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Renal cell carcinoma (RCC) is the most lethal of the common urologic malignancies, with approximately 40% of patients eventually dying of cancer progression. Approximately one third of patients present with metastatic disease, and up to 40% treated for localized disease have a recurrence. Recent advances in the understanding of the pathogenesis, behavior, and molecular biology of RCC have paved the way for developments that may enhance early diagnosis, better predict tumor prognosis, and improve survival for RCC patients. The recent discovery of molecular tumor markers is expected to revolutionize the staging of RCC in the future and lead to the development of new therapies based on molecular targeting. Cytokine-based immunotherapy can be considered standard therapy in the treatment of metastatic RCC today. However, new therapies such as tumor vaccines, anti-angiogenesis agents, and small molecule inhibitors are being developed to improve efficacy and treat those patients who are unable to tolerate or are resistant to systemic immunotherapy. The aim of this review is to provide an update on current therapeutic approaches and targeted molecular therapy for metastatic RCC. [ABSTRACT FROM AUTHOR]

Examines the staging of renal cell carcinoma (RCC). Use of local tumor growth, lymph node involvement and distant metastasis to categorize patients with RCC by the TNM system; Increase of the size threshold for T1 tumors to seven centimeters; Comparison between T3b and T3c classification of tumors with inferior vena caval involvement.

The foundations of the generally accepted principles underlying the surgical management of renal cell carcinoma (RCC) were best annunciated in 1969 by Robson in his classic description of the radical nephrectomy [J Urol 1969;101;297]. Since then, much has changed in our understanding of the basic biology and genetics of kidney cancer, advances in renal imaging and clinical staging have led to the increased detection of incidental, lower stage, organ-confined tumors more amendable to expanded surgical options, surgical techniques themselves have evolved, and surgical equipment technology has advanced to make possible new methods of managing renal tumors in situ. Thus, the management of both localized and metastatic RCC has changed dramatically in the last 20 years, predicated on these major advancements in renal imaging, surgical techniques, and the development of effective immunotherapies for advanced disease. In this review, the evolution in thinking regarding the tenets of the radical nephrectomy will be examined, including the necessity for removal of the entire kidney, the possibility of sparing the adrenal gland, when and how extensive a lymphadenectomy should be performed, the development of laparoscopic and percutaneous nephron-sparing surgery using ablative technologies, and the role of nephrectomy and metastasectomy in patients with metastatic RCC. Here, we review current concepts and outcomes on the surgical management of RCC to help elucidate some of these changes, from the evolution of open to laparoscopic to percutaneous, from radical to partial to ablative approaches. [Copyright &y& Elsevier]

Bacillus Calmette-Gue´rin (BCG) and interferon-α2B (IFN-α2B) have both been individually used for the intravesical treatment of superficial bladder cancer. We report our experience on the therapeutic efficacy and toxicity of combined intravesical BCG plus IFN-α2B for treating superficial bladder cancer, including patients failing previous BCG therapy. Thirty-two patients with superficial bladder cancer underwent 6 weekly treatments with full-, one-third, or one-tenth-dose of BCG plus 50 or 100 MU of IFN-α2B based on prior BCG exposure and tolerance. Patients with no evidence of disease proceeded onto maintenance therapy of 3 weekly treatments at 3 months followed by 2 additional maintenance cycles given 6 months apart. Response was assessed by cystoscopy/biopsy every 3 months after treatment. Before BCG plus IFN-α2B treatment, 20 patients (63%) had previously failed intravesical BCG therapy, 27 (84%) had aggressive disease (stage T1, grade 3, or carcinoma in situ), 27 (84%) had recurrent disease, 14 (44%) had multifocal disease, and 6 (19%) had disease of over 4 years duration. At median follow-up of 22 months, 21 patients (66%) remain disease-free and 11 patients (34%) had disease-recurrence. Nineteen of 32 patients (59%) were disease-free after the initial induction cycle. Six of 11 patients 55% ultimately failing combination therapy did so at the first 3 to 4 month evaluation. Four of 7 patients (57%) benefited from salvage re-induction therapy. Of the 20 patients previously treated with BCG, 12 patients (60%) remain disease-free. Combination BCG plus IFN-α2B intravesical therapy was well tolerated. Combination intravesical BCG plus IFN-α2B is an effective and tolerable alternative for patients with superficial bladder cancer, including those patients in whom intravesical BCG therapy had previously failed. Benefits of this combination therapy may include potentially less morbidity, improved clinical efficacy, and in the long term, fewer patients undergoing radical therapy. However, radical treatment options should be pursued for early failures of this combination regimen in those patients with risk factors for recurrence and progression. [Copyright &y& Elsevier]

: ObjectivesTo compare, in a single-surgeon, single-institution study, the efficacy of antegrade and retrograde endopyelotomy in terms of success rate and morbidity and to identify which risk factors affect treatment outcomes.: MethodsThe results were retrospectively reviewed for 88 patients with ureteropelvic junction obstruction treated with endopyelotomy. Antegrade endopyelotomy was performed with a hook knife, scissors, or cutting balloon device. Retrograde endopyelotomy was performed with a cutting balloon device. Objective results were based on intravenous urogram and/or diuretic nuclear renal scan findings, and subjective results were based on direct patient query and questionnaire.: ResultsNinety-three endopyelotomy procedures, 64 antegrade and 29 retrograde, were performed. The mean follow-up was 37.0 months (range 5 to 76). The overall success rates between antegrade and retrograde endopyelotomy (81.3% versus 75.9%) were not statistically different (P = 0.553). Patients with massive hydronephrosis and poor initial renal function were less likely to have successful endopyelotomy. Antegrade endopyelotomy, however, was more successful than retrograde endopyelotomy in patients with massive hydronephrosis (66.7% versus 20.0%; P = 0.046). The average operative time for antegrade and retrograde endopyelotomy was 93.9 and 32.7 minutes (P <0.001), respectively. The average length of hospital stay after antegrade and retrograde endopyelotomy was 3.20 and 0.14 nights (P <0.001), respectively.: ConclusionsBoth antegrade and retrograde endopyelotomy are effective treatments for ureteropelvic junction obstruction associated with minimal morbidity. Antegrade endopyelotomy appears to be more successful in patients with high-grade hydronephrosis. Retrograde endopyelotomy results in a shorter hospital stay, a shorter operative time, and less postoperative pain. [Copyright &y& Elsevier]

Replication competent viruses hold promise for treatment of advanced cancers resistant to available therapeutic modalities. Although preliminary clinical results have substantiated their efficacy, preclinical development of these novel approaches is limited by assay substrates. The evaluation of candidate agents could be confounded by differences between primary tumor cells and tumor cell lines, as discordance in the levels of surface receptors relevant for viral entry has been reported. Since primary tumor cells are difficult to analyze ex vivo for longitudinal observation of virus replication, we developed three-dimensional aggregates or spheroids of unpassaged and purified ovarian cancer cells as a means for prolonging primary tumor cell viability and as a three-dimensional in vitro model for replicative viral infection. Ovarian cancer cells purified from ascites samples were sustained for 30 days while retaining the infection profile with tropism modified and unmodified adenoviruses (Ads). Cell line and primary cell spheroids were used to quantitate the replication and oncolytic potency of replicative Ads in preclinical testing for human ovarian cancer trials. Therefore, spheroids provide a method to sustain purified unpassaged primary ovarian cancer cells for extended periods and to allow evaluation of replicative viruses in a three-dimensional model.Cancer Gene Therapy (2003) 10, 377-387. doi:10.1038/sj.cgt.7700578 [ABSTRACT FROM AUTHOR]

: ObjectivesTo evaluate the safety and efficacy of finasteride 5 mg during a 10-year period in men with enlarged prostates from a single center who participated in the double-blind and extension phases of the multicenter, Phase III, North American benign prostatic hyperplasia (BPH) trial. It is important that the long-term safety and efficacy of drugs intended for chronic administration in men with BPH be well understood.: MethodsThe Phase III North American BPH trial involved a 1-year, placebo-controlled, double-blind study, followed by a 5-year open extension with finasteride 5 mg/day. The trial enrolled men with symptomatic BPH, an enlarged prostate on digital rectal examination, and no evidence of prostate cancer. Of the 46 patients originally enrolled from our institution, 43 were randomized to receive finasteride or placebo, of whom 41 (95%) completed the double-blind study and entered the 5-year extension. Thirty (73%) of these 41 patients completed the 5-year extension. Patients continued to be followed up by their physicians for an additional 5 years, for a total follow-up of at least 10 years.: ResultsTwenty-four (56%) of the original 43 patients randomized to finasteride or placebo were judged as successfully treated during the 10-year finasteride follow-up (17 patients taking finasteride alone at 10 years and 7 patients who were taking finasteride alone when they discontinued during the 10-year follow-up for reasons not related to finasteride treatment). Altogether, 22 (51%) of the original 43 randomized patients continued finasteride treatment at 10 years (17 taking finasteride alone, 4 taking finasteride plus an alpha-blocker, and 1 taking finasteride for treatment of hematuria). Finasteride was well tolerated, with no new adverse experiences occurring with increasing duration of exposure to the drug.: ConclusionsThis long-term follow-up study has demonstrated that appropriately selected patients with symptomatic BPH and enlarged prostates are likely to have a long-term response to taking finasteride 5 mg daily. [Copyright &y& Elsevier]

A novel single-stage ac/dc isolated onboard charger with modular stacked switches structure utilizing interleaved control is proposed in this article for high-voltage (HV) battery systems in electric vehicles (EVs). In the proposed converter, modular interleaved bridgeless ac/dc boost converters are integrated with modular CLL resonant circuits through sharing the two legs of stacked switches. With this configuration, the voltage stress across each switch is reduced to half of the dc-link voltage, which makes the circuit applicable for HV battery system (such as 800 V) in EVs. In the proposed design, the integrated interleaved boost circuit modules allow low input current ripple to be achieved. Two step-up resonant circuit modules are then connected to the two interleaved legs with their outputs connected in series at the input of a current-fed high-frequency rectifier. Soft-switching commutation is achieved for all switches and diodes in the proposed converter. The descriptions of the proposed converter and its operating principles will be discussed in this article. A silicon-carbide-based hardware prototype with a rated power of 2.4 kW, 90–135 Vac/800 Vdc system has been tested in the laboratory. Results confirmed that a power factor of 0.97 and a peak efficiency of 97.9% were achieved. [ABSTRACT FROM AUTHOR]

Analyzes the reaction pathway of the N(1')-methyl derivative of 2-(1-hydroxybenzyl)thiamin (HBzT). Rates and products of decomposition of MBzT; Rate of exchange of the C(2alpha) proton of MBzT; Biphasic rate of fragmentation of MBzT in deuterium oxide.

The article presents a case study of 20-year-old male with a human immunodeficiency virus (HIV)-negative with hepatosplenomegaly. It notes that the results were consistent with acute lymphoblastic leukemia (ALL). It mentions that the study offers insights for leukemia or lymphoma and emphasizes further multidisciplinary approach.

Background Pyogenic liver abscess (PLA) is a significant cause of morbidity and mortality. Epidemiological data regarding risk factors and outcome determinants are often ascertained from referral population bases. We utilized a population-based study design to better understand PLA. Methods Calgary Health Zone (CHZ) residents ≥18 years of age (population ~1.3 million) who were hospitalized with PLA in 2017 were included. Charts were manually reviewed to determine demographics and clinical outcomes. Univariate and multivariate logistic regression were used to assess for factors associated with 30-day mortality using STATA 15.1 (College Stn. TX). Results Forty-four patients with PLA were identified (39% female, median age 61 [IQR 56–68] years) corresponding to an incidence rate of 3.7 cases per 100,000 population. Prevalent co-morbidities with PLA included; hemodialysis dependence (4.5%), cancer (25%), diabetes (23%), and cirrhosis (6.8%), each of which was significantly more common (P < 0.05) than in the general population; 85.3X, 11.2X, 3.6X, 29.9X, respectively. Rates of other comorbidities including ischemic heart disease, COPD, and rheumatoid arthritis did not differ from general populations (P > 0.05). The etiology of PLA was established in 72% of cases, of which biliary was most common (48%). Most (91%) cases had at least one organism identified via blood or liver aspirate culture. The most common organisms were Streptococcus anginosus group (12), Klebsiella pneumoniae (11), Klebsiella oxytoca (6), Escherichia coli (4), and obligate anaerobes (3). Blood cultures were positive in 25/44 (56%) cases. Thirty-day mortality from admission was 11% and had multiple risk factors (Table-1). Conclusion PLA in the CHZ is common and associated with high mortality. Understanding factors influencing PLA occurrence and outcome can assist in correctly identifying and optimally treating patients. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Large renal stone burdens within a nondilated collecting system in patients with a relative contraindication to percutaneous nephrolithotomy can be a challenging problem. We describe a novel technique using a ureteral access sheath combined with extracorporeal shock wave lithotripsy to facilitate passage of stone fragments in such patients. [Copyright &y& Elsevier]

Background: Mucormycosis is a group of rare but life threatening angioinvasive infections caused by fungi of the order Mucorales that often occurs in immunocompromised patients and individuals with poorly controlled diabetes. Rhinocerebral mucormycosis can mimic sinusitis but can rapidly progress to deeper disease and cause facial necrosis. Facial vascular thrombosis is a rare complication of mucormycosis and can confound diagnosis of the disease.Case Presentation: We report the case of a 25-year-old female with poorly controlled type 1 diabetes mellitus who initially presented with symptoms of sinusitis but rapidly progressed with signs of left-sided facial necrosis due to occlusion of the left internal maxillary artery. Early surgical debridement did not yield a microbiological diagnosis. Deeper surgical debridements ultimately revealed angioinvasive fungal disease consistent with mucormycosis. The patient recovered after repeated surgical intervention and aggressive parenteral antifungal therapy.Conclusion: This case illustrates an atypical complication of mucormycosis, and emphasizes that a high index of suspicion in vulnerable patient populations aids in the diagnosis of this life-threatening infection. [ABSTRACT FROM AUTHOR]

A lack of clinical response to empiric antimicrobials behooves the clinician to reflect further on diagnostic considerations. When prescribing antibiotics, determining the correct dose, most optimal route of administration, and considering the pharmacokinetic properties of the drug with respect to clinical and patient factors are crucial. Improving antibiotic usage is paramount. Antibiotic prescribing is a purposeful process, requiring a clinical indication, determination of the optimal drug dosage/route of administration, and consideration of clinical pharmacokinetics in a patient. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Amebic liver abscesses should be considered in adult males with a liver abscess and a history of travel to endemic areas. Effective treatment includes metronidazole, followed by paromomycin. [ABSTRACT FROM AUTHOR]

The article offers information on the annual Young Urologist Forum, that will be held during the annual meeting of the organization the American Urological Association (AUA), at the San Diego Convention Center in San Diego, California on May 9, 2016.

A new soft-switched, single-switch electrolytic capacitor-less step-up dc/dc microconverter for photovoltaic applications is presented in this article. The proposed circuit is an improved coupled-magnetics based single-switch topology that has low-voltage stress across the switch compared to the high voltage dc bus level (380–400 V). The proposed circuit is able to achieve zero voltage switching turn-on and zero current switching turn-off for the switch. Since the input inductor in the proposed circuit operates in continuous conduction mode, the required input filter capacitance is reduced and hence, allows for the small-size nonelectrolytic capacitor to be used. The main advantage of the proposed circuit is that it is able to achieve high voltage gain while the ratio between the peak switch voltage and the output dc-bus voltage is reduced compared to other coupled-inductor based topologies. In addition, the proposed converter is able to achieve maximum power point tracking through variable switching frequency control. Results are provided on a 40-V/380-V, 200-W system to highlight the merits of the proposed circuit. [ABSTRACT FROM AUTHOR]

The article offers a look at the prevalence of ureteropelvic junction obstruction (UPJO) in the U.S. UPJO is a condition referring to a blockage at the junction of the renal pelvis and the ureter, which causes prenatal and neonatal hydronephrosis. Between 1997 and 2000, hospitalization rates for UPJO were higher for males than for females. The article includes information on hospital length of stay, physician visits and treatment of UPJO.

The article discusses the establishment of the American Urological Association Young Urologists Committee with representation from association Sections, the Society of Government Service Urologists and osteopathic urologists. It also provides information on "The Prescription for Financial Health" presentation of MEDIQUS Asset Advisors, Inc. chief executive officer Ronald J. Paprocki at the Young Urologists Forum during the 2015 AUA Annual Meeting in New Orleans on May 18, 2015.

A 61-year-old male with subacute headache was found to have cryptococcal meningitis despite a negative BioFire FilmArray meningitis/encephalitis panel. This case underscores the importance of liberal cryptococcal antigen testing, and that a negative FilmArray panel is inadequate in excluding cryptococcal meningitis, particularly in a HIV-negative host. [ABSTRACT FROM AUTHOR]

Objective: Chronic occupational stress is common among health care practitioners, with potential impacts on personal mental health and staff turnover. This study investigated whether directing practitioners' attention to thankful events in work could reduce stress and depressive symptoms. Method: A doubleblind randomized controlled trial was conducted in 5 public hospitals with follow-up to 3 months posttreatment. One hundred two practitioners were randomly assigned into 3 conditions: gratitude, hassle, and nil-treatment. Those with scheduled long leaves were excluded. Participants in the gratitude and hassle group wrote work-related gratitude and hassle diaries respectively twice a week for 4 consecutive weeks. A no-diary group served as control. Depressive symptoms (primary outcome) and perceived stress (secondary outcome) were collected at baseline, posttreatment, and 3-month follow-up. Intent-to-treat analyses were performed with mixed-effects regression. Results: Significant Treatment X Time interaction effects were found for the gratitude intervention, whether it was compared with control or hassle; the general pattern was a decline in stress and depressive symptoms over time, but the rate of decline became less pronounced as time progressed. Hassle and control were basically indistinct from each other. Relative to control, the gratitude group reported lower depressive symptoms (-1 .5 0 points; 95% CI [-2.98, -0.01]; d = -0.49) and perceived stress (-2.65 points; 95% CI [-4.00, -1.30]; d = -0.95) at follow-up. Results for the comparison between gratitude and hassle were similar. Conclusion: Taking stock of thankful events is an effective approach to reduce stress and depressive symptoms among health care practitioners. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Anaemia and/or thrombocytosis were identified as independent predictors of poor survival in renal cell carcinoma (RCC). We tested the extent to which these markers worsen the prognosis in these patients. Methods: Analyses targeted 1828 patients with renal cell carcinoma. Univariable, multivariable, and predictive accuracy analyses addressed RCC-specific mortality (RCC-SM). Results: In univariable and multivariable analyses, both platelet count and preoperative haemoglobin level were statistically significant predictors of RCC-SM. However, neither platelet count nor preoperative haemoglobin level increased the combined multivariable accuracy of established RCC-SM (predictive accuracy gain=0.3%) predictors. Conclusions: Patients who present with severe anaemia or elevated platelets are at no higher risk of RCC-SM than that related to their stage, grade, histologic subtype, and Eastern Cooperative Oncology Group-Performance Status. [Copyright &y& Elsevier]

Abstract: Objectives: Laparoscopic partial nephrectomy (LPN) is a technically challenging procedure for the management of renal tumours. Major complications of LPN include bleeding and urine leakage. Haemostatic agents (HAs) and/or glues may reduce haemorrhage and urine leakage. We sought to examine the current practice patterns for urologists performing LPN with regard to HA use and its relationship with bleeding and urine leakage. Materials and methods: A survey was sent via e-mail to urologists currently performing LPN in centres in the United States and Europe. We queried the indications for HA/glue usage, type of HAs/glues used, and whether concomitant suturing/bolstering was performed. In addition, the total number of LPNs performed, laparoscopic tools used to resect the tumour, tumour size, and tumour position were queried. Results: Surveys suitable for analysis were received from 18 centres (n =1347 cases). HAs and/or glues were used in 1042 (77.4%) cases. Mean tumour size was 2.8cm, with 79% of the tumours being defined as exophytic and 21% deep. The HAs and glues used included gelatin matrix thrombin (FloSeal), fibrin gel (Tisseel), bovine serum albumin (BioGlue), cyanoacrylate glue (Glubran), oxidized regenerated cellulose (Surgicel), or combinations of these. Sixteen centres performed concomitant suturing/bolstering. The overall postoperative bleeding requiring transfusion and urine leakage rates were 2.7% and 1.9%, respectively. Conclusions: The use of HAs and/or glues is routine in most centres performing LPN. The overall haemorrhage and urine leakage rates are low following LPN. More studies are needed to assess the potential role of HAs and/or glues in LPN. [Copyright &y& Elsevier]

Objectives: Carbonic anhydrase-IX (CA-IX) is a cell surface tumor-associated antigen expressed by most clear cell renal cell carcinomas (RCCs). The specificity and the prognostic value of CA-IX provide impetus to create a mouse model of CA-IX-expressing RCC for testing CA-IX-targeted therapies against RCC. Methods: A retrovirus encoding the human CA-IX gene was used to transduce the murine RCC line, RENCA. In vivo growth kinetics and CA-IX expression were compared between RENCA and RENCA/CA-IX using heterotopic, metastatic, and orthotopic models. Results: Transduction of RENCA created the RENCA/CA-IX line with nearly 100% CA-IX surface expression. In the heterotopic model, subcutaneous injection of 500,000 and 50,000 cells led to tumor formation at 2 to 2.5 weeks after injection, with similar growth kinetics between the two cell lines at either cell number. In the pulmonary metastatic model, a similar number of metastases was noted after inoculation of RENCA and RENCA/CA-IX. In the orthotopic model, autopsy revealed a CA-IX-expressing renal tumor, as well as CA-IX-expressing metastases to the lungs, liver, contralateral kidney, intestines, and lymph nodes. In all the above models, the RENCA/CA-IX tumors retained expression of CA-IX, as demonstrated by immunohistochemistry staining. Conclusions: RENCA/CA-IX is the first tumor model that manifests in immunocompetent Balb/c mice and stably expresses a defined kidney cancer-associated antigen. It maintains antigen expression, forms metastases, and produces reliable tumor growth kinetics equivalent to that of its parental cell line. [ABSTRACT FROM AUTHOR]

The relative efficacy of mucosal (intratracheal) and systemic (intraperitoneal) delivery of interleukin (IL)-12 was evaluated in a mouse model of allergic lung eosinophilia. Mucosal administration of IL-12 achieved 100- to 600-fold higher bronchoalveolar lavage (BAL) levels of IL-12, but 2- to 10-fold lower serum levels compared to systemic administration. Whereas both mucosal and systemic IL-12 inhibited BAL eosinophil recruitment at high doses (100-1000ng), only mucosal IL-12 was effective at low doses (1-10ng). Mucosal, but not systemic, administration of 1000 ng of IL-12 increased interferon (IFN)-γ expression in BAL cells. In a model of ongoing eosinophilic inflammation, when mucosal or systemic IL-12 doses were initiated prior to peak eosinophilia, further eosinophil recruitment was inhibited. However, when IL-12 treatment was initiated after peak eosinophil recruitment occurred, recovery from eosinophilic inflammation was not facilitated. Our findings are the first to demonstrate that locally administered IL-12 inhibits eosinophil recruitment at 100-fold lower doses than systemic IL-12. The most likely mechanism of this enhanced inhibitory activity is a sustained increase in lung levels of IL-12 that augments IFN-γ production from BAL cells. We suggest that future studies should evaluate the efficacy of low doses of nebulized IL-12 in inhibiting eosinophilic lung inflammation in asthma. [ABSTRACT FROM AUTHOR]

The 2-unit CubeSat INSPIRE-2/AU03 was designed, built, tested, delivered, and accepted by the European Union's QB50 project in less than 10 months and for less than US$120,000 in non-salary outlays including launch, despite being a first satellite. It carried 5 instruments (a multi-Needle Langmuir Probe, a diffraction-limited spectrograph, an advanced GPS receiver, and 2 radiation detectors) and the satellite hardware included both Commercial Off-The-Shelf (COTS) and Australian components. INSPIRE-2 was deployed into space from the International Space Station by Nanoracks on 26 May 2017 following an Atlas V launch. The satellite was brought online a month after launch as a result of a major campaign with the international radio amateur community. The uplink function of the Communications board was badly damaged in July 2017 in the first of that year's two major, extended, space weather periods, plausibly due to radiation damage. While INSPIRE-2's radio beacons were resurrected and continued for over a year the Communications board's handshaking protocols meant that downlinking of data was not possible. INSPIRE-2 lived for over a year in space with mostly functioning systems. This paper summarises the major firsts and importance of INSPIRE-2 and its fellow Australian QB50 CubeSats UNSW-EC0 and SuSat (e.g., the first Australian CubeSats and the first Australian-built satellites in 16 years), as well as the science and technical goals, instruments, spacecraft systems, recovery, initial data, and evidence that the major space weather events of 12 July - 4 August 2017 significantly damaged INSPIRE-2 and caused an outage from 26 July to 5 September 2017. It also discusses the lessons learned and the reasons why CubeSats in constellations like QB50, whether international or Australian, provide excellent opportunities for scientific, technical, and commercial development, public outreach and engagement, and international engagement. [ABSTRACT FROM AUTHOR]

Objective: Rare co-existance of disease or pathology. Background: Transformation of primary cutaneous follicle center lymphoma (PCFCL), a low-grade B-cell non-Hodgkin lymphoma (NHL), into a high-grade NHL is rare with uncertain prognosis and treatment. A case is reported of a 40-year-old man who presented with a scalp mass that was diagnosed histologically as PCFCL. Imaging of the head and neck identified diffuse large B-cell lymphoma (DLBCL) involving the parotid gland and cervical lymph nodes, which responded well to radiation therapy. Case Report: A 40-year-old African American man presented with a two-year history of a progressively enlarging scalp mass that measured 10.5×7.1×6.6 cm. Histology showed a low-grade lymphoma with a follicular pattern. Immunohistochemistry was positive for B-cell markers and Bcl-6, consistent with a diagnosis of PCFCL. Computed tomography (CT) identified a 4.9×3.7×3.4 cm mass in the left parotid gland with bilateral cervical lymphadenopathy that had been present for the previous two or three months. The diagnosis of DLBCL was made on histology from a needle biopsy. Treatment began with rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH) chemotherapy, followed by radiation therapy to the scalp, both sides of the neck, and left parotid gland. At four-month follow-up, combined positron emission tomography (PET) and CT showed only diffuse low-level uptake in the scalp and parotid gland. Conclusions: Transformation of low-grade PCFCL to high-grade DLBCL is rare, and the approach to treatment varies. This case showed a good response to chemotherapy and radiation therapy. [ABSTRACT FROM AUTHOR]

To Promote and meet the projected levels of electric vehicle (EV) penetration, the development of charging infrastructure, i.e., both slow charging and dc-fast charging, is essential. Slow/onboard chargers pose weight, efficiency, and thermal management challenges to the designers, while the off-board fast/superfast/ultra-superfast chargers pose efficiency, power rating, and control challenges. In particular, the installation of dc fast chargers (including fast/superfast/ultra-superfast) is also dictated by the impact on the utility grid and the existing loads. New installation or retrofitting of the existing infrastructure is another significant investment challenge jointly explored by stakeholders, utility companies, and car/charger manufacturers. Another primary concern is battery life management limiting the charging current intake by the EV battery. [ABSTRACT FROM AUTHOR]

The article focuses on the role of repeatability and measured spectral range on the accuracy of optical critical dimension (OCD) analysis. It cites the capabilities of broadband polarized reflectometry through the use of the n&k Olympian optical metrology instrument. It also discusses the use of five silicon wafer test samples with space grating/line structures.

Asian Americans are one of the more under-researched groups in the United States. This holds true with regard to research on risk assessment, screening, and testing for human immunodeficiency virus (HIV) and hepatitis C (HCV). Here, we address that lack by exploring correlates of risk and testing for the two diseases among Chinese, Filipino, and Vietnamese men who have sex with men (MSM) and other at-risk men in the San Francisco Bay Area. We do so by analyzing findings from the study of a community-based prevention program, Project 3-3-3 (P333), designed to address the often comorbid conditions of substance abuse, HIV infection, and HCV infection among underserved and high-risk Chinese, Filipino, and Vietnamese adults, most of whom are MSM. A risk-behavior survey completed at preintervention identified risk factors related to HIV, HCV, and substance use among this population ( n = 273). The study of survey data identifies and distinguishes between correlates of HIV and HCV testing. Among our findings, significant differences were found between Asian ethnic subpopulation groups with respect to number of sexual partners ( p = .007), and HIV testing rates comparing MSM and heterosexual men differed significantly ( p < .002). Those who spoke English at home were more likely to be tested for HIV ( p < .008). With HCV testing, the number of partners was positively correlated to getting tested ( p < .047), and Filipino men were significantly more likely to get tested for HCV than Chinese men ( p < .022). [ABSTRACT FROM AUTHOR]

OBJECTIVES To compare cancer-specific mortality in patients with unclassified renal cell carcinoma (URCC) vs clear cell RCC (CRCC) after nephrectomy, as URCC is a rare but very aggressive histological subtype. PATIENTS AND METHODS Eighty-five patients with URCC and 4322 with CRCC were identified within 6530 patients treated with either radical or partial nephrectomy at 18 institutions. Of 85 patients with URCC, 55 were matched with 166 of 4322 for grade, tumour size, and Tumour, Node and Metastasis stages. Kaplan-Meier and life-table analyses were used to address RCC-specific survival. Subsequently, multivariate Cox regression analyses were used to test for differences in RCC-specific survival in unmatched samples. RESULTS Of patients with URCC, 80% had Fuhrman grades III or IV, vs 37.8% for CRCC. Moreover, 36.5% of patients with URCC had pathologically confirmed nodal metastases, vs 8.6% with CRCC. Finally, 54.1% of patients with URCC had distant metastases at the time of nephrectomy, vs 16.8% with CRCC. Despite these differences in the overall analyses, after matching for tumour characteristics, the URCC-specific mortality rate was 1.6 times higher ( P = 0.04) in matched analyses and 1.7 times higher ( P = 0.001) in multivariate analyses. CONCLUSIONS These findings indicate that URCC presents with a higher stage and grade, and even after controlling for the stage and grade differences, predisposes patients to 1.6–1.7 times the mortality of CRCC. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To analyse through a large multicentre series, morbidity of nephron-sparing surgery (NSS) in relation to tumour size and surgical indication. Methods: The study included patients from eight international academic centres. Age, sex, TNM stage, tumour size, Fuhrman grade, Eastern Cooperative Oncology Group performance status (ECOG-PS), surgical margins, local and distant recurrences, and overall and cancer-specific survival rates were collected and analysed. Indication for elective or mandatory NSS, medical and surgical complication rates, mean blood loss, blood transfusion, and length of hospital stay were specifically recorded for the purpose of this study. Groups were compared for qualitative and quantitative variables by using χ2 (Fischer exact test) and Student t tests, respectively. Results: A total of 1048 NSS procedures were included in this study. Mean tumour size was 3.4±2.1cm. In 730 elective procedures mean operative time (p =0.002), mean blood loss (p =0.01), the need for blood transfusion (p =0.001), and urinary fistula rate (p =0.01) were significantly increased for tumours >4cm. However, these differences did not result in significantly increased medical (p =0.4), surgical complication rates (p =0.6), or length of hospital stay (p =0.9). Finally, in elective procedures for malignant tumours, positive surgical margins, local or distant recurrence rates, and cancer-specific survival were not significantly different in tumours ≤4cm and >4cm. Conclusion: Excellent cancer control and outcomes can be achieved with NSS in carefully selected patients with tumours >4cm. Expanding the size indication of elective NSS results in an increased but acceptable morbidity. [Copyright &y& Elsevier]

An interesting group of papers in this section is headed by two papers on synchronous bilateral renal tumours, one from an international group of authors and one from Germany. The large series of patients are examined carefully by both groups, and the findings should be useful for all who are interested in this area. Authors from the UK examine the role of lactate dehydrogenase as a prognostic factor for testicular cancer. They found that it had limited sensitivity, specificity and positive predictive value for detecting relapse, with false-positive elevations being common. OBJECTIVE To present a multicentre experience and the largest cohort to date of nonmetastatic (N0M0) synchronous bilateral renal cell carcinoma (RCC), as because it is rare the single-institutional experience is limited. PATIENTS AND METHODS We retrospectively studied 10 337 patients from 12 urological centres to identify patients with N0M0 synchronous bilateral RCC; the clinicopathological features and cancer-specific survival were compared to a cohort treated for N0M0 unilateral RCC. RESULTS In all, 153 patients had synchronous bilateral solid renal tumours, of whom 135 (88%) had synchronous bilateral RCC, 118 with nonmetastatic disease; 91% had nonfamilial bilateral RCC. Bilateral clear cell RCC was the major histological subtype (76%), and papillary RCC was the next most frequent (19%). Multifocality was found in 54% of bilateral RCCs. Compared with unilateral RCC, patients did not differ in Eastern Cooperative Oncology Group performance status (ECOG PS) and T classification, but bilateral RCCs were more frequently multifocal (54% vs 16%, P < 0.001) and of the papillary subtype (19% vs 12%), and less frequently clear cell RCC (76% vs 83%, P = 0.005). For the outcome, patients with nonmetastatic synchronous bilateral RCC and unilateral RCC had a similar prognosis ( P = 0.63); multifocality did not affect survival ( P = 0.60). Multivariate analysis identified ECOG PS, T classification, and Fuhrman grade, but not laterality, as independent prognostic factors for cancer-specific survival. CONCLUSIONS Patients with N0M0 synchronous bilateral RCC and N0M0 unilateral RCC have a similar prognosis. The frequency of a familial history for RCC (von Hippel-Lindau disease or familial RCC) was significantly greater in bilateral synchronous than in unilateral RCC. The significant pathological findings in synchronous bilateral RCC are papillary subtype and multifocality. [ABSTRACT FROM AUTHOR]

OBJECTIVE To define the prognostic relevance of capsular involvement (invasion with no penetration) and collecting-system invasion in patients with stage I (pT1N0M0) and stage II (pT2N0M0) renal cell carcinoma (RCC), by evaluating the outcome of patients treated with nephrectomy. PATIENTS AND METHODS In all, 519 patients from a kidney cancer database treated with nephrectomy for stage I and II RCC between 1985 and 2005 were assessed retrospectively. The primary endpoint was recurrence-free survival time. The prognostic relevance of capsular involvement and collecting-system invasion were examined using univariate and multivariate survival analysis. RESULTS Capsular involvement and collecting-system invasion were evident in 112 (21.6%) and 39 (7.5%) patients, respectively. Capsular involvement was associated with higher Fuhrman grades and larger tumours. The incidence of collecting-system invasion was higher in patients with microvascular invasion. The median follow-up was 49 months. In univariate analysis, patients with capsular involvement and collecting-system invasion had a worse prognosis than patients without ( P = 0.007 and <0.001, respectively). In multivariate analysis, capsular involvement (hazard ratio 1.84, P = 0.036) and collecting-system invasion (3.78, P < 0.001) were independent prognostic factors of recurrence-free survival. Interestingly, there was no survival difference between patients with capsular involvement in stage I/II and patients with invasion of perinephric tissue (pT3aN0M0). CONCLUSIONS These findings suggest that capsular involvement and collecting-system invasion are poor prognostic findings in stage I and II RCC. They should both be considered when planning the follow-up. A revised pT3a stage including patients with capsular involvement could improve its prognostic validity. [ABSTRACT FROM AUTHOR]

Abstract: The WHO immunophenotype for plasma cell myeloma is deletion of CD19 and CD20, usual expression of CD38, CD138, and CD56, and occasional expression of CD10. Of the 39 cases of plasma cell dyscrasia in our study, the mean fluorescence intensities (MFI) of CD38, CD138, CD56, and CD19 were quantified in 30 cases. CD19 was absent in 38 of the cases (97.4%), whereas CD138 and CD38 were expressed in all 39 cases (100%). Most cases expressed CD38 and CD138 brightly with MFI values greater than 501, whereas all other marker expression was moderate with MFI greater than 301. Whereas CD38/CD56 dual expression was observed in 25 cases (64.1%), 14 failed to express CD56 (35.9%). CD56 expression was bright in 16 cases (53.3%), moderate in 2 cases (6.7%), and negative in the remaining 12 cases (40%) with MFI values of 200 or less. CD117 expression was positive in 9 of 24 cases (37.5%). In 32 of 39 cases, 27 were negative for CD20 (84.4%) and 28 were negative for CD10 (87.5%). Our results point to the value of quantitative fluorescence intensity in the flow cytometric evaluation of CD molecular expression or deletion in the diagnosis of hematopathologic disorders, such as plasma cell dyscrasia. [Copyright &y& Elsevier]

Abstract: Flow cytometric analysis of cluster of differentiation (CD) markers in abnormal lymphocyte populations is crucial in the diagnosis of precursor T cell acute lymphoblastic leukemia (T-ALL)/lymphoblastic lymphoma (LBL). The World Health Organization (WHO) suggested immunophenotype for pre-T ALL/LBL typically includes the expression of TdT, cCD3, and CD7, while CD2, CD3, CD4, CD5, CD8, and CD10 are variably expressed. The myeloid antigens CD13 and CD33 are usually positive, whereas CD117 and cCD79a are infrequently expressed. Furthermore, there is frequent dual expression of CD4 and CD8. In the present investigation, 19 cases of pre-TALL/LBL were analyzed for selected CD marker expression. Fifteen of 19 cases studied were evaluated for TdT, cCD3, and cCD79a expression. Eleven (73.3%) positively expressed TdT, 15 (100%) positively expressed cCD3, and 9 (60%) positively expressed cCD79a. Of the 17 cases analyzed for CD7, CD5, and CD10 expression, CD7 and CD5 were positive in all 17 (100%) cases, whereas CD10 was positive in 8 (47.1%) cases. Of the 18 cases evaluated for CD2, CD3, CD4, CD8, and dual expression of CD4 and CD8, CD2 was expressed in 14 (77.8%), while CD3 was expressed in 7 (38.9%) cases. CD4 was positive in 11 (61.1%), and CD8 was expressed in 9 (50%). Dual expression of CD4 and CD8 occurred in only 4 (22.2%) of the cases. Of the 16 analyzed for CD13, CD33, and CD117, only 1 case (6.3%) expressed CD13, while 2 (12.5%) cases expressed CD33 and CD117. Thus, these data point to the need for a more extensive study to reevaluate the current WHO defined immunophenotype used in the diagnosis of pre-TALL/LBL. [Copyright &y& Elsevier]