Guildford College

Recent advancements in artificial intelligence (AI) have revealed important patterns in pathology images imperceptible to human observers that can improve diagnostic accuracy and decision support systems. However, progress has been limited due to the lack of publicly available medical images. To address this scarcity, we explore Instagram as a novel source of pathology images with expert annotations. We curated the IPATH dataset from Instagram, comprising 45,609 pathology image-text pairs rigorously filtered and curated for domain quality using classifiers, large language models, and manual filtering. To demonstrate the value of this dataset, we developed a multimodal AI model called IP-CLIP by fine-tuning a pretrained CLIP model using the IPATH dataset. We evaluated IP-CLIP on seven external histopathology datasets using zero shot classification and linear probing, where it consistently outperformed the original CLIP model. Furthermore, IP-CLIP matched or exceeded several recent state-of-the-art pathology vision-language models, despite being trained on a substantially smaller dataset. We also assessed image-text alignment on a 5k held-out IPATH subset using image-text retrieval, where IP-CLIP surpassed CLIP and other specialized models. These results demonstrate the effectiveness of the IPATH dataset and highlight the potential of leveraging social media data to develop AI models for medical image classification and enhance diagnostic accuracy.

Inadvertent intra-arterial injection of sclerosants is an uncommon adverse event of both ultrasound-guided and direct vision sclerotherapy. This complication can result in significant tissue or limb loss and significant long-term morbidity. To provide recommendations for diagnosis and immediate management of an unintentional intra-arterial injection of sclerosing agents. An international and multidisciplinary expert panel representing the endorsing societies and relevant specialities reviewed the published biomedical, scientific and legal literature and developed the consensus-based recommendations. Actual and suspected cases of an intra-arterial sclerosant injection should be immediately transferred to a facility with a vascular/interventional unit. Digital Subtraction Angiography (DSA) is the key investigation to confirm the diagnosis and help select the appropriate intra-arterial therapy for tissue ischaemia. Emergency endovascular intervention will be required to manage the risk of major limb ischaemia. This includes intra-arterial administration of vasodilators to reduce vasospasm, and anticoagulants and thrombolytic agents to mitigate thrombosis. Mechanical thrombectomy, other endovascular interventions and even open surgery may be required. Lumbar sympathetic block may be considered but has a high risk of bleeding. Systemic anti-inflammatory agents, anticoagulants, and platelet inhibitors and modifiers would complement the intra-arterial endovascular procedures. For risk of minor ischaemia, systemic oral anti-inflammatory agents, anticoagulants, vasodilators and antiplatelet treatments are recommended. Inadvertent intra-arterial injection is an adverse event of both ultrasound-guided and direct vision sclerotherapy. Medical practitioners performing sclerotherapy must ensure completion of a course of formal training (specialty or subspecialty training, or equivalent recognition) in the management of venous and lymphatic disorders (phlebology), and be personally proficient in the use of duplex ultrasound in vascular (both arterial and venous) applications, to diagnose and provide image guidance to venous procedure. Expertise in diagnosis and immediate management of an intra-arterial injection is essential for all practitioners performing sclerotherapy.

How learning journeys help settings to capture the wonder of the early years and build a holistic picture of children's development. By Wendy Howes, Jackie Wells and Sally Cave

Aiming to provide a complete coverage for technician students, this book summarizes concisely all the essential building processes and techniques plus the regulations that govern them. Contents are grouped under site works, builders plant, substructure, superstructure and finishes.

ABSTRACT Based upon a search of literature in the respective countries, the current situation in France and England with regard to the Accreditation of Prior Learning (APL) and Prior Experiential Learning (APEL) is provided. The two systems, which have both developed from North American models, are broadly similar, though there are differences with regard to legal status and the operation. The systems are considered in general terms, as well as in regard to vocational qualifications and entrance to further and higher education. The systems are still developing, with other countries in the European Union also developing similar systems.

This is the first time that this journal, and to my knowledge any other journal, has dedicated a special issue to the subject of in-orbit-testing (IOT). This area is perhaps not the most glamorous, being sandwiched between the euphoria of a successful launch and the pragmatism of making money from the satellite operations. However, it is a very crucial area and is desperately important to the success of the total satellite mission. It was this realization in discussion with our guest editor, some two or three years ago, that prompted me to push for this special issue, and finally I am pleased to say that we have realized the project. Much credit for this must go to the guest editor, Bernard Kasstan, whose energy, enthusiasm and perseverance are testimony to the appearance of this issue. Bernard is both an old friend and a major current exponent in the IOT area with EUTELSAT. There can be no better choice of guest editor than somebody who is deeply involved in the IOT on behalf of a major satellite operating organization and I warmly welcome Bernard to the role.

A status passage is the process of change from one social status to another and, in this report, transition into the occupational role of nurse is described. The status passage includes the anticipations, entry, reporting of contrasts and changes which are often accompanied by surprise, and reality shock before making sense of the passage some months later. Subpassages are noted, and in particular the subtle process of divestiture which results in loss of personal identity. Personal identity is sought through patients and those outside the institution. Occupational role identity occurs between 6 and 10 months after entry into nurse training. The status transition is easier for those with higher self-esteem and lower anxiety scores. The study involved four cohorts of trainee nurses during their first year of training in two schools of nursing, and the study was undertaken using multiple research methods. Present and future policy implications are noted.