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31.
Acinar cell carcinoma (ACC) is a rare pancreatic malignancy with distinctive clinical, molecular, and morphological features. The long-term survival of ACC patients is substantially superior to that of pancreatic adenocarcinoma patients. As there are no significant patient series about ACCs, our understanding of this illness is mainly based on case reports and limited patient series. Surgical resection is the treatment of choice for patients with the disease restricted to one organ; however, with recent breakthroughs in precision medicine, medicines targeting the one-of-a-kind molecular profile of ACC are on the horizon. There are no standard treatment protocols available for people in which a total surgical resection to cure the condition is not possible. As a result of shared genetic alterations, ACCs are chemosensitive to agents with activity against pancreatic adenocarcinomas and colorectal carcinomas. The role of neoadjuvant or adjuvant chemoradiotherapy has not been established. This article aims to do a comprehensive literature study and present the most recent information on acinar cell cancer.  相似文献   
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Depression is a significant public health problem for young adults of college age, and negative life events exacerbate risk. Not all individuals who experience negative life events, however, report depressive symptoms, perhaps owing to protective characteristics. We examined one such characteristic, trait hope, a goal‐oriented construct, as a potential moderator of the association between negative life events and depressive symptoms in an ethnically diverse sample of 386 college students. In support of our hypotheses, negative life events were significantly associated with greater levels of depressive symptoms, and higher levels of hope attenuated this relationship, such that those with greater hope reported fewer depressive symptoms related to potentially traumatic events. The moderating effect of hope did not differ across ethnic groups. Our findings have implications for managing the sequelae of negative life events, including depression. Cognitive–behavioural interventions tailored to help young adults identify and attain important life goals might help to overcome psychopathology associated with life stress. Copyright © 2012 John Wiley & Sons, Ltd.  相似文献   
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ABSTRACT: BACKGROUND: Introducing a new method into family planning programs requires careful attention to ensure it meets an actual need and has a positive effect on program goals. The Standard Days Method(R) is a fertility awareness-based method of family planning that is being introduced into family planning programs in countries around the world. It is different from other methods offered by programs, and may bring new couples into family planning, and increase contraceptive prevalence. The study assesses the effect on contraceptive use and prevalence of Introducing Standard Days Method into existing family planning services in whole regions of India, Peru, and Rwanda. METHODS: In collaboration with the Ministry of Health, health providers were given a contraceptive update on all methods, then trained in counseling on Standard Days Method. Efforts were made to promote demand in the context of informed choice. Routine monthly service statistics in control and intervention areas were used to assess the effect of Standard Days Method introduction at the clinic level; baseline and endline household-based surveys were undertaken to obtain results at the community level (n > 3400 women at endline). RESULTS: Demand for the method is evident in countries with different levels of contraceptive prevalence. The method attracts couples new to family planning, and introducing it into services may increase overall contraceptive prevalence. CONCLUSIONS: Introducing Standard Days Method into existing family planning has the potential of benefiting men and women in diverse settings and populations. This study illustrates the critical role of evidence in scaling up a health innovation.  相似文献   
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