An Atypical Presentation of Lichen Planus-Like Reaction from Pembrolizumab.

Introduction:With the advent of immunotherapy, a new subtype of side effects called IRAEs or immune related adverse effects have become more common. They may present in various organ systems as colitis, pneumonitis, hypophysitis, and thyroiditis and commonly as dermatological reactions. Case:This is a case report of a lung cancer patient that was started on Pembrolizumab and developed shortly after what appeared to be clinically at first pustular psoriasis but on biopsy was confirmed to be lichen planus. She was discontinued on the Pembrolizumab and treated with both systemic and topical steroids and improved. Conclusion:This case highlights a cutaneous reaction from Pembrolizumab and the subsequent management that helped resolve her condition but also weighing the benefits against the risk of treatments and potential prognostic implications of having cutaneous side effects

Some Studies on life of Track Pin Rubber Bushes .

Track pin an important component in the tracks of heavy armoured vehicles is made of steel surrounded by rubber bush. This construction enables the pin to transmit the torsional loads. As the failure of track pin makes the vehicle immobilised, it is important to ensure a specified life for these pins. As the pin is made of rubber and steel, the theoretical studies become difficult. An attempt has been made to find out the parameters that influence the life of track pins. A finite element method is used to estimate the stresses in the rubber. The temperature rise due to the torsional loads, computed using the energy equation is found to be 64.86 °c for 1800 s at a speed of 30 km/hr. close to that obtained from actual field measurements

Optimizing Tissue Use: A Step-wise Approach to Diagnosing Squamous Cell Lung Carcinoma on Small Biopsies

© The Author(s) 2020. Background: Histologic subtyping of lung cancer has significant implications for treatment planning. Accurate diagnosis based on cytology/small biopsy specimens is challenging and frequently determined by morphology, as material is often not sufficient for immunohistochemical studies (IHC). We investigated the concordance between the rates of diagnosis from cytology/small biopsies compared with surgical specimens in patients with squamous cell lung cancer (SCC) and the utility of IHC for diagnostic precision in lung cancer subtyping. Methods: We conducted a 5-year retrospective analysis identifying cases of SCC diagnosed on cytology/small biopsies ± IHC and compared them with subsequent surgical specimens when available. The number of patients with SCC on surgical biopsy and the concordance between cytology ± IHC was determined. Results: Over the 5-year period (2011-2015), 231 cases were identified. Surgery was performed on 66 cases (28.5%), of which 87.9% concurred with cytological diagnosis (95% exact binomial confidence interval [CI] = 77.5%-94.6%). There were 36 cases diagnosed in 2014 and 2015 with IHC data. Of those cytology cases with IHC (n = 12), SCC was confirmed by surgery in 91.7% (95% CI = 61.5%-99.8%). Of those without IHC (n = 24), 95.8% were confirmed SCC by surgery (95% CI = 78.9%-99.9%). These rates were not different (Fisher exact test). All cases with IHC were morphologically squamous. Conclusions: Our data demonstrate that diagnostic precision of identifying SCC by cytology/small biopsy is comparable with or without additional IHC studies. We recommend judicious use of IHC on cytology specimens, reserving it for cases where cytomorphology is equivocal. Tissue should be preserved for molecular analysis, which may have therapeutic implications

Effect of differential uniform temperature with thickness-wise linear temperature gradient oninterfacial stresses of a bi-material assembly

The thermal mismatch induced interfacial stresses are one of the major reliability issues in electronic packaging and composite materials. Consequently an understanding of the nature of the interfacial stresses under different temperature conditions is essential in order to eliminate or reduce the risk of structural and functional failure. Approach: In this analysis, a model was proposed for the shearing and peeling stresses occurring at the interface of two bonded dissimilar materials with the effect of different uniform temperatures in the layers. The model was then upgraded by accounting thickness wise linear temperature gradients in the layers using two temperature drop ratios. The upgraded models were then compared with the existing uniform temperature model. The proposed model can be seen as a more generalized form to predict interfacial stresses at different temperature conditions that may occur in the layers. Results: The results were presented for an electronic bi-material package consisting of die and die-attach. Conclusion: The numerical simulation is in a good matching agreement with analytical results

Potential Of Renewable Wave And Offshore Wind Energy Sources In Malaysia.

Malaysia is a country vastly surrounded by water. Wave power and offshore wind power has been recognised by the international community as a renewable clean energy source. Analysis was conducted for the potential of wave energy and wind energy along the coastline of Malaysia from the data obtained by the Malaysia Meteorological Service (MMS) from 1985 to 2000

The Potential Of Wave And Offshore Wind Energy In Around The Coastline Of Malaysia That.Face The South China Sea.

The world wide estimated wave energy resource is more than 2 TW. Offshore wind speeds are generally higher than wind speeds over land, hence higher available energy resource. The estimated offshore wind potential in European waters alone is in excess of2500 TWh/annum. Offshore area also provides larger area for deploying wind energy devices. In recent year efforts to promote these two types of renewable and green energy sources have been intensify. Using the data obtained from the Malaysia Meteorological Service (MMS) analysis was conducted for the potential of wave energy and wind energy along the coastline of Malaysia facing the South China Sea. Maps of wave power potential were produced. The mean vector wind speed and direction were tabulated

Pretreatment nutritional status and response to checkpoint inhibitors in lung cancer.

Background:Checkpoint inhibitors are integral to non-small-cell lung cancer treatment. Existing data suggests that nutritional status may play a role in antitumor immunity. Materials & methods:This retrospective study of 106 non-small-cell lung cancer patients who started checkpoint inhibitors between 2014 and 2017 at our institution assessed relationship of nutritional parameters to overall survival (OS) and progression-free survival. Results:Mean age was 68.7 ± 9.2 years and 59.4% patients were male. On multivariate analysis for OS, hypoalbuminemia and significant weight loss were prognostic at p-values of 0.0005 and 0.0052, respectively. We noted a parabolic association between age and OS (p = 0.026, 0.0025). Conclusion:In our study, some malnutrition parameters were associated with decreased OS. U-shape relationship between age and OS noted here warrants further evaluation

A comprehensive review of contemporary literature for epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer and their toxicity

© 2020 Lee et al. Mutations in the epidermal growth factor receptor (EGFR) are common amongst those with non-small cell lung cancer and represent a major factor in treatment decisions, most notably in the advanced stages. Small molecule tyrosine kinase inhibitors (TKIs) that target the EGFR, such as erlotinib, gefitinib, icotinib, afatinib, dacomitinib and osimertinib, have all shown to be effective in this setting. Osimertinib, a third-generation EGFR TKI, is a favorable option, but almost all patients develop resistance at some time point. There are no effective treatment options for patients who progress on osimertinib, but ongoing trials will hopefully address this unmet need. The aim of this review is to provide a comprehensive review of the data with EGFR TKIs, management of the toxicities and the ongoing trials with this class of agents

Wind Characteristics Influencing Wind Energy.

Usually the wind speed for a particular site is given at a standard reference height of 10m. However, in the context of wind turbines, the hub height is a natural choice for estimating the power potential

Wind Characteristics Influencing Wind Energy.

Usually the wind speed for a particular site is given at a standard reference height of 10 m. However, in the context of wind turbines, the hub height is a natural choice for estimating the power potential