HE4 as a Biomarker for Endometrial Cancer

There are currently no blood biomarkers in routine clinical use in endometrial carcinoma (EC). Human epididymis protein 4 (HE4) is a glycoprotein that is overexpressed in the serum of patients with EC, making it a good candidate for use as a diagnostic and/or prognostic biomarker. HE4 is correlated with poor prognostic factors, including stage, myometrial invasion and lymph node metastases, which means it could be used to guide decisions regarding the extent of surgery and need for adjuvant therapy. Serum HE4 has also shown promise for predicting responses to progestin therapy in early-stage EC. The use of algorithms and indices incorporating serum HE4 and other biomarkers, including clinical and imaging variables, is an area of increasing interest. Serum HE4 levels rise with age and renal dysfunction, which may affect the interpretation of results. This review covers the evidence supporting the use of HE4 as an EC biomarker for diagnosis, prognosis, recurrence monitoring, and prediction of therapy response. The evidence for combining serum HE4 with other biomarkers, including clinical and imaging variables, its value as a biomarker in other biofluids and potential challenges of its clinical use are also discussed

Scale Invariance in a Perturbed Einstein-de Sitter Cosmology

This paper seeks to check the validity of the "apparent fractal conjecture" (Ribeiro 2001ab: gr-qc/9909093, astro-ph/0104181), which states that the observed power-law behaviour for the average density of large-scale distribution of galaxies arises when some observational quantities, selected by their relevance in average density profile determination, are calculated along the past light cone. Implementing these conditions in the proposed set of observational relations profoundly changes the behaviour of many observables in the standard cosmological models. In particular, the average density becomes observationally inhomogeneous, even in the spatially homogeneous spacetime of standard cosmology, change which was already analysed by Ribeiro (1992b, 1993, 1994, 1995: astro-ph/9910145) for a non-perturbed model. Here we derive observational relations in a perturbed Einstein-de Sitter cosmology by means of the perturbation scheme proposed by Abdalla and Mohayaee (1999: astro-ph/9810146), where the scale factor is expanded in power series to yield perturbative terms. The differential equations derived in this perturbative context, and other observables necessary in our analysis, are solved numerically. The results show that our perturbed Einstein-de Sitter cosmology can be approximately described by a decaying power-law like average density profile, meaning that the dust distribution of this cosmology has a scaling behaviour compatible with the power-law profile of the density-distance correlation observed in the galaxy catalogues. These results show that, in the context of this work, the apparent fractal conjecture is correct.Comment: 18 pages, 1 figure, LaTeX. Final version (small changes in the figure plus some references update). Fortran code included with the LaTeX source. To be published in "Fractals

Quantum and thermal Casimir interaction between a sphere and a plate: Comparison of Drude and plasma models

We calculate the Casimir interaction between a sphere and a plate, both described by the plasma model, the Drude model, or generalizations of the two models. We compare the results at both zero and finite temperatures. At asymptotically large separations we obtain analytical results for the interaction that reveal a non-universal, i.e., material dependent interaction for the plasma model. The latter result contains the asymptotic interaction for Drude metals and perfect reflectors as different but universal limiting cases. This observation is related to the screening of a static magnetic field by a London superconductor. For small separations we find corrections to the proximity force approximation (PFA) that support correlations between geometry and material properties that are not captured by the Lifshitz theory. Our results at finite temperatures reveal for Drude metals a non-monotonic temperature dependence of the Casimir free energy and a negative entropy over a sizeable range of separations.Comment: 11 pages, 5 figure

Thinning of superfluid films below the critical point

Experiments on $^4$He films reveal an attractive Casimir-like force at the bulk $\lambda$-point, and in the superfluid regime. Previous work has explained the magnitude of this force at the $\lambda$ transition and deep in the superfluid region but not the substantial attractive force immediately below the $\lambda$-point. Utilizing a simple mean-field calculation renormalized by critical fluctuations we obtain an effective Casimir force that is qualitatively consistent with the scaling function $\vartheta$ obtained by collapse of experimental data.Comment: 4 page

Obstetric and perinatal outcomes of singleton pregnancies conceived via assisted reproductive technology complicated by gestational diabetes mellitus : a prospective cohort study

Peer reviewedPublisher PD

HE4 as a Biomarker for Endometrial Cancer

From MDPI via Jisc Publications RouterHistory: accepted 2021-09-17, pub-electronic 2021-09-23Publication status: PublishedFunder: Manchester Biomedical Research Centre; Grant(s): IS-BRC-1215-20007Funder: National Institute for Health Research; Grant(s): NIHR300650There are currently no blood biomarkers in routine clinical use in endometrial carcinoma (EC). Human epididymis protein 4 (HE4) is a glycoprotein that is overexpressed in the serum of patients with EC, making it a good candidate for use as a diagnostic and/or prognostic biomarker. HE4 is correlated with poor prognostic factors, including stage, myometrial invasion and lymph node metastases, which means it could be used to guide decisions regarding the extent of surgery and need for adjuvant therapy. Serum HE4 has also shown promise for predicting responses to progestin therapy in early-stage EC. The use of algorithms and indices incorporating serum HE4 and other biomarkers, including clinical and imaging variables, is an area of increasing interest. Serum HE4 levels rise with age and renal dysfunction, which may affect the interpretation of results. This review covers the evidence supporting the use of HE4 as an EC biomarker for diagnosis, prognosis, recurrence monitoring, and prediction of therapy response. The evidence for combining serum HE4 with other biomarkers, including clinical and imaging variables, its value as a biomarker in other biofluids and potential challenges of its clinical use are also discussed

Assisted conception as a potential prognostic factor predicting insulin therapy in pregnancies complicated by gestational diabetes mellitus

Acknowledgments The authors would like to thank Royan institute and hospitals related to the Ministry of Health and Medical Education, as well as patients for their invaluable contributions to the performance of the current research. Funding No financial support.Peer reviewedPublisher PD

Enhancing the quality of international orthopedic medical mission trips using the blue distinction criteria for knee and hip replacement centers

Background: Several organizations seek to address the growing burden of arthritis in developing countries by providing total joint replacements (TJR) to patients with advanced arthritis who otherwise would not have access to these procedures. Because these mission trips operate in resource poor environments, some of the features typically associated with high quality care may be difficult to implement. In the U.S., many hospitals that perform TJRs use the Blue Cross/Shield’s Blue Distinction criteria as benchmarks of high quality care. Although these criteria were designed for use in the U.S., we applied them to Operation Walk (Op-Walk) Boston’s medical mission trip to the Dominican Republic. Evaluating the program using these criteria illustrated that the program provides high quality care and, more importantly, helped the program to find areas of improvement. Methods: We used the Blue Distinction criteria to determine if Op-Walk Boston achieves Blue Distinction. Each criterion was grouped according to the four categories included in the Blue Distinction criteria— “general and administrative”, “structure”, “process”, or “outcomes and volume”. Full points were given for criteria that the program replicates entirely and zero points were given for criteria that are not replicated entirely. Of the non-replicated criteria, Op-Walk Boston’s clinical and administrative teams were asked if they compensate for failure to meet the criterion, and they were also asked to identify barriers that prevent them from meeting the criterion. Results: Out of 100 possible points, the program received 71, exceeding the 60-point threshold needed to qualify as a Blue Distinction center. The program met five out of eight “required” criteria and 11 out of 19 “informational” criteria. It scored 14/27 in the “general” category, 30/36 in the “structure” category, 17/20 in the “process” category, and 10/17 in the “outcomes and volume” category. Conclusion: Op-Walk Boston qualified for Blue Distinction. Our analysis highlights areas of programmatic improvement and identifies targets for future quality improvement initiatives. Additionally, we note that many criteria can only be met by hospitals operating in the U.S. Future work should therefore focus on creating criteria that are applicable to TJR mission trips in the context of developing countries

Stiction, Adhesion Energy and the Casimir Effect in Micromechanical Systems

We measure the adhesion energy of gold using a micromachined doubly-clamped beam. The stress and stiffness of the beam are characterized by measuring the spectrum of mechanical vibrations and the deflection due to an external force. To determine the adhesion energy we induce stiction between the beam and a nearby surface by capillary forces. Subsequent analysis yields a value $\gamma =0.06$ J/m$^{2}$ that is a factor of approximately six smaller than predicted by idealized theory. This discrepancy may be resolved with revised models that include surface roughness and the effect of adsorbed monolayers intervening between the contacting surfaces in these mesoscopic structures.Comment: RevTex, 4 pages, 4 eps figure

Hyperpolarized 3He and 129Xe magnetic resonance imaging apparent diffusion coefficients: physiological relevance in older never- and ex-smokers

Noble gas pulmonary magnetic resonance imaging (MRI) is transitioning away from (3)He to (129)Xe gas, but the physiological/clinical relevance of (129)Xe apparent diffusion coefficient (ADC) parenchyma measurements is not well understood. Therefore, our objective was to generate (129)Xe MRI ADC for comparison with (3)He ADC and with well-established measurements of alveolar structure and function in older never-smokers and ex-smokers with chronic obstructive pulmonary disease (COPD). In four never-smokers and 10 COPD ex-smokers, (3)He (b = 1.6 sec/cm(2)) and (129)Xe (b = 12, 20, and 30 sec/cm(2)) ADC, computed tomography (CT) density-threshold measurements, and the diffusing capacity for carbon monoxide (DLCO) were measured. To understand regional differences, the anterior-posterior (APG) and superior-inferior (∆SI) ADC differences were evaluated. Compared to never-smokers, COPD ex-smokers showed greater (3)He ADC (P = 0.006), (129)Xe ADCb12 (P = 0.006), and ADCb20 (P = 0.006), but not for ADCb30 (P \u3e 0.05). Never-smokers and COPD ex-smokers had significantly different APG for (3)He ADC (P = 0.02), (129)Xe ADCb12 (P = 0.006), and ADCb20 (P = 0.01), but not for ADCb30 (P \u3e 0.05). ∆SI for never- and ex-smokers was significantly different for (3)He ADC (P = 0.046), but not for (129)Xe ADC (P \u3e 0.05). There were strong correlations for DLCO with (3)He ADC and (129)Xe ADCb12 (both r = -0.95, P \u3c 0.05); in a multivariate model (129)Xe ADCb12 was the only significant predictor of DLCO (P = 0.049). For COPD ex-smokers, CT relative are