Canagliflozin (CANA), a kind of sodium-glucose cotransporter-2 (SGLT-2) inhibition, study in which the role of CANA monotherapy in polycystic ovary syndrome (PCOS) has been investigated, and it could become a novel option in the PCOS treatment. Nevertheless, trials focused on SGLT-2 combination therapy’s efficacy, and safety in PCOS patients are limited. This randomized controlled trial compared the efficacy and safety of CANA and metformin (MET) combination therapy and MET monotherapy in endocrine and metabolic profiles of overweight and obese women with polycystic ovary syndrome (PCOS).Fifty-one overweight or obese non-diabetic PCOS women between 18 and 40 years old were enrolled. Patients were randomly allocated to receive either CANA/MET or MET treatment. The CANA/MET group received CANA 100 mg once daily plus MET 1000 mg twice daily, while the MET group received MET 1000 mg twice daily for three months. Changes in menstrual pattern, anthropometric parameters, gonadal parameters, glucose and lipid homeostasis, and adverse events (AEs) were evaluated.Compared with the MET group, women have a significantly lower level of total testosterone (TT), area under the curve for glucose (AUCGlu), and area under the curve for insulin (AUCIns) to AUCGlu ratio in the combination group. There were no significant differences in menstrual frequency, body weight, body mass index, follicle-stimulating hormone, luteinizing hormone, free androgen index, sex hormone-binding globulin, androstenedione, fasting blood glucose, fasting insulin, AUCIns, homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, total cholesterol, low-density lipoprotein cholesterol, apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), and APO B/A1 ratio. AEs were seen in 57.70% (15/26) and 68.00% (17/25) of patients in the CANA/MET and MET groups, respectively.In overweight and obese women with PCOS, CANA and MET combination therapy may be similar to MET monotherapy in improving menstrual frequency, weight control, hyperandrogenemia, and relieving insulin resistance. CANA/MET may have more benefits in reducing TT, AUCGlu, and the AUCIns/AUCGlu ratio within three months than MET monotherapy.ClinicalTrials.gov, NCT04973891. It affects 4–21% of women of reproductive age , 4. In ae damage , 18. Cure damage , and thee damage .Metformin (MET), the most extensively used insulin-lowering drug in PCOS , reducesSodium-glucose cotransporter-2 (SGLT-2) inhibitors, novel hypoglycemic oral drugs that promote renal glucose loss , are widTherefore, this randomized controlled trial (RCT) explored the difference in anthropometric indices, menstrual frequency, gonadal parameters, glucose and lipid homeostasis, and AEs between CANA/MET combination therapy and MET monotherapy in women with PCOS over three months. The present study aimed to provide additional options for PCOS treatment.Patients in this open-label RCT were selected from the outpatient clinics of Shengjing Hospital of China Medical University Endocrinology Department, Shenyang, Liaoning, China, from April 2021 to March 2022.This single-center, open-label, 1:1 RCT was examined and approved by the Scientific Research and New Technology Ethical Committee of the Shengjing Hospital of China Medical University (No.2021PS555K) and pre-registered at ClinicalTrials. gov (NCT04973891). All participants read and signed a written informed consent form before testing.2 (iii) PCOS diagnosis fulfills the Rotterdam 2003 criteria phenotype B with HA and oligo-/anovulation (Inclusion criteria: (i) 18-40 years (ii) Body mass index (BMI) ≥ 24 kg/mExclusion criteria: (i) Patients who were pregnant, intended to become pregnant, were breastfeeding or did not agree to birth control. (ii) Medication history in the recent three months included oral contraceptive pills, SGLT-2 inhibitors, glucagon-like peptide-1 receptor agonists, thiazolidinediones, MET, and Chinese herbs. (iii) Comorbidities ,  (iv) Severe hepatic  or renal function (eGFR < 60 ml/min per 1.73 m2) damage. (v) Current or past (last three months) involvement in other interventional studies. (vi) 17α-dihydroxy-progesterone > 2ng/ml, (vii) Women with persistent or recurrent symptomatic urinary tract infection (UTI), gastrointestinal (GI) problems, or any other conditions that could endanger the patient’s safety.Eligible PCOS patients who provided consent were recruited and randomly allocated to either the CANA/MET group or the MET group. Randomization was performed using a computer-generated random number sequence. CANA and MET tablets were provided by Janssen Ortho, LLC, and Bristol-Myers Squibb Company, respectively. For CANA, subjects were required to take 100 mg once daily before breakfast; for MET, subjects were asked to take 1000 mg/day  for one week, with the dose increased to 2000 mg/day , if tolerable. The management was for three months. All eligible patients were instructed to maintain their habitual diet, exercise level, and contraceptive use throughout the study period. They were also required to abstain from any drug with possible endocrine or metabolic effects.Each participant completed assessments at two-time points: baseline and 12 weeks post-randomization. All PCOS subjects had to fast when measurements were taken. At the beginning of the study, data on body composition, glucose and lipid homeostasis, and sex steroid hormone concentration were measured and recorded. At the end of the study, the subjects underwent repeat assessments identical to the initial visit. We frequently contacted PCOS patients through weekly phone calls or communication tools, asking about their menstrual cycle and medication AEs, reminding them to take supplements daily, and arranging a convenient time for the next visit.Each subject’s weight and height were measured and recorded by a nurse to calculate body mass index  wearing light indoor clothing without shoes. We acknowledged that according to the WHO, overweight/obesity was defined as a BMI ≧ of 25 since the individuals included were all Chinese, and a BMI of 24 and 28 were cutoffs for overweight and obesity for both males and females over 18 years of age , 40. HeiDue to all included PCOS patients meeting the Rotterdam 2003 criteria phenotype B , with ovFollicle-stimulating hormone (FSH) (mIU/mL) and LH (mIU/mL) levels were tested by chemiluminescent immunoassay. Total testosterone (TT) (ng/ml) was determined using an electrochemiluminescent immunoassay (ECLLA). HA was defined as TT was higher than 0.5ng/mL . Sex horGlucose tolerance and insulin sensitivity were assessed at baseline and 12 weeks post-randomization using the oral glucose tolerance test (OGTT). Blood samples were taken at 0, 60, and 120 min after a sugar meal and analyzed for blood glucose (mmol/L) using the hexokinase-6 phosphate dehydrogenase method or the chemiluminescence (double-antibody sandwich) for blood insulin (μU/mL) . The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as fasting insulin (FINS) (μU/mL) × fasting blood glucose (FBG) (mmol/L)/22.5. The area under the glucose curve (AUCGlu) (mmol/L · min) and insulin (AUCIns) (mU/L · min) were obtained by calculating the sum of the trapezoidal areas between 0, 60, and 120 min.The deionization and enzyme method was used to evaluate triglyceride (TG) (mmol/L) concentration. Total cholesterol (TC) (mmol/L) was measured using the cholesterol oxidase method, and low-density lipoprotein cholesterol (LDL-C) (mmol/L) was measured using the chemically modified enzyme method. Apolipoprotein A1 (Apo A1) (g/L) and apolipoprotein B (Apo B) (g/L) were detected by immunoturbidimetry, and the Apo B/A1 ratio was also calculated . The TG, TC, LDL-C, Apo A1, Apo B, and Apo B/A1 ratio assessment was performed at baseline and 12 weeks post-randomization. The AE severity was recorded and rated as mild, moderate, or severe.No evidence of PCOS in women treated with CANA/MET or MET combination has been reported. The sample size of the pilot study should be calculated based on its original purpose, comprehensive consideration, calculation, and analysis, so as to get the sample size. Based on the above characteristics, the explanation is as follows: The primary outcome was the three months change in body weight. The strategy of sample size calculation was based on the assumptions that the mean reduction of body weight (−2.10 ± 2.35) for the MET group, and the expectation of two more times reduction in the CANA/MET group (mean=−4.20), we required 21 subjects for each group. By considering α=0.05, power=80%, and an approximately 20% dropout rate, 50 patients were examined and equally assigned to each group (n=25).P-value < 0.05 (2-tailed). Results were obtained using GraphPad Prism Version 7.0  and SPSS .Continuous data were presented as mean, median, standard deviation (SD), and interquartile spacing; categorical data were presented as frequencies or percentages. AEs were calculated based on intention-to-treat principles, yet the treatment efficacy was measured using per-protocol analysis. First, normality was assessed using the D’Agostino and Pearson omnibus/Shapiro-Wilk test. The paired t-test or Wilcoxon signed-rank test was used for intragroup comparisons for continuous data. In contrast, an independent sample t-test or Mann-Whitney U test was performed for intergroup comparisons. For categorical variables, the chi-square test was used. Statistical significance was defined as a A total of 66 patients with PCOS based on the Rotterdam 2003 criteria were recruited from an outpatient endocrinology department. During the screening process, fifteen patients were excluded for definite reasons: four patients had a strong desire for pregnancy during the test; eight patients declined to participate; two patients had a history of taking multiple drugs ; one patient combined with other diseases (suffered from diabetes). Then, fifty-one PCOS patients who met the inclusion criteria were enrolled in the study, including 26 in the CANA/MET group and 25 in the MET group. Five patients dropped out in the CANA/MET group . Five patients withdrew from the trial in the MET group . Finally, 21 participants in the CANA/MET group and 20 in the MET group who completed the trial were included in the final analysis. Follow-up rates were 80.76% (21/26) and 80.00% (20/25), respectively Figure 1P=0.6118, P =0.2365, and P =0.1024, respectively). No statistically significant differences were found in interest outcomes according to baseline information. All baseline data were presented in The two groups did not differ significantly in age, weight, or BMI (P=0.5386)] and BMI  between the two groups. Within-group comparisons showed a significant decrease in body weight and BMI in the CANA/MET group  and the MET group   Table 2.P=0.6228). There was a clinically significant decrease in TT in the CANA/MET group compared to MET . No differences were noted in FSH , LH , FAI , SHBG , and AND . Within-group comparisons showed that both groups had significantly lower TT levels . In the CANA/MET group, the FAI (P =0.0457) at 12 weeks decreased significantly compared to baseline, but no changes were observed in the MET group. In the MET group, SHBG (P=0.0303) at 12 weeks increased significantly compared to that at baseline, but no changes were observed in the CANA/MET group. Both groups showed no significant changes in FSH, LH, or AND levels after treatment  and MET . There was no significant difference between the two interventions (reatment Table 2.P=0.0182)] and the AUCIns/AUCGlu ratio  compared with MET. There were no significant differences in FBG , FINS , AUCIns , and HOMA-IR . Within-group comparisons revealed that both groups had significantly lower FINS levels , the AUCIns/AUCGlu ratio , and HOMA-IR . Decreased FBG, AUCGlu, and AUCIns levels were observed in the CANA/MET group . However, these differences were not observed in the MET group ], TC , LDL-C , Apo A1 , Apo B , and the Apo B/A1 ratio . The TG and TC levels and the Apo B/A1 ratio declined from baseline only in the CANA/MET group . Both groups showed no significant changes in LDL-C, Apo A1, and ApoB levels after treatment  and 68.00% (17/25) patients in the CANA/MET and MET groups, respectively. Only one subject in the MET group had to withdraw due to severe vaginal bleeding. The details are summarized in To our knowledge, this is the first 3-month randomized clinical trial comparing the efficacy and safety of CANA (100 mg once daily)/MET (1000 mg twice daily) and MET (1000 mg twice daily) in overweight and obese women with PCOS. Our results supported MET as conventional therapy for PCOS, given its amelioration of menstrual frequency, body weight, BMI, TT, FINS, HOMA-IR, and AUCIns/AUCGlu either combined with CANA or as monotherapy. In addition, we found that CANA/MET might be more beneficial in reducing TT, AUCGlu, and the AUCIns/AUCGlu ratio than MET monotherapy within three months. CANA/MET supplementation may be similar to MET monotherapy in PCOS administration to improve menstrual pattern, weight control, and HOMA-IR in overweight and obese PCOS women.Weight loss is considered essential in PCOS management. In our study, participants in the CANA/MET group had a mean weight loss of 5.83 kg (7% of their body weight), and those in MET had 2.29 kg (3% of their body weight). However, the difference between the two groups did not reach statistical significance. This result agrees with an RCT that found that the effects of dapagliflozin (DAPA) (10 mg once daily)/MET (2000 mg once daily) combination therapy may be similar to those of MET (2000 mg once daily) monotherapy in promoting weight loss in PCOS patients . FurtherThere was an improvement in menstrual cycle frequency in the CANA/MET and MET groups, with no significant difference. This result is in line with that of Cai et al. . For gonMetformin corrects endocrine and metabolic abnormalities in women with PCOS; it counteracts IR by inhibiting hepatic glucose production . By reduIn our study, the serum TG levels decreased significantly in the CANA/MET group. No significant differences were found in TG and LDL-C levels between the two treatments. SGLT-2 inhibition was found to affect the plasma lipid profile of diabetic patients by decreasing TG levels and increasing LDL-C levels . The LDLIn our trial, CANA and MET were well tolerated by most patients. Only one patient withdrew owing to serious AEs and vaginal bleeding, which was considered unrelated to the study drug. Surprisingly, no UTI problems were observed in the CANA/MET therapy group. We speculate on possible reasons for the results. On the one hand, before starting medications, each participant was told to drink more water throughout the entire intervention period, also for the MET group. On the other hand, this may be because patients under this treatment had a small dose of CANA (100 mg q.d.) rather than CANA (300 mg q.d.). Nevertheless, we should still focus on the AEs after SGLT-2 inhibition supplementation, due to the small sample size. Most of the patients had mild or moderate GI problems in both groups, consistent with Cai et al. reports . MoreoveOur study has several strengths. Firstly, this is the first time assessing the differences between CANA/MET combination therapy and MET monotherapy in PCOS management. Until now, four clinical studies focusing on SGLT-2 inhibitors in PCOS management, and only one study compared the difference between DAPA/MET and MET monotherapy . The reaSGLT-2 inhibitors may be promising new therapeutic drugs for PCOS. However, whether used alone or in combination with other agents, its efficacy still needs to be explored. It is essential to understand the mechanisms underlying SGLT-2 inhibition in PCOS and its long-term complications. The sample size should be expanded in further clinical trials, and a meta-analysis should be conducted to obtain high-quality conclusions. More studies are needed to be carried out to determine more efficient PCOS therapies.In overweight and obese women with PCOS, CANA and MET combination therapy may be similar to MET monotherapy in improving menstrual frequency, weight control, HA, and relieving IR. Compared with MET monotherapy, CANA/MET may have more benefits in reducing TT, AUCGlu, and AUCIns/AUCGlu ratio within three months. Additional trials are necessary to assess the SGLT-2 inhibitor supplementation’s long-term effects in patients with PCOS.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.Ethical approval was obtained from the Scientific Research and New Technology Ethical Committee of the Shengjing Hospital of China Medical University (No.2021PS555K). Written informed consent was obtained from all participants prior to inclusion in the study. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.JZ and BH conceived, designed, and performed the experiments; JZ, XC, and CX analyzed the data; JZ wrote the paper. BH reviewed and edited the final manuscript. All authors read and approved the final manuscript.This work was supported by a grant from the National Natural Science Foundation of China (grant no. 81570765), the Science and Technology Department people’s livelihood Science and Technology Joint Program Funding of Liaoning Province (No. 2021JH2/10300125), and the “345 Talent Project” of Shengjing Hospital of China Medical University.We want to thank all the patients and their families, without them this study could never have been completed. We wish them all the best.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Continuous rigid-frame bridges are widely used, but the large deflection in the mid-span during operation has always been their disease. This problem is generally solved by setting the finished bridge pre-camber. There are many calculation methods for pre-camber, and the effects are different. In this paper, based on a large number of design parameters of continuous rigid-frame bridges obtained from the investigation, 18 finite element analysis models of different span combinations were established, and 30 sets of valid data were obtained under the action of multi-factor. The results show that the shrinkage and creep of concrete is the most important factor for the mid-span deflection of continuous rigid frame bridges, and the deflection amount has an obvious functional relationship with the span. The effect of prestress loss on mid-span deflection is second, and stiffness reduction has little effect on mid-span long-term deflection. In this paper, the least-squares method is used to perform polynomial fitting, and the fitting formula for the mid-span finished bridge pre-camber is finally obtained. The applicability of the calculation formula is proved by comparing it with the specification solution, the empirical solution, and the measured value. But they could not propose a reliable method for calculating the finished bridge mid-span pre-camber value. Some bridge designers conducted research on reasonable pre-camber for a single bridge, but they are not universal11. Yang Z.P. tracked and measured the mid-span deflection of a continuous rigid frame bridge with a main span of 270 m and obtained relevant data12. Wang P.J. analyzed these measured data and corrected the long-term growth coefficient, but the conclusions drawn from only one bridge data are difficult to apply to bridges of various spans13. Based on these measured data, He S.H. proposed the deflection growth coefficient correction coefficient K and predicted the change value of the mid-span deflection through the K value fitting curve14. However, to obtain the K value, a corresponding calculation model needs to be established.Many scholars have studied the factors that affect the excessive mid-span deflection of continuous rigid-frame bridges during operation and proposed that the bridge deflection monitoring should be tracked in the later periodf2 of continuous rigid-frame bridges in various places still adopts the empirical formula:l is the main span of the bridge, and d is the mid-span deflection under live load. With the improvement of the main beam concrete label in recent years, there have been many cases in which the selection of empirical values is too conservative, resulting in obvious mid-span upper arches of continuous rigid-frame bridges during operation. It affects the driving comfort. Design units reduced this value from 1/1000 to 1/1500, but the empirical value lacks a calculation basis and cannot be generally applied to continuous rigid-frame bridges of different spans. Based on a large number of real bridge survey data, this paper establishes continuous rigid-frame bridge models with different spans and performs finite element calculations under the influence of multi-factors one by one. By analyzing the calculation results, a method for selecting the finished bridge pre-camber value with wide applicability is obtained. After comparative analysis, its reliability is verified, which provides a reference for setting the finished bridge pre-camber value of continuous rigid-frame bridges.Although there have been many studies on the influencing factors of the mid-span deflection of continuous rigid-frame bridges, a method to correct the deflection growth coefficient is proposed based on a small amount of measured data. However, due to a lack of data, the value of the finished bridge pre-camber of the rigid frame bridge is still based on qualitative understanding, and the quantitative calculation formula is basically in the blind area. The value of 16. To further analyze the influence of the coupling effect of each factor on the structural deflection, it is particularly important to select a reasonable value.According to previous research results, it is clear that the shrinkage and creep of concrete, the reduction of structural stiffness, and the loss of longitudinal prestress are the three main factors that affect the mid-span deflection of continuous rigid frame bridges during the operation period18. For example, the Parrots Ferry continuous rigid frame bridge completed in 1978 in the United States has a main span of 195 m. When tested in 1990, its mid-span deflection was as large as 635 mm; the auxiliary channel bridge of the Humen Bridge built in China in 1997 has a main span of 270 m, and the maximum deflection of mid-span was 222 mm when it was tested in 2003.The creep of concrete often leads to an increase in the deflection of the beam, causing a loss of prestressing, which can lead to cracking. In the early years, due to the lack of understanding of shrinkage and creep and the limitations of the regulations at that time, many bridges at home and abroad suffered different degrees of disease due to shrinkage and creep20. According to this characteristic, the calculation time of shrinkage and creep is usually set as 1000–1500 days in the design stage. Therefore, this paper takes the deflection value after 3 years as the calculation target value of this factor.After the shrinkage and creep of the concrete continue for 6 months, the structural deformation can reach 70% ~ 80% of the final creep deformation. Then the deformation growth gradually slows downDuring the operation of the structure, due to shrinkage and creep, the deformation increases, the effective prestress decreases, and cracks begin to develop continuously. Therefore, the stiffness needs to be reasonably reduced to meet the actual situation.22, this paper reduces the concrete stiffness of the main beam by 10% after 3 years of operation.According to relevant research and the concrete fatigue stiffness attenuation test lawThe effective prestressing of steel tendons in prestressed concrete bridges will have a certain loss during construction and operation. Many factors cause the loss of prestress Fig. , and somThe prestressing of continuous rigid-frame bridges generally adopts the post-tensioning method. As early as 1958, the American Concrete Institute and Civil Science (ACI-ASCE) proposed the "Recommendations for the Design of Prestressed Concrete Structures", which stipulated the total loss value caused by the elastic compression, shrinkage and creep of concrete, and the relaxation of steel bars: post-tensioned members were taken as 172 MPa. With the development of engineering practice, considering the underestimation of the relaxation stress loss, the American ACI code and the American Highway Bridge Code (AASHTO) revised this in 1975, and the total loss value of the post-tensioned steel strand was taken as 228 MPa. The American Post-tensioned Concrete Institute (PTI) also revised the total prestress loss value, and the total prestress loss of the 1860 MPa steel strand was taken as 240 MPa (12.9%). Chinese-American Lin Tongyan proposed that the average total loss is 20% of the tension control stress. China has also made some statistical analysis on the total prestress loss value based on a lot of engineering practice experience, and proposed that when designing prestressed concrete structures, the effective prestress can be taken as 60%-80% of the tension control stress.27.In addition, prestressed concrete continuous rigid frame bridges generally have longitudinal, vertical, and lateral prestressing in the box girder. In the modeling process of this paper, only the longitudinal prestressing is considered, and the lateral and vertical prestressing effects are ignored. In this paper, Combined with the experimental data of the indoor scale model and the measured data of the actual bridge, as well as the prediction method of the prestress loss in recent years, this paper conservatively reduces the longitudinal prestress to 70% of the control stress after 3 years of operationThe finite element calculation and analysis of mid-span deflection of continuous rigid-frame bridges during operation is the focus of this paper. Relying on the science and technology project of the Department of Transportation of Shaanxi Province, China, this paper conducts a large number of investigations on the continuous rigid frame bridges in service. During the investigation, bridge design parameters for different span combinations were obtained.To obtain the mid-span deflection value of continuous rigid frame bridges with various span combinations, this paper selects a total of 18 bridges with main spans ranging from 80 to 200 m according to the design parameters obtained from the investigation.Due to limited space, the Xushuihe Bridge is selected here for parameter description Fig. . XushuihAccording to the design parameters, a finite element 3D model is established by Midas civil software. The dispersion of the structure is divided according to the construction beam section of the main beam. The piers are divided into segments every 3 m. This model has a total of 363 nodes and 356 units, and they constitute the framework of the entire model Fig. . The pieThe shrinkage and creep of concrete varies with time. In the program, the shrinkage and creep of concrete are simulated by defining time-dependent material properties and automatically calculating the theoretical thickness of the element. In the process of setting the boundary conditions of the model, the lower end of the bridge pier is set as the fixed end. Use rigid connections to connect the piers to the main girder nodes to achieve pier-girder consolidation. The two ends of the prestressed box girder are set as rolling bearings along the direction of the bridge to meet the deformation of the structure under temperature changes.According to the parameter values selected above, make corresponding modifications in the finite element model. A total of 5 calculation conditions are in this paper. In this way, the degree of influence of each factor and the degree of influence of multi-factor coupling on deflection can be solved. See Table A total of 18 models of continuous rigid-frame bridges with different span combinations are established in this paper, and 30 sets of valid data are obtained through finite element calculation and analysis. The calculation results are shown in Table After sorting and analyzing the solved data, the influence degree of each factor on the mid-span deflection is obtained. The scatter plot is shown in Fig. The calculation results show that: (1) The structural cracking causes the stiffness to decrease. However, the effect of stiffness reduction on mid-span deflection is only about 3 mm. The results are weakly correlated with span. It can be seen that its influence on the pre-camber value of the completed bridge can be ignored. (2) The mid-span deflection caused by the loss of longitudinal prestress is concentrated between  mm. Its value is approximately 35% of the deflection after 3 years of operation, but there is no obvious functional relationship with the span. (3) The mid-span deflection caused by the shrinkage and creep of concrete for 3 years increases with the increase of the span. And there is an obvious functional relationship. (4) The relationship between the mid-span deflection and span caused by shrinkage and creep is similar to the relationship between the mid-span deflection and span under the influence of multi-factor coupling. This further verifies the theory that concrete shrinkage and creep is the most important factor affecting the finished bridge pre-camber value of continuous rigid-frame bridges.Through the above analysis, we know that the mid-span deflection value under the action of multi-factor coupling has an obvious functional relationship with the span. Therefore, it is possible to fit discrete data using the least-squares method.Use the least-squares method to establish an approximate continuous model for a large number of discrete data.Given discrete data: Where Marked as Minimize the sum of squares, thenFrom this, a fitting curve that meets the requirements can be obtained.m) and the mid-span deflection value y (mm) under the action of multi-factor coupling.According to the above solution ideas, polynomial fitting is performed on the span x , the finished bridge pre-camber value 28). The parameters of each bridge are shown in Table This paper discusses 4 continuous rigid frame bridges. The current design specification solution Eq. , the empThe calculation results show that: (1) The pre-camber value of the completed bridge calculated according to the specification is far less than the measured deflection value. The result is difficult to meet the requirements of making the final linear shape of the continuous rigid-frame bridge smooth. (2) The pre-camber value of the completed bridge calculated according to the empirical formula is too conservative, which is about twice as large as the measured value. The bridge is still arched in the middle of the span after many years of operation, which affects the driving comfort. (3) The pre-camber value of the completed bridge calculated according to the fitting formula is the closest to the measured deflection value, which is about 0.8–1.3 times as large as the measured value. This shows that after the bridge has been in operation for 3 years, the mid-span alignment is close to the design alignment. The bridge deck is smooth and there is little change in the later period.f2 is determined, according to the usual practice, the finished bridge pre-camber of the side span is 1/4 of f2, and it is set at 3 l/8 of the side span. The rest of the points can be assigned according to the cosine curve.Therefore, the pre-camber value of the completed bridge calculated by the fitting formula in this paper has good applicability. After The stiffness reduction has little effect on the long-term deflection of the continuous rigid frame bridge. The mid-span deflection caused by the loss of prestressing accounts for about 35% of the total deflection. The shrinkage and creep of concrete is the main reason for the mid-span deflection of continuous rigid-frame bridges during operation, and the amount of deflection has an obvious functional relationship with the span.Under the action of multi-factor coupling, the least-square method is used to perform polynomial fitting on a large number of model calculation data. The calculated results of the fitting formula are in good agreement with the measured deflection values of the bridge.The method for selecting the finished bridge pre-camber value of continuous rigid-frame bridges proposed in this paper solves the problem that the empirical formulas are not uniform and the value is too large. This is of great significance for achieving the smoothness of the bridge deck during the operation period.Excessive deflection at mid-span during operation is the most common problem of continuous rigid-frame bridges. To solve this problem, by referring to the relevant research and literature, this paper selects reasonable values for the shrinkage and creep of concrete, the reduction of structural stiffness, and the loss of prestress. Based on a large number of design parameters of continuous rigid-frame bridges obtained from the investigation, 18 finite element analysis models of different span combinations were established, and 30 sets of valid data were obtained by reasonably modifying the calculation parameters. Using the least squares method to fit the discrete data, the pre-camber estimation formula of the completed bridge is obtained, and the applicability of the formula is verified. The main conclusions are as followings:Many factors cause the mid-span deflection of continuous rigid-frame bridges during operation, and some factors influence and depend on each other. Therefore, it is very complicated work to accurately calculate the deflection value. Establishing the functional relationship between the finished bridge pre-camber and the parameters such as span, structural material, and construction method is worth further research in the future.


Polymer concrete, which contains silica fume powder and vinyl ester resin as two replacements for Portland cement, has improved mechanical properties and durability compared to ordinary concrete. Thus, this kind of concrete is considered to be a high-strength concrete that is resistant to corrosion and chemical attacks. In this paper, the effects of the combination of silica fume powder and vinyl ester resin as two Portland cement replacements on the workability and slump value, initial and final water absorption, compressive and tensile strength, and failure and fracture paths of the polymer concrete have been investigated. All investigations have been based on 16 different polymer concrete mixture designs. The results indicate that the optimum percentages for a combination of silica fume and vinyl ester resin, which has the maximum compressive strength (34.26 MPa) and the maximum tensile strength (4.92 MPa), are a combination of 10% silica fume and 5% vinyl ester resin. To evaluate the durability of polymer concrete, the water absorption of all mixture designs has also been measured. Accordingly, the mixture design, which includes a combination of 15% vinyl ester resin and 5% silica fume, has a minimum initial and final water absorption equal to 0.62% and 1.95%, respectively. There is a significant amount of waste plastic in our natural environment, and this is a concern on a global scale ,2. ConcrThroughout their service lives, many structures made of reinforced concrete may be subject to material deterioration, unanticipated overloading that can cause physical damage, cyclic temperature changes, and chemical attack as a result of the harsh climatic conditions that they are exposed to. The mixture design proportions, placement, compaction, and curing procedures ,6 all plIn this context, a novel approach is the utilization of resin as an alternative to Portland cement in the production of concrete ,17. The In the context of the construction industry, the term “polymer concrete” refers to the use of a polymer, such as epoxy, polyester, or vinyl ester materials, as a coating, supplement, or cement replacement in order to improve the mechanical and durability properties of concrete. In general, the rate at which strength is developed in polymer concrete is significantly faster than that of conventional concrete. It is utilized in the production of high-strength concrete, which is a well-known substance that is resistant to corrosion and chemicals . In addiOn the basis of the content that was examined, a composition of vinyl ester polymer concrete as well as the results of experimental tests that were conducted to evaluate the fundamental mechanical properties of the material is presented. Following the strategy for sustainable development in the construction industry, the material cost of polymer concrete was reduced by lowering the consumption of raw materials and partially replacing the micro filler fraction with a recycled waste product known as calcium fly ash . This brAn investigation on the viability of repurposing broken glass from old lighting fixtures as an aggregate for polymer concrete was conducted and detailed in an article. The findings of the research have demonstrated that the aggregate that is obtained from waste glass can, in fact, be utilized fruitfully in the manufacturing of polymer concrete ,22. The Conventionally, polymer concrete is a type of concrete in which resin plays a role as a replacement for Portland cement in the cement paste ,28. For Epoxy resin is one of the applications of resins in polymer concrete. Epoxy resin can be used as a replacement for Portland cement or fine aggregates. Due to better environmental performance, the use of polymer concretes is mostly for non-structural purposes in industry, such as the lining of man-holes, septic tanks, etc. ,31,32,33Today, the use of polymers in ordinary cement concrete has become more important and attractive in order to reduce the consumption of Portland cement in the field of civil engineering and to preserve the environment . AdditioIn addition, Lokuge and Aravinthan  have conThe durability of concrete structures can be improved by including silica fume in the cement mixture. This will also extend their usable life. Therefore, the incorporation of silica fume into the cementitious components of concrete helps to lessen the capillary porosity and preserves the level of cement hydration that has already been achieved. As a consequence of this, the microstructure of the interfacial transition zone (ITZ) is improved by silica fume concrete, which in turn leads to a reduction in diffusion ,39. To aIn this paper, the effect of silica fume powder and vinyl ester resin as two Portland cement replacements in polymer concrete has been investigated. All investigations were based on 16 polymer concrete mixture designs. In the experimental studies of this paper, workability, initial and final water absorption, durability, compressive, and tensile strengths of polymer concrete mixture designs have been investigated. Additionally, the optimum percentages for a combination of silica fume and vinyl ester resin in a concrete mixture design are presented.An overview of the framework for this study is presented in In this section, the materials used in the preparation of the mixture design, the mixture proportions, and the process of preparation, casting, and curing of the specimens have been elaborated.3 and 3200 cm2/g, respectively. The chemical composition of Portland cement is summarized in The Portland cement used in this study is type II Portland cement, which was supplied by Neyzar Qom Cement Company, Qom Province, Iran. The specific gravity and blain of type II Portland cement are 3.18 g/cm3 and 4200 cm2/g, respectively. The chemical composition of the silica fume is summarized in The silica fume (SF) used as a replacement for Portland cement was supplied by the Iran Ferrosilicon Company, Semnan, Iran. The silica fume is a non-crystalline, amorphous type that can participate in the chemical reaction in concrete and combine with the lime in the cement paste to form an adhesive gel and to some extent reduce the alkalinity of the concrete environment. Its particle size is less than 45 microns. The specific gravity and blain of the silica fume are 2.14 g/cm2 gas from the cement production process and helps the environment, the silica fume has been used as a replacement for Portland cement in the concrete mixture design. Thus, in the mixture design, by including the silica fume at its optimal percentage, the slump and workability of the fresh concrete decreased and the compressive and tensile strengths increased.In this study, to reduce cement consumption, which reduces the release of COTo crosslink the vinyl ester resin in the mixture design, Methyl Ethyl Ketone Peroxide (MEKP) as a hardener in the amount of 1.5% by weight of the vinyl ester resin, Cobalt Naphthenate as an accelerator in the amount of 0.4% by weight of the vinyl ester resin, and Dimethyl Aniline (DMA) as an auxiliary accelerator in the amount of 0.4% by weight of the vinyl ester resin should be added to it at average temperatures. The properties of the vinyl ester resin are summarized in The crushed limestone aggregates used in this research were provided from the Khorabad Village, Kahak Section, Qom Province, Iran, and graded according to ASTM C33. The maximum size of the coarse aggregates is 12.5 mm. The specific gravity and absorption value are 2.71 and 2.73% for the coarse aggregates, and 2.65 and 1.01% for the fine aggregates, respectively.Additionally, to improve the workability of the fresh concrete, Polycarboxylate Ether Polymer superplasticizer was employed, which was supplied by the Shimi Sakhteman Company, Tehran, Iran. Water used for the mixing and processing of concrete specimens in this research was drinking water from the city of Qom, Iran.3 concrete and slump values of these 16 concrete mixture designs are summarized in In this study, various proportions of the mixtures were produced by changing the vinyl ester resin contents  and the silica fume contents . The mixture proportions for 1 mIn the laboratory in the Markazi Province of Iran, the concrete mixtures were made for the purpose of undergoing tests to determine their compressive strength, tensile strength, and water absorption. Cast in steel molds, the concrete specimens for the compressive strength and water absorption tests were cubes measuring 100 mm on a side and 100 mm on a height, while the specimens for the tensile strength test were cylinders measuring 100 mm on a diameter and 200 mm on a height. Both types of specimens were compacted on a vibrating table. After being cast for twenty-four hours, the specimens were demolded and cured in water for twenty-eight days at a temperature of twenty-one degrees Celsius and a relative humidity of thirty percent .M0 is the weight of the dried concrete inside the oven and M is the weight of the concrete after placing it in the water.The initial and final water absorption tests of concrete were performed according to ASTM C642. After 28 days, the specimens were placed in an oven at a temperature of 110–100 °C to reach a stabilized weight and dry thoroughly. They were then weighed, their dry weight recorded, and then placed in a tub of water. In order to test the initial water absorption, the specimens were taken out of the tub after 30 min, and after drying their surfaces with a cloth, they were weighed and the results recorded. To test the final water absorption, the specimens were returned to the tub for 48 h and then removed from the water. Subsequently, the surface of the samples was dried, and their weight was again measured and recorded . Finally3. Concrete cylindrical specimens measuring 150,300 mm were recommended in accordance with this standard. The application of axial load continued until the moment of failure of the specimen and the appearance of the rupture surface, in addition to reducing the compressive load. The results of this experiment depend on the specimen size, design, method of mixing, specimen age, temperature, sampling method, and humidity at the time of processing. According to this standard, the speed and rate of loading are 0.2 to 0.3 MPa per second, continuously. The compressive strength obtained in this study is based on the cubic specimen strength of 100 mm × 100 mm × 100 mm. Hence, this value has been converted to the 150 mm × 150 mm × 150 mm standard cubic strength and then to the equivalent strength of the standard cylinder specimen with 150 mm diameter and 300 mm height. These experiments have been performed on the specimens for 28 days.The compressive strength of concrete is a significant parameter in the design of reinforced concrete structures that determines the properties of concrete. In this study, the compressive strength test was performed according to the ASTM C39 standard a. This sIn this study, the tensile strength of the specimens has been obtained according to the Brazilian test method and the ASTM C496M b. Due toThe maximum load that can be tolerated by a concrete specimen depends on the geometric dimensions of the specimen, which determine the tensile strength of concrete. Therefore, the most effective and important criteria in determining the durability of concrete are its water absorption and tensile strength.In the polymer concrete prepared in this study, due to the use of the vinyl ester resin and silica fume as replacements for Portland cement, segregation in the aggregates as well as bleeding have occurred. Accordingly, the fine aggregates have gone to the top of the mold, and the coarse aggregates have gone to the bottom of the mold. Compaction, vibration, and concrete surface polishing became difficult and needed more time for molding. It is worth mentioning that with the increase in the silica fume in the mixture design, molding and surface polishing of the specimens became difficult due to the decrease in hydration temperature. With the increased use of the vinyl ester resin, due to the adhesion and crosslinking of vinyl ester during mixing, molding and surface polishing of specimens became difficult.In this section, the results of the tests to determine the percentage of water absorption, compressive strength, and tensile strength of polymer concrete specimens containing different percentages (by weight of cement) of the silica fume and vinyl ester resin have been analyzed.In this experiment, the amount of water absorption for 30 min is the same as the initial water absorption, and the 48 h absorption is the same as the final water absorption. As indicated in Finally, the maximum final water absorption (4.98%) is related to the mixture design containing a combination of 5% vinyl ester resin and 15% silica fume, and the minimum final water absorption (1.95%) is related to the mixture design containing a combination of 15% vinyl ester resin and 5% silica fume. Furthermore, the maximum initial water absorption (2.42%) is related to the mixture design containing a combination of 0% vinyl ester resin and 5% silica fume, and the minimum initial water absorption (0.61%) is related to the mixture design containing a combination of 10% vinyl ester resin and 10% silica fume. The vinyl ester resin causes adhesion and stiffness in the mixture design, and silica fume reduces the slump and workability of the mixture design. Accordingly, they should be combined with a suitable percentage of superplasticizer to ensure the workability of the concrete. The addition of the silica fume to the mixture causes a combination of silica particles with calcium hydroxide crystals and produces calcium silicate gel, which over time fills the pores in the cement paste and microstructure in the concrete and compacts the concrete structure. It also fills the pore spaces between the aggregates and the cement paste.The amount of initial water absorption is greatest when the percentage of resin in the mixture is at its lowest. This is because the vinyl ester resin has the property of increasing adhesion and stiffness in the mixture design. The results show that this occurs when the percentage of resin in the mixture is at its lowest. In addition, the highest possible level of water absorption can be accomplished by using a resin content of 5% of the total. According to the findings, the application of the silica fume does not have a substantial impact, either initially or ultimately, on the amount of water that is absorbed. According to the findings, there is not a discernible difference in the amount of water absorption that takes place when the percentage of the vinyl ester resin and silica fume is set at 5%. The quantity of initial water absorption drops by 47% when the amount of the vinyl ester resin and silica fume is reduced to 10%; nevertheless, the quantity of final water absorption rises by 16% when this is performed. Additionally, the initial and final water absorption both decrease by 42% and 15%, respectively, if there is a shift of 15% in the percentage of the vinyl ester resin and silica fume. This represents a 10% increase in the amount of resin and silica fume compared to the first scenario.As indicated in Furthermore, in the specimen containing 10% silica fume and without the vinyl ester resin, the slump value of the fresh concrete is 80 mm, which is 3 mm less than the control concrete slump. The compressive strength of this specimen compared to the control concrete has increased by 4.04 MPa. Its tensile strength has also increased by 1.71 MPa compared to the control concrete. Therefore, the optimum percentage of silica fume as a replacement for Portland cement is 10%.In the specimen containing 15% vinyl ester resin and without the silica fume, the slump value of the fresh concrete is 78 mm, which is 5 mm less than the control concrete slump. The compressive strength of this specimen compared to the control concrete has been reduced by 11.75 MPa. Its tensile strength has also decreased by 2.98 MPa compared to the control concrete.Therefore, the slump value of the fresh concrete in the specimen that contains 10% vinyl ester resin but does not contain the silica fume is 82 mm, which is one millimeter less than the slump of the control concrete. This specimen has a compressive strength that is 3.99 MPa lower than the control concrete when compared to the concrete used as the standard. In comparison to the concrete that served as the control, its tensile strength has likewise dropped by 1.31 MPa. The slump value of new concrete measured 85 mm in the specimen that included 5% vinyl ester resin but did not contain the silica fume; this value was 2 mm higher than the slump measured in the control concrete. When compared to the control concrete, this specimen has a compressive strength that is 6.12 MPa lower than the control concrete. In comparison to the concrete that served as the control, its tensile strength has likewise decreased by 0.64 MPa.The slump value of the fresh concrete in the specimen that contains a mixture of 10% silica fume and 5% vinyl ester resin is 80 mm, which is 3 mm smaller than the slump of the control concrete, which contains 0% silica fume and 0% vinyl ester resin. As a direct consequence of this, the control specimen’s compressive strength has been raised by 0.61 MPa when compared to the specimen under investigation. In comparison to the concrete that served as the control, its tensile strength has also increased by 0.07 MPa. Because of this, the formulation of this mixture is the best possible combination of the silica fume and vinyl ester resin that can be found in the polymer concrete.Accordingly, in the specimen containing a combination of 15% silica fume and 15% vinyl ester resin, the slump value of the fresh concrete was 82 mm, which is 1 mm less than the control concrete slump. Therefore, the compressive strength of this specimen has decreased by 14.39 MPa compared to the control concrete. Its tensile strength has also decreased by 3.49 MPa compared to the control concrete.According to Therefore, the optimum percentages of the vinyl ester resin, which has the maximum compressive strength (29.66 MPa) and the maximum tensile strength (4.21 MPa), are 10% and 5%, respectively. The optimum 10% silica fume has the maximum compressive strength (37.69 MPa) and the maximum tensile strength (6.56 MPa). Hence, the optimum percentages for a combination of the silica fume and vinyl ester resin, which provide the maximum compressive strength (34.26 MPa) and the maximum tensile strength (4.92 MPa), are a combination of 10% silica fume and 5% vinyl ester resin.(I)In the mixture design containing the vinyl ester resin and without the silica fume, by increasing the vinyl ester resin from 0 to 15%, the initial and final water absorption percentages decrease by 66.35% and 25.29%, respectively.(II)In the mixture design containing the silica fume and without the vinyl ester resin, by increasing the silica fume from 0 to 10%, the initial and final water absorption percentages decrease by 1.42% and 5.62%, respectively.(III)Among the results of the initial and final water absorption of all of the specimens, the mixture design including a combination of 15% vinyl ester resin and 5% silica fume has the minimum initial and final water absorption equal to 0.62% and 1.95%, respectively.(IV)Among the results of the strengths of all of the specimens, the specimen containing 10% silica fume has the maximum compressive strength (37.69 MPa) and the maximum tensile strength (6.56 MPa).(V)The optimum percentages of the vinyl ester resin, which have the maximum compressive strength (29.66 MPa) and the maximum tensile strength (4.21 MPa), are 10% and 5%, respectively.(VI)The optimum percentage of the silica fume, which has the maximum compressive strength (37.69 MPa) and the maximum tensile strength (6.56 MPa), is 10%.(VII)The optimum percentages for the combination of the silica fume and the vinyl ester resin, which have the maximum compressive strength (34.26 MPa) and the maximum tensile strength (4.92 MPa), are a combination of 10% silica fume and 5% vinyl ester resin.(VIII)In the specimen containing a combination of 10% silica fume and 5% vinyl ester resin, the slump value of the fresh concrete is 80 mm, which is 3 mm less than the slump value of the control concrete (0% silica fume and 0% vinyl ester resin).(IX)During the loading of the concrete specimens in the compressive strength test, shear cracks have appeared diagonally. Unlike the ordinary concrete, in the concrete specimens containing the vinyl ester resin and the silica fume, more fracture paths pass through the aggregates.Based on laboratory observations and the results of various experiments performed on the polymer concrete specimens in this study, the results are summarized as follows:


Aquatic products have an important role in global agriculture, but the challenges associated with preservation have limited their marketability. Essential oil (EO), such as sweet orange oil (SOEO), has been widely used for preservation due to its excellent antibacterial ability. However, the volatilization of EO limits its application in food preservation. In this study, SOEO was extracted from sweet orange peel by steam distillation and then stored in microcapsules. The components of the microcapsules were as follows: the porous starch was chosen as an adsorbed substrate to store SOEO (PS/SOEO), and sodium alginate (SA) and chitosan (CMCS) were used as shell material to delay the volatilization of SOEO using the sharp pore coagulation method. Our results showed that the main antibacterial ingredients in SOEO were aldehydes (33.93%) and d-limonene (15.38%). The microcapsules were of an irregular shape , and the size of the microcapsules was 1.2  Aquaculture is an essential economic pillar industry in many countries. However, due to its high nutrition, high moisture, and low connective tissue content, aquatic products easily decay, leading to severe economic loss. In recent years, plant essential oil (EO) has been considered a potential food preservative because of its antioxidant, biophilic, and antibacterial properties ,2,3. It At present, microencapsulation technology is widely used in the food, biological, and pharmaceutical fields . StudiesBacillus cereus [The shell of microcapsules can separate the substrate from the external environment, reducing the impact of oxygen, heat, lighting, and pH on the EO and enhancing its stability . Many res cereus .However, the forming capability of chitosan is very poor, so it needs to be combined with other materials. Many studies have shown that the combined use of two or more shell materials is beneficial to improve the loading capacity and stability of microcapsules . Sodium In the above-described context, the objectives of this study were to (1) prepare a porous corn starch using the enzymolysis method; (2) use porous corn starch as a substance to adsorb sweet orange essential oil and sodium alginate (SA) and modified carboxymethyl chitosan (CMCS) as shell to protect the SOEO; (3) characterize the resulting materials by Fourier transform infrared spectroscopy (FT-IR), pressure resistance analysis, X-ray diffraction (XRD), and scanning electron microscopy (SEM); (4) explore the effective antibacterial ingredients of sweet orange oil and its release kinetics; (5) test the antibacterial properties of SOEO and compare it with natural starch; and (6) determine the preservation of crawfish by SOEO microcapsules.Aeromonas sobria (ATCC43979) and Shwanella putrefaciens (ATCCBAA-1097), were purchased from Shanghai Preservation Biotechnology Centre . Sweet orange essential oil (SOEO) was sourced from sweet orange essential peel. The chitosan used in this experiment was treated with 10 KGY irradiation , 60Co-ray; the irradiation dose rate was 6.25 Gy/min, and the irradiation doses were set at 20, 40, 60, 80, and 100 KGy.The main materials used were natural starch (food grade), ethanol, n-hexane, acetic acid, disodium hydrogen phosphate, citric acid, calcium chloride anhydrous, sodium hydroxide, potassium bromide (KBr), magnesium oxide (MgO), nutrient agar, and carboxymethyl chitosan (CMCS); all were analytically pure materials and purchased from Sinopharm Chemical Reagent Co. . Sodium alginate (SA) was purchased from Shanghai Maclean Biochemical Technology Co. . BCP (bromocresol purple plate count agar) medium with 0.2% soluble starch was purchased from Beijing Wokai Biotechnology Co. . Two strains, According to the method of Fu et al. , the ort1 (g) is the weight of the initial porous starch, and m2 (g) is the final weight of the porous starch.The adsorption properties of porous starch on SOEO (PS/SOEO microspheres) were analyzed by the differential weight method. The porous starch was stirred at high speed with SOEO and then kept at room temperature to remove the surface residue. The adsorption rate of SOEO was then calculated by the following equation:The sweet orange peel was placed into a thermostatic drying chamber for drying and crushed. Then, 100 g treated sweet orange peel was put into 1000 mL distillation flask with a certain amount of water. The upper oil liquid was sweet orange oil (SOEO) after steam distillation.The essential oil of sweet orange was analyzed by 7890A-5975C gas chromatography–mass spectrometry (GC–MS). First, 10 μL of SOEO was diluted 1000-fold with n-hexane, and 1.5 μL of diluted solution was placed into the HS-SPME sample flask. The chromatographic conditions were as follows: DB-WAX model chromatographic column (30 × 0.25 mm); inlet temperature of 240 °C; pressure of 100 kPa; and high-purity helium as carrier gas. The initial temperature of 60 °C was held for 4 min, then ramped up to 240 °C at 4 °C/min and held for 2 min. The mass spectrometry conditions were as follows: ion source temperature of 200 °C and interface temperature of 220 °C. The solvent delay time was 5 min [Aeromonas sobria and Shwanella putrefaciens were applied to a suitable solid medium by the spread plate method. Three Oxford cups were placed on the surface of the plates, and 200 μL of SOEO was added to the Oxford cups. An equal volume of sterile water was used as control. After about 24 h, a vernier caliper was used to measure the diameter of the IZ.Referring to the relevant literature, the Oxford cup method was used to determine the diameter of the essential oil inhibition zone (IZ) . First, According to the method of Fu et al. , 1 g of The surface morphology of modified starch, natural starch, and SOEO microcapsules was studied by SEM (Hitachi SU8010). The images obtained were 50, 20, and 1 μm.−1, and 32 scans at 4 cm−1 resolution were achieved for each spectrum.Fourier infrared spectroscopy  was used to analyze the chemical composition of the samples . First, 1–2 mg of powder sample and 200 mg of pure KBr were finely ground, homogenized, and pressed into a transparent sheet on an oil press. The samples were then put into an infrared spectrometer for testing. The wavenumber range was 4000–400 cmTo study the packing characteristics and crystallinity of the material, the diffraction intensity of the samples  were recorded every 5° by XRD (Bruker D8 Advance 25) over a 2° to 60° . The resThe pressure resistance of SOEO microcapsules  was analyzed by a universal mechanical testing machine (CMT6103). The range of the load sensor was 10 kN, and the test speed was 1.5 mm/min. The compression deformation was obtained by displacement of the crosshead of the testing machine, so the compression elastic modulus calculated in this study is the apparent elastic modulus. Each sample was conducted in triplicate.2 = 0.9941.Ethanol is soluble in any proportion with water. It reduces the interfacial tension between EO and water, accelerates the dissolution of EO on the surface of microcapsules, accelerates the release of the core material, and shortens the period of the experiment . For thiNext, 0.2 g of SOEO microcapsules was added to 30 mL of 50% ethanol solution in a closed system at room temperature (25 °C). At each time point , an amount of the solution was removed and the absorbance at 670 nm  was measShewanella putrefaciens and Aeromonas sobria were spread on the medium, and microcapsules of SOEO  were fixed with double adhesive on the lids of the dishes. The culture dishes were then inverted and incubated in a constant temperature (37 °C) incubator for 48 h. The optimum amount of microcapsules was selected by the spread plate count method. The antibacterial properties against composite strains were also examined, and the proportion of composite strains was as follows: Aeromonas sobria/Shwanella putrefaciens ratio = 1:1, 50 μL.According to the method of Tu et al. , 100 μL Alive crawfish with an average weight of 30TVB-N value was estimated by the FOSS method. Crawfish was hacked through the packing, cleaned and drained in sterile environment (5.0 g), and homogenized with MgO (0.5 g) using a mixer. Finally, the mixture was placed into a FOSS digestion tube. TVB-N value was measured by an automatic Kjeldahl apparatus , and the level of TVB-N was expressed as mg N/100 g of crawfish.The TPC value was estimated as follows. First, the crawfish was hacked through the packing, cleaned and drained in sterile environment (10 g), and homogenized. Then, it was placed into a sterile bag with 90 mL aseptic sterile saline and beaten using a beating homogenizer for 3 min to obtain uniform bacterial suspension. The bacterial suspension was diluted by 10p < 0.05 was considered statistically significant. The SPSS software (version 26.0) was used for all statistical analyses.One-way analysis of variance (ANOVA) was utilized for a completely randomized statistical analysis; The chromatograms shown in  revealedOther researchers have proven that aldehydes (33.93%)  and d-liShewanella putrefaciens and Aeromonas sobria to carry out the bacteriostasis test because our previous studies found these bacteria to be the dominant spoilage bacteria for crawfish stored at room temperature (unpublished data). As shown in Shewanella putrefaciens and Aeromonas sobria. Measurements showed that the inhibition zone size was 1.1 Shewanella putrefaciens and 0.9 Aeromonas sobria. No inhibition zone was observed in the control group of both strains, indicating that SOEO has relatively high inhibition potential against Shewanella putrefaciens and Aeromonas sobria. Regarding the mechanism of inhibition, He et al. studied the inhibitory effect of eucalyptus essential oil on four strains of bacteria, including Escherichia coli and Shewanella putrefaciens, and showed that the use of eucalyptus essential oil resulted in increased permeability of bacterial cell membranes and impaired cellular integrity and cellular physiological functions, demonstrating the inhibitory effect of plant essential oil on specific spoilage bacteria in aquatic products [In this study, we used products .2) of CMCS wrapped the starch between them due to electrostatic attraction to form an electron layer, and white emulsion-like CMCS-SA-PS/SOEO was finally obtained [The modified starch was used as an adsorbent to adsorb SOEO, and SA and CMCS were used as wall materials to encapsulate the modified starch with adsorbed SOEO to form a microcapsule structure. The carboxyl group (−COOH) of SA and the amino group  by degradation and released from the microcapsules; second, the substrate starts to swell and the degradation or corrosion of the shells leads to the release of the EO; third, the released EO works on the bacteria . In thisTVB-N is one of the main indicators used to judge whether aquatic products have decayed. According to hygienic standards for marine products, the acceptable TVB-N values for marine fish and shrimp should be no more than 20 mg N/100 g . As showOverall, SOEO microcapsule showed a good ability in preserving crawfish, and the shelf life of crawfish could be extended to 6 days. Compared to other studies, our SOEO microcapsules were more stable. For example, Alotaibi used sweet potato starch and thyme essential oil to produce microcapsules and found that the rate of lipid oxidation in shrimp meat was significantly inhibited during storage. However, the shelf life of crawfish was only extended to 4 days because the essential oil was not protected in the form of a shell, which led to instability of the essential oil.In this study, SOEO microcapsule were prepared by SOEO, modified starch, CMCS, and SA. The modified starch was used as a substance to adsorb SOEO, and the best condition to modify starch was as follows: enzyme/starch ratio of 0.020:1, buffer solution pH of 5.5, and 45 °C water bath temperature. The main antibacterial agents were aldehydes and d-limonene. The results of characterization revealed that (1) SOEO had successfully been adsorbed by modified starch; (2) CMCS and SA could not only wrap the starch well but also improved the pressure resistance of the microcapsule; (3) combined with the results of release kinetics, the best rates of CMCS and SA were 1.2 and 2.4%, respectively. The results of antibacterial test showed that the overall cost-effectiveness of the film was the highest when 0.8 g of SOEO microcapsules was added. In the preservation test of crawfish, it was found that the shelf life of crawfish was greatly extended compared to other treatments.


Limiting the consumption of nonrenewable resources and minimizing waste production and associated gas emissions are the main priority of the construction sector to achieve a sustainable future. This study investigates the sustainability performance of newly developed binders known as alkali-activated binders (AABs). These AABs work satisfactorily in creating and enhancing the concept of greenhouse construction in accordance with sustainability standards. These novel binders are founded on the notion of utilizing ashes from mining and quarrying wastes as raw materials for hazardous and radioactive waste treatment. The life cycle assessment, which depicts material life from the extraction of raw materials through the destruction stage of the structure, is one of the most essential sustainability factors. A recent use for AAB has been created, such as the use of hybrid cement, which is made by combining AAB with ordinary Portland cement (OPC). These binders are a successful answer to a green building alternative if the techniques used to make them do not have an unacceptable negative impact on the environment, human health, or resource depletion. The Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) software was employed for choosing the optimal materials’ alternative depending on the available criteria. The results revealed that AAB concrete provided a more ecologically friendly alternative than OPC concrete, higher strength for comparable water/binder ratio, and better performance in terms of embodied energy, resistance to freeze–thaw cycles, high temperature resistance, and mass loss due to acid attack and abrasion. The first documented attempt for developing geopolymer concrete, which is also referred to as alkali-activated binder (AAB) concrete, was reported in 1939–1940 according to the historical review papers published by Li et al. . In termIn a research paper, the fracture behavior of geopolymer composites made of fly ash or metakaolin, fine aggregate, and river sand and reinforced with glass, carbon, and aramid fiber was examined at three different temperatures, around 3 °C, 20 °C, and 50 °C. As a potential working temperature for composite materials created using additive manufacturing technology, the temperatures were considered. Bending strength testing was the primary study methodology employed. The results revealed that adding fibers enhanced the bending strength of all composites substantially. The metakaolin-based composites and the sand reinforced with 2% of weight aramid fiber produced the greatest results at room temperature. The results at 50 °C revealed a considerable drop in bending strength for virtually all compositions, which is surprising given that geopolymers are advertised as materials designed to perform at high temperatures. For nearly all compositions, the test at low temperature (about 3 C) revealed an increase in bending strength .2 intensity of these binders is roughly 2.4 times lower than that of OPC [Several investigations have proven that acceptable geopolymer behavior may also be produced by employing industrial wastes as secondary source material, such as fly ash or slag. The environmental effect of geopolymer manufacturing is dependent on the type of raw material generated under different circumstances to attain different features . The AABt of OPC ,12. The t of OPC ,14,15. It of OPC . The usat of OPC .2 emissions in feedstocks, this technique enables a thorough comparison of material production, transit, usage, and demolition consequences. The life cycle phases for material feedstock production, such as collection, transportation, mining, and calcination of these feedstocks, are investigated first, followed by manufacturing stages, including the mixing process of these raw materials [One of the most essential criteria for sustainability performance is the life cycle assessment (LCA) of geopolymer concrete, which analyzes the ecological effect and environmental potential of materials based on the stages of production and manufacture, usage, and demolition. The LCA is divided into four stages: aim and scope definition, inventory analysis, impact assessment, and interpretation ,19. A liaterials ,21.Another aspect of sustainability is the availability of resources, which plays a significant role and has a major influence on the cost, including the following stages: excavation process, extraction, transportation, forming, and construction time. As a result, the high availability of resources activates the building process and decreases the overall project time in order to reduce purchasing effort while also reducing human potential in the search for alternatives ,23. In mBased on the current and anticipated momentum toward the use of AAB concrete in the field of sustainability, this study is performed to provide useful life cycle cost comparison between typical AAB and OPC concrete. The aim of this study is to develop effective analysis using the TOPSIS software that is beneficial to the field of green building sustainability. The methodology and interesting results are presented and discussed systematically in the following sections of this paper.Purdon’s work  as well tf) and compressive strength (f′c) do not directly relate according to Power’s law, given as: tf = k(f′c)0.5 [tf = 0.249 f′c0.772, to calculate the splitting tensile strength from the compressive strength of AAB concretes regardless of the grade or molarity. This proposed formula shows good agreement with experimental results [AAB concrete frequently has greater tensile and flexural strengths than its compressive strength when compared to OPC concrete. It is hypothesized that this would strengthen the fracture resistance of geopolymer concrete since it seems that the geopolymer gel is strongly bound to the aggregate particles ,27. The (f′c)0.5 . It was  results .One of the major benefits of AAB concrete over OPC concrete is their high resistance to acid attack. The OPC concrete has a typical mass loss after exposure to acid attack of approximately 70–95% compared to approximately 8–12% for the AAB concrete under the similar exposure condition. This indicates that the AAB concrete experiences a lower mass loss of approximately 88% ,31. Rega2 emissions, which is the greatest among all building material. On average, 0.81 kg of CO2 is produced for every 1 kg of cement during the Portland cement clinker manufacturing including the calcination process [2 emission that was almost 10% lower than comparable concrete with a 100% OPC binder [2 emissions and global warming [Manufacturing of Portland cement is thought to be responsible for approximately 8% of the world’s CO process . From a C binder . A recenC binder . The stu warming .In the designing of greenhouses, AAB concrete is shown to be much better than OPC and might be cost-competitive on a production-only basis. According to prime materials, the cost of ordinary OPC structural concrete is roughly 125 dollars per ton, but the cost of AAB structural concrete for the same specifications is between 118–175 dollars per ton . AnotherA life cycle assessment, or LCA, is a method for calculating the environmental effects associated with the extraction, mining, quarrying, manufacture, usage, and demolition stages of structural buildings . This se2 emission. To compute the CO2 emission and construct the life cycle stages, a concrete with 40 MPa compressive strength was studied for the two binder types according to the mixing proportions shown in 3 of OPC concrete and AAB concrete are displayed in schematic graphs shown in 2 emissions from the OPC concrete manufacturing, transportation from the cement factory to the ready-mix plant, aggregate extraction and transportation, mixing of the concrete ingredients, curing, and finally placement . 2 emission for the AAB concrete is lower than that of the OPC concrete by approximately 9% for each 1 m3, as presented in The production stages from cradle to gate of the OPC concrete and the AAB concrete  are reprijR)Step 1: Compute the normalized  should be used, whereas if the expectancy is the max-the-better, then Equation (2) should be used. The computation of the normalized (ijR) is illustrated in The PSI technique follows a systematic scientific approach to identify the optimum material for a given job. It is considered very useful when there is concern about the relative significance of aspects. The PSI for each option is computed using the overall preference value and the option with the maximum PSI value is chosen as the best alternative. The following calculations are an application of the PSI method  to compajPV)Step 2: Compute preference variation value Step 3: Determine overall preference value (Ψi for each criterion was measured using Equations (5) and (6) and is presented in The value of ΨiI) for each alternativeStep 4: Compute the preference selection index . The values of iI are presented in The final step is calculating the index iI between the OPC and AAB concretes is presented in iI is higher for AAB concrete for all applied criteria: acid attack, abrasion resistance, embodied energy, resistance to freeze–thaw cycles, and resistance to high temperature.A comparison of 2 emissions, minimum embodied energy, maximum resistance to freeze–thaw cycles and maximum resistance to high temperature. The core idea behind this strategy is that the chosen alternative should be mathematically closest to the ideal solution and farthest from the negative-perfect solution. The input values shown in A comparison study between alkali-activated binder concrete and OPC concrete has been conducted using TOPSIS software  to selec2 emissions while improving the strength of concrete.AAB concretes have the potential to be more ecologically and economically responsible in areas where cement would need to be transported over longer distances and in the event that cement becomes a scarcer resource in the future. In comparison to OPC concretes, the AAB concretes will have a favorable environmental impact. Examples of these types include the use of bricks, one-part geopolymers, and hybrid cements. As an excellent substitute for the clay combustion technique used in the production of burnt bricks, AAB concrete may be used in the form of blocks. In comparison to producing a Ca alumina silicate slag, producing a slag of albite and sodium hydroxide yields a highly reactive solid product with a high alkali content and Si and Al sources that are rapidly liberated in solution. The fundamental idea behind this sort is to combine OPC with AAB, which will reduce the COThe development of AAB concrete seems to provide a more ecologically friendly alternative to OPC concrete. In greenhouse applications, AAB concretes perform more efficiently than OPC concretes.According to the PSI technique of material selection, AAB concrete outperforms OPC concrete in the following criteria: mass loss due to acid attack, abrasion resistance, embodied energy, resistance to freeze–thaw cycles, and high temperature resistance.In terms of sustainability considerations, AAB concrete is preferable to OPC concrete, as indicated by the PSI technique and TOPSIS.Based on the results of this study, the following conclusions are drawn.


We compared the health‐related quality of life (HRQOL) in patients undergoing trimodality therapy for resectable stage I‐III esophageal cancer.A total of 96 patients were randomized to standard neoadjuvant cisplatin and 5‐fluorouracil chemotherapy plus radiotherapy (neoadjuvant) followed by surgical resection or adjuvant cisplatin, 5‐fluorouracil, and epirubicin chemotherapy with concurrent extended volume radiotherapy (adjuvant) following surgical resection.p = 0.759) with 36% versus 41% (neoadjuvant vs. adjuvant), respectively, showing an increase of ≥15 points compared to pre‐treatment (p = 0.638). The HRQOL was significantly inferior at 2 months in the neoadjuvant arm for FACT‐E, European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ‐OG25), and EuroQol 5‐D‐3 L in the dysphagia, reflux, pain, taste, and coughing domains (p < 0.05). Half of patients were able to complete the prescribed neoadjuvant arm chemotherapy without modification compared to only 14% in the adjuvant arm (p < 0.001). Chemotherapy related adverse events of grade ≥2 occurred significantly more frequently in the neoadjuvant arm . Surgery related adverse events of grade ≥2 were similar in both arms . There were no 30‐day mortalities and 2% vs. 10% 90‐day mortalities (p = 0.204). There were no significant differences in either overall survival (OS)  or disease‐free survival (DFS) .There was no significant difference in the functional assessment of cancer therapy‐esophageal (FACT‐E) total scores between arms at 1 year (Trimodality therapy is challenging for patients with resectable esophageal cancer regardless of whether it is given before or after surgery. Newer and less toxic protocols are needed. This randomized trial assessed the health related quality of life in esophageal cancer patients undergoing neoadjuvant versus adjuvant trimodality therapy. Every patient experienced at least one adverse event. The quality of life was worse for patients undergoing neoadjuvant compared to adjuvant chemoradiation with no significant difference in either overall survival or disease‐free survival. More effective therapy is needed. Esophageal cancer is a challenging disease entity that reduces a patient's health‐related quality‐of‐life (HRQOL) and is lethal in most cases.Epirubicin, cisplatin, and 5‐fluorouracil (ECF) along with extended field radiation that includes the anastomosis given in the adjuvant setting has been the standard of care at our center for several decades.We hypothesized that both trimodality treatment options would provide similar survival results but may have different patient‐centered experiences with respect to HRQOL and adverse events.The Quality of Life in Neoadjuvant vs. Adjuvant Therapy of Esophageal Cancer Treatment Trial (QUINTETT) was a single‐center, parallel‐group, centrally concealed, randomized superiority study. The Consolidated Standards of Reporting Trials (CONSORT) 2010 guideline was followed to report the details of this trial.The study population consisted of sequentially screened patients with stage I to III resectable cancer of the esophagus referred to our institution Figure . The incThe study took place from April 2009 to November 2016 at the London Health Sciences Centre and London Regional Cancer Program. The study was completed and approved by our local ethics review board in accordance with the Declaration of Helsinki, Good Clinical Practice guideline.2 × 4 days (=100 mg/m2) concurrent with 5‐FU 1000 mg/m2 per day for 96 hours continuous venous infusion for 2 cycles every 28 days with concurrent 50.4 Gy in 28 fractions of radiation therapy. Additional details are available in the protocol in Appendix In the neoadjuvant arm treatment began within 4 weeks of randomization and consisted of 2 cycles of induction cisplatin 25 mg/m2 and cisplatin 60 mg/m2 day 1, and 5‐FU by continuous venous infusion at 200 mg/m2 for 21 days) then cisplatin 60 mg/m2 day 1, and 5‐FU by continuous venous infusion at 200 mg/m2 for 21 days with concurrent 50.4 Gy radiation immediately afterward for 2 additional cycles as previously described.The adjuvant arm consisted of surgical resection followed by 2 cycles of ECF chemotherapy and concurrent extended volume radiation treatment that included the anastomosis and began between 8‐ and 12‐weeks following surgery. This was chemotherapy alone for 2 cycles  at 1 year.Secondary endpoints included additional HRQOL assessments using the tumor‐specific EORTC QLQ‐OG 25.t‐test, using two‐sided testing, α = 0.05, power = 80% and standard deviation (SD) = 25; 48 patients would be required in each arm  after adjusting for 10% lost to follow‐up.The sample size was estimated based on an improvement in the HRQOL as measured by the FACT‐E at 1 year of 15 points. Based on a two‐sample 2 test, Fisher's exact test, two‐sample t‐test, Wilcoxon rank‐sum test, or paired t‐test as appropriate. Univariable Cox proportional hazards regression was performed for OS and DFS  (Table p = 0.638). An improvement of more than 15 points is considered clinically significant for patients. Overall, just over one‐third of patients receiving neoadjuvant therapy had a clinically significant improvement in their HRQOL compared to less than one half of patient receiving adjuvant chemoradiation. FACT‐E scores over time stratified by arm are shown in Figure p = 0.007). The Trial Outcome Index  also showed a significantly larger decrease for the neoadjuvant arm at 2 months (p = 0.008) and a significant improvement at 1‐year for the neoadjuvant arm , but not for the adjuvant arm . Similarly, the esophageal cancer subscale also decreased more for the neoadjuvant arm at 2 months and had a significant improvement at 1‐year for both arms. Although the magnitude of improvement at 1‐year for FACT‐E, Trial Outcome Index, and esophagus cancer subscale was greater for the neoadjuvant arm, this was not statistically significant.At baseline there were no statistically significant differences in HRQOL. At 1‐year follow‐up, the mean ± SD FACT‐E score was 139.7 ± 20.0 in the neoadjuvant arm compared to 138.0 ± 21.9 in the adjuvant arm with a mean difference of 1.7 (9) Table . Both arp = 0.330; adjuvant: p = 0.550)  was 0.80 ± 0.18 in the neoadjuvant arm and 0.84 ± 0.15 in the adjuvant arm at baseline, clinically and statistically decreased at 2 and 4 months for the neoadjuvant arm, and decreased at 2 months for adjuvant arm during the 6 months of trimodality therapy but returned to baseline values also by 6 months  (Table p < 0.001). Thirteen patients (26%) in the adjuvant arm did not receive the allocated chemotherapy and radiation . Six patients in the neoadjuvant arm did not undergo allocated surgical resection for the following reasons: spinal metastases (n = 1); peritoneal metastases (n = 1); disease progression during induction chemotherapy (n = 1); massive pulmonary embolus (n = 1); and sever cerebral vascular event (n = 1)  Table . The stop < 0.001). A pathological complete response (ypT0N0) was observed in the resection specimens from 8 (21%) patients in the neoadjuvant arm all corresponding with adenocarcinomas. Regional lymph nodes were positive in 5% of neoadjuvant patients compared to 29% in the adjuvant arm (p < 0.001) (Table Adenocarcinomas were the most common (89% vs. 90%) followed by squamous cell (4% vs. 10%) with unknown histology for 3 (6%) patients in the neoadjuvant arm. A total of 92% of patients in the neoadjuvant arm had a complete R0 resection compared to only 51% in the adjuvant arm (p = 0.204), which is not surprising because the trial was powered to detect a difference. There were no significant differences comparing neoadjuvant and adjuvant arms in either OS (p = 0.409), 5‐year OS 35% vs. 32%, or DFS (p = 0.710), 5‐year DFS 31% vs. 30% , regional , or distant recurrences  between the neoadjuvant and adjuvant arms, respectively  90‐day mortality in the neoadjuvant arm and 5 (10%) 90‐day mortalities in the adjuvant arm p = 0.20, which ip < 0.001), whereas serious adverse events (grade ≥3) occurred in 79% of neoadjuvant and 55% of adjuvant patients (p = 0.014), more frequently in neoadjuvant arm (Table p < 0.05), whereas hypokalemia and hypomagnesemia related to chemoradiotherapy were significantly more frequent in the adjuvant arm (p < 0.05) (Table p = 0.107) and serious adverse events in 58% of neoadjuvant and 76% of adjuvant (p = 0.061), more frequently in adjuvant arm. Catheter infections and esophageal stenosis related to surgery were more frequent in the adjuvant arm (p < 0.05), whereas gastroesophageal reflux and pneumonia were more frequent in the neoadjuvant arm (p < 0.05). More specifically, esophageal anastomotic leak grade ≥2 was similar between the neoadjuvant arm  and the adjuvant arm  (p = 0.947); however, esophageal stenosis grade ≥2 was more frequent in the adjuvant arm  compared to the neoadjuvant arm  (p = 0.007)  attributed to chemoradiotherapy occurred in 100% of neoadjuvant and in 69% of adjuvant patients  of the studies unfortunately were of low quality.Our study is the only randomized trial that used the disease‐specific outcomes captured in the FACT‐E instrument to assess HRQOL in esophageal cancer patients undergoing trimodality therapy. Scarpa et al.To our knowledge, there has been no randomized trial evaluating neoadjuvant versus adjuvant chemoradiation for adenocarcinomas of the esophagus and gastroesophageal junction. Our trial evaluated two different perioperative protocols. The neoadjuvant arm consisted of cisplatin and 5‐FU plus radiation, which was the current standard at the time. Our adjuvant arm consisted of ECF chemotherapy plus radiation, which was adopted from our gastric cancer protocol at the time.40 compared surgery alone with surgery and adjuvant 5‐FU chemotherapy plus 45 Gy radiation for patients with resectable adenocarcinomas of the stomach and gastroesophageal junction, of which only 20% of the patients had cancers of the gastroesophageal junction. The median OS in the surgery only group was 27 months, as compared with 36 months in the chemoradiotherapy group (p = 0.005). Our 35% 5‐year OS in the neoadjuvant arm compares favorably with the 36% from the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial, whereas our 32% 5‐year OS in the adjuvant arm is inferior to the 42% from MacDonald et al.We observed no significant differences in OS and DFS between arms with comparable 5‐year rates. Most of the evidence currently suggests the optimal treatment for resectable esophageal cancer should consist of trimodality therapy, but the sequencing remains unclear.n = 80), postoperative chemoradiation (n = 78), and surgery alone (n = 80) and found no significant differences in OS and progression‐free survival, but there were fewer complications with postoperative chemoradiation. Our neoadjuvant arm OS rates were slightly inferior to the 44% 5‐year OS reported by Lv et al.Lv et al.There are several limitations of our study that should be noted. Our trial is based on a relatively small sample size with a reduced power to detect statistical differences in OS and DFS, but we did not expect there would be a difference. We hypothesized that both trimodality treatment options would provide similar survival results, but have different patient‐centered experiences with respect to HRQOL and adverse events. Our trial was adequately powered to detect a difference in the FACT‐E if difference exists. It turned out there was no difference overall, but there were differences in HRQOL and adverse events. The HRQOL was significantly inferior at 2 months in the neoadjuvant arm for FACT‐E, EORTC QLQ‐OG25, and EuroQol 5‐D‐3 L in the dysphagia, reflux, pain, taste, and coughing domains. Half of the patients were able to complete the prescribed neoadjuvant arm chemotherapy without modification compared to only 14% in the adjuvant arm. Chemotherapy related adverse events occurred significantly more frequently in the neoadjuvant arm.2 per cycle, a dose also used in the CALGB 9781 study.2 of cisplatin per cycle so the toxicities seen in the neoadjuvant arm from chemotherapy are likely more severe than those observed in current clinical practice, which has evolved since CALGB 9781 was published. We acknowledge that our two chemotherapy protocols are now considered obsolete in many centers in North America and Europe, but they were the standard of care at the inception of the trial and continue to be used elsewhere in the world. We recognize that some patients with stage I cancers were included in the neoadjuvant chemoradiation arm and may have been overtreated. This could have biased the results in favor for this arm, but this was not the case. We acknowledge the limitations of clinical staging, but felt it was appropriate to not deny patients the benefit of induction therapy if they were clinically under staged.Our study was a pragmatic trial of our ECF adjuvant trimodality protocol compared to the more common cisplatin and 5‐FU neoadjuvant protocol. It was not designed to compare the timing of similar chemoradiation protocols. The cisplatin dose for the neoadjuvant arm was 100 mg/mThe methodological strengths of our trial include the prospective randomized design and complete follow‐up data for all participants. The HRQOL data were based on multiple validated instruments that covered the spectrum of HRQOL research from disease‐specific to utility measurements. The adverse event data were collected every 2 months for 1 year following randomization that allowed for a detailed longitudinal investigation of the changes in HRQOL over time between arms. This is the only randomized trial evaluating neoadjuvant versus adjuvant chemoradiation for predominately adenocarcinomas of the esophagus and gastroesophageal junction that used HRQOL as the primary outcome measure.Neoadjuvant cisplatin and 5‐FU chemotherapy with radiation followed by surgery and adjuvant epirubicin, 5‐FU, and cisplatin chemotherapy with extended field radiation therapy are both challenging for patients, but provide similar survival benefits with different HRQOL experiences in patients with resectable esophageal cancer. More effective newer combinations and scheduling of systemic therapy, radiation, and surgery should be explored to improve survival and health related quality‐of‐life while and minimizing adverse effects.The authors do not have any conflict of interest to disclose with respect to this study.The study was completed and approved by our local ethics review board in accordance with the declaration of Helsinki, Good Clinical Practice guideline.All included patients provided written informed consent.ClinicalTrials.gov (NCT00907543).AppendixS1Click here for additional data file.Table S1Click here for additional data file.Table S2Click here for additional data file.Table S3Click here for additional data file.