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Although a modality effect indicating better learning from an animation with spoken learning guidance than from an animation with written learning guidance has often been found in research on learning from animation, the effect has hardly been investigated for learning from computer simulation. This study examined the interaction effects between the multimedia types of animation and computer simulation, and the presentation modes of written and spoken learning guidance. Based on cognitive load theory and the specific characteristics of the multimedia types it was hypothesized that a modality effect would be replicated in the animation condition and a reverse modality effect would be found in the simulation condition. Results partially supported the hypotheses, indicating that participants learned more from animation when it was accompanied with spoken text, and from a simulation when it was accompanied with written text. However, no effect was found for cognitive load. Based on the results, spoken text is recommended to be used to guide learners in animations assisted learning environments, and written text is recommended to be used to guide learners in simulations assisted learning environments.

Neoadjuvant systemic therapy (NAST) provides the unique opportunity to assess response to treatment after months rather than years of follow-up. However, significant variability exists in methods of pathologic assessment of response to NAST, and thus its interpretation for subsequent clinical decisions. Our international multidisciplinary working group was convened by the Breast International Group-North American Breast Cancer Group (BIG-NABCG) collaboration and tasked to recommend practical methods for standardized evaluation of the post-NAST surgical breast cancer specimen for clinical trials that promote accurate and reliable designation of pathologic complete response (pCR) and meaningful characterization of residual disease. Recommendations include multidisciplinary communication; clinical marking of the tumor site (clips); and radiologic, photographic, or pictorial imaging of the sliced specimen, to map the tissue sections and reconcile macroscopic and microscopic findings. The information required to define pCR (ypT0/is ypN0 or ypT0 yp N0), residual ypT and ypN stage using the current AJCC/UICC system, and the Residual Cancer Burden system were recommended for quantification of residual disease in clinical trials.

Chronic leg ulcer occurs in up to 13% of the general population and leads to economic and health care burdens. Approximately 20% of chronic nonhealing wounds are related to autoimmune diseases or vasculitis. Of these, chronic wounds associated with IgG4-related disease, a group of fibroinflammatory disorders that can have cutaneous and systemic involvement, are rarely reported. This case report describes a chronic leg ulcer associated with cutaneous IgG4-related disease. In addition to disease control with anti-inflammatory agents, following the principles of wound management and providing adjuvant wound treatment (eg, debridement, dressing, photobiomodulation therapy, or hyperbaric oxygen therapy) can promote the wound healing process. [ABSTRACT FROM AUTHOR]

Abstract We investigated interaction effects of multimedia representation format and learner’s prior knowledge level on learning outcomes. Eighty-seven high school students with a lower or a higher level of physics prior knowledge learned about the operation of a nuclear power plant and the concepts of generating electricity by studying static graphics, an animation, or a simulation. Results indicated that the lower physics prior knowledge level students learned more from the animations than from the static graphics, and the simulation. However, learning outcomes of the higher physics prior knowledge level students did not differ between the three multimedia format conditions. The results suggest that the learner’s prior knowledge level should be considered when choosing an appropriate multimedia representation format, especially for students with low prior knowledge. [ABSTRACT FROM AUTHOR]

Simple Summary: The VGH-TAYLOR study comprised a subgroup of early-stage breast cancer patients. Targeted sequencing was performed for both fresh-frozen paraffin-embedded (FFPE) tumor tissue and plasma. Common genes interrogated by both platforms were identified, and the concordance between paired targeted sequencing results from the same individual is reported. Only one-quarter of breast cancers were concordant between tumor and liquid biopsy from the same subject. Early-stage breast cancer might shed less circulating tumor DNA (ctDNA) from the tumor and compromise the detectability of liquid biopsy. In this study, we evaluated the concordance of targeted sequencing between paired ctDNA and matched tumor samples from early breast cancers treated with curative intention. Molecular profiling was performed using the Oncomine Comprehensive Assay v3 and the Oncomine Breast cfDNA Assay v2. The liquid biopsy detection rate was 39% (all-stage breast cancers, n = 612). Among 246 early-stage patients assayed for both ctDNA and matched tumor, the cfDNA assay detected 73 (29.6%) and the comprehensive assay detected 201 (81.7%) breast cancers with at least one alteration (χ2 test, p = 0.001). In total, 67 (25.6%) cases tested positive on both platforms, while the cfDNA and comprehensive assays detected an additional 10 (4%) and 138 (56%) cases, respectively. The most prevalent mutant genes were TP53 (68.3%) and KRAS (53.5%), while the PIK3CA (39.4%), AKT1 (45.9%), and ERBB2 (17.1%) mutations constituted biomarkers for FDA-approved therapeutics. Our study showed that tumor tissue should be the source of actionable mutation detection for early breast cancers, considering that the concordance rate between tumor and liquid biopsy was only one-quarter. [ABSTRACT FROM AUTHOR]

Background: Trichorhinophalangeal syndrome type 1 (TRPS1) is a novel immunohistochemical marker with excellent performance in distinguishing breast carcinoma from other cancers in surgical specimens. The aim of this study was to evaluate the diagnostic utility of TRPS1 compared with GATA3 for metastatic breast carcinoma in effusion cytology specimens. Methods: In total, 91 cell blocks of malignant effusion specimens, including 47 metastatic breast carcinomas (nine triple‐negative breast carcinomas [TNBCs] and 38 non‐TNBCs) and 44 nonmammary malignancies, were selected for TRPS1 and GATA3 immunohistochemistry. Modified H scores ≥ 200 were considered positive staining. Results: The positive rate of TRPS1 was similar between TNBC and non‐TNBC (77.8% vs 73.3%, p =.802), whereas the positive rate of GATA3 was lower in TNBC than in non‐TNBC (66.7% vs 89.5%, p =.087). The positive rate of TRPS1 was significantly higher in breast carcinoma than in urothelial carcinoma (74.5% vs 0%, p <.001), whereas the positive rate of GATA3 showed no difference between these two (85.1% vs 85.7%, p =.956). Notably, diffuse and strong aberrant expression of TRPS1 was observed in one lung adenocarcinoma and one serous adenocarcinoma in this series. The overall sensitivity, specificity, positive predictive value, and negative predictive value of TRPS1 immunohistochemistry for breast carcinoma were 74.5%, 95.5%, 94.6%, and 77.8%, respectively. Conclusion: TRPS1 is a sensitive and specific marker for metastatic breast cancer in serous effusion cell‐block specimens. It shows superior sensitivity and specificity compared with GATA3, especially in the TNBC setting and for excluding urothelial carcinoma. Comparing to GATA3, trichorhinophalangeal syndrome type 1 (TRPS1) showed equivalent to superior sensitivity and higher specificity for metastatic breast carcinoma in effusion cytology specimens. Notably, diffuse and strong aberrant expression of TRPS1 was observed in one lung adenocarcinoma and one serous adenocarcinoma in this series and should be taken into consideration when applying TRPS1 as a breast‐specific marker. [ABSTRACT FROM AUTHOR]