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Abstract Background Shoulder function complications are common after treatment for breast cancer. Quite a few survivors still report a limited shoulder range of motion, even though the free range-of-motion upper limb exercise is helpful to restore shoulder function. Mirror therapy (MT) is a classical and effective rehabilitation technique to recover motor and sensory function for the limbs; in addition, studies have reported that MT has an influence on patients with shoulder functional dysfunction including increasing shoulder range of motion, improving shoulder function scores, and decreasing pain scores. Here, we describe a protocol of a randomized controlled trial to explore if free range-of-motion upper limb exercise based on MT has efficacy on shoulder function in survivors after surgery of breast cancer. Methods/design This is a prospective, single-blind, two-arm randomized controlled trial. An estimated 70 participants will be randomly allocated to (1) the MT group or (2) the control group. The participants in the control group receive free range-of-motion upper limb exercise, and participants in the MT group will engage in free range-of-motion upper limb exercise based on MT. The intervention will start on the first day after surgery and be completed at 8 weeks after surgery. The primary outcome in this protocol is shoulder range of motion (ROM), while the Constant-Murley Score (CMS); Disability of the Arm, Shoulder, and Hand Questionnaire (DASH); Tampa Scale of Kinesiophobia (13-item TSK); visual analog scale (VAS); grip strength; arm circumference; and lymphedema are the secondary outcomes. Assessment will be conducted before allocation (baseline) and at 2 weeks, 4 weeks, and 8 weeks after surgery. Discussion Based on the results that MT has an influence on shoulder function immediately after intervention in patients without nerve injury, this randomized controlled trial is to observe the efficacy of MT on shoulder function after a long-term intervention in breast cancer survivors. We look forward to the innovation of this study for both breast cancer rehabilitation and MT. Trial registration Chinese Clinical Trial Registry ( ChiCTR ) ChiCTR2000033080. Registered on 19 May 2020

Abstract Background More than 50% cognitive impairment was reported by cancer patients before and after medical treatment. However, there are no effective interventions to manage the cognitive problem in women with breast cancer. This pilot study was designed to evaluate the protective effect of Baduanjin exercise on cognitive function and cancer-related symptoms in women with early-stage breast cancer undergoing chemotherapy. Method A single-blinded, randomized control trial was designed. The trial will recruit 70 patients with early-stage breast cancer scheduled to receive chemotherapy from Shanghai in China. All participants will be randomly assigned to (1:1) the supervised Baduanjin group (5 times/week, 30 min each time) or the wait-list control group for 3 months. The effect of Baduanjin exercise intervention will be evaluated by outcome measures including subjective and objective cognitive function, symptoms (fatigue, depression, and anxiety), and health-related quality of life at pre-intervention (T0), 8 weeks (T1), and 12 weeks (T2). The PCI score in the FACT-Cog as the primary cognitive outcome will be reported descriptively, while effect sizes and 95% confidence intervals (CIs) will be calculated. The collected data will be analyzed by using an intention-to-treat principle and linear mixed-effects modeling. Discussion This is the first randomized clinical trial to investigate whether Baduanjin exercise will have a positive role in improving cognitive function in women with breast cancer receiving chemotherapy. If possible, Baduanjin exercise will be a potential non-pharmacological intervention to manage cognitive dysfunction and promote survivorship care among breast cancer survivors. Trial registration Chinese Clinical Trial Registry (ChiCTR) ChiCTR2000033152 . Registered on 22 May 2020

Pancreatic adenocarcinoma (PAAD), the most common subtype of pancreatic cancer, is a highly lethal disease. In this study, we integrated the expression profiles of splicing factors (SFs) of PAAD from RNA-sequencing data to provide a comprehensive view of the clinical significance of SFs. A prognostic index (PI) based on SFs was developed using the least absolute shrinkage and selection operator (LASSO) COX analysis. The PI exhibited excellent performance in predicting the status of overall survival of PAAD patients. We also used the percent spliced in (PSI) value obtained from SpliceSeq software to quantify different types of alternative splicing (AS). The prognostic value of AS events was explored using univariate COX and LASSO COX analyses; AS-based PIs were also proposed. The integration of prognosis-associated SFs and AS events suggested the potential regulatory mechanisms of splicing processes in PAAD. This study defined the markedly clinical significance of SFs and provided novel insight into their potential regulatory mechanisms.

Abstract Background Allergic rhinitis (AR) is a worldwide health problem. Allergen avoidance is strongly recommended for AR patients. Air purification can reduce concentrations of particles in indoor air, including those of allergens. Air purifiers have been recommended by clinicians for AR patients, but few studies have focused on the removal of airborne allergens from home environments. Such studies have been limited by a lack of blinding, small samples, or a failure to measure allergen levels, disease activity, or a combination of these factors. This study investigates the efficacy of a high-efficiency air purifier in reducing disease activity in the homes of AR patients sensitive to the allergens produced by Artemisia (mugwort) pollen. Methods This is a randomized, double-blind, clinical controlled trial that will test active and inactive versions of an air purifier (Atmosphere®; Amway China). Sixty AR patients sensitive to the allergens produced by Artemisia pollen will be assigned randomly to two groups of equal numbers. All patients will undergo a 4-week treatment period and a 4-week observation period. Evaluation will be conducted at baseline (day 0) and on days 7, 14, 21, 28, and 56. The primary outcome measure will be the difference in visual analog scale scores from baseline. Secondary outcomes will be changes from baseline in nasal symptoms, allergy symptom scores, responses to the Rhinoconjunctivitis Quality of Life Questionnaire, Epworth Sleepiness Scale scores, and tolerability scores for the air purifier. Side effects of treatment will be recorded. Discussion Reducing exposure to allergens can reduce the risk of conditions such as AR. We hypothesise that AR patients sensitive to the allergens produced by Artemisia pollen will not suffer symptoms in a pollen-free environment. AR patients can remove pollen from their homes using air purifiers, decreasing the risk of symptoms. We expect that our study results will provide reliable evidence for determining the effects of air-purification therapy. Trial registration ChiCTR-INR-17012481. (Retrospectively registered 26 August 2017).

In order to modify in-situ synthesized Mg2Si particles in Mg2Si/Mg-4Si composite, the modification effect of calcium-magnesia phosphate fertilizer on primary Mg2Si phase in Mg2Si/Mg-4Si composite was investigated by means of X-ray diffraction (XRD), optical microscopy (OM), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) analysis. The results indicate that the morphology of the primary Mg2Si phase apparently changes from coarse dendrites to fine dispersive polygonal particles, and the mean size is decreased from 277 μm to 17 μm. With the addition of 4.0wt.% calcium-magnesia phosphate fertilizer as a modifier, the ultimate tensile strength and elongation of the Mg2Si/Mg-4Si composite are increased from 78.7 MPa and 2.1% to 105.2 MPa and 2.6%, as compared to those of the base composite, which is probably attributed to the formation of the phosphorous compound and the cluster of Ca compounds that acted as the heterogeneous nucleation substrates of the primary Mg2Si particles, resulting in a refined distribution of these precipitates.

The modification effects of ytterbium (Yb), Na3PO4 and Yb + Na3PO4 on primary Mg2Si phase in Mg-4Si alloys were investigated by means of X-ray diffraction (XRD), optical microscopy (OM), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) analysis in this work. The results indicate that the morphology of the primary Mg2Si phase apparently changes from coarse dendrites to fine dispersive polygonal particles and the mean size decreases from 276.6 μm to 7.1 μm, with combined modification of 0.8wt.% Yb and 2.64wt.% Na3PO4. Such a morphological evolution results in improvement in the ultimate tensile strength and elongation of the alloys as compared to the base alloy. This may be attributed to the formation of the YbP particles that acted as the heterogeneous nucleation substrates for the primary Mg2Si particles, resulting in a refined distribution of these precipitates. The results of XRD examination show that there was no reaction between Si and Yb or Na3PO4. Solo addition of Yb or Na3PO4 into the melt has no real modification effect on the microstructure, but the primary Mg2Si particles and α-Mg phases become coarser than that in the unmodified alloy.