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Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Schukow is an Ambassador for Knowledge In Knowledge Out but he does not receive financial compensation for this position. He has also published in Pathology Outlines and StatPearls, but does not acknowledge his specific chapters in this review as they are not pertinent or does he receive financial compensation. He does not receive financial compensation for his podcast titled “Bone and Soft Tissue Pathology Podcast” referenced in Table 2, nor is the intent to increase his audience. The authors’ X accounts are referenced in Table 2, but are done so to give readers more sources for authors who publish BSTpath-related materials and anonymized them for peer review. Riddle is an administrator for the Bone and Soft Tissue Pathology Facebook group referenced in Table 2, but she does not receive financial compensation for this position. Fitzhugh has no conflicts.

According to section IV.B.1.e of common residency program requirements from the Accreditation Council for Graduate Medical Education (ACGME), "[r]esidents must learn to communicate with patients and families to partner with them to assess their care goals, including, when appropriate, end-of-care [EOL] goals". EOL conversations are frequently appropriate for patients suffering from serious, life-threatening diseases (ie, terminal illness) or otherwise chronic health conditions with poor disease trajectories. These conversations are often followed with services and care from palliative medicine or hospice specialists depending on patients' projected prognoses (ie, 6 months or less). The focus of this patient-centered care, then, is on relieving patient and caregiver suffering, establishing clear treatment goals, and managing the physical, psychosocial, and spiritual burdens of disease. Although palliative medicine and hospice care have been shown to reduce health care costs and improve the overall care of patients who require these services, recent literature still suggests a gap in training programs being able to provide effective, educational strategies to their trainees regarding the appropriate and competent delivery of EOL conversations. Herein, this commentary will provide a discussion on what EOL is, palliative vs hospice care indications, and address current literature regarding EOL exposure within training programs while offering our personal insight and advocacy on the manner., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The use of social media in pathology has broadly had a positive impact on pathology education and outreach with the frequent posting of high-quality educational material of potential value to trainees, practicing pathologists, and other clinical and laboratory specialists. These posts are also of potential utility and interest to members of the public, who are now more than ever able to gain a window into the field and the role of pathologists in their medical care. There can be a lighthearted aspect to teaching material with the use of food items/analogies, emojis, or other descriptors, which may cross over into the classroom. However, when pathology discussion is taken to a public forum, such as on Twitter (parent company: X Corp.), there is the potential for posted material to be misunderstood, such as when certain emojis or adjectives may be used to describe a human disease state or patient sample. The authors present examples of potential areas of caution, suggestions of how to create a positive impact, and brief guidelines for social media etiquette on #PathTwitter that may apply to other social media platforms widely used by pathologists (including, but not limited to, Facebook, Instagram, YouTube, and KiKo). While the points discussed here may be common knowledge and well-known to pathologists who use social media for virtual medical education, the concerns mentioned here (such as using language like "beautiful" to describe abnormal mitotic figures and cancer cells) still exist and, henceforth, bear reinforcing., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Schukow is an ambassador for KiKo but he does not receive financial compensation for this position.

Given recent trends in National Resident Matching Program (NRMP) data, there exists a looming deficit of practicing pathologists. As such, the Pathology Outreach Program (POP) was established in 2018 in the United States, and in 2022 in Canada, to educate high school students about pathology and laboratory medicine to help curb this projected shortage. We present survey data gathered from several educational sessions hosted at high schools in the United States (U.S.) and Canada over a 5-year period comparing participants' perceptions and awareness of pathology both before and after each session. Using this data, we wish to highlight the positive impact of POP on increasing students' awareness and appreciation for careers in pathology or laboratory medicine. This data will also highlight the additional work that must be done to further boost public knowledge of laboratory medicine's contributions to patient care. We hope this project will lay the foundation for further improvements to laboratory visibility and inspire additional outreach efforts to mitigate a future workforce shortage., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Aims: Pathology education is a core component of medical training, and its literature is critical for refining educational modalities. We performed a cross-sectional bibliometric analysis to explore publications on pathology education, focusing on new medical education technologies., Methods: The analysis identified 64 pathology journals and 53 keywords. Relevant articles were collected using a web application, PaperScraper, developed to accelerate literature search. Citation data were collected from multiple sources. Descriptive statistics, with time period analysis, were performed using Microsoft Excel and visualised with Flourish Studio. Two article groups were further investigated with a bibliometric software, VOSViewer, to establish co-authorship and keyword relationships., Results: 8946 citations were retrieved from 905 selected articles. Most articles were published in the last decade (447, 49.4%). The top journals were Archives of Pathology & Laboratory Medicine (184), Human Pathology (122) and the American Journal of Clinical Pathology (117). The highest number of citations was found for Human Pathology (2120), followed by Archives of Pathology & Laboratory Medicine (2098) and American Journal of Clinical Pathology (1142). Authors with different backgrounds had the greatest number of articles and citations. 12 co-authorship, 3 keyword and 8 co-citation clusters were found for the social media/online resources group, 8 co-authorship, 4 keyword and 7 co-citation clusters for the digital pathology/virtual microscopy/mobile technologies group., Conclusions: The analysis revealed a significant increase in publications over time. The emergence of digital teaching and learning resources played a major role in this growth. Overall, these findings underscore the transformative potential of technology in pathology education., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Social media use in pathology has continued to grow and become more mainstream among pathologists, trainees, and medical students over the past decade. Twitter has historically been (and still seems to be) a positive platform for the social media pathology community to engage with each other virtually (ie, PathTwitter). However, as a new era of Twitter leadership began to unfold in October 2022, a young platform called "Mastodon" began to gain notice within this community as the hashtag #PathMastodon became prevalent. Founded in 2016 by Eugen Rochko, Mastodon is a decentralized, open-sourced, ads-free platform intended to promote public knowledge in a safe and public manner. When compared with Twitter, however, Mastodon is globally much smaller, and its medical professional server called "Med-Mastodon" is more cumbersome with certain features (eg, tracking analytics and username changes). Nevertheless, this new platform, which looks and feels much like Twitter, has great potential to provide continued medical education and virtual excellence among the social media pathology community. Thus, the purpose of this review is to provide a relevant synopsis of how Mastodon, Med-Mastodon, and #PathMastodon may benefit pathologists, trainees, and medical students who use social media. A qualitative analysis of pertinent peer-reviewed and non-peer-reviewed materials relative to the topic will be performed. In addition, we will provide a comparison of Mastodon and Twitter, provide example figures of #PathMastodon and related posts, and elaborate on the importance this discussion brings to the social media pathology community., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Large Language Models are forms of artificial intelligence that use deep learning algorithms to decipher large amounts of text and exhibit strong capabilities like question answering and translation. Recently, an influx of Large Language Models has emerged in the medical and academic discussion, given their potential widespread application to improve patient care and provider workflow. One application that has gained notable recognition in the literature is ChatGPT, which is a natural language processing "chatbot" technology developed by the artificial intelligence development software company OpenAI. It learns from large amounts of text data to generate automated responses to inquiries in seconds. In health care and academia, chatbot systems like ChatGPT have gained much recognition recently, given their potential to become functional, reliable virtual assistants. However, much research is required to determine the accuracy, validity, and ethical concerns of the integration of ChatGPT and other chatbots into everyday practice. One such field where little information and research on the matter currently exists is pathology. Herein, we present a literature review of pertinent articles regarding the current status and understanding of ChatGPT and its potential application in routine diagnostic pathology. In this review, we address the promises, possible pitfalls, and future potential of this application. We provide examples of actual conversations conducted with the chatbot technology that mimic hypothetical but practical diagnostic pathology scenarios that may be encountered in routine clinical practice. On the basis of this experience, we observe that ChatGPT and other chatbots already have a remarkable ability to distill and summarize, within seconds, vast amounts of publicly available data and information to assist in laying a foundation of knowledge on a specific topic. We emphasize that, at this time, any use of such knowledge at the patient care level in clinical medicine must be carefully vetted through established sources of medical information and expertise. We suggest and anticipate that with the ever-expanding knowledge base required to reliably practice personalized, precision anatomic pathology, improved technologies like future versions of ChatGPT (and other chatbots) enabled by expanded access to reliable, diverse data, might serve as a key ally to the diagnostician. Such technology has real potential to further empower the time-honored paradigm of histopathologic diagnoses based on the integrative cognitive assessment of clinical, gross, and microscopic findings and ancillary immunohistochemical and molecular studies at a time of exploding biomedical knowledge., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of hair-bearing intertriginous areas with a profound impact on quality of life., Objective: We sought to determine what barriers to treatment exist among both HS experts and non-experts., Methods: An IRB-approved, anonymous, voluntary survey was distributed to dermatologists through the HS Foundation listserv from June to September 2021., Results: Eighty-eight total responses were collected from 49 (55.7%) experts and 39 (44.3%) non-experts. Statistically significant differences were found in the comfort level of treating moderate ( p =0.0001) to severe ( p <0.0001) disease between experts and non-experts, as well as interest in treating moderate ( p =0.0001) and severe ( p <0.0001) disease. Multiple barriers to developing expertise were identified (e.g., access to necessary equipment). HS experts also indicated higher levels of knowledge and experience than non-experts with several medical treatments (e.g., IV Ertapenem, p <0.0001)., Limitations: We were unable to calculate response rate since listserv survey recipients were encouraged to share the survey through their personal networks., Conclusion: This data demonstrates statistically significant differences in levels of comfort and interest between experts and non-experts in treating moderate to severe disease, as well as differences in medical therapies utilized. Furthermore, multiple barriers to expertise were identified by both experts and non-experts., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2023. Matrix Medical Communications. All rights reserved.)

Background: The South Asian Association for Regional Cooperation (SAARC) covers Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. We conducted a comparative analysis of the trade-off between the health policies for the prevention of COVID-19 spread and the impact of these policies on the economies and livelihoods of the South Asia populations., Methods: We analyzed COVID-19 data on epidemiology, public health and health policy, health system capacity, and macroeconomic indicators from January 2020 to March 2021 to determine temporal trends by conducting joinpoint regression analysis using average weekly percent change (AWPC)., Results: Bangladesh had the highest statistically significant AWPC for new COVID-19 cases (17.0; 95% CI = 7.7-27.1, P < 0.001), followed by the Maldives (12.9; 95% CI = 5.3-21.0, P < 0.001) and India (10.0; 95% CI = 8.4-11.5, P < 0.001). The AWPC for COVID-19 deaths was significant for India (6.5; 95% CI = 4.3-8.9, P < 0.001) and Bangladesh (6.1; 95% CI = 3.7-8.5, P < 0.001). Nepal (55.79%), and India (34.91%) had the second- and third-highest increase in unemployment, while Afghanistan (6.83%) and Pakistan (16.83%) had the lowest. The rate of change of real GDP had the highest decrease for Maldives (557.51%), and India (297.03%); Pakistan (46.46%) and Bangladesh (70.80%), however, had the lowest decrease. The government response stringency index for Pakistan had a see-saw pattern with a sharp decline followed by an increase in the government health policy restrictions that approximated the test-positivity trend., Conclusions: Unlike developed economies, the South Asian developing countries experienced a trade-off between health policy and their economies during the COVID-19 pandemic. South Asian countries (Nepal and India), with extended periods of lockdowns and a mismatch between temporal trends of government response stringency index and the test-positivity or disease incidence, had higher adverse economic effects, unemployment, and burden of COVID-19. Pakistan demonstrated targeted lockdowns with a rapid see-saw pattern of government health policy response that approximated the test-positivity trend and resulted in lesser adverse economic effects, unemployment, and burden of COVID-19., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose the following activities and/or relationships: FBI reports grant from NorthStar Anesthesia, and personal fees for consultancy from Silicon Valley Innovation Center, Infineon Technologies AG, unrelated to this publication. All other authors declare no relevant interests., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

Context: Although pressure cookers are very common kitchen utensils used in the United States, only a few cases of serious injuries secondary to pressure cooker explosions have been reported in the medical literature. When second-degree (i.e., "partial-thickness") burns result from pressure cooker explosions, wounds involving near to or greater than 10% of total body surface area typically require multidisciplinary treatment, with burn center referral for proper wound care, potential fluid resuscitation, and eventual scar management., Example Case: The example patient described in this report was an African American female in her early 30s who presented during the summer of 2020 after suffering varying levels of second-degree burns to her bilateral upper torso and left wrist (i.e., approximately 10%, total body surface area). The authors first saw the patient during a primary care office visit a week after her initial injury when she first went to a local urgent care clinic. Upon her arrival to the second author's family medicine clinic, a multi-specialty wound recovery plan was initiated since her first urgent care visit treatment had been minimal without prophylactic antibiotic therapy or placement of a burn center referral., Conclusions: Partial and full-thickness burn injuries generally warrant immediate clinical (i.e., body surface area burn assessment, fluid resuscitation, empiric antibiotics) as well as ongoing (burn center referral, debridement procedures, active scar management, provision of psychological support) treatment needs. This paper discusses the critical opportunities posed for more extensive burn patients' physicians to first categorize the extent of burn wounds and initiate subsequent specialty care in other settings., Competing Interests: The authors declare no conflicts of interest.

Paramount to the efficacy of immune checkpoint inhibitors is proper selection of patients with adequate tumor immunogenicity and a robust but suppressed immune infiltrate. In colon cancer, immune-based therapies are approved for patients with DNA mismatch repair (MMR) deficiencies, in whom accumulation of genetic mutations results in increased neoantigen expression, triggering an immune response that is suppressed by the PD-L1/PD-1 pathway. Here, we report that characterization of the microenvironment of MMR-deficient metastatic colorectal cancer using multiplex fluorescent immunohistochemistry (mfIHC) identified increased infiltration of cytotoxic T lymphocytes (CTLs), which were more often engaged with epithelial cells (ECs) and improved overall survival. A subset of patients with intact MMR but a similar immune microenvironment to MMR-deficient patients was identified and found to universally express high levels of PD-L1, suggesting that they may represent a currently untreated, checkpoint inhibitor-responsive population. Further, PD-L1 expression on antigen-presenting cells (APCs) in the tumor microenvironment (TME) resulted in impaired CTL/EC engagement and enhanced infiltration and engagement of Tregs. Characterization of the TME by mfIHC highlights the interconnection between immunity and immunosuppression in metastatic colon cancer and may better stratify patients for receipt of immunotherapies.