CONTEXT.— Various pulmonary diseases can produce centrilobular (peribronchiolar) fibrosis, which may be isolated or associated with other patterns of more diffuse fibrosis. The major forms of interstitial lung disease in which centrilobular fibrosis is found are fibrotic (chronic) hypersensitivity pneumonitis, connective tissue disease-associated interstitial lung disease, and (a disputed issue) usual interstitial pneumonia/idiopathic interstitial fibrosis. OBJECTIVE.— To review recent literature that addresses separation of these entities. DATA SOURCES.— Data comprised recent publications. CONCLUSIONS.— In a specially constructed multidisciplinary discussion exercise, it was found that peribronchiolar metaplasia affecting more than half the bronchioles or more than 2 foci of peribronchiolar metaplasia per square centimeter of biopsy area was strongly associated with a confident diagnosis of fibrotic hypersensitivity pneumonitis. Giant cells or granulomas were only found in cases with a greater than 50% diagnostic confidence in hypersensitivity pneumonitis. Conversely, greater numbers of fibroblast foci per square centimeter and increasing measured amounts of subpleural fibrosis favored a diagnosis of usual interstitial pneumonia. Recent data also suggest that centrilobular fibrosis can be found in usual interstitial pneumonia, although the presence of centrilobular fibrosis statistically favors an alternate diagnosis. Connective tissue disease is a major confounder because many patterns are very similar to fibrotic hypersensitivity pneumonitis or usual interstitial pneumonia. Genetic abnormalities, such as the MUC5B minor allele overlap, in these conditions and at this point cannot be used for discrimination. Thus, the separation of fibrotic hypersensitivity pneumonitis and usual interstitial pneumonia remains a difficult problem. Accurate biopsy diagnosis of all of these diseases requires correlation with imaging and clinical findings, and is crucial for treatment.CONTEXT.— The 5th edition of the World Health Organization classification of digestive system tumors discusses several advancements and developments in understanding the etiology, pathogenesis, and diagnosis of several digestive tract tumors. OBJECTIVE.— To provide a summary of the updates with a focus on neuroendocrine neoplasms, appendiceal tumors, and the molecular advances in tumors of the digestive system. DATA SOURCES.— English literature and personal experiences. CONCLUSIONS.— Some of the particularly important updates in the 5th edition are the alterations made in the classification of neuroendocrine neoplasms, understanding of pathogenesis of appendiceal tumors and their precursor lesions, and the expanded role of molecular pathology in establishing an accurate diagnosis or predicting prognosis and response to treatment.Although HER2-targeted therapy has been shown to prolong the survival of patients with HER2-positive breast cancer, most patients eventually progress due to drug resistance. Novel treatment options are urgently needed to overcome resistance to HER2-targeted therapy. The VEGF/VEGFR (Vascular endothelial growth factor and its receptors) pathway is essential in tumor angiogenesis, which may be a promising target in HER2-positive breast cancer providing a rationale for the use of tyrosine kinase inhibitors (TKIs) targeting VEGFR. Here, we present a case of a heavily pretreated advanced breast cancer patient who did not respond to HER2-targeted therapy and developed resistance to multiple lines of HER2-targeted treatment. The patient was treated with apatinib at a dose of 500 mg daily, and obtained partial remission (PR) with a progression-free-stage (PFS) of 6 months. Selleckchem IACS-13909 Our case indicates that apatinib might have anti-tumor activity in patients with HER2-positive breast cancer with HER2-targeted resistance. This case is of value which may provide new insights into strategies for HER2-targeted therapy resistance options in the clinic.Power training has been suggested to be effective to improve strength, power, and functional capacity in older adults. However, there is still a lack of systematic investigations reporting its effectiveness for muscle hypertrophy. Thus, this study investigated the effect of power training on muscle hypertrophy and compared its magnitude with traditional moderate-velocity resistance training in older adults. A systematic search was conducted to identify clinical trials investigating the effect of power training on muscle hypertrophy (power training vs. control), and/or comparing the effect of power training vs. moderate-velocity resistance training for a meta-analytical approach. Ten studies comparing power training to control conditions and nine studies comparing power training to moderate-velocity resistance training were selected. Three studies were classified as high quality and two were preregistered. The meta-analysis showed that power training was superior for muscle hypertrophy compared to control condition (n=8 studies; SMD=0.31; 95%CI=0.04, 0.58; p=0.029), and resulted in similar hypertrophy compared to moderate-velocity resistance training (n=7 studies; SMD=0.07; 95%CI=-0.18, 0.32; p=0.50). No significant heterogeneity was observed (p=0.46 and 0.54, and I2=0 and 0%, respectively). Our data suggest that power training is effective for muscle hypertrophy in older adults, with similar effectiveness as moderate-velocity resistance training. Novelty -It is known that power training might be superior to moderate-velocity resistance training for function improvements in older adults, but there was no meta-analysis investigating its effect on muscle hypertrophy. -Power training is effective to induce muscle hypertrophy in older adults to a similar extent to moderate-velocity resistance training.Objective To determine whether students who engage in a sedentary task in an urban park-like setting experience improved mood and whether this effect is moderated by mindfulness meditation. Participants 234 (133 females) undergraduate students, who either engaged in outdoor recreation frequently or infrequently. Methods Participants engaged in 20 minutes of mindfulness meditation or a control task, either in a campus park-like setting or in a quiet room indoors. Before and after the activity, total mood disturbance (TMD) was assessed with the Profile of Mood States Questionnaire. Results Being outside or meditating reduced TMD for those who frequently recreated outside. Those who infrequently recreated outside experienced decreased TMD if they meditated inside and increased TMD if they did not. When outside, TMD decreased regardless of activity. Conclusions Spending time outside and practicing meditation may be effective approaches for improving college students’ mental health, particularly for students who infrequently go outside.