Locally advanced breast cancer patients should be cautious about the immediate breast reconstruction after mastectomy: a pooling analysis of safety and efficacy.

BACKGROUND: The purpose of this study was to compare safety and efficacy outcomes between immediate breast reconstruction (IBR) and mastectomy alone in locally advanced breast cancer patients. METHODS: We conducted a comprehensive literature search of PUBMED, EMBASE, and Cochrane databases. The primary outcomes evaluated were overall survival, disease-free survival, and local recurrence. The secondary outcome was the incidence of surgical complications. All data were analyzed using Review Manager 5.3. RESULTS: Sixteen studies, involving 15,364 participants were included in this meta-analysis. Pooled data demonstrated that patients underwent IBR were more likely to experience surgical complications than those underwent mastectomy alone (HR: 3.96, 95%CI [1.07,14.67], p = 0.04). No significant difference was found in overall survival (HR: 0.94, 95%CI [0.73,1.20], p = 0.62), disease-free survival (HR: 1.03, 95%CI [0.83,1.27], p = 0.81), or breast cancer specific survival (HR: 0.93, 95%CI [0.71,1.21], p = 0.57) between IBR group and Non-IBR group. CONCLUSIONS: Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of locally advanced breast cancer patients. However, IBR brings with it a nonnegligible higher risk of complications and needs to be fully evaluated and carefully decided.

The Impact of Cooperative Learning Method on the Oral Proficiency of Learners of the Training Program for English Tourist Guides.

Oral proficiency is the core element of training courses for English tourist guides. This ability needs to be addressed in training program for English tourist guides. Cooperative learning method is widely used by educators as a teaching method, but rarely used to improve oral proficiency. A quasi-experimental design involving 60 participants was conducted to investigate and examine the effectiveness of cooperative learning method on the oral proficiency of learners in the English tourist guide training program. There were 30 learners in the control group and the experimental group, respectively. The experimental group adopted cooperative learning method, while the control group adopted traditional approach, in both of which pre-test and post-test were conducted. The results of the study showed that the impact of teaching with the cooperative learning method on the oral proficiency of learners of the training program for English tourist guides was higher than that of teaching with the traditional approach. The importance of the cooperative learning method in the training program for English tourist guides is highlighted as a reference for educational institutions.

The Relationship Between Parental Satisfaction and Parental Loyalty in Kindergartens: The Mediating Role of Parental Trust and Parental Relationship Commitment.

This study aimed to explore the psychological mechanisms behind the relationship between kindergarten parental satisfaction and parental loyalty. This study used the parental satisfaction scale, parental trust scale, parental relationship commitment scale, and parental loyalty scale on 923 kindergarten parents. The test was conducted on 923 kindergarten parents. The results of this study showed that parental satisfaction significantly and positively affected parental loyalty. Parental trust was partially mediated between parental satisfaction and parental loyalty. Parental relationship commitment was also partially mediated between parental satisfaction and parental loyalty. Regarding to parental satisfaction and parental loyalty, parental trust and parental relationship commitment had chain mediation effect between parental satisfaction and parental loyalty. The findings of this study provided valuable insights into the effect of parental satisfaction on parental loyalty and offer concrete practical suggestions for kindergarten operators to improve the loyalty of kindergarten parents.

The Relationship Between Personality Traits and Entrepreneurial Intention Among College Students: The Mediating Role of Creativity.

Significant research has been conducted on the influence of entrepreneurial intention on entrepreneurial education and entrepreneurship practice. Similarly, this study aims to explore how creativity plays a mediating role in the influence of personality traits on entrepreneurial intention. As many as 674 valid questionnaires were collected from college students in China, allowing the relationship between personality traits, creativity, and entrepreneurial intention to be analyzed in detail. The following results are found through a series of explorations. First, neuroticism in personality traits has a significant negative impact on entrepreneurial intention, while conscientiousness, openness, and extraversion have a significant positive impact. Second, neuroticism has a significant negative impact on creativity, while conscientiousness, openness, and extraversion have a significant positive impact. Third, creativity has a significant positive impact on entrepreneurial intention, it has a partial mediating role between neuroticism, conscientiousness, extraversion, and entrepreneurial intention along with a complete mediating role between openness and entrepreneurial intention. The research results further provide a reference value for the improvement and optimization of entrepreneurial practice.

Relationship Between Emotional Labor and Mental Health in Preschool Teachers: Mediation of Psychological Capital.

This study explored the relationship among the emotional labor, psychological capital, and mental health of preschool teachers. A questionnaire survey was conducted on 411 preschool teachers in China. The results revealed the following: (1) One emotional labor strategy (Surface acting) had a significant negative effect on mental health, whereas two emotional labor strategies (expression of naturally felt emotions and deep acting) had significant positive effects. (2) The psychological capital of preschool teachers had a complete mediation on the relationship between expression of naturally felt emotions and mental health and between the deep acting and mental health.

Interleukin-24 protects against liver injury in mouse models.

BACKGROUND: Interleukin-24 (IL-24) binds to two kinds of receptor complexes, namely IL-20R1/IL-20R2 and IL-20R2/IL-22R1, which are also bound by IL-20. IL-20 plays a detrimental role in liver fibrosis. Due to the sharing of receptor complexes, we aimed to determine whether IL-24 also participates in liver fibrosis. METHODS: Clinical biopsy specimens from various stages of liver fibrosis were used to analyze IL-24 expression. IL-24 protein was administered to mice with thioacetamide (TAA)-induced liver injury. The direct effects of IL-24 on mouse primary hepatocytes or hepatic stellate cells (HSCs) were analyzed. Wild-type, IL-20R1-, and IL20R2-deficient mice were used to establish a model of acute TAA-induced liver injury. FINDINGS: Among patients with more severe liver fibrosis, there was a reduced IL-24/IL-20 ratio. Administration of IL-24 protein protected mice from TAA-induced liver injury and reduction of liver inflammation by antioxidant effects. IL-24 protected hepatocytes from TAA-induced apoptosis and prevented liver fibrosis through the inhibition of the HSCs activation. The protective role of IL-24 acted on liver cells were mainly IL-20R1-independent. IL-20R2-deficient mice exhibited more severe liver injury upon TAA treatment, thus confirming the protective role of IL-24. INTERPRETATION: IL-24 plays a key protective role in the progression of liver injury and has therapeutic potential for treating liver injuries. FUNDING: This work was supported by the Ministry of Science and Technology of Taiwan (MOST 106-2320-B-006-024) and Taiwan Liver Disease Prevention & Treatment Research Foundation.

Purification of Polybutylene Terephthalate by Oligomer Removal Using a Compressed CO2 Antisolvent.

In this study, the cyclic oligomers in the highly chemically resistant polyester polybutylene terephthalate (PBT) were effectively removed using a compressed CO2 antisolvent technique in which 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP) was used as the solvent. In addition to the oligomers, tetrahydrofuran was completely removed because of its low molecular weight and liquid state. The effects of the operating variables, including temperature, pressure, and the PBT concentration in HFIP, on the degree of removal of the oligomers were systematically studied using experimental design and the response surface methodology. The most appropriate operating conditions for the purification of PBT were 8.3 MPa and 23.4 °C when using 4.5 wt % PBT in HFIP. Under these conditions, the cyclic trimers and dimers could be removed by up to 81.4% and 95.7%, respectively, in a very short operating time.

Li2CsB7O10(OH)4: A Deep-Ultraviolet Nonlinear-Optical Mixed-Alkaline Borate Constructed by Unusual Heptaborate Anions.

A new noncentrosymmetric mixed-alkaline borate, Li2CsB7O10(OH)4 (1), was made under solvothermal conditions. This layered boron oxide framework consists of unique bird-shaped [B7O12(OH)4]7- clusters with large 14-ring pores. Its second-harmonic-generation (SHG) signal is 2.5KDP (KH2PO4), with its short ultraviolet (UV) cutoff edge indicating that this crystal is a potential deep-UV transparent nonlinear-optical material.

Centrosymmetric (Hdima)2[Ge5B3O15(OH)] and Noncentrosymmetric Na4Ga3B4O12(OH): Solvothermal/Surfactant-Thermal Synthesis of Open-Framework Borogermanate and Galloborate.

Under solvothermal/surfactant-thermal conditions, two new open-framework borogermanate and galloborate, centrosymmetric (Hdima)2[Ge5B3O15(OH)] (1; dima = dimethylamine) and noncentrosymmetric Na4Ga3B4O12(OH) (2), were obtained and characterized. Compound 1 contains an unusual basket-shaped Ge5B3O18(OH) cluster and displays a 3D open-framework layered structure. Compound 2 shows an interrupted 3,4-connected network constructed by alternately linked BO3 units and Ga3+ ions and displays weak second-harmonic-generation response.

An Ultraviolet Nonlinear Optic Borate with 13-Ring Channels Constructed from Different Building Units.

Under solvothermal conditions, a chair open-framework borate, Na2B9O15(H2O)(H3O) (1), has been synthesized. Compound 1 shows regular pores of zeolites as well as nonlinear optical (NLO) properties of borates. The large 13-ring channels of the boron oxide framework are constructed from different cluster units of B3O7 and B6O13 with three-ring units. The second harmonic generation (SHG) signal intensity of 1 is similar to that of KH2PO4 (KDP) and gradually increased with larger particle size. Compound 1 is a potential UV NLO material for its short wavelength absorption edge.

Surgical apgar score in patients undergoing lumbar fusion for degenerative spine diseases.

OBJECTIVE: Lumbar fusion is a procedure broadly performed for degenerative diseases of spines, but it is not without significant morbidities. Surgical Apgar Score (SAS), based on intraoperative blood loss, blood pressure, and heart rate, was developed for prognostic prediction in general and vascular operations. We aimed to examine whether the application of SAS in patients undergoing fusion procedures for degeneration of lumbar spines predicts in-hospital major complications. METHODS: One hundred and ninety-nine patients that underwent lumbar fusion operation for spine degeneration were enrolled in this retrospective study. Based on whether major complications were present (N=16) or not (N=183), the patients were subdivided. We identified the intergroup differences in SAS and clinical parameters. RESULTS: The incidence of in-hospital major complications was 8%. The duration of hospital stay for the morbid patents was significantly prolonged (p=0.04). In the analysis of multivariable logistic regression, SAS was an independent predicting factor of the complications after lumbar fusion for degenerative spine diseases [p=0.001; odds ratio (95% confidence interval)=0.35 (0.19-0.64)]. Lower scores were accompanied with higher rates of major complications, and the area was 0.872 under the receiver operating characteristic curve. CONCLUSION: SAS is an independent predicting factor of major complications in patients after fusion surgery for degenerative diseases of lumbar spines, and provides good risk discrimination. Since the scoring system is relatively simple, objective, and practical, we suggest that SAS be included as an indicator in the guidance for level of care after lumbar fusion surgery.

The prognostic implications of microvascular density and lymphatic vessel density in esophageal squamous cell carcinoma: Comparative analysis between the traditional whole sections and the tissue microarray.

Focal distribution of microvascular and lymphatic vessels is a critical issue in cancer, and is measured by tissue microarray (TMA) construction from paraffin-embedded surgically obtained tissues, a process that may not accurately reflect true focal distribution. The aim of this study was to assess the concordance of microvascular density (MVD) and lymphatic vessel density (LVD) in TMAs with corresponding whole sections, and to correlate the MVD or LVD with clinicopathological parameters in 124 cases of esophageal squamous cell carcinoma (ESCC). MVD, determined by CD105 immunohistochemistry of whole sections, was strongly associated with lymph node metastasis (p=0.000) and pTNM stage (p=0.001). Kaplan-Meier survival analysis showed that increasing CD105 microvessel count correlated with decreasing survival (p<0.001). The same result was acquired when MVD was calculated from tissue microarrays. Analysis of continuous data showed a highly significant correlation between whole sections and TMA data (Pearson r=0.522, p<0.001). Increasing LVD, as determined by D2-40 immunohistochemistry of whole sections, correlated with decreasing survival, but this relationship was undetectable using TMAs. In conclusion, we demonstrate that for the selected endothelial markers, TMAs can provide a realistic and reliable estimate of the extent of MVD, but not LVD in ESCC samples.

Altered expression of endogenous soluble vascular endothelial growth factor receptor-2 is involved in the progression of esophageal squamous cell carcinoma.

Endogenous soluble vascular endothelial growth factor receptor-2 (esVEGFR-2), a new splicing variant of VEGFR-2, was shown to be the first endogenous specific inhibitor of lymphatic vessel growth. The expression of esVEGFR-2 and its clinicopathological roles in esophageal squamous cell carcinoma (ESCC) are unclear. In this article, quantitative RT-PCR was employed to detect the mRNA levels of esVEGFR-2 and VEGF-C in 90 paired primary ESCC tissues, along with immunohistochemical staining to measure esVEGFR-2 protein in 182 ESCC primary tissues. Correlations between esVEGFR-2 expression and clinicopathological features were also analyzed. Compared with the corresponding non-neoplastic esophageal mucosa tissues, the mRNA level of esVEGFR-2 was decreased, whereas the mRNA level of VEGF-C was increased in ESCCs. Downregulation of esVEGFR-2 mRNA level was significantly correlated with pTNM stages (χ(2) = 7.790, p=0.02). Immunohistochemical staining of esVEGFR-2 was inclined to be reduced in ESCC tissues; lower esVEGFR-2 protein expression was related to better prognosis (χ(2) = 6.366, p=0.012), whereas higher esVEGFR-2 protein accumulation in ESCC tissues was an independent prognostic factor for poor survival of patients (hazard ratio, 1.606; 95% confidence interval, 1.042-2.476; p=0.032). Taken together, altered expression of esVEGFR-2 is correlated with progression of ESCC. esVEGFR-2 might serve as a new independent prognostic marker for ESCC patients.