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        Randomized study between radical surgery and radiotherapy for the treatment of stage IB–IIA cervical cancer: 20-year update

        Fabio Landoni,Alessandro Colombo,Rodolfo Milani,Franco Placa,Vanna Zanagnolo,Costantino Mangioni 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.3

        Objective: Stage IB–IIA cervical carcinoma can be equally cured either by radical surgery or radiotherapy (RT). Albeit such policies show the same efficacy, they carry a different morbidity. This is an update after 20 years of a previously published randomized trial of RT vs. surgery in the treatment of stage IB–IIA cervical cancers to assess long-term survival and morbidity and the different pattern of relapse between the 2 modalities. Methods: Between September 1986 and December 1991, women referred for a newly diagnosed stage IB and IIA cervical carcinoma were randomized to radical surgery or RT. The primary outcome measures were long-term survival and complications rate. The secondary outcome was recurrence of the disease. Results: Three-hundred forty-three eligible women were randomized: 172 to radical surgery and 171 to external RT. Minimum follow-up was 19 years. Thirty-three patients (10%) died of intercurrent disease (31 cases) or fatal complications (2 cases). Twenty-year overall survival is 72% and 77% in the 2 treatment groups (p=0.280), respectively. As a whole, 94 recurrences (28%) were observed. Median time to relapse was 13.5 (surgery group) and 11.5 months (radiotherapy group) (p=0.100), respectively. Multivariate analysis confirms that risk factors for survival are histotype (p=0.020), tumor diameter (p=0.008), and lymph node status (p<0.001). Conclusion: The results of the present study seem to suggest that there is no treatment of choice for early stage cervical carcinoma in terms of survival. Long term follow-up confirms that the best treatment for the individual patient should take into account clinical factors such as menopausal status, comorbidities, histological type, and tumor diameter.

      • Implicit Large Eddy Simulations of a rectangular 5:1 cylinder with a high-order discontinuous Galerkin method

        Andrea Crivellini,Alessandra Nigro,Alessandro Colombo,Antonio Ghidoni,Gianmaria Noventa,Andrea Cimarelli,Roberto Corsini 한국풍공학회 2022 Wind and Structures, An International Journal (WAS Vol.34 No.1

        In this work the numerical results of the flow around a 5:1 rectangular cylinder at Reynolds numbers 3 000 and 40 000, zero angle of attack and smooth incoming flow condition are presented. Implicit Large Eddy Simulations (ILES) have been performed with a high-order accurate spatial scheme and an implicit high-order accurate time integration method. The spatial approximation is based on a discontinuous Galerkin (dG) method, while the time integration exploits a linearly-implicit Rosenbrock-type Runge-Kutta scheme. The aim of this work is to show the feasibility of high-fidelity flow simulations with a moderate number of DOFs and large time step sizes. Moreover, the effect of different parameters, i.e., dimension of the computational domain, mesh type, grid resolution, boundary conditions, time step size and polynomial approximation, on the results accuracy is investigated. Our best dG result at Re=3 000 perfectly agrees with a reference DNS obtained using Nek5000 and about 40 times more degrees of freedom. The Re=40 000 computations, which are strongly under-resolved, show a reasonable correspondence with the experimental data of Mannini et al. (2017) and the LES of Zhang and Xu (2020).

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        Robust Supervisors for Intersection Collision Avoidance in the Presence of Legacy Vehicles

        Heejin Ahn,Andrea Rizzi,Alessandro Colombo 제어·로봇·시스템학회 2020 International Journal of Control, Automation, and Vol.18 No.2

        Vehicle coordination at road intersections to prevent collisions has recently drawn a lot of research attention, but still remains challenging due to a large volume of traffic composed of autonomous and human-driven vehicles. In this paper, we present the design and validation of a supervisory algorithm for collision avoidance at road intersections, in the simultaneous presence of measurement errors, unmodeled dynamics, and vehicles that are not equipped with autonomous driving features. We design a supervisor that takes control of vehicles that are capable of communication and autonomous actions, only when necessary to avoid a collision, or otherwise leaves control to their drivers. This supervisor is least restrictive, that is, it takes control away from drivers only when necessary to avoid future collisions. Since the complexity of the supervisor algorithm is combinatorial with the number of vehicles, we also design an approximate supervisor that can handle more realistic scenarios with a larger number of vehicles in polynomially bounded time at the expense of an additional, yet quantified, restrictiveness. The least restrictive supervisor is validated through experimental testings using three small-scale vehicles, and the approximate supervisor is validated through computer simulations.

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