Mediastinal masses - the bad, the ugly and the unusual!

Background: Differential diagnosis of mediastinal masses is wide and management of individual cases can be challenging. In addition to common malignancies e.g. lymphomas and thymomas. Many other benign and malignant conditions can present with mediastinal masses. Patients and Methods: We describe five patients with a diagnosis of mediastinal mass. We wish to showcase the range of diagnosis possible in these situations. This is followed by a brief discussion on the general approach to such cases. Conclusion: A good history, detailed careful clinical examination, judicious use of imaging and investigations e.g. blood counts and tumour makers can give a vital clue to the diagnosis of mediastinal mass

RLOps:Development Life-cycle of Reinforcement Learning Aided Open RAN

Radio access network (RAN) technologies continue to witness massive growth, with Open RAN gaining the most recent momentum. In the O-RAN specifications, the RAN intelligent controller (RIC) serves as an automation host. This article introduces principles for machine learning (ML), in particular, reinforcement learning (RL) relevant for the O-RAN stack. Furthermore, we review state-of-the-art research in wireless networks and cast it onto the RAN framework and the hierarchy of the O-RAN architecture. We provide a taxonomy of the challenges faced by ML/RL models throughout the development life-cycle: from the system specification to production deployment (data acquisition, model design, testing and management, etc.). To address the challenges, we integrate a set of existing MLOps principles with unique characteristics when RL agents are considered. This paper discusses a systematic life-cycle model development, testing and validation pipeline, termed: RLOps. We discuss all fundamental parts of RLOps, which include: model specification, development and distillation, production environment serving, operations monitoring, safety/security and data engineering platform. Based on these principles, we propose the best practices for RLOps to achieve an automated and reproducible model development process.Comment: 17 pages, 6 figrue

Role of Nanoparticles in Abiotic Stress

Nanotechnology is currently seeking much attention of researchers because of their wide applications in diverse sectors including agriculture. The influence of nanoparticles on physiological state of plants at the different levels of their organization, beginning from molecular, has been studied at various plants. It is known that nanoparticles in different concentrations can impact both positive and negative biological effects. Nanomaterials confer profound uses for sustainable crop production, reducing loss of nutrients, suppression of diseases and thereby enhancing the yields. Concerning the role of nanomaterials in alleviating the damage of plant abiotic stresses or in inhibiting plant growth and its toxicity, further studies are essential under different levels including plant molecular and cellular levels. A wide variety of research has been conducted to study plant responses to waterlogging stress that include various disciplines like molecular, biochemical, and physiological, anatomical and morphological examinations. Nano technological implications for curbing water-logged conditions recently came into limelight and have drawn much attention in the last few years. Nanotechnology is defined as the systems and processes which operate at a scale of 100 nm or less. Nanotechnology has many applications in the field of agriculture. There are majority of nano-materials which are known for its plant growth promoting effects. Nanoparticles have unique physiochemical properties such as high reactivity, particle morphology, and large surface area. They also boost the plant metabolism

A Rare Case of Missing Primary in Metastatic Renal Cell Carcinoma

Renal cell carcinoma (RCC) can present with a myriad of clinical symptoms and signs. It is also notorious for its initial presentation with distant metastasis. We report a case of a 42-year-old male diagnosed with papillary RCC (PRCC) presenting with pleural and nodal metastases in the absence of a radiographically-detected tumor primary. PRCC was diagnosed on immunohistochemical analysis of the tissue from the pleura and mediastinal lymph nodes and confirmed by gene expression profiling studies. As per treatment guidelines for metastatic RCC, the patient was started on sunitinib with evidence of disease progression after two cycles and palliative care approach was recommended due to rapidly declining performance status. Prospective data on the optimal management of metastatic PRCC are lacking, but drugs used are similar to the treatment of clear cell carcinomas (vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors) and checkpoint inhibitors. Further molecular study of these rare tumors is warranted to detect drivers of oncogenesis and identify targets for therapeutic intervention

Identification of Epidermal Growth Factor Receptor Tyrosine-Kinase Mutations in Non-small Cell Lung Cancer: Testing Platform Matters

Personalized medicine using targeted therapies has revolutionized the management of non-small cell lung cancer (NSCLC) in the past decade. The discovery that sensitizing epidermal growth factor receptor (EGFR) mutations are predictive for therapeutic benefit from EGFR tyrosine kinase inhibitors (TKIs) such as erlotinib marked the beginning of a new era in lung cancer therapeutics. Indeed, EGFR mutation testing is category A recommendation at the time of diagnosis for patients presenting with advanced-stage NSCLC. In our case, the original report of EGFR mutation testing using pyro-sequencing from the initial biopsy was reported out as wild-type/no mutation seen in the hot spots. However, the tumor had a long duration of response to erlotinib but later developed resistance, hence there was a high index of suspicion. Consequently, it was decided to retest the tumor with more sensitive technology. Next generation sequencing identified exon 19 deletion - a sensitizing mutation. This explained the excellent response on initiating erlotinib, however, exon 21 mutation was also reported which confers resistance to TKI. The case shows that test sensitivity can have a great impact on treatment decisions and if there is a high index of suspicion, initial testing and, or retesting using newer more sensitive technology should be considered