Adenoid cystic carcinoma misinterpreted as antrochoanal polyp: A rare presentation

Adenoid cystic Carcnoma (ACC) is an uncommon malignant tumour accounting for < 1% of all oral and maxillofacial tumors. However, in the sinonasal tract, ACC is the most common salivary gland tumor. The sinonasal ACC is asymptomatic initially or causes non-specific  symptoms that are similar to those caused by inflammatory sinus disease and local neurological symptoms such as trigeminal neuralgia in advance stage due to perineural invasion by the tumour.We present a case of 35-year-old female who presented with complaints of nasal obstruction and headache. CT scans revealed an antrochoanal polyp without any bony involvement. The histopathological examination revealed unremarkable respiratory epithelium with underlying sheets and acini of small hyperchromatic cells with hyaline-like material in the lumina, confirming adenoid cystic carcinoma. The highlight of this case is that sinonasal polyps are not always inflammatory in origin, these can be neoplastic also. &nbsp

Bridge deck flutter derivatives: efficient numerical evaluation exploiting their interdependence

Increasing the efficiency in the process to numerically compute the flutter derivatives of bridge deck sections is desirable to advance the application of CFD based aerodynamic design in industrial projects. In this article, a 2D unsteady Reynolds-averaged Navier-Stokes (URANS) approach adopting Menter׳s SST k-ω turbulence model is employed for computing the flutter derivatives and the static aerodynamic characteristics of two well known examples: a rectangular cylinder showing a completely reattached flow and the generic G1 section representative of streamlined deck sections. The analytical relationships between flutter derivatives reported in the literature are applied with the purpose of halving the number of required numerical simulations for computing the flutter derivatives. The solver of choice has been the open source code OpenFOAM. It has been found that the proposed methodology offers results which agree well with the experimental data and the accuracy of the estimated flutter derivatives is similar to the results reported in the literature where the complete set of numerical simulations has been performed for both heave and pitch degrees of freedom

Induction of T Lymphocytes Specific for Bovine Viral Diarrhea Virus in Calves with Maternal Antibody

Passive antibody to bovine viral diarrhea virus (BVDV) acquired through colostrum intake may interfere with the development of a protective immune response by calves to this virus. The objective of this study was to determine if calves, with a high level of maternal antibody to bovine viral diarrhea virus (BVDV), develop CD4+, CD8+, or γδ T lymphocyte responses to BVDV in the absence of a measurable humoral immune response. Colostrum or milk replacer fed calves were challenged with virulent BVDV at 2-5 weeks of age and/or after maternal antibody had waned. Calves exposed to BVDV while passive antibody levels were high did not mount a measurable humoral immune response to BVDV. However, compared to nonexposed animals, these animals had CD4+, CD8+, and γδ T lymphocytes that were activated by BVDV after exposure to in vitro BVDV. The production of IFNγ by lymphocytes after in vitro BVDV exposure was also much greater in lymphocytes from calves exposed to BVDV in the presence of maternal antibody compared to the nonexposed calves. These data indicate that calves exposed to BVDV while maternal antibody levels are high can develop antigen specific CD4+, CD8+, and γδ T lymphocytes in the absence of an active antibody response. A manuscript presented separately demonstrates that the calves with T lymphocytes specific for BVDV in this study were also protected from virulent BVDV genotype 2 challenge after maternal antibody became undetectable

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. Funding: Bill & Melinda Gates Foundation

A 25-year record of carbon sequestration and soil properties in intensive agriculture

As a major carbon pool on earth, soil organic carbon may act either as a sink or a source of atmospheric CO$_{2}$, a greenhouse gas. Soil organic carbon is also impacting fertility, and, in turn, crop yields. However, knowledge of the impact of cropping techniques on the long-term behavior of soil carbon is scarce. Several studies have shown that continuous cropping decreases soil organic carbon stocks, rapidly in the initial years then at a slower rate, approaching a new equilibrium after 30 to 50 years. For instance, a study of intensive corn cropping for 35 years on temperate soils showed a 50% decrease in soil organic carbon. Our study is located in the North Indian state of Punjab. It is the most intensively cultivated region in the country with a cropping intensity of 190%, predominantly of a rice-wheat system. Due to high nutrient demand and its continuous cultivation, the cropping system is presumed to adversely affect soil organic carbon and other soil properties. However, this has been postulated without any real-time data analysis on a regional scale. Therefore, we evaluated soil data for 25 years from 1981/82 to 2005/06 to investigate the impact of intensive agriculture on C sequestration and soil properties on a regional scale. The results showed that, unexpectedly, intensive agriculture has resulted in improved soil organic carbon (SOC) status. As a weighted average for the whole state, SOC increased from 2.9 g kg$^{-1}$ in 1981/82 to 4.0 g kg$^{-1}$ in 2005/06, an increase of 38%. Increased productivity of rice and wheat resulted in enhanced C sequestration in the plough layer by 0.8 t C ha$^{-1}$ per ton of increased grain production. Soil pH declined by 0.8 pH units from 8.5 in 1981/82 to 7.7 in 2005/06. This pH decline has positive implications for availability of phosphorus and micronutrients such as Zn, Fe and Mn. Changes in plant-available P in soil were related to the amount of fertilizer P applied. The status of available P in soils increased from 19.9 kg ha$^{-1}$ in 1981/82 to 29.2 kg P ha$^{-1}$ during 2005/06. The status of plant-available K in soil remained almost unaltered and averaged 106 and 123 mg kg$^{-1}$ soil in 1981/82 and 2005/06, respectively. The analysis showed that intensive cultivation of a rice-wheat system unexpectedly resulted in improved C sequestration, a favorable pH environment and amelioration of the soil salinity

Anxiety, alexithymia and attitude to the disease in children with severe bronchial asthma

The study of psychological characteristics of the children with bronchial asthma (BA) is extremely relevant in determining the severity of the course of the disease. The purpose of the study was to examine associations between BA severity and personal psychological characteristics. Levels of state (SA), trait (TA) and school anxiety (ScA) with self-reported State Trait Anxiety Inventory (Spielberger and Hanin), School Anxiety Inventory (Phillips) were examined, a Bekhterev institute personality questionnaire (LOBI) was used in order to diagnose the types of attitudes to BA, an adapted Toronto Alexithymia Scale (by G. Taylor) was used to detect alexithymia. The first clinical group was formed by 32 children with severe BA, and the II group of comparison included 30 children with moderate BA (GINA). High TA scores were observed in 26.6±1.7% of patients with severe BA versus 9.1±6.1% of children in control group (OR=4,0; 95%CI:0,75-21,2). High SA scores were revealed in 25±8.2% versus 22.7±8.3% of patients with severe and nonsevere BA correspondingly (p>0.05). The patients’ TA levels were associated with more severe children’s fears (r=0.3; p<0.03) and the presence of early warning signs of the BA attack (r=0.3; p <0.04). The experience of child’s social stress was associated with night attacks (r = 0.27; p <0.04). The higher level of ScA correlated with a child’s negative attitude to the need of daily medicines use (r=0.3; p<0.03) and higher scores of the bronchial lability (r=0.36; p<0.01). The high level of SA was a predictor of the lower efficacy of control treatment with inhaled corticosteroids (r=-0.6; p<0.02). The mean scores of the Toronto Alexithymia Scale were 71.2±2.1 versus 70.3±2.7 in groups of comparison (p>0.05), however, the presence of alexithymia correlated with the number of asthma attacks per year (r=0.36; p<0.05), the negative attitude toward hospitalization (r=0.37; p<0.04) and the need of daily intake of drugs (r=0.26; p<0.05). The neurasthenic and / or sensitized type of attitude to the disease was more often noted in children with severe asthma (OR=5.3; 95% CI:1.3-24.7), and euphoric / anosognosic types of attitudes were associated with lower levels of disease control and non-compliance to basic therapy. Thus, there was a tendency to higher TA, ScA and presence of the neurasthenic and / or sensitized type of attitude to the disease in children with severe BA

Soil temperature and horticultural traits as influenced by mulching materials and orchard floor management practices in ber (Zizypus mauritiana Lamk.)

Different type of mulches viz. paddy straw mulch (PSM), black polythene mulch (BPM), and white polythene mulch (WPM) were spreaded under the canopies of Indian ber (Zizypus mauritiana Lamk.) trees in second fortnight of October. The treatments of inter-cultivation (IC) and chemical weed management (CWM), and control trees were also kept for comparative analysis. The daily soil temperature recorded at 0900, 1200, 1400 and 1700 hours from October to April months during 2018-19 and 2019-20 revealed significant variations under different treatments. The respective soil temperature variation during 1st and 2nd year was minimum (9.2 and 9.9 oC) under PSM as compared to 16.5 oC in control plots throughout the investigation period. The soil temperature under PSM was higher during extreme winters whereas, it was comparatively lower during pre and post-winter season as compared to other treatments.The variations in intra-day average soil temperature during the months of October-November and again in March-April was higher than in December-February; the period of extreme winters. Significant reduction in physiological fruit drop was recorded under all the treatments with minimum fruit drop under PSM followed by BPM, while it was maximum in control trees. Likewise, fruit weight and fruit yield was also recorded highest under PSM followed by BPM treatments. The microbes in the rhizopshere of mulched trees with PSM followed by BPM exhibited highest and sustained activity from from Otober to April month under North-West Indian conditions