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Deep Neural Network Based Tissue Deconvolution Of Circulating Tumor Cell Rna, Fengyao Yan, Limin Jiang, Fei Ye, Jie Ping, Tetiana Y. Bowley, Scott A. Ness, Chung-I Li, Dario Marchetti, Jijun Tang, Yan Guo

Pathology Research and Scholarship

Prior research has shown that the deconvolution of cell-free RNA can uncover the tissue origin. The conventional deconvolution approaches rely on constructing a reference tissue-specific gene panel, which cannot capture the inherent variation present in actual data. To address this, we have developed a novel method that utilizes a neural network framework to leverage the entire training dataset. Our approach involved training a model that incorporated 15 distinct tissue types. Through one semi-independent and two complete independent validations, including deconvolution using a semi in silico dataset, deconvolution with a custom normal tissue mixture RNA-seq data, and deconvolution of longitudinal circulating …

Early Antibody Treatment, Inflammation, And Risk Of Post-Covid Conditions, Kelly A. Gebo, Sonya L. Heath, Yuriko Fukuta, Xianming Zhu, Sheriza Baksh, Allison G. Abraham, Feben Habtehyimer, David Shade, Jessica Ruff, Malathi Ram, Oliver Laeyendecker, Reinaldo E. Fernandez, Eshan U. Patel, Owen R. Baker, Shmuel Shoham, Edward R. Cachay, Judith S. Currier, Jonathan M. Gerber, Barry Meisenberg, Donald N. Forthal, Laura L. Hammitt, Moises A. Huaman, Adam Levine, Giselle S. Mosnaim, Bela Patel, James H. Paxton, Jay S. Raval, Catherine G. Sutcliffe, Shweta Anjan, Thomas Gniadek, Seble Kassaye, Janis E. Blair, Karen Lane, Nichol A. Mcbee, Amy L. Gawad, Piyali Das, Sabra L. Klein, Andrew Pekosz, Evan M. Bloch, Daniel Hanley, Arturo Casadevall, Aaron A R Tobian, David J. Sullivan

Pathology Research and Scholarship

Approximately 20% of individuals infected with SARS-CoV-2 experienced long-term health effects, as defined PCC. However, it is unknown if there are any early biomarkers associated with PCC or whether early intervention treatments may decrease the risk of PCC. In a secondary analysis of a randomized clinical trial, this study demonstrates that among outpatients with SARS-CoV-2, increased IL-6 at time of infection is associated with increased odds of PCC. In addition, among individuals treated early, within 5 days of symptom onset, with COVID-19 convalescent plasma, there was a trend for decreased odds of PCC after adjusting for other demographic and clinical …

Assessing Knowledge And Perceptions About Cancer Among American Indians Of The Zuni Pueblo, Nm, Safia Safi, Donica Ghahate, Jeanette Bobelu, Andrew L. Sussman, Joseph Rodman, Angela Wandinger-Ness, Shiraz I. Mishra, Thomas Faber, Cheryl Willman, Vallabh Shah

Pathology Research and Scholarship

American Indians (AIs) in New Mexico have lower cancer screening rates compared to other populations and are more likely to be diagnosed with cancer at an advanced stage of the disease as reported by Li et al. (Archives of Internal Medicine 163(1):49-56, 2003). AIs also have the lowest 5-year cancer survival rates compared to any ethnic/racial group in the USA as reported by Clegg et al. (Arch Intern Med 162:1985-1993, 2002) and Edwards et al. (Cancer 97:1407-1427, 2005). Numerous barriers such as cultural beliefs, fear, fatalism, mistrust, stigma, and lack of culturally appropriate interventions could contribute to low cancer screening …

Human Herpesvirus 8-Negative Effusion-Based Large B-Cell Lymphoma: A Distinct Entity With Unique Clinicopathologic Characteristics, Savanah D. Gisriel, Ji Yuan, Ryan C. Braunberger, Danielle L V Maracaja, Xueyan Chen, Xiaojun Wu, Jenna Mccracken, Mingyi Chen, Yi Xie, Laura E. Brown, Peng Li, Yi Zhou, Tarsheen Sethi, Austin Mchenry, Ronald G. Hauser, Nathan Paulson, Haiming Tang, Eric D. Hsi, Endi Wang, Qian-Yun Zhang, Ken H. Young, Mina L. Xu, Zenggang Pan

Pathology Research and Scholarship

Rare cases of human herpesvirus 8 (HHV8)-negative effusion-based large B-cell lymphoma (EB-LBCL) occur in body cavities without antecedent or concurrent solid mass formation. In contrast to HHV8 + primary effusion lymphoma (PEL), EB-LBCL has no known association with HIV or HHV8 infection. However, the small sample sizes of case reports and series worldwide, especially from non-Japanese regions, have precluded diagnostic uniformity. Therefore, we conducted a retrospective, multi-institutional study of 55 cases of EB-LBCL and performed a comprehensive review of an additional 147 cases from the literature to identify distinct clinicopathologic characteristics. In our study, EB-LBCL primarily affected elderly (median age …

The Validity Of Mcat Scores In Predicting Students' Performance And Progress In Medical School: Results From A Multisite Study, Joshua T. Hanson, Kevin Busche, Martha L. Elks, Loretta E. Jackson-Williams, Robert A. Liotta, Chad Miller, Cindy A. Morris, Barton Thiessen, Kun Yuan

Pathology Research and Scholarship

PURPOSE: This is the first multisite investigation of the validity of scores from the current version of the Medical College Admission Test (MCAT) in clerkship and licensure contexts. It examined the predictive validity of MCAT scores and undergraduate grade point averages (UGPAs) for performance in preclerkship and clerkship courses and on the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge examinations. It also studied students' progress in medical school.

METHOD: Researchers examined data from 17 U.S. and Canadian MD-granting medical schools for 2016 and 2017 entrants who volunteered for the research and applied with scores from …

Femur Morphology In Healthy Infants And Young Children, Nathan P. Brown, Angela Thompson, Karen Bertocci, Natalie L. Adolphi, Lauren Dvorscak, Mary Clyde Pierce, Gina Bertocci

Pathology Research and Scholarship

The objective of this study was to characterize femur morphology in healthy infants and young children. Anterior-posterior (AP) radiographs of the femur from children age 0-3 years with no history of bone disease were obtained from two children's hospitals and one medical examiner's office. Femur morphological measures (bone length, minimum diaphysis diameter, growth plate width, and femur radius of curvature) and sectional structural measures were determined. Measures were described and compared based on subject age and mass. Relationships between measures and age and mass were evaluated. The 169 AP femur radiographs were obtained from 99 children (59.6% males, median age …

Educating Health Professionals About Covid-19 With Echo Telementoring, Joanna G. Katzman, Karla Thornton, Nestor Sosa, Laura Tomedi, Leslie Hayes, Marla Sievers, Karissa Culbreath, Kent Norsworthy, Chamron Martin, Alaina Martinez, Jinyang Liu, Sanjeev Arora

Pathology Research and Scholarship

BACKGROUND: When the COVID-19 pandemic began, primary care clinicians had almost no knowledge regarding best practices COVID-19 treatment. Project ECHO developed a COVID-19 Infectious Disease Office Hours (Office Hours) program to respond to the needs of clinicians seeking COVID-19 information.

METHODS: This mixed-methods evaluation analyzed weekly post-session data and focus group results from the weekly Office Hours ECHO sessions during June 1, 2020- May 31, 2021.

RESULTS: A total of 1,421 participants attended an average of 4.9 sessions during the 45 Office Hours sessions studied. The most common specialties included: nurses= 530 (37%), physicians= 284 (20%), and 493 (34%) having …

Ethics Of Ai In Pathology: Current Paradigms And Emerging Issues, Chhavi Chauhan, Rama R. Gullapalli

Pathology Research and Scholarship

Deep learning has rapidly advanced artificial intelligence (AI) and algorithmic decision-making (ADM) paradigms, affecting many traditional fields of medicine, including pathology, which is a heavily data-centric specialty of medicine. The structured nature of pathology data repositories makes it highly attractive to AI researchers to train deep learning models to improve health care delivery. Additionally, there are enormous financial incentives driving adoption of AI and ADM due to promise of increased efficiency of the health care delivery process. AI, if used unethically, may exacerbate existing inequities of health care, especially if not implemented correctly. There is an urgent need to harness …

Depressed Right Ventricular Systolic Function In Heart Failure Due To Constrictive Pericarditis, Veena Raizada, Kimi Sato, Alaa Alashi, Arnav Kumar, Deborah Kwon, Jay Ramchand, Amy Dillenbeck, Ross E. Zumwalt, Adarsh S. Vangala, Tyler D. Earley, Allan Klein

Pathology Research and Scholarship

AIMS: Heart failure in constrictive pericarditis (CP) is attributed to impaired biventricular diastolic filling. However, diseases that cause CP due to myocardial infiltration and fibrosis can also impair biventricular systolic function (sf) and contribute to heart failure. This study of patients with CP examined biventricular sf and the effect of myocardial infiltration by pericardial diseases and the resulting fibrosis on ventricular sf.

METHODS AND RESULTS: Histopathologic examinations of right ventricular (RV) and left ventricular (LV) myocardia and pericardia were performed on three autopsied hearts of patients with pericardial diseases. Additionally, in 40 adults with clinical heart failure and 40 healthy …

Overcoming The Limitations Of 'Accident' As A Manner Of Death For Drug Overdose Mortality: Case For A Death Certificate Checkbox, Ian R H Rockett, Eric D. Caine, Hilary S. Connery, Kurt B. Nolte

Pathology Research and Scholarship

Collectively, the epidemic increases in the United States of opioid-related deaths and suicides during the first two decades of the 21st century have exposed shortcomings in current forensic and epidemiological approaches for determining and codifying manner of death-a vital function fulfilled by medical examiners, coroners and nosologists-the foundation for the National Violent Death Reporting System (NVDRS), an incident-based surveillance system providing individual-level information on decedent characteristics, manner, cause and circumstances of suicide, homicide and other violent injury deaths. Drug intoxication deaths are generally classified as 'accidents' or unintentional, a fundamental mischaracterisation; most arose from repetitive self-harm behaviours related to substance …

Hbme1 And Ck19 Expression In Non-Invasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (Niftp) Vs Other Follicular Patterned Thyroid Lesions, Qandeel Sadiq, Radhika Sekhri, Daniel T Dibaba, Qi Zhao, Shweta Agarwal

Pathology Research and Scholarship

BACKGROUND: Thyroid neoplasms with follicular architecture can have overlapping morphologic features and pose diagnostic confusion among pathologists. Various immunohistochemical stains have been investigated as potential diagnostic markers for PTC, among which HBME1 and CK19 have gained popularity. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) poses similar diagnostic challenges with interobserver variability and is often misdiagnosed as adenomatoid nodule or follicular adenoma. This study aims to evaluate expression of HBME1 and CK19 in NIFTPs in comparison to other well-differentiated thyroid neoplasms and benign mimickers.

METHOD: Seventy-three thyroid cases diagnosed over a period of 3 years at Methodist University Hospital, …

Surveillance Systems For Monitoring Cervical Cancer Elimination Efforts: Focus On Hpv Infection, Cervical Dysplasia, Cervical Screening And Treatment., Julia M L Brotherton, Cosette Wheeler, Gary M. Clifford, Miriam Elfström, Marion Saville, John Kaldor, Dorothy A. Machalek

Pathology Research and Scholarship

In order to achieve the global elimination of cervical cancer as a public health problem, close surveillance of progress in public health and clinical activities and outcomes across the three pillars of vaccination, screening and treatment will be required. Surveillance should ideally occur within an integrated system that is planned, funded, and regularly evaluated to ensure it is providing timely, accurate and relevant feedback for action. In this paper, we conceptualise the main public health surveillance objectives as process and outcome measures in each of the three pillars. Process measures include coverage/participation measures for vaccination, screening and treatment alongside the …

A Randomized Control Trial To Test A Peer Support Group Approach For Reducing Social Isolation And Depression Among Female Mexican Immigrants, Janet Page-Reeves, Cristina Murray-Krezan, Lidia Regino, Jackie Perez, Molly Bleecker, Daniel Perez, Bill Wagner, Susan Tigert, Elaine L. Bearer, Cathleen E. Willging

Pathology Research and Scholarship

BACKGROUND: Female Mexican Immigrants (FMIs) experience high rates of depression compared with other populations. For this population, depression is often exacerbated by social isolation associated with the experience of immigration. Aim 1. To measure whether a culturally situated peer group intervention will reduce depression and stress associated with the experience of immigration. Aim 2. To test whether an intervention using a "women's funds of knowledge" approach results in improved resilience, knowledge and empowerment. Aim 3. To investigate whether a culturally situated peer group intervention using a women's funds of knowledge approach can give participants a sense and experience of social …

The R-Enantiomer Of Ketorolac Reduces Ovarian Cancer Tumor Burden In Vivo, Martha M. Grimes, S Ray Kenney, Dayna R. Dominguez, Kathryn J. Brayer, Yuna Guo, Angela Wandinger-Ness, Laurie G. Hudson

Pathology Research and Scholarship

BACKGROUND: Rho-family GTPases, including Ras-related C3 botulinum toxin substrate 1 (Rac1) and cell division control protein 42 (Cdc42), are important modulators of cancer-relevant cell functions and are viewed as promising therapeutic targets. Based on high-throughput screening and cheminformatics we identified the R-enantiomer of an FDA-approved drug (ketorolac) as an inhibitor of Rac1 and Cdc42. The corresponding S-enantiomer is a non-steroidal anti-inflammatory drug (NSAID) with selective activity against cyclooxygenases. We reported previously that R-ketorolac, but not the S-enantiomer, inhibited Rac1 and Cdc42-dependent downstream signaling, growth factor stimulated actin cytoskeleton rearrangements, cell adhesion, migration and invasion in ovarian cancer cell lines and …

Evolution Of Brain-Wide Activity In The Awake Behaving Mouse After Acute Fear By Longitudinal Manganese-Enhanced Mri, Taylor W. Uselman, Daniel R. Barto, Russell E. Jacobs, Elaine L. Bearer

Pathology Research and Scholarship

Life threatening fear after a single exposure evolves in a subset of vulnerable individuals to anxiety, which may persist for their lifetime. Yet neither the whole brain's response to innate acute fear nor how brain activity evolves over time is known. Sustained neuronal activity may be a factor in the development of a persistent fear response. We couple two experimental protocols to provoke acute fear leading to prolonged fear: Predator stress (PS), a naturalistic approach to induce fear in rodents; and Serotonin transporter knockout mouse (SERT-KO) that responds to PS with sustained defensive behavior. Behavior was monitored before, during and …

Unrecognised Self-Injury Mortality (Sim) Trends Among Racial/Ethnic Minorities And Women In The Usa, Ian R H Rockett, Eric D. Caine, Hilary S. Connery, Kurt B. Nolte, Paul S. Nestadt, Lewis S. Nelson, Haomiao Jia

Pathology Research and Scholarship

AIM: To assess whether an enhanced category combining suicides with non-suicide drug self-intoxication fatalities more effectively captures the burden of self-injury mortality (SIM) in the USA among US non-Hispanic black and Hispanic populations and women irrespective of race/ethnicity.

METHODS: This observational study used deidentified national mortality data for 2008-2017 from the CDC's

RESULTS: While the suicide rate increased by 29% for blacks, 36% for Hispanics and 25% for non-Hispanic whites between 2008 and 2017, corresponding SIM rate increases were larger at 109%, 69% and 55% (p

CONCLUSION: Application of SIM exposed substantial excess burdens from substance poisoning relative to suicide …

At Three Years, Patients With Acute Lymphoblastic Leukaemia Are Still At Risk For Relapse. Results Of The International Mrc Ukallxii/Ecog E2993 Trial, Chezi Ganzel, Xin V. Wang, Jacob M. Rowe, Susan M. Richards, Georgina Buck, David I. Marks, Mark R. Litzow, Elisabeth M. Paietta, Letizia Foroni, Selina M. Luger, Cheryl L. Willman, Charles G. Mullighan, Kathryn G. Roberts, Peter H. Wiernik, Dan Douer, Hillard M. Lazarus, Martin S. Tallman, Anthony H. Goldstone

Pathology Research and Scholarship

Late relapse [>3 years from complete remission (CR)] in acute lymphoblastic leukaemia (ALL), is unusual. Data from the MRC UKALLXII/ECOG E2993 trial are presented to evaluate the incidence and characteristics of late relapse in adult ALL. Of 1,909 patients, 1,752 (92%) achieved CR and among these 757 (43·2%) relapsed; 691 (91·3%) within three years and 66 (8·7%) beyond. Among these 66 patients, median time to relapse was 47 (37-144) months. Relapse beyond three years occurred in 3·8% of all who achieved CR. The cumulative risk of relapse was 40%, 43% and 45% at three, five and ten years respectively. …

Cadmium Exposure Activates Akt/Erk Signaling And Pro-Inflammatory Cox-2 Expression In Human Gallbladder Epithelial Cells Via A Ros Dependent Mechanism, Priyanka Sharma, Trevar S. Caldwell, Megan N. Rivera, Rama R. Gullapalli

Pathology Research and Scholarship

Gallbladder cancer (GBC) is the commonest biliary tract cancer with an ill-defined etiology. We examined the role of Cd+2 exposures in a primary human gallbladder (GB) cell line model in this study. Cd+2 exposures induced decreased cell viability, reactive oxygen species (ROS) generation, altered Akt/ERK signaling pathway activation, PGE2 and COX-2 expression in a human primary gallbladder epithelial cell model. Pharmacological inhibitors were used to determine the key drivers of elevated COX-2 expression due to Cd+2 exposure. Our results show Cd+2 causes a dose- dependent reduction in GB cell viability (EC50 value – 18.6 μM). Dose-dependent activation of phospho-Akt and …

Clinical Performance Of The Novel Genmark Dx Eplex Blood Culture Id Gram-Positive Panel, Karen C. Carroll, Jennifer L. Reid, Adam Thornberg, Natalie N. Whitfield, Deirdre Trainor, Shawna Lewis, Teresa Wakefield, Thomas E. Davis, Keisha G. Church, Linoj Samuel, Ray Mills, Patricia Jim, Stephen Young, Frederick S. Nolte

Pathology Research and Scholarship

Rapid identification from positive blood cultures is standard of care (SOC) in many clinical microbiology laboratories. The GenMark Dx ePlex Blood Culture Identification Gram-Positive (BCID-GP) Panel is a multiplex nucleic acid amplification assay based on competitive DNA hybridization and electrochemical detection using eSensor technology. This multicenter study compared the investigational-use-only (IUO) BCID-GP Panel to other methods of identification of 20 Gram-positive bacteria, four antimicrobial resistance genes, and both Pan

Hobnail Cells In Encapsulated Papillary Thyroid Carcinoma: Report Of 2 Cases With Immunohistochemical And Molecular Findings And Literature Analysis, Shweta Agarwal, Qandeel Sadiq, Ibrahim Ortanca

Pathology Research and Scholarship

Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland with most tumors behaving in an indolent fashion. However, morphologic variants have been described, such as tall cell, diffuse sclerosing, columnar cell etc. which are biologically more aggressive. One of these variants includes the more recently described hobnail variant (HVPTC) which shows micropapillae and presence of large cells with apically placed hyperchromatic nuclei, reverse polarity, and eosinophilic cytoplasm, akin to hobnail cells. The presence of >30% hobnail cells in a PTC deserves categorization as a hobnail variant. This variant is usually associated with extra thyroidal extension, …

The Impact Of An Undergraduate Biology Class On Donor Recruitment At A Hospital-Based Blood Donor Center, Alexis R. Peedin, Yara A. Park, Marshall A. Mazepa, Thomas Neish, Jay S. Raval, R Chad Siniard

Pathology Research and Scholarship

OBJECTIVES: A biology class, BIOL 294H, taught undergraduates about platelet donation while partnering with the University of North Carolina's (UNC's) hospital-based Blood Donation Center to recruit apheresis platelet donors. We identified our platelet donors' demographics and learned how BIOL 294H affected recruitment.

METHODS: Every platelet donor presenting to the UNC Blood Donation Center from February 7, 2017, to March 10, 2017, was asked to complete an electronic 10-question survey.

RESULTS: A total of 159 unique donors completed the survey; 64% were female and 75% were between ages 18 and 25 years. Overall, 70% were UNC undergraduate students. Over half (56%) …

A Multicenter Study Of The Revogene C. Difficile System For Detection Of The Toxin B Gene From Unformed Stool Specimens, Michael J. Mashock, Matthew L. Faron, Karen C. Carroll, Christina Dang, Shawna Lewis, Hossein Salimnia, Paul Lephart, Vivian G. Loo, Bryan H. Schmitt, Stephen Young, Blake W. Buchan, Nathan A. Ledeboer

Pathology Research and Scholarship

Clostridioides difficile is the leading cause of diarrhea in hospitalized U.S. patients and results in over 400,000 cases of C. difficile infection per year. C. difficile infections have mortality rates of 6 to 30% and significantly increase health care costs, because of increased length of stay and increased frequency of readmissions due to recurrences. Efforts to reduce the spread of C. difficile in hospitals have led to the development of rapid sensitive diagnostic methods. A multicenter study was performed to establish the performance characteristics of the Revogene C. difficile test (Meridian Bioscience, Cincinnati, OH, USA) for use in detection of …

Therapeutic Plasma Exchange For Neuromyelitis Optica Spectrum Disorder: A Multicenter Retrospective Study By The Asfa Neurologic Diseases Subcommittee, Tina S. Ipe, Jay S. Raval, Leonor P. Fernando, Amit Gokhale, Cyril Jacquot, Andrew D. Johnson, Haewon C. Kim, Grace F. Monis, Yunchun D. Mo, Shanna M. Morgan, Monica B. Pagano, Huy P. Pham, Kimberly Sanford, Amy E. Schmidt, Joseph Schwartz, Jennifer Webb, Jeffrey L. Winters, Yanyun Wu, Chisa Yamada, Edward C C Wong, Amy Waldman

Pathology Research and Scholarship

IMPORTANCE: Neuromyelitis optica/neuromyelitis optica spectrum disorder patients' response to therapeutic plasma exchange (TPE) is currently incompletely characterized.

OBJECTIVE: Our study aims to understand the clinical status improvement of neuromyelitis optica/neuromyelitis optica spectrum disorder patients treated with TPE.

DESIGN, SETTING, AND PARTICIPANTS: This is a multicenter retrospective study conducted between 1 January 2003 and 31 July 2017 at 13 US hospitals performing apheresis procedures. Subjects studied were diagnosed with neuromyelitis optica/neuromyelitis optica spectrum disorder who received TPE during presentation with acute disease.

MAIN OUTCOMES AND MEASURES: The primary outcome was clinical status improvement in patients treated with TPE. Secondary measures were …

Tumor Heterogeneity As A Predictor Of Response To Neoadjuvant Chemotherapy In Locally Advanced Rectal Cancer, Alissa Greenbaum, David R. Martin, Thèrése Bocklage, Ji-Hyun Lee, Scott A. Ness, Ashwani Rajput

Pathology Research and Scholarship

BACKGROUND: Neoadjuvant chemoradiotherapy (nCRT) is the standard of care for locally advanced adenocarcinoma of the rectum, but it is currently unknown which patients have disease that will respond. This study tested the correlation between response to nCRT and intratumoral heterogeneity using next-generation sequencing assays.

PATIENTS AND METHODS: DNA was extracted from formalin-fixed, paraffin-embedded biopsy samples from a cohort of patients with locally advanced rectal adenocarcinoma (T3/4 or N1/2 disease) who received nCRT. High read-depth sequencing of > 400 cancer-relevant genes was performed. Tumor mutations and variant allele frequencies were used to calculate mutant-allele tumor heterogeneity (MATH) scores as measures of intratumoral …

Comparison Of Nylon-Flocked Swab And Dacron Swab Cytology For Anal Hsil Detection In Transgender Women And Gay, Bisexual, And Other Men Who Have Sex With Men, Dorothy J. Wiley, Hilary K. Hsu, Martha A. Ganser, Jenny Brook, David A. Elashoff, Stephen A. Young, Nancy E. Joste, Ronald Mitsuyasu, Teresa M. Darragh, David H. Morris, Otoniel M. Martínez-Maza, Roger Detels, Jian Yu Rao, Robert K. Bolan, Eric T. Shigeno, Ernesto Rodriguez, Matthrew G. Moran

Pathology Research and Scholarship

BACKGROUND: An anal histological high-grade squamous intraepithelial lesion (hHSIL) is an anal cancer precursor. Experts recommend Dacron swab anal cytology as a primary screen for anal hHSILs, especially among human immunodeficiency virus-infected and -uninfected men who have sex with men (MSM). Studies have shown that Dacron cytology inaccurately predicts anal hHSILs and results in unnecessary diagnostic procedures. Nylon-flocked (NF) swabs have been shown to trap pathogens and cells well. Thus, this study compared test characteristics of anal cytology using NF and Dacron swab collection protocols to predict anal hHSILs.

METHODS: A single-visit, randomized clinical trial compared NF and Dacron swab …