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In this article, an integrated computer-assisted process-planning and computer-assisted fixture layout planning system is presented for the automatic generation of process and fixture maps. The part feature model is created using various algorithms and the geometric reasoning approach. The feature-based methodology based on the machining database is then applied for the generation of process maps. The setup scheme algorithm allocates each feature to a definite setup based on its location. The part geometric database and setup plan aids the fixture layout planning process. During fixture layout planning, the standard fixture rules are applied to determine the locating arrangement and feasible datum along with the suitable positions using a fixture database for initial fixture layout planning data. Visual C++ is used to implement the proposed methodology because it interacts with current computer-aided design software. Then a case study is presented to develop an initial fixture layout. Afterwards, the ANSYS parametric design language optimisation tool is applied to automatically optimise locator and clamp positions that yield minimum workpiece deformation. At the end, finite element analysis results depicting deformation magnitudes are presented.

* Context.--PathElective.com was created in response to the pandemic's restrictions on interactions with trainees, and since has been incorporated into many training programs worldwide, serving as a unique means of delivering high-quality pathology and laboratory medical education at multiple levels of training. Objective.--To analyze student usage, performance, and satisfaction to provide insight into the effectiveness of virtual education to guide curricular evolution. Design.--Squarespace (Squarespace, Inc) was used for website development and to collect website analytics. Students were assessed before and after course participation using a dual-form crossover quiz design. Quiz data were anonymous and analyzed with a paired t test to account for varying student backgrounds. A novel analysis was performed aimed at examining the attrition rate of students across multiple modules. Results.--During the study period (May 1, 2020 to October 31, 2021), PathElective.com received 577 483 page views, 126180 visits, 59 928 unique visitors, and 10 278 registered users who earned 15 305 certificates. A total of 7338 premodule and postmodule quiz pairs were analyzed. The overall average increase in score was 13.83% (P = .02). All but 5 of the 56 courses experienced a statistically significant increase in score. All courses received median scores of Very Satisfied/ Satisfied in all 6 assessment domains. Aggregate attrition data revealed a unique, negative polynomial relationship ([R.sup.2] = 0.656). Conclusions.--PathElective.com is a free, effective means of enhancing anatomic/clinical pathology training in medical education. These analyses offer a unique perspective on the online user experience and could guide the development of future online medical education resources., As a result of the COVID-19 pandemic, medical education delivery transformed overnight. In-person experiences were converted to virtual experiences, with varying success. (1) Formal medical student exposure to pathology is [...]

Oxyuriasis, caused by the nematode Enterobius vermicularis, is one of the cosmopolitan intestinal infections of humans. Aspiculuris tetraptera commonly infects mice and it is morphologically similar to E. vermicularis. Parasitic resistance reduces the efficiency of synthetic drugs and poses economic impacts on the dairy sector, thus necessitating novel anthelmintic agents. Olea europaea L. (Olive) is a bioactive plant with potent pharmacological activities. However, its effects on oxyurids are poorly known, and no studies are currently exploring olives’ anthelmintic potential. In this study, we investigated the pharmacokinetic behaviors of O. europaea leaves extract (OLE) and its phenolic compound oleuropein in mice infected with A. tetraptera, in comparison with Albendazole (ABZ), a standard drug used to treat parasitic worms. Fecal flotation method was used to identify the infestation with A. tetraptera eggs by examining the stool samples from mice. Infected animals were divided into 7 groups. 250 mg/kg, 500 mg/kg, and 1000 mg/kg doses of OLE, 5 mg/kg and 20 mg/kg doses of oleuropein, 10 mg/kg of ABZ and tap water were orally administered by gavage for 7 days during treatments. Drug efficacies and statistical differences between the treatments and controls were evaluated. Our results revealed 92.43 % efficacy of ABZ, similar to 92.19 % efficacy of 1000 mg/kg of OLE. At the same time, 250 mg/kg and 500 mg/kg concentrations of OLE remained 70.03 % and 63.18 % effective in reducing worm counts. Efficacy percentages of 5 mg/kg and 20 mg/kg of oleuropein were 9.27 % and 70.56 %, respectively. Statistical analysis of ABZ was significant compared to 1000 mg/kg of OLE, which was almost equal but insignificant. In general, our results confirm the anthelmintic potential of OLE and oleuropein against mice pinworms and open the way for targeted extraction of bioactive compounds from plants to optimize its use in human and veterinary medicine.

Keratoconus (KC) is a corneal thinning dystrophy that leads to visual impairment. While the cause of KC remains poorly understood, changes in sex hormone levels have been correlated with KC development. This study investigated circulating gonadotropin-releasing hormone (GnRH) in control and KC subjects to determine if this master hormone regulator is linked to the KC pathology. Plasma and saliva were collected from KC subjects (n = 227 and n = 274, respectively) and non-KC controls (n = 58 and n = 101, respectively), in concert with patient demographics and clinical features. GnRH levels in both plasma and saliva were significantly lower in KC subjects compared to controls. This finding was retained in plasma when subjects were stratified based on age, sex, and KC severity. Control and KC corneal fibroblasts (HKCs) stimulated with recombinant GnRH protein in vitro revealed significantly increased luteinizing hormone receptor by HKCs and reduced expression of α-smooth muscle actin with treatment suggesting that GnRH may modulate hormonal and fibrotic responses in the KC corneal stroma. Further studies are needed to reveal the role of the hypothalamic–pituitary–gonadal axis in the onset and progression of KC and to explore this pathway as a novel therapeutic target.

Purpose: To present the clinical outcome of mitomycin intravascular chemoembolization (MICE) as a prophylactic treatment in a patient with HSV-induced corneal neovascularization (NV) before penetrating keratoplasty (PKP). Observations: A 53-year-old male patient presented with a medical history of recurrent herpes simplex virus (HSV) corneal infection. The patient reported worsening visual acuity despite maintenance treatment with systemic antivirals and topical corticosteroids. After the appearance of corneal NV, subconjunctival triamcinolone and bevacizumab injections were given with limited and temporary improvement. Due to worsening corneal NV, MICE was subsequently performed, resulting in the elimination of corneal NV from the visual axis, which allowed for successful PKP 4 months later. Cataract surgery was performed 6 months after PKP. Conclusions and importance: This report describes the potential efficacy of MICE as a prophylactic treatment for corneal NV prior to PKP.

Abstract Purpose To evaluate whether the volume of wash out rinse after povidone iodine (PI) application for intravitreal injections (IVI) affects patients’ ocular surface irritation. Methods This was a prospective, single-masked, randomized-controlled trial consisting of 142 subjects. A total of 51, 45, and 46 patients received 3-mL, 10-mL, and 15-mL of ocular rinse respectively. Reductions in the Ocular Surface Disease Index (OSDI) and the Standardized Patient Evaluation of Eye Dryness II (SPEED II) surveys, conducted before and at 24–72 h post-injection, were analyzed. Results There was no statistical difference in objective dry eye findings of Schirmer test (p-value = 0.788), tear break-up time (p-value = 0.403), Oxford fluorescein grade (p-value = 0.424) between the study groups prior to injections. Dry eye symptoms as measured by reductions in the OSDI and SPEEDII scores were not different between the study groups (p-value = 0.0690 and 0.6227, respectively). Conclusion There is no difference in patients’ ocular surface irritation between 3-mL, 10-mL, and 15-mL post injection rinse. Given the large number of IVIs performed, modification of practice patterns based on these findings could lead to significant reduction in global cost burden for IVIs.

The mTOR pathway is an essential regulator of cell growth and metabolism. Midbrain dopamine neurons are particularly sensitive to mTOR signaling status as activation or inhibition of mTOR alters their morphology and physiology. mTOR exists in two distinct multiprotein complexes termed mTORC1 and mTORC2. How each of these complexes affect dopamine neuron properties, and whether they have similar or distinct functions is unknown. Here, we investigated this in mice with dopamine neuron-specific deletion of Rptor or Rictor, which encode obligatory components of mTORC1 or mTORC2, respectively. We find that inhibition of mTORC1 strongly and broadly impacts dopamine neuron structure and function causing somatodendritic and axonal hypotrophy, increased intrinsic excitability, decreased dopamine production, and impaired dopamine release. In contrast, inhibition of mTORC2 has more subtle effects, with selective alterations to the output of ventral tegmental area dopamine neurons. Disruption of both mTOR complexes leads to pronounced deficits in dopamine release demonstrating the importance of balanced mTORC1 and mTORC2 signaling for dopaminergic function.

Context.--Myriad forces are changing teaching and learning strategies throughout all stages and types of pathology education. Pathology educators and learners face the challenge of adapting to and adopting new methods and tools. The digital pathology transformation and the associated educational ecosystem are major factors in this setting of change. Objective.--To identify and collect resources, tools, and examples of educational innovations involving digital pathology that are valuable to pathology learners and teachers at each phase of professional development. Data Sources.--Sources were a literature review and the personal experience of authors and educators. Conclusions.--High-quality digital pathology tools and resources have permeated all the major niches within anatomic pathology and are increasingly well applied to clinical pathology for learners at all levels. Coupled with other virtual tools, the training landscape in pathology is highly enriched and much more accessible than in the past. Digital pathology is well suited to the demands of peer-to-peer education, such as in the introduction of new testing, grading, or other standardized practices. We found that digital pathology was well adapted to apply our current understanding of optimal teaching strategies and was effective at the undergraduate, graduate, postgraduate, and peer-to-peer levels. We curated and tabulated many existing resources within some segments of pathology. We identified several best practices for each training or educational stage based on current materials and proposed high-priority areas for potential future development. doi: 10.5858/arpa.2021-0473-RA, We could just as well be writing this paper with a manually powered typewriter, or with ink drawn from a well by a quill pen, had not a series of [...]

BackgroundIncreasing numbers of residency applications create challenges for applicants and residency programs to assess if they are a good fit during the residency application and match process. Applicants face limited or conflicting information as they assess programs, leading to overapplying. A holistic review of residency applications is considered a gold standard for programs, but the current volumes and associated time constraints leave programs relying on numerical filters, which do not predict success in residency. Applicants could benefit from increased transparency in the residency application process. ObjectiveThis study aims to determine the information applicants find most beneficial from residency programs when deciding where to apply, by type of medical school education background. MethodsMatch 2023 applicants voluntarily completed an anonymous survey through the Twitter and Instagram social media platforms. We asked the respondents to select 3 top factors from a multiple-choice list of what information they would like from residency programs to help determine if the characteristics of their application align with program values. We examined differences in helpful factors selected by medical school backgrounds using ANOVA. ResultsThere were 4649 survey respondents. When responses were analyzed by United States-allopathic (US-MD), doctor of osteopathic medicine (DO), and international medical graduate (IMG) educational backgrounds, respondents chose different factors as most helpful: minimum United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Step 2 scores (565/3042, 18.57% US-MD; 485/3042, 15.9% DO; and 1992/3042, 65.48% IMG; P