Objective To study the clinicopathological significance of cyclin D1 expression in Rosai-Dorfman disease (RDD). Methods Seventeen cases of RDD were evaluated by HE, immunohistochemical staining and molecular genetic analysis. Expression of cyclin D1 was compared between RDDs and control group that included 29 cases of reactive histiocytosis, 9 cases of IgG4-related disease, and 2 cases of Erdheim-Chester disease. Results Cyclin D1 was expressed in RDDs (17/17), reactive histiocytosis (11/29), IgG4-related diseases (3/9), and Erdheim-Chester disease (2/2), respectively, with nuclear staining in the RDD cells or proliferative histiocytes. Chi-square test showed that expression of cyclin D1 was significantly higher in RDDs than in reactive histiocytosis and IgG4-related diseases (P0.05). The expression threshold for recalculating the percentage of cyclin D1 positive cells was 27.5% (AUC=0.981, P less then 0.01) by ROC curve. However, CCND1 gene had no rearrangement detected by fluorescence in situ hybridization, but with increased copies of gene in some RDD cells. ARMS-PCR analysis also did not detect KRAS, BRAF and NRAS gene mutations in any cases. Conclusions Cyclin D1 may serve as an additional diagnostic marker for RDDs. Its high expression may be related to activation of MAPK pathway, but the pathogenetic significance of cyclin D1 in RDDs needs further study.Objective To understand the effects and clinical significance of the 2019 guidelines for the human epidermal growth factor receptor 2 (HER2) detection. Methods According to the 2014 guidelines, 548 cases of invasive breast cancer with equivocal HER2 (2+) detected by immunohistochemistry (IHC) in Taizhou Enze Medical Center, Zhejiang Province, China from 2013 to 2019 were selected. The results of IHC and HER2/CEPl7 double-probe were reevaluated and divided into groups according to the 2019 guidelines for the comparative analysis. Results Among the 548 IHC HER2 (2+) invasive breast cancers, the number of positive, equivocal and negative cases for HER2 were 96 (17.52%), 81 (14.78%) and 371 (67.70%), respectively, according to the 2014 guidelines. However, according to the 2019 guidelines, 10 cases (1.82%) were reclassified as IHC 1+, 2 cases in the group 2 were reclassified as negative, and all the originally equivocal cases in group 4 were reclassified as negative. Finally, the total number of positive and negative cases for HER2 were 94 (17.15%) and 454 (82.85%), respectively. Conclusions After applying the 2019 guidelines, the number of IHC 2+ cases decreases, and the positive rate for HER2 also decreases slightly due to the reevaluation change in groups 2 and 4, leading to reclassification of the cases that were deemed equivocal according to the 2014 guidelines. In general, the new 2019 guidelines are more reasonable and easier to use.Objective To investigate the clinicopathological features, immunophenotype, differential diagnosis and prognosis of sinonasal renal cell-like adenocarcinoma. Methods Retrospective analysis was performed on the cases of sinonasal carcinoma from August 2014 to December 2018 at Eye, Ear, Nose and Throat Hospital, Fudan University. Renal cell-like adenocarcinoma was screened for clinicopathologic feature analysis, and relevant literatures were reviewed. Results There were 460 cases of sinonasal carcinoma, among which 70 cases (15.2%) were adenocarcinoma, with five (1.1%) being renal cell-like adenocarcinomas. Four patients were male and one was female, with a mean age of 46.5 years (range 29-52 years). The main clinical manifestations were nasal obstruction and epistasis. A red polypoid mass was found under nasal endoscopy. Imaging showed nasal cavity and ethmoid sinus mass with invasion into surrounding structures and bone destruction. Microscopically, the tumor cells were arranged in nests, alveoli and microcapspecial subtype of low-grade non intestinal adenocarcinoma, with low incidence and inert biologic behavior. At present, most of the literatures are case reports. Before a diagnosis is made, other primary and metastatic clear cell tumors need to be excluded. Immunohistochemistry is helpful for diagnosis and differential diagnosis. Surgical resection is the mainstay of treatment, and may be supplemented by radiotherapy.Objective To investigate the diagnostic role of NR4A3/NOR-1 immunohistochemistry in acinic cell carcinoma (AciCC) of the salivary gland. Methods A total of 142 tumors were collected from 2004 to 2020 at Nanjing Jinling Hospital, including 24 cases of AciCCs, 12 salivary gland secretory carcinomas,14 salivary duct carcinomas,16 adenoid cystic carcinomas,3 basal cell carcinomas,13 mucoepidermoid carcinomas,7 myoepithelial carcinomas,15 pleomorphic adenomas,15 warthin tumor, 8 myoepithelioma,8 basal cell adenomas, and 7 oncocytomas; 28 normal salivary gland tissues and 2 pancreatic AciCC were also included. Results NR4A3/NOR-1,a nuclear marker,was positive in 91.7% (22/24) of AciCC of the salivary gland,while DOG1,a membranous and cytoplasmic marker, demonstrated a sensitivity of 95.8% (23/24);there was no significant difference in the overall positive rates(P=0.551), but the stain pattern was different. NR4A3/NOR-1 was negative in normal salivary gland tissues and any other types of tumors in the salivary gland; however,DOG1 showed apical staining in the acinar cells in the salivary gland,as well as salivary gland secretory carcinomas,adenoid cystic carcinomas,basal cell carcinomas,mucoepidermoid carcinomas,myoepithelial carcinomas and basal cell adenomas(P less then 0.001). NR4A3/NOR-1 showed a high sensitivity(91.7%) and specificity(100%) to identify AciCC of the salivary gland,and in combination with DOG1, the sensitivity increased to 100%. Furthermore, NR4A3/NOR-1 were only positive for AciCC arising from salivary glands but not pancreas(0/2)(P=0.018). Conclusion NR4A3/NOR-1 is a special and sensitive biomarker for AciCC of salivary glands; combined NR4A3/NOR-1 and DOG1 can be an ideal diagnostic immunohistochemical panel for AciCC.Objective To investigate the relationship between six common cytogenetic abnormalities and bone marrow pathomorphology in multiple myeloma (MM). Methods Bone marrow biopsy was performed on 151 newly-diagnosed MM patients. Meanwhile, myeloma cells were enriched by CD138 immunomagnetic beads, and then lq+, 13q-, 17p-, t(4;14), t (11;14), t (14;16) and other common genetic abnormalities were detected using interphase fluorescence in situ hybridization (FISH). The relationship between different genetic abnormalities and biopsy morphology was compared. Results Of the 151 patients, 15 had extramedullary infiltration (9.9%). The rate of cytogenetic abnormalities was 76.2% (115/151), of which 1q+ accounted for 49.7% (75/151), 13q-39.1% (59/151), 17p-8.6% (13/151), t(4;14) 21.2% (32/151), t(11;14) 19.2% (29/151), and t(14;16) 2.0% (3/151). The proliferation patterns of MM plasma cells were nodular (48.3%, 73/151), interstitial (33.8%, 51/151) and diffuse (17.9%, 27/151). The morphology of plasma cells was mainly mature type (58.3%, 88/151), followed by juvenile type (20.5%, 31/151), intermediate type (15.9%, 24/151) and plasmacyte type (5.3%, 8/151). According to the mSMART risk stratification system, the proliferation pattern of myeloma cells in the high-risk group was mainly diffuse type, and the morphology was mainly immature and plasmacyte type. In the middle-risk group, mature type myeloma cells were mainly nodular proliferating. In the low-risk and negative group, mature type myeloma cells were mainly interstitial proliferating. There was no difference in the probability of different proliferation modes of intermediate type plasma cells in each group. Conclusions The proliferation pattern and morphology of plasma cells in bone marrow biopsy combined with cytogenetic markers can more accurately predict the severity and prognosis of MM.Objective To investigate the clinicopathological features, diagnosis and prognosis of polymorphous low-grade neuroepithelial tumor of the young (PLNTY). Methods Two cases of PLNTY diagnosed during January 2016 to December 2019 were collected from Ningbo Diagnostic Pathology Center, Zhejiang, China. The clinical features, histopathological characteristics, immunohistochemical and molecular genetic findings were analyzed and the relevant literature was reviewed. Results The two patients were both female, at the ages of 14 and 25 years, respectively. Both patients presented with seizure attacks. The imaging study showed a mixed signal in the cerebral cortex, located in the occipital and temporal lobes, respectively. Microscopically, the tumors were characterized by the invariable presence of oligodendroglioma-like appearance, often with calcification. Immunohistochemically, the tumors were diffusely and intensely CD34 positive with ramified, CD34-expressing neural elements in regional cortex. The tumors were positive for GFAP, Olig2 and ATRX, and negative for IDH1, Neu N, nestin and EMA. The Ki-67 labeling index was less than 2%. The case number 2 harbored the BRAF V600E mutation, while the case number 1 was negative for both the BRAF V600E mutation and 1p/19q codeletion. Both patients recovered very well and were free of seizures after the following-up of 2 and 24 months, respectively. Conclusions PLNTY is an uncommon neuroepithelial tumor. Histopathologic and immunohistochemical examinations are necessary for establishing the diagnosis and for excluding oligodendroglioma. PLNTY should be considered as a benign tumor corresponding to WHO Grade I. The prognosis is overall good after complete tumor-resection.Objective To investigate the clinicopathological characteristics, immunophenotype, molecular genetic characteristics and prognosis of the metaplastic thymoma (MT). Methods The clinicopathological and follow-up data of five MT cases were collected at Fujian Provincial Hospital from 2008 to 2019. Immunohistochemical staining and MAML2 gene detection were performed, and the relevant literature was reviewed. Results There were 2 males and 3 females, aged 36-64 years (mean age 52 years). The tumors ranged 3.2-7.3 cm in the greatest diameter (average 5.1 cm).Microscopically, the tumor showed a biphasic pattern with epithelial cells merging gradually with the spindle cell component. The two areas transited to each other or had obvious boundary. Both components showed mild atypia. No mitosis was observed in either area, and a small number of lymphocytes were observed in the stroma. Immunohistochemical staining showed that epithelioid cells were positive for CKpan, p63 and E-cadherin. Spindle cells were positive for vimentin and EMA, while the Ki-67 index was less than 5%, and lymphocytes were negative for TdT. MAML2 gene apart signal was detected in two of the cases (2/4) that were tested by FISH. Conclusions MT is a low-grade malignant epithelioid thymic tumor. Its diagnosis and differential diagnosis are dependent on the morphological characteristics, immunohistochemical staining and MAML2 gene detection. The primary treatment option is surgical resection, with an overall good prognosis.Objective To establish an artificial intelligence (AI)-assisted diagnostic system for lung cancer via deep transfer learning. Methods The researchers collected 519 lung pathologic slides from 2016 to 2019, covering various lung tissues, including normal tissues, adenocarcinoma, squamous cell carcinoma and small cell carcinoma, from the Beijing Chest Hospital, the Capital Medical University. The slides were digitized by scanner, and 316 slides were used as training set and 203 as the internal test set. The researchers labeled all the training slides by pathologists and establish a semantic segmentation model based on DeepLab v3 with ResNet-50 to detect lung cancers at the pixel level. To perform transfer learning, the researchers utilized the gastric cancer detection model to initialize the deep neural network parameters. The lung cancer detection convolutional neural network was further trained by fine-tuning of the labeled data. The deep learning model was tested by 203 slides in the internal test set and 1 081 slides obtained from TCIA database, named as the external test set. Results The model trained with transfer learning showed substantial accuracy advantage against the one trained from scratch for the internal test set [area under curve (AUC) 0.988 vs. 0.971, Kappa 0.852 vs. 0.832]. For the external test set, the transferred model achieved an AUC of 0.968 and Kappa of 0.828, indicating superior generalization ability. By studying the predictions made by the model, the researchers obtained deeper understandings of the deep learning model. Conclusions The lung cancer histopathological diagnostic system achieves higher accuracy and superior generalization ability. With the development of histopathological AI, the transfer learning can effectively train diagnosis models and shorten the learning period, and improve the model performance.Objective To study the clinicopathological features and PD-L1 expression of microsatellite instability-high (MSI-H) gastric cancer. Methods The clinicopathological data of the 2 472 patients who had undergone radical surgical resection and been performed immunohistochemical staining of four major mismatch repair (MMR) proteins (MLH1, PMS2, MSH2 and MSH6) from March 2014 to December 2018 at Peking University Cancer Hospital were collected. One hundred and seventy-one patients showed mismatch repair-deficient (dMMR), and microsatellite instability of these patients were detected with polymerase chain reaction (PCR). Then, taken PCR results as the standard, PD-L1 was assessed using immunohistochemistry (IHC) in the MSI-H gastric cancers. Results MSI-H (vs. MSI-L) in gastric cancers was associated with female gender, advanced age, gastric-antrum location, intestinal type, lesion diameter exceeding 5 cm, absence of lymph node metastasis and positive PD-L1 expression (P less then 0.05, respectively). Combined positlesions.Objective To investigate the optimal experimental conditions (including antigen retrieval time, antibody titers and antibody incubation time) for reliable detection of programmed death-ligand 1 (PD-L1) expression using PD-L1 (22C3) antibody concentrate, and to establish a laboratory developed test for PD-L1 detection. Methods Using Dako PD-L1 IHC 22C3 pharmDX staining procedure and scoring guidelines as the standard reference (group A), the PD-L1 expression in 25 tissue specimens (including 15 lung cancer tissues, 5 tonsil tissues and 5 placenta tissues) was detected with Flex+/HRP detection kit (EnVision) under 8 different experimental conditions (groups B1 to B8). The staining results were then compared to those in group A. Results In group B1, 3 tissue samples showed the percentages of PD-L1 positive tumor cells were similar to those in group A, while the percentages of PD-L1 positive tumor cells were lower than those in group A in the other samples. In group B7, two case showed a positive rate higher thanin, incubation with EnVision Flex+Linker at room temperature for 30 min, incubation with EnVision/HRP at room temperature for 30 min and DAB staining for 5 min), which could provide reliable results at minimum costs.

Fibro-osseous lesions of the paranasal sinuses can present various clinical conditions. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features.

Radiologically confirmed BFOLs except osteoma cases were reviewed retrospectively between 1994 and 2016. We compared demographic data between the surgery and observation groups. Reason for image study, radiographic features, histopathology, and clinical course with serial image scans were analyzed.

A total of 183 subjects were selected from a thorough review of head and neck radiologic tests (n= 606,068) in a tertiary referral hospital over 22 years. The mean age was 28.6 ± 18.1 years, and 56.3% were males. Diagnostic image workup was performed in 55.7% of patients due to facial asymmetry, headache, skull mass, or other symptoms related to BFOLs. Other patients (37.7%) found BFOLs incidentally on a CT or MRI. The most common diagnosis was fibrous dysplament should be considered in symptomatic patients with aggressive clinical features. Regular observation and management are needed, particularly in younger patients in their teens.This study reports the optimization of culture conditions and medium components of M9, an endophytic strain of Bacillus amyloliquefaciens, which we had previously isolated from kiwifruit, and evaluation of its effect on kiwifruit postharvest protection against soft rot. The method of one-factor-at-a-time was used to determine the optimum culture conditions, and response surface methodology was applied to optimize the medium constituents. After optimization, a high rate of antifungal activity (73.12% decrease in decay rate) by M9 culture filtrate against the soft rot fungal pathogen, Botryosphaeria dothidea, was obtained. Compared with the initial culture conditions, the antifungal activity of M9 culture filtrate was increased by 19.5%. Furthermore, a postharvest storage experiment on kiwifruit showed that M9 culture filtrate could maintain the quality of stored kiwifruit, delay fruit senescence, and significantly enhance the storability of kiwifruit. Using liquid chromatography-mass spectrometry, we found thadvanced strategies for the postharvest protection of kiwifruits.

The structure provided by school settings even with no specific obesity-intervention may prevent weight gain. This meta-analytic study considered this premise by examining weight outcomes from control groups in published randomized controlled trials of school-year obesity-related interventions conducted in-school and out-of-school.

A systematic review and random-effects meta-analysis were conducted in accordance with Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases were systematically searched and resulted in 1976 unique citations, with 14 retained for analysis. Analyses examined the change in weight outcomes among control group participants.

For studies (N=6) reporting body mass index (BMI) (kg/m

) the overall standardized mean difference (SMD) from pre- to post-intervention was 0.085 (raw units 0.278 kg/m

); for studies (N=9) reporting zBMI, the SMD was 0.022 (0.020 z-scores), for studies (N=2) reporting waist circumference (cm), the SMD was 0.149 (1.609 cm); for studies (N=2) reporting BMI percentile, the SMD was 0.064 (0.985 percentiles); and for studies (N=1) reporting percent body fat, the SMD was 0.031 (0.30 percentage).

Children assigned to control conditions (as part of school-based obesity-related interventions) experience, on average, minimal changes in weight outcomes during the school year. Therefore, routine practices of schools may protect against unhealthy weight gains.

Children assigned to control conditions (as part of school-based obesity-related interventions) experience, on average, minimal changes in weight outcomes during the school year. Therefore, routine practices of schools may protect against unhealthy weight gains.

Addressing school violence is an important public health goal. To assess the role of school mental health curricula in violence prevention, we evaluated effects of an anti-stigma curriculum on violence victimization/perpetration.

An ethnically/socioeconomically diverse sample of 751 sixth-graders (mean age 11.5 years) across 14 schools in Texas were block-randomized by school (2011-2012) to receive singly or in combination (1) a mental illness anti-stigma curriculum; (2) contact with 2 young adults with mental illness; or (3) merged control (printed materials/no intervention). Pre- and post-test assessments were self-completed during health education classes; prior to randomization, 484 (64.5%) agreed to 2-year, home-based longitudinal assessments. Statistical models tested short- and long-term effects on physical, verbal, and relational/social violence victimization/perpetration.

At 1-month post-test, students who received the curriculum versus control made fewer verbal threats (p < .05). Those with high-level mental health symptoms in the curriculum group versus control used less violence overall and received fewer verbal threats from peers short-term (p < .05). Curriculum effects of reducing violence perpetration sustained long-term among adolescents with high-symptoms (p < .01). The comparator contact intervention was ineffective short- and long-term.

Implementing efficacious mental health curricula can serve as a multi-pronged strategy with anti-bulling efforts to prevent violence and improve mental health.

Implementing efficacious mental health curricula can serve as a multi-pronged strategy with anti-bulling efforts to prevent violence and improve mental health.The cellular defense pathway plays a key role in maintaining the homeostasis, tissues and organisms. Nuclear factor E2-related factor 2 (Nrf2), as a key cell signaling pathway, plays an important role in encoding detoxification enzymes and other stress response mediators. Recent studies have shown that it is closely related to the prevention and treatment of acute kidney injury (AKI). Therefore, this article reviews the protective effects of Nrf2-related signaling pathways on acute kidney injury, and summarizes the strategies of natural pharmaceutical ingredients such as flavonoids, alkaloids, terpenes, phenylpropionic acid, polyphenols, and polysaccharides to prevent and treat acute kidney injury. It is of great significance to further study the relationship between Nrf2 regulated signal pathway and kidney disease and the development of new medicines for acute kidney injury treatment. It can also provide new ideas and treatment strategies for clinical treatment of acute kidney injury. PRACTICAL APPLICATIONS This article reviewed the mechanisms by which the active ingredients of natural medicines slow down acute kidney injury through the Nrf2 pathway. It will help us to understand the regulatory role of the Nrf2 pathway in AKI more comprehensively, and provide a theoretical basis for further exploring the mechanism of more natural drugs to reduce acute kidney injury.

Choose Health Food, Fun, and Fitness (CHFFF) is aimed at 3rd to 6th graders, and uses experiential learning, food preparation, active games, goal setting, and a family newsletter to target behaviors shown to decrease childhood obesity and chronic disease risk. This study aimed to evaluate CHFFF as intended in low-income settings.

A quasi-experimental design with delayed intervention was used. CHFFF participants in 27 after-school and 28 in-school groups in 5 New York counties in 2014 to 2015 completed a self-report survey at initial enrollment, after a no-intervention control period, and after receiving CHFFF. Statistical analyses were based on 561 3rd to 6th graders who completed all 3 surveys and participated in at least 4 of the 6 lessons.

Compared to their control period, after receiving CHFFF, youth significantly improved in the following multi-item dietary scores overall dietary intake (p < .001), vegetable intake (p < .001), fruit intake (p < .01), soda/fast food intake (p < .05) and intent to consume soda/fast food (p < .001). Youth also reported reading Nutrition Facts labels and sharing about healthy eating with their family more often (both p < .001), and greater likelihood of having tried a new food (p < .001).

Results provide evidence for the effectiveness of this curriculum in improving self-reported child diet and related behaviors.

Results provide evidence for the effectiveness of this curriculum in improving self-reported child diet and related behaviors.

For youth between the ages of 10 and 24, suicide is the third leading cause of death, and results in approximately 4600 lives lost each year. Body weight status and bullying is associated with increase mental health disorders.

We analyzed data from the 2015 Youth Risk Behavior Survey, consisting of 15,506 students in grades 9-12. Logistic regression analysis was performed using STATA13 to estimate the independent association of perceived weight status and bullying experienced at school and electronically to suicidal behaviors measured as-considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt, after controlling for socio-demographics.

Considered suicide and attempted suicide were significantly associated with very overweight, slightly overweight, very underweight, and slightly underweight weight perceptions. Made suicide plan was significantly associated with slightly and very overweight perceptions. Injurious suicide attempt was significantly associated with very underweight or very overweight perceptions. Bullying, at school and electronically was significantly associated with all suicidal behaviors.

Examination of not just body weight status but body weight perceptions held by adolescent students, and the experience of not just in-person bullying but also electronic bullying on youth suicidal behaviors is crucial.

Examination of not just body weight status but body weight perceptions held by adolescent students, and the experience of not just in-person bullying but also electronic bullying on youth suicidal behaviors is crucial.Anxiety disorder is a common psychiatric disease. Roman chamomile as medicine or tea has long been used as a mild tranquilizer to reduce anxiety, but the mechanism is unclear. This research is based on network pharmacology combined with database mining to find the ingredients, action pathways and key targets of Roman chamomile for the treatment of anxiety. About 126 common targets related to chamomile and anxiety were obtained, and these targets were involved in 56 KEGG pathways. GEO screened LRRK2 as a key protein, and molecular docking showed that the protein could stably bind to drug components. Roman chamomile has the characteristics of multi-target and multi-pathway in the treatment of anxiety disorder. Its possible mechanism is to intervene anxiety disorder in the process of disease development, such as neuroactive ligand-receptor interaction, serotonin synapse, and cAMP signaling pathway. LRRK2 may be an important gene for Roman chamomile in the treatment of anxiety disorder. PRACTICAL APPLICATIONS Roman chamomile is well known for its use in medicine and tea making. It contains many nutrients, which can relieve people’s anxiety, help sleep, antibacterial and anti-inflammatory. In this article, through network pharmacology combined with Gene Expression Omnibus data mining and molecular docking, the target and mechanism of Roman chamomile in the treatment of anxiety were discussed, and its efficacy was verified by model animals, which not only clarified its mechanism at the systematic level, but also proved to be effective at the biological level. It provides a reference for the further development and utilization of Roman chamomile.Noble-metal nanocrystals with anisotropic shapes have received increasing interest owing to their unique properties. Here, a facile route to the preparation of Pt nanobars with aspect ratios tunable up to 2.1 was reported by simply reducing a PtIV precursor in N,N-dimethylformamide (DMF) at 160 °C in the presence of poly(vinyl pyrrolidone) (PVP). In addition to its commonly observed roles as a solvent and a reductant, DMF could also decompose to generate CO, a capping agent capable of selectively passivating Pt100 facets to promote the formation of nanobars. The size and aspect ratio of the nanobars could be tuned by varying the amount of PtIV precursor involved in the synthesis, as well as the concentration of PVP because of its dual roles as a stabilizer and a co-reductant. Our mechanistic study indicated that the anisotropic growth resulted from both particle coalescence and localized oxidative etching followed by preferential growth.To further investigate the preservation mechanisms of trypsin, the synergistic mechanisms of trypsin and stoma-related genes were evaluated in Hylocereus undatus. Trypsin significantly induced the stoma closure and improved the storage quality of H. undatus. Transcriptomic analyses of H. undatus revealed that important antioxidant signal pathway, such as SREBP signaling pathway, cellular response to H2 O2 or cellular response to molecule of bacterial origin, were induced; while responses to water deprivation were impeded by trypsin. These results indicated that trypsin relieved pitaya of pressure of water deprivation and exhibited the protection on pitaya during storage. Furthermore, the analyses of networks of protein-protein interaction suggested that OST1, HK5, AT4G27585, and HIR1 act as hubs of stoma-related proteins induced by trypsin during storage of H. undatus. PRACTICAL APPLICATIONS Preservation of fruit is becoming increasingly important to the world. Keep the balance of production and scavenging of reactive oxygen species is efficient to improve the storage quality of fruit. Trypsin had a novel superoxide anion scavenging activity and protect fruit cells from cellular injury induced by excess ROS. This article investigates the hub genes and interaction mechanisms of stoma closure induced by trypsin during the storage of H. undatus. The application of trypsin provides a new strategy for the quality control of fruit storage. Trypsin will have a broad market and development potential in the area of food additives.We discuss the study by McNamara et al., who report that low levels of antigen-specific antibodies in serum can limit the boosting of antibody and B-cell responses following immunization with live attenuated malaria sporozoites.

School districts participating in the US Child Nutrition program are required to have a wellness policy. Many state agencies provide model policies to aid districts in policy creation. However, use of model wellness policies has not been associated with higher quality policies. Therefore, the purpose of the present study was to assess the quality of model wellness policies and to determine if federal regulations are more likely to be included than evidence-based best practices.

Model wellness polices available through state agency websites were analyzed for comprehensiveness and strength using the WellSAT 3.0 and item status as a federal regulation or best practice was assigned. We used linear regression to determine if federal regulation status was associated with inclusion in model wellness policies.

Overall, 34 states had model wellness policies available online. The total comprehensiveness and strength of model wellness policies was 59.3 ± 17.5 and 21.4 ± 17.6, respectively, out of 100 possible points. Among policy sections, comprehensiveness was highest within Nutrition Education (73.2 ± 31.6) and lowest in Wellness Promotion and Marketing (49.8 ± 27.2). On average, WellSAT items that were federal regulations were covered in 71% of model policies, while best practices were only covered in 54% of model policies (p=.008).

There is a need to improve the quality of model wellness policies. The development of a uniform model policy may be warranted to provide a comprehensive list of federal regulations and best practices, written with strong language, for inclusion within school wellness policies.

There is a need to improve the quality of model wellness policies. The development of a uniform model policy may be warranted to provide a comprehensive list of federal regulations and best practices, written with strong language, for inclusion within school wellness policies.Cryoneurolysis, otherwise known as cryoanalgesia, is a process of addressing nerve-related pain via disruption of nerve conduction utilizing extreme cold temperatures. Throughout the literature, cryoneurolysis has been described for decades across various specialties. Within the past few years, a growing movement of its application within orthopedics has provided pain relief solutions in both the non-surgical and surgical space. A review of the literature utilizing multiple medical search engines was performed to identify relevant orthopedic articles related to the treatment of joint pain with cryoneurolysis or cryoanalgesia. A review of the cryoneurolysis, indications, efficacy, and treatment gaps within the literature were identified to provide guidance for future research.

 Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis.

 By comprehensive retrieval of literature published between 2000 and 2019, 53 reports were obtained with 187patients recruited into this study. The extracted data included patient characteristics, tumor characteristics, treatment, follow-up and outcomes. Statistical analyses applied were student t, Fisher exact and I

tests. Patients were devided into 6 groups according to treatment of choices transarterial chemoembolization (TACE), surgery, radiotherapy, chemotherapy, interventional treatment and supportive care.

 The overall survival rate of this cohort was 40.8 %. The survival rate of patients receiving TACE was 33.3 % and that of surgical patients was 41.9 %. The survival time of patients with TACE was longer than surgical patients, but lack of a statistical significance. Patients had a follow-up of 15.7 ± 16.6 (median 10) months. The patients receiving radiotherapy had the longest follow-up among all groups. Intra- and/or extrahepatic recurrence of hepatocellular carcinoma was the major morbidity. The mortality rates in a decremental sequence for patients receiving different treatments were supportive care > radiotherapy > surgery > TACE > interventional treatment. No difference was found in mortality between patients reported from case reports and those from non-case reports.

 Advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy. Based on the results of median survival time, radiotherapy and TACE seemed to be associated with an improved prognosis and possible better survival.

 Advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy. Based on the results of median survival time, radiotherapy and TACE seemed to be associated with an improved prognosis and possible better survival.

 Intramural pseudodiverticulosis of the esophagus (EIPD) is a rare disease leading to dysphagia, chest pain, and weight loss. The diagnosis is difficult, and the disease can be confounded with eosinophilic esophagitis (EoE). We present a patient with esophageal intramural pseudodiverticulosis and a literature review.

 The 45-year-old white caucasian woman with a history of nicotine and alcohol abuse had progressive hoarseness and severe dysphagia for solid food. Esophagogastroduodenoscopy (EGD) showed proximal esophageal stenosis, thrush esophagitis, and mucosal alteration with trachealization suspicious of EoE. However, repeated bouginage EGD and barium swallow revealed typical signs of esophageal intramural pseudodiverticulosis (EIPD). The patient was treated successfully by bougingage, acid suppression, and antifungal therapy. The literature analysis revealed the characteristics ofEIPD according to age, sex, risk factors, and therapy modalities.

 The case report and the literature overview suggest that EIPD can be confounded with EoE.

 The case report and the literature overview suggest that EIPD can be confounded with EoE.

Education for residents in surgery varies not only throughout the world, but also throughout Europe. Our clinic is well connected to Maastricht University Medical in Centre in the Netherlands (European Surgical Centre Aachen Maastricht). On the other hand, there are clear differences in resident programs. In the Netherlands, a structured feedback according to the OSATS concept (Objective Structured Assessment of Technical Skills) is mandatory after every operation performed by residents. The aim of the present study was to transfer the OSATS concept from Maastricht to Aachen and to evaluate the feasibility and benefits of this concept for surgical education.

The OSATS concept was implemented for 3 months in our clinic within a prospective clinical trial. Seven out of 10 residents that were working in our clinic at that time participated in the study (70%). Half of these were assigned to structured written feedback after every autonomously performed operation. Additionally, all participants performed strucidents in continuous education. It can easily be implemented in resident education in Germany. Structured, written feedback by senior physicians is perceived as beneficial by residents.We performed off-pump ascending-to-descending aortic grafting with the debranching of left carotid and subclavian arteries and total aortic arch transection in three patients. We have called this technique „Penza’s Surgical Maneuver” and propose it for a safe surgery in cases where the aortic arch, the aortic isthmus, the beginning segment of the descending aorta, the esophagus, and a lung are diseased.About one-tenth of patients with untreated chronic syphilis and tertiary syphilis develop structural complications involving the coronary ostia, ascending aorta, or aortic root. We describe a unique case of a large aortic root aneurysm of the noncoronary sinus with extrinsic compression of the right coronary artery, a complication of tertiary syphilis. Surgical intervention involved valve-sparing aortic root reconstruction with right coronary ostia reimplantation (hemi-Yacoub). The patient’s postoperative course was uneventful; he is healthy approximately 2 years later.We report an intricate aortic root replacement in a young male patient suffering from native valve infective endocarditis due to Serratia marcescens. Further complicating the total root replacement, there was an unknown infected aortic thrombus and a concomitant anomalous right coronary artery with an intramural course. As a result of our more aggressive approach, we believe that we lowered the risk of recurrent infection of the bioprosthesis of the aortic root.

 Stanford Type A aortic dissection repair surgery is associated with high mortality and clinical practice remains variable among hospitals. Few studies have examined statewide practice variation.

 Patients who had Stanford Type A aortic dissection repair surgery in Maryland between July 1, 2014 and June 30, 2018 were identified using the Maryland Cardiac Surgery Quality Initiative (MCSQI) database. Patient demographics, comorbidities, surgery details, and outcomes were compared between hospitals. We also explored the impact of arterial cannulation site and brain protection technique on outcome.

 A total of 233 patients were included from eight hospitals during the study period. Seventy-six percent of surgeries were done in two high-volume hospitals (≥10 cases per year), while the remaining 24% were done in low-volume hospitals. Operative mortality was 12.0% and varied between 0 and 25.0% depending on the hospital. Variables that differed significantly between hospitals included patient age, the percentacannulation site, and brain protection technique. Continued efforts are needed within MCSQI and nationally to evaluate and employ the best practices for patients having acute aortic dissection repair surgery.

 There remains considerable practice variation in Stanford Type A aortic dissection repair surgery within Maryland including some modifiable factors such as intraoperative blood transfusion, arterial cannulation site, and brain protection technique. Continued efforts are needed within MCSQI and nationally to evaluate and employ the best practices for patients having acute aortic dissection repair surgery.

 This study aims to determine the impact of institutional volume on mortality in reoperative proximal thoracic aortic surgery patients using national outcomes data.

 The Nationwide Inpatient Sample was queried from 1998 to 2011 for patients with diagnoses of thoracic aneurysm and/or dissection who underwent open mediastinal repair. A total of 103,860 patients were identified. A total of 1,430 patients had prior cardiac surgery. Patients were further stratified into groups by institutional aortic volume low (<12 cases/year), medium (12-39 cases/year), and high (40+ cases/year) volume. Multivariable risk-adjusted analysis accounting for emergent status and aortic dissection among other factors was performed to determine the impact of institutional volume on mortality.

 Overall mortality was 12% in the reoperative population. When the redo cohort was divided into tertiles, high-volume group had a 5% operative mortality compared with 9 and 15% for the medium- and low-volume groups, respectively. Multivariable analysis revealed that patients operated on at low- (odds ratio [OR] = 5.0, 95% confidence interval [CI] 2.6-9.6,

 < 0.001) and medium-volume centers (OR = 2.1, 95% CI 1.1-4.2,

 = 0.03) had higher odds of mortality when compared with patients operated on at high-volume centers.

 High-volume aortic centers can significantly reduce mortality for reoperative aortic surgery, compared with lower volume institutions.

 High-volume aortic centers can significantly reduce mortality for reoperative aortic surgery, compared with lower volume institutions.Endovascular treatment in thoracic aortic diseases has increased in use exponentially since Dake and colleagues first described the use of a home-made transluminal endovascular graft on 13 patients with descending thoracic aortic aneurysm at Stanford University in the early 1990s. Thoracic endovascular aneurysm repair (TEVAR) was initially developed for therapy in patients deemed unfit for open surgery. Innovations in endograft engineering design and popularization of endovascular techniques have transformed TEVAR to the predominant treatment choice in elective thoracic aortic repair. The number of TEVARs performed in the United States increased by 600% from 1998 to 2007, while the total number of thoracic aortic repairs increased by 60%. As larger multicenter trials and meta-analysis studies in the 2000s demonstrate the significant decrease in perioperative morbidity and mortality of TEVAR over open repair, TEVAR became incorporated into standard guidelines. The 2010 American consensus guidelines recommend TEVAR to be „strongly considered” when feasible for patients with degenerative or traumatic aneurysms of the descending thoracic aorta exceeding 5.5 cm, saccular aneurysms, or postoperative pseudoaneurysms. Nowadays, TEVAR is the predominant treatment for degenerative and traumatic descending thoracic aortic aneurysm repair. Although TEVAR has been shown to have decreased early morbidity and mortality compared with open surgical repair, endovascular manipulation of a diseased aorta with endovascular devices continues to have significant risks. Despite continued advancement in endovascular technique and devices since the first prospective trial examined the complications associated with TEVAR, common complications, two decades later, still include stroke, spinal cord ischemia, device failure, unintentional great vessel coverage, access site complications, and renal injury. In this article, we review common TEVAR complications with some corresponding radiographic imaging and their management.

 Chondrogenic tumors are the most frequent primary bone tumors. Malignant chondrogenic tumors represent about one quarter of malignant bone tumors. Benign chondrogenic bone tumors are frequent incidental findings at imaging. Radiological parameters may be helpful for identification, characterization, and differential diagnosis.

 Systematic PubMed literature research. Identification and review of studies analyzing and describing imaging characteristics of chondrogenic bone tumors.

 The 2020 World Health Organization (WHO) classification system differentiates between benign, intermediate (locally aggressive or rarely metastasizing), and malignant chondrogenic tumors. On imaging, typical findings of differentiated chondrogenic tumors are lobulated patterns with a high signal on T2-weighted magnetic resonance imaging (MRI) and ring- and arc-like calcifications on conventional radiography and computed tomography (CT). Depending on the entity, the prevalence of this chondrogenic pattern differs. While high grHerget GW, Füllgraf H et al. Chondrogenic Bone Tumors The Importance of Imaging Characteristics. Fortschr Röntgenstr 2021; 193 262 - 274.

 the ductus venosus (DV) is not well known in general radiology, but it plays a role in the daily work of pediatric radiologists. Consequently all general radiologists who also care for a pediatric department should be familiar with the physiological and pathological findings related to the DV.

Literature research in Medline, using the keywords „ductus venosus” and „umbilical vein catheter”.

 In the first weeks of life the DV is regularly still patent. It should be recognized as DV and not be mistaken for a pathological portosystemic shunt.The ductus venosus is the lead structure for umbilical vein catheters. Radiologists should be able to assess the correct catheter position. Radiologically important findings of an umbilical vein catheter are mainly malposition and intrahepatic extravasation. Agenesis of the DV can lead to intra- or extrahepatic compensatory portosystemic shunts, in which as well as in the case of persistent patency of the DV, there may be the necessity for radiological-interventional or surgical occlusion.

  · In the first weeks of life in infants the Ductus venosus is regularly still patent.. · The Ductus venosus should not be mistaken for a pathological portosystemic shunt.. · An umbilcal vein catheter should project onto the Ductus venosus and end caudal to the right atrium.. · Intrahepatic portosystemic shunts in DV agenesis show a high rate of spontaneous closure postnatally..

· Born M. The Ductus Venosus. Fortschr Röntgenstr 2020; DOI 10.1055/a-1275-0984.

· Born M. The Ductus Venosus. Fortschr Röntgenstr 2020; DOI 10.1055/a-1275-0984.

Up to now, the main focus of analysis has been on determinants of the application for and utilization of medical rehabilitation due to back pain. The prevalence and determinants of motivational and volitional preceding stages of the application have not yet been well examined. Therefore, this study analyses the prevalence and determinants of the wish for rehabilitation and the intention to apply.

Data were derived from the baseline survey of a cohort study including a sample of 45,000 persons randomly drawn from the statutory pension agencies (GPI North and GPI Central Germany). The baseline data of persons aged 45-59 years with back pain within the past 3 months, neither receiving disability pension nor medical rehabilitation during the past 4 years were analysed. Determinants of the wish for rehabilitation and the intention to apply were identified using multivariate logistic regression analyses.

2,348 of the 6,549 persons with back pain (36%) wished to participate in a rehabilitation program. Of thesterminants should be considered. The support by family and friends as well as physicians and therapists are important. This is a further indication that information and the involvement of these actors are key elements to ensure an acquired access to rehabilitation.

Up to now, there has been a lack of proactive approaches on the part of the rehabilitation providers, while simultaneously a suspected unmet rehabilitation need exists in some groups of insured persons. Therefore, the effectiveness of the invitation to a web-based self-test for rehabilitation needs as a new access route to medical rehabilitation was evaluated. The main question was whether the intervention leads to more approved rehabilitation applications in the follow-up period of 22 months and whether this effect is also apparent after controlling other influencing variables.

A randomized, controlled study with N=8000 insured persons of two regional statutory pension insurance agencies was conducted to check the effectiveness of the intervention. Insured persons of the intervention group (IG; n=4000) were informed by mail about the web-based self-test and received individual access data for it (user ID and PIN). The control group (CG; n=4000) received no information about the self-test. The primary oute rate of meaningful rehabilitation applications.

The medication adherence of people with chronic diseases is often deficient. The present study investigated facilitators and barriers of the implementation of prescribed medication among rehabilitants with cardiological diseases in medical rehabilitation.

In total, 22 rehabilitants with cardiological diseases in medical rehabilitation were interviewed by means of a guided interview. All interviews were digitally recorded and literally translated. The analysis of the interviews was software-based (MAXQDA 12) according to the comprehensive content-analytic approach of Mayring. The main categories (barriers/facilitators) were deductively and the subcategories inductively developed.

In total, 698 passages were coded in 22 documents, on average 32 per interview (SD=13.2, range 12-65). The 370 entries in the main category barriers are divided into 13 subcategories (e. g. carelessness, lack of information, reservations, burdens, forgetfulness). The 328 statements given in the main category facilitators could be allocated to 14 subcategories (e. g. individual strategies, knowledge, aids, patient insight into the necessity of treatment, communication).

The findings suggest that a lack of medication adherence can be improved, in particular through individualized multi-level barrier management.

The findings suggest that a lack of medication adherence can be improved, in particular through individualized multi-level barrier management.

Patients with inflammatory bowel diseases (IBD) are often impaired in their occupational participation and ability to work due to IBD-symptoms and complex psychosocial problems. The aim was to explore work-related problems and requested support of IBD-patients and to develop adequate occupational-oriented offers in rehabilitation with a multi-perspective approach.

Guided interviews with employed IBD-patients in medical rehabilitation at 2 measurement points (N=12), guided interviews with employed IBD-patients in specialist gastroenterological care (N=7), 4 focus group interviews with rehabilitation staff (N=27) and expert interviews (N=8) were conducted. The qualitative data have been examined in MAXQDA using content-structuring qualitative content analysis.

The 4 different interview groups report a similar spectrum of work-related problems and describe various somatic and psychosocial impairments in the working life of IBD-patients. Physical as well as cognitive impairments, fatigue, pain and psychosocial barriers, which are often associated with reduced productivity at work, are described.