Numerical investigation of the wake bi-stability behind a notchback Ahmed body

Large-eddy simulations are used to investigate the origin of the wake asymmetry and symmetry behind notchback Ahmed bodies. Two different effective backlight angles, beta(1) = 17.8 degrees and beta(2) = 21.0 degrees, are simulated resulting in wake asymmetry and symmetry in flows without external perturbations, in agreement with previous experimental observations. In particular, the asymmetric case presents a bi-stable nature showing, in a random fashion, two stable mirrored states characterized by a left or right asymmetry for long periods. A random switch and several attempts to switch between the bi-stability are observed. The asymmetry of the flow is ascribed to the asymmetric separations and reattachments in the wake. The deflection of the near-wall flow structures behind the slant counteracting the asymmetry drives the wake to be temporarily symmetric, triggering the switching process of the bi-stable wake. The consequence of deflection that forces the flow structure to form on the opposite side of the slant is the decisive factor for a successful switch. Modal analysis applying proper orthogonal decomposition is used for the exploration of the wake dynamics of the bi-stable nature observed

Transarterial chemoembolization with or without multikinase inhibitors for patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis of randomized controlled trials

BackgroundRandomized controlled trials (RCTs) testing the combination therapy of transarterial chemoembolization (TACE) plus multikinase inhibitor (MKI) in patients with unresectable hepatocellular carcinoma (HCC) have yielded inconsistent results.MethodsIn this work, a systematic review and meta-analysis was performed to compare the TACE+MKI combination therapy versus TACE monotherapy in HCC patients with time to progression (TTP) adopted as primary outcome.ResultsA total of 10 RCTs comprising 2837 patients receiving combination therapy (TACE plus sorafenib, brivanib, orantinib or apatinib) were included. TACE+MKI significantly prolonged TTP (hazard ratio [HR] 0.74, 95% CI 0.62-0.89, p=0.001) versus TACE monotherapy. Subgroup analysis suggested MKI administration before TACE might be preferable to post-TACE MKI for TTP. TACE+MKI also increased objective response rate (ORR) (risk ratio [RR] 1.17, 95% CI 1.03-1.32, p=0.01), but failed to improve overall survival (OS) (HR 0.98, 95% CI 0.86-1.13, p=0.82) and progression-free survival (PFS) (HR 0.75, 95% CI 0.50-1.12, p=0.16). The incidence of any adverse event (AE) did not significantly differ between TACE+MKI and TACE groups (RR 1.17, 95% CI 0.96-1.42, p=0.01), while serious AEs showed significant difference (RR 1.41, 95% CI 1.26-1.59, p<0.0001). Nevertheless, these AEs showing significant difference were mainly associated with MKI toxicities rather than TACE. ConclusionsTACE+MKI combination therapy improved TTP and ORR but not OS and PFS in patients with unresectable HCC. Further high-quality trials are needed to verify these clinical benefits, and our findings could be very informative for future trial design