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Toremifene, a selective estrogen receptor modulator, is commonly used in China for premenopausal breast cancer patients. This real‐world study aimed to compare patient‐reported outcome (PRO) and survival between toremifene and aromatase inhibitor (AI) plus ovarian function suppression (OFS) in patients with moderate‐/high‐risk premenopausal hormone receptor (HR)‐positive breast cancer. The primary endpoint was PROs, assessed using SF‐36 and EQ‐5D‐5L questionnaires between January and March 2023. A total of 392 patients were included, with 171 receiving toremifene and 221 receiving AI. The toremifene group showed significantly higher scores in the role physical (p = 0.034) and mental health (p = 0.009) dimensions of SF‐36 and lower anxiety/depression (AD) scores (p = 0.038) in EQ‐5D‐5L compared to AI group. The estimated 5‐ and 8‐year disease‐free survival (DFS) rates were similar in toremifene and AI groups: 96.5% versus 91.9%, and 87.4% versus 87.8% (p = 0.39), respectively. Adverse event rates were similar in two groups, except for a greater risk of endometrial thickening (p < 0.001) and a lower occurrence of morning stiffness (p < 0.001) in the toremifene compared to the AI group. Premenopausal HR‐positive breast cancer patients receiving toremifene plus OFS had better role physical and mental health outcomes and lower AD dimensions than those receiving AI plus OFS. Both treatments had comparable DFS and favorable tolerability profiles. [ABSTRACT FROM AUTHOR]

Background and Aims: Guillain‐Barré syndrome (GBS) is an acute, self‐limited, immune‐mediated peripheral neuropathy. Current treatments for GBS include intravenous immunoglobulin (IVIg) and plasma exchange, which may not sufficiently benefit severely affected patients. This study evaluated the efficacy and safety of eculizumab add‐on therapy to IVIg (standard‐of‐care treatment) in patients with severe GBS. Methods: This phase 3, multicenter, double‐blind, randomized, placebo‐controlled clinical trial (NCT04752566), enrolled Japanese adults (age ≥ 18 years) with severe GBS (Hughes functional grade [FG] score FG3 or FG4/FG5 within 2 weeks of onset of GBS). Participants were randomized 2:1 to receive intravenous infusion of eculizumab or placebo (once weekly for 4 weeks) with IVIg treatment with 20 weeks of follow‐up. Primary efficacy endpoint was the time to first reach FG score ≤1 (able to run). Key secondary endpoints were proportion of participants achieving FG ≤1 at weeks 8 and 24 and FG improvement ≥3 at week 24. Pharmacodynamic analysis of serum free C5 concentration over time was performed. Safety was evaluated. Results: The analysis included 57 participants (eculizumab, n = 37; placebo, n = 20). Primary endpoint was not achieved (hazard ratio, 0.9; 95% CI, 0.45–1.97; p =.89). Key secondary endpoints did not reach statistical significance. Serum C5 concentration was reduced by 99.99% at 1 h postdose and sustained to week 5 but returned to baseline at the end of follow‐up period. No new safety signals for eculizumab were identified. Interpretation: Although well tolerated, eculizumab treatment did not show significant effects on motor function recovery compared to placebo in patients with GBS. [ABSTRACT FROM AUTHOR]

After a long period of geological tectonic action, the rock mass develops defects such as pores and fissures of different sizes and scales. The mechanical properties of the rock are largely affected by these discontinuous structures, and there will be obvious stress concentration at the edge of the hole inside the rock. Under the action of concentrated stress, cracks initiate, expand, and penetrate from the edge of the hole to form the final fracture surface and cause instability and failure of the rock mass. In practical engineering, due to the limitation of various factors, it is impossible to conduct uniaxial compressive strength test for each geotechnical engineering. Therefore, the rock in the weak part of the project can be selected as the test specimen before the indoor physical tests. In this paper, the static uniaxial compression test of specimens with circular holes with different diameters is carried out. Digital Image Correlation (DIC) monitoring system is used to observe the test process in real time; then, the data from uniaxial compression test and DIC monitoring test are obtained. At the same time, the macroscopic failure characteristics and crack propagation law of rock specimens are obtained, and the evolution law of strain field during the failure process of rock specimens is also obtained. Meanwhile, Realistic Failure Process Analysis (RFPA) is carried out to verify the accuracy of static uniaxial compression physical tests numerically. Physical tests show that the uniaxial compressive strength of marble specimens with circular holes and the dispersion of measured peak stress data decrease with the increase of hole diameter. The main failure type of marble specimens with circular holes is tension shear failure; the macroscopic failure zone of the sample, the strain field localization zone, and the maximum shear stress field of the numerical test are distributed in a semi-“X” shape with the hole as the center. The localization zone of the strain field on the specimen is usually the region of crack initiation, propagation, and penetration on the surface of the marble specimens. It also shows that specimen breaks in the radial direction along the y-axis of the circular hole, and cracks connecting both ends of the circular hole and the specimen are generated on the specimen. It is of great theoretical value and practical significance to the influence of the cavities in the rock specimens on the stress and strain characteristics and the initiation, propagation, and penetration modes.

Information and Communication Technology (ICT) has improved education widely in China, transforming traditional teaching into an interactive one. It is important to build a new evaluation model to measure teaching efficiency in an "ICT-enabled classroom". This study designed an evaluation model named "TPOCME Deep classroom" through ongoing five iterations. It includes six dimensions, which are higher-order Thinking, classroom Participation, Openness of educational system, Cooperative learning, Meaningful learning and Effectiveness of technology use (named TPOCME). This model helps educational researchers and teachers gain a comprehensive understanding of ICT in education.

The overall appeal of ICT in education in China is promoting deep integration of ICT technology with teaching. From a regional point of view, intelligent terminals, such as laptop and tablet, were integrated into classroom, in Beijing, Shanghai and other developed cities. Interactive media equipment (whiteboards, interactive TVs and iPad, etc.) have been applied in classroom teaching with deeper and broader ways. However, regarding the pedagogy, it is still a challenge to apply ICT technology for the revolution and further development of classroom instruction properly. In order to evaluate the quality of classroom teaching in an ICT environment and support teachers teaching with ICT technology in daily life practices, this study explored, measured and analyzed the features of classroom instruction in ICT environment, according to the sample lessons from a district in Beijing. Based on our prior research findings on Pad-enhanced teaching pedagogy, the "TPOCME Deep Classroom model" was proposed. 66 sample lessons that applied the TPOCME model were analyzed. The study found that student's Higher-order Thinking, Classroom Participation and Meaningful learning all have qualitative improvement compared with the traditional classes. The progress concerning the integration of ICT in education and teaching changes the relations between teaching and learning in traditional classes. This study also proved the effectiveness of the proposed model and provided a basis for further development. It was an exploration of promoting ICT-enabled classroom teaching pedagogy in China.

Background As a newly identified subtype of HER2-negative tumors associated with a less favorable prognosis, it remains crucial to evaluate potential prognostic and predictive factors, particularly non-invasive biomarkers, for individuals with human epidermal growth factor 2 (HER2) low early-stage breast cancer (EBC). Multiple investigations have highlighted that HER2-negative patients with EBC exhibiting high homologous recombination deficiency (HRD) scores display lower rates of pathological complete response (PCR) to neoadjuvant chemotherapy (NAC). Nevertheless, no study to date has explored the correlation between HRD and the long-term prognosis in HER2-low patients with EBC. Patients and methods This retrospective observational study focuses on primary EBC sourced from The Cancer Genome Atlas dataset (TCGA). It reveals the gene mutation landscape in EBC with low HER2 expression and elucidates the tumor immune landscape across different HRD states. Utilizing bioinformatics analysis and Cox proportional models, along with the Kaplan-Meier method, the study assesses the correlation between HRD status and disease-specific survival (DSS), disease-free interval (DFI), and progression-free interval (PFI). Subgroup analyses were conducted to identify potential variations in the association between HRD and prognosis. Results In the patients with HER2-low breast cancer, patients with homologous recombination related genes (HRRGs) defects had an HRD score about twice that of those without related genes mutations, and were at higher risk of acquiring ARID1A , ATM , and BRCA2 mutations. We also found that most immune cell abundances were significantly higher in EBC tumors with high HRD than in EBC tumors with low HRD or HRD-medium, particularly plasma B-cell abundance, CD8 T-cell abundance, and M1 macrophages. In addition, these tumors with HRD-high also appear to have significantly higher tumor immune scores and lower interstitial scores. Then, we analyzed the relationship between different HRD status and prognosis. There was statistical significance (P  = .036 and P  = .046, respectively) in DSS and PFI between the HRD-low and HRD-high groups, and patients with HRD-high EBC showed relatively poor survival outcomes. A medium HRD score (hazard ratio, HR = 2.15, 95% CI: 1.04-4.41, P  = .038) was a significant risk factor for PFI. Hormone receptor positivity is an important factor in obtaining medium-high HRD score and poor prognosis. Conclusion Higher HRD scores were associated with poorer PFI outcomes, particularly in people with HR+/HER2-low. Varied HRD states exhibited distinctions in HRRGs and the tumor immune landscape. These insights have the potential to assist clinicians in promptly identifying high-risk groups and tailoring personalized treatments for patients with HER2-low EBC, aiming to enhance long-term outcomes. [ABSTRACT FROM AUTHOR]