Airflow Dynamics of Human Jets: Sneezing and Breathing - Potential Sources of Infectious Aerosols

10.1371/journal.pone.0059970PLoS ONE84

Capecitabine plus bevacizumab versus capecitabine in maintenance treatment for untreated characterised KRAS exon 2 wild-type metastatic colorectal cancer: a retrospective analysis in Chinese postmenopausal women

Abstract Background Capecitabine plus bevacizumab (CAP-B) maintenance treatment after 6 cycles of capecitabine, oxaliplatin, and bevacizumab (CAPOXB) has demonstrated clinical activity and failure to compromise quality of life in patients with metastatic colorectal cancer (MCC) in a previous phase 3 CAIRO3 study. The objective of this study is to evaluate the efficacy and safety of CAP-B versus CAP in maintenance treatment after 6-cycle CAPOXB induction therapy in Chinese postmenopausal women with untreated characterised KRAS exon 2 wild-type MCC. Methods During 2012–2016, prospectively maintained databases were reviewed to evaluate cohorts with untreated characterised KRAS exon 2 wild-type MCC and stable disease or better after 6-cycle CAPOXB induction treatment. After induction treatment, all patients received either CAP-B or capecitabine (CAP) as maintenance treatment. Median progression-free survival (mPFS) and median overall survival (mOS) were the primary endpoints. Safety was the secondary endpoint. Results A total of 263 women with untreated characterised KRAS exon 2 wild-type MCC and stable disease or better after 6-cycle CAPOXB induction treatment were included for the evaluation of efficacy and safety (CAP-B-treated cohort, n = 130 and CAP-treated cohort, n = 133). The mPFS was 11.5 months (95% confidence interval [CI], 5.6–17.4) and 9.2 months (95% CI, 3.6–14.8) for the CAP-B-treated and CAP-treated cohorts, respectively (HR 0.54, 95% CI 0.32~0.85; P = 0.013). The mOS was 16.2 months (95% CI, 11.4–18.7) and 12.4 months (95% CI, 10.6–15.5) for the CAP-B- and CAP-treated cohorts, respectively (HR 0.72, 95% CI 0.51~0.94; P = 0.022). The CAP-B-treated cohort experienced significantly more grade 3 or 4 diarrhoea (P < 0.001) than the CAP-treated cohort. Conclusions CAP-B maintenance treatment after 6-cycle CAPOX-B in Chinese postmenopausal women with untreated KRAS exon 2 wild-type MCC is poorer tolerated but has a more modest, if any, benefit compared with that of CAP maintenance treatment

Double-sliding door snapshots (side and top views; left-to-right, top-to-bottom).

<p>The series of 4 snapshots with each door-opening, manikin movement scenario were taken with respect to the following events, rather than at specific times: food dye movement due to door-opening motions alone then with any initial manikin movement – manikin interaction and any entrainment food dye – final food dye movements once the manikin had come to rest at its destination position. All movement parameters are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0066663#pone-0066663-t001" target="_blank"><b>Table 1</b></a> for these double-sliding door scenarios. Note that with the sliding doors, the scenarios where the manikin enters or leaves the isolation room are effectively symmetrical (unlike with the hinged-door scenarios). <b>A.</b> Manikin moving into/out of the isolation room (seen from outside/inside, respectively), V<b> = </b>0.79 in water (1.22 in air) m/s, door-opening gap velocity = 0.42 in water (0.64 in air) m/s. <b>B.</b> Manikin moving out of/into the isolation room (seen from outside/inside, respectively), V<b> = </b>0.79 in water (1.22 in air) m/s, door-opening gap velocity = 0.42 in water (0.64 in air) m/s.</p

Single-hinged door snapshots (sideviews only; left-to-right).

<p>The series of 4 snapshots with each door-opening, manikin movement scenario were taken with respect to the following events, rather than at specific times: food dye movement due to door-opening motions alone then with any initial manikin movement – manikin interaction and any entrainment food dye – final food dye movements once the manikin had come to rest at its destination position. All movement parameters are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0066663#pone-0066663-t002" target="_blank"><b>Table 2</b></a> for these single-hinged door ‘fast’ scenarios. <b>A.</b> Manikin moving into the isolation room (seen from outside, V1 = 0.79 in water (1.22 in air) m/s, angular velocity = 184.68 in water (28.63 in air) deg/s.). <b>B.</b> Manikin moving into the isolation room (seen from inside), V2 = 0.75 in water (1.17 in air) m/s, angular velocity = 184.68 in water (28.63 in air) deg/s. <b>C.</b> Manikin moving out of the isolation room (seen from outside), V<b> = </b>0.77 in water (1.19 in air) m/s; angular velocity = 184.68 in water (28.63 in air) deg/s. <b>D.</b> Manikin moving out of the isolation room (seen from inside), V<b> = </b>0.77 in water (1.19 in air) m/s; angular velocity = 184.68 in water (28.63 in air) deg/s.</p

Sneezing airflow parameters.

<p>A: Measured visible propagation distances and derived velocities; B: Measured 2-dimensional (2D) areas and derived expansion rates.</p

Double-hinged door snapshots (sideviews only; left-to-right).

<p>The series of 4 snapshots with each door-opening, manikin movement scenario were taken with respect to the following events, rather than at specific times: food dye movement due to door-opening motions alone then with any initial manikin movement – manikin interaction and any entrainment food dye – final food dye movements once the manikin had come to rest at its destination position. All movement parameters are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0066663#pone-0066663-t002" target="_blank"><b>Table 2</b></a> for these double-hinged door ‘fast’ scenarios. <b>A.</b> Manikin moving into the isolation room (seen from outside, V1 = 0.71 in water (1.1 in air) m/s, angular velocity = 163.1 in water (25.3 in air) deg/s.). <b>B.</b> Manikin moving into the isolation room (seen from inside), V2 = 0.88 in water (1.36 in air) m/s, angular velocity = 163.1 in water (25.3 in air) deg/s. <b>C.</b> Manikin moving out of the isolation room (seen from outside), V<b> = </b>0.73 in water (1.14 in air) m/s; angular velocity = 163.1 in water (25.3 in air) deg/s. <b>D.</b> Manikin moving out of the isolation room (seen from inside), V<b> = </b>0.73 in water (1.14 in air) m/s; angular velocity = 163.1 in water (25.3 in air) deg/s.</p

Photograph of camera and light-source layout.

<p>These images were taken at the stage just before the addition of the colored food dye to one of the chambers in the experimental water-tank.</p