In 2011, with a probing tip functionalized with a CO molecule, internal details of molecular wavefunctions, the nodal structures, was experimentally observed and mapped in real space using scanning tunneling microscopy (STM). Together with the charge density contours of atomic and molecular wavefunctions directly observed and mapped by STM in the 2000s, wavefunctions are proven to be an observable physical field. A fact is, STM is a non-destructive imaging method, and the measurement process does not disturb the wavefunctions under observation. For many decades, wavefunction has been imagined as an abstract complex subject, not directly observable. The new developments showed that wavefunction is an observable, like electrical and magnetic fields. Those new developments enable a realistic interpretation of quantum mechanics, as advocated by Planck, Einstein, Schrödinger and de Broglie; and enable a significant simplification in teaching and learning quantum mechanics. (The original title was **Experimental Observation and Mapping of Atomic and Molecular Wavefunctions: Consequences on the Fundamental Understanding of Quantum Mechanics**).

PCOS is though to stem from prenatal exposures and seems to translate into increased comorbidity risk. The health insults, however, vary depending on the age. The presentation will go through the health risks related to PCOS over the lifespan.

Background: Invasive fungal sinusitis is a rare but possibly fatal complication of Covid-19 infection. We report an extremely rare case of invasive fungal sinusitis due to an uncommon pathogen, Alternaria. Case Presentation: Patient is a 49-year-old female with a history of poorly controlled diabetes presenting with right maxillary fungal sinusitis with abscess. One month prior, after recovering from COVID-19 pneumonia, she developed right facial swelling, diplopia, blurry vision, and pain with extraocular movements. She was admitted at an outside hospital for diabetic ketoacidosis and facial cellulitis with right maxillary sinusitis, which was treated with piperacillin-tazobactam and vancomycin. She also received micafungin for possible fungal infection, which was discontinued after culture showed no growth at 1 week. Later, the patient had progressive facial symptoms prompting her to return to the emergency room. MRI of the orbit showed acute abscess with concerns for meningeal involvement in her right orbital structures and she was restarted on antibiotics. Fungal culture from prior admission was noted to have grown Alternaria species. She was transferred to our hospital and was treated with multiple surgical debridements and 2 weeks of voriconazole, amphotericin B, and daptomycin with improvement in her symptoms. She was discharged to a SNF to continue receiving treatment. Discussion: While studies on fungal sinusitis in association with COVID-19 have been limited, Mucor and Aspergillus appear to be the most common pathogens. Possible risk factors for COVID-19 associated fungal sinusitis include steroid use, diabetes, renal failure, and hypertension. Alternaria is a dematiaceous hyphomycete commonly involved in human infection. The most frequent clinical manifestations are cutaneous and subcutaneous infections, followed by oculomycosis, rhinosinusitis, and onychomycosis. Important risk factors include solid organ transplantation, Cushing’s syndrome, and bone marrow transplants. A noted complication in the care of our patient was the delayed recognition of fungal sinusitis; her fungal culture did not show growth until after discharge. Many species involved in fungal sinusitis, including Alternaria, are detected after 1 week of culture; however, fungi can be detected after longer incubation periods. In patients with multiple risk factors and COVID-19 infection, it may be important to continue monitoring for fungal isolates, even if patients are improving clinically.

Background: Although Mycobacterium chelonae is ubiquitously found in the environment, cutaneous infections with M. chelonae are rarely reported. The few reported cases generally feature opportunistic infections in immunocompromised hosts. Due to its uncommon nature, providers often overlook this mycobacterium as the causative agent of a painful erythematous rash in their differential diagnosis. This case highlights common presentations and features of M. chelonae infection and demonstrates the importance of looking to ordinarily benign organisms as harmful and virulent in our immunocompromised population. Case Presentation: A 48-year-old female with refractory Behçet’s disease, maintained on methylprednisolone and apremilast, presented for a painful rash on her left lower extremity. She reported two months of tender nodules spreading from her ankle up to her medial thigh. Exam revealed erythematous and violaceous nodules in a sporotrichoid pattern. Three skin biopsies were performed over a period of two months; the first two were inconclusive, while the third showed marked dermal and subcutaneous inflammation with microabscess formation. Fite and AFB stains highlighted acid fast organisms. Subsequent acid-fast bacilli tissue culture grew M. chelonae. The patient was initiated on triple antibiotic therapy with tobramycin, linezolid, and clarithromycin; however, her course was complicated by drug-induced liver injury. She was then transitioned to tobramycin and imipenem, leading to acute kidney injury and rhabdomyolysis. This prompted a final shift to imipenem and omadacycline, which was ultimately successful in resolving the rash. Discussion: Although cutaneous infections with M. chelonae and other atypical mycobacteria are rare, providers should maintain a high level of suspicion in immunocompromised patients presenting with skin lesions, especially in a sporotrichoid pattern. Violaceous nodules in immunocompromised hosts should always warrant an infectious work-up. The diagnosis of atypical mycobacterial cutaneous infections in a timely fashion may be challenging. Multiple representative biopsies may be required for histopathological examination, which should include acid-fast staining, followed by routine bacterial and mycobacterial culture to achieve the most accurate diagnosis.

Background Orthopaedic surgery has been an increasingly popular field for medical students. Many schools offer elective time to explore areas of interest through clinical rotations and research; however, most are reserved for senior medical students. The purpose of this study was to evaluate the impact of a dedicated orthopaedic surgery symposium to increase awareness about the field, and to assess students’ interest and knowledge of orthopaedic surgery before and after the symposium. Methods A one-day free, virtual medical student orthopaedic surgery symposium was organized. Abstracts were reviewed and selected from nine different orthopaedic subspecialty categories. Survey assessments were sent to medical students to complete before and after the symposium. The survey included questions related to participant demographics, as well as interest and knowledge about the field of orthopaedic surgery. Statistical analyses were completed to compare the participants’ responses before and after the symposium. Results In total, 962 medical students registered for the four-hour symposium. Of these, 58.5% completed the pre-symposium survey, and 48.0% completed the post-symposium survey. 13.3% of the respondents reported being “very knowledgeable” about the various orthopaedic surgery subspecialties before the symposium, which increased to 18.4% after the symposium (p=0.137). 46.9% of the participants stated that they were “knowledgeable” about the daily life of an orthopaedic surgery resident before the symposium, which increased to 67.3%, post-symposium (p<0.001). Similarly, the percentage of respondents who reported that they were “very knowledgeable” about the residency match process increased from 12.2% pre-symposium to 22.4% post-symposium (p<0.001). 61.7% and 80.5% of participants reported being “very satisfied” with the breakout room sessions and the educational panels respectively, with 84% of participants reporting they would recommend the symposium to others. Conclusions As the interest in a career in orthopaedic surgery increases, medical students desire access to information, mentorship, and opportunities to present their research in preparation for residency applications. Our study demonstrated that a large-scale national orthopaedic surgery symposium provided a platform to augment medical students’ knowledge of the field, present their research, and interact with faculty members.

Background Asylum seekers face significant and unique healthcare challenges, requiring healthcare practitioners specifically trained in caring for this patient population. However, there is limited understanding of medical students’ interest in and future ability to care for the population of asylum seekers in the United States. We aim to better understand U.S. medical students’ interest, experience, and knowledge in providing care for asylum seekers to inspire change in the ways in which medical schools introduce asylum seeker care to learners. Methods A 23-question survey was administered to U.S. medical students at four institutions with asylum programs affiliated with Physicians for Human Rights (PHR) from June 2020 to March 2021, querying various aspects of providing care to asylum seekers. Results Of the approximately 2846 students who received the survey, 436 students (15%) completed it in its entirety. Most respondents desired training about caring for asylum seekers (91%). Over half (52%) rated their knowledge of asylum issues overall as “poor” or “none," and 73% thought their medical school's curriculum on asylum seeker health needed improvement. Conclusion This study demonstrated that medical students at schools with affiliated asylum clinics desire to care for asylum patients but feel unprepared to do so, highlighting an unmet need for formal asylum education in U.S. medical schools.