A Seismic Performance Classification Framework to Provide Increased Seismic Resilience

Several performance measures are being used in modern seismic engineering applications, suggesting that seismic performance could be classified a number of ways. This paper reviews a range of performance measures currently being adopted and then proposes a new seismic performance classification framework based on expected annual losses (EAL). The motivation for an EAL-based performance framework stems from the observation that, in addition to limiting lives lost during earthquakes, changes are needed to improve the resilience of our societies, and it is proposed that increased resilience in developed countries could be achieved by limiting monetary losses. In order to set suitable preliminary values of EAL for performance classification, values of EAL reported in the literature are reviewed. Uncertainties in current EAL estimates are discussed and then an EAL-based seismic performance classification framework is proposed. The proposal is made that the EAL should be computed on a storey-by-storey basis in recognition that EAL for different storeys of a building could vary significantly and also recognizing that a single building may have multiple owners

Systemic drug therapy of malignant pleural mesothelioma.

Malignant pleural mesothelioma (MPM) is an uncommon malignancy characterized by a rapid clinical course. Few patients are possible candidates for radical surgery. According to most reviews, radiotherapy has a limited role in the treatment of MPM. The role of chemotherapy in the management of pleural mesothelioma still remains uncertain. The available data indicate that although 10-20% of patients are known to achieve on objective response to a number of chemotherapeutic agents, the impact on survival appears limited and improvement in the quality of life remains uncertain. The results of combination chemotherapy are comparable to those of single-agent chemotherapy and no major difference is detectable among the various combinations. Prospective phase II trials are recommended for the identification of new active treatments while large-scale randomized phase III trials are needed to identify the best available treatment. In addition, new standard criteria for eligibility and response assessment are required. This paper reviews the available literature on the systemic drug therapy of MP

Management of malignant pleural effusions

Malignant pleural effusions (MPEs) represent a common complication of advanced malignancies. However, adequate palliation of this highly symptomatic accompaniment to cancer can be achieved in most patients by adopting the appropriate therapy. Several options are available for the treatment of MPE. Systemic therapy may control the effusion in patients whose underlying malignancy is sensitive to anticancer agents. Repeated thoracocentesis can be appropriate for patients with limited life expectancy or slowly recurrent effusions. In the majority of the remaining cases the treatment of choice is pleurodesis with sclerosing agents administered via tube thoracostomy. Controversy still exists as to which drug produces the best results: talc and bleomycin appear to be among the most cost-effective agents. The debate over the best agent to be used for pleurodesis refers to the difficulty in comparing results of studies using different eligibility criteria, response assessment and end-points. This article describes the various treatments which have been reported in the literature to play a role in the management of MPEs. It is also aimed at providing guidelines in allocating patients to appropriate treatments