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Breast cancer, a heterogeneous disease, is notable for its high morbidity, recurrence, and mortality. T3N0M0 is controversial in terms of clinical prognosis and therapeutic decision-making. We collected baseline and treatment information on patients with T3N0M0 between 2010 and 2015 from the Surveillance, Epidemiology, and End Results programme (SEER) database. Univariate analyses of clinicopathological characteristics were performed using the log-rank test, while variables that were statistically significant ( p  < 0.05) were included in multivariate analyses to identify prognostic risk factors included in the construction of nomograms. Receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA) curves were applied to evaluate the nomogram. We obtained a total of 4,641 patient clinical characteristics from the SEER database. In T3N0M0 group, the overall survival (OS) for 3, 5 and 10 years was 87.1%, 79.5% and 71.6%, and breast cancer-specific survival (BCSS) was 92.0%, 88.1% and 85.3%, respectively. We ultimately identified eight variables (age, grade, surgery, radiation, chemotherapy, ER-status, PR-status, Her2-status) were associated with OS while seven variables (age, grade, surgery, radiation, chemotherapy, PR-status, Her2-status) were associated with BCSS. The nomogram was constructed based on independent prognostic risk factors, the area under the curve (AUC) values were well performed, the ROC curves, calibration curves and DCA curves all indicated that the nomogram had better clinical practicability. The current study provides a new clinical assessment tool for T3N0M0 breast cancer patients, as well as a reference for clinicians in selecting management decisions.

Introduction Metachronous bilateral ectopic breast cancer (MBEBC) is clinically rare, but the incidence has been increasing in recent years and no clear therapeutic guidance or prognostic assessment is available. Methods Data on MBEBC patients from the Surveillance, Epidemiology, and End Results (SEER) database were gathered and randomly split into a training set and a validation set at a 7:3 ratio. Independent prognostic risk factors were identified through both univariate and multivariate analyses, and a nomogram was constructed based on these factors to predict survival outcomes. Results From the SEER database, we collected data on a total of 8240 patients spanning the years 2005–2015. These patients were then randomly divided into a training set (5768) and a validation set (2472) for analysis. The clinicopathological features indicated that Grade 2 tumors were the most prevalent, with invasive ductal carcinoma comprising 71.2% of the cases. Additionally, the majority of MBEBC patients were classified as N0, and only a small fraction (4.2%) exhibited distant metastases. A multivariate COX regression model was developed to identify independent prognostic risk factors for patients whose first and second tumors were both invasive ductal carcinomas, as well as those with more extensive pathological types. Nomograms were also constructed for survival prediction of overall survival (OS) and breast cancer-special survival (BCSS) at 3, 5, and 10 years. Receiver operating characteristic (ROC) curves were plotted and area under the curve (AUC) values were calculated. The AUC was greater than 0.7 in all models, with a 10-year OS of 78.0 (76.0–80.0) and a BCSS of 77.6 (76.0–79.3) in all patients. The calibration curves and decision curve analysis (DCA) demonstrate that the nomogram possesses strong clinical predictive capability and high predictive accuracy. Conclusion This study detailed the clinicopathological characteristics of patients with the clinically rare MBEBC and identified independent prognostic risk factors across various pathology types. Additionally, a nomogram was developed for individualized prediction of patients' BCSS and OS, offering a new adjunctive tool for the clinical management of MBEBC patients.

Introduction Breast angiosarcoma is a rare malignancy of endovascular origin, accounting for less than 1% of all mammary cancers. Our aim was to explore clinicopathological features and the factors associated with prognosis. Methods We extracted information from the Surveillance, Epidemiology, and End Results Program (SEER) for all patients with breast angiosarcoma between 2004 and 2015. Chi-square analysis was used to compare the clinicopathological features in all patients. Overall survival (OS) was assessed using the Kaplan and Meier method. Univariate and multivariate analyses were performed to evaluate the factors associated with prognosis. Results A total of 247 patients were included in the analyses. The median OS of patients with primary breast angiosarcoma (PBSA) and secondary breast angiosarcoma (SBAB) was 38 months and 42 months, respectively. The 1-, 3- and 5-year OS with PBSA was 80%, 39%, and 25%, respectively, and the 1-, 3- and 5-year OS with SBAB was 80%, 42%, and 34%, respectively. Multivariate analysis revealed that tumor size ( p  = 0.001), tumor grade ( p  < 0.001), tumor extension ( p  = 0.015), and tumor spread ( p  < 0.001) were statistically significant factors for OS. Partial mastectomy with radiation (HR = 0.160, 95% CI, 0.036–0.719, p  = 0.016), partial mastectomy with chemotherapy (HR = 0.105, 95% CI, 0.011–1.015, p  = 0.052), and partial mastectomy (HR = 0.125, 95% CI, 0.028–0.583, p  = 0.007) were related to significantly better OS outcomes in primary angiosarcoma. Conclusion Primary breast angiosarcoma has a better clinical phenotype than secondary breast angiosarcoma. Although overall survival was not statistically significant, primary breast angiosarcoma was better than secondary breast angiosarcoma with systemic therapy. Depending on the outcome of survival, partial mastectomy is effective in treating primary breast angiosarcoma.

Background Neutrophil extracellular traps (NETs) are composed of DNA chains from neutrophils and associated proteolytic enzymes, which play an important role in cancer metastasis. However, the molecular mechanism of NET-mediated lung metastasis in triple-negative breast cancer (TNBC) remains unclear. Methods The expression levels of NETs in breast cancer specimens and serum were analyzed and compared with normal samples. Single-cell sequencing bioinformatics analysis was conducted to identify differentially expressed genes and functional enrichment related to NET formation in patients with breast cancer. The effects of c-FOS on neutrophil recruitment and NET formation in TNBC were investigated. The upstream and downstream regulatory mechanisms mediated by c-FOS were explored through in vitro and in vivo experiments. Therapeutic approaches targeting c-FOS for treating TNBC were further studied. Results Inhibition of c-FOS can suppress tumor growth and lung metastasis in TNBC. Mechanistically, c-FOS promotes transcription by binding to the PAD4 promoter region, facilitating the formation of NETs. Additionally, the activation of the ROS-p38 pathway further enhances c-FOS expression. High expression of c-FOS also promotes the expression of inflammatory factors, facilitating neutrophil recruitment. Both in vitro and in vivo experiments demonstrated that the application of T5224 effectively inhibits the formation of NETs, suppressing lung metastasis and tumor growth. Conclusion In summary, this study demonstrates that the ROS-p38-cFOS-PAD4 axis can increase NET formation in TNBC and promote the expression of inflammatory factors, facilitating neutrophil recruitment. Therefore, targeting this pathway may help inform new therapeutic strategies and provide new insights for immunotherapy in TNBC.

The construction of channel regulation projects, reservoirs, and other human activities have led to significant changes in channel geometry and hydrodynamic conditions in mountainous macrotidal estuaries. However, their impact on the long-term evolution of the turbidity maximum zone (TMZ) in these estuaries is still unclear. Therefore, the Minjiang Estuary (ME) was selected as the study area and using the Gabor filter and surface suspended sediment concentration (SSSC) data retrieved from GF PMS/WFV and Landsat-TM/ETM+/OLI images in the flood season from 1986 to 2020, the flow direction of Chuanshi Waterway, the spatiotemporal evolution characteristics of TMZ in the ME, and the influence of human activities on these were analyzed. The results indicate that during flood tides in the past 35 years, the TMZ was mainly distributed in sections from the Changmen to the Chuanshi and Meihua waterways. The construction of the Shuikou Reservoir caused the SSSC to decrease by 65 mg/L at the Chuanshi Tidal Gauge Station in the ME. The TMZ in the ME waterway channel notably migrated toward the sea due to the waterway regulation project, with the landward and seaward boundaries moving by 2.5 km and 3 km seaward, respectively. The main distribution area moved from Jinpaimen to the section from Chuanshi Waterway to the mouth of the ME. These variation characteristics were basically consistent with the annual average TMZ in the flood season. Through the interactions between nature and human interventions, the flow regime of the ME tended to converge in the flood season. Therefore, human activities have significantly impacted the long-term evolution of the TMZ in the ME.

The lateral bathymetry in the estuary results in different degrees of tidal mixing asymmetry, which has significant impacts on the longitudinal sediment transport by changing the temporal variation of vertical eddy diffusion. This study focus on the lateral variation of tidal mixing asymmetry and longitudinal sediment transport at the landward boundary of turbidity maximum zone in the North Channel of Yangtze estuary, which is a typical time-dependent salt wedge estuary. A transect survey was carried out in December, 2018; five vertical profiles of flow velocity, salinity and suspended sediment concentration were simultaneously measured covering a spring tidal cycle. Analysis of the data revealed that, after the maximum ebb, the stratification in the main and secondary channel was stronger than that on the shoal. In the channel, during ebb tide, the stronger stratification restrained the turbulent mixing induced by vertical shear, vertical mixing during the flood tide was stronger than that during ebb tide and vertical mixing coefficients ranged from 0.06 to 0.12, showing regular tidal mixing asymmetry over a flood–ebb tidal cycle. Therefore, stronger eddy diffusion caused by vertical mixing resulted in higher suspended sediment concentrations during flood tide, the larger landward tidally averaged sediment transport rate was induced by tidal pumping with the transportation of flood tidal current and the net sediment transport over a flood–ebb tidal cycle in the channel was landward. Meanwhile, on the shoal, under the effect of vertical shear, the vertical mixing during flood tide was weaker than that during ebb tide; vertical mixing coefficients ranged from −0.27 to −0.02, showing the reversed tidal mixing asymmetry. Higher suspended sediment concentration was transported seaward by the ebb current, the tidally averaged sediment transport rate by both tidal pumping and advection was seaward and the net sediment transport was seaward. Furthermore, large river discharge increased the seaward advection sediment flux on the surface layer in the main channel, resulting in the seaward tidally averaged sediment flux. Strong resuspension increased the seaward advection sediment flux near the bottom in the main and secondary channel, resulting in the seaward tidally averaged sediment flux.

Bedforms in macrotidal estuaries and deltas are distinguished from those in rivers and oceans due to the tidally-driven water depth variations and the varying hydrodynamic processes resulting from the interaction between tidal and fluvial flows. The relations between hydrodynamics, sediment transport, and bedform morphology in these estuaries are complex, but research on the morphodynamics of bedforms in such environments is still lacking. This study explores the morphodynamic development patterns of multiscale bedforms in mountainous estuaries and tidal deltas, using the Minjiang Estuary as a representative case. Field observations were conducted in the Minjiang Estuary in the East China Sea in December 2021 (dry season) and August 2023 (flood season) using a multibeam echosounder system and an Acoustic Doppler Current Profiler (ADCP). Bedform presence and characteristics were calculated from bed elevation data. The results indicate that bedforms are widely developed from the underwater delta plain to the delta front channel of the Minjiang Estuary, with large compound bedforms being prevalent. Both primary and secondary bedforms coexist, with wavelengths ranging from 2 to 233 meters and heights from 0.1 to 6 meters. About 60% of primary bedforms exhibit ebb asymmetry, indicating ebb-directed sediment transport in the main channel. The average flood/ebb lee side angle is 6°, with an average maximum angle of 19°. The maximum side angle of primary bedforms is observed to be on average greater than that of secondary bedforms. Water depth and riverbed slope significantly affect bedform density, with non-sloping riverbeds favoring bedform development. Variations in bed shear stress throughout the tidal cycle drive differences in bedform size and morphology. High clay content in surface sediments correlates with lower bedform density, indicating fine-grained materials may inhibit bedform development. This study highlights a feedback mechanism where structural geology shapes channel morphology, influencing energy distribution and bedform evolution. The findings enhance our understanding of sediment transport and hydrodynamic processes in macrotidal estuaries, offering insights for estuarine management and conservation. Future research should explore how seasonal and tidal variations influence bedform evolution to refine models of estuarine dynamics.

Effectively simulating the variation in suspended sediment concentration (SSC) in estuaries during typhoons is significant for the water quality and ecological conditions of estuarine shoal wetlands and their adjacent coastal waters. During typhoons, SSC undergoes large variations due to the significant changes in meteorological and hydrological factors such as waves, wind speed, and precipitation, which increases the difficulty in simulating SSC. Therefore, in this study, we use an optimized Principal Component Analysis Long Short-Term Memory (PCA-LSTM) framework with an attention mechanism to simulate the SSC in the Yangtze Estuary during Typhoon In-Fa. First, we integrate data from different sources into a multi-source dataset. Second, we use the PCA to reduce the dimensionality of the multi-source data and eliminate redundant variables in the feature data. Third, we introduce an attention mechanism to optimize the long and short-term memory (LSTM) model. Finally, we use the differential evolution (DE) algorithm for hyperparameter selection and merge the feature data with the SSC data as the input of the optimized LSTM network to simulate SSC. The results showed that SSC’s fitting coefficients (R2) at four hydrological stations improved by 7.5%, 6.1%, 7.4%, and 7.8%, respectively, using the attention-based PCA-LSTM compared to the PCA-LSTM. Moreover, compared to the traditional LSTM model, the R2 was improved by 33.8%, 30.5%, 32.0%, and 28.6%, respectively, using the attention-based PCA-LSTM framework. The study indicates that the selection of input variables can affect the model results. Introducing an attention mechanism can effectively optimize the PCA-LSTM framework and improve the simulation accuracy, which helps simulate the non-linear process of SSC variation occurring during Typhoon In-Fa.

Cancer vaccines are promising as an effective means of stimulating the immune system to clear tumors as well as to establish immune surveillance. In this paper, we discuss the main platforms and current status of cancer vaccines and propose a new cancer vaccine platform, the cytosolic vesicle vaccine. This vaccine has a unique structure that can integrate antigen and adjuvant carriers to improve the delivery efficiency and immune activation ability, which brings new ideas for cancer vaccine design. Tumor exosomes carry antigens and MHC-peptide complexes, which can provide tumor antigens to antigen-processing cells and increase the chances of recognition of tumor antigens by immune cells. DEVs play a role in amplifying the immune response by acting as carriers for the dissemination of antigenic substances in dendritic cells. OMVs, with their natural adjuvant properties, are one of the advantages for the preparation of antitumor vaccines. This paper presents the advantages of these three bacteria/extracellular vesicles as cancer vaccines and discusses the potential applications of functionally modified extracellular vesicles as cancer vaccines after cellular engineering or genetic engineering, as well as current clinical trials of extracellular vesicle vaccines. In summary, extracellular vesicle vaccines are a promising direction for cancer vaccine research.

Riverbed micro-topographical features, such as crest and trough, flat bed, and scour pit, indicate the evolution of fluvial geomorphology, and have an influence on the stability of underwater structures and overall scour pits. Previous studies on bedform feature extraction have focused mainly on the rhythmic bed surface morphology and have extracted crest and trough, while flat bed and scour pit have been ignored. In this study, to extend the feature description of riverbeds, geomorphic elements mapping was used by employing three geomorphic element classification methods: Wood’s criteria, a self-organization map (SOM) technique, and geomorphons. The results showed that geomorphic element mapping can be controlled by adjusting the slope tolerance and curvature tolerance of Wood’s criteria, using the map unit number and combination of the SOM technique and the flatness of geomorphons. Relatively flat bed can be presented using “plane”, “flat planar”, and “flat” elements, while scour pit can be presented using a “pit” element. A comparison of the difference between parameter settings for landforms and bedforms showed that SOM using 8 or 10 map units is applicable for land and underwater surface and is thus preferentially recommended for use. Furthermore, the use of geomorphons is recommended as the optimal method for characterizing bedform features because it provides a simple element map in the absence of area loss.