RESUMEN
Prognostic markers in routine clinical management of breast cancer are often assessed using RNA-based multi-gene panels that depend on fluctuating tumor purity. Multiplex fluorescence immunohistochemistry (mfIHC) holds the potential for an improved risk assessment. To enable automated prognosis marker detection (i.e., progesterone receptor [PR], estrogen receptor [ER], androgen receptor [AR], GATA3, TROP2, HER2, PD-L1, Ki67, TOP2A), a framework for automated breast cancer identification was developed and validated involving thirteen different artificial intelligence analysis steps and an algorithm for cell distance analysis using 11+1-marker-BLEACH&STAIN-mfIHC staining in 1404 invasive breast cancers of no special type (NST). The framework for automated breast cancer detection discriminated normal glands from malignant glands with an accuracy of 98.4%. This approach identified that five (PR, ER, AR, GATA3, PD-L1) of nine biomarkers were associated with prolonged overall survival (p ≤ 0.0095 each) and two of these (PR, AR) were found to be independent risk factors in multivariate analysis (p ≤ 0.0151 each). The combined assessment of PR-ER-AR-GATA3-PD-L1 as a five-marker prognosis score showed strong prognostic relevance (p < 0.0001) and was an independent risk factor in multivariate analysis (p = 0.0034). Automated breast cancer detection in combination with an artificial intelligence-based analysis of mfIHC enables a rapid and reliable analysis of multiple prognostic parameters. The strict limitation of the analysis to malignant cells excludes the impact of fluctuating tumor purity on assay precision.
RESUMEN
The effect of flow separation and turbulence on the performance of a jet pump in oscillatory flows is investigated. A jet pump is a static device whose shape induces asymmetric hydrodynamic end effects when placed in an oscillatory flow. This will result in a time-averaged pressure drop which can be used to suppress acoustic streaming in closed-loop thermoacoustic devices. An experimental setup is used to measure the time-averaged pressure drop as well as the acoustic power dissipation across two different jet pump geometries in a pure oscillatory flow. The results are compared against published numerical results where flow separation was found to have a negative effect on the jet pump performance in a laminar flow. Using hot-wire anemometry the onset of flow separation is determined experimentally and the applicability of a critical Reynolds number for oscillatory pipe flows is confirmed for jet pump applications. It is found that turbulence can lead to a reduction of flow separation and hence, to an improvement in jet pump performance compared to laminar oscillatory flows.
RESUMEN
The design of compact thermoacoustic devices requires compact jet pump geometries, which can be realized by employing jet pumps with multiple orifices. The oscillatory flow through the orifice(s) of a jet pump generates asymmetric hydrodynamic end effects, which result in a time-averaged pressure drop that can counteract Gedeon streaming in traveling wave thermoacoustic devices. In this study, the performance of jet pumps having 1-16 orifices is characterized experimentally in terms of the time-averaged pressure drop and acoustic power dissipation. Upon increasing the number of orifices, a significant decay in the jet pump performance is observed. Further analysis shows a relation between this performance decay and the diameter of the individual holes. Possible causes of this phenomenon are discussed. Flow visualization is used to study the differences in vortex ring interaction from adjacent jet pump orifices. The mutual orifice spacing is varied and the corresponding jet pump performance is measured. The orifice spacing is shown to have less effect on the jet pump performance compared to increasing the number of orifices.
RESUMEN
A computational fluid dynamics model is used to predict the oscillatory flow through tapered cylindrical tube sections (jet pumps). The asymmetric shape of jet pumps results in a time-averaged pressure drop that can be used to suppress Gedeon streaming in closed-loop thermoacoustic devices. However, previous work has shown that flow separation in the diverging flow direction counteracts the time-averaged pressure drop. In this work, the characteristics of flow separation in jet pumps are identified and coupled with the observed jet pump performance. Furthermore, it is shown that the onset of flow separation can be shifted to larger displacement amplitudes by designs that have a smoother transition between the small opening and the tapered surface of the jet pump. These design alterations also reduce the duration of separated flow, resulting in more effective and robust jet pumps. To make the proposed jet pump designs more compact without reducing their performance, the minimum big opening radius that can be implemented before the local minor losses have an influence on the jet pump performance is investigated. To validate the numerical results, they are compared with experimental results for one of the proposed jet pump designs.
RESUMEN
The oscillatory flow through tapered cylindrical tube sections (jet pumps) is characterized by a numerical parameter study. The shape of a jet pump results in asymmetric hydrodynamic end effects which cause a time-averaged pressure drop to occur under oscillatory flow conditions. Hence, jet pumps are used as streaming suppressors in closed-loop thermoacoustic devices. A two-dimensional axisymmetric computational fluid dynamics model is used to calculate the performance of a large number of conical jet pump geometries in terms of time-averaged pressure drop and acoustic power dissipation. The investigated geometrical parameters include the jet pump length, taper angle, waist diameter, and waist curvature. In correspondence with previous work, four flow regimes are observed which characterize the jet pump performance and dimensionless parameters are introduced to scale the performance of the various jet pump geometries. The simulation results are compared to an existing quasi-steady theory and it is shown that this theory is only applicable in a small operation region. Based on the scaling parameters, an optimum operation region is defined and design guidelines are proposed which can be directly used for future jet pump design.
RESUMEN
A two-dimensional computational fluid dynamics model is used to predict the oscillatory flow through a tapered cylindrical tube section (jet pump) placed in a larger outer tube. Due to the shape of the jet pump, an asymmetry in the hydrodynamic end effects will exist which will cause a time-averaged pressure drop to occur that can be used to cancel Gedeon streaming in a closed-loop thermoacoustic device. The performance of two jet pump geometries with different taper angles is investigated. A specific time-domain impedance boundary condition is implemented in order to simulate traveling acoustic wave conditions. It is shown that by scaling the acoustic displacement amplitude to the jet pump dimensions, similar minor losses are observed independent of the jet pump geometry. Four different flow regimes are distinguished and the observed flow phenomena are related to the jet pump performance. The simulated jet pump performance is compared to an existing quasi-steady approximation which is shown to only be valid for small displacement amplitudes compared to the jet pump length.
RESUMEN
La extracción y análisis del linfonodo centinela (LNC) en cáncer de mama en estadío inicial es una alternativa válida en la etapificación de la axila, reduciendo la morbilidad asociada al vaciamiento axilar. Su marcación y localización requiere de experiencia para reducir la tasa de falsos negativos. El objetivo de este trabajo fue evaluar la seguridad en la identificación del linfonodo centinela en nuestro medio. Se estudiaron 46 mujeres con cáncer de mama infiltrante T1, T2 inyectándose Tc99m Nanocint y azul patente 1 por ciento peritumoral y posteriormente se modificó a periareolar. El 80 por ciento de los casos correspondió histológicamente a un carcinoma ductal infiltrante. En el 46.5 por ciento de las pacientes el LNC fue negativo para metástasis, al igual que el resto de los ganglios linfáticos axilares. El 53,5 por ciento restante presentó un LNC (+), en 15 de 20 pacientes, el LNC fue el único ganglio comprometido por tumor. Las 5 restantes tenían varios ganglios comprometidos, incluido el LNC. La tasa global de identificación en pabellón fue de 100 por ciento; 95 por ciento con radiocoloides y 95 por ciento con azul. El azul patente mostró 2 casos de falsos negativos y no hubo falsos negativo con radiocoloides. En conclusión, la técnica empleada sumado a la experiencia quirúrgica permiten una elevada y correcta detección del LNC.
