Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.

Rates of positive margins after surgical resection of invasive lobular carcinoma (ILC) are high (ranging from 18 to 60%), yet the efficacy of re-excision lumpReceptor subtypeectomy for clearing positive margins is unknown. Concerns about the diffuse nature of ILC may drive increased rates of completion mastectomy to treat positive margins, thus lowering breast conservation rates. We therefore determined the success rate of re-excision lumpectomy in women with ILC and positive margins after surgical resection. We identified 314 cases of stage I-III ILC treated with breast conserving surgery (BCS) at the University of California, San Francisco. Surgical procedures, pathology reports, and outcomes were analyzed using univariate and multivariate statistics and Cox-proportional hazards models. We evaluated outcomes before and after the year 2014, when new margin management consensus guidelines were published. Positive initial margins occurred in 118 (37.6%) cases. Of these, 62 (52.5%) underwent re-excision lumpectomy, which cleared the margin in 74.2%. On multivariate analysis, node negativity was significantly associated with successful re-excision (odds ratio [OR] 3.99, 95% CI 1.15-13.81, p = 0.029). After 2014, we saw fewer initial positive margins (42.7% versus 25.5%, p = 0.009), second surgeries (54.6% versus 20.2%, p < 0.001), and completion mastectomies (27.7% versus 4.5%, p < 0.001). In this large cohort of women with ILC, re-excision lumpectomy was highly successful at clearing positive margins. Additionally, positive margins and completion mastectomy rates significantly decreased over time. These findings highlight improvements in management of ILC, and suggest that completion mastectomy may not be required for those with positive margins after initial BCS

Use of the Term Elderly

Using the term elderly for a person who is robust and independent as well as for a person who is frail and dependent says little about the individual

Gamifying education for classroom engagement in primary schools

Gamification carries the element of fun and creativity into classroom teaching. It is not an unusual fact that playing games varied among learners and created an effective classroom environment. In the 21st-century teaching era, learners’ fun and creative learning environment are prioritized. Lessons filled with fun games are believed to produce a positive outcome during a lesson. Therefore, gamification prepares learners to be active and take responsibility for their learning. This study aimed to explore learners’ comprehension of the term ‘gamification’ and the effects of gamified elements implemented in the lesson on the targeted learners. A set of questionnaires was administered through an online survey to 100 respondents from local primary schools around Selangor who took part in a service-learning programmed. The data was then analyzed and presented in the form of tables. Results showed that respondents had prior knowledge of the term ‘gamification’ and the game culture’s overall context. The respondents agreed that their respective teachers had implemented several game elements when conducting a gamified lesson. Results also indicated that respondents were in preference to learn using gamified learning activities that helped them learn subconsciously.