Choosing the Right Treatment Option for the Right R/M HNSCC Patient: Should We Adhere to PFE for First-Line Therapy?

BackgroundThe landmark EXTREME trial established cisplatin, 5-fluorouracil and cetuximab (PFE) as first-line chemotherapy (1L-ChT) for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). We were interested in outcome differences of R/M HNSCC in 1L-ChT and factors influencing outcome in certain subgroups, especially patients receiving PFE, and the value of PFE compared to other 1L-ChT regimens to provide real world evidence (RWE).MethodsFor this retrospective monocentric study, 124 R/M HNSCC patients without curative surgical or radiotherapy options receiving at least one cycle of 1L-ChT were eligible. We analyzed their outcome using Kaplan-Meier plot and Cox regression to identify predictors for prolonged survival.ResultsSubgroups benefiting significantly from PFE were patients suffering from an index HNSCC outside the oropharynx. The PFE regimen proved to be superior to all other 1L-ChT regimens in clinical routine. Significant outcome differences between PFE treatment within or outside controlled trials were not seen.ConclusionThis retrospective analysis provides RWE for factors linked to improved outcome. Subgroup analyses highlight the lasting value of PFE among the growing spectrum of 1L-ChT. Importantly, fit smokers with high level alcohol consumption benefit from PFE; considering the patient’s lifestyle factors, PFE should not be ignored in decision-making.

Passive Morphing in Aerospace Composite Structures

Attempts to add the advanced technologies to aerospace composite structures like fan blade have been on in recent times to further improve its performance. As part of these efforts, it has been proposed that the blade morph feasibility could be studied by building and optimizing asymmetric lay up of composite plies inside the blade which will help generate enough passive morphing between max cruise and climb conditions of the flight. This will have a direct efficiency (Specific Fuel Consumption) benefit. This research describes the various ideas that were tried using in house-developed lay-up optimization code and Ansys commercial software to study the possibility of generating enough passive morphing in the blade. In the end, this report concludes that the required degree of passive morphing could not be generated using various ideas with passive morphing technology and only up to some extent of morphing is shown to be feasible using the technologies used here.

Heavy Metals Contamination in Shellfish: Benefit-Risk Evaluation in Central Italy

Seafood is a source of nutrients in human diet but also of environmental contaminants and its consumption could pose a risk to consumers’ health. A survey regarding the exposure to cadmium, lead and mercury through the consumption of bivalve mollusks, gastropods and sea urchins collected on Italian coasts was carried out among central Italian population over a period of three years. A limited number of samples exceeds the threshold set by legislation (6 samples) and the average level of contamination was low in all the species considered. The contribution Acceptable Daily Intake (ADI) was higher for cadmium (9.17%) than lead (1.44%) and mercury (0.20%). The benefit-risk evaluation suggests that the bivalve mollusks and sea urchins consumption (Benefit Risk Quotient < 1) could be increased without health detrimental effects.

The Effect of Income on the Benefit of Consumption of Pusong Fishermen in Lhokseumawe City

This study aims to determine and analyze the effect of income on the consumption benefit of Pusong fishermen in Lhokseumawe City. The results of the research show that partially the income has a significant influence on the consumption benefit of Pusong fishermen in Lhokseumawe City. An adjusted R square figure of 0.775 indicates that 75.5% of the benefit variable consumption bias explains the income used in the regression equation. While the remaining 24.5% is influenced by other variables not included in this study.

IC Engine Air System Uni-, Bi-, and Tri-Directional Energy Flow Optimisation: Turbocharging, Turbocompounding and Turbodischarging

Air systems are becoming increasingly complex and important for achieving IC engine performance and emission targets. Turbocharging is becoming increasingly prevalent enabling high power density engines, improved pumping work and improved fuel economy. Turbo-compounding allows turbine energy to contribute directly to crankshaft work with the aim of improving fuel economy. Turbodischarging allows turbine energy to be used to extract exhaust gases from the engine reducing pumping work and residual gas fraction while simultaneously increasing the amount of energy that can be recovered by the turbine(s). The optimum energy flow split between turbocharging, turbodischarging and turbocompounding has not previously been explored. This paper presents results of a study investigating the potential of tri-directional energy flow optimisation in comparison to uni-directional optimisation and bi-directional optimisation (i.e. using all three approaches, any two approaches or turbocharging alone). Thermodynamic analysis demonstrates the potential of bi-directional optimisation to achieve realistically 4% fuel consumption benefit for both turbocharging and discharging, and turbocharging and compounding on gasoline engines from pumping work alone. The peak benefit of the former occurs at a slightly lower engine torque than the latter as the energy cost of a unit fuel consumption benefit with turbodischarging increases with increasing levels of exhaust depressurisation. The Tri-directional optimisation shows a complex optimum position utilising all three systems and achieving a realistic peak benefit of 4.4% fuel consumption improvement. Optimisation on diesel engine architectures suggests significantly lower potential in the order of 1% benefit while lean burn gas engines showed up to 2.6% benefit. Sensitivity to compression and expansion efficiencies, exhaust manifold volume and system temperatures are presented. The future hybridisation of IC engine air systems may enable energy storage. This paper offers fundamental insight into the marginal fuel cost of capturing energy from the three systems and the marginal fuel value of using stored energy in the air system.