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The P-block atom can effectively regulate the activity of two-electron CO2 reduction on Sn(200) surface.

Designing photocatalysts with suitable band alignment and considerable carrier mobility is extremely important. Here, by means of first-principles calculation, we systematically investigated the structural, photoelectronic, and carrier mobility behavior of the two-dimensional Janus MoSSe/WSSe superlattice. The results show that both armchair-type (A

Two-dimensional Janus MXY materials have been successfully synthesized from their parent species by CVD, SEAR, or PLD techniques. However, their detailed evolution process and underlying atomistic mechanism are far from understood conclusively, which are prompts for further research. Here, taking Janus MoSSe as a representation, the evolution process from MoS

Background: This study aimed to investigate the distribution and drug resistance of pathogens in hospitalized patients in the respiratory and critical care medicine department during the Coronavirus Disease 2019 (COVID-19) pandemic, analyze the risk factors of drug- resistance, and construct the risk prediction model.Methods: Patients who showed positive results in the bacterial culture in the Department of Respiratory and Critical Care Medicine of a large tertiary teaching hospital were enrolled using WHONET 5.6 software from December 2019 to June 2021. The patients were divided into training and validation sets based on a random number table method (8:2). A prediction model was then developed using the training set and verified using the validation set. Single factor analysis was used to compare the general situation and clinical characteristics of patients in the two groups. The risk prediction model of drug-resistant bacteria was constructed using the multi-factor logistic regression. A line diagram was then established based on the regression coefficient of the model. The model was internally and externally verified using receiver operating characteristic (ROC), area under the curve (AUC), and calibration curve.Results: Klebsiella pneumoniae (196/791, 24.78%), Pseudomonas aeruginosa (136/791, 17.19%), Acinetobacter baumannii (82/791, 10.37%), Escherichia coli (82/791, 10.37%), and Enterococcus faecalis (35/791, 4.42%) were the top five bacterial isolates. The isolated drug-resistant bacteria mainly included ESBL-producing E. coli (53/174, 30.46%) and K. pneumonia (28/174, 16.09%), carbapenem-resistant Acinetobacter baumannii (CR-Ab) (34/179, 19.54%), carbapenem-resistant Pseudomonas aeruginosa (CR-Pa) (17/174, 9.77%) and Klebsiella pneumoniae (CR-Kp) (7/174, 4.02%), and methicillin-resistant Staphylococcus aureus (MRSA) (11/174, 6.32%). gram-negative bacteria had a high resistance to ampicillin, ceftriaxone, cefotaxime, cefazolin, cefuroxime, aztreonam, cefepime, and ceftazidime. However, resistance rates of gram-negative bacteria to tigecycline, ertapenem, and cefoxitin were low. The nosocomial infection prediction model of drug-resistant bacteria was developed based on the combined use of antibiotics (antifungal drugs or respiratory quinolones), pharmacological immunosuppression, PCT > 0.5 ng/mL, CKD stage 4-5, indwelling catheter, and age > 60 years via multivariate logistic regression. The AUC under the ROC curve of the training and validation sets were 0.768 (95 % CI:0.624 - 0.817) and 0.753 (95 % CI: 0.657-0.785), respectively, indicating that the model had good discrimination. The predictive ability of the model was evaluated using calibration curve. The Hosmer-Lemeshow test showed that the model fitting had no significant difference (P > 0.05).Conclusions: E. coli, A. baumannii, K. pneumoniae, and P. aeruginosa are the main drug-resistant bacteria in nosocomial infection. COVID-19 does not increase the drug resistance pressure of the main strains. The combined use of antifungal, respiratory quinolone antibiotics, indwelling catheter, chronic renal failure, and age > 60 years are the independent risk factors of drug-resistant bacteria infection. The risk prediction model of drug-resistant bacteria infection can help in the prevention and control of hospital antibacterial-resistant bacteria infection.

The Schottky barrier height (ESBH) is a crucial factor in determining the transport properties of semiconductor materials and it directly regulates the carrier mobility in opto-electronics devices.

Efforts to concurrently test for enemy release of both above- and belowground enemies for invasive plants in non-native range are limited. Moreover, direct evidence for the causal link between enemy release and performance is rare for invasive plants. Thus, we sought to investigate if above- and/or belowground enemies are involved in the enemy release mechanisms at various life stages of a temperate invader and their consequences on plant community properties. We conducted field surveys of enemy damage and plant performance, and plant-soil feedback experiments in the glasshouses using Ambrosia trifida in both its non-native and native ranges across the seed, seedling, and adult life stages. Field surveys showed that seeds of A. trifida were more severely damaged by aboveground enemies in the native relative to the non-native range, while the difference in leaf damage between ranges was small. Plant-soil feedback experiments showed that release from belowground enemies was also important, as seed germination and plant growth were significantly reduced in soils from the native range compared with soils from the non-native range. Consistent with the above results, A. trifida was larger, produced more seeds, had higher density, and exerted stronger impacts on co-occurring native plants in the non-native relative to the native range. Our results demonstrated that release from both above- and belowground enemies at various life stages contributed to the invasion success of A. trifida in its non-native range and highlighted the importance of considering both above- and belowground enemy release when studying plant invasions.

It is believed that eukaryotes arise from prokaryotes, which means that organelles can form de novo in prokaryotes. Such events, however, had not been observed previously. Here, we report the biogenesis of organelles in the endosymbiotic cyanobacterium TDX16 (prokaryote) that was released from its senescent/necrotic host cell of green alga Haematococcus pluvialis (eukaryote). Microscopic observations showed that organelle biogenesis in TDX16 initiated with cytoplasm compartmentalization, followed by de-compartmentalization, DNA allocation, and re-compartmentalization, as such two composite organelles-the primitive chloroplast and primitive nucleus sequestering minor and major fractions of cellular DNA respectively were formed. Thereafter, the eukaryotic cytoplasmic matrix was built up from the matrix extruded from the primitive nucleus; mitochondria were assembled in and segregated from the primitive chloroplast, whereby the primitive nucleus and primitive chloroplast matured into the nucleus and chloroplast respectively. While mitochondria subsequently turned into double-membraned vacuoles after matrix degradation. Results of pigment analyses, 16S rRNA and genome sequencing revealed that TDX16 is a phycocyanin-containing cyanobacterium resembling Chroococcidiopsis thermalis, which had acquired 9,017,401 bp DNAs with 10,301 genes from its host. Accordingly, we conclude that organelle biogenesis in TDX16 is achieved by hybridizing the acquired eukaryotic DNAs with its own one and expressing the hybrid genome. The formation of organelles in cyanobacterium TDX16 is the first case of organelle biogenesis in prokaryotes observed so far, which sheds an unprecedented light on eukaryotes and their connections with prokaryotes, and thus has broad implications on biology.

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

To investigate the clinical results of the application of critical rehabilitation pathway in the rehabilitation after total knee arthroplasty.From March 2015 to December 2019, 67 patients with total knee arthroplasty (TKA) were included. There were 49 females and 18 males, 42 cases on the left and 25 cases on the right, with an average age of 60 to 81(70.72±5.92) years old. Critical rehabilitation paths included intensive strength and gait rehabilitation exercises. All patients were evaluated before operation and 3, 12 months after operation. The evaluation indexes included stair climbing test (SCT), six minute walk test (6MWT), quadriceps and hamstring strength, range of motion, visual pain scale (VAS), Western Ontario McMasterUniversity Osteoarthritis score(WOMAC).All the patients completed the entire pathway and the assessment. The results of pre-operative, 3 months after surgery and 12 months after surgery were as follows respectively. SCT-up: (16.32±3.58) s, (18.16±2.46) s, (11.00±1.29) s,Critical rehabilitation path is safe and effective. The knee function of patients who receive critical rehabilitation path after TKA is significantly improved in the first 12 months after operation.

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

Developing an efficient electrocatalyst with the desired architectural and electronic properties is paramount for water splitting. Here, we apply theoretical calculations to experimental studies to uncover the influence of structure engineering (quantizing and support coupling) on the HER catalytic activity and develop an optimized C3N4 hybrid catalyst. Impressively, the desired atom-thick C3N4 quantum dots on graphene (CNQDs@G) has been successfully obtained and achieves HER performance with low overpotential (110 mV) at 10 mA cm–2, large exchange current density (3.67 μA cm–2), and long-term durability, better than those of many metallic catalysts. In combination with the experimental results, DFT calculations also disclose that the HER catalytic activity of CNQDs@G originates from bisynergetic effects: one between G and CNQDs and another between the edge pyridinic-N sites and the molecular sieve structure.

The development of an electrocatalyst based on abundant elements for the oxygen evolution reaction (OER) is important for water splitting associated with renewable energy sources. In this study, we develop an interconnected Ni(Fe)OxHy nanosheet array on a stainless steel mesh (SSNNi) as an integrated OER electrode, without using any polymer binder. Benefiting from the well-defined three-dimensional (3D) architecture with highly exposed surface area, intimate contact between the active species and conductive substrate improved electron and mass transport capacity, facilitated electrolyte penetration, and improved mechanical stability. The SSNNi electrode also has excellent OER performance, including low overpotential, a small Tafel slope, and long-term durability in the alkaline electrolyte, making it one of the most promising OER electrodes developed.

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.

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.

Eight possible native point defects in Mg24Y5 are studied from the density functional theory (DFT) calculations within GGA approximation. The energetic results show that anti-site defects with lower formation energies are energetically favored over vacancies. Under both Mg-rich and Y-rich conditions, MgY1 defect is dominant due to the lowest defect formation energy, followed by YMg2, MgY2 and YMg1, which reasonably explains the Mg-rich off-stoichiometry of Mg24Y5 alloys. For vacancy defects, the formation energies on the two Mg sub-lattices are smaller than ones on two Y sub-lattices, and VMg1 has the lowest formation energy, while VY2 is most unlikely due to the highest formation energy originating from the large mismatch in atomic size and the strong interaction of Y with surrounding atoms. The defect concentration distribution as a function of temperature and stoichiometry is further obtained from grand canonical statistics. The size factor and electronic structure are further discussed, demonstrating that Mg24Y5 alloy is typical system in which the point defects are affected by strong size effect due to the large atomic size radius and strong electronic factor caused by the intensive interaction of Y with the surrounding atoms.

It is generally accepted that eukaryotic cell arises from prokaryotic cell, which means that organelle can be formed in prokaryotic cell. However, no such an instance has been detected till now. Here, we report organelle biogenesis in the endosymbiotic cyanobacterium TDX16 released from the green alga Haematococcus pluvialis, which occurred through six steps. (1) An inner intracytoplasmic membrane (IIM), an outer intracytoplasmic membrane (OIM) and an intervening peptidoglycan-like layer (PL) were synthesized by merging cytoplasmic membrane (CM)-derived thick margin vesicles, which partitioned the thylakoid-less cytoplasm into three compartments: an inner cytoplasm (ICP), an outer cytoplasm (OCP) and a sandwiched intracytoplasmic space (IS). (2) Osmiophilic granules that blistered from CM, OIM and IIM developed into primary thylakoids (PT) in ICP; while OCP disappeared and thus OIM and CM combined into a double-membraned cytoplasmic envelope (CE). (3) ICP decondensed; IIM and PT disassembled into tiny vesicles (TV) and double-membraned vesicles (DMV) respectively. Such that DNA fibers (DF) aggregated and migrated to PL. (4) TV fused into a double-membraned intracytoplasmic envelope (ICE), which re-compartmentalized the coalesced IS and ICP into a new intracytoplasmic space (NS) sequestering most DF and a new inner cytoplasm (NIC) with only few DF. Then ribosomes were formed in both NS and NIC, while DMV opened and extended into secondary thylakoids (ST) only in NIC. (5) NIC developed into the primitive chloroplast (PC) surrounded by ICE, in which ST disassembled, while ST-derived plastoglobuli developed into primitive eukaryotic thylakoids (PMT). After PL dismantled, the matrix of NS was concentrated and encased with the membranes synthesized from ICE-derived dotted vesicles into the primitive nucleus (PN). So, NS vanished, CE wrapped PC and PN. Outside CE, eukaryotic cell wall was formed by assembling sheath at the outer membrane of original cell wall and modifying the peptidoglycan layer. (6) Eukaryotic cytoplasm was built up from the matrix extruded from PN. Mitochondria were assembled in and segregated from PC by encapsulating a portion of stroma with the membranes synthesized from PMT-derived dense-margined vesicles. Then, most mitochondria turned into double-membraned vacuoles after matrix degradation, which mediated unconventional exocytosis and endocytosis. When this process finished, PN got matured into a nucleus enclosed by two sets of envelopes; PC matured into a chloroplast with its PMT maturing into thylakoids. Consequently, the prokaryotic TDX16 cell developed into a eukaryotic cell (TDX16-DE). Results of pigment analyses and 16S rRNA sequencing revealed that TDX16-DE chloroplast contained chlorophyll b and lutein showing 99% similarity to that of Chlorella vulgaris, TDX16 was a phycocyanin-containing cyanobacterium resembling Chroococcidiopsis thermalis (98% identity). Whereas, TDX16 genome size (15,333,193 bp) and gene number (13,415) were 2.43 and 2.40 times those of C. thermalis (6,315,792 bp; 5593 genes) respectively, indicating that TDX16 acquired at least 7822 genes from its host H. pluvialis. Therefore, the mechanism underlying organelle biogenesis in TDX16 was the integration and expression of the obtained genes.

Study the gene and protein expression of NACHT-PYD-containing protein 3 (NALP3) inflammasome and extracellular regulated protein kinase (ERK), the intervention effects of sodium ferulate (SF) in human lung epithelial cells A549 under oxidative stress, and to investigate the possible mechanism.Human lung epithelial cells A549 culturedCompared with the control group,H₂O₂ not only increased the mRNA and protein expression levels of caspase-1 and NALP3 and the protein expression levels of p-ERK/ERK, but also enhanced the secretion of IL-1β in human lung epithelial cells A549 (SF may reduce the expression of caspase-1, NALP3 and IL-1β by inhibiting ERK, so as to reduce the inflammation caused by oxidative stress.

The fungal community composition, size and several physico-chemical properties were individually investigated in ten macrophyte rhizospheric substrates using nested PCR-denaturing gradient gel electrophoresis and soil chemical methods. Results indicated that both Dothideomycetes and Sordariomycetes were dominant fungi in macrophyte rhizospheric substrates, and denitrifying fungi (Fusarium graminearum) was found in nine of ten macrophyte rhizospheres. Fungal Shannon-Wiener diversity index (H) and richness (S) in Thalia dealbata, Typha latifolia, Iris hexagona and Hemerocallis aurantiaca rhizospheres were higher than those in other six rhizospheres. Fungal number and biomass were 1.91 × 103 CFUs g−1 dw and 1.53 μg ergosterol g−1 dw in Iris pseudacor rhizosphere, and were greater than in other nine rhizospheres. The correlation analysis showed that fungal number and biomass significantly and positively correlated to total soil phosphorus, while fungal H and S were significantly and negatively correlated to total organic carbon. The principal components analysis (PCA) showed that the fungal community significantly divided ten macrophyte rhizospheres into four groups, showing the significant difference of fungal communities among ten rhizospheric substrates. The current study revealed for the first time the importance of rhizospheric fungal community in distinguishing macrophyte rhizospheres, thus will undoubtedly widen our insight into fungal communities in aquatic rhizospheres.

Association rules analysis is an important subject in data mining. At present, association rules mining algorithms frequently generate a large number of association rules, but most of the algorithm evaluations make advances only from an aspect, which makes the users select difficultly. Therefore, the comprehensive evaluation of association rules has become highly necessary. A comprehensive evaluation system of association rules based on the AHP (Analytic Hierarchy Process) was presented, which can evaluate the association rules from multi-angle and multi-dimensional. Many evaluation results are integrated into the system, eventually presenting a unified comprehensive coefficient to users. Practical data make it clear that the comprehensive evaluation system is rational and superior.

An internally circulating fluidized bed (ICFB) was applied to investigate the behavior of refuse derived fuels (RDF) incineration. The temperature distribution along bed height was measured by the thermocouple and the pollutant emissions in the flue gas were measured by Fourier transform infrared spectrometry Gasmet DX-3000. In the tests the concentrations of the species CO CO2 HCl N2O SO2 were measured online. The experimental results showed that the RDF could combust steadily in the fluidized bed. The concentrations of the CO HCl N2O in flue gas were higher than the values of national environmental standards.

Objective Although many studies have documented the tumor-promoting role of hepsin in several types of malignancies, little is known about its clinical and biological significance in breast cancer. Materials and Methods Hepsin expression was examined in 4 pairs of fresh breast tumor samples and corresponding nontumor breast tissues by Western blotting. Immunohistochemistry for hepsin was performed on an additional cohort of 215 archival breast cancer samples. The clinical significance of hepsin expression was analyzed. Knockdown of hepsin expression was performed in 2 breast cancer cell lines, MDA-MB-231 and HER18, with a high abundance of endogenous hepsin, and the effects of hepsin silencing on cell invasion and proliferation were evaluated. Results Hepsin was aberrantly overexpressed in breast cancer tissues relative to adjacent nontumor tissues. Its overexpression was significantly associated with tumor stage ( P = 0.037), lymph node metastasis ( P = 0.010), estrogen receptor positivity ( P = 0.019), and progesterone receptor positivity ( P < 0.0001) in patients with breast cancer. Down-regulation of hepsin expression by small interfering RNA (siRNA) significantly reduced cell proliferation and invasion in both the MDA-MB-231 and HER18 cells compared to nonspecific control small interference RNA. Conclusion Our data demonstrate that hepsin expression is frequently up-regulated in breast cancer tissues, which is associated with tumor growth and progression. Thus, inhibition of hepsin expression might be of therapeutic significance.

Fascin, an actin-cross-linking protein, is up-regulated in breast cancer and correlates with a more aggressive disease. This study was conducted to elucidate the effects of manipulating fascin in breast cancer cells on the metastasis-associated events, including proliferation, adhesion, invasion, epithelial–mesenchymal transition (EMT) and enrichment of a CD44+/CD24− subpopulation that show some stem/progenitor cell properties. Western blot analysis of a panel of breast cancer cell lines revealed high expression of fascin in MDA-MB-435 and MDA-MB-231 cells but revealed no or low expression in MDA-MB-453, Her-18 and T47D. Gain-of-function and loss-of-function studies in breast cancer cells demonstrated that forced expression of fascin promoted cell proliferation assessed by the MTT assay, decreased cellular adhesion to fibronectin and potentiated the invasive capacity in the Transwell chamber invasion assay. Conversely, down-regulation of fascin via small interfering RNA increased cell adhesion and facilitated cell proliferation and invasion. In addition, fascin participated in the EMT and modulated the proportion of the CD44+/CD24− subpopulation in breast cancer cells. In conclusion, our data highlight an important role for fascin in breast cancer progression in vitro through orchestrating a variety of cellular events associated with metastasis, and thus, targeting this gene might have therapeutic implications. Copyright © 2011 John Wiley & Sons, Ltd.

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.

Inflammatory myofibroblastic tumors (IMTs) are uncommon, mesenchymal lesions, and malignant transformation is extremely rare. The current study presents the case of a 56-year-old female with a rapidly growing mass in the right breast, which was diagnosed as IMT. Immunohistochemically, the mass was positive for smooth muscle actin (SMA) and Ki-67 (positive staining in 30% of the cells), and negative for S-100, cluster of differentiation (CD)34, p63 and cytokeratin. Malignant transformation to metaplastic carcinoma of the spindle-cell type was observed following surgical resection. This metaplastic carcinoma demonstrated positive immunoreactivity for cytokeratin, vimentin, CD34, p63 and Ki-67 (>30%), and was negative for cytokeratin 7, SMA, desmin and S-100. The patient underwent total mastectomy of the right breast, followed by palliative chemotherapy with capecitabine; however, the patient succumbed to the disease after 12 weeks. The unusual case presented in the current study emphasizes the importance of pre-operative examinations to determine the benign or malignant nature of IMTs, which aids in the choice of appropriate surgical procedures.