Chronic Invasive Fungal Sinusitis due to Scedosporium Apiospermum causing Orbital Apex Syndrome

Abstract Introduction: Chronic invasive fungal sinusitis (CIFS) is defined as fungal invasion of the sinonasal submucosa for greater than 12 weeks. Common causes are dematiaceous molds followed by Aspergillus species, but can rarely be caused by other pathogens Case: A 71-year-old immunocompetent male presented with orbital apex syndrome found to be due to chronic invasive fungal sinusitis caused by Scedosporium apiospermum. After surgical debridement and appropriate systemic antifungal therapy, he made a near full recovery. Discussion: Scedosporium apiospermum is an emerging pathogen and a rare cause of chronic invasive fungal sinusitis. The diagnostic and treatment dilemmas involved with this rare but emerging clinical entity will be discussed

Systemic Inflammation is Associated with Disease Extent and Survival in Oral Cavity Squamous Cell Carcinoma

Background: Although systemic immune-inflammation index (SII) correlates with patient survival in various solid malignancies limited information is available in the setting of oral cavity squamous cell carcinoma (OCSCC). Methods: We retrospectively reviewed 222 patients who underwent a resection of curative intent for patients with OCSCC. SII was determined prior to surgical resection as platelet count × neutrophil count/lymphocyte count. Results: At a median follow-up of 30.6 months, 2-year disease-free survival (DFS) and overall survival (OS) rates were 63.9% and 76.4%, respectively. A high SII (\u3e1047) was associated with poor performance status and disease extent. A low SII was independently associated with improved DFS (HR: 0.440, pp=0.007) rates. Conclusions: SII values at diagnosis were associated with patient performance status, disease extent at the time of diagnosis, improved disease control rates, and improved patient survival

Assessing the Educational Quality of Training Videos for Collection of a Nasopharyngeal Swab

Introduction: The SARS-CoV-2 pandemic has forced healthcare systems to disseminate their training materials quickly and broadly, including instruction on identifying cases of infection through correct nasopharyngeal swabbing. Incorrect nasopharyngeal swabbing technique leads to substandard sampling, patient discomfort, and increased risk of complications. We set out to evaluate the quality of educational videos on the nasopharyngeal swab procedure. Methods: Using video search engines, videos on nasopharyngeal swabbing were identified and distributed to two reviewers. The quality of videos was assessed using a scoring system that examined indications, contraindications, personal protective equipment use, swab depth, swab angle, and audiovisual quality. Descriptive statistics and Spearman’s correlation coefficients were utilized to analyze video quality and its association with individual video characteristics. Results: Videos received an average composite score of 5.4 (range: 0-10), with about half of all videos properly discussing and demonstrating the nasopharyngeal swab technique. Over 62% of reviews indicated that the reviewer would not recommend the video to a trainee, with the vast majority identifying improper swab technique as the main factor. There were no statistically significant associations between video score and publication date, number of views, and subscribers to the publisher. Conclusion: Our study shows a glaring lack of quality educational videos on the nasopharyngeal swab procedure. Health care providers should be cautious when using educational videos to learn procedures as popularity may not be associated with accuracy

Randomized Controlled Trial of Intense Therapeutic Ultrasound for the Treatment of Chronic Plantar Fasciitis

Category: Sports Introduction/Purpose: Initial treatment of plantar fasciitis (PF), consisting of anti-inflammatories, stretching and in-shoe orthosis (heel pad, heel wedge, or arch support), leads to symptomatic resolution in over 90% of patients but takes 3-6 months. This study was conducted to test the effectiveness of a minimally invasive modality, intense therapeutic ultrasound (ITU), in accelerating the healing of chronic plantar fasciitis (PF). ITU uses high-frequency high-intensity focused ultrasound to create small thermal injury zones inside soft tissue without damage to surrounding structures. ITU has been shown to initiate a tissue repair cascade and promote collagen generation in dermal and musculoskeletal tissue and is FDA approved for use in non-surgical brow lifts [1,2]. The goal of this study was to determine if ITU when combined with standard therapy could speed the healing of chronic PF. Methods: 47 patients with chronic (greater than 3 months) heel pain due to PF were randomized to standard therapy (anti- inflammatory pills, stretching, and gel heel cups) plus ITU (“ITU”, n=33) or standard therapy plus sham ITU (“control”, n=14) groups. ITU treatments were administered at enrollment and two-weeks later using a custom 3.3 MHz therapeutic ultrasound system (Guided Therapy Systems, Mesa, AZ). Sham treatment utilized the same protocol but with the energy set to 0 Joules. Treatment effect was assessed at 2, 4, 6, and 12 weeks after the initiation of treatment using diagnostic ultrasound and patient reported outcomes (PROMIS physical function computer adaptive test, PROMIS global health, Foot Function Index pain subscale, and a non-validated heel pain specific questionnaire). Ultrasound images were analyzed to determine the size of lesions within the PF. Both the sonographer and the study coordinator administering the patient reported outcome instruments were blinded to group assignment. Results: 38 patients completed the 12 week study (ITU: n=37, Control: n=11.). The ITU group reported a significantly greater reduction in heel pain scores [Mean 8.27, SD 4.69, P=0.027] compared to the control group [Mean 2.25, SD 5.92] (Figure 1). Ultrasound imaging showed an 81% decrease in perifascial lesion size in the treatment group, compared to a 26% increase in lesion size in the control group (Figure 2). Conclusion: Preliminary results of this clinical study of noninvasive ITU for the treatment of chronic PF showed that ITU treatment as compared to sham control lead to a larger and more rapid reduction of heel pain and perifascial lesion size. ITU holds promise as a potential therapy to accelerate the healing of chronic plantar fasciiti

Beyond Point Masses. II. Non-Keplerian Shape Effects Are Detectable in Several TNO Binaries

About 40 trans-Neptunian binaries (TNBs) have fully determined orbits with about 10 others being solved except for breaking the mirror ambiguity. Despite decades of study, almost all TNBs have only ever been analyzed with a model that assumes perfect Keplerian motion (e.g., two point masses). In reality, all TNB systems are non-Keplerian due to nonspherical shapes, possible presence of undetected system components, and/or solar perturbations. In this work, we focus on identifying candidates for detectable non-Keplerian motion based on sample of 45 well-characterized binaries. We use MultiMoon , a non-Keplerian Bayesian inference tool, to analyze published relative astrometry allowing for nonspherical shapes of each TNB system’s primary. We first reproduce the results of previous Keplerian fitting efforts with MultiMoon , which serves as a comparison for the non-Keplerian fits and confirms that these fits are not biased by the assumption of a Keplerian orbit. We unambiguously detect non-Keplerian motion in eight TNB systems across a range of primary radii, mutual orbit separations, and system masses. As a proof of concept for non-Keplerian fitting, we perform detailed fits for (66652) Borasisi-Pabu, possibly revealing a J _2 ≈ 0.44, implying Borasisi (and/or Pabu) may be a contact binary or an unresolved compact binary. However, full confirmation of this result will require new observations. This work begins the next generation of TNB analyses that go beyond the point mass assumption to provide unique and valuable information on the physical properties of TNBs with implications for their formation and evolution

Tropospheric Aqueous-Phase Chemistry: Kinetics, Mechanisms, and Its Coupling to a Changing Gas Phase

[no abstract available

Reproducibility of fluorescent expression from engineered biological constructs in E. coli

We present results of the first large-scale interlaboratory study carried out in synthetic biology, as part of the 2014 and 2015 International Genetically Engineered Machine (iGEM) competitions. Participants at 88 institutions around the world measured fluorescence from three engineered constitutive constructs in E. coli. Few participants were able to measure absolute fluorescence, so data was analyzed in terms of ratios. Precision was strongly related to fluorescent strength, ranging from 1.54-fold standard deviation for the ratio between strong promoters to 5.75-fold for the ratio between the strongest and weakest promoter, and while host strain did not affect expression ratios, choice of instrument did. This result shows that high quantitative precision and reproducibility of results is possible, while at the same time indicating areas needing improved laboratory practices.Peer reviewe