Treatment strategies in primary vitreoretinal lymphoma: a 17-center European collaborative study.

IMPORTANCE: The best treatment option for primary vitreoretinal lymphoma (PVRL) without signs of central nervous system lymphoma (CNSL) involvement determined on magnetic resonance imaging or in cerebrospinal fluid is unknown. OBJECTIVE: To evaluate the outcomes of treatment regimens used for PVRL in the prevention of subsequent CNSL. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study was conducted at 17 referral ophthalmologic centers in Europe. We reviewed clinical, laboratory, and imaging data on 78 patients with PVRL who did not have CNSL on presentation between January 1, 1991, and December 31, 2012, with a focus on the incidence of CNS manifestations during the follow-up period. INTERVENTIONS: The term extensive treatment was used for various combinations of systemic and intrathecal chemotherapy, whole-brain radiotherapy, and peripheral blood stem cell transplantation. Therapy to prevent CNSL included ocular radiotherapy and/or ocular chemotherapy (group A, 31 patients), extensive systemic treatment (group B, 21 patients), and a combination of ocular and extensive treatment (group C, 23 patients); 3 patients did not receive treatment. A total of 40 patients received systemic chemotherapy. MAIN OUTCOMES AND MEASURES: Development of CNSL following the diagnosis of PVRL relative to the use or nonuse of systemic chemotherapy and other treatment regimens. RESULTS: Overall, CNSL developed in 28 of 78 patients (36%) at a median follow-up of 49 months. Specifically, CNSL developed in 10 of 31 (32%) in group A, 9 of 21 (43%) in group B, and 9 of 23 (39%) in group C. The 5-year cumulative survival rate was lower in patients with CNSL (35% [95% CI, 50% to 86%]) than in patients without CNSL (68% [95% CI, 19% to 51%]; P = .003) and was similar among all treatment groups (P = .10). Adverse systemic effects occurred in 9 of 40 (23%) patients receiving systemic chemotherapy; the most common of these effects was acute renal failure. CONCLUSIONS AND RELEVANCE: In the present series of patients with isolated PVRL, the use of systemic chemotherapy was not proven to prevent CNSL and was associated with more severe adverse effects compared with local treatment

EFFECT OF INACCURACY OF TRAFFIC GROWTH RATE IN A HIGHWAY PPP PROJECT -A CASE STUDY

ABSTRAC

INTERNATIONAL JOURNAL OF CIVIL AND STRUCTURAL ENGINEERING Volume 2, No 2, 2011 Performance of steel fiber on standard strength concrete in compression

ABSTRACT In this investigation a series of compression tests were conducted on 150mm, cube and 150mm x 300mm, cylindrical specimens using a modified test method that gave the complete compressive strength, static, dynamic modulus of elasticity, ultrasonic pulse velocity and stress-strain behavior using silica fume with and without steel fiber of volume fractions 0, 0.5, 1.0, and 1.5 %, of 0.5mm Ø of aspect ratio of 60 on Portland Pozzolona cement concrete. As a result the incorporation of steel fibers, silica fume and cement has produced a strong composite with superior crack resistance, improved ductility and strength behavior prior to failure. Addition of fibers provided better performance for the cement-based composites, while silica fume in the composites may adjust the fiber dispersion and strength losses caused by fibers, and improve strength and the bond between fiber and matrix with dense calcium-silicate-hydrate gel. The results predicted by mathematically modeled expressions are in excellent agreement with experimental results. On the basis of regression analysis of large number of experimental results, the statistical model has been developed. The proposed model was found to have good accuracy in estimating interrelationship at 28 and 90 days age of curing. On examining the validity of the proposed model, there exists a good correlation between the predicted values and the experimental values as showed in figures