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Extant research has yet to uncover whether cultural differences exist in reactions to family member illness and how observed differences may be explained theoretically. The current project examines the impact of cultural worldview on health assessment and behavior—using inclusive measures capturing a range of health promoting activities—when a family member is ill. Following two phases of study, grounded in Markus and Kitayama’s (1991) conjectures about self-construal and culture, results point to a relationship of interdependent construals of self and helping behavior as a form of health promotion in the context of a family illness. In light of research emphasizing the role of culture in motivating altruistic and relationship concerns, we propose two mechanisms through which the relationship among interdependent self-construal, family illness, and prosocial behavior can be explained.

Background Ancillary molecular testing has been recommended for thyroid fine-needle aspirates (FNA) with indeterminate cytologic diagnoses. Rosetta Genomics and Interpace Diagnostics have developed assays that can utilize direct smears as the testing substrate. Methods A retrospective study of indeterminate thyroid FNAs with known histologic follow-up was performed. One Diff-Quik-stained smear and one Papanicolaou-stained smear with similar cellularity (at least 60-100 lesional cells) from each case were sent to Rosetta and Interpace, respectively, for analysis. The results were directly compared and correlated with the final histopathology. Neither company was aware of the follow-up histologic findings in these cases. Results A total of 10 thyroid FNAs were identified from our 2015 files. The cytologic diagnoses included follicular lesion of undetermined significance (FLUS, n = 5), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN, n = 4), and suspicious for malignancy (SM, n = 1). Of the seven cases with benign histology, six smears were classified as benign by the RosettaGX microRNA classifier, and one case was designated as suspicious. Five cases were negative by both ThyGenX oncogene panel and ThyraMIR microRNA classifier. One case was negative by ThyGenX and positive on follow-up ThyraMIR, and one case was positive for KRAS mutation and positive on ThyraMIR. Both the RosettaGX and ThyGenX/ThyraMIR tests demonstrated positive results for the three histologically malignant cases. Conclusion This study demonstrates that two molecular testing platforms performed equally well using our stained direct smears. Both molecular tests revealed a 100% negative predictive rate. RosettaGX showed a 75% positive predictive value in comparison to 60% for ThyGenX/ThyraMIR.

Distributed generation has many potential benefits including use of renewable resources, increased customer participation, and decreased losses. However, as the penetration of distributed renewable energy sources increases, the technical challenges of integrating these resources into the power system increase as well. One such challenge is the rapid variation of voltages along distribution feeders in response to photovoltaic (PV) output fluctuations, and the reactive power capability of PV inverters can be used to address this challenge. A method of achieving optimal expected performance with respect to a figure of merit of interest to the distribution system operator while maintaining appropriate system voltage magnitudes and considering the uncertainty of PV power injections is proposed. The method utilises reactive power injection both to improve system performance and to compensate for variations in active power injection. It requires infrequent communication between the distribution system operator and the PV inverters and bases its decisions on short-term forecasts, formulating voltage magnitude requirements as chance constraints. The proposed method is validated using the IEEE 123-node radial distribution test feeder and shown to improve the distribution system performance (with respect to existing methods) and maintain suitable voltages.

In this work, quartz crystal microbalance with dissipation (QCM-D) was employed to study the kinetic processes involved in the interaction of proteins with self-assembled monolayers (SAMs) of multimodal (MM) ligands. SAMs were fabricated to mimic two chromatographic multimodal resins with varying accessibility of the aromatic moiety to provide a well-defined model system. Kinetic parameters were determined for two different proteins in the presence of the arginine and guanidine and a comparison was made with chromatographic retention data. The results indicated that the accessibility of the ligand's aromatic moiety can have an important impact on the kinetics and chromatographic retention behavior. Interestingly, arginine and guanidine had very different effects on the protein adsorption and desorption kinetics in these MM systems. For cytochrome C, arginine resulted in a significant decrease and increase in the adsorption and desorption rates, respectively, while guanidine produced a dramatic increase in the desorption rate, with minimal effect on the adsorption rate. In addition, at different concentrations of arginine, two distinct kinetic scenarios were observed. For α-chymotrypsin, the presence of 0.1 M guanidine in the aromatic exposed ligand system produced an increase in the adsorption rate and only a moderate increase in the desorption rate, which helped to explain the surprising increase in the chromatographic salt elution concentration. These results demonstrate that protein adsorption kinetics in the presence of different mobile phase modifiers and MM ligand chemistries can play an important role in contributing to selectivity in MM chromatography.

Introduction/Objective SMARCA4-deficient thoracic sarcoma/carcinoma is a highly aggressive neoplasm characterized by SMARCA4 (chromatin remodeling complex) deficiency. It affects mostly smokers (85%) with a broad age range of presentation (mean age: 50 years). Most patients present with advanced disease and extensive involvement of thoracic structures. The cytomorphologic features of this entity have not been fully described. Methods/Case Report A 59-year-old female, former smoker, with a prior history of lung adenocarcinoma, presented with a new 2.8 cm right infrahilar nodule concerning for recurrence. The second patient, a 54-year-old male who is a smoker, presented with an 8.0 cm right perihilar mass extending into the right lung and mediastinum with encasement of the right main pulmonary artery. Cytologically, the smears from both aspirates were comprised of single cells and loosely cohesive clusters of ovoid to spindle cells with scant to moderate cytoplasm, stippled chromatin, and focally prominent nucleoli. Numerous mitotic figures were appreciated. Necrosis was present within the smear background. The cell block sections showed tumor cells arranged in glandular and focal papillary architecture with a myxoid background. In one case, intermediate to large-sized cells with focal cytoplasmic clearing and patchy extracellular metachromatic material were also noted. Rhabdoid morphology was not appreciated. Immunohistochemically, the tumor cells were at least focally positive for vimentin, TLE-1, SALL4, CK AE1/AE3 and TTF-1, while being negative for CK7, CK20, Napsin-A, SOX-10, p40 and neuroendocrine markers. Both tumors showed SMARCA4 (BRG1) loss of expression. Results (if a Case Study enter NA) N/A Conclusion While the cytomorphologic findings of SMARCA4-deficient thoracic sarcomas/carcinomas are not specific, the FNA diagnosis should be considered for any poorly differentiated neoplasm involving the lungs or mediastinum which should prompt an appropriate immunocytochemical work-up that includes SMARCA4/BRG1 assessment

Introduction/Objective Thyroid carcinoma showing thymus-like differentiation also known as intrathyroidal thymic carcinoma is a rare thyroid neoplasm arising from either an ectopic intrathyroidal thymic tissue or from remnants of thymobranchial pouches. On fine needle aspiration (FNA) its diagnosis can be challenging due to overlapping morphologic features with other aggressive thyroid carcinomas. Methods/Case Report A 31-year-old female consulted for 6-month history of neck swelling and tenderness. Thyroid ultrasound demonstrated a 2.6 x 2.5 x 2.1 cm nodule in the right lobe with punctate calcifications. FNA showed cellular smears composed of loosely cohesive and single basaloid neoplastic cells exhibiting significant cellular and nuclear pleomorphism. Focal squamous differentiation with keratinization was noted on the cell block sections. Immunocytochemical stains showed that the tumor was positive for cytokeratin AE1/AE3, p40, p63, CD117 and CD5 consistent with intrathyroidal thymic carcinoma. The Ki67 proliferative index was approximately 40%. A right thyroidectomy with central neck dissection confirmed the diagnosis and showed a 3.0 cm tumor with invasion into skeletal muscle, lymphovascular invasion and positive lymph nodes. The patient completed adjuvant radiotherapy and remain in remission at 3-months follow-up. Results (if a Case Study enter NA) NA Conclusion Intrathyroidal thymic carcinoma is a rare thyroid neoplasm that frequently shows squamous differentiation and therefore overlaps with papillary thyroid carcinoma with squamous morulae, squamous cell carcinoma and anaplastic carcinoma. The coexpression of squamous markers together with CD5 and CD117 allows the recognition of CASTLE on FNA samples.

Brushless excitation systems are widely used for synchronous machines. As a critical part of the system, rotating rectifiers have a significant impact on the system behavior. This paper presents a numerical average-value model (AVM) for rotating rectifiers in brushless excitation systems, where the essential numerical functions are extracted from the detailed simulations and vary depending on the loading conditions. Open-circuit voltages of the brushless exciter armature are used to calculate the dynamic impedance that represents the loading condition. The model is validated by comparison with an experimentally validated detailed model of the brushless excitation system in three distinct cases. It has been demonstrated that the proposed AVM can provide accurate simulations in both transient and steady states with fewer time steps and less runtime compared with detailed models of such systems and that the proposed AVM can be combined with AVM models of other rectifiers in the system to reduce the overall computational cost.

During stainless steel production, new chromium units are obtained from ferrochrome, a relatively crude alloy produced from chromite ore. Large chromite reserves have recently been discovered in the so-called Ring of Fire, Canada. Due to the strategic importance of uninterrupted stainless steel production in North America, it is highly likely that these reserves will be exploited in the foreseeable future. However, the Ring of Fire is located in an area that forms part of the largest peatland in the world, as well as the traditional territories of several First Nations (indigenous American communities), which highlights the environmental and social sensitive nature of the intended developments. In this review, relevant mining and/or smelting processes were considered within the context of possible prevention and mitigation of hexavalent chromium, Cr(VI), formation, and the treatment of possible Cr(VI) containing waste materials. Cr(VI) is classified as a carcinogen and it has several negative environmental impacts. Prior to commencing chromite mining in the Ring of Fire, baseline studies should be undertaken to determine the possible natural occurrence of Cr(VI) in soils, untreated chromite ore and surface/groundwater, as well as sources thereof. During mining and ore processing, dry milling was identified as the only process step with the potential to generate Cr(VI); therefore, it should be avoided. Instead, wet milling should be used. Assessments of all process steps associated with conventional ferrochrome production indicated that smelting will lead to the formation of unintended small amounts of Cr(VI) (mg.kg −1 concentration range), irrespective of the technology applied. However, this review proved that it will be possible to produce ferrochrome without causing occupational/community health issues related to Cr(VI), as well as environmental pollution, if appropriate preventative and mitigation measures are applied. Apart from Cr(VI) related considerations, it is acknowledged that factors such as physical and chemical characteristics of the ore, capital and operational costs, specific electricity consumption, carbon footprint, and availability of expertise will determine what process options will be implemented.

Background Fine needle aspiration (FNA) is considered an excellent technique for documenting metastatic neuroendocrine tumors (NETs). This study aims to evaluate the accuracy of FNA in diagnosing metastatic NETs to the liver and determining the grade and origin of these metastases. Methods Our laboratory information system was searched from 1997 to 2016 to identify all cases of metastatic NETs to the liver that were sampled by FNA. The cytopathology and surgical pathology reports as well as the patients' electronic medical records were reviewed. The cytohistologic type and grade of the metastatic NETs, as well as the site of the patient's primary were recorded. Results High-grade NETs, including small cell and poorly differentiated neuroendocrine carcinomas, constituted 62% (167/271) of the cases, while low-grade NETs, including well differentiated NET (grade1 and grade 2), pheochromocytomas, paragangliomas, and carcinoid tumors of lung, constituted 38% (104/271) of cases. The most common diagnosis was metastatic small cell carcinoma accounting for 45% (122/271) of cases. The most common primary sites were lung (44%; 119/271) followed by pancreas (19%; 51/271). The FNA diagnosis was confirmed by histopathology in 121 cases that had a concurrent biopsies or resection specimens. Conclusions FNA is an accurate method for diagnosing metastatic NETs to the liver. There were significantly more high-grade (62%) than low-grade (38%) metastatic NETs to the liver. In our practice, lung (44%) and pancreas (19%) were the most common primary sites of metastatic NETs involving the liver. In 16% of the cases, a primary site could not be established.

In this paper, a simulation tool was employed to identify and appropriately incorporate differences between MiniColumns and benchtop column systems. It was first demonstrated that including multi-step gradients and fraction collection into the simulations resulted in improved agreement between simulated and experimental linear gradient profiles as well as calculated first moments in the MiniColumn experiments. Step elution experiments of binary mixtures (a monoclonal antibody and one of three model proteins) were then carried out to examine comparability of the MiniColumns to the benchtop system. Although the peak shapes were qualitatively similar, peak elution began earlier in the MiniColumn system while improved separation was observed between overlapping peaks using the benchtop format. Simulations were then carried out to demonstrate that increased dispersion of the eluent breakthrough in the benchtop system could readily explain these observed differences. Importantly, by incorporating these system differences into the simulations, we were able to predict benchtop step elution performance using the parameters solely obtained from the MiniColumns. The findings presented in this paper illustrate that the appropriate consideration of system differences can facilitate the implementation of miniature chromatography columns as scale-down models for bioprocess development.

Multimodal (MM) chromatography provides a powerful means to enhance the selectivity of protein separations by taking advantage of multiple weak interactions that include electrostatic, hydrophobic and van der Waals interactions. In order to increase our understanding of such phenomena, a computationally efficient approach was developed that combines short molecular dynamics simulations and continuum solvent based coarse-grained free energy calculations in order to study the binding of proteins to Self Assembled Monolayers (SAM) presenting MM ligands. Using this method, the free energies of protein-MM SAM binding over a range of incident orientations of the protein can be determined. The resulting free energies were then examined to identify the more "strongly bound" orientations of different proteins with two multimodal surfaces. The overall free energy of protein-MM surface binding was then determined and correlated to retention factors from isocratic chromatography. This correlation, combined with analytical expressions from the literature, was then employed to predict protein gradient elution salt concentrations as well as selectivity reversals with different MM resin systems. Patches on protein surfaces that interacted strongly with MM surfaces were also identified by determining the frequency of heavy atom contacts with the atoms of the MM SAMs. A comparison of these patches to Electrostatic Potential and hydrophobicity maps indicated that while all of these patches contained significant positive charge, only the highest frequency sites also possessed hydrophobicity. The ability to identify key binding patches on proteins may have significant impact on process development for the separation of bioproduct related impurities.

Cutaneous injuries due to industrial high-pressure paint guns are well-documented in the literature; however, the histologic characteristics are uncommonly described, and facial involvement has not been previously reported. Histopathologic features of paint gun injuries vary depending on the time since injection and type of material. Early lesions display an acute neutrophilic infiltrate, edema, and thrombosis, with varying degrees of skin, fat, and muscle necrosis. More developed lesions (120-192 hours after injury) have prominent histiocytes and fibrosis around necrotic foci, possibly with the pitfall of muscle regenerative giant cells that could be mistaken for sarcoma. Continuing inflammation, swelling, and resultant vascular compression could explain ongoing necrosis months after the accident. The histopathologic differential diagnosis in the absence of clinical history includes paint in an abrasion, foreign body reaction to tattoo, giant cell tumor of tendon sheath, and various neoplasms. If available, radiologic studies can substitute for clinical photographs to indicate the extent of injury. The radiologic differential, uninformed by history, may include calcific periarthritis, gouty tophus, and tumoral calcinosis. Seven cases of injury due to high-velocity paint guns are presented with 4 additional cases mimicking paint gun injury and with review of the literature.

The effect of EUS-guided pancreatic cyst ablation (PCA) on sonographic morphology and cyst fluid cytology is unknown. The aim of this study was to evaluate morphologic, cytologic, and change in cyst fluid DNA after PCA.In a prospective single-center study, consecutive patients with suspected benign 10- to 50-mm pancreatic cysts underwent baseline EUS-FNA and EUS-PCA followed 2 to 3 months later by repeat EUS, cyst fluid analysis, and possible repeat PCA. Surveillance imaging after ablation was performed at least annually and classified as complete response (CR), partial response, or persistent, with 5%, 5% to 25%, and 25% of the original cyst volume, respectively.Thirty-six patients underwent EUS-PCA with ethanol alone (n = 8) or ethanol and paclitaxel (n = 28), and CR occurred in 19 patients (56%). After EUS-PCA, EUS showed an increase in wall diameter in 68%, decreased number of septations in 24%, increased debris in 24%, loss of mural nodule or novel calcification in 21%, and alteration of fluid viscosity in 48%. Follow-up cytology showed increased epithelial cellularity in 27%, loss or decreased cellular atypia in 15%, increased or appearance of macrophages in 24%, and inflammatory cells in 15%. Postablation DNA amount increased and quality decreased in 71% each. Between the CR and non-CR patients, there was no significant difference in frequency of sonographic or cytologic features. In the CR group, mean DNA quantity was significantly increased after ablation (P = .023) without a change in quality (P = .136).EUS-PCA induces morphologic and cytologic changes of pancreatic cysts, none of which appears to predict overall imaging-defined response to ablation. (Clinical trial registration numbers: NCT00233038 and NCT01643460.).

Recent studies have shown that by combining orthogonal, non-affinity chromatography steps, it is possible to rapidly develop efficient purification processes for molecules of interest. Here, we build upon previous work to develop a flexible framework for identifying resins that remove optimally orthogonal sets of impurities for a wide variety of products. Our approach involves screening a library of proteins with diverse properties (pI ranging from 5.0–11.4 and varying hydrophobicity measured by retention in a HIC gradient) on a library of resins and quantifying each resin’s ability to separate every protein pair in the library. Orthogonality is then defined as the degree to which two resins separate mutually exclusive sets of protein pairs. We applied this approach to a library of model proteins and a series of strong, salt tolerant, and multimodal ion exchangers and evaluated which resin combinations performed well and which performed poorly. In particular, we found that strong cation and strong anion exchangers were orthogonal, while strong and salt tolerant anion exchangers were not orthogonal. Interestingly, salt tolerant and multimodal cation exchangers were found to be orthogonal and the best resin combination included a multimodal cation exchange resin and a tentacular anion exchange resin. This approach for quantifying orthogonality is valuable in that it can be used both as a criteria for resin design as well as process design. We envision that, using this framework, it will be possible to design a set of next generation chromatography ligands that are explicitly engineered to optimize separability and orthogonality.

Immune checkpoints including PD-1 and CTLA-4 help to regulate the intensity and timeframe of the immune response. Since they become upregulated in cancer and prevent sufficient antitumor immunity, monoclonal antibodies against these checkpoints have shown clinical promise for a range of cancers. Multimodal treatment plans combining immune checkpoint inhibitors with other therapies, including photodynamic therapy (PDT), may help to expand treatment efficacy and minimize side effects. PDT's cytotoxic effects are spatially limited by the light activation process, constraining PDT direct effects to the treatment field. The production of damage-associated molecular patterns and tumor-associated antigens from PDT can encourage accumulation and maturation of antigen-presenting cells and reprogram the tumor microenvironment to be more susceptible to therapies targeting immune checkpoints.

Objectives: This study examined the association between pure tone hearing sensitivity and music listening behaviors among traditional college-aged students and sought to determine factors that mediate hearing sensitivity, including health and fitness levels, gender, and personal listening device (PLD) use. Methods: A convenience sample of college students (N = 182; 133 females, 49 males, mean age = 19.8 ± 1.4 year, average PLD use = 1.52 ± 7.1 hours•day−1) completed hearing assessments, music listening behavior questionnaires, and health and fitness tests. Results: Most students listened to music at safe intensity levels (Conclusion: The majority of college students had healthy music listening behavior and fitness, contributing to normal hearing sensitivity in most. In cases where greater hearing threshold levels at one or more frequencies was detected, TC:HDL and TC:TG were statistically related and at 2 kHz, males were more likely to demonstrate higher listening levels compared with females of similar health and fitness level.

The objective of this study is to assess the frequency and type of drug-related problems (DRPs) (1) raised and discussed (2) raised but not discussed or (3) not raised during patients' visits to healthcare practitioners (HCPs). In this cross-sectional study in Dutch outpatient clinics, GP practices and pharmacies, verbal cues from patients and HCPs indicating DRPs were inventoried by an observer during visits. It was also observed whether raised DRPs were discussed between patient and HCP. Post-encounter interviews (HCPs) were conducted and post-encounter questionnaires (patient) were distributed to identify DRPs not raised. In total, 431 patients were observed during a single visit. In 42.2% of these visits, 311 DRPs were raised (weighted mean (SD) 0.7 (+/- 1.1) DRP/patient). Of these 311 DRPs, 82.0% were discussed between HCP and patient. HCPs did not raise existing DRPs in 3.9% of the 431 visits; in 6.3% of the 176 questionnaires the patient reported an existing DRP that had not been raised. In conclusion, almost one in six of the DRPs raised during visits are not discussed between HCP and patient. Furthermore, existing DRPs are not even raised in 4-6% of the visits. HCPs and patients should be aware that, although patients often have DRPs, these are not always discussed or not even raised during patients' visits.

Funding Acknowledgements PLN Genetic Heart Disease Foundation Background Carriers of the phospholamban (PLN) R14del founder mutation may develop an arrhythmogenic and/or dilated cardiomyopathy. Overt disease is preceded by a pre-symptomatic phase of variable length in which structural abnormalities seem to be absent. Purpose We aimed to explore echocardiographic characteristics of PLN R14del mutation carriers, particularly in early disease stages. Methods We included 120 PLN R14del mutation carriers and classified them to the pre-symptomatic stage (no symptoms and no structural disease, n = 60), the arrhythmic stage (arrhythmic symptoms and left ventricular ejection fraction (LVEF) ≥50%, n = 30) or the structural stage (LVEF Results Values are provided in the abstract table. Patients in the structural stage had significantly impaired left/right ventricular (LV/RV) function and increased LV/RV size when compared to the other mutation carriers (p Conclusion Echocardiographic deformation imaging reveals biventricular mechanical alterations in PLN R14del mutation carriers before arrhythmic symptoms and overt structural disease. Longitudinal studies are needed to determine the incremental prognostic value of these findings. Control subjects (n = 60) Pre-symptomatic (n = 60) Arrhythmic (n = 30) Strucutral (n = 30) LVEF(%) 60.3 ± 4.2 58.6 ± 4.2 57.1 ± 5.3 38.8 ± 10.6* LVEDV (ml/m2) 54.6 ± 10.0 53.7 ± 9.5 56.1 ± 11.6 70.1 ± 25.8* LV GLS (%) 21.5 ± 1.8 19.5 ± 1.5* 19.1 ± 1.7* 12.7 ± 3.8* LV MD (msec) 24.4 ± 5.9 33.1 ± 9.5* 48.2 ± 13.3* 60.8 ± 17.1* RV FAC (%) 46.4 ± 4.9 44.7 ± 5.0 42.6 ± 7.4* 33.2 ± 8.0* RV GLS (%) 26.5 ± 3.7 24.2 ± 2.9* 22.5 ± 4.2* 15.1 ± 5.7* FAC = Fractional area change; GLS = Global longitudinal strain; LV/RV = Left/right ventricular; LVEDV = Left ventricular end-diastolic volume; LVEF = Left ventricular ejection fraction; MD = Mechanical dispersion. *p Abstract 1041 Figure. Clinical stages in PLN mutation carriers

This chapter describes the process of developing a corpus of evidence-based mobile messages for expectant and recent fathers using an approach blending principles of participatory action and participatory design research. Launched in the summer of 2015, the Text4Dads initiative aimed to increase engagement and involvement of expectant/recent fathers through a mobile-messaging intervention. The first phase of the project involved developing a public online forum inviting stakeholders in fatherhood work (fathers, health practitioners, community workers, government agency contacts, academicians, etc.) to comment on proposed content for a series of mobile messages to be sent to fathers before and after their child was born. The chapter will focus on the two methodologies informing engagement with fatherhood stakeholders in this phase—participatory action research and participatory research design—as well as the themes emerging from online forum participation.

Energy conversion is one of the key steps for human utilizing the energy. In particular, as the key component for electromechanical energy conversion, electric machines play a significant role and greatly promote the development of modern civilization. Actually, the conventional types of electric machines, namely DC machines, induction machines, and synchronous machines, as well as surface permanent-magnet (SPM) machines and inserted-PM (IPM) machines, have been widely applied for various aspects in human lives. In recent years, emerging electric machines, including the double-salient type, hybrid-excitation type, PM memory type, magnetic-gearing type, PM vernier type, advanced magnetless type, multiport type, and some newly developing types, are proposed for new application occasions such as electric vehicles (EVs), electric ships, electric aircraft, electric robotics, wind power generation, unmanned propulsion systems, and so on. In addition, the corresponding advanced control strategies have presented for electric drives, which include the direct torque control (DTC), field oriented control (FOC), finite control set model predictive control (FCS-MPC), fault-tolerant control, and sensorless control. Thus, emerging electric machines and drives take active roles for applications with more electric or full electric. This special section brings new findings of electric machines and drives on their topologies, structures, analysis approaches, advanced control strategies, and new applications.

Separation of DNA by length using CGE is a mature field. Separation of DNA by sequence, in contrast, is a more difficult problem. Existing techniques generally rely upon changes in intrinsic or induced differences in conformation. Previous work in our group showed that sets of ssDNA of the same length differing in sequence by as little as a single base could be separated by CZE using simple buffers at high ionic strength. Here, we explore the basis of the separation using circular dichroism spectroscopy, fluorescence anisotropy, and small angle X-ray scattering. The results reveal sequence-dependent differences among the same length strands, but the trends in the differences are not correlated to the migration order of the strands in the CZE separation. They also indicate that the separation is based on intrinsic differences among the strands that do not change with increasing ionic strength; rather, increasing ionic strength has a greater effect on electroosmotic mobility in the normal direction than on electrophoretic mobility of the strands in the reverse direction. This increases the migration time of the strands in the normal direction, allowing more time for the same-length strands to be teased apart based on very small differences in the intrinsic properties of the strands of different sequence. Regression analysis was used to model the intrinsic differences among DNA strands in order to gain insight into the relationship between mobility and sequence that underlies the separation.

As part of a preclinical trial for the treatment of peritoneal carcinomatosis (PC) with photodynamic therapy (PDT), we have assessed changes in optical properties, tissue oxygenation and drug concentration as a result of benzoporphyrin derivative (BPD)-mediated PDT using diffuse reflectance and fluorescence measurements. PDT can effectively treat superficial disease spread, but treatment efficacy is influenced by physical properties of the treated tissue which can change over the treatment time. In this study, healthy canines were given BPD and irradiated with 690 nm light during a partial bowel resection, and spectroscopic and fluorescence measurements were made using an in-house built spectroscopic probe. Hemoglobin concentration, oxygenation and optical properties were determined to be highly heterogeneous between canines and at different anatomical locations within the same subject, so further development of PDT dosimetry systems will need to address this patient and location-specific dose optimization. Compared to other photosensitizers, we found no apparent BPD photobleaching after PDT.

Background: Reducing hospital-acquired pressure ulcers (PUs) in intensive care units (ICUs) has emerged as an important quality metric for health systems internationally. Limited work has been done to characterize the profile of PUs in the ICU using observational data from the electronic health record (EHR). Consequently, there are limited EHR-based prognostic tools for determining a patient’s risk of PU development, with most institutions relying on nurse-calculated risk scores such as the Braden score to identify high-risk patients.Methods and Results: Using EHR data from 50,851 admissions in a tertiary ICU (MIMIC-III), we show that the prevalence of PUs at stage 2 or above is 7.8 percent. For the 1,690 admissions where a PU was recorded on day 2 or beyond, we evaluated the prognostic value of the Braden score measured within the first 24 hours. A high-risk Braden score (

Paper-based scaffolds support the three-dimensional culture of mammalian cells in tissue-like environments. These Tissue Papers, a name that highlights the use of materials obtained from (plant) tissue to generate newly functioning (human) tissue structures, are a promising analytical tool to quantify cellular responses in physiologically relevant extracellular gradients and coculture architectures. Here, we highlight current examples of Tissue Papers, commonly used methods of analysis, and current measurement challenges.

In this work, we employed fusions of affinity peptides and elastin-like polypeptide (ELP) to carry out a proof-of-concept study for the single-step purification of model, tag-free proteins. Three known peptide-protein binding pairs of varied binding strengths were evaluated. The peptide-protein binding was first characterized through in-solution binding techniques such as fluorescence spectroscopy. Peptide-ELP constructs were then produced in E. coli and purified by phase transition. The binding of the peptide-ELP constructs to the products were then evaluated using competitive fluorescence spectroscopy. Affinity capture, precipitation and recovery experiments were then conducted using the three constructs to evaluate the efficacy of these peptide-ELP based affinity precipitation processes. Two out of the three systems tested were successful in capturing the product and yielding pure protein in a single affinity precipitation step. These results indicated that peptide-protein affinity played an important role in both the effective capture of the protein, and also in the required binding molar ratio for the affinity precipitation process. In addition, for intermediate affinity systems, constructs containing two copies of the peptide at the N-terminus of the ELP were beneficial towards achieving both high purity and yield, likely due to increased affinity from avidity effects. This proof-of-concept study lays the foundations for the development of new peptide-ELP-based affinity purification processes for industrially relevant proteins and other classes of biologics.

With the advent of high energy pulse mission loads and distributed power and energy on all-electric ship platforms, a new total ship control system capability is emerging that could significantly impact overall mission success. No longer are loads limited to an all-or-nothing power per use approach. Rather, energy applied to advanced mission loads can be scaled—even regulated—to achieve a desired outcome. Within this new framework, the effectiveness of unique missions can be quantified as a function of the amount and allocation of power to service each mission load. Power elasticity enables a new frontier of how decisions are made during intense operational scenarios where limited power and energy resources are applied to competing load demands. Herein, a power allocation strategy that addresses this challenge is proposed. The general approach is to use state-space models to represent the evolution of both the mission and the engineering system that is supporting the mission. An optimal control problem is performed to maximize some functional over the mission state and actions. By doing so, it indicates the capability of the engineering system to support such missions. The uniqueness of this approach is that solutions become far more mission specific. Results based on a simple two-function platform—each competing for the same limited power resources—show that this approach can be used to assess the probability of success given a certain initial allocation of power.

Background Many prior institutional and multi-institutional studies have applied the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) retrospectively to their specimens to determine the risk of malignancy (ROM) of each category. Most of these studies focused on general assessment of the system and risk classification. However, there seems to be less focus on the category of atypia of undetermined significance (AUS) that could be attributed to the low number of cases that could fit into this category. Herein, we present a bi-institutional experience with this category. Methods A computerized search of the databases was performed to identify all salivary gland fine-needle aspiration (FNA) in two institutions over a period of 12 years. The final diagnosis of each case was reclassified based on MSRSGC, and histology follow-up was retrieved. Results Sixty AUS cases (out of 1560 salivary gland FNA) were identified with a rate of 3.8%. Forty cases (66%) had a subsequent tissue material. Correlation with histology revealed that the estimated ROM is 37.5% (15/40) and the overall ROM is 25% (15/60). Fifty percent of the cases had a prominent lymphoid component and most commonly represented lymphomas, reactive lymph node or sialadenitis. Conclusion The AUS category is a heterogeneous group of lesions with predominant lymphoid-rich entities. Some variability exists between institutions with most having higher ROM than the suggested 20% by the MSRSGC atlas.

While quantitative structure activity relationship (QSAR) models have been employed successfully for the prediction of small model protein chromatographic behavior, there have been few reports to date on the use of this methodology for larger, more complex proteins. Recently our group generated focused libraries of antibody Fab fragment variants with different combinations of surface hydrophobicities and electrostatic potentials, and demonstrated that the unique selectivities of multimodal resins can be exploited to separate these Fab variants. In this work, results from linear salt gradient experiments with these Fabs were employed to develop QSAR models for six chromatographic systems, including multimodal (Capto MMC, Nuvia cPrime, and two novel ligand prototypes), hydrophobic interaction chromatography (HIC; Capto Phenyl), and cation exchange (CEX; CM Sepharose FF) resins. The models utilized newly developed "local descriptors" to quantify changes around point mutations in the Fab libraries as well as novel cluster descriptors recently introduced by our group. Subsequent rounds of feature selection and linearized machine learning algorithms were used to generate robust, well-validated models with high training set correlations (R2 > 0.70) that were well suited for predicting elution salt concentrations in the various systems. The developed models then were used to predict the retention of a deamidated Fab and isotype variants, with varying success. The results represent the first successful utilization of QSAR for the prediction of chromatographic behavior of complex proteins such as Fab fragments in multimodal chromatographic systems. The framework presented here can be employed to facilitate process development for the purification of biological products from product-related impurities by in silico screening of resin alternatives. Biotechnol. Bioeng. 2017;114: 1231-1240. © 2016 Wiley Periodicals, Inc.

BACKGROUND The ability to produce adequate cell blocks profoundly impacts the diagnostic usefulness of cytology specimens. Cell blocks are routinely processed from fine-needle aspiration specimens or concentrated fluid samples. Obtaining directed passes for the sole purpose of producing a cell block is common practice, particularly when the cytopathologist anticipates the need for ancillary immunocytochemical stains and/or molecular studies. METHODS The authors developed an effective and inexpensive process for producing cell blocks that consistently yields abundant cellular material, which they have termed the Cell-Gel method. This method can be simplified into 3 main steps: 1) preparing the sample; 2) constructing the cell block; and 3) processing the cell block. Highlights of the protocol include using a hemolytic fixative for sample preparation and disposable base molds for cell block construction. RESULTS The cell block failure rate in the current study decreased from 18% with the HistoGel Tube method (January 2014-December 2014) to 6% with the Cell-Gel method (January 2015-December 2016). The authors evaluated 110 cell blocks processed with the HistoGel Tube method and 110 cell blocks processed with the Cell-Gel method, for a total evaluation of 220 cell blocks. CONCLUSIONS The authors have developed an effective and inexpensive protocol for producing cell blocks that consistently yields abundant cellular material. The Cell-Gel method uses a hemolytic fixative and disposable base molds to produce adequate cell blocks. When the method was implemented, the cell block failure rate of the study laboratory decreased by approximately 67%. Cancer Cytopathol 2017;125:267–276. © 2016 American Cancer Society.

The present study explored the relation between personal characteristics and romantic relationship satisfaction as mediated by communication. Couples in established heterosexual romantic relationships of at least 3 months (N = 96 couples) were recruited from an undergraduate population at a university through a Psychology Participant Pool System. It’s been hypothesized that there would be a relation between predicting variables — four of five-factor personality traits, emotional intelligence and self-disclosure — and relationship satisfaction as mediated by communication behaviours. Results indicate that for both genders, conscientiousness is related to one’s own relationship satisfaction which is mediated by communication. For females only, communication mediated the relation between emotional intelligence and her relationship satisfaction. For males and females, self-disclosure is related to both one’s own and one’s partner’s relationship satisfaction which is mediated by communication. Collectively, these results suggest that personal characteristics are related to communication which influences the relationship satisfaction of both members of a couple.

We evaluated predation on Lost River Suckers Deltistes luxatus and Shortnose Suckers Chasmistes brevirostris by American white pelicans Pelecanus erythrorhynchos and double-crested cormorants Phalacrocorax auritus nesting at mixed-species colonies in the Upper Klamath Basin of Oregon and California during 2009–2014. Predation was evaluated by recovering (detecting) PIT tags from tagged fish on bird colonies and calculating minimum predation rates, as the percentage of available suckers consumed, adjusted for PIT tag detection probabilities but not deposition probabilities (i.e., probability an egested tag was deposited on- or off-colony). Results indicate that impacts of avian predation varied by sucker species, age-class (adult, juvenile), bird colony location, and year, demonstrating dynamic predator–prey interactions. Tagged suckers ranging in size from 72 to 730 mm were susceptible to cormorant or pelican predation; all but the largest Lost River Suckers were susceptible to bird predation. Min...

Sexual arousal has been shown to have an impact on risk-taking and intentions to engage in risky sexual behaviour (e.g., Ariely & Loewenstein, 2006; Shuper & Fisher, 2008; Skakoon-Sparling, Cramer, & Shuper, 2016); however, the mechanisms underlying this effect are not well understood. To further investigate the effects of sexual arousal on sexual health decision-making, the current study was designed to examine the associations among self-control, sexual self-restraint, and motivational state, as well as the impact of sexual arousal on these factors. Forty-nine female and 26 male participants viewed either sexually arousing (experimental condition) or control video clips and responded to inventories designed to measure their self-control, sexual self-restraint, and meta-motivational state balance (within the Rules domain of Reversal Theory). A moderate positive correlation was found across all participants between self-control and self-restraint. Participants in the sexual arousal condition scored significantly lower on measures of self-control and sexual self-restraint; no effect was found for the meta-motivational state measure used. The results of this study suggest that sexual arousal either functions to deplete individuals' internal reserves of self-control or that it creates conditions that make it difficult to access the cognitive capacity to engage in self-control. This effect, combined with the correspondingly low score on our measure of sexual self-restraint, suggest that this may be an avenue through which sexual arousal negatively impacts sexual health decision-making.

Through the strategic absence of discourse about race within the portrayed interracial relationships, the writers, creators, and producers of the modern TV medical drama Grey’s Anatomy strategically portray a racially progressive, postracial, and color-blind society. By utilizing Scott’s (1993) absence as presence, the creators, writers, and producers situate the characters as race neutral or White and enable the dismissal and forgetting of racism’s long history and its impact on the current structures that produce and reproduce racial inequality. By doing so, they obviate contemporary racism’s presence and its influence at both the societal and individual levels, thus contributing to postracism (Ono, 2011).

We evaluated the impact of predation on juvenile steelhead Oncorhynchus mykiss and yearling and subyearling Chinook Salmon O. tshawytscha by piscivorous waterbirds from 11 different breeding colonies in the Columbia River basin during 2012 and 2014. Fish were tagged with both acoustic tags and PIT tags and were tracked via a network of hydrophone arrays to estimate total smolt mortality (1 – survival) at various spatial and temporal scales during out-migration. Recoveries of PIT tags on bird colonies, coupled with the last known detections of live fish passing hydrophone arrays, were used to estimate the impact of avian predation relative to total smolt mortality. Results indicated that avian predation was a substantial source of steelhead mortality, with predation probability (proportion of available fish consumed by birds) ranging from 0.06 to 0.28 for fish traveling through the lower Snake River and the lower and middle Columbia River. Predation probability estimates ranged from 0.03 to 0.09 fo...

This research examines cultural influence on the preference of promotive (i.e., trying to eat more healthy foods) and preventive (i.e., trying to avoid unhealthy foods) dietary practices. Survey data were collected from students and older adults in Korea (N = 287) and the U.S. (N = 245). Only students participated in the survey in Japan (N = 145). Consistent with the prediction, Study 1 shows Korean mature adults are more willing to adopt preventive dietary practices, while American counterparts favor promotive eating habits. The pattern of the data was inconsistent with the prediction among student participants across the three nations. Individual-level data from Study 2 (N = 284) confirm that independent self-construal affects promotive dietary practice via increasing promotive regulatory self-focus. The indirect impact of interdependent self-construal on preventive dietary practice was less apparent. Practical implications for doctor-patient communication are discussed.

BACKGROUND The significance of apoptosis and its association with high-grade urothelial carcinoma (HGUC) in urine cytology has yet to be determined. METHODS A computerized search of the study laboratory information system was performed over a 3-year period for all urine cytology specimens processed using the SurePath liquid-based preparation technique. Only those cases with correlating surgical pathology obtained within 6 months after the urine cytologic samples were included in the current study. Cases from ileal conduit samples were excluded. A semiquantitative numerical scoring system (apoptotic index) was used to assess the amount of pyknosis or karyorrhexis, with 0 indicating none, 1 indicating 30 per 10 high-power fields. Statistical analysis using the Pearson chi-square test was performed. RESULTS A total of 228 cases including 105 benign cases, 79 cases of HGUC, and 44 cases of low-grade urothelial carcinoma (LGUC) diagnosed on follow-up surgical pathology were selected. A score of 0 was observed in 70 benign, 11 HGUC, and 8 LGUC cases; a score of 1 was observed in 31 benign, 21 HGUC, and 23 LGUC cases; a score of 2 was observed in 3 benign, 27 HGUC, and 9 LGUC cases; and a score of 3 was observed in 1 benign, 20 HGUC, and 4 LGUC cases. CONCLUSIONS Excluding ileal conduit urine specimens, the finding of a high apoptotic index (score ≥ 2) with the presence of pyknosis or karyorrhexis in ≥10 per 10 high-power fields in the urine cytology appears to be significantly associated with HGUC (P

Objectives Multi-institutional studies are required for the validation of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Methods A total of 1,560 fine-needle aspirations of the salivary glands were retrieved from two institutions for a 12-year period. The diagnoses were reclassified based on the MSRSGC. Risk of malignancy (ROM) for each category was calculated based on 694 histologic follow-up cases. Results The ROM for each category was: 18.3% for nondiagnostic, 8.9% for nonneoplastic, 37.5% for atypia of undetermined significance (AUS), 2.9% for benign neoplasm, 40.7% for salivary gland neoplasm of uncertain malignant potential (SUMP), 100% for suspicious for malignancy, and 98.3% for malignant. The sensitivity, specificity, positive predictive rate, and negative predictive rates were 89%, 99%, 98%, and 96%, respectively. Conclusions The results of the current study are in keeping with the MSRSGC. The indeterminate categories of AUS and SUMP showed intermediate ROMs at 37.5% and 40.7%, respectively.

In this work, two phage biopanning strategies were developed to identify affinity peptides for a single Fab and multiple kappa Fabs. For the biopanning rounds, protein L beads were employed to bind Fab targets in a fixed orientation, and NHS functionalized magnetic beads were used to facilitate evaluation of low pH elution conditions. The resulting peptide sequences were synthesized and the binding to different Fabs was evaluated using fluorescence polarization. The first biopanning approach yielded a peptide with similar affinities for two forms of the Fab (recombinantly expressed and post papain-digestion) as well as the intact antibody. While moderate affinity was observed toward a murine variant of the Fab with the same complementarity determining regions (CDR) region but different framework, minimal binding occurred to a Fab with high sequence homology but containing different CDR loops. The second biopanning strategy yielded a peptide with affinity for all three kappa Fabs indicating that it may be a good lead for the development of more general affinity reagents for recombinant kappa Fabs. Finally, an affinity peptide column was developed, and its efficacy was demonstrated for Fab purification from a complex cell culture fluid mixture. The results presented in this article demonstrate that different peptide-based phage biopanning strategies can be effectively employed to identify affinity peptide leads for specific Fab and more general kappa Fab purifications.

Acute postoperative pain is associated with the development of persistent postsurgical pain, but it is unclear which aspect is most estimable.To identify patient clusters based on acute pain trajectories, preoperative psychosocial characteristics associated with the high-risk cluster, and the best acute pain predictor of remote outcomes.A secondary analysis of the Stanford Accelerated Recovery Trial randomized, double-blind clinical trial was conducted at a single-center, tertiary, referral teaching hospital. A total of 422 participants scheduled for thoracotomy, video-assisted thoracoscopic surgery, total hip replacement, total knee replacement, mastectomy, breast lumpectomy, hand surgery, carpal tunnel surgery, knee arthroscopy, shoulder arthroplasty, or shoulder arthroscopy were enrolled between May 25, 2010, and July 25, 2014. Data analysis was performed from January 1 to August 1, 2018.Patients were randomized to receive gabapentin (1200 mg, preoperatively, and 600 mg, 3 times a day postoperatively) or active placebo (lorazepam, 0.5 mg preoperatively, inactive placebo postoperatively) for 72 hours.A modified Brief Pain Inventory prospectively captured 3 surgical site pain outcomes: average pain and worst pain intensity over the past 24 hours, and current pain intensity. Within each category, acute pain trajectories (first 10 postoperative pain scores) were compared using a k-means clustering algorithm. Fifteen descriptors of acute pain were compared as predictors of remote postoperative pain resolution, opioid cessation, and full recovery.Of the 422 patients enrolled, 371 patients (≤10% missing pain scores) were included in the analysis. Of these, 146 (39.4%) were men; mean (SD) age was 56.67 (11.70) years. Two clusters were identified within each trajectory category. The high pain cluster of the average pain trajectory significantly predicted prolonged pain (hazard ratio [HR], 0.63; 95% CI, 0.50-0.80; P .001) and delayed opioid cessation (HR, 0.52; 95% CI, 0.41-0.67; P .001) but was not a predictor of time to recovery in Cox proportional hazards regression (HR, 0.89; 95% CI, 0.69-1.14; P = .89). Preoperative risk factors for categorization to the high average pain cluster included female sex (adjusted relative risk [ARR], 1.36; 95% CI, 1.08-1.70; P = .008), elevated preoperative pain (ARR, 1.11; 95% CI, 1.07-1.15; P .001), a history of alcohol or drug abuse treatment (ARR, 1.90; 95% CI, 1.42-2.53; P .001), and receiving active placebo (ARR, 1.27; 95% CI, 1.03-1.56; P = .03). Worst pain reported on postoperative day 10 was the best predictor of time to pain resolution (HR, 0.83; 95% CI, 0.78-0.87; P .001), opioid cessation (HR, 0.84; 95% CI, 0.80-0.89; P .001), and complete surgical recovery (HR, 0.91; 95% CI, 0.86-0.96; P .001).This study has shown a possible uniform predictor of remote postoperative pain, opioid use, and recovery that can be easily assessed. Future work is needed to replicate these findings.ClinicalTrials.gov Identifier: NCT01067144.

Satellite power systems can be understood as islanded dc microgrids supplied by specialized and coordinated solar cell arrays augmented by electrochemical battery systems to handle high-power loads and periods of eclipse. The periodic availability of power, the limited capacity of batteries, and the dependence of almost all mission service on power consumption create a unique situation in which temporal power and energy scarcity exist. Any satellite power system must be properly designed so the power generation and energy storage portions of the system have enough generation potential and storage capacity to reliably meet the load requirements of a given satellite mission. A multi-period model of an orbital satellite power system's performance over a mission's duration can be constructed. A modular power system architecture is used to characterize the system's constraints. The periodic and generally predictable nature of a satellite's mission environment provides a useful opportunity for these techniques. Using mathematical programming, an optimization problem can be posed such that the optimal power and energy ratings for the power system are determined for any load schedule imposed by a given mission's requirements. The optimal energy trajectory of the electrical power system over a mission's duration is also determined when the mathematical programming problem is solved. A generic set of mission requirements is identified to test this approach, but the objective function of the resulting optimization problem can be modified in order to return different results, and these differing results can provide a clear illustration of the trade-offs that designers of such power systems consider in the design process. For this paper specifically, this means that the same mission is evaluated in two ways for comparison: first by selecting the optimally-minimum mass, and then the optimally-minimum volume, of the system's generation and battery elements. The design approach is demonstrated for a typical mission involving a CubeSat platform that periodically records image data and transfers this data once per-orbit.

Background The management of thyroid nodules with indeterminate cytology is challenging. Recently, molecular testing on fine-needle aspirates (FNAs) has been advocated to determine whether clinical follow-up or surgery is warranted for patients. Three different testing platforms were performed on aspirates from our institution (Afirma Thyroid FNA Analysis, RosettaGX Reveal, and Interpace ThyGenX/ThyraMIR). This study compares their diagnostic efficacy. Methods We conducted a retrospective analysis of indeterminate thyroid FNAs with correlating molecular testing over 4 years (2015-2018). The aspirates included diagnoses of follicular lesion of undetermined significance, follicular neoplasm, or suspicious for malignancy (SM). Based on cases that underwent surgical resection (Afirma, n = 37; Rosetta, n = 19; Interpace, n = 14), we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for risk of malignancy and neoplasia. Results The three tests performed similarly when predicting risk of malignancy. They showed high sensitivity (80-100%) and NPV (90-100%) but lower specificity (10-64%) and PPV (21-44%). When assessing their value to predict neoplasia, each test had a high PPV (76-89%) but low NPV (20-33%). The sensitivity for neoplasm was intermediate to high (50-93%), and the specificity remained extremely variable (11-67%). Conclusion Overall, these molecular platforms performed similarly, displaying high NPV but low to intermediate PPV for malignancy and low NPV but high PPV for neoplasm. The risk of neoplasm is a good index for surgery, and we argue that many of the neoplasms are low-risk tumors. We endorse conservative treatment with lobectomy for cases that are indeterminate at FNA but suspicious by molecular testing.

Background Papillary renal cell carcinoma (pRCC) is classified as type 1 or type 2 on the basis of histomorphologic features. Type 1 pRCC typically carries a better prognosis, and renal cell carcinoma is often diagnosed by fine-needle aspiration (FNA). Thus, this study was designed to characterize cytomorphologic features present in FNA cases that could be used to discriminate between type 1 and type 2 pRCC. Methods Electronic records of Indiana University were searched for pRCC FNA cases (2007-2018). Corresponding surgical pathology reports were reviewed to classify patients as having type 1 or type 2 pRCC. FNA slides were reviewed to assess cytomorphologic features (ie, nuclear grade; cell size; cytoplasmic volume and quality; and the presence of single cells, papillary clusters, nuclear grooves, foamy histiocytes, hemosiderin pigment, psammoma bodies, and hyaline globules). A semiquantitative score was assigned to each feature. The nuclear grade was assigned with the World Health Organization/International Society of Urological Pathology grading system. The cytomorphologic features of type 1 and type 2 pRCC were compared. Results Sixteen patients with type 1 pRCC and 12 patients with type 2 pRCC were included in the study. Type 2 pRCC had a higher nuclear grade, a higher volume of cytoplasm, and more granular cytoplasm. Type 1 pRCC more frequently had nuclear grooves and clear cytoplasm. The remaining features (ie, cell size, papillary clusters, single cells, foamy histiocytes, hemosiderin pigment, psammoma bodies, and hyaline globules) were not statistically significant. Conclusions Nuclear grade, cytoplasmic volume and granularity or clarity, and nuclear grooves are cytomorphologic features that may aid in the distinction between type 1 and type 2 pRCC.