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Positive, Negative, and Zero Work00:58

Positive, Negative, and Zero Work

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Work is done on an object when energy is transferred to the object. In other words, work is done when a force acts on a body that undergoes a displacement from one position to another. By definition, the work done by a force is the integral of the force with respect to the displacement along its path. Forces can vary as a function of position, and displacements can occur along various paths between two points. The magnitude of a force multiplied by the cosine of the angle that the force makes...
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Strong Acid and Base Solutions03:22

Strong Acid and Base Solutions

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A strong acid is a compound that dissociates completely in an aqueous solution and produces a concentration of hydronium ions equal to the initial concentration of acid. For example, 0.20 M hydrobromic acid will dissociate completely in water and produces 0.20 M of hydronium ions and 0.20 M of bromide ions.
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Calculating pH for Titration Solutions: Strong Acid/Strong Base
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In any solution, the value of pKa indicates whether an acid is completely dissociated or not. A negative pKa corresponds to a stronger acid, whereas a positive pKa corresponds to a weaker acid. Consider the reaction between ammonia and an ethoxide ion. In this reaction, ethanol with a pKa of 15.9 is a stronger acid than ammonia with a pKa of 38. Recall that the strong acid forms a weak conjugate base, and a weak acid forms a strong conjugate base. Hence, the ethoxide ion is a weak base.
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A Practical Immunohistochemistry-Based Model for Predicting Pathologic Complete Response in Estrogen Receptor-Strong

Su Min Lee1, Jeong Eon Lee1, Seok Jin Nam1

  • 1Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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This study developed an immunohistochemistry (IHC)-based model to predict pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in estrogen receptor (ER)-positive breast cancer. High-scoring patients may benefit from NAC, guiding personalized treatment decisions.

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Area of Science:

  • Oncology
  • Breast Cancer Research
  • Chemotherapy Efficacy

Background:

  • Neoadjuvant chemotherapy (NAC) benefits are established for HER2-positive and triple-negative breast cancers.
  • Effectiveness and patient selection for NAC in ER-positive, HER2-negative breast cancers require further definition.
  • Pathological complete response (pCR) is a key endpoint in assessing NAC efficacy.

Purpose of the Study:

  • To identify immunohistochemistry (IHC)-based predictors of pCR in ER-strong positive/HER2-negative breast cancer.
  • To develop and validate a predictive scoring model for pCR in this patient subgroup.
  • To evaluate the prognostic impact of pCR based on the developed model.

Main Methods:

  • Retrospective analysis of a prospective cohort of 522 patients with ER-strong positive/HER2-negative tumors receiving NAC.
  • Evaluation of IHC markers: progesterone receptor (PR), Ki-67, EGFR, CK5/6, and p53 as potential pCR predictors.
  • Development of a weighted 4-point scoring model using multivariate logistic regression and assessment of its performance via ROC analysis.

Main Results:

  • PR-negative status, positivity for basal-like markers (EGFR or CK5/6), and Ki-67 ≥ 50% were independent predictors of pCR.
  • The scoring model showed good discrimination for pCR (AUC = 0.754), with pCR rates of 4.9% (low), 10.7% (intermediate), and 36.2% (high).
  • High-score group pCR significantly improved disease-free and distant metastasis-free survival; no significant survival difference in low/intermediate groups.

Conclusions:

  • An IHC-based model effectively predicts pCR and identifies ER-positive/HER2-negative breast cancer subgroups benefiting from NAC.
  • High-scoring patients may benefit from NAC, while low/intermediate-score patients might be better managed with surgery and endocrine therapy.
  • The model supports personalized treatment decisions regarding NAC in ER-positive/HER2-negative breast cancer.