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.

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.

[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.

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.

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-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.

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.

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.

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.

An optimized technique for all quadrant oncoplasty in women with small- to medium-sized breasts.

BACKGROUND: Oncoplastic surgery is a method to extend the possibility of breast-preserving surgery that can avoid breast deformities and reduce both mastectomy and re-excision rates. Round-block mammoplasty is reported as an alternative method in mammary reductions. AIM: In this study, the round-block mammoplasty was modified and presented as a better surgical choice for all quadrant-located cancers in small- to medium-sized breasts with good aesthetic results. PATIENTS AND METHODS: From June to December 2011, 30 patients with T1-T2 breast lesions that were candidate for breast conserving surgery underwent this kind of surgery. RESULTS: Only half of breast skin envelope development was necessary compared to conventional round-block mammoplasty techniques. Those excised specimens weighed 35 g on average, with the biggest one measuring 7x6x3 cm in a medium-sized breast without deformity. No drains were placed after surgery and only one patient had a seroma formation that needed to be aspirated. Half-breast dissection between the glandular tissue and subcutaneous fat instead of whole breast dissection is enough to reach a good operative field, lower the possibility of post-operative seroma and decrease the amount of operation time. To avoid the nipple areolar complex widening, a monofilament purse-string suture was used to reduce its diameter. Besides, radiation therapy did not affect the cosmetic outcome after a short-term follow-up. CONCLUSIONS: Compared to whole breast dissection, half-breast dissection between glandular tissue and subcutaneous fat is enough to reach a good operative field, lowers the possibility of post-operation seroma and reduces the operation time. This method is recommended to be used to help improve the cosmetic results of breast surgery.

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.

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.

Capsaicin may induce breast cancer cell death through apoptosis-inducing factor involving mitochondrial dysfunction.

The majority of breast cancer patients are resistant to chemotherapy or radiotherapy due to the down-regulation or lack of caspase-3 expression. Capsaicin was found to inhibit cancer cell growth in caspase-3-deficient human breast cancer cells. This study aimed to investigate the growth-inhibitive effect of capsaicin and its mechanisms in human breast cancer cell lines, MCF-7 and BT-20. The results showed that cell viability decreased in a dose-dependent manner in both the caspase-3-deficient and non-deficient cells through inducing cell apoptosis and arresting the cell cycle in the S phase. Capsaicin significantly decreased mitochondria membrane potential, induced the cleavage of PARP-1, and decreased procaspase-7 expression in both cells. Apoptosis-inducing factor (AIF) was distinctly released from mitochondria and translocated into the cytoplasm and nucleus in MCF-7 cells (52.9%), but not in BT-20 cells (2%) after treatment with 200 µM of capsaicin for 24 hours. Capsaicin inhibited breast cancer cell growth through inducing cell apoptosis and cell cycle arrest in the S phase. This apoptotic effect could be induced through the mitochondrial pathway, and PARP-1 subsequently cleaved by activation of caspase-7. The application of capsaicin in clinical therapy could be useful for breast cancer patients.

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.

Prognostic significance of triple negative breast cancer at tumor size 1 cm and smaller.

AIMS: The purpose of this study was to clarify the prognostic significance of triple-negative breast cancer (TNBC) with a tumor size ≤ 1 cm. MATERIALS AND METHODS: Patients with primary operable breast cancer with a tumor size ≤ 1 cm were enrolled at Changhua Christian Hospital and National Cheng-Kung University Hospital. Tumors negative for ER, PR, and HER-2 were classified as TNBCs and compared with tumors with any receptor positivity (non-TNBC) for disease-free survival (DFS) and cancer-specific survival (CSS). RESULTS: From 1995 to 2006, a total of 377 patients with tumor size ≤ 1 cm were enrolled. Compared with non-TNBC patients, TNBC patients with a tumor size ≤ 1 cm as a whole or in a lymph node-positive subgroup were not associated with a poorer 5-year DFS and CSS. In lymph node-negative patients (pT1a-bN0M0), TNBC was associated with a poorer 5-year CSS but not DFS. Compared with the hormone receptor-positive, HER-2-negative subgroup, TNBC was associated with poorer DFS and CSS. In the multivariate Cox regression hazard analysis, lymph node invasion was the most important cause of disease recurrence and cancer-specific death. CONCLUSION: TNBC is very likely an independent risk factor in small (≤1 cm) node-negative invasive breast cancer. With tumors 1 cm and smaller, lymph node invasion was the single most important prognostic factor.

Correlation between SF-36 and six-minute walk distance in liver donors.

OBJECTIVE: We employed the 36-item short-form health survey (SF-36) and 6-minute walk distance (6MWD) to assess the quality of life (QoL) of donors after living-donor liver transplantation (LDLT). METHODS: This longitudinal prospective study had data collection via an interview and test or a mailed survey. Fifty-one liver LDLT donors underwent testing before and after donation using the SF-36 questionnaire and 6MWD. RESULTS: The physical component summary (PCS) of the SF-36 declined (P < .0001) and the mental component summary (MCS) increased significantly (P = .04) at 1 month after donation. The 6MWD declined significantly at 2 weeks after donation (P < .0001). After standardization, there was a high correlation between PCS and 6MWD (r(2) = 0.766). CONCLUSIONS: Liver donation had a moderate impact on donor physical status, but enhanced mental status. Similar decreasing trends were observed in 6MWD and PCS. After donation, real physical performance predicted PCS but not MCS.

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.