Associations of relative deprivation with self-rated health and health-related quality of life: mediating role of subjective social status.

OBJECTIVES: Relative deprivation has been linked to various adverse health outcomes. However, the potential mediating factors in the association between relative deprivation and health outcomes remain unclear. This study aimed to (1) examine the association between relative deprivation and self-rated health and health-related quality of life among the working-age population in Taiwan and (2) investigate the mediating effect of subjective social status. STUDY DESIGN: Cross-sectional study using nationally representative data. METHODS: Data were obtained from the 2022 Taiwan Social Change Survey conducted from September 2021 to April 2022. We analyzed 1108 participants aged 25-64 years. Relative deprivation was measured using the Yitzhaki Index based on individual monthly income from all sources. Health-related quality of life was assessed using the 12-item Short Form Health Survey. RESULTS: After adjusting for all covariates and absolute income, least-squares regression models indicated a negative association between the Yitzhaki Index and self-rated health, as well as the physical and mental components of health-related quality of life. Furthermore, subjective social status partially mediates the association between relative income deprivation and poorer self-rated health and health-related quality of life. CONCLUSIONS: The findings support the psychosocial effect of the relative deprivation measure, emphasizing the importance of addressing relative deprivation to improve health-related quality of life among the working-age population.

[Myxiod pleomorphic liposarcoma: a clinicopathological and molecular genetic analysis of six cases].

Objective: To investigate the clinicopathologic and molecular genetic characteristics of myxoid pleomorphic liposarcoma (MPLPS). Methods: Six cases of MPLPS diagnosed and consulted in Fujian Provincial Hospital from 2015 to 2021 were collected for histomorphological observation, immunohistochemistry, and fluorescence in situ hybridization (FISH) detection of DDIT3 (CHOP) gene translocation and MDM2/CDK4 gene amplification. Results: There were four males and two females, aged 26-74 years (mean 53.8 years). The tumor size was 3.8-16.0 cm (mean 11.8 cm). All six cases had similar histopathologic features, showing overlapping histologic morphology of myxoid liposarcoma and pleomorphic liposarcoma. Four cases (4/6) were positive for S-100 protein, and the Ki-67 index was 50%-95%. All cases (6/6) were negative for DDIT3 (CHOP) translocation and MDM2/CDK4 amplification by FISH. TP53 (p.R248w) germline mutation was found in one case. Conclusions: MPLPS is a rare subtype of liposarcoma, characterized by overlapping morphology of myxoid liposarcoma and pleomorphic liposarcoma. Genetically, a few of them have TP53 gene germline mutations, but they lack of DDIT3 (CHOP) translocation or MDM2/CDK4 amplification.

The use of albendazole and diammonium glycyrrhizinate in the treatment of eosinophilic meningitis in mice infected with Angiostrongylus cantonensis.

Angiostrongylus cantonensis (A. cantonensis) infection causes eosinophilic meningitis in humans. Eosinophilia and a Th2-type immune response are the crucial immune mechanisms for eosinophilic meningitis. CD4+CD25+ regulatory T cells (Treg) are involved in the pathogenesis of A. cantonensis. Diammonium glycyrrhizinate (DG) is a compound related to glycyrrhizin (GL), a triterpene glycoside extracted from liquorice root. We investigated the curative effects and probable mechanisms of therapy involving a combination of albendazole and DG in BALB/c mice infected with A. cantonensis, and compared these with therapy involving albendazole and dexamethasone. We analysed survival time, body weight, signs, eosinophil numbers, immunoglobulin E (IgE), interleukin-5 (IL-5), and eotaxin concentrations, numbers and Foxp3 expression of CD4+CD25+ Treg, worm recovery and histopathology. The present results demonstrated that the combination of albendazole and DG could increase survival time more efficiently and relieve neurological dysfunction; decrease weight loss, eosinophil numbers, concentrations of IgE, IL-5 and eotaxin, the number and expression of Foxp3 of CD4+CD25+ Treg; and improve worm recovery and histopathology changes in treated animals, compared with the combination of albendazole and dexamethasone. The observations presented here suggest that the albendazole and dexamethasone combination could be replaced by the combination of albendazole and DG.

Tertiary Lymphoid Structure Raises Survival and Immunotherapy in HPV- HNSCC.

Immune checkpoint blockade (ICB) targeting PD-1/PD-L1 has been used for the treatment of head and neck squamous cell carcinoma (HNSCC). However, the overall response rate to ICB therapy for HNSCC remains less than 20%. It has recently been reported that the appearance of tertiary lymphoid structures (TLSs) in tumor tissue is correlated with better prognosis and response to ICB treatment. Here, we demonstrated an immune classification for the tumor microenvironment (TME) of HNSCC by analyzing The Cancer Genome Atlas (TCGA)-HNSCC data set and found that immunotype D with TLS enrichment had a better prognosis and response to ICB treatment. Furthermore, we observed that TLSs were present in a part of tumor samples of human papillomavirus (HPV) infection negative HNSCC (HPV- HNSCC) and were associated with the densities of dendritic cell (DC)-LAMP+ DCs, CD4+ T cells, CD8+ T cells, and progenitor T cells in TME. We established an HPV- HNSCC mouse model with TLS-enriched TME by overexpressing LIGHT in a mouse HNSCC cell line. We found that the induction of TLS formation enhanced the response to PD-1 blockade treatment in the HPV- HNSCC mouse model, accompanied by increases in DCs and progenitor exhausted CD8+ T cells in the TME. Elimination of CD20+ B cells attenuated the therapeutic effect of PD-1 pathway blockade in TLS+ HPV- HNSCC mouse models. These results indicate that TLSs contribute to the favorable prognosis and antitumor immunity of HPV- HNSCC. Inducing TLS formation in HPV- HNSCC tumors is a potential therapeutic method for improving the ICB response rate in patients with HPV- HNSCC.

The development of postgraduate anaesthesia and intensive care training at the University of the West Indies.

The one-year Diploma in Anaesthetics (DA) was the first postgraduate programme offered by the then Faculty of Medicine of The University of the West Indies (UWI). It was instituted in 1966, when the need for trained physician anaesthetists became paramount. Over 200 physicians have been awarded the DA which was discontinued in 1994. The four-year Doctor of Medicine in Anaesthetics [DM (Anaesthetics)] was commenced in 1974 and continues to train most of the region's physician anaesthetists. The majority of the 119 graduates (as of December 2011) are providing invaluable services to the people of the Caribbean. The time has come for the establishment of a regional certifying body, the Caribbean College of Anaesthetists. This college would determine the standards for the training and clinical practice of anaesthetists as perioperative physicians including: the conduct of anaesthesia, critical care, acute and chronic pain management. It would also facilitate continuing medical education and recertification of all practising anaesthetists within the region.

Effects of Ce, Sm and Yb on cavitation erosion of NAB alloy in 3.5% NaCl solution.

The influences of Ce, Sm and Yb on cavitation erosion of NAB alloy in 3.5% NaCl solution are evaluated using mass loss, SEM, 3D morphology and Tafel plot, respectively. The results show that the addition of Ce or Sm or Yb enhances the mechanical property of NAB alloy, and the sizes of κⅠ and κⅡ phases within NAB alloy decrease with adding Ce or Sm or Yb, resulting in the prevention of the propagation of the cracks caused by cavitation erosion initially originated at the phase boundaries between α and κ phases, and finally the cavitation erosion damage significantly decreases with adding Ce or Sm or Yb. The corrosion of NAB alloy in 3.5% NaCl solution can promote the cavitation erosion of NAB alloy, while the corrosion resistance of NAB alloy increases with the addition of Ce or Sm or Yb, and then the cavitation erosion resistance is accordingly improved with the addition of rare earth element.

Chemical production in electrocautery smoke by a novel predictive model.

OBJECTIVES: The hazards of electrocautery smoke have been known for decades. However, few clinical studies have been conducted to analyze the responsible variables of the smoke production. This study collected clinical smoke samples and systematically analyzed all possible factors. METHODS: Thirty diathermy smoke samples were collected during mastectomy and abdominal cavity operations. Samples were analyzed using a gas chromatographer with a flame ionization detector. Data were applied to construct prediction models for chemical production from electrosurgeries to identify all possible factors that impact chemical production during electrosurgery. RESULTS: Toluene was detected in 27 smoke samples (90%) with concentrations of 0.003-0.463 mg/m(3) and production of 176.0-2,780.0 ng. Ethyl benzene and styrene were identified in very few cases. General linear regression analysis demonstrates that surgery type, patient age, electrocautery duration and imparted coagulation energy explained 67.63% of the variation in toluene production. CONCLUSION: Surgery type and patient age are known prior to surgery. In terms of risk precaution, the operating team should pay close attention to exposure when certain positive factors of increasing the chemical production are known in advance.

Investigation on ultrasonic cavitation erosion of TiMo and TiNb alloys in sulfuric acid solution.

Two kinds of Ti-alloys, i.e., TiMo and TiNb alloys are manufactured in this paper, and their ultrasonic cavitation erosion behaviors in 0.1 M H2SO4 solution are evaluated by the mean depth erosion (MDE), SEM and white light photograph. The results show that MDE of TiMo and TiNb alloys obviously increase with increasing the cavitation erosion time, however, they evidently decrease with the increment of Mo or Nb content at each fixed cavitation erosion time, and even some large blank areas (uneroded areas) still exist on the sample surface after ultrasonic cavitation erosion for 2 h in the case of Ti10Mo and Ti20Nb samples, implying the enhanced anti-cavitation erosion property of Ti-alloy by adding Mo or Nb element. The MDE of Ti10Mo or Ti20Nb sample is lower than that of TC4 sample in the case of each cavitation erosion time, indicating the better cavitation erosion resistance of of Ti10Mo or Ti20Nb sample. The influences of Mo and Nb on the passivity of TiMo and TiNb alloys during the ultrasonic cavitation erosion are detected by potentiodynamic curves. The results display that Ti, TC4, TixMo (x = 1, 5, 10) and TixNb (x = 5, 10, 20) samples are all almost in the passive state within the potential region from 0VSCE to 1.5VSCE during ultrasonic cavitation erosion, and the passive current density evidently decreases with increasing Mo or Nb content, indicating the enhanced passive characteristic by adding Mo or Nb alloys during the ultrasonic cavitation erosion.

Effect of micro/nano-particles in cavitation erosion.

The tests in de-ionized water with micro/nano CeO2 particles are carried out to study the effect of the micro/nano particles in inception of cavitation erosion. The existence of micro/nano particles is found to be the requisite factor and the degree of cavitation erosion is related to the sizes of the particles. Particles in the micro/nano scale may act as the transporters of micro bubbles to keep or get close to the solid surface together and the pressure fluctuation induced by the surface roughness causes the collapse of bubbles and erosion of the surface. Discrete phase models are employed to simulation the moving tracks of the particles. The sizes of the particles affect their capabilities of keeping and getting close to the surface. The effect of the particles of a certain size in cavitation erosion is determined by the combinational action of the two.

Classification of benign and malignant breast tumors using neural networks and three-dimensional power Doppler ultrasound.

OBJECTIVES: To evaluate the use of three-dimensional (3D) power Doppler ultrasound in the differential diagnosis of solid breast tumors using a neural network model as a classifier. METHODS: Data from 102 benign and 93 malignant breast tumor images that had pathological confirmation were collected consecutively from January 2003 to February 2004. We used 3D power Doppler ultrasound to calculate three indices (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)) for the tumor itself and for the tumor plus a 3-mm shell surrounding it. These data were applied to a multilayer perception (MLP) neural network model and we evaluated the model as a classifier to assess the capability of 3D power Doppler sonography to differentiate between benign and malignant solid breast tumors. RESULTS: The accuracy of the MLP model for classifying malignancy was 84.6%, the sensitivity was 90.3%, the specificity was 79.4%, the positive predictive value was 80.0% and the negative predictive value was 90.0%. When the neural network was used to combine the three 3D power Doppler indices, the area under the receiver-operating characteristics curve was 0.89. CONCLUSIONS: 3D power Doppler ultrasound may serve as a useful tool in distinguishing between benign and malignant breast tumors, and its capability may be increased by using a MLP neural network model as a classifier.

Computer-aided diagnosis using morphological features for classifying breast lesions on ultrasound.

OBJECTIVES: To develop and evaluate a computer-aided diagnosis (CAD) system with automatic contouring and morphological analysis to aid in the classification of breast tumors using ultrasound. METHODS: We evaluated 118 breast lesions (34 malignant and 84 benign tumors). Each tumor contour was automatically extracted from the digitized ultrasound image. Nineteen practical morphological features from the extracted contour were calculated and principal component analysis (PCA) was applied to find independent features. A support vector machine (SVM) classifier utilized the selected principal vectors to identify the breast tumor as benign or malignant. In this study, all the cases were sampled with k-fold cross-validation (k = 10) to evaluate the performance by receiver-operating characteristics (ROC) curve analysis. RESULTS: The areas under the ROC curves for the proposed CAD systems using all morphological features and the lower-dimensional principal vector were 0.91 and 0.90, respectively. The classification ability for breast tumors using morphological information was good. CONCLUSIONS: This system differentiates benign from malignant breast tumors well and therefore provides a clinically useful second opinion. Moreover, the morphological features are nearly setting-independent and thus available to various ultrasound machines.

Enhancement of cavitation erosion resistance of 316 L stainless steel by adding molybdenum.

The influence of Mo on ultrasonic cavitation erosion of 316 L stainless steel in 3.5% NaCl solution were investigated using an ultrasonic cavitation erosion (CE) facility. The morphologies of specimen after cavitation erosion were observed by scanning electron microscopy (SEM). The results showed that the addition of Mo can sharply decrease the mean depth of erosion (MDE) of 316 L SS, implying the increased resistance of cavitation erosion. In order to better understanding the influence of Mo on the cavitation erosion of 316 L SS, the semi-conductive property of passive films on 316 L SS containing different concentrations of Mo were studied by Mott-Schottky plot. Based on Mott-Schottky results and semiconductor physics, a physical model was proposed to explain the effect mechanism of Mo on cavitation erosion of 316 L SS.

Effect of micro-particles on cavitation erosion of Ti6Al4V alloy in sulfuric acid solution.

The influences of micro-particles on ultrasonic cavitation erosion of Ti6Al4V alloy in 0.1M H2SO4 solution were investigated using mass loss weight, scanning electron microscopy (SEM) and white light interferometer. Mass loss results revealed that the cavitation erosion damage obviously decreased with increasing particle size and mass concentration. Open circuit potential recorded during cavitation erosion shifted to positive direction with the decreased mass loss. Meanwhile, the mass loss sharply decreased with applying a positive potential during the entire ultrasonic cavitation erosion, and the relationship between the open circuit potential and the cavitation erosion resistance was discussed.

The diagnostic utility of preoperative breast magnetic resonance imaging (MRI) and/or intraoperative sub-nipple biopsy in nipple-sparing mastectomy.

BACKGROUND: The necessity of routine sub-nipple biopsy was uncertain, and the role of preoperative magnetic resonance imaging (MRI) in detecting nipple invasion in patients who have been selected for nipple sparing mastectomy (NSM) has not been adequately evaluated. METHODS: We retrospectively collected and analyzed the medical and surgical records of 434 patients with primary operable breast cancer who met the criteria for NSM and underwent breast surgery during the period January 2011 to December 2015. Patients were stratified into three risk groups (low, intermediate, and high) according to tumor size and tumor-to-nipple distance. RESULTS: Among the 434 patients in this study, 29 (6.7%) had occult invasion of the nipple-areola complex (NAC). Sub-nipple biopsy had a sensitivity of 84.6%, a specificity of 100%, a false negative rate of 1.2%, a false positive rate of 0%, and an overall accuracy rate of 98.8% in confirming NAC invasion. The NAC invasion rate was 0% in the low-risk group, 5.1% in the intermediate-risk group, and 19.7% in the high-risk group (P < 0.01). The overall NPV of preoperative MRI for predicting NAC invasion was 94.8%. Cost analysis revealed that the cost of NSM with sub-nipple biopsy was significantly higher than that of NSM alone, with a mean difference in cost of USD 238.5 (P < 0.01). CONCLUSION: The high negative predictive value of MRI for NAC invasion is useful for selection of patients receiving NSM. Sub-nipple biopsy is a reliable procedure to detect occult NAC invasion, however, routine use is not cost-effect for low risk patients.

Personal experience of ultrasound-guided 14-gauge core biopsy of breast tumor.

AIM: This study was aimed to examine the efficacy of ultrasound-guided core needle biopsy of breast tumor and compared with the results of previous publications. METHODS: From January 2001 to September 2003, 546 lesions in 513 consecutive patients with the identification of a tumor on ultrasound examination categorized belong and above C3 according to BIRADS (Breast Image Reporting and Data Systems). A minimum of three samples was taken during the biopsy process. RESULTS: The patients' ages ranged from 17 to 89 years (mean, 43 years); tumors were from 5.7 to 41.6 mm in diameter (mean, 20.3 mm). There were 341 lesions with benign findings, 202 lesions with malignancy and 3 lesions with atypical ductal hyperplasia (ADH). Underestimates were found in five patients. Two patients were "ADH-DCIS (ductal carcinoma in situ) underestimate", and three patients were "DCIS-IDC (invasive ductal carcinoma) underestimate". The ADH underestimation rate was 40% (2/5) and DCIS underestimation rate was 43% (3/7). No false-positive results were observed. According to this study, the accuracy rate was 99%, sensitivity rate 97.6%, specificity rate 100%, and false-negative rate 2.4%. CONCLUSIONS: Both palpable and impalpable breast lesions should be examined under image guidance and automated core biopsy is the technique of first choice. Fourteen-gauge core biopsy can provide a definitive diagnosis in 99% of solid tumors in this series.

Influence of passive potential on the electronic property of the passive film formed on Ti in 0.1 M HCl solution during ultrasonic cavitation.

The influence of the applied passive potential on the electronic property of the passive film formed on Ti at different potentials in 0.1M HCl solution during ultrasonic cavitation, was investigated by electrochemical impedance spectra (EIS) and Mott-Schottky plot. The influence of the applied passive potential on the structure and composition of the passive film was studied by X-ray photoelectron spectroscopy (XPS) and Auger electron spectroscopy (AES). The results showed that the applied passive potential can obviously affect the electronic property of the passive film formed on Ti during ultrasonic cavitation. The resistance of the passive film increased, and the donor density of the passive film decreased with increasing the potential. The flat band potential moved to positive direction and the band gap of the passive film moved to negative direction with increasing potential. AES and XPS results indicated that the thickness of the passive film increased evidently with applying passive potential. The passive film was mainly composed of the mixture of TiO and TiO2. While the TiO2 content increased with increasing the applied passive potential, and the crystallization of the passive film increased with the increased potential.

The role of passive potential in ultrasonic cavitation erosion of titanium in 1 M HCl solution.

The influence of the applied passive potential on the ultrasonic cavitation erosion of Ti specimen in 1 M HCl solution was investigated by mass loss experiment, scanning electron microscopy (SEM), electrochemical impedance spectra (EIS) and Mott-Schottky plot. The results showed that Ti was in the passive state within the potential region from -0.3 VSCE to 1.5 VSCE under ultrasonic cavitation erosion. The applied passive potential can obviously decrease the mass loss of Ti caused by ultrasonic cavitation erosion in 1 M HCl solution. The resistance of the passive film increased, the flat band potential moved to positive direction, and the donor density of the passive film decreased with increasing the passive potential. Finally, a physical model was provided to explain the experimental results based on energy band and semi-conductive theories.

Objective and noninvasive detection of sub-clinical lung injury in breast cancer patients after radiotherapy.

AIMS: We employed technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan to detect sub-clinical lung injury after radiation therapy of 60 female patients diagnosed with right breast cancer. METHODS: The degree of pulmonary vascular endothelium damage was represented as lung/liver uptake ratios (L/L ratios) calculated on Tc-99m HMPAO lung scan. All patients underwent simple mastectomy and post-operative radiotherapy of approximately 50 Gy. We divided the patients into three groups according to the interval between radiotherapy and lung Tc-99m HMPAO lung scan: Group 1 included 20 patients who received the lung scan within 1-3 months after radiotherapy, group 2 included 20 patients were within 3-9 months after radiotherapy, and group 3 included 20 patients were more than 9 months after radiotherapy. In addition, 20 age-matched normal women were included as the control group. RESULTS: The L/L ratios were 0.32+/-0.04 for normal controls, 0.59+/-0.10 for group 1, 0.55+/-0.07 for group 2, and 0.34+/-0.04 for group 3, respectively. Based on our preliminary results, we found that sub-clinical lung injury and significantly increased L/L ratio in breast cancer patients received radiotherapy may occur within the first 6 months after radiotherapy. However, the L/L ratio is markedly decreased after 9 months. CONCLUSION: Our findings concluded that the degree of pulmonary vascular endothelium damage represented as the L/L ratio on Tc-99m HMPAO lung scan has the potential to be a sensitive, objective and noninvasive method to detect sub-clinical lung injury in breast cancer patients received radiotherapy.

Ultrasonic cavitation erosion of Ti in 0.35% NaCl solution with bubbling oxygen and nitrogen.

The influences of oxygen and nitrogen on the ultrasonic cavitation erosion of Ti in 0.35%NaCl solution at room temperature, were investigated using a magnetostrictive-induced ultrasonic cavitation erosion (CE) facility and scanning electron microscopy (SEM). The roles of oxygen and nitrogen in the composition and the electronic property of the passive film on Ti, were studied by Mott-Schottky plot and X-ray photoelectron spectroscopy (XPS). The results showed that the mass loss of Ti in 0.35%NaCl solution increased with increasing cavitation time. Bubbling oxygen can evidently increase the resistance of ultrasonic cavitation erosion comparing with bubbling nitrogen. XPS results showed that the thickness of the passive film on Ti in 0.35%NaCl solution in the case of bubbling oxygen for 3 weeks, was about 7 nm, and the passive film was mainly composed of TiO2 with an anatase structure. While TiO2 with a rutile structure was found to be the major component of the passive film on Ti in 0.35%NaCl solution in the case of bubbling nitrogen for 3 weeks, and the film thickness was 5 nm. The results extracted from Mott-Schottky plot showed that the passive film on Ti in the case of bubbling oxygen had more donor density than the passive film on Ti in the case of bubbling nitrogen.