Para-iliac actinomycetoma presenting as sarcoma, a late complication of appendicitis: A case report

AbstractINTRODUCTIONActinomycosis is known to mimic several types of neoplasms, leading to morbid surgical interventions.PRESENTATION OF CASEWe report the particular case of an extensive right para-iliac actinomycetoma presenting as a sarcoma, which to our knowledge has not yet been described in the literature, in a patient with previous ruptured appendicitis. Thanks to the collaborative work between the orthopedic and general surgeons, pathologist and microbiologist, the diagnosis of actinomycosis was made pre-operatively, saving this 15-year-old patient from a tumor resection protocol.DISCUSSIONActinomycetomas have often been reported to present in the same way as several abdominal and gynecological neoplasms, and on rare occasions been described as mimicking other soft-tissue sarcomas, leading to unnecessary morbid tumor resection protocols. The most common cause of abdominal actinomycosis is perforated appendicitis, and may present several years later.CONCLUSIONWhile faced with a soft tissue mass transgressing tissue planes and possibly extending to the region of the right lower quadrant, especially with a history of previous perforated appendicitis, one should consider the possibility of an abscess caused by pathogens of intestinal origin, including the gram positive anaerobe Actinomycosis israelii. Failure to actively search for this pathogen, which is not detectable with routine staining techniques and may take up to 1–2 weeks to isolate, may lead to unnecessary morbid surgical procedures

Aging yields a smaller number of fixations and a reduced gaze amplitude when driving in a simulator

With the increasing number of elderly drivers, it is important to better understand if strategies for capturing visual information are affected by age and by the complexity of the driving contexts. Ten young (aged 21-31 years) and older (aged 65-75 years) active drivers drove through a continuous simulated scenario (STISIM, v2.0). The scenario included drinving on open roads (less demanding), stopping at intersections and passing maneuvers (more demanding). Eye movements were recorded with an oculometer (ASL, model 510). Compared to younger drivers, older drivers showed a smaller horizontal amplitude between fixations and a smaller variance in the amplitude of the eye movements. They also showed a smaller number of fixations/sec for the more complex driving maneuvers that were analyzed (passing maneuvers). Overall, this may reveal a "tunnel effect" (or perceptual narrowing) phenomenon when the driving context increases in complexity

Ground operation of robotics on Space Station Freedom

This paper reflects work carried out on Ground Operated Telerobotics (GOT) in 1992 to refine further the ideas, procedures, and technologies needed to test the procedures in a high latency environment, and to integrate GOT into Space Station Freedom operations. Space Station Freedom (SSF) will be in operation for 30 years, and will depend on robots to carry out a significant part of the assembly, maintenance, and utilization workload. Current plans call for on-orbit robotics to be operated by on-board crew members. This approach implies that on-orbit robotics operations use up considerable crew time, and that these operations cannot be carried out when SSF is unmanned. GOT will allow robotic operations to be operated from the ground, with on-orbit crew interventions only when absolutely required. The paper reviews how GOT would be implemented, how GOT operations would be planned and supported, and reviews GOT issues, critical success factors, and benefits

Atrial natriuretic factor during atrial fibrillation and supraventricular tachycardia

Plasma immunoreactive atrial natriuretic factor was measured in 10 patients with chronic atrial fibrillation before and after cardioversion to sinus rhythm, and in 14 patients during electrophysiologic evaluation of paroxysmal supraventricular tachycardia. The mean plasma concentration of atrial natriuretic factor in atrial fibrillation was 138 ± 48 pg/ml and decreased to 116 ± 45 pg/ml 1 hour after cardioversion to sinus rhythm (p < 0.005). The mean plasma concentration of atrial natriuretic factor increased from 117 ± 53 pg/ml in sinus rhythm to 251 ± 137 pg/ml during laboratory-induced supraventricular tachycardia (p < 0.005). Right atrial pressures were recorded in 12 patients; the baseline atrial pressure was 4.3 ± 1.9 mm Hg and increased to 7.4 ± 3.6 mm Hg during supraventricular tachycardia (p < 0.005). A modest but significant linear relation was noted between the changes in plasma atrial natriuretic factor and right atrial pressure measurements during induced supraventricular tachycardia (r = 0.60, p < 0.05).In conclusion, changes in atrial rhythm and pressure may be an important factor modulating the release of atrial natriuretic factor in the circulation and raised levels of this hormone may be a contributing factor for the polyuria and the hypotension associated with paroxysmal supraventricular tachyarrhythmias

Process intensification education contributes to sustainable development goals: Part 2

Achieving the United Nations sustainable development goals requires industry and society to develop tools and processes that work at all scales, enabling goods delivery, services, and technology to large conglomerates and remote regions. Process Intensification (PI) is a technological advance that promises to deliver means to reach these goals, but higher education has yet to totally embrace the program. Here, we present practical examples on how to better teach the principles of PI in the context of the Bloom's taxonomy and summarise the current industrial use and the future demands for PI, as a continuation of the topics discussed in Part 1. In the appendices, we provide details on the existing PI courses around the world, as well as teaching activities that are showcased during these courses to aid students’ lifelong learning. The increasing number of successful commercial cases of PI highlight the importance of PI education for both students in academia and industrial staff.We acknowledge the sponsors of the Lorentz’ workshop on“Educating in PI”: The MESA+Institute of the University of Twente,Sonics and Materials (USA) and the PIN-NL Dutch Process Intensi-fication Network. DFR acknowledges support by The Netherlands Centre for Mul-tiscale Catalytic Energy Conversion (MCEC), an NWO Gravitationprogramme funded by the Ministry of Education, Culture and Sci-ence of the government of The Netherlands. NA acknowledges the Deutsche Forschungsgemeinschaft (DFG)- TRR 63¨Integrierte Chemische Prozesse in flüssigen Mehrphasen-systemen¨(Teilprojekt A10) - 56091768. The participation by Robert Weber in the workshop and thisreport was supported by Laboratory Directed Research and Devel-opment funding at Pacific Northwest National Laboratory (PNNL).PNNL is a multiprogram national laboratory operated for theUS Department of Energy by Battelle under contract DE-AC05-76RL0183

SARS-CoV-2 spike antigen-specific B cell and antibody responses in pre-vaccination period COVID-19 convalescent males and females with or without post-covid condition

Background Following SARS-CoV-2 infection a significant proportion of convalescent individuals develop the post-COVID condition (PCC) that is characterized by wide spectrum of symptoms encompassing various organs. Even though the underlying pathophysiology of PCC is not known, detection of viral transcripts and antigens in tissues other than lungs raise the possibility that PCC may be a consequence of aberrant immune response to the viral antigens. To test this hypothesis, we evaluated B cell and antibody responses to the SARS-CoV-2 antigens in PCC patients who experienced mild COVID-19 disease during the pre-vaccination period of COVID-19 pandemic. Methods The study subjects included unvaccinated male and female subjects who developed PCC or not (No-PCC) after clearing RT-PCR confirmed mild COVID-19 infection. SARS-CoV-2 D614G and omicron RBD specific B cell subsets in peripheral circulation were assessed by flow cytometry. IgG, IgG3 and IgA antibody titers toward RBD, spike and nucleocapsid antigens in the plasma were evaluated by ELISA. Results The frequency of the B cells specific to D614G-RBD were comparable in convalescent groups with and without PCC in both males and females. Notably, in females with PCC, the anti-D614G RBD specific double negative (IgD-CD27-) B cells showed significant correlation with the number of symptoms at acute of infection. Anti-spike antibody responses were also higher at 3 months post-infection in females who developed PCC, but not in the male PCC group. On the other hand, the male PCC group also showed consistently high anti-RBD IgG responses compared to all other groups. Conclusions The antibody responses to the spike protein, but not the anti-RBD B cell responses diverge between convalescent males and females who develop PCC. Our findings also suggest that sex-related factors may also be involved in the development of PCC via modulating antibody responses to the SARS-CoV-2 antigens

SARS-CoV-2 spike antigen-specific B cell and antibody responses in pre-vaccination period COVID-19 convalescent males and females with or without post-covid condition

BackgroundFollowing SARS-CoV-2 infection a significant proportion of convalescent individuals develop the post-COVID condition (PCC) that is characterized by wide spectrum of symptoms encompassing various organs. Even though the underlying pathophysiology of PCC is not known, detection of viral transcripts and antigens in tissues other than lungs raise the possibility that PCC may be a consequence of aberrant immune response to the viral antigens. To test this hypothesis, we evaluated B cell and antibody responses to the SARS-CoV-2 antigens in PCC patients who experienced mild COVID-19 disease during the pre-vaccination period of COVID-19 pandemic.MethodsThe study subjects included unvaccinated male and female subjects who developed PCC or not (No-PCC) after clearing RT-PCR confirmed mild COVID-19 infection. SARS-CoV-2 D614G and omicron RBD specific B cell subsets in peripheral circulation were assessed by flow cytometry. IgG, IgG3 and IgA antibody titers toward RBD, spike and nucleocapsid antigens in the plasma were evaluated by ELISA.ResultsThe frequency of the B cells specific to D614G-RBD were comparable in convalescent groups with and without PCC in both males and females. Notably, in females with PCC, the anti-D614G RBD specific double negative (IgD-CD27-) B cells showed significant correlation with the number of symptoms at acute of infection. Anti-spike antibody responses were also higher at 3 months post-infection in females who developed PCC, but not in the male PCC group. On the other hand, the male PCC group also showed consistently high anti-RBD IgG responses compared to all other groups.ConclusionsThe antibody responses to the spike protein, but not the anti-RBD B cell responses diverge between convalescent males and females who develop PCC. Our findings also suggest that sex-related factors may also be involved in the development of PCC via modulating antibody responses to the SARS-CoV-2 antigens