The influence of mass media on countryside leisure visit behaviour compared to the influence of childhood socialization: a structural model of relationships.

Those involved with the management of the countryside have an imperative to understand the drivers of behaviour towards it. This is particularly so, since the UK population is largely urban-based and yet still retains an attachment to green open spaces and engagement with the pastoral scene (DEFRA, 2009; Natural England, 2016). The media has been recognised as playing an important role in sustaining this attachment but its relative influence compared to the role of the family, other social groups and education is less well understood in this context. The aim of this research is to provide a measure of the influences that underpin this attachment, specifically to develop a better understanding of the role of mass media as a component of the socializing factors which influence attitudes towards leisure behaviour in the countryside. The measurement and exploration of these influences is based upon a pilot study, followed by a survey of 2775 respondents, in six urban centres in England during 2011 and 2012. The data was analysed in order to investigate the relative role of developmental and mass media influences on countryside leisure behaviour. The cognitive and emotional processes that catalyse these relationships were also evaluated. A structural model of relationships was then developed, which provided predictive measures of the formative influences upon countryside leisure behaviour. Three key findings emerged from the research. The first confirmed that interest in countryside leisure may be derived from early socialization influences but significantly there are sub-groups for whom this early experience is irrelevant. These sub-groups developed their interest in countryside in later adulthood, inspired by the cultural discourse of rural themes represented in the media. Secondly the research identified that the relative influence of early exposure to countryside interests from family and friends is weaker than the direct effect of media on current countryside visit behaviour. Thirdly the predictive relationship suggests that countryside knowledge, the normative and control influences of others and the media, work largely through emotional rather than cognitive processes in their effect upon countryside visit behaviour. A further outcome of the research identified a control influence upon attitudes and engagement with the countryside, driven by pragmatic considerations of countryside as a resource for housing and infrastructure needs. The significant findings from this research make a contribution to knowledge regarding the processes that influence countryside leisure attitudes and behaviour. Specifically, it confirms the importance of developing media strategy that reflects the emotional bond that people have with the countryside and targeting robust market segments, differentiated by media responsiveness and developmental influences. An effective media strategy is particularly important for those sections of the population, who have had little encouragement to engage with the countryside during childhood but are, in adulthood, responsive to its portrayal in the media

Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusions: Clinical Features, Treatments and Prognosis

<div><p>To investigate the clinical characteristics, treatments and prognosis of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions (Xp11.2 tRCC), the epidemiological features and treatment results of 34 cases of Xp11.2 tRCC, which were diagnosed by immunohistochemistry staining of TFE3 and fluorescence in situ hybridization at our center, were retrospectively reviewed. The 34 patients included 21 females and 13 males aged 3 to 64 years (median age: 27 years). Four patients were children or adolescents (<18 years of age), and 26 patients were young or middle-aged adults (18–45 years). Radical nephrectomy was performed on 25 patients. Laparoscopic nephron-sparing surgery was performed on 9 patients who presented with an isolated mass with a small diameter (<7 cm) and well-defined boundary on computed tomography imaging. Postoperative staging showed that 25 cases (73.53%) were at stage I/II, while 9 cases (26.47%) were at stage III/IV. All stage I/II patients received a favorable prognosis with a three-year overall survival rate of 100%, including the patients who underwent laparoscopic nephron-sparing surgery. With the exception of 2 children, the other 7 stage III/IV patients died or developed recurrence with a median follow-up of 29 months. On univariate analysis, maximum diameter, adjuvant treatment, TNM stage, lymph node metastasis, inferior vena cava tumor thrombosis and tumor boundary were identified as statistically significant factors impacting survival (P<0.05). Multivariate analysis indicated that TNM stage and inferior vena cava tumor thrombosis were independent prognostic factors (P<0.05). In conclusion, Xp11.2 tRCC is a rare subtype of renal cell carcinoma that mainly occurs in young females. Nephron-sparing surgery was confirmed effective preliminarily in the treatment of small Xp11.2 tRCCs with clear rims. Advanced TNM stage and inferior vena cava tumor thrombosis were associated with poor prognosis.</p></div

Clinical data of 34 cases of Xp 11.2 tRCC.

<p>Clinical data of 34 cases of Xp 11.2 tRCC.</p

<i>PRCC-TFE3</i> dual-fusion FISH assay: A new method for identifying <i>PRCC-TFE3</i> renal cell carcinoma in paraffin-embedded tissue

<div><p><i>PRCC-TFE3</i> renal cell carcinoma (RCC) is one of the most common types of Xp11.2 translocation renal cell carcinoma (tRCC), of which the diagnosis mainly relies on reverse transcription-polymerase chain reaction (RT-PCR) or chromosomal analysis in fresh frozen samples. Herein, we developed a new dual-fusion fluorescence in situ hybridization (FISH) probe to succinctly identify <i>PRCC-TFE3</i> RCC in paraffin-embedded tissue. We immunohistochemically analyzed TFE3 and cathepsin K expression in 23 cases of Xp11.2 tRCC which had been confirmed by break-apart <i>TFE3</i> FISH probe. Next, the dual-fusion FISH assay was performed on these selected cases. Twenty typical cases of clear renal cell carcinoma and 20 cases of papillary renal cell carcinoma were collected as control groups. Seven cases were finally confirmed as <i>PRCC-TFE3</i> RCC by FISH detection, emerging dual-fusion signals, of which 2 cases were identified as <i>PRCC-TFE3</i> RCC by RT-PCR previously. All remaining cases were negative for the <i>PRCC-TFE3</i> rearrangement by FISH. The TFE3 immunohistochemistry was positive in 22/23 cases and the cathepsin K was positive in 16/23 cases. All 7 <i>PRCC-TFE3</i> RCCs showed positive cathepsin K immunoreactivity. Our results reveal that <i>PRCC-TFE3</i> dual-fusion FISH probe is an efficient and concise technique for diagnosing <i>PRCC-TFE3</i> RCC in paraffin-embedded tissue.</p></div

Images of microscopic morphology for <i>PRCC-TFE3</i> RCC.

<p><b>(A) Photomicrograph showed solid nested architecture composed of compactly arranged, eosinophilic cells (H&E,×100); (B) Tumor cells showed irregular nuclei, inconspicuous nucleoli, eosinophilic cytoplasm, and indistinct cell borders (H&E,×200); (C) Photomicrograph showed histopathology of neoplasm containing clear to eosinophilic cells with voluminous cytoplasm arranged in a papillary pattern(H&E,×100); (D) Photomicrograph showed acinar pattern composed of compactly arranged, clear to slightly eosinophilic cells, and a psammoma body(arrow)(H&E,×100);</b> RCC, renal cell carcinoma; H&E, hematoxylin and eosin.</p

Kaplan-Meier univariate analysis of prognostic factors for overall survival (OS) and progression-free survival (PFS).

<p>Kaplan-Meier univariate analysis of prognostic factors for overall survival (OS) and progression-free survival (PFS).</p

The data of clinicopathologic features, TFE3 and cathepsin K IHC, <i>PRCC-TFE3</i> FISH assay of <i>PRCC-TFE3</i> renal cell carcinomas.

<p>The data of clinicopathologic features, TFE3 and cathepsin K IHC, <i>PRCC-TFE3</i> FISH assay of <i>PRCC-TFE3</i> renal cell carcinomas.</p

Images of immunohistochemical staining for <i>PRCC-TFE3</i> RCC.

<p><b>(A) Strong nuclear immunostaining for TFE3 protein (×100); (B) The neoplastic cells showed diffuse cytoplasmic labeling for cathepsin K (×100).</b> RCC, renal cell carcinoma; TFE3, transcription factor E3; H&E, hematoxylin and eosin.</p

Images of the <i>PRCC-TFE3</i> Dual-Fusion FISH assay.

<p><b>(A) Photomicrograph showed a pair of split red signals and a green signal (negative result, red and green arrows) in each nucleus in male (×1000); (B) Photomicrograph showed a pair of split red signals and two split green signals (negative result, red and green arrows) in each nucleus in female (×1000); (C) A positive result included 2 fused and 1 red signals (yellow and red arrows) in each nucleus in male, indicating that <i>PRCC-TFE3</i> fusion genes have been formed (×1000); (D) A positive result of female patient showed 2 fused, 1 green and 1red signals (yellow, green and red arrows) in each nucleus (×1000).</b> FISH, fluorescence in situ hybridization.</p

Multivariate Cox regression analyses of progression-free survival.

<p>Multivariate Cox regression analyses of progression-free survival.</p