A Comparison of Venaseal Versus Radiofrequency Ablation Outcomes Within a Managed Care Organization.

BACKGROUND: Chronic venous insufficiency is a common medical condition that afflicts over 30 million adults in the United States. Treatment and management have changed dramatically over the past 20 years with the introduction of various endovenous therapies, including radiofrequency ablation (RFA) and cyanoacrylate closure using the Venaseal system. In this study, we explore a direct comparison of outcomes between RFA and VenaSeal conducted by a single surgeon within a managed care organization. METHODS: Between May 2020 and December 2021, there were 87 patients undergoing 97 total procedures who were treated with either VenaSeal (n = 55) or RFA (n = 42), conducted by a single surgeon within a managed care organization. Primary outcomes included successful greater saphenous vein (GSV) closure, postoperative deep vein thrombosis (DVT), embolization, saphenofemoral junction (SFJ) thrombosis, skin reaction (allergic or thrombophlebitis), or procedure-related emergency room (ER) and urgent care (UC) visits. Retrospective chart review was conducted to describe patient demographics, indications for treatment, treatment details (number of access sites and indication for treatment), as well as follow-up adjunctive vein procedures (sclerotherapy and stab phlebectomy). RESULTS: All patients had postprocedural ultrasound (US) performed within 7 days by the operating surgeon and mean overall patient follow-up from index procedure was 12 months; 2 patients were lost to follow-up due to death. All operations utilized intraoperative US, and SFJ thrombosis was not observed in any patient postprocedure. The average age of VenaSeal and RFA groups was 59.05 and 59.51 years, respectively. The average number of access sites during the procedure for VenaSeal and RFA was 1.56 and 1.20, respectively. Of the 55 VenaSeal treatments, 9.1% of patients reported postoperative skin reactions, and 9.1% of patients underwent subsequent stab phlebectomy (22 stabs on average). Of the 42 RFA treatments, 7.1% of RFA patients reported postoperative skin reactions, and 9.5% underwent subsequent stab phlebectomy (36 stabs on average). The percentage of patients who had postoperative UC or emergency department visits related to the procedure in the VenaSeal and RFA groups was 3.6% and 0%, respectively. CONCLUSIONS: Both VenaSeal and RFA demonstrated effective vein closure of the GSV at 12-month follow-up, with VenaSeal demonstrating continued noninferiority to RFA. Based on our data, postoperative skin reactions do not appear to be significantly higher with VenaSeal treatment, as previously reported.

Lingual bracket transfer accuracy of double vacuum-formed indirect bonding tray using 3D-printed model: an in vivo study.

INTRODUCTION: This study aimed to assess the transfer accuracy of a digital indirect bonding method for lingual brackets using double vacuum-formed trays in vivo. METHODS: Twenty-five patients in need of lingual orthodontic treatment were consecutively recruited. Bracket placement was performed on ideal setups, followed by fabricating indirect bonding trays through vacuum-forming on 3-dimensional printed models. Transfer accuracy was measured at each bracket after superimpositions of postbonding scans and reference data. One-tailed t tests were used to determine whether bracket deviations were within the limit of 0.5 mm and 2° for linear and angular dimensions, respectively. RESULTS: A total of 611 lingual brackets were evaluated. Mean linear transfer errors were 0.06 mm, 0.09 mm, and 0.12 mm, with frequencies of deviations within the 0.5 mm limit of 99.7%, 99.8%, and 98.0% for mesiodistal, buccolingual, and occlusogingival dimensions, respectively. Regarding angular measurements, mean transfer errors were 1.28°, 1.73°, and 2.96°, with frequencies of deviations within the 2° limit of 81.0%, 68.9%, and 51.1% for rotation, tip, and torque, respectively. Mean errors fell within the clinically accepted limits for all linear dimensions and rotation but exceeded the limit for tip and torque. CONCLUSIONS: Lingual bracket indirect bonding using double vacuum-formed trays fabricated on 3-dimensional printed models has high transfer accuracy in the mesiodistal, buccolingual, and occlusogingival dimensions and rotation. However, the transfer of tip and torque is less accurate.

Hydroxyapatite: A journey from biomaterials to advanced functional materials.

Hydroxyapatite (HAp), a well-known biomaterial, has witnessed a remarkable evolution over the years, transforming from a simple biocompatible substance to an advanced functional material with a wide range of applications. This abstract provides an overview of the significant advancements in the field of HAp and its journey towards becoming a multifunctional material. Initially recognized for its exceptional biocompatibility and bioactivity, HAp gained prominence in the field of bone tissue engineering and dental applications. Its ability to integrate with surrounding tissues, promote cellular adhesion, and facilitate osseointegration made it an ideal candidate for various biomedical implants and coatings. As the understanding of HAp grew, researchers explored its potential beyond traditional biomaterial applications. With advances in material synthesis and engineering, HAp began to exhibit unique properties that extended its utility to other disciplines. Researchers successfully tailored the composition, morphology, and surface characteristics of HAp, leading to enhanced mechanical strength, controlled drug release capabilities, and improved biodegradability. These modifications enabled the utilization of HAp in drug delivery systems, biosensors, tissue engineering scaffolds, and regenerative medicine applications. Moreover, the exceptional biomineralization properties of HAp allowed for the incorporation of functional ions and molecules during synthesis, leading to the development of bioactive coatings and composites with specific therapeutic functionalities. These functionalized HAp materials have demonstrated promising results in antimicrobial coatings, controlled release systems for growth factors and therapeutic agents, and even as catalysts in chemical reactions. In recent years, HAp nanoparticles and nanostructured materials have emerged as a focal point of research due to their unique physicochemical properties and potential for targeted drug delivery, imaging, and theranostic applications. The ability to manipulate the size, shape, and surface chemistry of HAp at the nanoscale has paved the way for innovative approaches in personalized medicine and regenerative therapies. This abstract highlights the exceptional evolution of HAp, from a traditional biomaterial to an advanced functional material. The exploration of novel synthesis methods, surface modifications, and nanoengineering techniques has expanded the horizon of HAp applications, enabling its integration into diverse fields ranging from biomedicine to catalysis. Additionally, this manuscript discusses the emerging prospects of HAp-based materials in photocatalysis, sensing, and energy storage, showcasing its potential as an advanced functional material beyond the realm of biomedical applications. As research in this field progresses, the future holds tremendous potential for HAp-based materials to revolutionize medical treatments and contribute to the advancement of science and technology.

Operando Revealing the Crystal Phase Transformation and Electrocatalytic Activity Correlation of MnO2 toward Glycerol Electrooxidation.

In this work, we report for the first time a comprehensive operando investigation of the intricate correlation between dynamic phase evolution and glycerol electrooxidation reaction (GEOR) performance across three primary MnO2 crystallographic phases (α-, ß-, and γ-MnO2). The results showed that all three electrocatalysts exhibited comparable selectivity toward three-carbon products (∼90%), but γ-MnO2 exhibited superior performance, with a low onset potential of ∼1.45 VRHE, the highest current density of ∼1.9 mA cm-2 at 1.85 VRHE, and reasonable stability. Operando Raman spectroscopy revealed the potential-induced surface reconstruction of different MnO2 structures from which a correlation among the applied potential, electrocatalytic activity, and product distribution was identified. The higher the applied potential, the greater conversion from the original structure to δ-MnO2, resulting in lower C-C cleavage and higher 3C product selectivity. This study not only provides a systematic understanding of structure-controlled electrocatalytic activity for high selectivity toward 3C products of MnO2 but also contributes to the development of a non-noble and environmentally friendly catalyst for valorizing glycerol.

Monkeypox Virus Infection in 2 Female Travelers Returning to Vietnam from Dubai, United Arab Emirates, 2022.

Mpox was diagnosed in 2 women returning to Vietnam from the United Arab Emirates. The monkeypox viruses belonged to an emerging sublineage, A.2.1, distinct from B.1, which is responsible for the ongoing multicountry outbreak. Women could contribute to mpox transmission, and enhanced genomic surveillance is needed to clarify pathogen evolution.

Massively parallel sequencing uncovered disease-associated variant spectra of glucose-6-phosphate dehydrogenase deficiency, phenylketonuria and galactosemia in Vietnamese pregnant women.

BACKGROUND: Several inherited metabolic diseases are underreported in Vietnam, namely glucose-6-phosphate dehydrogenase deficiency (G6PDd), phenylketonuria (PKU) and galactosemia (GAL). Whilst massively parallel sequencing (MPS) allows researchers to screen several loci simultaneously for pathogenic variants, no screening programme uses MPS to uncover the variant spectra of these diseases in the Vietnamese population. METHODS: Pregnant women (mean age of 32) from across Vietnam attending routine prenatal health checks agreed to participate and had their blood drawn. MPS was used to detect variants in their G6PD, PAH and GALT genes. RESULTS: Of 3259 women screened across Vietnam, 450 (13.8%) carried disease-associated variants for G6PD, PAH and GALT. The prevalence of carriers was 8.9% (291 of 3259) in G6PD and 4.6% (152 of 3259) in PKU, whilst GAL was low at 0.2% (7 of 3259). Two GALT variants, c.593 T > C and c.1034C > A, have rarely been reported. CONCLUSION: This study highlights the need for routine carrier screening, where women give blood whilst receiving routine prenatal care, in Vietnam. The use of MPS is suitable for screening multiple variants, allowing for identifying rare pathogenic variants. The data from our study will inform policymakers in constructing cost-effective genetic metabolic carrier screening programmes.

The Effectiveness of Early Childhood Caries Treatment with MI Varnish Fluor in Obese Subjects: A Study from Vietnam.

Objective: We conducted this work to evaluate the effectiveness of treatment for early childhood caries (ECC) using MI Varnish Fluor in obese children aged from 36 to 71 months. Methods: This study was conducted on 300 carious teeth of obese children and normal-weight children in Hanoi, Vietnam, over the period 2019-2020. Diagnodent KaVo 2190 laser equipment was used to diagnose ECC. The children in each group were selected on the basis of similarities in age, gender, and study location, and the teeth in the two groups were selected on the basis of similarities in damage level and jaw position. ECC treatment was performed once a week for four consecutive weeks with MI Varnish Fluor. The child, the child's family, and the child's teacher were consulted on diet and oral hygiene during the treatment. Children were examined and monitored throughout the treatment period. Children were re-examined after 3 and 6 months from the start time of treatment. The Mann-Whitney U test and Kruskal-Wallis tests were used, with statistical significance indicated at p < 0.05. Results: After six months of treatment with MI Varnish Fluor, the number of cases of code 0 damage recovery (D0) increased in both groups. The result showed that MI Varnish fluor was effective in ECC treatment. D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children were observed after six months of treatment, but there was no statistically significant difference between the two groups. Furthermore, there was no statistically significant difference between the two groups according to age, tooth position, or tooth surface position in D0 damage recovery. Conclusions: MI Varnish Fluor was effective in ECC treatment, with D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children after six months of treatment.

Early Childhood Caries in Obese Children: The Status and Associated Factors in the Suburban Areas in Hanoi, Vietnam.

Obesity and early childhood caries are two prominent health problems affecting the majority of children worldwide. Thus, early childhood caries in obese children must be studied. This study was conducted to investigate the status of early childhood caries in obese children in Hanoi, Vietnam, and its associated factors. A cross-sectional study was conducted on 234 obese children, 234 normal children (non-obese) aged 36 to 71 months, and their mothers at some kindergartens in Hanoi. Study subjects were randomly selected with similarities in age, gender, and study location. Decayed tooth of children was detected by clinical examination and Diagnodent Kavo 2190 machine of Germany. In addition, a questionnaire for their mothers was used to find out related factors. We found that, in the Obese Group, the rate of early childhood caries (ECC), severe-early childhood caries (S-ECC), dmft index (the number of decayed teeth, teeth lost due to cavities, filled decayed teeth or filled cavity), and dmfs index (the number of surfaces of the teeth decay, surfaces of teeth were lost due to cavities, surfaces of filled decayed teeth) were 82.91%, 59.83%, 6.84 ± 4.92, and 9.10 ± 7.48, respectively. In the Normal Group, these rates were smaller than in the Obese Group, but the difference was not statistically significant. Regarding related factors, the hobby of drinking soft drinks, the habits and frequency of drinking milk at night and eating sweet marshmallows were associated with ECC in the Obese Group with p < 0.05. In conclusion, the higher rates of ECC were seen in obese children, with eating hobbies and habits being the related factors. Therefore, it is necessary to have appropriate policies and effective communication strategies to minimize ECC in the future.

Skeletal Class III Malocclusion with Lateral Open Bite and Facial Asymmetry Treated with Asymmetric Lower Molar Extraction and Lingual Appliance: A Case Report.

A skeletal Class III malocclusion with open bite tendency is considered very difficult to treat orthodontically without surgery. This case report describes the lingual orthodontic treatment of an adult skeletal Class III patient with mandibular deviation to the left side, lateral open bite, unilateral posterior crossbite, zero overbite and negative overjet. The lower incisors were already retroclined to compensate with the skeletal discrepancy. The patient was treated by asymmetric molar extraction in the mandibular arch to retract the lower incisors and correct the dental midline, with the help of intermaxillary elastics. Lingual appliance was used with over-torqued lower anterior teeth's brackets to control the torque of mandibular incisors. After a 30-month treatment, satisfactory smile and facial esthetics and good occlusion was achieved. A 12-month follow-up confirmed that the outcome was stable. Asymmetric molar extraction could be a viable option to retract mandibular incisors in Class III malocclusion with lower dental midline deviation.

Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.

Bruxism, Related Factors and Oral Health-Related Quality of Life Among Vietnamese Medical Students.

Although bruxism is a common issue with a high prevalence, there has been a lack of epidemiological data about bruxism in Vietnam. This cross-sectional study aimed to determine the prevalence and associated factors of bruxism and its impact on oral health-related quality of life among Vietnamese medical students. Bruxism was assessed by the Bruxism Assessment Questionnaire. Temporomandibular disorders were clinically examined followed by the Diagnostic Criteria for Temporomandibular Disorders Axis I. Perceived stress, educational stress, and oral health-related quality of life were assessed using the Vietnamese version of Perceived Stress Scale 10, the Vietnamese version of the Educational Stress Scale for Adolescents, and the Vietnamese version of the 14-item Oral Health Impact Profile, respectively. The prevalence of bruxism, sleep bruxism, awake bruxism, and both conditions in Vietnamese medical students were 51.2%, 38.2%, 23.4%, and 10.4% respectively. Stress, temporomandibular joint pain, masticatory muscle pain, and tooth attrition were associated with the presence of bruxism. Vietnamese medical students were negatively affected by bruxism in terms of oral health-related quality of life.

The Combination of Adaptive Convolutional Neural Network and Bag of Visual Words in Automatic Diagnosis of Third Molar Complications on Dental X-Ray Images.

In dental diagnosis, recognizing tooth complications quickly from radiology (e.g., X-rays) takes highly experienced medical professionals. By using object detection models and algorithms, this work is much easier and needs less experienced medical practitioners to clear their doubts while diagnosing a medical case. In this paper, we propose a dental defect recognition model by the integration of Adaptive Convolution Neural Network and Bag of Visual Word (BoVW). In this model, BoVW is used to save the features extracted from images. After that, a designed Convolutional Neural Network (CNN) model is used to make quality prediction. To evaluate the proposed model, we collected a dataset of radiography images of 447 patients in Hanoi Medical Hospital, Vietnam, with third molar complications. The results of the model suggest accuracy of 84% ± 4%. This accuracy is comparable to that of experienced dentists and radiologists.

Perceptions of Dentists and Non-Professionals on Some Dental Factors Affecting Smile Aesthetics: A Study from Vietnam.

Aim: It is important to meet the aesthetic expectation regarding the smile concept of both dentists and non-professionals after treatment is complete. Therefore, the study aims to evaluate the effects of altered displays in incisors, gingival margin, and other smile-related-factors on dentists' vs. non-professionals' aesthetics perceptions. Materials and method: We altered the features of 42 digital smile photographs to generate the changed displays in incisors, gingival margin, and other smile-related-factors. Then, these altered photographs were presented to 51 dentists and 51 non-professionals, and each picture was rated by each participant with a visual analog scale ranging from 0 (very ugly) to 100 (very beautiful). Results: We found that the alterations in incisors, gingival margin, and other factors affected studied groups' aesthetic perception of smile. The ugly smile threshold rated by both groups for crown length of maxillary central incisors was 2.0 mm. This threshold was 2.5mm for dentists, with moving the gingival margin of maxillary lateral incisors to the incisal ridge. The ugly thresholds for other smile-related-factors were different between studied groups; for example, the ugly thresholds for gingival exposure levels were 3 and 4mm for dentists and non-professionals, respectively. Thus, our data indicate that altered displays in incisors, gingival margin, and other smile-related-factors affected perceptions of both studied groups on smile aesthetics, but dentists tended to feel more refined than non-professionals. Dentists and non-professionals had significantly different aesthetic perceptions of the alteration of the gingival exposure level. Conclusion: Both dentists and non-professionals' perceptions should be fully considered during orthodontic and prosthodontic treatment to achieve optimum aesthetic results.

Anion-induced morphological regulation of cupric oxide nanostructures and their application as co-catalysts for solar water splitting.

Morphological control of nanomaterials is essential for their properties and potential applications, and many strategies have been developed. In this work, a new strategy for simultaneously preparing and modulating the morphological structure evolution of copper layered hydroxyl salts and oxides is introduced. By changing the nature of the anions in the electroplating solution, significant variations in the size and porosity of nanosheets are achieved. Porous CuO nanosheets with a higher surface area were obtained by the use of copper nitrate as a copper source, while CuO nanoflakes were produced from copper sulfate. Photoanodes combining these porous CuO nanomaterials and a typical light absorber (BiVO4) exhibited good morphology-dependent activities for photoelectrochemical water splitting. The composite electrode displays a negative shift of 180 mV for the onset potential and an approximately 2-fold enhancement in the photocurrent compared to the bare BiVO4. The charge recombination rate in the photoelectrode with the porous CuO nanosheets was significantly lower than the bare photoanode due to the favorable electron diffusion path and effective charge collection. This research offers an effective method for constructing a highly active photoelectrocatalytic system for overall water splitting.

An Update on the Progress of Isolation, Culture, Storage, and Clinical Application of Human Bone Marrow Mesenchymal Stem/Stromal Cells.

Bone marrow mesenchymal stem/stromal cells (BMSCs), which are known as multipotent cells, are widely used in the treatment of various diseases via their self-renewable, differentiation, and immunomodulatory properties. In-vitro and in-vivo studies have supported the understanding mechanisms, safety, and efficacy of BMSCs therapy in clinical applications. The number of clinical trials in phase I/II is accelerating; however, they are limited in the size of subjects, regulations, and standards for the preparation and transportation and administration of BMSCs, leading to inconsistency in the input and outcome of the therapy. Based on the International Society for Cellular Therapy guidelines, the characterization, isolation, cultivation, differentiation, and applications can be optimized and standardized, which are compliant with good manufacturing practice requirements to produce clinical-grade preparation of BMSCs. This review highlights and updates on the progress of production, as well as provides further challenges in the studies of BMSCs, for the approval of BMSCs widely in clinical application.

Effect of Domain Size, Boundary, and Loading Conditions on Mechanical Properties of Amorphous Silica: A Reactive Molecular Dynamics Study.

Mechanical properties are very important when choosing a material for a specific application. They help to determine the range of usefulness of a material, establish the service life, and classify and identify materials. The size effect on mechanical properties has been well established numerically and experimentally. However, the role of the size effect combined with boundary and loading conditions on mechanical properties remains unknown. In this paper, by using molecular dynamics (MD) simulations with the state-of-the-art ReaxFF force field, we study mechanical properties of amorphous silica (e.g., Young's modulus, Poisson's ratio) as a function of domain size, full-/semi-periodic boundary condition, and tensile/compressive loading. We found that the domain-size effect on Young's modulus and Poisson's ratio is much more significant in semi-periodic domains compared to full-periodic domains. The results, for the first time, revealed the bimodular and anisotropic nature of amorphous silica at the atomic level. We also defined a "safe zone" regarding the domain size, where the bulk properties of amorphous silica can be reproducible, while the computational cost and accuracy are in balance.

Author Correction: Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Controllable electrodeposition of binary metal films from deep eutectic solvent as an efficient and durable catalyst for the oxygen evolution reaction.

In this work, we present an easy and scalable electrodeposition protocol that operates in a deep eutectic solvent, used to prepare self-supported Ni-Fe alloy films directly grown on copper foils. Unlike electrodeposition in aqueous baths, alloy compositions deposited in deep eutectic solvent are found to be the same as in plating solution owing to the enlargement of the deposition window and secondary reaction suppression. By rationally tuning the Ni/Fe ratio in deep eutectic solvent plating solution, the best oxygen evolution reaction performance was achieved by a Ni75Fe25 catalyst, which requires only a 316 mV overpotential to reach a current density of 10 mA cm-2, while its Tafel slope is as low as 62 mV dec-1. This catalyst can operate at 10 mA cm-2 with negligible activity degradation for over 10 h, promising its potential use as a low-cost, high-performance and stable electrocatalyst in water splitting devices.

School education and childhood obesity: A systemic review.

Childhood obesity prevalence is shooting up at a phenomenal rate worldwide, leading to long-term devastating consequences. A great number of studies have investigated factors contributing to the increase in BMI of children and adolescents. School-based, home-based and clinic-based solutions have been suggested as possible viable strategies, among which school-based interventions is believed to produce a noticeable effect on a massive scale. However, the question of whether school interventions, especially school education exert significant impact on childhood obesity or not, is left with mixing results. This article aims to holistically review the relationship between school education and childhood obesity. Various factors are covered, including health education, nutrition education, school nutrition, physical education, teachers' awareness, teaching practice and school stress, In all, school education is not the answer to childhood obesity but just part of it. More attempts from other stakeholders (parents, community, policy makers, researchers, etc.) should be made in order to solve this complicated puzzle.

The Effects of Adipocytes on the Regulation of Breast Cancer in the Tumor Microenvironment: An Update.

Obesity is a global pandemic and it is well evident that obesity is associated with the development of many disorders including many cancer types. Breast cancer is one of that associated with a high mortality rate. Adipocytes, a major cellular component in adipose tissue, are dysfunctional during obesity and also known to promote breast cancer development both in vitro and in vivo. Dysfunctional adipocytes can release metabolic substrates, adipokines, and cytokines, which promote proliferation, progression, invasion, and migration of breast cancer cells. The secretion of adipocytes can alter gene expression profile, induce inflammation and hypoxia, as well as inhibit apoptosis. It is known that excessive free fatty acids, cholesterol, triglycerides, hormones, leptin, interleukins, and chemokines upregulate breast cancer development. Interestingly, adiponectin is the only adipokine that has anti-tumor properties. Moreover, adipocytes are also related to chemotherapeutic resistance, resulting in the poorer outcome of treatment and advanced stages in breast cancer. Evaluation of the adipocyte secretion levels in the circulation can be useful for prognosis and evaluation of the effectiveness of cancer therapy in the patients. Therefore, understanding about functions of adipocytes as well as obesity in breast cancer may reveal novel targets that support the development of new anti-tumor therapy. In this systemic review, we summarize and update the effects of secreted factors by adipocytes on the regulation of breast cancer in the tumor microenvironment.