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Radiation therapy (RT) is frequently used for post-operative treatment in breast cancer (BC) patients who received preoperative systemic therapy (PST) and surgery. Nevertheless, the optimal timing to start RT is unclear. Data from BC patients who underwent chemotherapy as PST, breast surgery and RT at 3 Institutions in Brazil and Canada from 2008 to 2014 were evaluated. Patients were classified into three groups regarding to the time to initiation of RT after surgery: <8 weeks, 8–16 weeks and >16 weeks. A total of 1029 women were included, most of them (59.1%; N = 608) had clinical stage III. One hundred and forty-one patients initiated RT within 8 weeks, 663 between 8 and 16 weeks and 225 beyond 16 weeks from surgery. With a median follow-up of 32 months, no differences in disease-free survival (DFS), overall survival and locoregional recurrence-free survival (LRRFS) were observed of time to indicated RT (<8 weeks versus 8–16 weeks versus >16 weeks). However, in luminal subtype patients (46.5%; N = 478), initiation of RT up to 8 weeks after surgery was associated with better LRRFS (<8 weeks versus >16 weeks: HR 0.22; 95%CI 0.05–0.86; p = 0.03), with a tendency to a better DFS (<8 weeks versus >16 weeks: HR 0.50; 95%CI 0.25–1.00). RT initiated up to 8 weeks after surgery was related to better LRRFS in luminal BC patients who underwent PST. Our results suggest that early start of RT is important for these patients. • RT is used for treatment in breast cancer patients who received chemotherapy as preoperative systemic therapy (PST). • The optimal timing to start RT is unclear. • RT initiated up to 8 weeks after surgery was related to better local control in luminal BC patients who underwent PST. [ABSTRACT FROM AUTHOR]

Simulation-based assessment relies on instruments that measure knowledge acquisition, satisfaction, confidence, and the motivation of students. However, the emotional aspects of assessment have not yet been fully explored in the literature. This dimension can provide a deeper understanding of the experience of learning in clinical simulations. In this study, a computer (software) model was employed to identify and classify emotions with the aim of assessing them, while creating a simulation scenario. A group of (twenty-four) students took part in a simulated nursing care scenario that included a patient suffering from ascites and respiratory distress syndrome followed by vomiting. The patient's facial expressions were recorded and then individually analyzed on the basis of six critical factors that were determined by the researchers in the simulation scenario: 1) student-patient communication, 2) dealing with the patient's complaint, 3) making a clinical assessment of the patient, 4) the vomiting episode, 5) nursing interventions, and 6) making a reassessment of the patient. The results showed that emotion recognition can be assessed by means of both dimensional (continuous models) and cognitive (discrete or categorical models) theories of emotion. With the aid of emotion recognition and classification through facial expressions, the researchers succeeded in analyzing the emotions of students during a simulated clinical learning activity. In the study, the participants mainly displayed a restricted affect during the simulation scenario, which involved negative feelings such as anger, fear, tension, and impatience, resulting from the difficulty of creating the scenario. This can help determine which areas the students were able to master and which caused them greater difficulty. The model employed for the recognition and analysis of facial expressions in this study is very comprehensive and paves the way for further use and a more detailed interpretation of its components. • Explore emotional aspects of assessment on a simulation scenario. • Used a computer model to identify and classify emotions in the simulation scenario. • The results show a predominance of restricted affect during the simulation scenario. • The model of recognition of facial expressions is very comprehensive and paves the way for other uses and interpretation. [ABSTRACT FROM AUTHOR]

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São Paulo state, Brazil, is one of the main areas of sugar cane planting in the world. Extensive use of ametryn, a triazine herbicide, in sugar cane agriculture and the properties of this herbicide suggest it could be present in the environment as a potential contaminant of soil, surface water, groundwater, and river sediment. In order to clarify the mechanism through which ametryn could be toxic, an in vivo study with Wistar rats was conducted using hematological, biochemical, molecular, morphological and genotoxic approaches. For this purpose, two sub-lethal ametryn concentrations (15 mg and 30 mg/kg/day) were administered to 42 rats divided into three groups ( n = 12) by gavage during 56 days, whereupon blood, liver and bone marrow were collected. The results showed ametryn genotoxic activity by in vivo micronuclei testing. This event probably occurred as consequence of oxidative stress induction demonstrated by GSTM1 transcript levels increase (indicating complexation between ametryn and/or metabolites with GSH) and by SOD activity decrease. Also, Mn-SOD transcripts were increased, probably avoiding mtDNA damage caused by EROS. These mechanisms displayed hepatic stellate cell (HSCs) activation because two major biomarkers were regulated, connexin and cadherin. N-cad transcripts were increased on both exposed groups while E-cad decreased in the T1 group, indicating epithelial-to-mesenchymal transition. In addition, Cx43 transcripts were decreased suggesting an increase in collagen content. Volumetric proportion of sinusoids was significantly decreased in T1 group and no significant alteration in hepatocyte volume was observed, indicating an increase in the space of Disse, due to fibrosis. Hepatocyte nuclei showed significant decrease in diameter and volume. Few hematological alterations were found. We emphasize the importance of other approaches, such as cell death and proliferation assays, so that ametryn toxicity can better be understood. [ABSTRACT FROM AUTHOR]