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In patients with breast cancer for whom neoadjuvant chemotherapy (NAC) is planned, it is recommended to mark the primary tumour before treatment (planned surgery). However, surgeons may have to perform breast-conserving surgery on patients whose tumours are not marked (unplanned surgery). This study focused on the results obtained with planned and unplanned level II oncoplastic surgery (OPS) techniques applied to patients after NAC.

Patient groups who underwent planned, unplanned OPS and mastectomy after NAC were compared. Surgical margin status, re-operation and re-excision requirements, ipsilateral breast tumour recurrence (IBTR) and axillary recurrence rates recorded. Long-term local recurrence-free survival (LRFS), disease-free survival and overall survival were evaluated.

There was no significant difference between the planned and unplanned OPS groups in terms of surgical margin status, re-excision requirement, and mastectomy rates. During an average follow-up period of 43months, 5.3% and 4% of the patients in the planned OPS group developed IBTR and axillary recurrence, respectively, whereas these rates were 6.6% and 5.3% in the unplanned OPS group. In the mastectomy group, the rates of IBTR and axillary recurrence were found to be 4.1% and 3.8%, respectively. There was no significant difference between the three groups in terms of IBTR (P .06) and axillary recurrence (P .08) rates.

Breast conserving surgery can be applied using level II OPS techniques with the post-NAC radiological examination and marking even if primary tumour marking is not done in the pre-NAC period.

Breast conserving surgery can be applied using level II OPS techniques with the post-NAC radiological examination and marking even if primary tumour marking is not done in the pre-NAC period.

Survival among patients diagnosed with acute promyelocytic leukemia (APL) has significantly improved with the use of all-trans retinoic acid and arsenic trioxide. However, the need for immediate diagnosis and access to specialized care and the cost associated with APL management can potentially act as barriers for disadvantaged patients. The influence of sociodemographic factors on the outcomes of patients with APL remains unclear.

The authors used the National Cancer Institute's Surveillance, Epidemiology, and End Results program to characterize the impact of sociodemographic factors on survival in patients younger than 65 years with APL.

The authors identified 1787 cases 816 who were younger than 40 years and 971 who were 40 years old or older. Insured patients who were younger than 40 years had an improved 5-year overall survival (OS) rate in comparison with patients without insurance. Among patients who were 40 years or older, having insurance (other than Medicaid) was associated with better survivawith patients with insurance. These findings point to an opportunity to improve survival in APL by addressing access to care.We examined the association between genotype and resistance training-induced changes (12 wk) in dual x-ray energy absorptiometry (DXA)-derived lean soft tissue mass (LSTM) as well as muscle fiber cross-sectional area (fCSA; vastus lateralis; n = 109; age = 22 ± 2 y, BMI = 24.7 ± 3.1 kg/m2 ). Over 315 000 genetic polymorphisms were interrogated from muscle using DNA microarrays. First, a targeted investigation was performed where single nucleotide polymorphisms (SNP) identified from a systematic literature review were related to changes in LSTM and fCSA. Next, genome-wide association (GWA) studies were performed to reveal associations between novel SNP targets with pre- to post-training change scores in mean fCSA and LSTM. Our targeted investigation revealed no genotype-by-time interactions for 12 common polymorphisms regarding the change in mean fCSA or change in LSTM. Our first GWA study indicated no SNP were associated with the change in LSTM. However, the second GWA study indicated two SNP exceeded the sigc responses to resistance training given the potential link between this gene and satellite cell physiology.

Adverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children.

To examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association.

Data for this cross-sectional secondary analysis study came from the 2017-2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches.

Based on parent reports, we found that 4.1% (1697/40,953) of the children reponal difficulties partially mediate this association.

To evaluate the efficacy of fremanezumab in patients with chronic migraine (CM) and moderate to severe depression.

Fremanezumab, a fully humanized monoclonal antibody that selectively targets calcitonin gene-related peptide, has been approved for the preventive treatment of migraine in adults. CM and depression are highly comorbid.

The 12-week, Phase 3 HALO trial randomized patients with CM to fremanezumab quarterly (675mg/placebo/placebo), fremanezumab monthly (675/225/225mg), or placebo. Post hoc analyses evaluated the effects of fremanezumab in patients with moderate to severe depression (baseline 9-item Patient Health Questionnaire sum score ≥10) on monthly number of headache days of at least moderate severity; monthly migraine days; Patient Global Impression of Change (PGIC); 6-item Headache Impact Test (HIT-6) scores; and depression.

For the 219/1121 (19.5%) patients with moderate to severe depression at baseline, fremanezumab was associated with a significant reduction in monthly number of headache days of at least moderate severity for active treatment versus placebo (least-squares mean change±standard error for quarterly dosing -5.3±0.77; for monthly dosing -5.5±0.72; and for placebo -2.2±0.81; both p<0.001). More patients achieved a ≥50% reduction in headache days of at least moderate severity with fremanezumab (quarterly 31/78 [39.7%]; monthly 39/96 [40.6%]) than placebo (9/67 [13.4%]; both p<0.001). Compared with placebo, fremanezumab improved PGIC and HIT-6 scores.

Fremanezumab demonstrated efficacy in the preventive treatment of CM and reduced headache impact in patients with comorbid depression.

Fremanezumab demonstrated efficacy in the preventive treatment of CM and reduced headache impact in patients with comorbid depression.Thyroid hormones regulate adult metabolism partly through actions on mitochondrial oxidative phosphorylation (OXPHOS). find more They also affect neurological development of the brain, but their role in cerebral OXPHOS before birth remains largely unknown, despite the increase in cerebral energy demand during the neonatal period. Thus, this study examined prepartum development of cerebral OXPHOS in hypothyroid fetal sheep. Using respirometry, Complex I (CI), Complex II (CII), and combined CI&CII OXPHOS capacity were measured in the fetal cerebellum and cortex at 128 and 142 days of gestational age (dGA) after surgical thyroidectomy or sham operation at 105 dGA (term ~145 dGA). Mitochondrial electron transfer system (ETS) complexes, mRNA transcripts related to mitochondrial biogenesis and ATP production, and mitochondrial density were quantified using molecular techniques. Cerebral morphology was assessed by immunohistochemistry and stereology. In the cortex, hypothyroidism reduced CI-linked respiration and CI abundance at 128 dGA and 142 dGA, respectively, and caused upregulation of PGC1α (regulator of mitochondrial biogenesis) and thyroid hormone receptor β at 128 dGA and 142 dGA, respectively. In contrast, in the cerebellum, hypothyroidism reduced CI&II- and CII-linked respiration at 128 dGA, with no significant effect on the ETS complexes. In addition, cerebellar glucocorticoid hormone receptor and adenine nucleotide translocase (ANT1) were downregulated at 128 dGA and 142 dGA, respectively. These alterations in mitochondrial function were accompanied by reduced myelination. The findings demonstrate the importance of thyroid hormones in the prepartum maturation of cerebral mitochondria and have implications for the etiology and treatment of the neurodevelopmental abnormalities associated with human prematurity and congenital hypothyroidism.The search for economical, active and stable electrocatalysts towards the hydrogen evolution reaction (HER) is highly imperative for the progression of water electrolysis technology and related sustainable energy conversion technologies. The delicate optimization of chemical composition and architectural configuration is paramount to design high-efficiency non-precious metal HER electrocatalysts. Herein, we report a one-step scalable template/solvent-free pyrolysis approach for in situ immobilizing uniform CoP nanoparticles onto N and P co-doped carbon porous nanosheets (denoted as CoP@N,P-CNSs hereafter). The simultaneous consideration of architectural design and nanocarbon hybridization renders the formed CoP@N,P-CNSs with plentiful well-dispersed anchored active sites, shortened pathway for mass diffusion, enhanced electric conductivity, and reinforced mechanical stability. As a consequence, the optimized CoP@N,P-CNSs exhibit an overpotential of 115 mV to afford a current density of 10 mA cm-2 , small Tafel slope of 74.2 mV dec-1 , high Faradaic efficiency of nearly 100 %, and superb long-term durability in an alkaline medium. Given the fabrication feasibility, mass production potential and outstanding HER performance, the CoP@N,P-CNSs may hold great promise for large-scale electrochemical water splitting. More importantly, the explored one-step template/solvent-free pyrolysis methodology offers a feasible and versatile route to fabricate carbon nanosheet-based nanocomposites for diverse energy conversation-related applications.The dynamic spreading phenomenon of liquids is vital for both understanding wetting mechanisms and visual reaction time-related applications. However, how to control and accelerate the spreading process is still an enormous challenge. Here, a unique microchannel and nanofiber array morphology enhanced rapid superspreading (RSS) effect on animals' corneas with a superspreading time (ST) of 830 ms is found, and the respective roles of the nanofiber array and the microchannel in the RSS effect are explicitly demonstrated. Specifically, the superspreading is induced by in-/out-of-plane nanocapillary forces among the nanofiber array; the microchannel is responsible for tremendously speeding up the superspreading process. Inspired by the RSS strategy, not only is an RSS surface fabricated with an ST of only 450 ms, which is, respectively, more than 26 and 1.8 times faster than conventional superamphiphilic surfaces and animal's corneas and can be applied as RSS surfaces on video monitors to record clear videos, but also it is demonstrated that the RSS effect has tremendous potential as advanced ophthalmic material surfaces to enhance its biocompatibility for clear vision.