#Dr. James J. Woytash

[drjamesjwoytash]

A Beginner’s Guide to Histology

Histology is the study of tissues. As an essential field of medical science, histology is used to diagnose and treat diseases, understand the anatomy and physiology of different organs, and develop new therapies. This branch of science is crucial in medical diagnosis, scientific research, forensic investigation, and archaeological studies.

Medical professionals, including pathologists, diagnose diseases like cancer and infections using histology. By studying tissues at a cellular level, histologists help bridge the gap between anatomy and physiology, providing valuable insights into tissue behavior and reactions to treatments.

The human body has four main types of tissues: epithelial, connective, muscle, and nervous tissue. Epithelial tissue covers the body surfaces, lines the organs and cavities, and serves as a barrier to protect against physical, chemical, and biological threats. Connective tissue supports and anchors the organs, stores and transports nutrients and waste, and participates in immune responses.

Muscle tissue contracts and relaxes to generate movement and force. It is classified into three types: skeletal, cardiac, and smooth muscle. Nervous tissue transmits and processes information through specialized cells called neurons and glia, forming the complex nervous system network.

Histological analysis involves essential steps to prepare tissues for microscopic examination. The process includes fixing the tissue to prevent decay, processing and embedding the tissue in supporting material, sectioning it into thin slices, and finally, staining the sections to highlight specific structures. Various stains are available, each chosen to enhance the visibility of certain components within the tissues.

The most common and widely used stain is the Hematoxylin and Eosin (H&E) stain, which colors cell nuclei blue and cytoplasm pink. Toluidine blue, Wright's stain, and trichrome stains are other techniques that produce different colors to reveal specific structures or proteins within the tissues.

Pathologists carefully examine tissue samples obtained through biopsies or autopsies, identifying abnormal cells and providing valuable information for treatment planning. This helps doctors make accurate diagnoses and develop appropriate treatment strategies.

In the field of research, scientists utilize histology to investigate tissues at a cellular level, contributing to advancements in medicine, biology, and genetics. The detailed examination of tissues aids in understanding various diseases and unlocking potential therapeutic targets.

Histology also leaves its mark on forensic science. In unexplained deaths, microscopic analysis of tissues from autopsies provides critical clues, helping forensic experts unravel the circumstances surrounding such incidents.

Beyond the present, histology also aids in exploring our past. In archaeology, the study of ancient tissues, like bones and teeth, sheds light on the lives of past civilizations and species. These insights provide valuable knowledge about our evolutionary history.

Not limited to human health, histology also plays a vital role in veterinary science. Veterinarians rely on histology to diagnose animal diseases accurately, allowing for timely and appropriate treatments. Additionally, histology helps assess the effects of treatments and monitor animal health.

Finally, in the fascinating world of plants, plant histology, also known as plant anatomy, reveals the microanatomy of plant tissues. By studying these tissues, researchers gain insights into plant growth and development, which can affect agriculture and environmental conservation.

[craigcomer]

Mixed-Use Buildings That Have Multi-Family Units on the Rise

A resident of Milford, Michigan, Craig Comer is the owner of Mosquito Joe of Southwest Michigan and Salon Suite. In addition to operating franchises, Craig Comer has interests in multi-family real estate.

In 2022, multi-family units remain part of a more significant mixed-use development trend. Multi-family units can potentially generate income for investors. In the last decade, rental prices and real estate values for multi-family units have increased by 10 percent in 65 of 150 major cities. Even with the rising rents, occupancy rates rose by 96.5 percent, and rental retention remained strong in 2021.

At the same time, multi-family units contained in mixed-use buildings are trending. The mixed-use building incorporates commercial and residential space. The building will house retail establishments, such as coffee shops or offices on the ground floor and residential spaces on the top floors.

The remote working trend helped increase demand in mixed-use spaces. It is common to see coworking spacing mixed in with retail and residential units. This trend started in urban areas and spread out to suburban ones.

[drjamesjwoytash]

Post Morten Examinations/Autopsies

An autopsy, also known as a post-mortem examination, is a medical examination to determine the cause of death or gather other relevant medical information. It involves surgical procedures identifying and establishing various mechanisms associated with a person’s death .

Usually, autopsies are performed on two occasions: when requested by a coroner or medical examiner known as a forensic autopsy, or when requested by a hospital doctor, known as a clinical/ hospital autopsy. A coroner is usually an elected /appointed judicial officer empowered to investigate or inquire about the causes or circumstances which led to a person’s death.

Coroners may be doctors or lawyers or lay people with various experiences in their field. Although laws may vary from state to state, a forensic autopsy is usually required where the death is sudden, unusual, or violent. In some states, it may be required where the person dies in the absence of an attending physician who is needed to sign the death certificate.

Hospital medical pathologists perform the hospital autopsy to learn more about a particular illness or the nature or cause of death. They may also be asked by the patients attending physician to investigate the effectiveness of certain medical procedures in order to advance research into specific areas of medicine. The hospital autopsy will develop quality assurance data and to improve patient outcomes in healthcare facilities.

Medical examinations such as autopsies are important in providing insight to families regarding the death of their loved ones. As this medical procedure is diagnostic, it can help identify the specific cause such as an unknown disease, and provide reassurance or insight to the deceased’s loved ones on how it may have contributed to their death. When carried out by hospital doctors, autopsies are performed with the consent of the legal next-of-kin of the deceased .

Postmortem medical examinations are performed in a hospital morgue examining facility or a medical examiner official laboratory.They may occur as early as the first 24 hours of death, but usually within two to three days after a person’s death. The extent of an autopsy may range from an examination of just a single organ in the body to a full, extensive examination. The examination is mainly determined by the consent of the legal next of kin for a hospital postmortem procedure.

The autopsy procedure involves an external examination, recording information such as the weight and height and identifying marks, such as scars and tattoos. This is then followed by an internal evaluation as determined by the legal consent if this is a hospital autopsy.

The organs are examined first visually and then subsequently evaluated in surgical detail to reveal abnormalities, such as tumors. The medical pathologist records these findings in an official hospital report and delivers it to the coroner or the patient’s attending physician as the case may be. After completion of the medical examination the body is prepared for release to the funeral director.

[drjamesjwoytash]

How Machine Learning Algorithms Might Improve Wound-Age Estimation

Multiple studies reiterate the importance of estimating the age of violently inflicted wounds, also called wound age estimation, in forensic science and reconstructing crime scenes. While very important in forensics, finding methods for accurately determining when someone received a wound/injury has been challenging until now.

However, a February 2023 article published in the academic journal Diagnostic discussed a specific type of machine learning that can help forensic scientists make more accurate conclusions about wound age.

This innovation begins with histology (study of cells and tissues) and pathology (study of diseases). After histologists prepare tissues for a crime scene investigation, they give them to pathologists who identify diseases, conditions, or whether an abnormality in tissue exists, explaining how someone might have died. Then forensic pathologists look at the age of a wound to determine the time of the injury. If there are other injuries, the order of the infliction of the injuries must be determined, especially if the case involves multiple offenders because sometimes law enforcement agencies charge offenders for crimes based on the severity of the injury.

Forensic pathologists must look at various factors in determining whether an injury occurred before or after the person died. Pathologists examine the tissue for hemorrhaging, granulation tissue formation, and inflammatory cells. The pathologist also evaluates the tissue for wound vitality reactions, determining whether the person was alive when they received the injury and how long they were alive before dying.

Biomarkers pathologists use with wound estimation are mRNA (messenger RNA) and proteins. A biomarker is a measurable part of the body, such as blood pressure.

In basic cell science, mRNA takes the instructions from the nucleus and delivers them to the cytoplasm, where tRNA (transfer RNA) provides instruction through amino acid sequencing (ATCG) for protein synthesis or DNA coding that creates long protein strands. In a nutshell, this process is basically how the nucleus gives the cells commands for functions to carry out in the body.

The paper published in the February 2023 Diagnostics issue attempts to show how multiple mRNA biomarkers combined with a stacking ensemble can offer pathologists more accurate predictions for wound estimation. Research has shown that relying on mRNA markers as opposed to proteins to estimate the time of an injury because the structure changes earlier than that of proteins. However, mRNA is less stable than a protein, so pathologists cannot use it by itself in making wound age estimations.

At the same time, researchers believe that machine learning models using stacking ensembles offer forensic pathologists a way to determine wound age using mRNA accurately. Ensemble machine learning methods rely on using multiple models to make predictions, and stacking is a type of ensemble machine learning that searches for the best combination of algorithms to develop the best performance.

This study looked at the potential for stacked ensemble machine learning to develop algorithms for nine mRNA expression characteristics. Researchers compared these different algorithms to see which stacking ensemble made the best prediction.

Researchers investigated skeletal muscle wounds in 56 Sprague-Dawley rats, an albino strain of rats kept at room temperature. Incidentally, skeletal muscle wounds are the most violent injury cases, which might be why researchers used this type in this study.

The research culminated in stacking ensemble models that showed promise for accurately predicting wound age estimation. However, the article's authors acknowledged that one of the study's limitations was that rats were the subject instead of humans. Simple animal models can generate working conclusions that might not occur with humans.

For researchers to conclusively say that stacking ensemble using mRNA can accurately predict wound age estimation, humans must be the trial subject. Even so, the study stated that stacking ensembles or mRNA biomarkers could solve wound age estimation when the injury occurred long before the person died.

[drjamesjwoytash]

Popular Hiking Destinations in New York State

Nearly 59 million Americans went hiking at least once in 2021, while 10.3 million people embarked on a backpacking excursion, according to results from the 2022 Outdoor Participation Trends Report released in March 2023. There is a wide range of physical and mental health benefits associated with hiking, from improved muscle and bone strength to decreased levels of stress and anxiety. Hiking enthusiasts in the state of New York have a number of popular hiking areas to choose from, including the Catskill Mountains, Lake Placid, the Finger Lakes, Bear Mountain State Park, and Watkins Glen State Park.

The Catskill Mountains are located in the southeastern part of the state between Albany and New York City. Encompassing some 700,000 acres, the region provides thousands of miles of diverse hiking trails. Families with young children can find plenty of quiet trails winding peacefully through the forests, while more adventurous hikers can take on the Catskill 3500 Club, which consists of 33 climbs all exceeding 3,500 feet in elevation. Popular trails include Giant Ledge, a moderately challenging climb that provides some of the most sweeping views in the Catskills, and the Ashokan Rail Trail, an 11.5-mile trail compliant with Americans with Disabilities Act standards.

Lake Placid is a village in the Adirondack Mountains known as the host of the 1932 and the 1980 Winter Olympics and the home of the 2,170-acre lake of the same name. In addition to various aquatic activities in and on the lake, hikers can take advantage of the 20-plus miles of challenging terrain, not to mention additional hiking locations throughout the Adirondacks. Like the Catskills, Lake Placid maintains an informal club for hikers interested in taking on the region’s 46 iconic peaks. That said, there are a number of trails better suited to families and hikers more interested in relaxing and taking in the scenery.

The Finger Lakes are a five-hour drive not just from New York City, but nearby metropolitan hubs such as Washington, DC, Boston, and Philadelphia, making it an attractive destination for hikers throughout the Northeast. The trail system features more than 1,000 miles of trails, including the 950-mile-long Finger Lakes Trail (FLT). The FLT begins in Allegheny State Park at the border of Pennsylvania and runs into the Catskill Forest Preserve. Backpackers can extend the route to Niagara Falls, the Great Eastern Trail, and other multi-day treks.

Bear Mountain State Park is situated alongside the Hudson River. The park consists of dozens of trails for hikers of various skill levels, from the moderate 3.8-mile Bear Mountain Loop Trail to the challenging Perkins Memorial Tower climb, which takes most hikers over two hours to complete despite spanning just 3.4 miles. The Perkins Memorial Tower route provides hikers direct access to the Appalachian Trail.

Finally, Watkins Glen State Park is a park in the Finger Lakes region. Hikers can visit parks.ny.gov and download a trail map. The map includes recommended hikes that guide hikers to 19 waterfalls. Trails include straightforward paths like Lover’s Lane as well as more challenging climbs, such as Jacob’s Ladder and the North Rim Trail.

[drjamesjwoytash]

Common Fly Fishing Mistakes and How to Correct Them

Fly fishing refers to fishing where anglers use a fly, an artificial lightweight lure, to catch fish. Unlike other types of fishing, fly fishing uses a weighted line, which functions as the weight that casts the bait. Thus, fly fishing casting techniques significantly differ.

Fishing at the right spot is crucial for a successful catch. Yet many anglers rely on chance. While it can occasionally work, having a good grasp of the aquatic environment and fish behavior underlies finding the best fishing spots. Fish typically shoal in certain sections of water. By learning to locate these hotspots in any given body of water, anglers can increase their likelihood of a good catch.

They can start by carefully and stealthily scanning the water for fish. With time and practice, anglers will get familiar with fish needs and preferences and how they favor certain places over others depending on the time of the day or season. For example, in summer, trout may prefer deeper waters on bright afternoons but move up to shallower ones to actively feed after sunset.

One of the most common mistakes in fly fishing is excessive false casting. False casting occurs when an angler repeatedly moves the rod forward and backward in the air without the fly line touching the water. Its primary purpose is for a fast line extension and target change. Too many false casts have multiple undesirable effects, including tiring out the angler, worsening their line motion and accuracy, and spooking the fish. In addition, excessive false casting increases the risk of tangles.

Professionals recommend the number of false casts not exceed three. Anglers should let the rod fully load as they cast it backward to limit false casting. Doing so will result in the line building up speed and shooting the fly forward.

Another widespread mistake related to casting is the distance. Many anglers worry they will frighten the fish and thus cast a long line instead of approaching it. However, casting too far leads to too much line on the water and aggravates the angler's reaction time to set the hook. Setting the hook refers to the angler raising the rod tip over their head to tighten the line between them and the fish.

Time is of the essence with the hook set because fish usually keep the fly in their mouth for about a second before spitting it out. A longer line translates into a slower hook set due to the slack. Professionals advise moving closer to the fish whenever possible. Also, with more practice, anglers should be able to find the optimal distance.

Finally, many anglers fail to use the right fly for the fish they are after and stay empty-handed. Fishing a salmon fly for trout during a caddisfly hatch is highly unlikely to be successful. The reason is that caddisflies are an integral part of trout's diet, particularly their larvae, which resemble long, cylindrical nymphs. Knowing what the different fish species eat, when this food is available, its lifecycle, how it looks and moves in the water, and learning to imitate it is a critical fly fishing skill. By applying that knowledge whenever they go fishing, anglers can significantly improve their success rate.

[drjamesjwoytash]

CAP Receives Grant Award and Contract in 2022

The College of American Pathologists (CAP) is a 75-year-old organization comprised of board-certified pathologists serving other pathologists, patients, and the public through excellent laboratory medicine and pathology practices globally. CAP regularly participates in activities to obtain funding to improve laboratory practices. In 2022, CAP received a grant award and a contract from the US Food and Drug Administration (FDA).

In a September 2022 press release, CAP announced that it received a $100,000 Council of Medical Specialty Society (CMSS) Award. CMSS gave the award to 48 specialty societies comprised of over 800,000 physicians in healthcare to promote diagnostic practices. The grant can be for various projects related to developing and spreading resources that facilitate the timeliness, efficiency, safety, accuracy, and equity of diagnostic outcomes for Americans.

Projects selected for the award focused on cardiovascular conditions, infection, and cancer. The award program is a collaboration among the CMSS, which administers the grant program, the Gordon and Betty Moore Foundation, an organization that funded $1.26 million in grants for specialty organizations, and the John Hartford Foundation, which has also contributed funding for two organizations that focus on older adults.

CAP President Emily Volk, MD, stated the funding would help the organization connect with patients to find ways to create easily digestible pathology reports for laypeople dealing with a cancer diagnosis. In the case of cancer reports, the pathology report is the first thing patients encounter upon diagnosis, making it vital that they understand the report. Otherwise, it can make a cancer diagnosis confusing for patients and caregivers, in addition to being a source of anxiety.

CMSS’ role in the awards was not only to select and disperse grants, but it also will act as a coordinator. The organization will support and monitor awardees’ best practices, collaboration, and learning across specialties throughout the duration of the project.

The CMSS’ focus on medical specialties relates to the fact that these groups are in a position to provide education and also serve as a resource for spreading information. Accredited continuing medical education, journals, clinical guidelines, peer-reviewed journals, clinical registries, and research are avenues that this information spreads. According to CMSS CEO Helen Burstin, MD, the organization is happy about providing funding to projects that might culminate in breakthroughs in diagnostic excellence.

CMSS is not the only organization that has recognized CAP’s value. In a November 2022 CAP press release, the organization received a contract from the FDA for $1 million. With this money, CAP will find ways to improve and develop laboratory test code standards to increase positive outcomes for public health and patient care.

The contract focuses on two areas. The first area will focus on classifying coding to facilitate the transfer of qualitative and quantitative lab results. The second area will focus on ways to verify data accuracy and transparency. CAP will start in October 2023 to organize activities around planning and resourcing, and then they will connect with the FDA and other partners to officially launch the project.

The one-year contract might expand to three years and an additional $2.5 million to fund other proposed CAP projects: Laboratory Coding Transmission Proof-of-concept, Test-Menu Coding Education and Training Proof-of-Concept, and Analysis NorPublishedal Form Clinical Narrative Development and Roundtrip Testing. For more information on either of these awards, visit the CAP website at https://www.cap.org/about-the-cap.