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These data have been accessed over 2500 times by over 100 distinct users. Median length of each user session is approximately 4.9 minutes. see more Because our lab information system does not persistently store tracking information while our system does, we have been able to iteratively recalculate time to result values for each tracking stop as workflows have changed over time. Facility with informatics and programming concepts coupled with clinical understanding have allowed us to swiftly develop and iterate on applications which provide efficiency gains, allowing laboratory resources to focus on generating test results for our patients.The COVID-19 pandemic created new challenges in health care, and pathology departments have led with innovations in testing and education. While the medical community and public showed great interest in gross and histologic findings in COVID-affected patients, paradoxically many autopsy services nationwide closed due to uncertainties surrounding the proximity to infected patient tissue, shortages in personal protective equipment, and pressures to discontinue perceived nonessential hospital operations. These disruptions furthermore negatively impacted pathology trainee education. The autopsy division at Northwestern Memorial Hospital, with the belief that a fully functioning autopsy service is especially crucial at this time, adopted a framework for continuing at full capacity for both clinical care and education. New operations were modeled on national protocols by the Centers for Disease Control and Prevention and the College of American Pathologists, and the service continually adjusted policies to reflect rapidly changing guidelines and feedback from trainees and staff. Between January and December 2020, we performed 182 adult autopsies including 45 COVID-19 autopsies. Twelve residents, 4 staff, and 5 attendings rotated through the service. In exit interviews, participants expressed (1) improved comfort managing both COVID-related and general autopsies; (2) sense of personal safety on service (despite the increased risk of exposure); (3) belief that both COVID-related and general autopsies contributed to their personal education and to the medical community. There have been zero known autopsy-related COVID-19 infections to date. We hope that our innovative autopsy service restructuring can serve as a framework for other academic programs during the current and in future pandemics.The COVID-19 pandemic has forced educational programs, including pathology residency, to move to a physically distanced learning environment. Tandem microscopic review (also known as "double-scoping") of pathology slides is a traditional cornerstone of pathology education. However, this requires the use of a double- or multi-headed optical light microscope which is unfortunately not amenable to physical distancing. The loss of double-scoping has forced educational innovation in order to continue teaching microscopy. Digital pathology options such as whole slide imaging could be considered; however, financial constraints felt by many departments often render this option cost-prohibitive. Alternatively, a shift toward teaching via dynamic virtual microscopy offers a readily available, physically distanced, and cost-conscious alternative for pathology education. Required elements include a standard light microscope, a mounted digital camera, computers, and videoconferencing software to share a slide image with the learner(s). Through survey data, we show immediate benefits include maintaining the essence of the traditional light microscope teaching experience, and additional gains were discovered such as the ability for educators and learners to annotate images in real time, among others. Existing technology may not be initially optimized for a dynamic virtual experience, resulting in lag time with image movement, problems focusing, image quality issues, and a narrower field of view; however, these technological barriers can be overcome through hardware and software optimization. Herein, we share the experience of establishing a dynamic virtual microscopy educational system in response to the COVID-19 pandemic, utilizing readily available technology in the pathology department of a major academic medical center.Whipple's disease is a bacterial infection caused by Tropheryma whipplei and is known to cause perplexing clinical presentations, making its diagnosis challenging. The beginning by the involvement of the gastrointestinal tract, Whipple's disease can slowly progress to affect almost any organ system and lead to chronic multi-system inflammatory disease. Hereby, we present a middle age man who initially manifested with shortness of breath and chronic weight loss. He subsequently developed pleuro-pericardial effusion, ascites, mesenteric lymphadenopathy, possible myocarditis, and severe osteopenia with multiple vertebral fractures during his illness. Esophagogastroduodenoscopy with the biopsy and subsequent molecular confirmation of disease led to the confirmation of WD. Therapeutic management included two separate antibiotic regimens in an attempt to address the refractory course of WD in this patient.Nanoparticle-based targeted drug delivery holds promise for treatment of cancers. However, most approaches fail to be translated into clinical success due to ineffective tumor targeting in vivo. Here, the delivery potential of mesoporous silica nanoparticles (MSN) functionalized with targeting ligands for EGFR and CCR2 is explored in lung tumors. The addition of active targeting ligands on MSNs enhances their uptake in vitro but fails to promote specific delivery to tumors in vivo, when administered systemically via the blood or locally to the lung into immunocompetent murine lung cancer models. Ineffective tumor targeting is due to efficient clearance of the MSNs by the phagocytic cells of the liver, spleen, and lung. These limitations, however, are successfully overcome using a novel organ-restricted vascular delivery (ORVD) approach. ORVD in isolated and perfused mouse lungs of Kras-mutant mice enables effective nanoparticle extravasation from the tumor vasculature into the core of solid lung tumors. In this study, ORVD promotes tumor cell-specific uptake of nanoparticles at cellular resolution independent of their functionalization with targeting ligands.
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