Possible Skull Base Erosion After Prolonged Frontal Sinus Stenting

Frontal sinus stenting is widely used with the goal of maintaining nasofrontal duct patency after sinus surgery. The general recommendation is to leave stents in place for 6 months; however, prolonged stenting up to 6 years has been reported with no complication. We present the first reported case of frontal sinus posterior table and skull base erosion following prolonged frontal sinus stenting. A 57-year-old female presented with chronic sinusitis and nasal obstruction. Imaging revealed pansinusitis with retained stents in each frontal sinus that were placed 8 years prior. On the right, there was an area of skull base erosion at the tip of the stent. The patient underwent functional endoscopic sinus surgery with polypectomy. The stents were removed, revealing posterior table erosion on the right side but intact mucosa. Two months after surgery, there were no signs or symptoms of cerebrospinal fluid leak or other complications. Recent literature has suggested that prolonged stenting is safe; however, this case highlights a complication with potentially serious outcomes that can result from prolonged stenting. We recommend stent removal once stable nasofrontal duct patency has been achieved. If prolonged stenting is utilized, patients should be closely monitored and consideration should be given to periodic imaging to evaluate stent position

MPHASYS: a mouse phenotype analysis system

<p>Abstract</p> <p>Background</p> <p>Systematic, high-throughput studies of mouse phenotypes have been hampered by the inability to analyze individual animal data from a multitude of sources in an integrated manner. Studies generally make comparisons at the level of genotype or treatment thereby excluding associations that may be subtle or involve compound phenotypes. Additionally, the lack of integrated, standardized ontologies and methodologies for data exchange has inhibited scientific collaboration and discovery.</p> <p>Results</p> <p>Here we introduce a Mouse Phenotype Analysis System (MPHASYS), a platform for integrating data generated by studies of mouse models of human biology and disease such as aging and cancer. This computational platform is designed to provide a standardized methodology for working with animal data; a framework for data entry, analysis and sharing; and ontologies and methodologies for ensuring accurate data capture. We describe the tools that currently comprise MPHASYS, primarily ones related to mouse pathology, and outline its use in a study of individual animal-specific patterns of multiple pathology in mice harboring a specific germline mutation in the DNA repair and transcription-specific gene Xpd.</p> <p>Conclusion</p> <p>MPHASYS is a system for analyzing multiple data types from individual animals. It provides a framework for developing data analysis applications, and tools for collecting and distributing high-quality data. The software is platform independent and freely available under an open-source license <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>.</p

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Search for associated production of dark matter with a Higgs boson decaying to bbˉb\bar{b} or γγ\gamma\gamma at s\sqrt{s} = 13 TeV

A search for dark matter is performed using events with large missing transverse momentum and a Higgs boson decaying either to a pair of bottom quarks or to a pair of photons. The data from proton-proton collisions at a center-of-mass energy of 13 TeV, collected with the CMS detector at the LHC, correspond to an integrated luminosity of 2.3 inverse-femtobarns. Results are interpreted in the context of a Z'-two-Higgs-doublet model, where a high-mass resonance Z' decays into a pseudoscalar boson A and a CP-even scalar Higgs boson, and the A decays to a pair of dark matter particles. No significant excesses are observed over the background prediction. Combining results from the two decay channels yields exclusion limits in the signal cross section in the m[Z']-m[A] phase space. The observed data exclude, for Z' coupling strength g[Z'] = 0.8 and m[A] = 300 GeV for example, the Z' mass range of 600 to 1860 GeV. This is the first result on a search for dark matter produced in association with a Higgs boson that includes constraints on h to gamma-gamma obtained at sqrt(s) = 13 TeV

Search for heavy resonances decaying into a vector boson and a Higgs boson in final states with charged leptons, neutrinos, and b quarks

A search for heavy resonances decaying to a Higgs boson and a vector boson is presented. The analysis is performed using data samples collected in 2015 by the CMS experiment at the LHC in proton-proton collisions at a center-of-mass energy of 13 TeV, corresponding to integrated luminosities of 2.2-2.5 inverse femtobarns. The search is performed in channels in which the vector boson decays into leptonic final states ($\mathrm{Z} \to \nu\nu$, $\mathrm{W}\to \ell \nu$, and $\mathrm{Z} \to \ell \ell$, with $\ell = \mathrm{e}$, $\mu$), while the Higgs boson decays to collimated b quark pairs detected as a single massive jet. The discriminating power of a jet mass requirement and a b jet tagging algorithm are exploited to suppress the standard model backgrounds. The event yields observed in data are consistent with the background expectation. In the context of a theoretical model with a heavy vector triplet, a resonance with mass less than 2 TeV is excluded at 95% confidence level. The results are also interpreted in terms of limits on the parameters of the model, improving on the reach of previous searches

Search for associated production of dark matter with a Higgs boson decaying to bb‾ \mathrm{b}\overline{\mathrm{b}} or γγ\gamma \gamma at s=13 \sqrt{s}=13 TeV

A search for dark matter is performed looking for events with large missing transverse momentum and a Higgs boson decaying either to a pair of bottom quarks or to a pair of photons. The data from proton-proton collisions at a center-of-mass energy of 13 TeV, collected in 2015 with the CMS detector at the LHC, correspond to an integrated luminosity of 2.3 fb$^{−1}$. Results are interpreted in the context of a Z′-two-Higgs-doublet model, where the gauge symmetry of the standard model is extended by a U(1)$_{Z ′}$ group, with a new massive Z′ gauge boson, and the Higgs sector is extended with four additional Higgs bosons. In this model, a high-mass resonance Z′ decays into a pseudoscalar boson A and a light SM-like scalar Higgs boson, and the A decays to a pair of dark matter particles. No significant excesses are observed over the background prediction. Combining results from the two decay channels yields exclusion limits in the signal cross section in the m$_{Z ′}$ - m$_{A}$ phase space. For example, the observed data exclude the Z$^{′}$ mass range from 600 to 1860 GeV, for Z′ coupling strength g$_{Z ′}$ = 0.8, the coupling of A with dark matter particles g$_{χ}$ = 1, the ratio of the vacuum expectation values tan β = 1, and m$_{A}$ = 300 GeV. The results of this analysis are valid for any dark matter particle mass below 100 GeV

Search for heavy resonances decaying into a vector boson and a Higgs boson in final states with charged leptons, neutrinos, and b quarks

A search for heavy resonances decaying to a Higgs boson and a vector boson is presented. The analysis is performed using data samples collected in 2015 by the CMS experiment at the LHC in proton–proton collisions at a center-of-mass energy of 13 TeV, corresponding to integrated luminosities of 2.2–2.5 fb$^{−1}$ . The search is performed in channels in which the vector boson decays into leptonic final states (Z → $\nu\nu$ , W → ℓ $\nu$, and Z → ℓℓ , with ℓ = e, $\mu$), while the Higgs boson decays to collimated b quark pairs detected as a single massive jet. The discriminating power of a jet mass requirement and a b jet tagging algorithm are exploited to suppress the standard model backgrounds. The event yields observed in data are consistent with the background expectation. In the context of a theoretical model with a heavy vector triplet, a resonance with mass less than 2 TeV is excluded at 95% confidence level. The results are also interpreted in terms of limits on the parameters of the model, improving on the reach of previous searches