Comparison of ovarian cancer markers in endometriosis favours HE4 over CA125

Endometriosis is a gynaecological condition with an associated chronic inflammatory response. The ectopic growth of 'lesions', consisting of endometrial cells outside the uterine cavity, stimulates an inflammatory response initiating the activation of macrophages, and resulting in increased cytokine and growth factor concentrations in the peritoneal fluid (PF). Endometriosis‑associated inflammation is chronic and long lasting. In patients with endometriosis, the risk of developing ovarian cancer within 10 years, particularly of the endometrioid or clear cell subtype, is increased 2.5‑4 times. Endometriosis creates a peritoneal environment that exposes the affected endometriotic and the normal ovarian surface epithelial cells to agents that have been suggested to be involved in the pathogenesis of cancer. Concentrations of several cytokines and growth factors were increased in the PF of patients with endometriosis. The ovarian cancer marker, CA125, was one such growth factor; however, this remains to be confirmed. Human epididymis protein 4 (HE4) was detected at high concentrations in patients with ovarian cancer and was identified as the best biomarker for the detection of ovarian cancer. The present study determined the levels of HE4 and CA125 in the peritoneal fluid of 258 patients with and 100 control individuals without endometriosis attending the Department of Obstetrics and Gynaecology, University of Berne (Berne, Switzerland) between 2007 and 2014. The cases were subdivided into groups without hormonal treatment (n=107), or treated with combined oral contraceptives (n=45), continuous gestagens (n=56) or GnRH agonists (n=50). Both of these markers were significantly increased in the non‑treated endometriosis samples compared with the control group. Hormone treatment with either of the three agents mentioned resulted in the concentration of CA125 returning to the control levels and the concentration of HE4 decreasing to below the control levels. CA125, however not HE4, significantly differed between the proliferative and secretory cycle phases. Since HE4 is sensitive to hormonal treatment and robust towards menstrual cycle variation, HE4 is potentially superior to CA125 as an endometriosis marker and therefore has greater potential as a marker for the identification of women at risk of developing ovarian cancer.

Correlation between dental care utilization and oral cavity cancer in a large sample of community-based United States residents

Cancer of the oral cavity and pharynx remains one of the ten leading causes of cancer death in the United States (US). Besides smoking and alcohol consumption, there are no well established risk factors. While poor dental care had been implicated, it is unknown if the lack of dental care, implying poor dental hygiene predisposes to oral cavity cancer. This study aimed to assess the relationship between dental care utilization during the past twelve months and the prevalence of oral cavity cancer. A cross-sectional design of the National Health Interview Survey of adult, non-institutionalized US residents (n=30,475) was used to assess the association between dental care utilization and self reported diagnosis of oral cavity cancer. Chi square statistic was used to examine the crude association between the predictor variable, dental care utilization and other covariates, while unconditional logistic regression was used to assess the relationship between oral cavity cancer and dental care utilization. There were statistically significant differences between those who utilized dental care during the past twelve months and those who did not with respect to education, income, age, marital status, and gender (p < 0.05), but not health insurance coverage (p = 0.53). Also, those who utilized dental care relative to those who did not were 65% less likely to present with oral cavity cancer, prevalence odds ratio (POR), 0.35, 95% Confidence Interval (CI), 0.12–0.98. Further, higher income advanced age, people of African heritage, and unmarried status were statistically significantly associated with oral cavity cancer, (p < 0.05), but health insurance coverage, alcohol use and smoking were not, p > 0.05. However, after simultaneously controlling for the relevant covariates, the association between dental care and oral cavity cancer did not attenuate nor persist. Thus, compared with those who did not use dental care, those who did wee 62% less likely to present with oral cavity cancer adjusted POR, 0.38, 95% CI, 0.13-1.10. Among US adults residing in community settings, use of dental care during the past twelve months did not significantly reduce the predisposition to oral cavity cancer. However, due to the nature of the data used in this study, which restricts temporal sequence, a large sample prospective study that may identify modifiable factors associated with oral cancer development namely poor dental care, is needed. ^

Response to chemotherapy, recurrence and survival in advanced-stage ovarian, fallopian tube and primary peritoneal cancer patients with non-Ashkenazi Jewish BRCA mutations, compared to those without

Objectives. Previous studies have shown a survival advantage in ovarian cancer patients with Ashkenazi-Jewish (AJ) BRCA founder mutations, compared to sporadic ovarian cancer patients. The purpose of this study was to determine if this association exists in ovarian cancer patients with non-Ashkenazi Jewish BRCA mutations. In addition, we sought to account for possible "survival bias" by minimizing any lead time that may exist between diagnosis and genetic testing. ^ Methods. Patients with stage III/IV ovarian, fallopian tube, or primary peritoneal cancer and a non-Ashkenazi Jewish BRCA1 or 2 mutation, seen for genetic testing January 1996-July 2007, were identified from genetics and institutional databases. Medical records were reviewed for clinical factors, including response to initial chemotherapy. Patients with sporadic (non-hereditary) ovarian, fallopian tube, or primary peritoneal cancer, without family history of breast or ovarian cancer, were compared to similar cases, matched by age, stage, year of diagnosis, and vital status at time interval to BRCA testing. When possible, 2 sporadic patients were matched to each BRCA patient. An additional group of unmatched, sporadic ovarian, fallopian tube and primary peritoneal cancer patients was included for a separate analysis. Progression-free (PFS) & overall survival (OS) were calculated by the Kaplan-Meier method. Multivariate Cox proportional hazards models were calculated for variables of interest. Matched pairs were treated as clusters. Stratified log rank test was used to calculate survival data for matched pairs using paired event times. Fisher's exact test, chi-square, and univariate logistic regression were also used for analysis. ^ Results. Forty five advanced-stage ovarian, fallopian tube and primary peritoneal cancer patients with non-Ashkenazi Jewish (non-AJ) BRCA mutations, 86 sporadic-matched and 414 sporadic-unmatched patients were analyzed. Compared to the sporadic-matched and sporadic-unmatched ovarian cancer patients, non-AJ BRCA mutation carriers had longer PFS (17.9 & 13.8 mos. vs. 32.0 mos., HR 1.76 [95% CI 1.13–2.75] & 2.61 [95% CI 1.70–4.00]). In relation to the sporadic- unmatched patients, non-AJ BRCA patients had greater odds of complete response to initial chemotherapy (OR 2.25 [95% CI 1.17–5.41]) and improved OS (37.6 mos. vs. 101.4 mos., HR 2.64 [95% CI 1.49–4.67]). ^ Conclusions. This study demonstrates a significant survival advantage in advanced-stage ovarian cancer patients with non-AJ BRCA mutations, confirming the previous studies in the Jewish population. Our efforts to account for "survival bias," by matching, will continue with collaborative studies. ^

Percepciones de la imagen corporal de los adolescentes y su familia, en tratamiento de diálisis peritoneal

Esta investigación intenta, a través de un estudio descriptivo, reflejar el grado de afectación de la imagen corporal de los niños y adolescentes que asisten al Servicio de Diálisis Peritoneal Continua Ambulatorio, del Hospital Notti de la provincia de Mendoza. Los objetivos son: identificar las distintas percepciones de los jóvenes y su familia en el tratamiento de diálisis peritoneal, lograr una visión de la realidad de los jóvenes y su familia que asisten al tratamiento y planificar acciones que tiendan a mejorar la calidad de vida de los adolescentes y su familia.

Three-dimensional flow instability in a lid-driven isosceles triangular cavity

Linear three-dimensional modal instability of steady laminar two-dimensional states developing in a lid-driven cavity of isosceles triangular cross-section is investigated theoretically and experimentally for the case in which the equal sides form a rectangular corner. An asymmetric steady two-dimensional motion is driven by the steady motion of one of the equal sides. If the side moves away from the rectangular corner, a stationary three-dimensional instability is found. If the motion is directed towards the corner, the instability is oscillatory. The respective critical Reynolds numbers are identified both theoretically and experimentally. The neutral curves pertinent to the two configurations and the properties of the respective leading eigenmodes are documented and analogies to instabilities in rectangular lid-driven cavities are discussed.

Effect of Aspect Ratio on the Three-Dimensional Global Instability Analysis of Incompressible Open Cavity Flows

The stability analysis of open cavity flows is a problem of great interest in the aeronautical industry. This type of flow can appear, for example, in landing gears or auxiliary power unit configurations. Open cavity flows is very sensitive to any change in the configuration, either physical (incoming boundary layer, Reynolds or Mach numbers) or geometrical (length to depth and length to width ratio). In this work, we have focused on the effect of geometry and of the Reynolds number on the stability properties of a threedimensional spanwise periodic cavity flow in the incompressible limit. To that end, BiGlobal analysis is used to investigate the instabilities in this configuration. The basic flow is obtained by the numerical integration of the Navier-Stokes equations with laminar boundary layers imposed upstream. The 3D perturbation, assumed to be periodic in the spanwise direction, is obtained as the solution of the global eigenvalue problem. A parametric study has been performed, analyzing the stability of the flow under variation of the Reynolds number, the L/D ratio of the cavity, and the spanwise wavenumber β. For consistency, multidomain high order numerical schemes have been used in all the computations, either basic flow or eigenvalue problems. The results allow to define the neutral curves in the range of L/D = 1 to L/D = 3. A scaling relating the frequency of the eigenmodes and the length to depth ratio is provided, based on the analysis results.

Wave-like Disturbances on the Downstream Wall of an Open Cavity

This contribution presents results of an incompressible two-dimensional flow over an open cavity of fixed aspect ratio (length/depth) L/D = 2 and the coupling between the three dimensional low frequency oscillation mode confined in the cavity and the wave-like disturbances evolving on the downstream wall of the cavity in the form of Tollmien-Schlichting waves. BiGlobal instability analysis is conducted to search the global disturbances superimposed upon a two-dimensional steady basic flow. The base solution is computed by the integration of the laminar Navier-Stokes equations in primitive variable formulation, while the eigenvalue problem (EVP) derived from the discretization of the linearized equations of motion in the BiGlobal framework is solved using an iterative procedure. The formulation of the BiGlobal EVP for the unbounded flow in the open cavity problem introduces additional difficulties regarding the flow-through boundaries. Local analysis has been utilized for the determination of the proper boundary conditions in the upper limit of the downstream region

Modeling Reflective Bistability in Vertical-Cavity Semiconductor Optical Amplifiers

The characteristics of optical bistability in a vertical- cavity semiconductor optical amplifier (VCSOA) operated in reflection are reported. The dependences of the optical bistability in VCSOAs on the initial phase detuning and on the applied bias current are analyzed. The optical bistability is also studied for different numbers of superimposed periods in the top distributed bragg reflector (DBR) that conform the internal cavity of the device. The appearance of the X-bistable and the clockwise bistable loops is predicted theoretically in a VCSOA operated in reflection for the first time, to the best of our knowledge. Moreover, it is also predicted that the control of the VCSOA’s top reflectivity by the addition of new superimposed periods in its top DBR reduces by one order of magnitude the input power needed for the assessment of the X- and the clockwise bistable loop, compared to that required in in-plane semiconductor optical amplifiers. These results, added to the ease of fabricating two-dimensional arrays of this kind of device could be useful for the development of new optical logic or optical signal regeneration devices.

Vertical-cavity semiconductor optical amplifiers (VCSOAs) as optical sensing elements

Semiconductor Optical Amplifiers (SOAs) have mainly found application in optical telecommunication networks for optical signal regeneration, wavelength switching or wavelength conversion. The objective of this paper is to report the use of semiconductor optical amplifiers for optical sensing taking into account their optical bistable properties. As it was previously reported, some semiconductor optical amplifiers, including Fabry-Perot and Distributed-Feedback Semiconductor Optical Amplifiers (FPSOAs and DFBSOAs), may exhibit optical bistability. The characteristics of the attained optical bistability in this kind of devices are strongly dependent on different parameters including wavelength, temperature or applied bias current and small variations lead to a change on their bistable properties. As in previous analyses for Fabry-Perot and DFB SOAs, the variations of these parameters and their possible application for optical sensing are reported in this paper for the case of the Vertical-Cavity Semiconductor Optical Amplifier (VCSOA). When using a VCSOA, the input power needed for the appearance of optical bistability is one order of magnitude lower than that needed in edge-emitting devices. This feature, added to the low manufacturing costs of VCSOAs and the ease to integrate them in 2-D arrays, makes the VCSOA a very promising device for its potential use in optical sensing applications.

Low-power vertical cavity NAND gate

The study of the Vertical-Cavity Semiconductor Optical Amplifiers (VCSOAs) for optical signal processing applications is increasing his interest. Due to their particular structure, the VCSOAs present some advantages when compared to their edge-emitting counterparts including low manufacturing costs, high coupling efficiency to optical fibers and the ease to fabricate 2-D arrays of this kind of devices. As a consequence, all-optical logic gates based on VCSOAs may be very promising devices for their use in optical computing and optical switching in communications. Moreover, since all the boolean logic functions can be implemented by combining NAND logic gates, the development of a Vertical-Cavity NAND gate would be of particular interest. In this paper, the characteristics of the dispersive optical bistability appearing on a VCSOA operated in reflection are studied. A progressive increment of the number of layers compounding the top Distributed Bragg Reflector (DBR) of the VCSOA results on a change on the shape of the appearing bistability from an S-shape to a clockwise bistable loop. This resulting clockwise bistability has high on-off contrast ratio and input power requirements one order of magnitude lower than those needed for edge-emitting devices. Based on these results, an all-optical vertical-cavity NAND gate with high on-off contrast ratio and an input power for operation of only 10|i\V will be reported in this paper.

On linear instability mechanisms in incompressible open cavity flow

A theoretical study of linear global instability of incompressible flow over a rectangular spanwise-periodic open cavity in an unconfined domain is presented. Comparisons with the limited number of results available in the literature are shown. Subsequently, the parameter space is scanned in a systematic manner, varying Reynolds number, incoming boundary-layer thickness and length-to-depth aspect ratio. This permits documenting the neutral curves and leading eigenmode characteristics of this flow. Correlations constructed using the results obtained collapse all available theoretical data on the three-dimensional instabilities.

Instability Analysis of Incompressible Open Cavity Flows

El problema del flujo sobre una cavidad abierta ha sido estudiado en profundidad en la literatura, tanto por el interés académico del problema como por sus aplicaciones prácticas en gran variedad de problemas ingenieriles, como puede ser el alojamiento del tren de aterrizaje de aeronaves, o el depósito de agua de aviones contraincendios. Desde hace muchos a˜nos se estudian los distintos tipos de inestabilidades asociadas a este problema: los modos bidimensionales en la capa de cortadura, y los modos tridimensionales en el torbellino de recirculación principal dentro de la cavidad. En esta tesis se presenta un estudio paramétrico completo del límite incompresible del problema, empleando la herramienta de estabilidad lineal conocida como BiGlobal. Esta aproximación permite contemplar la estabilidad global del flujo, y obtener tanto la forma como las características de los modos propios del problema físico, sean estables o inestables. El estudio realizado permite caracterizar con gran detalle todos los modos relevantes, así como la envolvente de estabilidad en el espacio paramétrico del problema incompresible (Mach nulo, variación de Reynolds, espesor de capa límite incidente, relación altura/profundidad de la cavidad, y longitud característica de la perturbación en la dirección transversal). A la luz de los resultados obtenidos se proponen una serie de relaciones entre los parámetros y características de los modos principales, como por ejemplo entre el Reynolds crítico de un modo, y la longitud característica del mismo. Los resultados numéricos se contrastan con una campaña experimental, siendo la principal conclusión de dicha comparación que los modos lineales están presentes en el flujo real saturado, pero que existen diferencias notables en frecuencia entre las predicciones teóricas y los experimentos. Para intentar determinar la naturaleza de dichas diferencias se realiza una simulación numérica directa tridimensional, y se utiliza un algoritmo de DMD (descomposición dinámica de modos) para describir el proceso de saturación. ABSTRACT The problem of the flow over an open cavity has been studied in depth in the literature, both for being an interesting academical problem and due to the multitude of industrial applications, like the landing gear of aircraft, or the water deposit of firefighter airplanes. The different types of instabilities appearing in this flow studied in the literature are two: the two-dimensional shear layer modes, and the three-dimensional modes that appear in the main recirculating vortex inside the cavity. In this thesis a parametric study in the incompressible limit of the problem is presented, using the linear stability analysis known as BiGlobal. This approximation allows to obtain the global stability behaviour of the flow, and to capture both the morphological features and the characteristics of the eigenmodes of the physical problem, whether they are stable or unstable. The study presented here characterizes with great detail all the relevant eigenmodes, as well as the hypersurface of instability on the parameter space of the incompressible problem (Mach equal to zero, and variation of the Reynolds number, the incoming boundary layer thickness, the length to depth aspect ratio of the cavity and the spanwise length of the perturbation). The results allow to construct parametric relations between the characteristics of the leading eigenmodes and the parameters of the problem, like for example the one existing between the critical Reynolds number and its characteristic length. The numerical results presented here are compared with those of an experimental campaign, with the main conclusion of said comparison being that the linear eigenmode are present in the real saturated flow, albeit with some significant differences in the frequencies of the experiments and those predicted by the theory. To try to determine the nature of those differences a three-dimensional direct numerical simulation, analyzed with Dynamic Mode Decomposition algorithm, was used to describe the process of saturation.

Linear instability analysis of incompressible flow over a cuboid cavity

Direct numerical simulations are performed to analyze the three-dimensional instability of flows over three-dimensional cavities. The flow structures at different Reynolds numbers are investigated by using the spectral-element solver nek5000. As the Reynolds number increasing, the lateral wall effects become more important, the recirculation zone shrinks, the front vortex increases and the flow structure inside of the cavity becomes more complex. Results show that the flow bifurcates from a steady state to an oscillatory regime beyond a value of Reynolds number Re = 1100.