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OBJECTIVES To better characterize the clinicopathologic presentation and outcomes of follicular lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double-hit and triple-hit follicular lymphoma), we present three cases from our institution and perform a literature review of 37 published cases. METHODS Cases were identified using institutional SoftPath software and the MEDLINE database via the PubMed search engine. Clinical and pathologic data were collected with subsequent stratification by histologic grade and treatment for comparison. RESULTS Similar to classic follicular lymphoma, patients presented most often with low-grade (1-2) but high-stage (III-IV) disease with absence of B symptoms; however, overall survival was worse than that of traditional follicular lymphoma. In a small sample size, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R) achieved better outcomes than a regimen of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Specific pathologic features that might prompt testing for MYC rearrangement include elevated proliferation index out of proportion to cytology and aggressive features such as angioinvasion. CONCLUSIONS Double-hit and triple-hit follicular lymphoma may be better classified as a distinct entity from classical follicular lymphoma with a worse prognosis. Aggressive therapy with a treatment regimen used for high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements might be beneficial, but more evidence is needed to justify aggressive treatment as standard of care. © American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.BACKGROUND Spinal cord injury (SCI) is a serious nervous system injury, causing extremely low quality of life and immensurable economic losses. However, there is few therapies that can effectively cure the injury. The goal of the present study was to explore the potential therapeutic effects of dihydrotanshinone I (DI) for SCI and the involving mechanism. MATERIAL AND METHODS A SCI rat model was structured to investigate the effects of DI on recovery of SCI. Tarlov’s scale was employed to assess the neuronal function and histopathological examination was carried out by hematoxylin and eosin staining. In addition, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-1ß, inducible nitric oxide synthase (iNOS), total oxidant status (TOS) and total antioxidant status (TAS) levels were detected. Tunel assay and western blot analysis were performed to evaluate cell apoptosis. Furthermore, western blot assay was used to measure the protein expressions. RESULTS The results demonstrated that the treatment of DI alleviated the pathological damage induced by SCI and promoted the neuronal functional recovery. DI suppressed TNF-alpha, IL-1ß, IL-6, iNOS, and TOS levels while improved the TAS level. Moreover, increased cell apoptosis in SCI rats was inhibited by administration of DI. Most importantly, DI reserved the soaring of TLR4, MyD88, HMGB1, and NOX4 level after induction of SCI. Thus, the observation revealed that the HMGB1/TLR4/NOX4 pathway may be involved in the protective effects of DI on SCI. CONCLUSIONS In conclusion, the findings suggest that DI alleviates SCI by restraining secretion of inflammatory factors, and occurrence of oxidative stress and apoptosis in vivo. DI may be developed into an effective alternative therapy for SCI in clinic.Although Nepal is a country rich in natural beauty, along with an abundance of natural resources, the children of this diverse nation still face several serious health issues arising from their own environment (water pollution, air pollution, chemical pollution, solid waste issues and drainage issues). Nepal also ranks as a highly vulnerable country to the adverse impacts of climate change. Children are more vulnerable to various infections for immunological, physiological and social reasons. this website Their inherent immunity diminishes within months after birth. There are risk factors for the development of various diseases, e.g. unsafe drinking water and lack of sanitation, which contribute to diarrheal diseases, trachoma, hookworm and amoebic dysentery; another risk factor is indoor air pollution. The infant mortality rate (IMR) is higher in rural areas with 55 per 1000 live births, compared to urban areas with 38 per 1000 live births. Likewise, the under-5-year-old mortality rate (MR) in rural areas is 64 and that ization (WHO) air quality guidelines, which poses a serious health risk to hundreds of thousands of Nepalese people 133 out of 1,000,000 deaths each year are related to air pollution. Dramatically, Kathmandu city is a silent killer to walk around due to air pollution, and its air quality is ranked as the worst out of 180 countries, according to the 2018 Environmental Performance Index. However, insufficient studies have been conducted to explore children’s environmental health issues. It is therefore essential to carry out more scientific studies to explore the issues of children’s environmental health as environmental health problems in children are serious in the Nepalese context.Background Informed by the person-environment transactional model of stress, the purpose of the study was to explore the relationships of environment-related moral distress and person-related anxious and avoidant adult attachment insecurities, and personality proneness to guilt and shame with burnout in neonatal intensive care unit (NICU) nurses. Methods This was a multicenter cross-sectional self-report questionnaire cohort study comprising 142 NICU nurses currently working on six Level 3-4 NICUs in New South Wales, Australia. Results Burnout was reported by 37% of NICU nurses. Moral distress, anxious and avoidant attachment, and guilt- and shame-proneness had moderate-large zero-order correlations with burnout. Overall, these predictor variables explained 40% of the variance in burnout. Moral distress (β = 0.40, P  less then  0.001), anxious attachment (β = 0.18, P  less then  0.05) and shame-proneness (β = 0.22, P  less then  0.01) were unique predictors of burnout. Shame-proneness partially mediated the effect of anxious attachment on burnout [indirect effect, B = 0.