Hemangiomatous Ameloblastoma: A Rare Variant

Ameloblastoma is a true neoplasm of enamel organ type tissue. It is the most common odontogenic neoplasm with more frequency in the mandible. A 20 years old male patient presented with a swelling in the right side of the mandible of 10 months duration. Orthopantomograph revealed multilocular radiolucency extending from the region of 46 to the condyle. Incision biopsy revealed features of plexiform ameloblastoma. Numerous vascular spaces of varying size were seen throughout the stroma. Excision biopsy also revealed similar findings. Based on these findings, a diagnosis of hemangiomatous plexiform ameloblastoma was made. Hemangiomatous ameloblastoma (HA) is still a controversial entity, with some pathologists ruling it out as a  separate lesion. This paper discusses the possibility that HA might be an aggressive variant of ameloblastoma and reviews relevant literature.&nbsp

Irrigation application efficiency and uniformity of water distribution using multi-outlet pipe and resource conservation technologies

Irrigation experiments were conducted during November to April under wheat crop in the winter season of 2012-13 and 2013-14 in the farmer’s field at Galibkhedi village located in Karnal District, Haryana State, India. In the study, collapsible multi-outlet pipe (MOP) along with single outlets pipe (SOP) was tested in farmer’s field under wheat cultivation. Irrigation was carried out in five treatments including tillage (T) with SOP and MOP; zero-tillage (ZT) with SOP and MOP, and furrow irrigation with raised bed (FIRB). Iso-time profile of waterfront spreading and advance indicated that irrigation water distribution was uniform under the plot irrigated using MOP as compared to plot irrigated using SOP. In addition, water distribution was uniform under zero tilled plots as compared to tilled plot. Results implied that MOP has several advantages over SOP in terms of application efficiency (AE) and uniformity of water distribution. Average application efficiency for the first study year was found to be in the order of ZT-MOP (82.41%) > FIRB (76.79%) > ZT-SOP (75.25%) > T-MOP (74.85%) > T-SOP (69.79%). Average application efficiency for the second study year was found to be in the same order as first year with some deviation in values. In the second year values of mean application efficiencies were ZT-MOP (82.58%) > FIRB (77.13%) > ZT-SOP (73.04%) > T-MOP (69.65%) > T-SOP (66.13%). Overall, this study concludes that irrigation under wheat crop using collapsible multi-outlet pipe (MOP) with zero tillage practices is a suitable option for surface irrigation that accomplishes uniform distribution of water with higher application efficiency

Evaluation of groundwater quality and its suitability for drinking and agricultural use in Thanjavur city, Tamil Nadu, India

As groundwater is a vital source of water for domestic and agricultural activities in Thanjavur city due to lack of surface water resources, groundwater quality and its suitability for drinking and agricultural usage were evaluated. In this study, 102 groundwater samples were collected from dug wells and bore wells during March 2008 and analyzed for pH, electrical conductivity, temperature, major ions, and nitrate. Results suggest that, in 90% of groundwater samples, sodium and chloride are predominant cation and anion, respectively, and NaCl and CaMgCl are major water types in the study area. The groundwater quality in the study site is impaired by surface contamination sources, mineral dissolution, ion exchange, and evaporation. Nitrate, chloride, and sulfate concentrations strongly express the impact of surface contamination sources such as agricultural and domestic activities, on groundwater quality, and 13% of samples have elevated nitrate content (>45 mg/l as NO3). PHREEQC code and Gibbs plots were employed to evaluate the contribution of mineral dissolution and suggest that mineral dissolution, especially carbonate minerals, regulates water chemistry.Groundwater suitability for drinking usage was evaluated by the World Health Organization and Indian standards and suggests that 34% of samples are not suitable for drinking. Integrated groundwater suitability map for drinking purposes was created using drinking water standards based on a concept that if the groundwater sample exceeds any one of the standards, it is not suitable for drinking. This map illustrates that wells in zones 1, 2, 3, and 4 are not fit for drinking purpose. Likewise, irrigational suitability of groundwater in the study region was evaluated, and results suggest that 20% samples are not fit for irrigation. Groundwater suitability map for irrigation was also produced based on salinity and sodium hazards and denotes that wells mostly situated in zones 2 and 3 are not suitable for irrigation. Both integrated suitability maps for drinking and irrigation usage provide overall scenario about the groundwater quality in the study area. Finally, the study concluded that groundwater quality is impaired by man-made activities, and proper management plan is necessary to protect valuable groundwater resources inThanjavur city

Ice Shapes on a Tail Rotor

Testing of a thermally-protected helicopter rotor in the Icing Research Tunnel (IRT) was completed. Data included inter-cycle and cold blade ice shapes. Accreted ice shapes were thoroughly documented, including tracing, scanning and photographing. This was the first time this scanning capability was used outside of NASA. This type of data has never been obtained for a rotorcraft before. This data will now be used to validate the latest generation of icing analysis tools

Assessment on performance and emission characteristics of the CRDI engine fueled with ethanol/diesel blends in addition to EGR

In this research, the CRDI engine characteristics were analyzed with the aid of exhaust gas recirculation rate (EGR) adoption fueled with ethanol blends. The test fuels were the various blends with ethanol, such as (10% of ethanol + 90% of diesel) E10D90 (20% of ethanol + 80% of diesel), E20D80, and (30% of ethanol + 70% of diesel) E30D70. From the results, it was revealed that performance characteristics were reduced when using a higher concentration of the alcohols mixed with diesel fuel. The blend E30D70 showed that brake thermal efficiency (BTE) without EGR drops by 3.8%, increased by 9.14% of BSFC, a 9.25% decrease in oxides of nitrogen emissions, and slightly decreased CO and HC emissions compared to baseline diesel operation at 60% load condition. The blend E10D90 with 20% EGR shows the highest BTE of 8.87% when compared with base fuel, due to proper fuel mixture taking place in the inlet manifold. The results indicate that the engine runs smoothly, and E30D70 has chosen an optimum blend. A further experiment was performed using E30D70 with different rates of exhaust gas recirculation system. The addition of exhaust gas recirculation with E30D70 in the common rail diesel engine exhibits oxides of nitrogen emission, but in contrast, it was noticed to have inferior performance characteristics and drastically decreased HC and CO emissions. The hydrocarbon emission decreased E10D90, E20D80, and E30D70 at 60% load condition by 21.42%, 37.38%, and 48.76%, respectively. The blends E10D90, E20D80, and E30D70 decreased carbon dioxide by 7.9%, 30.08%, and 31.98%, respectively. The maximum reduction of NOx emission was observed at about 51.06% at an EGR rate of 20% with E30D70.http://www.hindawi.com/journals/ijceam2023Mechanical and Aeronautical Engineerin

High-grade Endometrial Carcinomas: Morphologic and Immunohistochemical Features, Diagnostic Challenges and Recommendations

This review of challenging diagnostic issues concerning high-grade endometrial carcinomas is derived from the authors' review of the literature followed by discussions at the Endometrial Cancer Workshop sponsored by the International Society of Gynecological Pathologists in 2016. Recommendations presented are evidence-based, insofar as this is possible, given that the levels of evidence are weak or moderate due to small sample sizes and nonuniform diagnostic criteria used in many studies. High-grade endometrioid carcinomas include FIGO grade 3 endometrioid carcinomas, serous carcinomas, clear cell carcinomas, undifferentiated carcinomas, and carcinosarcomas. FIGO grade 3 endometrioid carcinoma is diagnosed when an endometrioid carcinoma exhibits >50% solid architecture (excluding squamous areas), or when an architecturally FIGO grade 2 endometrioid carcinoma exhibits marked cytologic atypia, provided that a glandular variant of serous carcinoma has been excluded. The most useful immunohistochemical studies to make the distinction between these 2 histotypes are p53, p16, DNA mismatch repair proteins, PTEN, and ARID1A. Endometrial clear cell carcinomas must display prototypical architectural and cytologic features for diagnosis. Immunohistochemical stains, including, Napsin A and p504s can be used as ancillary diagnostic tools; p53 expression is aberrant in a minority of clear cell carcinomas. Of note, clear cells are found in all types of high-grade endometrial carcinomas, leading to a tendency to overdiagnose clear cell carcinoma. Undifferentiated carcinoma (which when associated with a component of low-grade endometrioid carcinoma is termed "dedifferentiated carcinoma") is composed of sheets of monotonous, typically dyscohesive cells, which can have a rhabdoid appearance; they often exhibit limited expression of cytokeratins and epithelial membrane antigen, are usually negative for PAX8 and hormone receptors, lack membranous e-cadherin and commonly demonstrate loss of expression of DNA mismatch repair proteins and SWI-SNF chromatin remodeling proteins. Carcinosarcomas must show unequivocal morphologic evidence of malignant epithelial and mesenchymal differentiation

X-Linked thrombocytopenia causing mutations in WASP (L46P and A47D) impair T cell chemotaxis

BACKGROUND: Mutation in the Wiskott-Aldrich syndrome Protein (WASP) causes Wiskott-Aldrich syndrome (WAS), X-linked thrombocytopenia (XLT) and X-linked congenital neutropenia (XLN). The majority of missense mutations causing WAS and XLT are found in the WH1 (WASP Homology) domain of WASP, known to mediate interaction with WIP (WASP Interacting Protein) and CIB1 (Calcium and Integrin Binding). RESULTS: We analyzed two WASP missense mutants (L46P and A47D) causing XLT for their effects on T cell chemotaxis. Both mutants, WASP(R)(L46P) and WASP(R)(A47D) (S1-WASP shRNA resistant) expressed well in Jurkat(WASP-KD) T cells (WASP knockdown), however expression of these two mutants did not rescue the chemotaxis defect of Jurkat(WASP-KD) T cells towards SDF-1α. In addition Jurkat(WASP-KD) T cells expressing these two WASP mutants were found to be defective in T cell polarization when stimulated with SDF-1α. WASP exists in a closed conformation in the presence of WIP, however both the mutants (WASP(R)(L46P) and WASP(R)(A47D)) were found to be in an open conformation as determined in the bi-molecular complementation assay. WASP protein undergoes proteolysis upon phosphorylation and this turnover of WASP is critical for T cell migration. Both the WASP mutants were found to be stable and have reduced tyrosine phosphorylation after stimulation with SDF-1α. CONCLUSION: Thus our data suggest that missense mutations WASP(R)(L46P) or WASP(R)(A47D) affect the activity of WASP in T cell chemotaxis probably by affecting the turnover of the protein. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12929-014-0091-1) contains supplementary material, which is available to authorized users

Cutaneous Head and Neck Squamous Cell Carcinoma with Regional Metastases: The Prognostic Importance of Soft Tissue Metastases and Extranodal Spread

Extranodal spread (ENS) is an established adverse prognostic factor in metastatic cutaneous squamous cell carcinoma (cSCC); however, the clinical significance of soft tissue metastases (STM) is unknown. The aim of this study was to evaluate the prognosis of patients with STM from head and neck cSCC, and to compare this with that of node metastases with and without ENS. Patients with cSCC metastatic to the parotid and/or neck treated by primary surgical resection between 1987 and 2007 were included. Metastatic nodes > 3 cm in size were an exclusion criterion. A Cox proportional hazard model was used to determine the effect of STM adjusting for other relevant prognostic factors. The population included 164 patients with a median follow-up of 26 months. There were 8 distant and 37 regional recurrences. There were 22 were cancer-specific deaths, and 29 patients died. STM was a significant predictor of reduced overall (hazard ratio 3.3; 95% confidence interval 1.6-6.4; P = 0.001) and disease-free survival (hazard ratio 2.4; 95% confidence interval 1.4-4.1; P = 0.001) when compared to patients with node disease with or without ENS. After adjusting for covariates, STM and number of involved nodes were significant independent predictors of overall and disease-free survival. In metastatic cSCC of the head and neck, the presence of STM is an independent predictor of reduced survival and is associated with a greater adverse effect than ENS alone

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London