approx} 60\;{\rm dB} $ for TE and ${\approx} 48\;{\rm dB} $ for TM) with a compact coupling length (${\approx} 14.5\,\,\unicode{x00B5}{\rm m}$). The insertion loss is also negligible (${\lt}{0.6}\;{\rm dB}$). The bandwidth is ${\gt}{80}$ (30) nm for the TE (TM) extinction ratio ${\gt}{20}\;{\rm dB}$. Our ultra-high extinction ratio PBS is crucial in implementing efficient polarization diversity circuits, especially where a high degree of polarization distinguishability is necessary, such as photonic quantum information processing.

Telecytology implementation: Deployment of telecytology for rapid on-site evaluations at an Academic Medical Center.

INTRODUCTION: There are limited publications that address technical and practical informatics considerations when implementing telecytology for rapid on-site evaluation (ROSE). Our aim was to share the experience of deploying telecytology for ROSE at our institution. MATERIALS AND METHODS: Key informatics issues relevant to adopting telecytology for ROSE at our institution were appraised including workflow, information technology (IT), validation, training, and quality assurance (QA). RESULTS: A dynamic telemicroscopy solution was selected that required trained cytotechnologists to attend on-site procedures for ROSE. For validation 60 cases were reviewed using the first camera at each facility, but only 20 cases to validate subsequent cameras. A concordance rate of >90% between ROSE interpretation performed digitally to original interpretations was required for clinical validation. After reviewing 440 cases from two comparable time periods before and after implementation, employing telecytology was shown to decrease cytopathologists' work time per ROSE case from an average of 20.95 min per case to 2.91 min per case (86% time savings). The non-diagnostic rate for traditional ROSE was 7.7% compared with 4.1% after the implementation of telecytology, and the deferral rate went from 43.6% for traditional ROSE to 44.1% with telecytology. Traditional ROSE diagnoses correlated with final diagnoses in 91.8% cases, compared to 95.5% with telecytology. CONCLUSIONS: Challenges when implementing telecytology for ROSE included technical issues, workflow concerns, and incorporating trainees into daily practice. The end result of our implementation was the adoption of an innovative way to deliver a ROSE service that maximised efficiency for cytopathologists without compromising diagnostic performance.

Augmented Reality Technology Using Microsoft HoloLens in Anatomic Pathology.

Context Augmented reality (AR) devices such as the Microsoft HoloLens have not been well used in the medical field. Objective To test the HoloLens for clinical and nonclinical applications in pathology. Design A Microsoft HoloLens was tested for virtual annotation during autopsy, viewing 3D gross and microscopic pathology specimens, navigating whole slide images, telepathology, as well as real-time pathology-radiology correlation. Results Pathology residents performing an autopsy wearing the HoloLens were remotely instructed with real-time diagrams, annotations, and voice instruction. 3D-scanned gross pathology specimens could be viewed as holograms and easily manipulated. Telepathology was supported during gross examination and at the time of intraoperative consultation, allowing users to remotely access a pathologist for guidance and to virtually annotate areas of interest on specimens in real-time. The HoloLens permitted radiographs to be coregistered on gross specimens and thereby enhanced locating important pathologic findings. The HoloLens also allowed easy viewing and navigation of whole slide images, using an AR workstation, including multiple coregistered tissue sections facilitating volumetric pathology evaluation. Conclusions The HoloLens is a novel AR tool with multiple clinical and nonclinical applications in pathology. The device was comfortable to wear, easy to use, provided sufficient computing power, and supported high-resolution imaging. It was useful for autopsy, gross and microscopic examination, and ideally suited for digital pathology. Unique applications include remote supervision and annotation, 3D image viewing and manipulation, telepathology in a mixed-reality environment, and real-time pathology-radiology correlation.

Comparison of glass slides and various digital-slide modalities for cytopathology screening and interpretation.

BACKGROUND: Whole-slide imaging in cytology is limited when glass slides are digitized without z-stacks for focusing. Different vendors have started to provide z-stacking solutions to overcome this limitation. The Panoptiq imaging system allows users to create digital files combining low-magnification panoramic images with regions of interest (ROIs) that are imaged with high-magnification z-stacks. The aim of this study was to compare such panoramic images with conventional whole-slide images and glass slides for the tasks of screening and interpretation in cytopathology. METHODS: Thirty glass slides, including 10 ThinPrep Papanicolaou tests and 20 nongynecologic cytology cases, were digitized with an Olympus BX45 integrated microscope with an attached Prosilica GT camera. ViewsIQ software was used for image acquisition and viewing. These glass slides were also scanned on an Aperio ScanScope XT at ×40 (0.25 µm/pixel) with 1 z-plane and were viewed with ImageScope software. Digital and glass sides were screened and dotted/annotated by a cytotechnologist and were subsequently reviewed by 3 cytopathologists. For panoramic images, the cytotechnologist manually created digital maps and selected representative ROIs to generate z-stacks at a higher magnification. After 3-week washout periods, panoramic images were compared with Aperio digital slides and glass slides. RESULTS: The Panoptiq system permitted fine focusing of thick smears and cell clusters. In comparison with glass slides, the average screening times were 5.5 and 1.8 times longer with Panoptiq and Aperio images, respectively, but this improved with user experience. There was no statistical difference in diagnostic concordance between all 3 modalities. Users' diagnostic confidence was also similar for all modalities. CONCLUSIONS: The Aperio whole-slide scanner with 1 z-plane scanning and the Panoptiq imaging system with z-stacking are both suitable for cytopathology screening and interpretation. However, ROI z-stacks do offer a superior mechanism for overcoming focusing problems commonly encountered with digital cytology slides. Unlike whole-slide imaging, the acquisition of representative z-stack images with the Panoptiq system requires a trained cytologist to create digital files. Cancer Cytopathol 2017;125:701-9. © 2017 American Cancer Society.

Fourier ptychographic microscopy using an infrared-emitting hemispherical digital condenser.

Fourier ptychographic microscopy is demonstrated in the near-infrared spectral range using a computer-controlled hemispherical digital condenser comprising multiple 940 nm wavelength light emitting diodes. This technique was used to image periodic patterned samples (photonic crystals). Experimental and simulated results using a phase retrieval algorithm were found to be in excellent correspondence. We show that for samples with a single period in each direction, the resolution of the obtained high-resolution near-infrared images is limited by the Rayleigh criteria.

Exploring virtual reality technology and the Oculus Rift for the examination of digital pathology slides.

BACKGROUND: Digital slides obtained from whole slide imaging (WSI) platforms are typically viewed in two dimensions using desktop personal computer monitors or more recently on mobile devices. To the best of our knowledge, we are not aware of any studies viewing digital pathology slides in a virtual reality (VR) environment. VR technology enables users to be artificially immersed in and interact with a computer-simulated world. Oculus Rift is among the world's first consumer-targeted VR headsets, intended primarily for enhanced gaming. Our aim was to explore the use of the Oculus Rift for examining digital pathology slides in a VR environment. METHODS: An Oculus Rift Development Kit 2 (DK2) was connected to a 64-bit computer running Virtual Desktop software. Glass slides from twenty randomly selected lymph node cases (ten with benign and ten malignant diagnoses) were digitized using a WSI scanner. Three pathologists reviewed these digital slides on a 27-inch 5K display and with the Oculus Rift after a 2-week washout period. Recorded endpoints included concordance of final diagnoses and time required to examine slides. The pathologists also rated their ease of navigation, image quality, and diagnostic confidence for both modalities. RESULTS: There was 90% diagnostic concordance when reviewing WSI using a 5K display and Oculus Rift. The time required to examine digital pathology slides on the 5K display averaged 39 s (range 10-120 s), compared to 62 s with the Oculus Rift (range 15-270 s). All pathologists confirmed that digital pathology slides were easily viewable in a VR environment. The ratings for image quality and diagnostic confidence were higher when using the 5K display. CONCLUSION: Using the Oculus Rift DK2 to view and navigate pathology whole slide images in a virtual environment is feasible for diagnostic purposes. However, image resolution using the Oculus Rift device was limited. Interactive VR technologies such as the Oculus Rift are novel tools that may be of use in digital pathology.

Evaluation of panoramic digital images using Panoptiq for frozen section diagnosis.

INTRODUCTION: Whole slide imaging (WSI) permits intraoperative consultations (frozen sections) to be performed remotely. However, WSI files are large and can be problematic if there are tissue artifacts (e.g., tissue folds) or when slides are scanned without multiplanes (Z-stacks) to permit focusing. The Panoptiq dynamic imaging system allows users to create their own digital files that combine low power panoramic digital images with regions of interest that can be imaged using high power Z-stacks. The aim of this study was to determine the utility of the Panoptiq dynamic imaging system for frozen section telepathology. MATERIALS AND METHODS: Twenty archival randomly selected genitourinary surgical pathology frozen sectional cases were evaluated using conventional light microscopy (glass slides), panoramic images, and whole slide images. To create panoramic images glass slides were digitized using a Prosilica GT camera (model GT1920C, Allied Vision Technologies) attached to an Olympus B × 45 microscope and Dell Precision Tower 810 computer (Dell). Panoptiq 3 version 3.1.2 software was used for image acquisition and Panoptiq View version 3.1.2 to view images (ViewsIQ, Richmond, BC, Canada). Image acquisition using Panoptiq software involved a pathology resident, who manually created digital maps (×4 objective) and then selected representative regions of interest to generate Z-stacks at higher magnification (×40 objective). Whole slide images were generated using an Aperio XT Scanscope (Leica) and viewed using ImageScope Software (Aperio ePathology, Leica). Three pathologists were asked to render diagnoses and rate image quality (1-10) and their diagnostic confidence (1-10) for each modality. RESULTS: The diagnostic concordance with glass slides was 98.3% for panoramic images and 100% for WSI. Panoptiq images were comparable to the glass slide viewing experience in terms of image quality and diagnostic confidence. Complaints regarding WSI included poor focus near tissue folds and air bubbles. Panoptiq permitted fine focusing of tissue folds and air bubbles. Issues with panoramic images included difficulty interpreting low-resolution ×4 image maps and the presence of tiling artifacts. In some cases, Z-stacked areas of Panoptiq images were limited or not representative of diagnostic regions. The image file size of Panoptiq was more than 14 times smaller than that of WSI files. CONCLUSIONS: The Panoptiq imaging system is a novel tool that can be used for frozen section telepathology. Panoramic digital images were easy to generate and navigate, of relatively small file size, and offered a mechanism to overcome focusing problems commonly encountered with WSI of frozen sections. However, the acquisition of representative Panoptiq images was operator dependent with the individual creating files that may impact the final diagnosis.

Pocket pathologist: A mobile application for rapid diagnostic surgical pathology consultation.

INTRODUCTION: Telepathology allows the digital transmission of images for rapid access to pathology experts. Recent technologic advances in smartphones have allowed them to be used to acquire and transmit digital images of the glass slide, representing cost savings and efficiency gains over traditional forms of telepathology. We report our experience with developing an iPhone application (App - Pocket Pathologist) to facilitate rapid diagnostic pathology teleconsultation utilizing a smartphone. MATERIALS AND METHODS: A secure, web-based portal (http://pathconsult.upmc.com/) was created to facilitate remote transmission of digital images for teleconsultation. The App augments functionality of the web-based portal and allows the user to quickly and easily upload digital images for teleconsultation. Image quality of smartphone cameras was evaluated by capturing images using different adapters that directly attach phones to a microscope ocular lens. RESULTS: The App was launched in August 2013. The App facilitated easy submission of cases for teleconsultation by limiting the number of data entry fields for users and enabling uploading of images from their smartphone's gallery wirelessly. Smartphone cameras properly attached to a microscope create static digital images of similar quality to a commercial digital microscope camera. CONCLUSION: Smartphones have great potential to support telepathology because they are portable, provide ubiquitous internet connectivity, contain excellent digital cameras, and can be easily attached to a microscope. The Pocket Pathologist App represents a significant reduction in the cost of creating digital images and submitting them for teleconsultation. The iPhone App provides an easy solution for global users to submit digital pathology images to pathology experts for consultation.

Bio-mimic optimization strategies in wireless sensor networks: a survey.

For the past 20 years, many authors have focused their investigations on wireless sensor networks. Various issues related to wireless sensor networks such as energy minimization (optimization), compression schemes, self-organizing network algorithms, routing protocols, quality of service management, security, energy harvesting, etc., have been extensively explored. The three most important issues among these are energy efficiency, quality of service and security management. To get the best possible results in one or more of these issues in wireless sensor networks optimization is necessary. Furthermore, in number of applications (e.g., body area sensor networks, vehicular ad hoc networks) these issues might conflict and require a trade-off amongst them. Due to the high energy consumption and data processing requirements, the use of classical algorithms has historically been disregarded. In this context contemporary researchers started using bio-mimetic strategy-based optimization techniques in the field of wireless sensor networks. These techniques are diverse and involve many different optimization algorithms. As far as we know, most existing works tend to focus only on optimization of one specific issue of the three mentioned above. It is high time that these individual efforts are put into perspective and a more holistic view is taken. In this paper we take a step in that direction by presenting a survey of the literature in the area of wireless sensor network optimization concentrating especially on the three most widely used bio-mimetic algorithms, namely, particle swarm optimization, ant colony optimization and genetic algorithm. In addition, to stimulate new research and development interests in this field, open research issues, challenges and future research directions are highlighted.

Experience with multimodality telepathology at the University of Pittsburgh Medical Center.

Several modes of telepathology exist including static (store-and-forward), dynamic (live video streaming or robotic microscopy), and hybrid technology involving whole slide imaging (WSI). Telepathology has been employed at the University of Pittsburgh Medical Center (UPMC) for over a decade at local, national, and international sites. All modes of telepathology have been successfully utilized to exploit our institutions subspecialty expertise and to compete for pathology services. This article discusses the experience garnered at UPMC with each of these teleconsultation methods. Static and WSI telepathology systems have been utilized for many years in transplant pathology using a private network and client-server architecture. Only minor clinically significant differences of opinion were documented. In hematopathology, the CellaVision(®) system is used to transmit, via email, static images of blood cells in peripheral blood smears for remote interpretation. While live video streaming has remained the mode of choice for providing immediate adequacy assessment of cytology specimens by telecytology, other methods such as robotic microscopy have been validated and shown to be effective. Robotic telepathology has been extensively used to remotely interpret intra-operative neuropathology consultations (frozen sections). Adoption of newer technology and increased pathologist experience has improved accuracy and deferral rates in teleneuropathology. A digital pathology consultation portal (https://pathconsult.upmc.com/) was recently created at our institution to facilitate digital pathology second opinion consults, especially for WSI. The success of this web-based tool is the ability to handle vendor agnostic, large image files of digitized slides, and ongoing user-friendly customization for clients and teleconsultants. It is evident that the practice of telepathology at our institution has evolved in concert with advances in technology and user experience. Early and continued adoption of telepathology has promoted additional digital pathology resources that are now being leveraged for other clinical, educational, and research purposes.

Management of Jehovah's Witnesses in otolaryngology, head and neck surgery.

It is imperative that surgeons should have some knowledge and understanding of the beliefs of Jehovah's Witnesses to respect the patient's wishes and effectively minimize and manage blood loss. The objective of this review was to provide a management strategy for Jehovah's Witness patients undergoing otolaryngology, head and neck surgery, because there is paucity of information regarding this within our literature. A systematic review of medical literature was conducted. Articles were identified using MEDLINE (1966-2007). The search strategy used Medical Subject Heading terms Jehovah's Witnesses, Beliefs, Ethical and Legal issues, Blood transfusion alternatives, ENT, Head and Neck surgery in Jehovah' witnesses. There is a broad range of nonblood surgical management strategies available in other specialities, making major surgery possible within this population. This review suggests recommendations in elective surgery, trauma, and emergencies.

Webcasting pathology department conferences in a geographically distributed medical center.

As academic pathology departments have become increasingly based in large, regional medical systems spread across hundreds of square miles, new methods are needed to tie these increasingly distributed departments together as integrated units. An important part of that integration is the ability to share academic and teaching conferences across long distances. In this article we present an effective, low-cost webcasting system that has evolved at the University of Pittsburgh Medical Center Department of Pathology over the past several years based on inexpensive, widely available software. To date, the system has broadcast and archived more than 400 conferences and currently serves approximately 80 to 100 requests each week. Important factors in the success of the program include the creation of a faculty steering committee to control resources and manage growth, the availability of informatics faculty and support for technical staff, and the decision to operate the service as part of the core information technology infrastructure of the department. Webcasting will likely become an even more important academic and operational tool in the future as more of the department's conferences, seminars, and even working meetings are communicated through the webcasting infrastructure.