Pneumonitis is a common and potentially deadly complication of combined chemoradiation and immune checkpoint inhibition (CRT-ICI) in patients with locally advanced non-small cell lung cancer ...(LA-NSCLC). In this study we sought to identify the risk factors for pneumonitis with CRT-ICI therapy in LA-NSCLC cases and determine its impact on survival.
We conducted a retrospective chart review of 140 patients with LA-NSCLC who underwent curative-intent CRT-ICI with durvalumab between 2018 and 2021. Pneumonitis was diagnosed by a multidisciplinary team of clinical experts. We used multivariable cause-specific hazard models to identify risk factors associated with grade ≥2 pneumonitis. We constructed multivariable Cox proportional hazard models to investigate the impact of pneumonitis on all-cause mortality.
The median age of the cohort was 67 years; most patients were current or former smokers (86%). The cumulative incidence of grade ≥2 pneumonitis was 23%. Among survivors, 25/28 patients had persistent parenchymal scarring. In multivariable analyses, the mean lung dose (hazard ratio 1.14 per Gy, 95% confidence interval 1.03–1.25) and interstitial lung disease (hazard ratio 3.8, 95% confidence interval 1.3–11.0) increased the risk for pneumonitis. In adjusted models, grade ≥2 pneumonitis (hazard ratio 2.5, 95% confidence interval 1.0–6.2, P = 0.049) and high-grade (≥3) pneumonitis (hazard ratio 8.3, 95% confidence interval 3.0–23.0, P < 0.001) were associated with higher all-cause mortality.
Risk factors for pneumonitis in LA-NSCLC patients undergoing CRT-ICI include the mean radiation dose to the lung and pre-treatment interstitial lung disease. Although most cases are not fatal, pneumonitis in this setting is associated with markedly increased mortality.
•Cohort of 140 patients with locally advanced non-small cell lung cancer.•Thoracic radiation dose and pre-existing interstitial lung disease were the best predictors of grade ≥ 2 pneumonitis.•Pneumonitis, especially if grade ≥ 3, is a significant predictor of mortality.•Grade ≥ 3 pneumonitis is associated with a high incidence of permanent lung fibrosis.
In this work, the IR thermography was used to study the steel specimens (DIN 50125 Standard) undergoing the tensile tests. The tensile tests were performed using GUNT® Hamburg Universal Material ...Tester. The tensile specimens were clamped, and the test force was generated using a handoperated hydraulic system. A dial gauge measured the elongation of the specimens. Using the WP 300.20 system for data acquisition, the measured values for force and displacement were recorded in a PC. The IR thermographic imaging was performed using the FLIR® T1030sc IR camera and ResearchIR Max software. The steel specimens were coated with high emissivity paint. Thermography revealed that the steel specimens show noticeable thermal signature when undergoing tensile loading. The samples were found to be warmer by 20-25 °C at the time of failure. The tests were repeated under various surrounding temperatures such as 25 °C, -5 °C, -10 °C, -15 °C, and -20 °C. The same study was compared with the finite element numerical simulation in ANSYS® Workbench. The experimental and simulation results were found to be in a qualitative agreement.
Background: The association of treatment failure and mortality with vancomycin minimum inhibitory concentration creep (MIC) is a matter of serious concern in patients with severe methicillin ...resistant Staphylococcus aureus (MRSA) infections. The purpose of the study was to identify and characterize staphylococcal cassette chromosome mec (SCCmec) and clonal types of MRSA strains, exhibiting the vancomycin MIC creep phenomenon. Methods: A total of 3305 S. aureus strains were isolated from various clinical samples of Lahore General Hospital, Lahore, Pakistan. MRSA strains were identified by cefoxitin resistant (less than or equal to 21mm) followed by mecA and mecC gene genotyping. Vancomycin MIC creep was determined by E-test. Isolates having MIC values >1.5 microg/mL were further subjected for SCCmec typing (I-V and XI) and multiple-locus variable number tandem repeat analysis (MLVA) by amplification of spa, sspA, clfA, clfB, and sdrCDE genes. A dendrogram was created based on the similarity index using bioneumerics software. Results: About 13.3% (440/3305) isolates were MRSA with 99.3% (437/440) and 0.7% (3/440) carried mecA and mecC genes, respectively. In 120 MRSA isolates, the MIC of vancomycin was >1.5microg/mL. In MRSA isolates with high vancomycin MIC (>1.5microg/ mL), the most common SCCmec type was SCCmec III (38.3%), followed by SCCmec IVa (15.8%), SCCmec IIIa (13.3%,), SCCmec IVc (7.5%), SCCmec IVe (5.8%), SCCmec IVd (5.8%), SCCmec IVb (4.2%), SCCmec II (2.5%), SCCmec V (1.7%), SCCmec I (1.7%) and SCCmec XI (1.7%). MLVA revealed 60 genotypic groups of MRSA isolates having a 92% similarity index. Conclusion: SCCmec III was the most common type in genetically related MRSA isolates showing vancomycin MIC creep. The presence of SCCmec XI may further add burden to infection control measures. Keywords: methicillin resistant Staphylococcus aureus, staphylococcal chromosomal cassette, multilocus variable number tandem repeat analysis
The paper reviews thermographic and vibrothermography applications such as cold climate operations, determine the temperature profile of steel samples under tensile testing and perform composites ...Non-Destructive Testing (NDT). This review paper discusses studies, where IR thermography has been used effectively in research and development projects at the UiT The Arctic University of Norway and AGH UST. The applications discussed in this work are to determine:
- Thermal conductivity and heat transfer coefficient of freshwater and marine ice
- An industrial solution for detecting icing
- Relative required insulation (IREQ) of apparels
- Variation of tensile strength and surface temperature of steel samples under tensile testing under cold temperatures
- Vibrothermography for Non-Destructive Testing (NDT) of composites
In wavelet analysis, the signal reconstruction and statistical estimators are strongly influenced by the wavelet shape that controls the time-frequency localization properties. However, this ...dependency does not imply that the wavelet form is physically relevant to extract spatially invariant wavelet-based shape signatures. A new statistical estimator is proposed in order to quantify the influence of the wavelet on the spatial detection. This indicator is then used to analyze signals obtained from the topography of abraded surfaces. It is shown that the Coiflet wavelet is physically adapted to reproduce the elementary mechanical process which creates the abrasion of the surface. Using 8 different wavelets, the analysis of the signal obtained by scanning the abraded surface leads to the same spatial localization regardless the parameters of the abrasive process and whatever the wavelet shapes. No statistical difference related to the type of wavelets is found between the indicators (RMS, spectral moments…) extracted from the reconstructed signals calculated on different scales and for various abrasive processes. If the wavelet decomposition is seen as a multiscale microscope, a surface can be seen in different ways according to the type of wavelets. However, the morphological changes of the surface caused by external mechanical causes and characterized by several statistical parameters are statistically similar regardless the shape of the wavelets.
Synoptic of the wavelet analyses applied on the ground surfaces obtained by the belt finishing process. Display omitted
•Abraded surfaces are composed of a succession of scratches with different depths.•All wavelets localize the relevant scales for all processes of abrasion.•The values of roughness parameters depend on the wavelet forms.•The Coiflet wavelet well distinguishes an elementary scratch of abrasion.•For a large databank of signal, abrasion effects do not depend of the wavelet shape.
In this study, a numerical weak coupling strategy for the modeling of a conjugate heat transfer phenomenon is considered. Where the incompressible Navier-Stokes equations are solved using the ...Semi-Implicit Method for Pressure Linked Equations (SIMPLE) as a first step, and then the heat conduction equation for solid is solved in a second step considering the convective velocity field resulting from the first step. A finite-difference approach is used for both discretized time and spatial operators. In this paper, a two-dimensional simulation case study of a steady uniform streamwise flow around heated rectangular and triangle solids is presented. The simulation is forward in time until the steady-state regime is reached as the residuals converge and tend to zero. The spatial analysis of the temperature is obtained through the numerical resolution of the incompressible Navier-Stokes energy equation and the heat diffusion equation for the fluid and solid media, respectively. The results show the temperature, velocity, and pressure fields in the space domain. The code is written in MATLAB®, and the flow chart of the method is provided. It was noted that the convection was more dominant than the diffusion.
Composite materials are becoming more popular in technological applications due to the significant weight savings and strength these materials offer compared to metallic materials. In many of these ...practical situations, the structures suffer from drop impact loads. Materials and structures significantly change their behavior when submitted to impact loading conditions as compared to quasi-static loading. The present work is devoted to investigating the elastic strain wave in Carbon-Fiber-Reinforced Polymers (CFRP) when subjected to a drop test. A novel drop weight impact test experimental method evaluates parameters specific to 3D composite materials during the study. A strain gauge rosette is employed to record the kinematic on the composites' surface. Experimental results were validated through numerical analysis by FDM Numerical Simulations in Matlab® and Ansys Explicit Dynamic Module. A MATLAB® code was developed to solve wave equation in a 2-D polar coordinate system by discretizing through a Forward-Time Central-Space (FTCS) Finite Difference Method (FDM). Another FEA analysis was performed in ANSYS® Workbench Explicit Dynamics module to simulate the elastic waves produced during the DWIT. The study demonstrates that the elastic waves generated upon impact with a 33 g steel ball from a height of 1 m in a quasi-isotropic CFRP sheet give a strain wave frequency of 205 Hz and finish in almost 0.015 s due to a significant damping effect. Numerical simulations were in good agreement with the experimental findings.
The harsh climate of the Arctic has always posed significant challenges to car drivers. The severe loss in traction due to snow and icing on the roads has led to an increased risk of collisions. The ...purpose of this work is to replace the conventional air-filled tire with a non-pneumatic tire to improve the grip in the Arctic conditions. The grip obtained for tires is determined by the weight of the car and the friction between the tire and the road. The friction coefficient, used to determine friction, is a function of the contact pressure. This research work involve obtaining a concentrated pressure profile for the airless tire, compared to a conventional tire. A finite element analysis using ANSYS® Workbench, is performed on two distinct models. The different pressure profiles of the models are analyzed, and the results proved the non-pneumatic tires have a more concentrated pressure profile with higher pressure values.
OBJECTIVES
Video-assisted thoracoscopic surgery (VATS) for thymoma has uncertain safety and effectiveness in comparison with trans-sternal resection. This feasibility study compared short- and ...mid-term outcomes for patients undergoing these two procedures, highlights weaknesses in current research and makes recommendations for long-term technological evaluations in this field.
METHODS
Consecutive thymoma cases between 2004 and 2010 were identified. Patients were divided into two groups according to surgical approach (Group I trans-sternal; Group II VATS) and comparisons were made between groups. The primary outcome was overall survival. Secondary outcomes included operative morbidity and mortality, hospital stay, recurrence rate and disease-free survival.
RESULTS
Thirty-nine patients were included (Group I: n = 22 vs Group II: n = 17). There were no differences between groups at baseline for all measured covariates. No deaths occurred within 30 days of surgery. More patients in Group I developed complications (Group I: n = 10 vs Group II: n = 3; P = 0.093), while hospital stay was shorter in Group II (Group I: 6.4 ± 4.6 days vs Group II: 4.4 ± 1.8 days; P = 0.030). Five-year overall survival (Group I: 93.8 ± 6.1% vs Group II: 83.3 ± 11.2%; P = 0.425), 5-year disease-free survival (Group I: 71.0 ± 15.3% vs Group II: 83.3 ± 11.2%; P = 0.827) and recurrence rates at final follow-up (Group I: n = 2 vs Group II: n = 1; P = 0.363) were similar between the groups.
CONCLUSION
VATS thymectomy for thymoma is feasible, safe and has comparable mid-term oncological outcomes to trans-sternal thymectomy. Future research is required to evaluate long-term oncological outcomes of VATS thymectomy for thymoma in national registries and randomized, controlled trials.
Carbon Fiber Reinforced Polymer (CFRP) composites have emerged as a major class of structural materials that have a significant potential use as a substitute for metals in aerospace, marine, ...automotive, and architecture due to their higher-strength-to-weight-ratio. CFRP is well suited for various applications, but their mechanical properties such as ‘low-velocity impact resistance’ are not well studied. In this study, the low-velocity impact resistance of CFRP woven composite was investigated with the help of Charpy impact tests. The CFRP samples were tested at room temperature (22°C) and at low temperature (-20°C). The experimental results indicated about 10% drop in energy-absorbing capability of CFRP samples at low temperatures in comparison to room temperature. The experimental results obtained for the room temperature were validated through finite element simulations using ANSYS® Workbench Explicit Dynamics. The mesh sensitivity analysis was performed to improve the accuracy of the finite element model. The numerical results helped to narrow down on the CFRP material properties that changed with temperature drop. It was found at -20°C, orthotropic Elasticity (Young’s moduli in three mutually perpendicular directions) increases for CFRP woven composite as compared to room temperature (22°C), however the CFRP become brittle and there is a significant drop in their toughness. The current outcomes are useful for applications using CFRP under impact loading at low temperatures.
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