Seismic Design of Earth-Retaining Structures

Earth-retaining structures provide support to excavations or earth fills: the earth pressure is either transmitted to the soil located below the foundations of the structure, as in gravity retaining walls, or balanced by a combination of horizontal passive forces in the ground and the reaction forces of additional structural elements, as in the case of embedded retaining structures. Seismic forces have a detrimental effect on these structures, producing an increase in the earth pressure and a decrease in the available soil resistance. Commonly, the seismic design of an earth-retaining structure is carried out using a pseudo-static approach, in which the seismic forces are derived from a uniform acceleration field and are applied statically to the soil-structure system. This approach has the advantage of being relatively simple to implement, but the rationale for the choice of the constant acceleration values needs careful consideration

A prospective multicenter phase II study evaluating multimodality treatment of patients with peritoneal carcinomatosis arising from appendiceal and colorectal cancer: the COMBATAC trial

BACKGROUND: Peritoneal carcinomatosis is regarded as a common sign of advanced tumor stage, tumor progression or local recurrence of appendiceal and colorectal cancer and is generally associated with poor prognosis. Although survival of patients with advanced stage CRC has markedly improved over the last 20 years with systemic treatment, comprising combination chemotherapy +/- monoclonal antibodies, the oncological outcome-especially of the subgroup of patients with peritoneal metastases-is still unsatisfactory. In addition to systemic therapy, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are specific treatment options for a selected group of these patients and may provide an additional therapeutic benefit in the framework of an interdisciplinary treatment concept. METHODS/DESIGN: The COMBATAC trial is a prospective, multicenter, open-label, single-arm, single-stage phase II trial investigating perioperative systemic polychemotherapy including cetuximab in combination with CRS and HIPEC patients with histologically proven wild-type KRAS colorectal or appendiceal adenocarcinoma and synchronous or metachronous peritoneal carcinomatosis. The planned total number of patients to be recruited is 60. The primary endpoint is progression-free survival (PFS). Secondary endpoints include overall survival (OS), perioperative morbidity and treatment-associated toxicity, feasibility of the combined treatment regimen, quality of life (QoL) and histopathological regression after preoperative chemotherapy. DISCUSSION: The COMBATAC trial is designed to evaluate the feasibility and efficacy of the combined multidisciplinary treatment regimen consisting of perioperative systemic combination chemotherapy plus cetuximab and CRS plus bidirectional HIPEC with intraperitoneal oxaliplatin. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01540344, EudraCT number: 2009-014040-1

Gender-Medizin in der Augenheilkunde

Gender-specific or sex-specific medicine is part of "personalized" medicine. After differences in heart diseases between women and men were first identified and increasingly published in the field of cardiology since the 1980s, differences between the sexes have also become the focus of interest in other disciplines. Immunological and hormonal aspects indicate significant differences, e.g. in the severity of the disease or the response to treatment. Even in ophthalmology epidemiological differences in some diseases are known but so far these do not lead to a different approach in the practical treatment of patients. This CME article aims to raise awareness of gender medicine also in the field of ophthalmology and at the same time to promote understanding of these differences by presenting the fundamental differences between the sexes