16 research outputs found
Shear and Bearing Capacity of Corroded Steel Beam Bridges and the Effects on Load Rating
Corrosion in the girders of steel girder bridges often occurs due to the deicing salts, water, and other debris that leak through the deck joints into the web and bottom flange at the girder ends. Corrosion causes loss of cross-sectional area leading to a reduction in section properties of the member, which eventually results in a reduction in structural resistance against shear and bearing. In this study, seven full-scale tests were performed on decommissioned steel girders acquired from bridges scheduled for demolition in Indiana. Two of the four girders had severe corrosion with cracks and holes in the bottom of the web induced by corrosion, while four girders had moderate section loss induced artificially. All seven girders were subjected to shear loading to determine the residual shear and bearing capacity. Test results revealed a reduction in strength due to section loss compared to nominal sections. Failure modes observed during these four large-scale experiments were shear buckling, shear rupture, and web local crippling. Finite element models were developed and benchmarked to the experimental results. Parametric studies were performed for unstiffened and stiffened girders and included different corrosion scenarios by varying parameters such as corrosion height, length, and thickness loss. Results were analyzed to investigate the effect of each parameter and a modification factor was developed to estimate the residual shear and bearing capacity of corroded girders
Treatment strategies for oesophageal cancer - time-trends and long term outcome data from a large tertiary referral centre
<p>Abstract</p> <p>Background and objectives</p> <p>Treatment options for oesophageal cancer have changed considerably over the last decades with the introduction of multimodal treatment concepts dominating the progress in the field. However, it remains unclear in how far the documented scientific progress influenced and changed the daily routine practice. Since most patients with oesophageal cancer generally suffer from reduced overall health conditions it is uncertain how high the proportion of aggressive treatments is and whether outcomes are improved substantially. In order to gain insight into this we performed a retrospective analysis of patients treated at a larger tertiary referral centre over time course of 25 years.</p> <p>Patients and methods</p> <p>Data of all patients diagnosed with squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the oesophagus, treated between 1983 and 2007 in the department of radiation oncology of the LMU, were obtained. The primary endpoint of the data collection was overall survival (calculated from the date of diagnosis until death or last follow up). Changes in basic clinical characteristics, treatment approach and the effect on survival were analysed after dividing the cohort into five subsequent time periods (I-V) with 5 years each. In a second analysis any pattern of change regarding the use of radio(chemo)therapy (R(C)T) with and without surgery was determined.</p> <p>Results</p> <p>In total, 503 patients with SCC (78.5%) and AC (18.9%) of the oesophagus were identified. The average age was 60 years (range 35-91 years). 56.5% of the patients were diagnose with advanced UICC stages III-IV. R(C)T was applied to 353 (70.2%) patients; R(C)T+ surgery was performed in 134 (26.6%) patients, 63.8% of all received chemotherapy (platinum-based 5.8%, 5-fluorouracil (5-FU)12.1%, 42.3% 5-FU and mitomycin C (MMC)). The median follow-up period was 4.3 years. The median overall survival was 21.4 months. Over the time, patients were older, the formal tumour stage was more advanced, the incidence of AC was higher and the intensified treatment had a higher prevalence. However there was only a trend for an improved OS over the years with no difference between RCT with or without surgery (p = 0.09). The use of radiation doses over 54 Gy and the addition of chemotherapy (p = 0.002) were associated with improved OS.</p> <p>Conclusion</p> <p>Although more complex treatment protocols were introduced into clinical routine, only a minor progress in OS rates was detectable. Main predictors of outcome in this cohort was the addition of chemotherapy. The addition of surgery to radio-chemotherapy may only be of value for very limited patient groups.</p
No increase in incidence or risk of recurrence of breast cancer in ospemifene-treated patients with vulvovaginal atrophy (VVA)
Objective: To estimate the incidence and recurrence of breast cancer (BC) in patients with vulvovaginal atrophy (VVA) treated with ospemifene and matched untreated VVA patients using real-world data.
Study design: Retrospective matched cohort study.
Main Outcome Measures: VVA patients were identified from the 2011\u20132018 US MarketScan\uae insurance claims database. For incidence, ospemifene-treated VVA patients without evidence of BC prior to index treat- ment were matched to two untreated VVA controls similarly without history of BC on age, index VVA year, geographic region, Charlson Comorbidity categories, and follow-up time. BC after the index treatment was identified by BC diagnosis codes, mastectomy, chemotherapy, or radiation procedure. Incidence rate, rate ratio (RR) and their 95 % confidence intervals (CI) were calculated. The process was repeated to estimate BC re- currence in patients with a history of BC in 1:1, 1:2 and 1:3 matches.
Results: 1728 ospemifene users and 3456 untreated patients met the inclusion and matching criteria for asses- sing incidence. The average number of days for which ospemifene was supplied was 314 (standard deviation [SD] = 340). Average follow-up time from index treatment was 937 days (SD = 392) for treated patients and 915 days (SD = 396) for controls. BC incidence rates per 1000 person-years was 2.03 (95 % CI: 1.06 123.91) for treated patients and 3.53 (95 % CI: 2.49 124.99) for controls (RR = 0.58, 95 % CI: 0.28 121.21). No difference in recurrence was observed between ospemifene-treated and matched untreated patients. Ten (32.3 %) treated vs. 25 (40.3 %) controls in the 1:2 matched analysis had a recurrence.
Conclusion: No differences were observed in the BC incidence and recurrence rates in ospemifene users com- pared with matched controls
Comparison of clinical outcomes of patients with METDex14 NSCLC treated with first-line capmatinib in the GEOMETRY mono-1 study with those of a cohort of real-world patients
Alpelisib plus fulvestrant in PIK3CA-mutated, hormone receptor-positive advanced breast cancer after a CDK4/6 inhibitor (BYLieve): one cohort of a phase 2, multicentre, open-label, non-comparative study.
Background Alpelisib, a PI3Kα-selective inhibitor and degrader, plus fulvestrant showed efficacy in hormone receptor-positive, HER2-negative, PIK3CA-mutated advanced breast cancer in SOLAR-1; limited data are available in the post-cyclin-dependent kinase 4/6 inhibitor setting. BYLieve aimed to assess alpelisib plus endocrine therapy in this setting in three cohorts defined by immediate previous treatment; here, we report results from cohort A.Methods This ongoing, phase 2, multicentre, open-label, non-comparative study enrolled patients with hormone receptor-positive, HER2-negative, advanced breast cancer with tumour PIK3CA mutation, following progression on or after previous therapy, including CDK4/6 inhibitors, from 114 study locations (cancer centres, medical centres, university hospitals, and hospitals) in 18 countries worldwide. Participants aged 18 years or older with an Eastern Cooperative Oncology Group performance status of 2 or less, with no more than two previous anticancer treatments and no more than one previous chemotherapy regimen, were enrolled in three cohorts. In cohort A, patients must have had progression on or after a CDK4/6 inhibitor plus an aromatase inhibitor as the immediate previous treatment. Patients received oral alpelisib 300 mg/day (continuously) plus fulvestrant 500 mg intramuscularly on day 1 of each 28-day cycle and on day 15 of cycle 1. The primary endpoint was the proportion of patients alive without disease progression at 6 months per local assessment using Response Evaluation Criteria in Solid Tumors, version 1.1, in patients with a centrally confirmed PIK3CA mutation. This trial is registered with ClinicalTrials.gov, NCT03056755.Findings Between Aug 14, 2017, and Dec 17, 2019 (data cutoff), 127 patients with at least 6 months' follow-up were enrolled into cohort A. 121 patients had a centrally confirmed PIK3CA mutation. At data cutoff, median follow-up was 11·7 months (IQR 8·5-15·9). 61 (50·4%; 95% CI 41·2-59·6) of 121 patients were alive without disease progression at 6 months. The most frequent grade 3 or worse adverse events were hyperglycaemia (36 [28%] of 127 patients), rash (12 [9%]), and rash maculopapular (12 [9%]). Serious adverse events occurred in 33 (26%) of 127 patients. No treatment-related deaths were reported.Interpretation BYLieve showed activity of alpelisib plus fulvestrant with manageable toxicity in patients with PIK3CA-mutated, hormone receptor-positive, HER2-negative advanced breast cancer, after progression on a CDK4/6 inhibitor plus an aromatase inhibitor.Funding Novartis Pharmaceuticals
Salivary Biomarkers in Periodontitis Post Scaling and Root Planing
Objectives: This study was conducted to evaluate the levels of salivary uric acid and arginase in patients with periodontitis, generalized gingivitis, and in healthy individuals. Then, the effects of non-surgical periodontal therapy on levels of salivary arginase and uric acid were also investigated. Methods: A total of 60 subjects were divided into three groups based on periodontal health: group I comprised 20 healthy individuals; group II comprised 20 subjects who had generalized gingivitis; group III comprised 20 subjects who had generalized periodontitis. On day 0, the clinical examination of periodontal status was recorded, following which saliva samples were collected. Group II and group III subjects underwent non-surgical periodontal therapy. These patients were recalled on day 30 to collect saliva samples. The periodontal parameters were reassessed on day 90, and saliva samples were collected for analysis of salivary arginase and uric acid levels. Results: Group II and group III showed improvement in clinical parameters following non-surgical periodontal therapy on the 90th day. The MGI score, PPD, and CAL showed improvement. On day 0, at baseline, salivary arginase levels in group III and group II were higher than those in healthy subjects, whereas on day 0, salivary uric acid levels in group III and group II were lower than those in healthy subjects. Both on day 0 and day 90, the salivary arginase level showed a positive correlation with the periodontal parameters, whereas the salivary uric acid level was positively correlated with the periodontal parameters on day 90. Conclusion: the level of salivary arginase was a pro-inflammatory marker and a raised level of salivary uric acid was an anti-inflammatory marker following periodontal therapy, suggesting their pivotal role in assessing periodontal status and evaluation of treatment outcome
Changes in racial and ethnic disparities in lumbar spinal surgery associated with the passage of the Affordable Care Act, 2006–2014
Understanding the Development of IOS-Based Trading Partner Relationships: A Structural Model with Empirical Validation
Electro-optical characterization of cyanine-based GUMBOS and nanoGUMBOS
© 2014, The Korean Institute of Metals and Materials and Springer Science+Business Media Dordrecht. Over the last decade in materials science, molecular electronics has emerged as one of the most rapidly developing interdisciplinary research areas with the prospects of ultimate miniaturization and integration of functional organic species with traditional silicon based semiconductor technology. To this end, fundamental studies to investigate the electrical and optical properties of organic nanomaterials deserve special attention. In this work, conductive probe atomic force microscopy (CP-AFM) and Raman spectroscopy have been performed on a new class of ionic materials, referred to as group of uniform materials based on organic salts (GUMBOS) and nanoparticles derived from these GUMBOS, termed as nanoGUMBOS. The GUMBOS investigated in this study are 1,1′-Diethyl-2,2′-cyanine bis (trifluoromethanesulfonyl) imide ([PIC][NTf2]) and 1,1′-Diethyl-2,2′-cyanine bis (pentafluoromethanesulfonyl) imide ([PIC][BETI]), which have been synthesized by use of a facile, template free anion exchange reaction between their respective parent compounds, followed by an ultrasonication assisted, additive free re-precipitation reaction to obtain the nanoscale particles (nanoGUMBOS). The ([PIC][NTf2] nanoGUMBOS were found to self-assemble into distinct diamond-like, trapezoid structures whereas [PIC][BETI] exhibited rod-like structures. [PIC][NTf2] nanoGUMBOS induced ~25 and ~38 times enhancement in the Raman signal intensity as compared to the parent compound [PIC][I] and [PIC][BETI] nanoGUMBOS respectively. In conjunction with the results of Raman spectra, the current-voltage (I-V) data obtained by CP-AFM are also presented as first-time evidence of electrical performance exhibited by these unique class of materials. The results reported in this study are indicative of their potential incorporation into next generation organic thin film applications in optoelectronics, dye-sensitized solar cells, and chemical sensors