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Aim of the study: To evaluate the efficacy of a nutraceutical compound containing Uticlin® (D-mannose, cranberry, bearberry, Olea europaea), inulin, Orthosiphon and Lactobacillus acidophilus, in preventing recurrent urinary tract infections (UTIs) in menopausal women. Material and methods: This was a prospective cohort study of menopausal women recruited with a history of recurrent UTIs in the previous twelve months and who intended to treat their bladder problem without the use of antibiotics and/or anti-inflammatories. Women were proposed the use of an oral nutraceutical compound. The drug was taken for ten days, every month. Women were assigned to two parallel cohorts: patients using (group 1) or not using (group 2) this nutraceutical compound. The primary objective of the study was to evaluate the number of women with less than two infective episodes in the 6-month follow-up and less than three episodes in the 12-month follow-up. The secondary endpoints were to evaluate the reduction of related symptoms at 12-month follow-up, according to the Visual Analog Scale (VAS). Results: At 6 months of therapy, the reduction in the number of patients with ≥ 2 UTIs was statistically significant (p < 0.05) compared to baseline only in group 1. At 12 months, the number of patients who were disease-free was significantly higher (p < 0.05) in group 1 compared to group 2. Moreover, the improvement of related symptoms was statistically significant (p < 0.05) in group 1, as shown by the reduction in the VAS scale value. Conclusions: In menopausal women, the combination of D-mannose, inulin, cranberry, bearberry, Olea europaea, Orthosiphon and Lactobacillus acidophilus SGL 11 per os represents a useful therapy for recurrent UTIs in women wanting a natural approach.

Background Urinary tract infections (UTIs) are among the most common bacterial infection diagnosed in women. The standard therapy is represented by short course of anti-microbial treatment to eradicate causative pathogens. However, due to antibiotic treatment, normal microbiota of the gastrointestinal tract is at risk of depletion and prolonged use of antibiotics can lead to the development of resistant strains. The aim of this pilot study was to assess the efficacy of Acidif plus®, a novel preparation containing L-Methionine, Boswellia serrata and Hibiscus sabdariffa, in the treatment of UTIs in women, in comparison with standard antibiotic treatment with fosfomycin. Methods We performed a pilot clinical study with 88 patients with uncomplicated UTIs treated in ambulatory care clinics. The subjects recruited in the study were divided into two groups: the treatment group included 57 patients with both symptomatic and asymptomatic uncomplicated, bacteriuria-positive UTIs, who were treated by oral administration of Acidif plus® two tablets per day (1 tablet in the morning and 1 tablet in the evening) for 7 days. The control group included 31 patients with both symptomatic and asymptomatic bacteriuria-positive uncomplicated UTIs, treated with fosfomycin for two consecutive days. Clinical improvement of symptoms and urine bacteriuria were evaluated as treatment outcomes. Results More than 50% of Acidif plus® treated patients were free of symptoms of UTIs at the end of the treatment regime. In addition, Acidif plus® treatment was effective in eliminating the bacterial infection in the post-treatment urine cultures in more than 85% of the patients. Conclusions In this study Acidif plus® treatment in patients with uncomplicated UTIs was found to be non-inferior to the standard antibiotic therapy. In acute setting, Acidif plus® was shown to be even more effective in alleviating the symptoms than fosfomycin and in eliminating bacteria in urine cultures. It is therefore possible to propose Acidif plus® as a potential alternative option to reduce the problem of multi-drug resistance in urinary infections.

RATIONALE Time-of-Flight (TOF) Mass Spectrometry is a powerful analytical technique, provided that an accurate calibration by standard molecules in the same m/z range of the analytes is performed. Calibration in a very large m/z range is a difficult task, particularly in studies focusing on the detection of high molecular weight clusters of different molecules or high molecular weight species. METHODS External calibration is the most common procedure used for TOF mass spectrometric analysis in the gas phase and, generally, the only available standards are made up of mixtures of noble gases, covering a small mass range for calibration, up to m/z 136 (higher mass isotope of xenon). In this work, an accurate calibration of a Molecular Beam Time-of Flight Mass Spectrometer (MB-TOFMS) is presented, based on the use of water clusters up to m/z 3000. RESULTS The advantages of calibrating a MB-TOFMS with water clusters for the detection of analytes with masses above those of the traditional calibrants such as noble gases were quantitatively shown by statistical calculations. A comparison of the water cluster and noble gases calibration procedures in attributing the masses to a test mixture extending up to m/z 800 is also reported. In the case of the analysis of combustion products, another important feature of water cluster calibration was shown, that is the possibility of using them as "internal standard" directly formed from the combustion water, under suitable experimental conditions. CONCLUSIONS The water clusters calibration of a MB-TOFMS gives rise to a ten-fold reduction in error compared to the traditional calibration with noble gases. The consequent improvement in mass accuracy in the calibration of a MB-TOFMS has important implications in various fields where detection of high molecular mass species is required. In combustion products analysis, it is also possible to obtain a new calibration spectrum before the acquisition of each spectrum, only modifying some operative conditions. Copyright © 2016 John Wiley & Sons, Ltd.

In order to better assess non-nutritive sweetener (NNS) consumption, measurement tools with greater utility are needed. The objective of this investigation is to determine the reproducibility and validity of a newly developed NNS food frequency questionnaire (NNS-FFQ) that measures five types of NNS (saccharin, aspartame, acesulfame potassium, sucralose and erythritol). Adult participants (n = 123, 56% female, 75% Caucasian, mean age = 36.8 ± 16.6) completed the NNS-FFQ twice and had 24-h dietary recalls three times over a two-week study period. Reproducibility between two administrations of the NNS-FFQ was assessed via Bland–Altman plots, Spearman’s correlations (rs) and paired samples t-tests. Bland–Altman plots, Cohen’s κ, Spearman’s correlations (rs), and paired samples t-tests compared NNS intake between the two methods for validity. For reproducibility analyses, Bland–Altman analyses revealed agreement levels above the 95% acceptance level for total NNS (99.2%), erythritol (99.2%), and aspartame (96.7%). Agreement levels for acesulfame potassium (94.3%), saccharin (94.3%), and sucralose (94.3%) were slightly below the acceptable level. For validity analyses, Bland–Altman analyses revealed agreement levels above the 95% acceptance level for total NNS (95.1%), sucralose (95.9%), saccharin (95.9%), and erythritol (95.1%). Agreement levels for aspartame (94.3%) and acesulfame potassium (92.7%) were slightly below the acceptable level. Although less than desirable agreement was found between the methods for aspartame and acesulfame potassium, some variance was expected due to the habitual nature of the NNS-FFQ as compared to the recent intake reported by recalls. Within the context of this constraint, the NNS-FFQ demonstrates acceptable reproducibility and validity. The NNS-FFQ is a brief questionnaire that could be administered among diverse participants at the individual and population levels to measure habitual NNS intake. Published version

Few data assessing non-nutritive sweetener (NNS) intake are available, especially within rural, health-disparate populations, where obesity and related co-morbidities are prevalent. The objective of this study is to characterize NNS intake for this population and examine the variance in demographics, cardio-metabolic outcomes, and dietary intake between NNS consumers and non-consumers. A cross-sectional sample (n = 301) of Virginian adults from a randomized controlled trial (data collected from 2012 to 2014) targeting sugar-sweetened beverage (SSB) intake completed three 24-h dietary recalls, and demographics and cardio-metabolic measures were assessed. The frequency, types, and sources of NNS consumption were identified. Thirty-three percent of participants reported consuming NNS (n = 100). Sucralose was the largest contributor of mean daily NNS intake by weight (mg), followed by aspartame, acesulfame potassium, and saccharin. NNS in tabletop sweeteners, diet tea, and diet soda were the top contributors to absolute NNS intake. The most frequently consumed NNS sources were diet sodas, juice drinks, and tabletop sweeteners. Although mean body mass index (BMI) was greater for NNS consumers, they demonstrated significantly lower food, beverage, and SSB caloric intake and energy density, and higher overall dietary quality. It remains unclear whether NNS use plays a role in exacerbating weight gain. NNS consumers in this sample may have switched from drinking predominantly SSB to drinking some NNS beverages in an effort to cope with weight gain. Future studies should explore motivations for NNS use across a variety of weight and health categories. Published version

Time-of-Flight (TOF) Mass Spectrometry is a powerful analytical technique, provided that an accurate calibration by standard molecules in the same m/z range of the analytes is performed. Calibration in a very large m/z range is a difficult task, particularly in studies focusing on the detection of high molecular weight clusters of different molecules or high molecular weight species.External calibration is the most common procedure used for TOF mass spectrometric analysis in the gas phase and, generally, the only available standards are made up of mixtures of noble gases, covering a small mass range for calibration, up to m/z 136 (higher mass isotope of xenon). In this work, an accurate calibration of a Molecular Beam Time-of Flight Mass Spectrometer (MB-TOFMS) is presented, based on the use of water clusters up to m/z 3000.The advantages of calibrating a MB-TOFMS with water clusters for the detection of analytes with masses above those of the traditional calibrants such as noble gases were quantitatively shown by statistical calculations. A comparison of the water cluster and noble gases calibration procedures in attributing the masses to a test mixture extending up to m/z 800 is also reported. In the case of the analysis of combustion products, another important feature of water cluster calibration was shown, that is the possibility of using them as "internal standard" directly formed from the combustion water, under suitable experimental conditions.The water clusters calibration of a MB-TOFMS gives rise to a ten-fold reduction in error compared to the traditional calibration with noble gases. The consequent improvement in mass accuracy in the calibration of a MB-TOFMS has important implications in various fields where detection of high molecular mass species is required. In combustion products analysis, it is also possible to obtain a new calibration spectrum before the acquisition of each spectrum, only modifying some operative conditions. Copyright © 2016 John WileySons, Ltd.

RATIONALE: Time-of-Flight (TOF) Mass Spectrometry is a powerful analytical technique, provided that an accurate calibration by standard molecules in the same m/z range of the analytes is performed. Calibration in a very large m/z range is a difficult task, particularly in studies focusing on the detection of high molecular weight clusters of different molecules or high molecular weight species. METHODS: External calibration is the most common procedure used for TOF mass spectrometric analysis in the gas phase and, generally, the only available standards are made up of mixtures of noble gases, covering a small mass range for calibration, up to m/z 136 (higher mass isotope of xenon). In this work, an accurate calibration of a Molecular Beam Time-of Flight Mass Spectrometer (MB-TOFMS) is presented, based on the use of water clusters up to m/z 3000. RESULTS: The advantages of calibrating a MB-TOFMS with water clusters for the detection of analytes with masses above those of the traditional calibrants such as noble gases were quantitatively shown by statistical calculations. A comparison of the water cluster and noble gases calibration procedures in attributing the masses to a test mixture extending up to m/z 800 is also reported. In the case of the analysis of combustion products, another important feature of water cluster calibration was shown, that is the possibility of using them as "internal standard" directly formed from the combustion water, under suitable experimental conditions. CONCLUSIONS: The water clusters calibration of a MB-TOFMS gives rise to a ten-fold reduction in error compared to the traditional calibration with noble gases. The consequent improvement in mass accuracy in the calibration of a MB-TOFMS has important implications in various fields where detection of high molecular mass species is required. In combustion products analysis, it is also possible to obtain a new calibration spectrum before the acquisition of each spectrum, only modifying some operative conditions.

OBJECTIVE: This study was conducted to examine the influence of insulin resistance on weight change in postmenopausal women of various ethnic groups. SUBJECTS: Data were obtained from 3389 women (60% White, 20% Black, 12% Hispanic, and 8% Asian/Pacific Islander), ages 50–79, enrolled in either the Women's Health Initiative Clinical trial or Observational Study, whose blood samples were selected randomly from the full cohort of 161 809 women for analyses. MEASUREMENTS: Glucose, insulin, and lipids were measured on fasting serum samples drawn at baseline and after 3 y of follow-up. Weight, height, waist circumference, and blood pressure were measured. Physical activity and energy intake were assessed via questionnaire. Insulin resistance was estimated using the HOMA (homeostasis model) calculation. RESULTS: Average age was 62 y, average BMI (body mass index) was 27.4 kg/m2, and average weight change was a gain of 0.4 kg in 3 y. In a multivariate analysis, insulin resistance and insulin concentrations were independent predictors of increases in weight in White women (P=0.002 and 0.004, respectively) and in the combined group (P=0.027 and 0.039). For the whole group, after adjustment for other covariates, those in the highest quartile of insulin resistance gained 0.4 kg in 3 y, whereas those in the lowest quartile lost 0.06 kg. Similar trends were found for insulin resistance and weight gain in Hispanic and Asian/Pacific Islander women, but they did not reach statistical significance. In Black women, no relation was seen between either insulin or insulin resistance and weight change. A significant interaction between obesity and insulin resistance was observed (P=0.002 for White women and 0.032 for the whole group), so that there is weight gain with increasing insulin resistance in the leaner women, but weight loss with increasing insulin resistance in the most obese. CONCLUSION: Insulin resistance appears to be a predictor of weight gain in postmenopausal women, except for the most obese women. The effect is more pronounced in women who have a lower BMI, and the effect was not seen in the Black women who as a group had a higher BMI.

Mass spectrometry has currently achieved a mass resolution capable of discerning chemical composition and structure in complex mixtures. However, whatever is the mass spectrometric system used, complex mixtures produce spectra with a huge number of peaks which generally make difficult the data analysis. In the present work, a method involving Fast Fourier Transform (FFT) analysis and a home-made software was applied for interpreting the mass spectra of complex PAH-laden samples derived from combustion systems and from heavy fossil fuels, therby giving information on their composition. Large polycyclic aromatic hydrocarbons (LPAHs) were found to be the major components in the complex mixtures. Iso-abundance plots were introduced to sort and visualize the molecular constituents into different types based on the carbon and double bond equivalence (DBE) numbers. The differences between the different carbonaceous materials could be easily observed by comparing their isoabundance plots.

The analysis and characterization of flame-formed products (i.e. Polycyclic Aromatic Hydrocarbons (PAH) and soot) still represents a crucial point not only for a deepening of the knowledge on reaction pathways in flames, but also for the control and monitoring of air anthropogenic emissions due to their dangerous effect on human health and on the environment. Gas Chromatography coupled to Mass Spectrometry (GC-MS) is the analytical technique usually applied to aromatic compounds relevant in the combustion field for the qualitative and quantitative analysis of PAH, according to the UNICHIM 825/1988 and EPA (US Environmental Protection Agency) methods 8270D and 610. However, GC-MS technique is limited to the detection of PAH up to coronene (7 rings, 300 Da) and lacks in the detection of high molecular weight aromatic species (>300 Da), commonly present in complex matrixes generated from fuel-rich combustion systems [3]. This strict limitation is mainly due to the low volatility of heavy aromatic species [4], which hinders the sample vaporization necessary for the gas chromatographic analysis. Moreover, the quadrupole analyzer generally coupled with GC, presents an upper mass range limit of m/z 1000. In the present work, different kinds of ionization systems and mass analyzers for mass spectrometric techniques have been explored in order to test their potentiality in extending the detection range of combustion products analysis with respect to GC-MS. In particular, Atmospheric Pressure Photo-ionization-Mass Spectrometry (APPI-MS) and Laser Desorption Ionization-Time of Flight Mass Spectrometry (LDI-TOFMS) have been tested in the analysis of samples collected in a fuel-rich premixed flame of ethylene-oxygen.

Spatial and temporal variability of HfOx-based resistive random access memory (RRAM) are investigated for manufacturing and product designs. Manufacturing variability is characterized at different levels including lots, wafers, and chips. Bit-error-rate (BER) is proposed as a holistic parameter for the write cycle resistance statistics. Using the electrical in-line-test cycle data, a method is developed to derive BERs as functions of the design margin, to provide guidance for technology evaluation and product design. The proposed BER calculation can also be used in the off-line bench test and build-in-self-test (BIST) for adaptive error correction and for the other types of random access memories., Comment: 4 pages. Memory Workshop (IMW), 2015 IEEE International

Polycyclic aromatic hydrocarbons (PAH), formed from incomplete combustion of a wide range of combustion sources, are believed to be hazardous to human health and to be soot precursors. The current European legislation provides PAH monitoring from exhaust through timeconsuming sampling by condensation, washing by solvent, filtration and off-line mass spectrometric analysis. Continuous on-line measurement of PAH inside and at the exhaust of combustion systems is still challenging. This is due to the small concentrations and limited selectivity of available measurement methods. The development of on-line mass spectrometric analysis, such as flame-sampling Molecular-Beam Time of Flight Mass Spectrometry (MB-TOFMS), has enabled the selective and sensitive detection of PAH, since the expansion of the flame gases through a nozzle into a lower pressure region leads to the formation of a nearly collisionless molecular beam. In the past several years, substantial progress has been achieved by supplementing traditional electron ionization molecular-beam mass spectrometry (EI-MBMS) with isomer-specific measurements using photo-ionization (PI-MBMS). However the inherent characteristics of on-line sampling and laser ionization allow PAH identification and comparative profiles along the flame evaluation whereas prevent PAH quantitative determination. In this work a quantitative analysis of flame-formed PAH with a MB-TOFMS is proposed through a calibration made with off-line techniques. Flame products from a premixed atmospheric pressure ethylene/oxygen laminar flame just above the soot formation threshold have been collected for several hours and concurrently analyzed on-line with the MB-TOFMS apparatus. The collected samples were extracted in solvent and off-line analysed by conventional GC-MS for quantitative determination of PAH. The GC-MS undetectable fraction was moreover analysed by other off-line chemical and spectroscopic techniques. From the on-line mass spectra acquired, the total area of each flame species has been evaluated and related to its concentration obtained by means of GCMS, thus calibrating the MB-TOFMS apparatus. Moreover, a measure of the sensitivity of such experimental apparatus and a comparison with the common off-line, less sensitive and more time-expensive, GC-MS for PAH analysis is given.

A novel apparatus based on Time of Flight Mass Spectrometry (TOF-MS) was recently developed and successfully applied for the on-line analysis of combustion products from atmospheric pressure combustion systems. The main advantage of this apparatus is the possibility of real-time mass spectra detection of big molecules nominally up to thousands of mass units and therefore it is very promising for its application in soot precursors detection above the polycyclic aromatic hydrocarbons (PAH) masses. However, in order to detect masses in so high mass range, accurate calibration by standard molecules in similar mass ranges is necessary. In gas phase the only standards generally employed are constituted by gas noble mixtures, therefore arriving at 136 Da. In the present work the accurate calibration of TOF-MS system is presented by using water clusters formed by condensation of water vapor in the supersonic beam as it passes from the atmospheric to low pressure region of the source through an orifice. Water clusters up to 160 water molecules have been detected, therefore extending the calibration range up to more than 3000 Da, in the optimal operative conditions. More than the large detection extension, the other advantage of using water clusters for calibration is the possibility of regulating the operative conditions in order to form the clusters from combustion water. This can allow to calibrate the system for the analysis of combustion products before each set of measurements, without any necessity of changing the injection system for introducing external standard molecules.

Large gaps in care quality resulting from ineffective communication between health providers, patients, and other health care organizations have been documented. Research suggests that effective, empathic communication positively influences health outcomes. Many studies focused on the assessment of clinicians empathy, while there is still a lack of evidence on the role and level of empathy for public health medical doctors,especially during their postgraduate education. The aim of this study was to assess empathy level of public health residents, and to investigate differences in empathy scores using a validated questionnaire. The Italian version of the Jefferson scale of Physician Empathy was mailed to all the resident doctors of the Italian Schools in Hygiene and Public Health during the month of April 2013. Individual Empathy Scores (IES) were calculated, as well as descriptive statistics for the items and scale levels. The difference in empathy scores according to physician’s gender, age class, career rank, place of residency, work experiences(medical direction vs research career) were examined trough t test or ANOVA as appropriate. 352 out of 402 resident doctors replied the questionnaire(response rate 87%). The mean of IES was 118.5 (SD 13.4; range = 54-140; median = 120). There were no IES differences between career rank (p = 0.3), age class (p = 0.2), and place of residency (p = 0.07), while females had higher IES than males (120.3 vs 114.9; p < 0.01). Physicians who have had experience in healthcare administration reported higher IES compared to those who only performed research activity (120.4 vs 117.1; p = 0.02). In addition the respondent physicians believe that the development of social skills should be promoted with greater attention during the undergraduate education (78%)and during the postgraduate education in public health (65%). Our results show a good level of IES in the public health residents, with some significant differences according to gender and physicians work experience. Furthermore, considering empathy and cultural competence essential for public health professionals in order to provide and manage high quality patient-centred care, the widespread demand for specific training outlined by this survey should be taken into adequate account.

En esta oportunidad analizaremos la posición editorial de los matutinos La Prensa, The Buenos Aires Herald y El Día frente a uno de los conflictos que casi llevó a la Argentina a una guerra durante la última dictadura militar. Nos referimos específicamente a la disputa entablada entre nuestro país y Chile por la soberanía sobre el canal de Beagle entre el 2 de mayo de 1977 -cuando ambos países conocieron el resultado del laudo arbitral comunicado por la corona británica- y el 9 de enero de 1979 -momento en el cual se firmó entre ambas representaciones diplomáticas el acuerdo de Montevideo bajo la observancia del enviado papal, cardenal Antonio Samoré-. Para comprender más acabadamente el discurso editorial de los medios propuestos creemos ilustrativo presentar previamente una breve reseña de la vida institucional de cada uno y los antecedentes históricos y detonantes del conflicto estudiado, para luego desarrollar el análisis del corpus, el cual tendrá en cuenta las estrategias y argumentos esgrimidos por cada periódico para justificar su posición favorable o desfavorable frente a la guerra como posible forma de resolución del conflicto.

We consider the Jahn-Teller system E\ensuremath{\bigotimes}\ensuremath{\epsilon} consisting of an orbital doublet coupled with a two-dimensional phonon. We attack the problem within the continued-fraction formalism, and we provide exact solutions for the optical absorption, the magnetic circular dichroism, and the reduction factors of the electronic orbital angular momentum. The elegant solutions provided by the continued-fraction formalism allow us to study the system in any range of coupling, where other methods in the literature would be inadequate. In particular, Slonczewsky resonances are clearly established in the strong-coupling case.

Elements such as sodium and potassium can contaminate oxides in semiconductor devices, including buried oxides in Silicon-On-Insulator (SOI) devices. Common fabrication processes use chemicals which contain such contaminants - an example being chemical-mechanical polish slurries - which can contain high levels of sodium or potassium. When charge contamination, particularly mobile charge contamination, gets under SOI devices, it can shift characteristics such as threshold voltage, and when this happens in sensitive analog circuits, it can lead to yield and reliability issues. We will describe an example and suggest possible layout mitigation strategies.

Abdominal scar recurrence of endometrial carcinoma after abdominal total hysterectomy is very rare. We report a case of a 65-year-old woman who had two recurrences in the abdominal incisional scar after total hysterectomy.A 65-year-old woman underwent total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy because of well-differentiated endometrial adenocarcinoma (Stage IIB). Thus, the patient was treated by external beam radiotherapy. She developed two recurrences in the abdominal incisional scar two and three years after total hysterectomy, respectively. Surgery plus chemotherapy and surgery plus hormonal therapy were used for treatment of the first and second scar recurrence, respectively.It is a very intriguing and controversial biologic question how neoplastic cells can implant and grow in an abdominal scar without other concomitant metastases. We report a review of the literature and the possible mechanism of recurrences in laparotomy wounds.

The term female adnexal tumor of probable Wolffian origin "FATWO" designs this tumor wich arises by the rare persisting remnants of the mesonephric duct (Wolffian duct). About 40 cases have been reported in literature. Few cases of recurrence have been reported, FATWO usually shows no signs of hormonal activity. We report a case of the youngest patient affected by FATWO in October 2002. At laparotomy the left adnexa were deformed by a well-capsulated mass, totally removed and sent to the pathologist with a specimen of peritoneal fluid and of the omentum. The histological examination showed a prevalent tubular structure with focal retiform area, without intraluminal mucines. Immunohistochemical findings of the case reported are similar to those described by other authors, except for inhibin which has not been detected by us. The cytofluorimetry showed the low presence of aneuploid cells, with a very low prolifing component (1%).

To assess CA-125 in defining tumor response in patients treated with paclitaxel.We analyzed 150 women treated for epithelial ovarian carcinoma with platinum or paclitaxel. We compared the patients treated with two agents, using a precise definition of CA-125 response, determined by 50% and 75% reductions, like other authors have published.CA-125 criteria gave response rates very similar to the standard response rates, both for patients treated with platinum (75% vs 63%) and also for those treated with paclitaxel (40% vs 39%). Rates of false-positive prediction of response by CA-125 were also similar for patients treated with these two agents.Precise 50% or 75% CA-125 response criteria are as sensitive as standard criteria for assessing activity of therapy for the ovarian cancers treated with platinum or paclitaxel. We propose that they may be useful in defining response in lieu of or in addition to standard response criteria in clinical trials involving epithelial ovarian cancer.