Coronavirus disease 2019 (COVID-19) is a novel disease resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has quickly risen since the beginning of 2020 to become a global pandemic. As a result of the rapid growth of COVID-19, hospitals are tasked with managing an increasing volume of these cases with neither a known effective therapy, an existing vaccine, nor well-established guidelines for clinical management. The need for actionable knowledge amidst the COVID-19 pandemic is dire and yet, given the urgency of this illness and the speed with which the healthcare workforce must devise useful policies for its management, there is insufficient time to await the conclusions of detailed, controlled, prospective clinical research. Thus, we present a retrospective study evaluating laboratory data and mortality from patients with positive RT-PCR assay results for SARS-CoV-2. The objective of this study is to identify prognostic serum biomarkers in patients at greatest risk of mortality. To this end, we develop a machine learning model using five serum chemistry laboratory parameters (c-reactive protein, blood urea nitrogen, serum calcium, serum albumin, and lactic acid) from 398 patients (43 expired and 355 non-expired) for the prediction of death up to 48 h prior to patient expiration. The resulting support vector machine model achieved 91% sensitivity and 91% specificity (AUC 0.93) for predicting patient expiration status on held-out testing data. Finally, we examine the impact of each feature and feature combination in light of different model predictions, highlighting important patterns of laboratory values that impact outcomes in SARS-CoV-2 infection.

The COVID-19 pandemic put most in-person pathology electives on-hold as departments adapted to changes in education and patient care. To address the subsequent void in pathology education, we created a free, virtual, modular, and high-quality pathology elective website. Website traffic from June 1, 2020, to October 1, 2020, was monitored using the built-in analyses on Squarespace. Twitter engagement was analyzed using Twitter analytics and the Symplur Social Graph Score. A voluntary satisfaction survey was sent to all PathElective users and results were analyzed. During this time, the site saw 25 467 unique visitors, over 34 988 visits, 181 302 page views, and 4449 subscriptions from 99 countries. Countries with the highest traffic are the United States (14 682), India (5210), and the Philippines (2195). PathElective’s Twitter social graph score increased from 63.59 to 89.3 with the addition of 1637 followers. Data from surveyed users (n = 177) show most to be pathology residents (41%). Most subscribers (89%) are committed to a career in pathology. The majority heard of the website via Twitter (55%). Almost half of those surveyed engaged with the PathTwitter community on Twitter and of those who participated, 99% found that interaction useful. In all survey questions surrounding satisfaction and usefulness, a large majority of the users were either satisfied or very satisfied. PathElective is a novel pathology elective that offers a unique opportunity to educate medical students and residents from around the globe and demonstrates high effectiveness and satisfaction among users.

Intrahepatic macrophages influence the composition of the microenvironment, host immune response to liver injury, and development of fibrosis. Compared with stellate cells, the role of macrophages in the development of fibrosis remains unclear. Multispectral imaging allows detection of multiple markers in situ in human formalin‐fixed, paraffin‐embedded tissue. This cutting‐edge technology is ideal for analyzing human liver tissues, as it allows spectral unmixing of fluorophore signals, subtraction of auto‐fluorescence, and preservation of hepatic architecture. We analyzed five different antibodies commonly observed on macrophage populations (CD68, MAC387, CD163, CD14, and CD16). After optimization of the monoplex stains and development of a Spectral Library, we combined all of the antibodies into a multiplex protocol and used them to stain biopsies collected from representative patients with chronic liver diseases, including chronic hepatitis C, nonalcoholic steatohepatitis, and autoimmune hepatitis. Various imaging modalities were tested, including cell phenotyping, tissue segmentation, t‐distributed stochastic neighbor embedding plots, and phenotype matrices that facilitated comparison and visualization of the identified macrophage and other cellular profiles. We then tested the feasibility of this platform to analyze numerous regions of interest from liver biopsies with multiple patients per group, using batch analysis algorithms. Five populations showed significant differences between patients positive for hepatitis C virus with advanced fibrosis when compared with controls. Three of these were significantly increased in patients with advanced fibrosis when compared to controls, and these included CD163+CD16+, CD68+, and CD68+MAC387+. Conclusion: Spectral imaging microscopy is a powerful tool that enables in situ analysis of macrophages and other cells in human liver biopsies and may lead to more personalized therapeutic approaches in the future.

The use of social media at academic conferences is expanding, and platforms such as Twitter are used to share meeting content with the world. Pathology conferences are no exception, and recently, pathology organizations have promoted social media as a way to enhance meeting exposure. A social media committee was formed ad hoc to implement strategies to enhance social media involvement and coverage at the 2018 and 2019 annual meetings of the Association of Pathology Chairs. This organized approach resulted in an 11-fold increase in social media engagement compared to the year prior to committee formation (2017). In this article, the social media committee reviews the strategies that were employed and the resultant outcome data. In addition, we categorize tweets by topic to identify the topics of greatest interest to meeting participants, and we discuss the differences between Twitter and other social media platforms. Lastly, we review the existing literature on this topic from 23 medical specialties and health care fields.

Participants at academic conferences frequently use social media to disseminate educational content learned while at the meeting. Although most agree that this activity is harmless, some have expressed concern regarding the accuracy of the shared content and whether it truly reflects the intent and message of the speaker. As part of the goals of the APC 2018 social media committee to promote excellence through social media, a study was conducted to measure the perceived accuracy of tweets that represented an opinion or statement from a speaker and was shared during the annual meeting. Tweets shared on Twitter using the meeting hashtag (#APCPRODS2018) were collected and a survey unique to each speaker was created, to which 54% responded. The majority of speakers regarded the use of Twitter at the conference as beneficial in spreading their intended message in an accurate way. This study exemplifies the positive impact that social media use can have at academic meetings.

The range of lesions with a serrated appearance within the large intestine has expanded and become more complex over the last 30 years. The majority of these were previously known as metaplastic polyps but are today called hyperplastic polyps (HPs). HPs show two main growth patterns: microvesicular and goblet cell-rich. The former type shows morphological and molecular similarities (eg, BRAF mutations) to the more recently described sessile serrated lesion (SSL). In this review, we debate whether these lesions represent a biological spectrum or separate entities. Whichever view is held, microvesicular HPs and SSLs are distinct from the goblet cell-rich HP and the traditional serrated adenoma (TSA), which may themselves share molecular changes (eg, KRAS mutations), with the goblet cell-rich HP representing a precursor to the TSA. Both SSLs and the goblet cell-rich HP-TSA pathway are routes to colorectal cancer within the serrated pathway and overlaps between them can occur, for example, a (BRAF-mutated) TSA may arise from an SSL.