The most common malignancy of the esophagus is squamous cell carcinoma (SCC) and regional lymph node metastases are an important prognostic factor. Isolated tumor cells (ITCs) are defined as single tumor cells or small clusters of tumor cells not exceeding 0.2 mm. The prognostic role of ITCs is not clear. This study aimed to determine the prevalence of ITCs in regional lymph nodes in patients with esophageal SCC and to investigate how frequently ITCs represent part of a true metastasis. Surgical specimens from 100 patients with SCC of the esophagus were included. All original H&E stained slides containing lymph nodes were reviewed by two gastrointestinal pathologists. In lymph nodes containing ITCs, additional levels were cut and stained with a H&E- and a cytokeratin stain. Areas of tumor cells that measured >0.2 mm on the deeper sections were classified as metastases. A total of 2460 lymph nodes were examined. ITCs were detected in 10 lymph nodes (0.4%) from nine patients (9%). Deeper sections revealed metastases in five out of the 10 lymph nodes (50%). ITCs in regional lymph nodes of patients with SCC of the esophagus is a rare finding compared with patients with adenocarcinoma of the esophagogastric junction. However, deeper sections often revealed metastases. Therefore, in patients with SCC of the esophagus, we recommend additional sectioning and immunohistochemical examination of lymph nodes when ITCs are detected on the first slide. The increasing salinity in soils and irrigation water is a major concern for growers of strawberry, a salt-sensitive horticultural crop. The hormone melatonin (N-acetyl-5-methoxytryptamine) is involved in many biological processes and affects plant responses to environmental stresses. The effects of weekly 100 and 200 μM melatonin sprays on leaf composition parameters (photosynthetic pigment and macronutrient concentrations, oxidative stress markers, antioxidant defense systems and abscisic acid concentrations), fruit yield and quality parameters (soluble solids, total acidity, ascorbic acid, total antioxidants and phenolics and sugars), and leaf and fruit melatonin have been studied in strawberry grown under non-saline, moderate and intense salinity conditions (0, 40 and 80 mM NaCl, respectively). Salinity led to decreases in yield, fruit quality parameters and leaf photosynthetic pigments and macronutrient concentrations, as well as to increases in oxidative stress, with melatonin foliar application alleviating all these changes. On the other hand, salinity led to increases in the leaf levels of antioxidant enzymes, abscisic acid and melatonin, with foliar applications of melatonin boosting those increases. In the absence of salinity stress, melatonin led to smaller changes in all parameters in the same direction to that observed in the presence of salinity. Furthermore, melatonin resulted in increases in strawberry fruit yield and quality, especially in plants grown under salinity. Results indicate that the effects of melatonin application are associated with a boost in leaf antioxidant enzymes and abscisic acid, and support that the application of melatonin is a promising tool for mitigating salt stress in strawberry. PURPOSE Assess outcomes of depression screening among adolescents accessing pediatric primary care-based services. These findings will contribute to development of clinical protocols for depression screening and intervention in primary care settings. DESIGN AND METHODS Retrospective chart review conducted via electronic medical records at a pediatric primary care-based clinic to extract PHQ-9 data for adolescents screened from 1/17/2018 to 4/18/2018. De-identified data included age, gender, ethnicity, provider, PHQ-9, and referral/follow-up/medication status. RESULTS Data included 1213 adolescents of whom N = 600 were depressed without additional comorbidities; 96 adolescents had PHQ-9 scores >5. Descriptive analyses by age, gender, ethnicity, referral type, follow-up, and provider services identified targeted primary care-based interventions for depression and referral. Depression screening occurred primarily at well child visits. 82.5% of those with PHQ-9 scores >5 were not currently receiving treatment. Overall, referrals by physicians (45.8%) and nurse practitioners (42.9%) were equivalent with more referrals for adolescents with moderate-severe depression. Nurse practitioners provided more counseling than physicians among adolescents with mild to moderate depression. CONCLUSIONS Adolescent mental health necessitates an enhanced continuum of care. Primary care-based interventions provided by pediatric nurse practitioners are imperative to address adolescent mental health needs. Findings provide practical means to incorporate protocols for depression enhancing primary care-based mental health access. PRACTICE IMPLICATIONS Need for incorporation of practical modalities for depression assessment and follow up as recommended by American Academy of Pediatrics. Future study for comparison of methods (phone/text reminder, follow up appointment, online resource reminder, telehealth), indicated to enhance follow-up care for adolescents experiencing depression.  https://www.selleckchem.com/products/liraglutide.html  Atriplex canescens is a C4 shrub with excellent adaptation to saline and arid environments. Our previous study showed that the secretion of excessive Na+ into leaf salt bladders is a primary strategy in salt tolerance of A. canescens and external 100 mM NaCl can substantially stimulate its growth. To investigate whether NaCl could facilitate Atriplex canescens response to drought stress, five-week-old seedlings were subjected to drought stress (30% of field water capacity) in the presence or absence of additional 100 mM NaCl. The results showed that, under drought stress, the addition of NaCl could substantially improve the growth of A. canescens by increasing leaf relative water content, enhancing photosynthetic activity and inducing a significant declined leaf osmotic potential (Ψs). The addition of NaCl significantly increased Na+ concentration in leaf salt bladders and the Na+ contribution to leaf Ψs, while had no adverse effects on K+ accumulation in leaf laminae. Therefore, the large accumulation of Na+ in salt bladders for enhancing osmotic adjustment (OA) ability is a vital strategy in A.