COVID-19 Pandemic: Huge Stress Test for Health System Could Be a Great Opportunity to Update the Workflow in a Modern Surgical Pathology

Background: On December 2019, an outbreak of atypical pneumonia, known as COVID-19, was identified in Wuhan, China. This disease, characterized by the rapid human-to-human transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly in more than 200 countries. Northern Italy’s regions have been hit hard in terms of deaths. Here, we report the experience of the Pathology Department of the Fondazione IRCCS Istituto Nazionale Tumori (INT) in Milan, the first Italian public cancer center, in the period of the lockdown that took place in Lombardy from March to May 2020. Method: The variation in terms of exams was calculated in two different timeframes: December 2019–February 2020 (pre-COVID-19) and March–May 2020 (COVID-19). During these periods, Turn-Around-Time (TAT) metrics released by the Lombardy Region were calculated to assess if changes applied to guarantee the safeguarding of workers affected the average diagnosis time. Results: In the COVID-19 period, there was a decrease for all the performed exams. The most considerable decrease was observed for PAP tests (−81.6%), followed by biopsies (−48.8%), second opinions (−41.7%), and surgical (−31.5%), molecular (−29.4%) and cytological (−18.1%) tests. Measures applied within the Pathology Department, such as digital pathology, remote working, rotations and changes in operating procedures, improved the diagnostic performance as required by the guidelines of the Lombardy Region in terms of TAT. At the same time, the measures applied for the safeguarding of the personnel turned out to be feasible and did not affect the overall performance of the Pathology Department. Conclusions: The sharp slowdown in cancer screening during the first wave of COVID-19 could seriously endanger cancer prevention in the near future.

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Quality control stress test for deep learning-based diagnostic model in digital pathology

Modern Pathology ◽

10.1038/s41379-021-00859-x ◽

2021 ◽

Author(s):

Birgid Schömig-Markiefka ◽

Alexey Pryalukhin ◽

Wolfgang Hulla ◽

Andrey Bychkov ◽

Junya Fukuoka ◽

...

Keyword(s):

Deep Learning ◽

Cancer Detection ◽

Stress Testing ◽

Computational Analysis ◽

Stress Test ◽

Digital Pathology ◽

Model Performance ◽

Diagnostic Model ◽

Model Accuracy ◽

Diagnostic Models

AbstractDigital pathology provides a possibility for computational analysis of histological slides and automatization of routine pathological tasks. Histological slides are very heterogeneous concerning staining, sections’ thickness, and artifacts arising during tissue processing, cutting, staining, and digitization. In this study, we digitally reproduce major types of artifacts. Using six datasets from four different institutions digitized by different scanner systems, we systematically explore artifacts’ influence on the accuracy of the pre-trained, validated, deep learning-based model for prostate cancer detection in histological slides. We provide evidence that any histological artifact dependent on severity can lead to a substantial loss in model performance. Strategies for the prevention of diagnostic model accuracy losses in the context of artifacts are warranted. Stress-testing of diagnostic models using synthetically generated artifacts might be an essential step during clinical validation of deep learning-based algorithms.

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Outpatient Care

10.1007/978-3-030-82052-7_4 ◽

2021 ◽

pp. 21-33

Author(s):

Ian Qianhuang Wu ◽

Francesca Lorraine Wei Inng Lim ◽

Liang Piu Koh

Keyword(s):

T Cell ◽

Cancer Care ◽

Hospital Admissions ◽

Care Delivery ◽

Cost Effective ◽

Outpatient Setting ◽

Cancer Center ◽

T Cell Therapy ◽

Car T Cell Therapy ◽

Near Future

AbstractManagement of haematology-oncology patients has historically been largely inpatient-based. With advances in the understanding of disease and improvements in supportive care, patients are increasingly being managed in the outpatient setting. This is especially evident in autologous stem cell transplantation, which is now routinely done as an outpatient procedure at various centres. As clinicians gain more experience in novel therapies such as chimeric antigen receptor (CAR)-T cell therapy and bispecific T cell engager (BiTE) therapy, these may potentially be administered in the outpatient setting in the near future with the adoption of a risk-stratified approach. Such a paradigm shift in the practice of haematology-oncology is inevitable and has been driven by several factors, including pressure from the institution/hospital to avoid unnecessary hospital admissions and for optimal use of inpatient resources to be more cost-effective and efficient. With favourable local regulations and funding, outpatient cancer care can be economically beneficial. The success of an outpatient cancer center is heavily dependent on planning the facility to be equipped with the appropriate infrastructure, together with the trained medical and supportive personnel in place. This, coupled with the utilization of emerging technology such as telemedicine, has the potential to revolutionize cancer care delivery in the outpatient setting.

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Experimental Investigation of Communication Performance of Drones Used for Autonomous Car Track Tests

Sustainability ◽

10.3390/su13105602 ◽

2021 ◽

Vol 13 (10) ◽

pp. 5602

Author(s):

Melih Yildiz ◽

Burcu Bilgiç ◽

Utku Kale ◽

Dániel Rohács

Keyword(s):

Traffic Safety ◽

Autonomous Vehicles ◽

Transportation Safety ◽

High Tech ◽

Disruptive Technology ◽

Communication Performance ◽

Great Opportunity ◽

Test Track ◽

Vehicle To Vehicle ◽

Near Future

Autonomous Vehicles (AVs) represent an emerging and disruptive technology that provides a great opportunity for future transport not only to have a positive social and environmental impact but also traffic safety. AV use in daily life has been extensively studied in the literature in various dimensions, however; it is time for AVs to go further which is another technological aspect of communication. Vehicle-to-Vehicle (V2V) technology is an emerging issue that is expected to be a mutual part of AVs and transportation safety in the near future. V2V is widely discussed by its deployment possibilities not only by means of communication, even to be used as an energy transfer medium. ZalaZONE Proving Ground is a 265-hectare high-tech test track for conventional, electric as well as connected, assisted, and automated vehicles. This paper investigates the use of drones for tracking the cars on the test track. The drones are planned to work as an uplink for the data collected by the onboard sensors of the car. The car is expected to communicate with the drone which is flying in coordination. For the communication 868 MHz is selected to be used between the car and the drone. The test is performed to simulate different flight altitudes of drones. The signal strength of the communication is analyzed, and a model is developed which can be used for the future planning of the test track applications.

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Comment on “Response of a comprehensive cancer center to the COVID-19 pandemic: the experience of the Fondazione IRCCS–Istituto Nazionale dei Tumori di Milano”

Tumori Journal ◽

10.1177/0300891620953471 ◽

2020 ◽

Vol 106 (6) ◽

pp. 524-525

Author(s):

Andrea Romanzi ◽

Alberto Vannelli

Keyword(s):

Therapeutic Strategies ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Phase 2 ◽

Viable Option ◽

Locoregional Anesthesia ◽

Operating Theatres ◽

Containment Measures ◽

Transitional Phase ◽

Fondazione Irccs

Although European governments have launched the so-called phase 2 in the coronavirus disease 2019 (COVID-19) pandemic (a transitional phase of beginning to downsize containment measures), intensive care units are not COVID-19–free and this restricts our therapeutic strategies. Moreover, minimally invasive surgery and general anesthesia are under debate as they are both aerosol-generating procedures and may contribute to contamination spread inside operating theatres. During this pandemic, 13 fragile patients needing abdominal surgery underwent awake open surgery under locoregional anesthesia at our department. This approach was feasible, safe, and, in specific cases, the only viable option. In the COVID-19 era, this approach could allow surgeons to carry out undeferrable surgeries, preventing viral transmission inside the operating room.

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Response of a comprehensive cancer center to the COVID-19 pandemic: the experience of the Fondazione IRCCS–Istituto Nazionale dei Tumori di Milano

Tumori Journal ◽

10.1177/0300891620923790 ◽

2020 ◽

Vol 106 (3) ◽

pp. 193-202 ◽

Cited By ~ 10

Author(s):

Franco Valenza ◽

Gabriele Papagni ◽

Alfonso Marchianò ◽

Maria Grazia Daidone ◽

Filippo De’Braud ◽

...

Keyword(s):

Comprehensive Cancer Center ◽

Cancer Center ◽

Rt Pcr ◽

Patients With Cancer ◽

Laboratory Confirmation ◽

Rapid Spread ◽

Hospital Patients ◽

Set Up ◽

Low Dose Computed Tomography ◽

Fondazione Irccs

Background: The rapid spread of coronavirus disease (COVID-19) is affecting many countries. While healthcare systems need to cope with the need to treat a large number of people with different degrees of respiratory failure, actions to preserve aliquots of the healthcare system to guarantee treatment to patients are mandatory. Methods: In order to protect the Fondazione IRCCS–Istituto Nazionale dei Tumori di Milano from the spread of COVID-19, a number of to-hospital and within-hospital filters were applied. Among others, a triage process to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in patients with cancer was developed consisting of high-resolution low-dose computed tomography (CT) scan followed by reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 in nose–throat swabs whenever CT was suggestive of lung infection. To serve symptomatic patients who were already admitted to the hospital or in need of hospitalization while waiting for RT-PCR laboratory confirmation of infection, a COVID-19 surveillance zone was set up. Results: A total of 301 patients were screened between March 6 and April 3, 2020. Of these, 47 were hospitalized, 53 needed a differential diagnosis to continue with their cancer treatment, and 201 were about to undergo surgery. RT-PCR was positive in 13 of 40 hospitalized patients (32%), 14 of 52 day hospital patients (27%), and 6 of 201 surgical patients (3%). Conclusion: Applying filters to protect our comprehensive cancer center from COVID-19 spread contributed to guaranteeing cancer care during the COVID-19 crisis in Milan. A surveillance area and surgical triage allowed us to protect the hospital from as many as 33 patients infected with SARS-CoV-2.

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A LABORATORY WORK WITH BIOMASS: A CEMENT REPLACEMENT MATERIAL IN CONCRETE MIX

Jurnal Teknologi ◽

10.11113/jt.v78.8234 ◽

2016 ◽

Vol 78 (5) ◽

Author(s):

Noor Faisal Abas

Keyword(s):

Waste Management ◽

Raw Materials ◽

Biomass Ash ◽

Biomass Waste ◽

Great Opportunity ◽

Cement Production ◽

Cement Replacement ◽

Increasing Demand ◽

Near Future ◽

Effective Result

The cement production facing the current environmental issue like CO2 emission and scarcity of raw materials, burning of higher amount fossil fuel for production and rapidly increasing demand for cement and concrete can be of a greater problem in the near future. On the other hand there is an ongoing issue of biomass waste management, so there is great opportunity for biomass ash to be used as a cement replacement material as many ongoing researches suggest. This can help to cut down the production of cement and with waste management. The pozzolanic characteristic of several biomass ash can be advantageous, and if the required strength of concrete can be achieved with a certain amount of replacement of cement with biomass ash, then this can be used widely if allowed by structural codes. This report explores the scope of biomass as a cement replacement material in several percentages (5%, 10%, 20%) and shows an effective result with 5 to 10% replacement as the cement with this percentage showed almost same engineering and durability properties like the traditional mix.

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Digital Pathology Operations at an NYC Tertiary Cancer Center During the First 4 Months of COVID-19 Pandemic Response

Academic Pathology ◽

10.1177/23742895211010276 ◽

2021 ◽

Vol 8 ◽

pp. 237428952110102

Author(s):

Orly Ardon ◽

Victor E. Reuter ◽

Meera Hameed ◽

Lorraine Corsale ◽

Allyne Manzo ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

New York ◽

Public Transportation ◽

Care Delivery ◽

New York State ◽

Digital Pathology ◽

Public Health Emergency ◽

Cancer Center ◽

The Public

Implementation of an infrastructure to support digital pathology began in 2006 at Memorial Sloan Kettering Cancer Center. The public health emergency and COVID-19 pandemic regulations in New York City required a novel workflow to sustain existing operations. While regulatory enforcement discretions offered faculty workspace flexibility, a substantial portion of laboratory and digital pathology workflows require on-site presence of staff. Maintaining social distancing and offering staggered work schedules. Due to a decrease in patients seeking health care at the onset of the pandemic, a temporary decrease in patient specimens was observed. Hospital and travel regulations impacted onsite vendor technical support. Digital glass slide scanning activities onsite proceeded without interruption throughout the pandemic, with challenges including staff who required quarantine due to virus exposure, unrelated illness, family support, or lack of public transportation. During the public health emergency, we validated digital pathology systems for a remote pathology operation. Since March 2020, the departmental digital pathology staff were able to maintain scanning volumes of over 100 000 slides per month. The digital scanning team reprioritized archival slide scanning and participated in a remote sign-out validation and successful submission of New York State approval for a laboratory developed test. Digital pathology offers a health care delivery model where pathologists can perform their sign out duties at remote location and prevent disruptions to critical pathology services for patients seeking care at our institution during emergencies. Development of standard operating procedures to support digital workflows will maintain turnaround times and enable clinical operations during emergency or otherwise unanticipated events.

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A Survival Guide for the Rapid Transition to a Fully Digital Workflow: The “Caltagirone Example”

Diagnostics ◽

10.3390/diagnostics11101916 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1916

Author(s):

Filippo Fraggetta ◽

Alessandro Caputo ◽

Rosa Guglielmino ◽

Maria Giovanna Pellegrino ◽

Giampaolo Runza ◽

...

Keyword(s):

Digital Pathology ◽

Primary Diagnosis ◽

Pathology Laboratory ◽

Digital Workflow ◽

Pathology Department ◽

Health Level 7 ◽

2D Barcode ◽

Glass Slides ◽

Rapid Transition ◽

Routine Assessment

Digital pathology for the routine assessment of cases for primary diagnosis has been implemented by few laboratories worldwide. The Gravina Hospital in Caltagirone (Sicily, Italy), which collects cases from 7 different hospitals distributed in the Catania area, converted the entire workflow to digital starting from 2019. Before the transition, the Caltagirone pathology laboratory was characterized by a non-tracked workflow, based on paper requests, hand-written blocks and slides, as well as manual assembling and delivering of the cases and glass slides to the pathologists. Moreover, the arrangement of the spaces and offices in the department was illogical and under-productive for the linearity of the workflow. For these reasons, an adequate 2D barcode system for tracking purposes, the redistribution of the spaces inside the laboratory and the implementation of the whole-slide imaging (WSI) technology based on a laboratory information system (LIS)-centric approach were adopted as a needed prerequisite to switch to a digital workflow. The adoption of a dedicated connection for transfer of clinical and administrative data between different software and interfaces using an internationally recognised standard (Health Level 7, HL7) in the pathology department further facilitated the transition, helping in the integration of the LIS with WSI scanners. As per previous reports, the components and devices chosen for the pathologists’ workstations did not significantly impact on the WSI-based reporting phase in primary histological diagnosis. An analysis of all the steps of this transition has been made retrospectively to provide a useful “handy” guide to lead the digital transition of “analog”, non-tracked pathology laboratories following the experience of the Caltagirone pathology department. Following the step-by-step instructions, the implementation of a paperless routine with more standardized and safe processes, the possibility to manage the priority of the cases and to implement artificial intelligence (AI) tools are no more an utopia for every “analog” pathology department.

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The impact of modern technology on the activities of museums

Bulletin of "Turan" University ◽

10.46914/1562-2959-2021-1-1-145-151 ◽

2021 ◽

pp. 145-151

Author(s):

G. I. Yeshenkulova ◽

R. Ye. Agybetova ◽

Y. E. Galiakbarov ◽

A. G. Gizzatzhanova

Keyword(s):

Virtual Reality ◽

New Technologies ◽

Modern Technology ◽

Great Opportunity ◽

The Past ◽

Modern Period ◽

Industry Needs ◽

The Impact ◽

Near Future ◽

Modern Technologies

The article describes the state of museums in the past, the impact of monotonous activities in the country on the number of visitors, as well as the introduction of new technologies and their impact on museums. The importance of using new technologies in the provision of their services, quickly focused on the modern period of museums that are among the top 10 world-famous museums, is emphasized. Virtual tours in 3D format of several foreign and patronymic museums and exhibitions with the use of modern technologies and augmented virtual reality indicate that the museum's attendance is increasing both online and offline. The situation in our country shows that significant work needs to be done to increase the number of visitors to museums, including the use of new technologies, good advertising, various promotions. This idea can be confirmed by the results of a survey on the use of augmented reality and virtual reality technologies in the museum in our country. The desire of a total of 179 participants to visit the museum confirms the need to develop this area. In the near future, people's visits to museums may change, their situation shows that the industry needs to be developed in the future, there is a great opportunity to deliver art to people previously unavailable, people who do not have the opportunity to travel and visit famous museums have online access to the world's best collections. Strict restrictions due to the pandemic have increased people's interest in listening to virtual tours of museums, which, among other things, is due to the fact that the museums themselves are beginning to quickly direct visitors to online tours.

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The future of artificial intelligence in digital pathology - results of a survey across stakeholder groups

10.1101/2021.12.16.472990 ◽

2021 ◽

Author(s):

Celine N Heinz ◽

Amelie Echle ◽

Sebastian Foersch ◽

Andrey Bychkov ◽

Jakob Nikolas Kather

Keyword(s):

Artificial Intelligence ◽

Treatment Response ◽

Online Survey ◽

Digital Pathology ◽

Genetic Alterations ◽

Future Application ◽

Cell Detection ◽

Tissue Segmentation ◽

Computational Pathology ◽

Near Future

Artificial intelligence (AI) provides a powerful tool to extract information from digitized histopathology whole slide images. In the last five years, academic and commercial actors have developed new technical solutions for a diverse set of tasks, including tissue segmentation, cell detection, mutation prediction, prognostication and prediction of treatment response. In the light of limited overall resources, it is presently unclear for researchers, practitioners and policymakers which of these topics are stable enough for clinical use in the near future and which topics are still experimental, but worth investing time and effort into. To identify potentially promising applications of AI in pathology, we performed an anonymous online survey of 75 computational pathology domain experts from academia and industry. Participants enrolled in 2021 were queried about their subjective opinion on promising and appealing sub-fields of computational pathology with a focus on solid tumors. The results of this survey indicate that the prediction of treatment response directly from routine pathology slides is regarded as the most promising future application. This item was ranked highest in the overall analysis and in sub-groups by age and professional background. Furthermore, prediction of genetic alterations, gene expression and survival directly from routine pathology images scored consistently high across subgroups. Together, these data demonstrate a possible direction for the development of computational pathology systems in clinical, academic and industrial research in the near future.

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