Coccidiomycosis infection of the patella mimicking a neoplasm - two case reports.

BackgroundCoccidioidomycosis is an endemic fungal infection in the southwestern of United States. Most infections are asymptomatic or manifest with mild respiratory complaints. Rare cases may cause extrapulmonary or disseminated disease. We report two cases of knee involvement that presented as isolated lytic lesions of the patella mimicking neoplasms.Case presentationThe first case, a 27 year-old immunocompetent male had progressive left anterior knee pain for four months. The second case was a 78 year-old male had left anterior knee pain for three months. Both of them had visited general physicians without conclusive diagnosis. A low attenuation lytic lesion in the patella was demonstrated on their image studies, and the initial radiologist's interpretation was suggestive of a primary bony neoplasm. The patients were referred for orthopaedic oncology consultation. The first case had a past episode of pulmonary coccioidomycosis 2 years prior, while the second case had no previous coccioidal infection history but lived in an endemic area, the central valley of California. Surgical biopsy was performed in both cases due to diagnostic uncertainty. Final pathologic examination revealed large thick walled spherules filled with endospores establishing the final diagnosis of extrapulmonary coccidioidomycosis.ConclusionsThough history and laboratory findings are supportive, definitive diagnosis still depends on growth in culture or endospores identified on histology. We suggest that orthopaedic surgeons and radiologists keep in mind that chronic fungal infections can mimic osseous neoplasm by imaging

Designing Automated Vehicle and Traffic Systems towards Meaningful Human Control

Ensuring operational control over automated vehicles is not trivial and failing to do so severely endangers the lives of road users. An integrated approach is necessary to ensure that all agents play their part including drivers, occupants, vehicle designers and governments. While progress is being made, a comprehensive approach to the problem is being ignored, which can be solved in the main through considering Meaningful Human Control (MHC). In this research, an Integrated System Proximity framework and Operational Process Design approach to assist the development of Connected Automated Vehicles (CAV) under the consideration of MHC are introduced. These offer a greater understanding and basis for vehicle and traffic system design by vehicle designers and governments as two important influencing stakeholders. The framework includes an extension to a system approach, which also considers ways that MHC can be improved through updating: either implicit proximal updating or explicit distal updating. The process and importance are demonstrated in three recent cases from practice. Finally, a call for action is made to government and regulatory authorities, as well as the automotive industry, to ensure that MHC processes are explicitly included in policy, regulations, and design processes to ensure future ad-vancement of CAVs in a responsible, safe and humanly agreeable fashion.Comment: In: Research Handbook on Meaningful Human Control of Artificial Intelligence Systems. Edward Elgar Publishin

Remote Advanced Payload Test Rig (RAPTR) Portable Payload Test System for the International Space Station (ISS)

The RAPTR was developed to test ISS payloads for NASA. RAPTR is a simulation of the Command and Data Handling (C&DH) interfaces of the ISS (MIL-STD 1553B, Ethernet and TAXI) and is designed to facilitate rapid testing and deployment of payload experiments to the ISS. The ISS Program's goal is to reduce the amount of time it takes a payload developer to build, test and fly a payload, including payload software. The RAPTR meets this need with its user oriented, visually rich interface. Additionally, the Analog and Discrete (A&D) signals of the following payload types may be tested with RAPTR: (1) EXPRESS Sub Rack Payloads; (2) ELC payloads; (3) External Columbus payloads; (4) External Japanese Experiment Module (JEM) payloads. The automated payload configuration setup and payload data inspection infrastructure is found nowhere else in ISS payload test systems. Testing can be done with minimal human intervention and setup, as the RAPTR automatically monitors parameters in the data headers that are sent to, and come from the experiment under test

Extra-Abdominal Desmoid Tumors Associated with Familial Adenomatous Polyposis

Extra-abdominal desmoid tumors are a significant cause of morbidity in patients with familial adenomatous polyposis syndrome. Understanding of the basic biology and natural history of these tumors has increased substantially over the past decade. Accordingly, medical and surgical management of desmoid tumors has also evolved. This paper analyzes recent evidence pertaining to the epidemiology, molecular biology, histopathology, screening, and treatment of extra-abdominal desmoid tumors associated with familial adenomatous polyposis syndrome

At-Risk Populations for Osteosarcoma: The Syndromes and Beyond

Osteosarcoma is the most common primary malignancy of bone. Most cases are sporadic without a known genetic or environmental cause. Heritable genetic predisposition syndromes are associated with a small percentage of osteosarcomas. Study of these rare disorders has provided insight into the molecular pathogenesis of osteosarcoma. Screening of at-risk families and surveillance of affected individuals for these syndromes may permit earlier diagnosis and more effective treatment of osteosarcoma in these populations. This paper reviews the genetic and clinical features of the known osteosarcoma predisposition syndromes

Harmonizing the agricultural biotechnology debate for the benefit of African farmers

The intense debate over agricultural biotechnology is at once fascinating, confusing and disappointing. It is complicated by issues of ethical, moral, socio-economic, political, philosophical and scientific import. Its vocal champions exaggerate their claims of biotechnology as saviour of the poor and hungry, while, equally loudly, its opponents declare it as the doomsday devil of agriculture. Sandwiched between these two camps is the rest of the public, either absorbed or indifferent. Biotechnology issues specific to the African public must include crop and animal productivity, food security, alleviation of poverty and gender equity, and must exclude political considerations. Food and its availability are basic human rights issues—for people without food, everything else is insignificant. Although we should discuss and challenge new technologies and their products, bringing the agricultural biotechnology debate into food aid for Africa where millions are faced with life-or-death situations is irresponsible. Agricultural biotechnology promises the impoverished African a means to improve food security and reduce pressures on the environment, provided the perceived risks associated with the technology are addressed. This paper attempts to harmonize the debate, and to examine the potential benefits and risks that agricultural biotechnology brings to African farmers. Key words: Agriculture, biotechnology, biotechnology debate, biotechnology and Africa, biotechnology issues, food security, poverty alleviation. African Journal of Biotechnology Vol.2(11) 2003: 394-41

Impact of wound edge protection devices on surgical site infection after laparotomy: multicentre randomised controlled trial (ROSSINI Trial).

OBJECTIVE: To determine the clinical effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery. DESIGN: Multicentre observer blinded randomised controlled trial. PARTICIPANTS: Patients undergoing laparotomy at 21 UK hospitals. INTERVENTIONS: Standard care or the use of a wound edge protection device during surgery. MAIN OUTCOME MEASURES: Surgical site infection within 30 days of surgery, assessed by blinded clinicians at seven and 30 days and by patient's self report for the intervening period. Secondary outcomes included quality of life, duration of stay in hospital, and the effect of characteristics of the patient and operation on the efficacy of the device. RESULTS: 760 patients were enrolled with 382 patients assigned to the device group and 378 to the control group. Six patients in the device group and five in the control group did not undergo laparotomy. Fourteen patients, seven in each group, were lost to follow-up. A total of 184 patients experienced surgical site infection within 30 days of surgery, 91/369 (24.7%) in the device group and 93/366 (25.4%) in the control group (odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). This lack of benefit was consistent across wound assessments performed by clinicians and those reported by patients and across all secondary outcomes. In the secondary analyses no subgroup could be identified in which there was evidence of clinical benefit associated with use of the device. CONCLUSIONS: Wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy, and therefore their routine use for this role cannot be recommended. TRIAL REGISTRATION: Current Controlled Trials ISRCTN 40402832