Head-tracking as an interface device for image control in digital pathology: a comparative study / Reconocimiento facial como interfaz de usuario para el manejo de la imagen en patología digital: un estudio comparativo

BACKGROUND: Inasmuch as the conventional mouse is not an ideal input device for digital pathology, the aim of this study was to evaluate alternative systems with the goal of identifying a natural user interface (NUI) for controlling whole slide images (WSI). DESIGN: Four pathologists evaluated three webcam-based, head-tracking mouse emulators: Enable Viacam (eViacam, CREA Software), Nouse (JLG Health Solutions Inc), and Camera Mouse (CM Solutions Inc). Twenty WSI dermatopathological cases were randomly selected and examined with Image Viewer (Ventana, AZ, USA). The NASA-TLX was used to rate the perceived workload of using these systems and time was recorded. In addition, a satisfaction survey was used. RESULTS: The mean total time needed for diagnosis with Camera Mouse, eViacam, and Nouse was 18'57", 19'37" and 22'32", respectively (57/59/68seconds per case, respectively). The NASA-TLX workload score, where lower scores are better, was 42.1 for eViacam, 53.3 for Nouse and 60.62 for Camera Mouse. This correlated with the pathologists' degree of satisfaction on a scale of 1-5: 3.4 for eViacam, 3 for Nouse, and 2 for Camera Mouse (p < 0.05). CONCLUSIONS: Head-tracking systems enable pathologists to control the computer cursor and virtual slides without their hands using only a webcam as an input device. - Of the three software solutions examined, eViacam seems to be the best of those evaluated in this study, followed by Nouse and, finally, Camera Mouse. - Further studies integrating other systems should be performed in conjunction with software developments to identify the ideal device for digital pathology

INTRODUCCIÓN: Considerando que el ratón convencional no es el controlador ideal en patología digital, el objetivo del estudio fue evaluar sistemas alternativos y tratar de identificar una interfaz natural de usuario para controlar preparaciones digitalizadas. MATERIAL Y MÉTODOS: Cuatro patólogos evaluaron tres emuladores de ratón con reconocimiento facial a través de webcam: eViacam, Nouse y Camera Mouse. Se seleccionaron 20 casos digitalizados de dermatopatología aleatoriamente para su diagnóstico, empleando el software Image Viewer (Ventana, AZ, USA). Se utilizó el sistema NASA-TLX para registrar la carga de trabajo percibida y se grabaron los tiempos. Adicionalmente, se empleó un cuestionario de satisfacción. RESULTADOS: El tiempo medio requerido para diagnosticar con Camera Mouse, eViacam y Nouse fue de 18'57", 19'37"y 22'32", respectivamente (57/59/68 segundos por caso, respectivamente). La carga de trabajo NASA-TLX, donde registros menores implican menor carga, fue de 42,1 para eViacam, 53,3 para Nouse y 60,62 para Camera Mouse, correlacionándose con el grado de satisfacción de los patólogos en una escala de 1-5: 3,4 para eViacam (3,4), Nouse (3) y Camera Mouse (2) (p < 0,05). CONCLUSIONES: El reconocimiento facial posibilita a los patólogos el control del cursor y las preparaciones virtuales sin utilizar las manos, empleando únicamente una webcam como dispositivo de entrada. - De los tres sistemas, eViacam es el mejor software evaluado en este estudio, seguido de Nouse y, finalmente, de Camera Mouse. - Deben ser desarrollados estudios adicionales, integrando otros sistemas, en conjunción con el desarrollo de software para alcanzar el sistema ideal en patología digital

Anatomical pathology (human structural biopathology) in the era of "Big Data", digitalization, 5G and artificial intelligence: Evolution or Revolution? / Anatomía patológica (biopatología estructural humana)

A proposal of an updated system of the Organization of Scientific Biomedical Kowledge is presented, integrating the historical achievements in pathology from the 15th to the 21st century. Scientific understanding of disease (Human Biopathology) is actually acquired at consecutive levels: 1) Etiopathogenic, 2) Structural, 3) Physiopathological, and 4) Clinical. A complete spectrum of etiological factors is presented. A new organization of the structural basis of disease processes (Human Structural Biopathology) is presented. Two unique polar types of cellular pathology are proposed: cellular injury and cellular change. Translation of these two types of cellular pathology into the integrative structural cytotissular levels, gives rise to only ten basic structural processes, that can be organized in three main cytotissular (CT) structural complexes: 1) CT maldevelopment that includes: congenital malformation(1), tumoral maldevelopment (2), hereditary non malformative congenital organopathy (3). 2) Complex of CT injury or non-hereditary organopathies (4), associating: CT necrosis-inflammatory reaction- repair. 3. complex of CT change: atrophy (5), hypertrophy (6), hyperplasia (7), metaplasia (8), dysplasia (9) and neoplasia (10). This system provides a precise basis for the organization of Human Biopathology, which could be applied to: 1) the development of a Universal Medical Curriculum, 2) Departamental Organization of a Faculty of Medicine, 3) the development of a New Global System for Disease Control. As we enter the era of Big Data, 5G, digitalization and artificial intelligence, a rational, scientific and efficient organization of biomedical information will be crucial in determining the success or failure of its applications to the health system

Propuesta actualizada de un sistema de Organización del Conocimiento Científico Biomédico. Integra los avances históricos de la Anatomía patológica desde los siglos xv a XXI. El conocimiento científico de los procesos de enfermedad (Biopatología Humana), se adquiere por 4 niveles secuenciales: 1) Etiopatogénico, 2) Estructural, 3) Fisiopatológico y 4) Clínico. Se completa el espectro de los factores etiológicos. Se desarrolla una nueva organización de las «bases estructurales existentes en los procesos de enfermedad». Se definen 2 únicos tipos polares de patología celular: Lesión y Cambio celular. El traslado de la patología celular al «nivel de integración estructural citotisular» da origen a solo 10 «procesos estructurales básicos», organizados en 3 principales «complejos de biopatología estructural citotisular» (CT): 1) Complejo del Maldesarrollo CT: Malformación Congénita (1), Maldesarrollo Tumoral (2), Organopatía Congénita No Malformativa Hereditaria (3). 2) Complejo de Lesión CT. Organopatía No hereditaria. Asociación secuencial a: Necrosis CT - Reacción Inflamatoria - Reparación CT.3) Complejo del Cambio CT: Atrofia (5), Hipertrofia (6), Hiperplasia (7), Metaplasia (8), Displasia (9), Neoplasia (10). Este sistema aporta las bases precisas para la organización de la Biopatología Humana. El desarrollo completo del sistema propuesto podría aplicarse a: 1. desarrollo de un Currículum Médico Universal, 2.Organización Departamental de las Facultades de Medicina, 3. desarrollo de un Nuevo Sistema Global de Control de los Procesos de Enfermedad. Entrando en la «era del big data, G5, digitalización e inteligencia artificial», una organización científica, racional y eficiente del conocimiento biomédico determinará el éxito o el fracaso de su aplicación a los Sistemas de Salud

Disinfection of corona virus in histopathology laboratories.

Severe acute respiratory syndrome (SARS CoV-2/COVID-19) is a highly contagious and deadly disease caused by a virus belonging to the coronaviridae family. Researchers working in histopathology laboratories, dealing with morbid samples, are particularly vulnerable to infection unless they have very strong immunity. Hence, a proper precautionary protocol is required for the safety of the laboratory staff. The current review highlights the biological and physical agents that can be used to inactivate the virus and disinfect the surrounding environment in the laboratory.

WASP (Write a Scientific Paper): The role of the pathology department in clinical research.

The pathology laboratory is the hub of investigatory medical care, and constitutes an invaluable asset for clinical research. A number of disciplines fall under the cap of a pathology laboratory. Researchers may gain access to such services provided ethical and laboratory administrative permissions have been granted. While establishing the research budget it is essential to have a clear understanding of what goes on behind the path lab curtains as this may impinge on what can and cannot be done, financially and otherwise. Indeed, the process is far more complex than just handing a specimen and obtaining the respective result. Infrastructure, material and human resources need to be quantified and their respective costing identified. Liaison with the laboratory section personnel facilitates the smooth provision of service and research outcomes.

Estudio de la evolución en la actividad en un Departamento de Anatomía Patológica de un hospital de tercer nivel en la última década (2007-2016) / Study of the evolution in the activity of a Department of Pathology from a third level hospital in the last decade (2007-2016)

Objetivo: Estudiar la evolución de variables de interés de un Departamento de Anatomía Patológica de un hospital de tercer nivel durante la última década. Valorar el impacto del traslado hospitalario en la actividad (año 2014). Material y método: Estudio retrospectivo observacional en el que se analizaron las muestras registradas (biopsias, citologías, PAAF, autopsias, intraoperatorias) así como las técnicas complementarias (IHQ, histoquímica, IF y FISH) y la cartera de servicios, durante la década 2007-2016. Para el análisis estadístico se compararon los quinquenios 2007-2011 y 2012-2016. Resultados: Las siguientes variables han sido estadísticamente significativas: citologías (34055,8±1994,0 vs. 26590,4±2938,3; p=0,002), autopsias (156,2±27,3 vs. 122,0±14,78; p=0,039), inmunohistoquímica (17855,4±3424,2 vs. 28559,2±4734,7; p=0,003), histoquímica (11117,8±2300,9 vs. 6225,0±1330,5; p=0,003) e inmunofluorescencia (610,2±185,3 vs. 1205,4±154,0; p=0,001). Se han identificado correlaciones estadísticas de interés entre las variables. En el año 2014 se observó que las variables de mayor peso específico (biopsias, citologías, IHQ e histoquímica) en la carga asistencial del Departamento mostraron un descenso medio del 12,5%. Se ha identificado un incremento generalizado en el catálogo de muestras disponibles. El número de anticuerpos (78,7%), la histoquímica (38,7%) y FISH (400%) fueron los que mayor aumento mostraron. Conclusión: Se han identificado variaciones relevantes del volumen de actividad, así como en la cartera de servicios, especialmente en las técnicas orientadas a mejorar la precisión diagnóstica (IHQ e IF); y un descenso importante en el número de citologías, autopsias e histoquímica. En el año 2014 se ha observado un descenso de más del 12% en las principales variables del estudio

Objective: To study the evolution of variables of interest in a department of pathology from a third level hospital during the last decade and to evaluate the impact on these of the hospital relocation in 2014. Material and method: Retrospective observational study in which the recorded samples (biopsies, cytology specimens, FNA, autopsies, intraoperative) as well as the complementary techniques (IHC, Histochemistry, IF and FISH) and portfolio of services were analyzed during the years 2007-2016 inclusive. For the statistical analysis, the five-year periods 2007-2011 and 2012-2016 were compared. Results: The following variables were statistically significant: cytology (34055.8±1994.0 vs 26590.4±2938.3, p=0.002), autopsies (156.2±27.3 vs 122.0±14.78, p=0.039), immunohistochemistry (17855.4±3424.2 vs 28559.2±4734.7, p=0.003), histochemistry (11117.8±2300.9 vs 6225.0±1330.5, p=0.003) and immunofluorescence (610.2±185.3 vs. 1205.4±154.0, p=0.001). Statistical correlations of interest among variables have been identified. In 2014, it was observed that the variables of greater specific weight (biopsies, cytology, IHQ and histochemistry) in the work load of the Department showed an average decrease of 12.5%. A generalized increase in the panel of available samples has been identified, the largest increase being seen in the number of antibodies (78.7%), histochemistry (38.7%) and FISH (400%). Conclusion: Relevant variations in work volume, as well as the service portfolio, have been identified, especially in the techniques aimed at improving diagnostic accuracy (IHQ and FI), and a significant decrease in the number of cytology specimens, autopsies and histochemistry. In the year 2014 a decrease of more than 12% in the main variables of the study was observed

[Study of the evolution in the activity of a Department of Pathology from a third level hospital in the last decade (2007-2016)]. / Estudio de la evolución en la actividad en un Departamento de Anatomía Patológica de un hospital de tercer nivel en la última década (2007-2016).

OBJECTIVE: To study the evolution of variables of interest in a department of pathology from a third level hospital during the last decade and to evaluate the impact on these of the hospital relocation in 2014. MATERIAL AND METHOD: Retrospective observational study in which the recorded samples (biopsies, cytology specimens, FNA, autopsies, intraoperative) as well as the complementary techniques (IHC, Histochemistry, IF and FISH) and portfolio of services were analyzed during the years 2007-2016 inclusive. For the statistical analysis, the five-year periods 2007-2011 and 2012-2016 were compared. RESULTS: The following variables were statistically significant: cytology (34055.8±1994.0 vs 26590.4±2938.3, p=0.002), autopsies (156.2±27.3 vs 122.0±14.78, p=0.039), immunohistochemistry (17855.4±3424.2 vs 28559.2±4734.7, p=0.003), histochemistry (11117.8±2300.9 vs 6225.0±1330.5, p=0.003) and immunofluorescence (610.2±185.3 vs. 1205.4±154.0, p=0.001). Statistical correlations of interest among variables have been identified. In 2014, it was observed that the variables of greater specific weight (biopsies, cytology, IHQ and histochemistry) in the work load of the Department showed an average decrease of 12.5%. A generalized increase in the panel of available samples has been identified, the largest increase being seen in the number of antibodies (78.7%), histochemistry (38.7%) and FISH (400%). CONCLUSION: Relevant variations in work volume, as well as the service portfolio, have been identified, especially in the techniques aimed at improving diagnostic accuracy (IHQ and FI), and a significant decrease in the number of cytology specimens, autopsies and histochemistry. In the year 2014 a decrease of more than 12% in the main variables of the study was observed.

Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P < .0001, Fisher exact test), with a marked reduction in variability. Further, the time from autopsy to presentation at weekly clinicopathological rounds was also reduced (median: 73 days prior to lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

Control del formaldehído, xileno y compuestos orgánicos volátiles mediante el sistema integral de friocongelación y fotocatalización / Prevention and control of formaldehyde, xylene and volatile organic compounds by photocatalysis and freezing integral system mileida

Antecedentes: En anatomía patológica, existen variedad de agentes químicos que deben ser controlados. Por su potencial cancerígeno destacan el Formaldehído (CH2 O), Xileno y los Compuestos Orgánicos Volátiles (COVs). Objetivo: Valorar la eficacia del uso de purificadores mediante la fotocatalización y los sistemas de friocongelación, para el control de los niveles de exposición a CH2 O, Xileno y COVs. Objetivo Secundario: Comparar mediciones de Formaldehído con otros 3 hospitales de la Comunidad de Madrid. Metodología: Se realizaron 26 mediciones ambientales en Anatomía Patológica del Hospital Universitario de Fuenlabrada (HUF), en febrero del año 2017 y en marzo del mismo año, posterior a la instalación de los purificadores y sistemas de friocongelación, en las áreas de laboratorio y sala de tallado. Se valora Xileno y COVs con el método PID (detector de fotoionización, PID por sus siglas en inglés, PhotoIonization Detector) y de CH2 O a través de un Sistema de Detección de Gas. Como criterio para valorar la exposición a COVs se tomó como gas de referencia el isobutileno con un VLA-EC de 100 ppm. Para el Xileno se compararon los resultados con el VLA-EC 100 ppm y para el CH2 O con el VLA-EC de 0,3 ppm, establecidos en la guía de «Límites de Exposición Profesional para Agentes Químicos» del Instituto Nacional de Seguridad e Higiene en el Trabajo. Resultados: Los niveles de exposición previos no superaban los valores límites. Se observó que tras la implantación de las medidas preventivas colectivas estos valores disminuyeron, obteniéndose resultados estadísticamente significativos: COVs (p= 0.0002; IC 95% 2.393- 5.506), Xileno (p= 0.0002; IC 95% 1.021- 2.359) y CH2 O (p= 0.0004; IC 95% 0.210-0.350). Conclusiones: El sistema integral de friocongelación y purificación mediante fotocatalización optimizan el control de la exposición a dichos agentes químicos, anulando las fuentes de emisión

Background: In anatomical pathology, there are a variety of chemical agents that must be controlled due to their carcinogenic potential, such as formaldehyde (CH2 O), Xylene and Volatile Organic Compounds (VOCs). Objective: To evaluate the effectiveness use of purifiers by photocatalysis and freezing systems for the control of exposure levels to CH2 O, Xylene and VOCs. Secondary Objective: To compare the Formaldehyde measurements among other 3 hospitals in the Community of Madrid. Methodology: 26 environmental assessments were performed in the Anatomical Pathology Department at the Hospital Universitario de Fuenlabrada (HUF, Madrid), in February 2017 and in March of the same year, after installing the purifiers and the freezing systems in the laboratory and room carved areas. Xylene and VOCs are evaluated using the PID method (Photo-Ionization Detector) and CH2 O through a Gas Detection System. As a criterion for assessing exposure to VOCs, isobutylene was used as a reference gas with a VLA-EC of 100 ppm. For Xylene the results were compared with the VLA-EC 100 ppm and for the CH2 O with the VLA-EC of 0.3 ppm, established in the guide of "Occupational Exposure Limits for Chemical Agents" from the National Institute of Occupational Safety and Health. Results: Previous exposure levels did not exceed the limit values. It was observed that these values decreased after the implementation of collective preventive measures, obtaining statistically significant results: VOCs (p = 0,0002, 95% CI 2,393-5,506), Xylene (P = 0,0002, 95% CI 1,021-2,359) and CH2 O (p = 0,0004, 95% CI 0,210-0,350). Conclusions: The integrated system of freeze-thawing and photocatalytic purification optimize the exposure control to these chemical agents, canceling emission sources

[Work quota setting and man-hour productivity estimation in pathologists]. / Normirovanie truda i otsenka trudozatrat vrachei patologoanatomicheskikh otdelenii.

The paper considers the development and current state of the regulation of work quota setting and remuneration in pathologists. Reasoning from the current staff standards for morbid anatomy departments (units), the authors present a method to calculate the load of pathologists. The essence of the proposed method is demonstrated using a specific example.

Volatile Organic Compounds in Anatomical Pathology Wards: Comparative and Qualitative Assessment of Indoor Airborne Pollution.

The impact of volatile organic compounds (VOCs) on indoor air quality and on human health is widely recognized. However, VOC contamination in hospital indoor air is rarely studied and chemical compounds that singularly do not show high toxicity are not submitted to any regulation. This study aimed to compare VOC contamination in two different anatomical pathology wards in the same hospital. Hydrocarbons, alcohols, and terpenes were sampled by passive diffusive samplers. Analytical tests were performed by thermal desorption coupled with gas chromatography and mass spectrometry detector. Results highlighted a different VOC pollution in the two wards, due to the structural difference of the buildings and different organizational systems. The scarcity of similar data in the literature shows that the presence of VOCs in pathology wards is an underestimated problem. We believe that, because of the adverse effects that VOCs may have on the human health, this topic is worth exploring further.

Fractional Exhaled Nitric Oxide (FeNO) and Spirometry as Indicators of Inhalation Exposure to Chemical Agents in Pathology Workers.

OBJECTIVE: The objective of this study was to examine whether fractional exhaled nitric oxide (FeNO) and spirometry can be used as indices to evaluate adverse health effects of low-concentrated chemical inhalation exposure, mainly to formaldehyde. METHODS: Thirty-three subjects (pathology technicians) and 30 controls (workers without handling any chemicals in the same hospitals) participated in this study. All participants underwent FeNO measurement and spirometry before and after 5 days of work. RESULTS: FeNO significantly increased in the subjects with a history of asthma (P < 0.05), whereas forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) decreased in the subjects (P < 0.05). Furthermore, work duration and pre-work levels of FEV1 in the subjects had a significant association. CONCLUSION: The results suggest that FeNO, FVC, and FEV1 represent effective health-effect indices of low-concentrated chemical inhalation exposure.

Valor añadido del patólogo: las interconsultas / Interconsultations: the added value of the pathologist

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[What do our clients want? : Is speed all that matters?] / Was wünschen unsere Einsender : Ist Geschwindigkeit alles?

The pathology department of the University Hospital Bonn conducted a survey among all its clients in order to evaluate their expectations concerning the diagnostics and service from a university department of pathology. A questionnaire including 30 topics was sent by mail to all senders. The questions could be answered using a scale ranging from "0" ("not important at all") to "10" ("very important"). Most important for the clients were "speed of communication of the diagnosis", "personal availability of the responsible pathologist by telephone" and "friendliness of contact". Less important were "autopsy diagnostics", "24 h on-call duty" and "service on Saturdays". A critical analysis of the results made us realize that pathology is threatened to be seen exclusively as a service discipline and that we should convey its methods and possibilities and also its requirements better to clinicians.

Simulación médica en punción aspiración con aguja fina utilizando maniquíes. Experiencia docente universitaria / Medical simulation training in fine needle aspiration cytology using phantoms. University teaching experience

Introducción. La punción aspiración con aguja fina (PAAF) es un procedimiento diagnóstico mínimamente invasivo y extremadamente útil para tipificar lesiones. La limitación de medios en las prácticas de anatomía patológica ha dificultado su enseñanza. Describimos la incorporación de maniquíes diseñados para realizar PAAF en nuestro centro. Material y métodos. Los maniquíes consisten en 2 simuladores de tareas, artesanales y a tamaño natural, de las regiones facial/cervical (modelo de utilidad U201500372) y de torso, respectivamente, revestidos por silicona, simulando piel, con áreas tumorales. Permiten realizar PAAF (palpación, punción, aspiración, obtención de material y extensión sobre portaobjetos) y son reutilizables. La práctica se realizó durante 3 cursos académicos (2013-2016) y consistió en realizar PAAF de manera individualizada sobre contexto clínico, con ulterior correlación citológica. Resultados. Un total de 178 estudiantes de medicina de la Universidad de Murcia de tercer curso realizaron la práctica (28 grupos: 105 mujeres, 73 hombres). La tasa de acierto (punción, aspiración de material y extensión en portaobjetos) fue del 97,2% con la primera punción. Además, 13 estudiantes procedentes de otras 10 universidades (nacionales e internacionales) llevaron a cabo la práctica, refiriendo la no existencia en sus centros de procedencia. Fue considerada como de gran valor sobre encuesta anónima. Discusión. Las prácticas de PAAF son fácilmente implementables y potencialmente incorporables a los formatos evaluativos tipo examen clínico objetivo estructurado (ECOE). No existe una adecuada estandarización en las prácticas de diferentes centros universitarios. Las prácticas de PAAF mejoran la formación del estudiante y proporciona un mayor conocimiento y una mejor consideración de nuestra especialidad (AU)

Background. Fine needle aspiration cytology (FNAC) is a minimally invasive and extremely useful procedure. The characteristics of the practice of pathology, together with limited equipment, make teaching this technique difficult. We therefore have introduced phantoms designed to perform FNAC as part of the medical education programme in our hospital. Material and methods. Phantoms are two life-sized hand-made reproductions of an adult head & neck (utility model ES1140059) and a trunk, respectively, coated with silicone simulating skin and with inserted tumor areas. They allow the whole FNAC process (palpation, puncture, aspiration, placement of material on slide and smear preparation) to be performed and, furthermore, are reusable. During 3 academic years (2013-2016) FNAC samples have been obtained in this way by each student individually, in a clinical context and with subsequent cytological correlation. Results. A total of 178 third year medical students from the University of Murcia, Spain, took part in the FNAC training programme (28 groups: 105 women, 73 men). The success rate in the first attempt (puncture, aspiration of material, placing and extending the obtained material on slides) was 97.2%. Furthermore, 13 students from 10 other universities (national and international) also took part, not having such a programme in their medical schools. In an anonymous survey the consensus was that it was valuable practical training. Discussion. Training in FNAC techniques is easy to include in the undergraduate curriculum and also in the Objective Structured Clinical Examination (OSCE) evaluation format. There is no proper standardization in training among different universities. FNAC simulation provides students with greater knowledge and appreciation of our specialty (AU)

The Impact of Cross-Unit Coordination and Process Improvement Efforts in Anatomic Pathology: A Systems Perspective.

BACKGROUND: The impact of coordination and problem solving on health care quality has become increasingly prevalent within the literature. However, few studies have empirically investigated the impact of these factors across organizational boundaries. METHODS: This was an embedded, single-case study conducted within a large, academic Anatomic Pathology department. We surveyed 96 team members within 18 distinct processing or specialty units within the department and forward the Network Alignment Approach to measure coordination between units. In addition, we measure perceived safety culture and frequency of error in specimen documentation and preparation. RESULTS: Regression results suggest that downstream cross-unit coordination between units (clarity of customer requirements) significantly improves safety culture (P < .001). In addition, within-unit process improvement efforts improved safety culture (P < .001). These 2 factors alone accounted for 30% of the variation in the regression model, with safety culture as our dependent variable. CONCLUSION: Clarity of customer requirements and process improvement efforts significantly improve safety culture within the system. This approach to understanding and analyzing connections within complex systems provides insight into specific ways that leaders can begin to understand how each unit or department can improve as both a customer and a supplier within the larger system.

Una nueva figura en la anatomía patológica actual: el patólogo intervencionista / The interventional pathologist: a new role in modern pathology

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The benefits of a joint venture for pathology.

A merger of two foundation trusts' pathology services led to more sophisticated technology, shorter turnaround times and lower costs, as David James explains.