Invasive maxillary sinus aspergillosis: a case report successfully treated with voriconazole and surgical debridement

Introduction: Invasive aspergillosis of the paranasal sinuses is a rare disease and often misdiagnosed; however, its incidence has seen substancial growth over the past 2 decades. Definitive diagnosis of these lesions is based on histological examination and fungal culture. Case Report: An 81-year-old woman with a history of pain in the left maxillary region is presented. The diagnosis was invasive maxillary aspergillosis in immunocompetent patient, which was successfully treated with voricona - zole and surgical debridement. Possible clinical manifestations, diagnostic imaging techniques and treatment used are discussed. Since the introduction of voriconazole, there have been several reports of patients with invasive aspergillosis who responded to treatment with this new antifungal agent. Conclusions: We report the importance of early diagnosis and selection of an appropriate antifungal agent to achie - ve a successful treatment

Cavernous hemangioma of the parotid gland in adults

Hemangiomas account for 0.4-0.6% of all tumors of the parotid gland and most of them occur in children, never - theless in adults hemangiomas are very rare. We report the case of a 62 year old woman with a mass in the parotid right tail associated with fluctuating swelling episodes unrelated to meals and with a slowly progressive growth. The provisional diagnosis was a pleomorphic adenoma, so a right superficial parotidectomy was performed. During surgery, the macroscopic appearance makes suspect a vascular lesion. The histopathological result was a cavernous hemangioma. The classic clinical presentation of a parotid hemangioma is an intraglandular mass associated or not with skin lesions characterized by reddish macules and/or papules, and a vibration or pulsation when palpating the parotid region. In imaging tests, phleboliths could be observed which are very suggestive of a hemangioma or a vascular malformation. In the absence of these signs, the diagnosis could be difficult, particularly in an adult due to its low prevalence, with about 50 cases reported worldwide. However a hemangioma should be considered in the differential diagnosis of parotid tumors in adults

Targeting sustainable competitiveness in Croatia by implementation of “20 Keys” methodology

Throughout the current wave of regulatory reforms, several theoretical models have been proposed that call for the emergence of instruments of self-regulation under some form of state supervision as part of the demand to improve product development performances aligned with awareness of environmental needs, to help with meeting regulation and to reduce the risk of production nonconformance. “20 Keys” is one example of a mass application of a methodology for raising sustainable development and holistic approach to competitiveness in new EU member the Republic of Croatia, and therefore, the aim of this study is to observe the results of the methodology application in Croatian companies. 20 Keys is a methodology that brings an integrated set of tools aimed at increasing overall productive efficiency and quality level with simultaneous reduction of costs. As it was shown in this paper, implementation success is coincident with senior management’s active role in setting the main goals for implementation, assuring that suitable methods and tools are used, allocating resources appropriately and enabling communication within the company

Untangling the socio-political knots: A systems view on Indonesia's inclusive energy transitions

National energy transitions face complex socio-political challenges, ranging from inertia to exacerbated inequalities. There are limited studies investigating these dimensions, especially in developing economies. This paper presents Indonesia, a country with high fossil fuel dependency, as a valuable case study to investigate the societal interplay affecting transitions. Interviews and literature analyses were conducted to assess barriers and levers to success. The findings are further analysed with systems thinking (ST), highlighting dynamic patterns and interdependencies. It is found that conflicting interests, inconsistent regulation, and low capability at the implementation level are among the most persistent barriers creating disparities between intentions and reality. These leave some groups disproportionately disadvantaged; notably, regions with fossil fuel-dependent income, informal sectors, and indigenous and local communities. Recommendations include the creation of an independent agency for the energy transition, and empowering regional participation. Addressing inclusion is imperative for social justice as well as to ensure adoptability and acceptance from all

Planetary Dynamics and Habitable Planet Formation In Binary Star Systems

Whether binaries can harbor potentially habitable planets depends on several factors including the physical properties and the orbital characteristics of the binary system. While the former determines the location of the habitable zone (HZ), the latter affects the dynamics of the material from which terrestrial planets are formed (i.e., planetesimals and planetary embryos), and drives the final architecture of the planets assembly. In order for a habitable planet to form in a binary star system, these two factors have to work in harmony. That is, the orbital dynamics of the two stars and their interactions with the planet-forming material have to allow terrestrial planet formation in the habitable zone, and ensure that the orbit of a potentially habitable planet will be stable for long times. We have organized this chapter with the same order in mind. We begin by presenting a general discussion on the motion of planets in binary stars and their stability. We then discuss the stability of terrestrial planets, and the formation of potentially habitable planets in a binary-planetary system.Comment: 56 pages, 29 figures, chapter to appear in the book: Planets in Binary Star Systems (Ed. N. Haghighipour, Springer publishing company

Incorporating social mechanisms in energy decarbonisation modelling

The achievement of national pledges that are compatible with the Paris Agreements warming limit of 1.5C is a massive challenge, as it requires not only an acceleration of technological innovation, but also a socio-economic and cultural transformation. Reducing uncertainties demands a better integration of behavioural evolutions in models exploring future energy pathways, including non-monetary barriers and drivers to technology diffusion. This study provides suggestions on incorporating social mechanisms of change such as resistance to change and the diffusion of environmental values into a UK-focused probabilistic energy system model, with a focus on people's attitudes towards residential heating technologies. We also offer a comprehensive literature review on interdisciplinary energy transitions modelling and exploratory scenarios embedding climate risks perceptions. We argue that efficient policy-making to meeting net-zero emissions targets must fully embrace whole-system approaches, support the more constrained segments of society, and account for interconnected socio-political factors