Human papillomavirus related head and neck cancer survival: A systematic review and meta-analysis

Human Papillomavirus (HPV) related oropharyngeal squamous cell carcinomas (OPSCCs) are reported to have improved prognosis and survival in comparison to other head and neck squamous cell cancers (HNSCCs). This systematic review and meta-analysis examines survival differences in HPV-positive HNSCC and OPSCC subtypes including tonsillar carcinoma in studies not previously investigated. Four electronic databases were searched from their inception till April 2011. A random effects meta-analysis was used to pool study estimates evaluating disease-specific (death from HNSCC), overall (all-cause mortality), progression-free and disease-free (recurrence free) survival outcomes in HPV-positive vs. HPV-negative HNSCCs. All statistical tests were two-sided. Forty-two studies were included. Patients with HPV-positive HNSCC had a 54% better overall survival compared to HPV-negative patients HR 0.46 (95% CI 0.37-0.57); the pooled HR for tonsillar cancer and OPSCC was 0.50 (95% CI 0.33-0.77) and HR 0.47 (95% CI 0.35-0.62) respectively. The pooled HR for disease specific survival was 0.28 (95% CI 0.19-0.40); similar effect sizes were found irrespective of the adjustment for confounders, HPV detection methods or study location. Both progression-free survival and disease-free survival were significantly improved in HPV-positive HNSCCs. HPV-positive HNSCCs and OPSCCs patients have a significantly lower disease specific mortality and are less likely to experience progression or recurrence of their cancer than HPV-negative patients; findings which have connotations for treatment selection in these patients.

Cube, cylinder, core and pull-off strength relationships

This limited experimental investigation examined the relationships between the compressive strengths of cubes, cylinders, cores and the estimated compressive strengths derived from pull-off tests for a relatively low-strength structural-grade concrete (<35 N/mm2). Test specimens were cast and tested at 7, 14, 28, 56 and 84 days. The relationships of the trends of the test results to the trends of results of standard cube specimens and standard cylinder specimens were compared. It was found that the mean strength of each type of specimen tended to increase as a function of the natural logarithm of the specimen age. The mean strength of cylinders of length/diameter ratio 2.0 was found to be slightly greater (by about 7.5%) than the generally accepted value of 80% of the mean cube strength. Core results were corrected using correction factors defined in BS 6089 and the UK national annex to BS EN 12504-1. The mean corrected cube strength of cores taken from cubes was approximately 12% greater than the mean companion cube strength. The mean corrected cylinder strength of cores taken from cubes was approximately 5% greater than the mean companion cylinder strength. The potential cube and cylinder strengths of cores taken from slabs cured under different environmental conditions correlated well with companion cube and cylinder strengths respectively at 28 days. The pull-off test results gave a variable but, on average, slightly conservative estimate of the cube compressive strength of the relatively low-strength structural-grade concrete, using a simple general linear estimated compressive cube strength to tensile strength correlation factor of 10.

The use of a GA to improve the postbuckling strength of stiffened composite panels susceptible to secondary instabilities

The use of genetic algorithms (GAs) for structural optimisation is well established but little work has been reported on the inclusion of damage variables within an optimisation framework. This approach is particularly useful in the optimisation of composite structures which are prone to delamination damage. In this paper a challenging design problem is presented where the objective was to delay the catastrophic failure of a postbuckling secondary-bonded stiffened composite panel susceptible to secondary instabilities. It has been conjectured for some time that the sudden energy release associated with secondary instabilities may initiate structural failure, but this has proved difficult to observe experimentally. The optimisation methodology confirmed this indirectly by evolving a panel displaying a delayed secondary instability whilst meeting all other design requirements. This has important implication in the design of thin-skinned lightweight aerostructures which may exhibit this phenomenon.

Effect of offset web holes on web crippling strength of cold-formed steel channel sections under end-two-flange loading condition

A combination of experiments and non-linear finite element analyses are used to investigate the effect of offset web holes on the web crippling strength of cold-formed steel channel sections under the end-two-flange (ETF) loading condition; the cases of both flanges fastened and unfastened to the support are considered. The web holes are located at the mid-depth of the sections, with a horizontal clear distance of the web holes to the near edge of the bearing plate. Finite element analysis results are compared against the laboratory test results; good agreement was obtained in terms of both strength and failure modes. A parametric study was then undertaken to investigate both the effect of the position of holes in the web and the cross-section sizes on the web crippling strength of the channel sections. It was demonstrated that the main factors influencing the web crippling strength are the ratio of the hole depth to the depth of the web, and the ratio of the distance from the edge of the bearing to the flat depth of the web. Design recommendations in the form of web crippling strength reduction factors are proposed in this study.

Aerobic capacity, strength, flexibility, and activity level in unimpaired extremely low birth weight (

To compare aerobic capacity, strength, flexibility, and activity level in extremely low birth weight (ELBW) adolescents at 17 years of age with term-born control subjects.

Shear Strength Model for FRP-Strengthened RC Beams with Adverse FRP-Steel Interaction

RC beams shear strengthened with externally bonded fiber-reinforced polymer (FRP) U strips or side strips usually fail owing to debonding of the bonded FRP shear reinforcement. Because such debonding usually occurs in a brittle manner at relatively small shear crack widths, some of the internal steel stirrups intersected by the critical shear crack may not have reached yielding at beam shear failure. Consequently, the yield stress of internal steel stirrups in such a strengthened RC beam cannot be fully utilized. This adverse shear interaction between the internal steel shear reinforcement and the external FRP shear reinforcement may significantly reduce the benefit of the shear strengthening FRP but has not been considered explicitly by any of the shear strength models in the existing design guidelines. This paper presents a new shear strength model considering this adverse shear interaction through the introduction of a shear interaction factor. A comprehensive evaluation of the proposed model, as well as three other shear strength models, is conducted using a large test database. It is shown that the proposed shear strength model performs the best among the models compared, and the performance of the other shear strength models can be significantly improved by including the proposed shear interaction factor. Finally, a design recommendation is presented.