The incidence of biliary tract cancer(BTC)(1),including gallbladder cancer(GBC)(2),is *** curative surgery is possible in only approximately 20%,and adjuvant capecitabine,versus observation after resection,has been re...
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The incidence of biliary tract cancer(BTC)(1),including gallbladder cancer(GBC)(2),is *** curative surgery is possible in only approximately 20%,and adjuvant capecitabine,versus observation after resection,has been reported to improve survival in a prespecified sensitivity and per-protocol analyses of the phase 3 randomised trial BILCAP(capecitabine compared with observation in resected BTC)(adjusting for minimisation factors,nodal status,grade,and gender)(3,4).The prognosis for patients with advanced BTC is poor;the median overall survival(OS)for patients receiving standard of care cisplatin/gemcitabine in the first-line setting was 11.7 months in the advanced Biliary Cancer-02(ABC-02)study(5).There has been no alteration in the established choice of first-line systemic treatment for advanced BTC for over a ***,a recent press release announced that the phase 3 randomised study of durvalumab in combination with cisplatin/gemcitabine versus placebo with cisplatin/gemcitabine as a first-line treatment for patients with advanced BTC(TOPAZ-1)had met its primary endpoint of OS at the interim analysis;detailed results are awaited(NCT03875235).
This paper investigates the thermal performance of a new adaptive window which is seasonally *** new window is similar in construction to the regular double-hung low-e windows,but can reverse its *** this window,the l...
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This paper investigates the thermal performance of a new adaptive window which is seasonally *** new window is similar in construction to the regular double-hung low-e windows,but can reverse its *** this window,the low-e coating faces the inside during the heating season,which reflects the infrared radiation to the *** the cooling season,the low-e coating faces the outside to reflect the outside *** window was tested in two test cells to evaluate its thermal ***5.2a software was used to predict the window thermal properties and BEANS building simulation software was used to predict the energy savings of the new window *** simulation results showed an increase in the heat gain through the new window of up to 38%over the conventional double-glazing low-e window during the heating period for heavy thermal mass buildings,and 14%for light weight thermal mass *** the same time,the window maintained its low heat gain properties in the cooling *** used in moderate climates,the new adaptive window will significantly reduce energy consumption in buildings during both the heating and the cooling seasons.
AIM: To determine the impact (morbidity/mortality) of biliary stent-related events (SRE) (cholangitis or stent obstruction) in chemotherapy-treated pancreatico-biliary ***: All consecutive patients with advanced pancr...
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AIM: To determine the impact (morbidity/mortality) of biliary stent-related events (SRE) (cholangitis or stent obstruction) in chemotherapy-treated pancreatico-biliary ***: All consecutive patients with advanced pancreatobiliary cancer and a biliary stent in-situ prior to starting palliative chemotherapy were identified retrospectively from local electronic case-note records (Jan 13 to Jan 15). The primary end-point was SRE rate and the time-to-SRE (defined as time from first stenting before chemotherapy to date of SRE). Progression-free survival and overall survival were measured from the time of starting chemotherapy. Kaplan-Meier, Cox and Fine-Gray regression (univariate and multivariable) analyses were employed, as appropriate. For the analysis of time-to-SRE, death was considered as a competing ***: Ninety-six out of 693 screened patients were eligible; 89% had a metal stent (the remainder were plastic). The median time of follow-up was 9.6 mo (range 2.2 to 26.4). Forty-one patients (43%) developed a SRE during follow-up [cholangitis (39%), stent obstruction (29%), both (32%)]. There were no significant differences in baseline characteristics between the SRE group and no-SRE groups. Recorded SRE-consequences were: none (37%), chemotherapy delay (24%), discontinuation (17%) and death (22%). The median time-to-SRE was 4.4 mo (95%CI: 3.6-5.5). Patients with severe comorbidities (P ad a shorter time-to-SRE on multivariable analysis. Stage was an independent prognostic factor for overall survival (P = 0.029) in the multivariable analysis adjusted for primary tumour site, performance status and development of SRE (SRE group vs no-SRE group).CONCLUSION: SREs are common and impact on patient’s morbidity. Our results highlight the need for prospective studies exploring the role of prophylactic strategies to prevent/del
Pancreatic ductal adenocarcinoma(PDAC)is a major cause of cancer-related death *** recent advances in treatment options,prognosis remains poor,and data estimates from the United States(US)show that PDAC will surpass c...
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Pancreatic ductal adenocarcinoma(PDAC)is a major cause of cancer-related death *** recent advances in treatment options,prognosis remains poor,and data estimates from the United States(US)show that PDAC will surpass colorectal cancer to become the second most common cause of cancer-related death by 2040(1).Surgery followed by adjuvant chemotherapy is the only potentially curative treatment option for patients with PDAC;however,the majority present with advanced stage,non-resectable *** diagnosis could improve the dismal prognosis for this patient group,but this remains challenging due to numerous factors including a lack of approved biomarkers and screening programmes,and non-specificity or late presentation of symptoms.
This paper delves into the critical aspects of sheet pile walls in civil engineering, highlighting their versatility in soil protection, retention, and waterproofing, all while emphasizing sustainability and efficient...
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This paper delves into the critical aspects of sheet pile walls in civil engineering, highlighting their versatility in soil protection, retention, and waterproofing, all while emphasizing sustainability and efficient construction practices. The paper explores two fundamental approaches to sheet pile design: limit equilibrium methods and numerical techniques, with a particular focus on finite element analysis. Utilizing the robust PLAXIS 2016 calculation code based on the finite element method and employing a simplified elastoplastic model (Mohr-Coulomb), this study meticulously models the interaction between sheet pile walls and surrounding soil. The research offers valuable insights into settlement and deformation patterns that adjacent buildings may experience during various construction phases. The central objective of this paper is to present the study’s findings and recommend potential mitigation measures for settlement effects on nearby structures. By unraveling the intricate interplay between sheet pile wall construction and neighboring buildings, the paper equips engineers and practitioners to make informed decisions that ensure the safety and integrity of the built environment. In the context of the Cotonou East Corniche development, the study addresses the limitations of existing software, such as RIDO, in predicting settlements and deformations affecting nearby buildings due to the substantial load supported by sheet pile walls. This information gap necessitates a comprehensive study to assess potential impacts on adjacent structures and propose suitable mitigation measures. The research underscores the intricate dynamics between sheet pile wall construction and its influence on the local environment. It emphasizes the critical importance of proactive engineering and vigilant monitoring in managing and mitigating potential hazards to nearby buildings. To mitigate these risks, the paper recommends measures such as deep foundations, ground improvement tech
The understanding of the long-term trend in climatic variables is necessary for the climate change impacts studies and for modeling several processes in environmental engineering. However, for climatic variables, long...
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The understanding of the long-term trend in climatic variables is necessary for the climate change impacts studies and for modeling several processes in environmental engineering. However, for climatic variables, long-term trend is usually unknown whether there is a trend component and, if so, the functional form of this trend is also unknown. In this context, a conventional strategy consists to assume randomly the shape of the local trends in the time series. For example, the polynomial forms with random order are arbitrarily chosen as the shape of the trend without any previous justification. This study aims to 1) estimate the real long-term nonlinear trend and the changing rate of the yearly high temperature among the daily minimum (YHTaDMinT) and maximum temperatures (YHTaDMaxT) observed at Cotonou city, 2) find out for these real trend and trend increment, the best polynomial trend model among four trend models (linear, quadratic, third-order and fourth-order polynomial function). For both time series, the results show that YHTaDMinT and YHTaDMaxT time series are characterized by nonlinear and monotonically increasing trend. The trend increments present different phases in their nonmonotone variations. Among the four trend estimations models, the trend obtained by third-order and fourth-order polynomial functions exhibits a close pattern with the real long-term nonlinear trend given by the Improved Complete Ensemble Empirical Mode Decomposition with adaptive Noise (ICEEMDAN). But, the fourth-order polynomial function is optimal, therefore, it can be used as the funct
This thorough review explores the complexities of geotechnical engineering, emphasizing soil-structure interaction (SSI). The investigation centers on sheet pile design, examining two primary methodologies: Limit Equi...
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This thorough review explores the complexities of geotechnical engineering, emphasizing soil-structure interaction (SSI). The investigation centers on sheet pile design, examining two primary methodologies: Limit Equilibrium Methods (LEM) and Soil-Structure Interaction Methods (SSIM). While LEM methods, grounded in classical principles, provide valuable insights for preliminary design considerations, they may encounter limitations in addressing real-world complexities. In contrast, SSIM methods, including the SSI-SR approach, introduce precision and depth to the field. By employing numerical techniques such as Finite Element (FE) and Finite Difference (FD) analyses, these methods enable engineers to navigate the dynamics of soil-structure interaction. The exploration extends to SSI-FE, highlighting its essential role in civil engineering. By integrating Finite Element analysis with considerations for soil-structure interaction, the SSI-FE method offers a holistic understanding of how structures dynamically interact with their geotechnical environment. Throughout this exploration, the study dissects critical components governing SSIM methods, providing engineers with tools to navigate the intricate landscape of geotechnical design. The study acknowledges the significance of the Mohr-Coulomb constitutive model while recognizing its limitations, and guiding practitioners toward informed decision-making in geotechnical analyses. As the article concludes, it underscores the importance of continuous learning and innovation for the future of geotechnical engineering. With advancing technology and an evolving understanding of soil-structure interaction, the study remains committed to ensuring the safety, stability, and efficiency of geotechnical structures through cutting-edge design and analysis techniques.
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