Awareness and associated factors of venous thromboembolism in breast cancer surgical patients: a cross-sectional study.

BACKGROUND: Venous thromboembolism (VTE) is a major complication of breast cancer surgical patients. Assessing VTE awareness enables medical staff to tailor educational programs that improve patient self-management and reduce VTE risk. Therefore, this study aimed to assess VTE awareness among breast cancer surgical patients and identify factors influencing their awareness level. METHODS: A multicenter cross-sectional study was conducted on breast cancer patients scheduled for surgery from May 2023 to November 2023. Data were collected using a general information form and a validated self-assessment questionnaire on VTE awareness for breast cancer surgical patients. Univariate analysis and multiple linear regression analysis were used to analyze the data. RESULTS: Of 1969 patients included, the term awareness rates for deep vein thrombosis and pulmonary embolism were 42.5% and 26.1%, respectively. Information about VTE was primarily obtained from doctors (30.4%), nurses (24.0%), and social media (23.3%). The overall average VTE awareness score was 1.55 ± 0.53, with the dimension of VTE preventive measures scoring highest, and VTE clinical symptoms/signs scoring lowest. Multivariate analysis identified education level, personal VTE history, chemotherapy and surgical history, and the hospital's regional location as significant factors associated with VTE awareness level (p < 0.05). CONCLUSION: This study highlights a critical need for improved VTE awareness among breast cancer surgical patients, particularly regarding clinical symptoms/signs. Health education programs are recommended especially tailored for patients with lower education levels, no history of VTE, or without prior surgery or chemotherapy, to improve their understanding of VTE.

Translation and validation of the Chinese version of the BCPT Eight Symptom Scale (BESS) in patients with breast cancer.

Objective: This study aimed to translate the Breast Cancer Prevention Trial Eight Symptom Scale (BESS) into Chinese and subsequently examine the latent constructs and psychometric properties of the Chinese BESS (C-BESS) among patients with breast cancer. Methods: In Phase 1, the BESS was translated from English into Chinese using the FACIT translation method. An expert panel was convened to assess the content validity, and pilot testing was performed with 20 patients with breast cancer. In Phase 2, a total of 427 patients with breast cancer from four Grade-A public hospitals in China were recruited to examine psychometric properties of the C-BESS. The internal consistency was evaluated based on the Cronbach's α, and the construct validity was tested using confirmatory factor analysis, convergent validity, and discriminant validity. Results: The C-BESS demonstrated satisfactory content validity index (item-level content validity index [I-CVI]: 0.8-1.0; scale-level content validity index [S-CVI]: 0.97). The Cronbach's α value for the entire C-BESS scale was 0.92. Confirmatory factor analysis indicated that eight-factor structure of the C-BESS was a good fit to the data (CFI = 0.959, AGFI = 0.904, RMSEA = 0.05, RMR = 0.029). The scale exhibited good convergent validity and discriminant validity. Conclusions: This study translated and validated the C-BESS for use in the Chinese population. The results demonstrate that the C-BESS exhibits good reliability and validity, with ideal psychometric properties for assessing the symptom burden in Chinese patients with breast cancer. This tool can be effectively integrated into the routine symptom monitoring of patients with breast cancer in China, helping Chinese clinical professionals in conducting comprehensive assessments of symptom burden.

Insights into Nano- and Micro-Structured Scaffolds for Advanced Electrochemical Energy Storage.

Adopting a nano- and micro-structuring approach to fully unleashing the genuine potential of electrode active material benefits in-depth understandings and research progress toward higher energy density electrochemical energy storage devices at all technology readiness levels. Due to various challenging issues, especially limited stability, nano- and micro-structured (NMS) electrodes undergo fast electrochemical performance degradation. The emerging NMS scaffold design is a pivotal aspect of many electrodes as it endows them with both robustness and electrochemical performance enhancement, even though it only occupies complementary and facilitating components for the main mechanism. However, extensive efforts are urgently needed toward optimizing the stereoscopic geometrical design of NMS scaffolds to minimize the volume ratio and maximize their functionality to fulfill the ever-increasing dependency and desire for energy power source supplies. This review will aim at highlighting these NMS scaffold design strategies, summarizing their corresponding strengths and challenges, and thereby outlining the potential solutions to resolve these challenges, design principles, and key perspectives for future research in this field. Therefore, this review will be one of the earliest reviews from this viewpoint.

Symptom experience in endocrine therapy for breast cancer patients: A qualitative systematic review and meta-synthesis.

Objective: The purpose of this study was to systematically integrate the experience of symptoms of breast cancer patients receiving endocrine therapy, analyze the patients' understanding and coping status of symptoms, and provide information for the development of targeted symptom management measures. Methods: We searched databases including PubMed/MEDLINE, MEDLINE (Ovid), Web of Science, EMBASE (Ovid), CINAHL (EBSCO), and ProQuest from inception to September 25, 2023. Literature was screened and analyzed using Endnote software, evaluated using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research, and the results were integrated using JBI's Pooled Integration Methodology. Results: Three composite findings were derived from 10 studies: symptom distress during endocrine therapy; coping in symptom experience; and support needs. Conclusions: Emphasis should be placed on the symptomatic experience of breast cancer patients undergoing endocrine therapy, and effective interventions should be developed to improve patients' medication compliance and quality of life. Finally, the long-term survival rate of patients is improved. Systematic review registration: CRD42023466073.

Suffering and adjustment: a grounded theory of the process of coping with financial toxicity among young women with breast cancer.

PURPOSE: To explore the process of coping with financial toxicity among young women with breast cancer and formulate a grounded theory that serves as a foundation for creating intervention strategies aimed at supporting cancer survivors. METHODS: A qualitative study using the Corbin and Strauss variant of grounded theory. A series of in-depth interviews were carried out with young women with breast cancer (n = 29) using the theoretical sampling method. We analyzed data by coding core categories in the patients' coping processes and developing theory around these categories. Data collection and analysis were performed simultaneously. RESULTS: A substantial theory of the process of coping with financial toxicity among young female breast cancer survivors was constructed. Two core concepts, suffering and adjustment, were identified. Young women with breast cancer suffered from financial toxicity, which was related to risk factors, coping resources, and unmet needs. To overcome financial toxicity, young women with breast cancer adjusted by reshaping consumption concept, re-dividing of family functions, re-planning of occupation career, and rebuilding life confidence. CONCLUSION: This qualitative study constructed a theory delineating the coping strategies employed by young women with breast cancer in response to financial toxicity, offering profound insights into the intricacies of cancer-related financial toxicity. Identifying risk factors, enhancing coping resources, and meeting unmet needs would be helpful to patients' adjustment to financial stress.

The self-management instrument for breast cancer patients undergoing adjuvant therapy: Development and psychometric testing using the COSMIN methodology.

Objective: This study aims to develop and test the self-management instrument for breast cancer patients undergoing adjuvant therapy (SMAT-B). Methods: After a qualitative interview with 29 patients and two rounds of Delphi expert consultation with 15 experts, 49 items were initially generated. Before item reduction, another structured interview was conducted for content validity. Item analysis and exploratory factor analysis (n â€‹= â€‹377) were used for item reduction. After that, internal consistency, split-half reliability, test-retest reliability (n â€‹= â€‹30), measurement error, construct validity, and structural validity (n â€‹= â€‹342) were preliminarily evaluated using the COnsesus-based Standards for the selection of health Measurements INstruments guidelines. Results: The final version of SMAT-B includes 7 dimensions and 31 items after item reduction. The testing results suggested that SMAT-B had good internal consistency (Total Cronbach's α â€‹= â€‹0.952), good split-half reliability (Spearman-Brown coefficient â€‹= â€‹0.904), good stability (Total intraclass correlation coefficient = â€‹0.797), acceptable measurement error (SEM â€‹= â€‹5.28), and acceptable construct validity (Standardized root mean square residual â€‹= â€‹0.055). The hypotheses of construct validity were all verified to a certain extent (r â€‹> â€‹0.20, P â€‹< â€‹0.01). Conclusions: The 31-item SMAT-B, developed in interviews with patients and consultation with experts, demonstrated good psychometric properties and can be recommended for researchers and clinicians for further validity testing and evaluation of the self-management ability of breast cancer patients. Trial registration: ChiCTR2100052868.

Symptom Profiles and Related Factors Among Breast Cancer Patients Undergoing Endocrine Therapy: A Latent Profile Analysis.

BACKGROUND: To provide person-centered symptom management, the interindividual variability in breast cancer patients merits further exploration. However, how sociodemographic and clinical characteristics influence symptom profile membership in endocrine therapy for breast cancer is still unknown. OBJECTIVES: This study aimed to explore symptom profiles of breast cancer patients undergoing endocrine therapy and to identify sociodemographic and clinical characteristics among symptom subgroup members. METHODS: A cross-sectional study was conducted, and participants were invited to complete a general information questionnaire and Functional Assessment of Cancer Therapy-Endocrine Subscale. Latent profile analysis, univariate analysis, and multinomial logistic regression were performed to explore symptom profiles and identify interindividual variability. RESULTS: Three distinct subgroups were identified: "all high" (9.8%), "all moderate but high sexual symptoms" (25.4%), and "all low" (64.8%). Age, body mass index, main payment source for medical expenses, type of endocrine therapy, and history of breast cancer treatment were factors that determined membership in these 3 symptom subgroups. CONCLUSION: Patients' demographic and clinical characteristics were associated with their endocrine therapy-related symptom profiles. In general, those younger in age who pay out of pocket for medical expenses, use aromatase inhibitors, present a history of chemotherapy, and have a higher body mass index have a greater risk of symptom burden. IMPLICATION FOR PRACTICE: The findings of this study will contribute to implementing individual cancer care based on the characteristics and needs of patient subgroups, which may improve the allocation of medical resources and provide interventions tailored to patients' unique needs.

Psychological and reproductive decision-making experiences of young women after breast cancer diagnosis: a qualitative study.

BACKGROUND: Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The treatment has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences then increase patients' concerns over future reproduction. At present, nor do medical staffs continuously assess their overall well-being, or ensure that they have the knowledge necessary to manage their reproductive concerns. This qualitative study aimed to explore psychological and reproductive decision-making experiences of young women who had experienced childbirth after their diagnosis. METHODS: The phenomenological research, as a kind of qualitative study, was conducted on 12 young women who experienced childbirth after breast cancer diagnosis. Data collection was from September 2021 to January 2022 and content analysis method was used to analyze the data. RESULTS: Five main themes were identified: (1) desire for childbearing from individual, familial, and social aspects after the diagnosis of breast cancer; (2) emotional experiences through pregnancy till raising children; (3) support needs from professionals, family, and peer; (4) self and doctors' influencing factors on reproductive decision-making; and (5) satisfaction with the outcome of reproductive decision-making. CONCLUSIONS: The desire for childbearing of young women should be considered during the reproductive decision-making process. A multidisciplinary team is suggested to be set up to provide professional support. During the reproductive process, professional and peer support should be strengthened to improve decision-making abilities, alleviate negative emotional experience, and smoothen the process of reproductive experience for young patients.

Symptom Clusters and Quality of Life in Patients With Breast Cancer Receiving Endocrine Therapy in China.

OBJECTIVES: Breast cancer patients undergoing endocrine therapy experience various symptoms that have long-term effects on their quality of life. However, which symptom clusters are expressed and affect patients' quality of life remain significantly controversial. Therefore, we aimed to explore symptom clusters among breast cancer patients receiving endocrine therapy and identify the impact of these clusters on their quality of life. DATA SOURCES: This secondary analysis of data from a cross-sectional study aimed to explore the symptom experiences and quality of life of breast cancer patients receiving endocrine therapy. The participants were invited to complete the Functional Assessment of Cancer Therapy-Breast (FACT-B) and Endocrine Subscale (ES). Principal component analysis, Spearman correlation analyses, and multiple linear regression were used to explore symptom clusters and identify their influence on quality of life. CONCLUSION: Data from 613 participants were obtained, and 19 symptoms were included in the principal component analysis, which identified five symptom clusters: the systemic, pain and emotional, sexual, vaginal, and vasomotor symptom clusters. Adjustment for covariates revealed that the systemic and pain and emotional symptom clusters were negative predictors of quality of life. The fitted model explained approximately 38.1% of the variance. IMPLICATIONS FOR NURSING PRACTICE: This study demonstrated that breast cancer patients receiving endocrine therapy experienced symptoms that tended to occur in five clusters (i.e., systemic, pain and emotional, sexual, vaginal, and vasomotor symptoms). Developing interventions for the systemic and pain and emotional symptom clusters may effectively improve patients' quality of life.

Contemporaneous symptom networks and correlates during endocrine therapy among breast cancer patients: A network analysis.

Background: Endocrine therapy-related symptoms are associated with early discontinuation and quality of life among breast cancer survivors. Although previous studies have examined these symptoms and clinical covariates, little is known about the interactions among different symptoms and correlates. This study aimed to explore the complex relationship of endocrine therapy-related symptoms and to identify the core symptoms among breast cancer patients. Methods: This is a secondary data analysis conducted based on a multicenter cross-sectional study of 613 breast cancer patients in China. All participants completed the 19-item Chinese version of the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES). Multivariate linear regression analysis was performed to identify significant factors. A contemporaneous network with 15 frequently occurring symptoms was constructed after controlling for age, payment, use of aromatase inhibitors, and history of surgery. Network comparison tests were used to assess differences in network structure across demographic and treatment characteristics. Results: All 613 participants were female, with an average age of 49 years (SD = 9.4). The average duration of endocrine therapy was 3.6 years (SD = 2.3) and the average symptom score was 18.99 (SD = 11.43). Irritability (n = 512, 83.52%) and mood swings (n = 498, 81.24%) were the most prevalent symptoms. Lost interest in sex (mean = 1.95, SD = 1.39) and joint pain (mean = 1.57, SD = 1.18) were the most severe symptoms. The edges in the clusters of emotional symptoms ("irritability-mood swings"), vasomotor symptoms ("hot flashes-cold sweats-night sweats"), vaginal symptoms ("vaginal discharge-vaginal itching"), sexual symptoms ("pain or discomfort with intercourse-lost interest in sex-vaginal dryness"), and neurological symptoms ("headaches-dizziness") were the thickest in the network. There were no significant differences in network structure (P = 0.088), and global strength (P = 0.330) across treatment types (selective estrogen receptor modulators vs. aromatase inhibitors). Based on an evaluation of the centrality indices, irritability and mood swings appeared to be structurally important nodes after adjusting for the clinical covariates and after performing subgroup comparisons. Conclusion: Endocrine therapy-related symptoms are frequently reported issues among breast cancer patients. Our findings demonstrated that developing targeted interventions focused on emotional symptoms may relieve the overall symptom burden for breast cancer patients during endocrine therapy.

Communication between mothers with breast cancer and minor children: a qualitative systematic review and meta-synthesis.

PURPOSE: Both women with breast cancer and their minor children were affected by a breast cancer diagnosis. The purpose of this review was to synthesize the evidence from qualitative studies on illness-related communication between mothers with breast cancer and their minor children from mothers' perspectives. METHODS: A thorough systematic review and meta-synthesis of qualitative studies was conducted. English articles published prior to 6 November 2021 were searched from five databases, including PubMed/ MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO. After screening the titles, abstracts, and full texts, seven articles were finally included in the quality appraisal and meta-aggregation. RESULTS: Four synthesized findings were derived from seven articles, including disclosure dilemma, factors impacting disclosure, methods of communication, and information needs. CONCLUSIONS: This systematic review offered insight into the communication between mothers with breast cancer and their minor children. Various factors influenced the decision-making process on illness-related disclosure, as well as the methods and contents of the communication. Future studies should be undertaken to explore the common model shared by mothers and children who have had comparable experiences, as well as to completely analyze the differences between different cultures in this topic.

Psychometric properties of the Chinese version of female self-advocacy in cancer survivorship scale.

Objective: To translate Female Self-Advocacy in Cancer Survivorship (FSACS) scale and evaluate the psychometric properties of Chinese version of FSACS scale among female cancer survivors in China. Methods: This study employed a cross-sectional design. FSACS scale was forward-backward translated and cognitive interviews were conducted for cultural adaptation. The newly translated tool was distributed to female cancer survivors to test psychometric properties, including item analysis, content validity, construct validity, criterion validity, internal consistency, and test-retest reliability. Results: A total of 436 female cancer survivors were recruited in a Chinese tertiary cancer center from May to August in 2021. Item analysis showed statistical significance (P < 0.05) for each one and no ceiling or floor effect. The item-level content validity index ranged from 0.86 to 1.00 and the scale-level content validity index was 0.98. Three factors were extracted based on parallel analysis, and confirmatory factor analysis proved a good model fit with the original 3-factor structure. Pearson's correlation coefficient showed acceptable criterion validity. The Cronbach's α of 0.880 demonstrated the scale's internal consistency reliability, and the Alpha coefficients were 0.826, 0.763, and 0.859 for its three dimensions, respectively. The interclass correlation coefficients for test-retest reliability was 0.904 (0.870-0.891, P < 0.01) which confirmed the external reliability of the scale. Conclusions: The Chinese version of FSACS scale proved to be a valid and reliable instrument that can be applied among Chinese female cancer survivors. Further research could be conducted in larger populations or people in different cancer stages.

[Main components in different varieties of Xihuangcao by UPLC-Q-TOF-MS and UPLC-DAD].

This study established an ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS) method to analyze the main components in different varieties of Xihuangcao and established a UPLC-DAD method to simultaneously determine the five active components(caffeic acid, rosmarinic acid, schaftoside, isoschaftoside, and oridonin).The chromatographic separation was performed on a Waters ACQUITY UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 µm) with a gradient elution of methanol(B)-water containing 0.1% formic acid(A) at a flow rate of 0.3 mL·min~(-1).The column temperature was 30 ℃.The Q-TOF-MS discriminant analysis was performed under positive electrospray ion mode and the split ratio was 1∶1. Quantitative analysis was carried out by UPLC-DAD.The determination wavelength was set at 245 nm.Thirty-two main components of Xihuangcao were separated and identified by UPLC-Q-TOF-MS, where 19 were identified in Rabdosia serra, nine in R.nervosa, 10 in R.lophanthoides, 15 in R.lophanthoides var.graciliflora, 10 in R.lophanthoides var.gerardianus, and seven in R.stracheyi.The UPLC-DVD method was developed for simultaneously determining five active components in different varieties of Xihuangcao.The standard curves for five compounds showed good linearity with correlation coefficients higher than 0.999 0.The precision, repeatability, and stability were good.The average recoveries(n=6) were between 97.01% and 102.7% with RSD<3.0%.The results of UPLC-Q-TOF-MS analysis provided a scientific basis for the use of R.stracheyi as a medicinal material of Xihuangcao and the equivalent use of R.lophanthoides var.gerardianus with R.lophanthoides var.graciliflora to some extent.The UPLC-DAD method for simultaneously determining five active components is simple, rapid, and accurate.This study can provide the basis for the quality control of different varieties of Xihuangcao.

An investigation into the reproductive concerns of young women with breast cancer.

Objective: Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The survival rate of young patients with breast cancer has improved significantly, but the treatment to which they are subjected has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences, in turn, increase patients' concerns over future reproduction and childrearing. At present, patients lack easy access to the informative consultations and accurate patient education. Nor do medical staff continuously assess their overall wellbeing, engage in mental health interventions, or ensure that they have the knowledge necessary to manage their reproductive concerns. This study sought to investigate the reproductive concerns of young female patients with breast cancer, identify the factors that influence those concerns, and provide a theoretical and practical scientific basis for the future fertility management of this specific population. Methods: Our study is based on a cross-sectional survey of 112 young patients with breast cancer recruited by a convenience sampling method in the Shanghai Cancer Center, Fudan University, from October 2020 to January 2021. A self-designed questionnaire and the Chinese version of the Reproductive Concerns After Cancer were used for data collection. Multivariable linear regression was performed to analyze the data. Results: The total score for reproductive concerns was 59.96 â€‹± â€‹9.91, indicating that young women with breast cancer have relatively high levels of concern about reproduction. Multivariable linear regression analyses suggested that age, education level, and the desire for parenthood were the factors that influenced these concerns. The younger the patient, the higher the level of concern. Patients with a higher level of education and a greater desire for parenthood indicated greater levels of concern about reproductive issues. Conclusions: The levels of concern about reproduction expressed by these young patients with breast cancer were high. The factors that influenced their concern were their age, education level, and desire to have children. We suggest that medical staff focus on young patients during treatment and develop effective intervention measures based on their desire for parenthood, disease condition, and psychological status to promote the patients' physical and mental health.

Medical professionals' knowledge of the use of external breast prostheses among breast cancer patients in China-a cross-sectional study.

BACKGROUND: Breast loss has a negative effect on women physically, psychologically and socially. External breast prostheses can improve patients' figure physically, increase their self-confidence, and thus improve quality of life. Little is known about the knowledge of medical professionals on the use of external breast prostheses in mainland China. This study sought to examine medical professionals' knowledge of the use of external breast prostheses among breast cancer patients in China. METHODS: Self-designed questionnaires were administered to 635 medical professionals specializing in breast cancer in China to examine their knowledge. RESULTS: Medical professionals who were older in age, those who had higher levels of education and those who had senior professional titles had a broader professional knowledge of external breast prostheses. Medical professionals who were younger in age and those who had junior professional titles thought that the patients were willing to choose direct-adhesive breast prostheses. Medical professionals who were older in age, those who had higher levels of education, those who had senior professional titles and those who had been working for many (but less than 30) years were more likely to think that patients could wear external breast prostheses shortly after surgery, and at all times except when sleeping. More highly educated doctors, head nurses and medical staffs from the East were more likely to think that patients would accept the use of high-priced external breast prostheses. CONCLUSIONS: Medical professionals' knowledge about the wearing of external breast prostheses is lacking. A number of factors, including age, education level, professional title, number of years working years and geographical region have different effects on medical professionals' knowledge. Medical professionals with a good knowledge of external breast prostheses, especially specialist breast nurses, can provide patients with comprehensive information about breast prostheses, assist patients in selecting the appropriate prostheses, understand patients' wearing experiences, and help to reduce patients' physical and mental distress.

A Short-Term Effect of Wearable Technology-Based Lifestyle Intervention on Body Composition in Stage I-III Postoperative Breast Cancer Survivors.

BACKGROUND AND AIM: A healthy body composition can improve the prognosis of breast cancer survivors. The study aimed to describe the body composition profile of breast cancer survivors and find out whether a short-term (3 months) wearable device-based lifestyle intervention had an effect on patients' body weight and body composition. METHODS: A before-and-after study was conducted on patients with stage I-III postoperative breast cancer, aged 18-70 years. Body composition was analyzed at baseline, and then patients went for a health education program. A wearable activity tracker and a goal of calorie consumption based on each individual's weight were provided to each participant, and they were required to be equipped for 90 days. After 3 months, body composition was analyzed again. RESULTS: Of 113 patients who completed the study, 65.49% showed a normal body mass index (BMI) at baseline assessment, 71.68% had a body fat percentage of more than 30%, and 41.59% had less skeleton muscle mass. During the intervention, the daily step count was 8,851.28 ± 2,399.31, and 59.21% reached the set goal calorie consumption. After a 3-month intervention, the patients had a significant reduction in body weight, fat mass, BMI, body fat percentage, and visceral fat area, but not in protein mass and skeleton muscle mass. Patients of different age, molecular classification, and therapy benefited from the intervention. CONCLUSION: Wearable technology with body composition analysis and health education for breast cancer survivors may help reduce weight and improve body composition even in a short time. CLINICAL TRIAL REGISTRATION: http://www.chictr.org.cn/showproj.aspx?proj=40672, identifier ChiCTR1900024258.

Physical and psychological effects of different temperature-controlled breast prostheses on patients with breast cancer during rehabilitation: a randomized controlled study (CONSORT).

BACKGROUND: Breast loss causes negative influence on women physically, psychologically, and socially. Breast prosthesis can improve patient's figure externally, increase self-confidence, thus improving quality of life (QOL). Prospective study of different breast prostheses has not yet been performed in China. Our objective was to evaluate the QOL of patients wearing different types of breast prostheses and to compare the physical and psychological effects of different temperature-controlled breast prostheses on patients. METHODS: Thirty patients with breast cancer were recruited through the Yankang E-follow-up Platform at the Department of Breast Surgery of Fudan University, Shanghai Cancer Center and were randomized into either intervention or control group. Random number tables were used in this study for randomization. In the first 6 weeks of the study, self-adhesive breast prostheses and conventional breast prostheses had been used in the intervention and control group, respectively. In the later 6 weeks, the breast prostheses used were switched into another kind. Several dimensional parameters including skin conditions, breast prosthesis knowledge, breast prosthesis knowledge, QOL, and body image were examined by different questionnaires in the end of both 6th and 12th week. RESULTS: There were no significant difference in QOL and body image between the 2 groups during 6th and 12th week. At the 6th week of the study, patients of the intervention group preferred to the self-adhesive breast prosthesis, indicating that the self-adhesive breast prosthesis seemed more likely to feel like part of their body, while prosthesis cleaning remaining their biggest concern. At the end of 12th week, in comparison with the number at 6th week, more patients in both groups were willing to choose self-adhesive breast prosthesis. CONCLUSIONS: We conclude that women are satisfied with the temperature-controlled breast prosthesis and are more willing to choose self-adhesive breast prostheses although cleaning remains a problem. In China, patients still lack information about breast prostheses. Therefore, specialist breast nurses should provide comprehensive information about breast prostheses, assist patients in selecting suitable breast prostheses, collect feedback about the prostheses, and reduce each patient's physical and mental discomfort.

Research on the Microstructures and Mechanical Properties of Bainite/Martensite Rail Treated by the Controlled-Cooling Process.

A bainite/martensite multiphase rail is treated by the controlled-cooling process with different finish-cooling temperatures. The simulated temperature-time curves of the position of 5 mm and 15 mm below the rail tread (P5 and P15) express different trends. P5 has greater impact toughness and lower tensile strength than P15. Microstructural characterization was carried out by conducting scanning electron microscopy, X-ray diffraction, electron backscatter diffraction, and transmission electron microscopy. The greater tensile strength is due to the dispersed ε-carbides hindering the movement of dislocations. The greater impact toughness is attributed to the filmy retained austenite and the smaller effective grain with high-angle boundary. Finite element modeling (FEM) and microstructural characterization reasonably explain the changes of mechanical properties. The present work provides experimental and theoretical guidance for the development of rail with excellent mechanical properties.

Improvement of Verticillium Wilt Resistance by Applying Arbuscular Mycorrhizal Fungi to a Cotton Variety with High Symbiotic Efficiency under Field Conditions.

Arbuscular mycorrhizal fungi (AMF) play an important role in nutrient cycling processes and plant stress resistance. To evaluate the effect of Rhizophagus irregularis CD1 on plant growth promotion (PGP) and Verticillium wilt disease, the symbiotic efficiency of AMF (SEA) was first investigated over a range of 3% to 94% in 17 cotton varieties. The high-SEA subgroup had significant PGP effects in a greenhouse. From these results, the highest-SEA variety of Lumian 1 was selected for a two-year field assay. Consistent with the performance from the greenhouse, the AMF-mediated PGP of Lumian 1 also produced significant results, including an increased plant height, stem diameter, number of petioles, and phosphorus content. Compared with the mock treatment, AMF colonization obviously inhibited the symptom development of Verticillium dahliae and more strongly elevated the expression of pathogenesis-related genes and lignin synthesis-related genes. These results suggest that AMF colonization could lead to the mycorrhiza-induced resistance (MIR) of Lumian 1 to V. dahliae. Interestingly, our results indicated that the AMF endosymbiont could directly inhibit the growth of phytopathogenic fungi including V. dahliae by releasing undefined volatiles. In summary, our results suggest that stronger effects of AMF application result from the high-SEA.

Arabidopsis thalianaACS8 plays a crucial role in the early biosynthesis of ethylene elicited by Cu2+ ions.

Cu2+ ions are required by all living organisms and play important roles in many bactericides and fungicides. We previously reported that Cu2+ can elicit defense responses, which are dependent on the ethylene signaling pathway in Arabidopsis However, the mechanism by which Cu2+ elicits the biosynthesis of ethylene remains unclear. Here, we show that CuSO4 treatment rapidly increases the production of ethylene. In addition, it upregulates the expression of several defense-related genes and ethylene biosynthesis genes, including genes encoding S-adenosylmethionine synthase, 1-aminocyclopropane-1-carboxylate (ACC) synthase (ACS) and ACC oxidase. Among these genes, Arabidopsis thaliana (At)ACS8 was identified as essential for the defense response and early ethylene biosynthesis induced by Cu2+ Furthermore, Cu2+-induced AtACS8 expression depended on the copper-response cis-element (CuRE) in the promoter of AtACS8 Our study indicates that Cu2+ specifically activates the expression of AtACS8 to promote the early biosynthesis of ethylene that elicits plant immunity in Arabidopsis plants.