bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise above the maximal lactate steady state does not elicit a V̇O2 slow component that leads to attainment of V̇O2max
Authors: Hill David W. , McFarlin Brian K. , Vingren Jakob L.
Published: August 2020

There is a pervasive belief that the severe-intensity domain is defined as work rates above the power associated with a maximal lactate steady state (MLSS) and by a oxygen uptake (V̇O2) response that demonstrates a rapid increase (primary phase) followed by a slower increase (slow component), which leads to maximal oxygen uptake (V̇O2max) if exercise is continued long enough. Fifteen university students performed 5 to 7 tests to calculate power at MLSS (154 ± 29 W). The tests included 30 min of exercise at each of 3 work rates: (i) below (–2 ± 1 W) power at MLSS, (ii) above (+4 ± 1 W) the power at MLSS, and (iii) well above (+19 ± 8 W) power at MLSS. The V̇O2 response in each test was described using mathematical modeling. Contrary to expectation, the response at the supra-MLSS work rates had not 2, but 3, distinct phases: the primary phase and the slow component, plus a “delayed” third phase, which emerged after ∼15 min. V̇O2max was not attained at supra-MLSS work rates. These results challenge commonly held beliefs about definitions and descriptions of exercise intensity domains.

Novelty: The V̇O2 response at work rates that are too high to sustain a lactate steady state but not high enough to elicit V̇O2max features not 2, but 3, distinct phases. There is no consensus on whether intensity domains should be defined by their boundaries or by the responses they engender.
Relocalization switch in a triple quantum dot molecule in 2D
Authors: Znojil Miloslav
Published: August 2020

A symmetric chain of three quantum dots (i.e., one of the simplest quantum dot molecules) is constructed using a three-parametric non-separable version of an asymptotically separable sextic polynomial potential [Formula: see text]. The probability density [Formula: see text] (admitting either the central or off-central dominance) is assumed measured. A dynamical regime is found with an enhanced sensitivity of the central—off-central transition to the parameters. Quantitatively, the possibility of control of such a switch alias “relocalization catastrophe” is illustrated non-numerically.
Modeling and theoretical investigation of curved parabolized surface of second-order velocity slip flow: Combined analysis of entropy generation and activation energy
Authors: Qayyum Sumaira , Khan M. Ijaz , Chammam Wathek , Khan W. A. , Ali Zulfiqar , Ul-Haq Wasim
Published: August 2020

Here our purpose is to explore the entropy generation in nanofluid MHD flow by curved stretching sheet; second-order slip is considered. Additional effects of viscous dissipation, Joule heating, and activation energy are taken. Temperature and concentration boundary conditions are considered convectively. For convergence of series solution NDSolve MATHEMATICA is used. Velocity, Bejan number, concentration, temperature, and entropy generation graphs are sketched for important parameters. For greater estimations of first- and second-order velocity slip parameters fluid velocity reduces. The thermal and solutal Biot numbers enhance the temperature and concentration, respectively. The concentration also has direct relation with activation energy. Entropy generation reduces for chemical reaction parameter and first- and second-order slip parameters.
HIGH TEMPERATURE STEAM CORROSION OF MICROARC OXIDATION COATINGS ON 6061 ALUMINUM ALLOY AT 300∘C/3 MPa STEAM
Authors: QU YAO , YANG CHAOLIN , JIN XIAOYUE , DU JIANCHENG , XUE WENBIN
Published: August 2020

The structural and phase transformation of microarc oxidation (MAO) coatings on 6061 aluminum alloy at 300∘C/3[Formula: see text]MPa steam were evaluated. After 10 days steam corrosion, the weight loss of coated alloys with 15[Formula: see text][Formula: see text]m and 75[Formula: see text][Formula: see text]m thickness was only about 1/10 and 1/50 of weight gain of bare alloy, respectively. The [Formula: see text]-Al2O3 and [Formula: see text]-Al2O3 phases in the MAO coatings were stable at 300∘C/3[Formula: see text]MPa steam, but many fine needle-like or brick-like boehmite crystalline particles also appeared on coating surface. The boehmite had a large influence on the permittivity of coatings at low frequency. The MAO treatment on 6061 aluminum alloy improved its corrosion resistance at high-temperature and high-pressure steam.
INTERBANK CREDIT RISK MODELING WITH SELF-EXCITING JUMP PROCESSES
Authors: LEUNGA CHARLES GUY NJIKE , HAINAUT DONATIEN
Published: August 2020

The credit crunch of 2007 caused major changes in the market of interbank rates making the existing interest rate theory inconsistent. This paper puts forward one way to reconcile practice and theory by modifying the arbitrage-free condition. In this framework, the forward Libor rate is no longer considered as a risk-free rate and the credit and liquidity risks within the interbank market partly drive its dynamics. In a similar manner to the multiple-curve approach, we model the evolution of default-free rates, assimilated to overnight interest swap rates, and the default times of an interbank market segment determined by its tenor. For each segment, we use the reduced form approach to model the arrival rate of defaults with a self-exciting jump-diffusion process. Then, we deduce the dynamics of the spot forward Libor rates and provide closed-form approximation pricing formulae for options on forward Libor rates and swap rates. Even in a context of negative interest rates and compared to other forms of intensity processes such as a CIR, the self-excitation property allows a better understanding of the spread OIS-IRS and provides information about the interbank credit risk. Furthermore, our framework enables to parse the impact of the interbank credit risk on forward Libor as well as on interest rates derivatives like caps, floors, and swaptions.
TOTALLY CLASSICAL CALOGERO MODEL
Authors: KLIMČÍK C.
Published: August 2020

We show that the standard Calogero Lax matrix can be interpreted as a
function on the fuzzy sphere and the Avan–Talon r-matrix as a function on
the direct product of two fuzzy spheres. We calculate the limiting Lax
function and r-function when the fuzzy sphere tends to the ordinary sphere
and we show that they define an integrable model interpreted as a large N
Calogero model by Bordemann, Hoppe and Theisen.
Effective properties of a porous inhomogeneously polarized by direction piezoceramic material with full metalized pore boundaries: Finite element analysis
Authors: Nasedkin Andrey , Nassar Mohamed Elsayed
Published: August 2020

This paper concerns the homogenization problems for porous piezocomposites with infinitely thin metalized pore surfaces. To determine the effective properties, we used the effective moduli method and the finite element approaches, realized in the ANSYS package. As a simple model of the representative volume, we applied a unit cell of porous piezoceramic material in the form of a cube with one spherical pore. We modeled metallization by introducing an additional layer of material with very large permittivity coefficients along the pore boundary. Then we simulated the nonuniform polarization field around the pore. For taking this effect into account, we previously solved the electrostatic problem for a porous dielectric material with the same geometric structure. From this problem, we obtained the polarization field in the porous piezomaterial; after that, we modified the material properties of the finite elements from dielectric to piezoelectric with element coordinate systems whose corresponding axes rotated along the polarization vectors. As a result, we obtained the porous unit cell of an inhomogeneously polarized piezoceramic matrix. From the solutions of these homogenization problems, we observed that the examined porous piezoceramics composite with metalized pore boundaries has more extensive effective transverse and shear piezomoduli, and effective dielectric constants compared to the conventional porous piezoceramics. The analysis also showed that the effect of the polarization field inhomogeneity is insignificant on the ordinary porous piezoceramics; however, it is more significant on the porous piezoceramics with metalized pore surfaces.
Smart Light-Based Information Leakage Attacks
Authors: Maiti Anindya , Jadliwala Murtuza
Published: August 2020

Modern Internet-enabled smart lights promise energy efficiency and many additional capabilities over traditional bulbs. However, these connected lights also expose a new attack surface, which can be maliciously used to violate users' privacy and security. We design and evaluate novel inference attacks that take advantage of the light emitted by these smart lights to infer sensitive user data and preferences.
The Existence and Effect of Dark Energy Redshift on Cosmological Age
Authors: Storti Riccardo C.
Published: August 2020

A derivation of Cosmological Age explicitly constrained by Cosmic Microwave Background Radiation (CMBR) is presented, demonstrating that the correct value of Cosmological Age is equal to the Hubble Age. It is shown that utilizing “z = 0” for Cosmological Redshift in the Present Epoch introduces a fundamental flaw into Cosmological Age calculations. However, this flaw is captured and corrected by the Polarizable-Vacuum (PV) Model of Gravity developed by Puthoff, suggesting that the Dark Energy Field exists as a massive photonic field. Consequently, it is demonstrated that for a Dark Energy Driven description of Accelerated Cosmological Expansion, Cosmological Redshift takes a negative value in the Present Epoch.
A Maintenance Task Similarity-Based Prior Elicitation Method for Bayesian Maintainability Demonstration
Authors: Wu Zhenya , Hao Jianping
Published: August 2020

Prior distribution elicitation is a challenging problem for a Bayesian inference-based mean time to repair (MTTR) demonstration because if inaccurate prior information is introduced into the prior distribution, the results become unreliable. This paper proposes a novel maintenance task representation model based on the similarity of attributed maintenance items. A novel similarity computation algorithm for maintenance tasks is then formulated on the basis of this model. Optimistic and pessimistic values are ascertained from the time data for similar maintenance tasks to obtain a prior distribution. The main idea is to separate maintenance tasks into distinct items and use attribute sets to extract key features. Each pair of items is then compared to quantify the differences between reference and candidate tasks. Candidate tasks with an acceptable difference from the reference task are taken as prior information sources for constructing the prior distribution. A case study involving a high-frequency (HF) transceiver MTTR Bayesian demonstration shows that the proposed method can effectively obtain maintenance tasks similar to those of information sources for prior distribution elicitation.
Detection Rate of 18F-Fluorethylcholine-PET/CT in relation to PSA Value in PCA Patients Referred with Biochemical Relapse
Authors: Takesh Mustafa , Odat Allh Khaldoun , Zechmann Christian M.
Published: August 2020

Attempts to predict the likelihood of positive morphological imaging related with PSA value in patients referred with biochemical recurrence were the focus of many studies. Using nuclear medicine modalities, numerous studies likewise had been performed for the same purpose, however mostly using C-11-labeled choline. For this purpose, we selected 193 prostate cancer patients from our database between 2006 and 2010. They had been referred to our department to undergo 18F-fluorethylcholine (FECH)-PET/CT due to biochemical recurrence after potentially curative procedures. As a result, in 84 out of 193 patients, 18F-FECH-PET demonstrated positive findings with an overall detection rate of 44%. Statistically, there was a significant difference in PSA values in positive findings vs. negative findings (p<0.001), and there was a linear correlation between the detection rate and PSA value (r = 0.91). Moreover, there was a relation between initial therapy and recurrence type. So, the local relapse was the most frequent recurrence (>70%) after radiation therapy alone. By contrast, patients after radical prostatectomy followed by salvage radiotherapy showed a low likelihood of local recurrence. In conclusion, PSA value was confirmed to have a determinant role in 18F-FECH-PET outcome. Moreover, there was a link between recurrence type and initial therapy, which—if prospectively confirmed—may play a guiding role in selecting the appropriate diagnostic methods.
Research on the Optimization Management of Cloud Privacy Strategy Based on Evolution Game
Authors: Sun Pan Jun
Published: August 2020

Cloud computing services have great convenience, but privacy security is a big obstacle of popularity. In the process result of privacy protection of cloud computing, it is difficult to choose the optimal strategy. In order to solve this problem, we propose a quantitative weight model of privacy information, use evolutionary game theory to establish a game model of attack protection, design the optimal protection strategy selection algorithm, and make the evolutionary stable equilibrium solution method from the limited rational constraint. In order to study the strategic dependence of the same game group, the classical dynamic replication equation is improved by using the incentive coefficient, an improved evolutionary game model of attack protection is constructed, the stability of equilibrium point is further analyzed by Jacobian matrix method, and the optimal selection strategy is obtained under different conditions. Finally, the correctness and validity of the model are verified by experiments, different strategies of the same group have the dual effects of promotion and inhibition, and the advantages of this paper are shown by comparing with other articles.
Cord Malaria Infection, Complement Activation, Oxidative Stress, Gestational Age, and Birth Weight, Characterized by HighPlasmodium falciparumPrevalence in Bamenda, Cameroon
Authors: Mahamat Oumar , Gisele Ndum Kidio , Laurentine Sumo , Ngum Helen Ntonifor
Published: August 2020

Background. It is unknown whether the presence ofPlasmodium falciparummalaria parasites in umbilical cord blood denotes activation of complement and oxidative stress to affect the duration of pregnancy and birth weight.Methods. In a cross-sectional study conducted from January to April 2019 in Bamenda, Cameroon, cord blood samples were collected from 300 women at delivery. Parasitaemia was determined microscopically. Babies’ weight and age of gestation were recorded. Plasma levels of complement and oxidative stress were measured by specific tests.Results. Cord blood malaria prevalence was 21.33%. Babies with an infected cord showed a low birth weight and gestation age than those with uninfected cords. More babies with infected cords had LBW (6.25%) compared to the counterparts (5.50%). The levels of parasitaemia and the babies’ weight showed a weak positive correlation. The prevalence of preterm and postterm birth was 4.33% and 24.33% respectively, with a weak negative correlation between the age of gestation and the umbilical cord parasitaemia. There was correlation between cord parasitaemia and levels of complement haemolytic activity titter (CH50) and specific classical pathway activity (CPA) in cord blood. CH50and CPA levels, however, were significantly higher in infected cord blood samples, compared with uninfected cord blood samples. CH50showed a negative correlation with the birth weight and gestational age in infected cord blood samples. The levels of total oxidative stress (TOS) and total antioxidant defense were significantly lower in infected cord blood than uninfected. TOS displayed a positive correlation with the density of parasitaemia and a weak negative correlation with the birth weight and gestational age in infected cord blood.Conclusion. Cord blood infection lowers the complement haemolytic titter, oxygen radicals and total antioxidant defense in neonates. This lowering of complement haemolytic titter and oxygen radical compounds in umbilical cord malaria are associated with low birth weight and preterm birth.
A Simple Synthesis of Higher Refractive Index Polymeric Nanocomposite Containing the Pendant ZnS Nanocrystals Capping Different Amount of Mercaptoethanol
Authors: Li Xinxin , Xu Jinku
Published: August 2020

In this paper, three kinds of ZnS NPs capping different amount of mercaptoethanol (ME) were synthesized, and the effect of capping amount on ZnS NPs was studied, indicating that the capping amount of ME on ZnS surface decreases, while ZnS size increases as the decrease of added capping agent in synthesis process, and ZnS NP capping middle amount of ME (~27.7 wt%) shows a highest apparent refractive index (RI) value. ZnS NPs were composited into polymeric matrices by a simple “one-step” thermocuring method characterized by adding a small amount of functional monomer of glycidyl methacrylate (GMA) and solvent of N,N-dimethylformamide (DMF) The reaction mechanism, studied by 1H NMR spectra, indicates that the epoxy of GMA monomer can be easily opened and chemically grafted on ME-capped ZnS surface under the catalysis of DMF, and then copolymerized with other monomer. By the route, ZnS NPs can be composited into pure poly(N,N-dimethylacrylamide)-type (DMA-type), DMA-type copolymer, and DMA-free matrices to fabricate transparent films, and its RI value can be improved by either optimizing capping amount on ZnS surface or increasing ZnS content in the nanocomposites. The RI value of resulting dried nanocomposites can be improved to 1.764 by compositing 80 wt% ZnS capping middle amount of ME.
Mucocutaneous Manifestations in HIV-Infected Patients and Their Relationship to CD4 Lymphocyte Counts
Authors: Mirnezami Mina , Zarinfar Nader , Sofian Masoomeh , Botlani Yadegar Bahareh , Rahimi Hoda
Published: August 2020

Background. More than 90% of human immunodeficiency virus- (HIV-) infected patients show at least one mucocutaneous manifestation during the course of their disease. The frequency, pattern, and associated factors of these complications vary among different populations. Objective. This study was planned to evaluate the frequency of cutaneous presentations in HIV-infected patients and their association with the count of CD4 cells. Methods. A cross-sectional study was conducted on eighty-four HIV-positive patients, who attended the Behavior Consultation Center of Arak University of Medical Sciences. All subjects had a complete physical examination by an expert dermatologist. Further diagnostic procedures were performed, if necessary. Counts of CD4 were determined using flow cytometry. Results. From 84 patients who enrolled in this study, 95.2% manifested at least one type of mucocutaneous lesions. The most common presentation was xerosis, followed by seborrheic dermatitis, herpes simplex, and oral candidiasis. Oral candidiasis and furuncle were significantly associated with decrease in CD4 cell counts. Conclusions. Cutaneous manifestations are common in HIV-positive patients, some of which (oral candidiasis and furuncle) could be applicable as useful clinical indicators to predict the immune status of the patients. Therefore, regular skin examinations are recommended as routine HIV-infected patients’ healthcare programs.
Internet Addiction, Oral Health Practices, Clinical Outcomes, and Self-Perceived Oral Health in Young Saudi Adults
Authors: Al-Ansari Asim , El Tantawi Maha , AlMadan Nasser , Nazir Muhammad , Gaffar Balgis , Al-Khalifa Khalifa , AlBaty Ali
Published: August 2020

The study assessed the relationship between Internet addiction and oral health practices and clinical outcomes and whether this was affected by oral health perception. In 2017, a cross-sectional study included university students in the Eastern Province of Saudi Arabia. Questionnaires assessed demographic background, oral health practices (consuming sugar, tobacco use, and oral hygiene), perceived oral health, and Internet addiction. Caries experience and gingivitis were assessed using the World Health Organization criteria. The multivariate general linear analysis assessed the relationship between dependent variables (oral health practices, DMFT, and gingivitis) and exposure (Internet addiction). Data were available for 919 participants, 75.4% females, mean age = 19.8 years, and 1.6% with significant Internet use problem. The mean percentage of teeth with gingivitis was 8.5% and mean DMFT was 2.9. Among those with good perception of oral health and compared with participants with significant Internet use problem, average Internet users had lower consumption of sugar and tobacco (B = −6.52,P=0.03andB = −2.04,P=0.03), better oral hygiene practices (B = 2.07,P=0.33), higher DMFT (B = 2.53,P=0.10), and lesser gingivitis (B = −15.45,P=0.06). Internet addiction was associated with negative oral health practices and poor clinical outcomes among young Saudis. Holistic health promotion approaches need to address the negative impact of Internet addiction on health and oral health status for this at-risk age group.
Seismic Response of Rock Slopes with the Anchor Cable in Centrifuge Modeling Tests
Authors: Nie Yong , Zhao Yufei , Wang Xiaogang , Li Linhao , Zhang Hongtao
Published: August 2020

In order to study the seismic response of the rock slopes with the anchor cable, centrifuge modeling tests were performed on concrete slope models. Different seismic loadings were performed to investigate the horizontal acceleration response, the rock slope displacement, and the stress of anchor cables. The results show that the horizontal acceleration response is obviously amplified by a rock slope. Under the same conditions, the higher the seismic intensity is, the larger the acceleration amplification coefficient will be. Anchor cable can effectively reduce the acceleration amplification effect of the slope. For the slope with a structural plane, the anchor cable at the structural plane is stressed greatly during the seismic action, and the strength of anchor cables near the expected structural plane is important.
Observed Performance of Highway Embankment over Soft Marine Clay: A Case Study in Wenzhou, China
Authors: Bian Xia , Yan Jin-Kai , Zhang Wei
Published: August 2020

This paper presents a case history of observed performance of highway embankment over soft marine clay in Wenzhou, China. During the embankment construction, the changes of ground settlement, ground displacement, and lateral displacement of subsoil with the construction time were monitored and analyzed. The monitoring results indicate that the ground settlement and lateral displacement of subsoil account for about 75% in the process of embankment construction. The measured maximum values of ground settlement, ground displacement, and lateral displacement of subsoil are 37.88 mm, 21.50 mm, and 23.56 mm, respectively. After the completion of the embankment construction, the settlement gradually tended to be stable. It is suggested that the monitoring data of settlement and displacement of embankment are smaller than the design requirements, and the embankment stability is also ensured.
Abstract A014: Development of a culturally grounded brochure to enhance colorectal cancer screening in Southwestern American Indian communities
Authors: Sussman Andrew L. , English Kevin , Frank Matthew , Guest Dolores , Helitzer Deborah , Mishra Shiraz
Published: August 2020

Elimination of colorectal cancer disparities is a national priority. Despite the effectiveness of colorectal cancer (CRC) screening tests for average risk adults, these tests are underutilized by American Indians/Alaska Natives. Subsequently, these populations have experienced either no change or an increase in CRC incidence. Prior to conducting a trial to determine the efficacy of interventions of graded intensity on screening behavior among six tribal communities in the Southwest United States, we set out to develop a culturally appropriate and theoretically grounded brochure to increase community demand for CRC screening. In order to ensure the brochure's health literacy to diverse tribal participants, we utilized the Suitability Assessment of Materials and Comprehensibility of Materials (SAM+CAM) instrument as a basis for structuring this process. Using an iterative process, we conducted two focus groups and made modifications to the brochure. We then implemented the SAM+CAM assessment. We report here on the findings from both the focus groups and the SAM+CAM testing. We organized focus group findings by the SAM+CAM categories, including content, literacy demand, numeracy, graphic material, layout/typography, and learning stimulation/motivation. We will provide quotes and summaries of the relevance for each of these SAM+CAM categories. By structuring focus groups with American Indian participants using these categories, we then made revisions to the brochure. The resulting SAM+CAM scores confirmed that the brochure was suitable and comprehensible to participants. Overall, the SAM+CAM scores were generally high as the overall rating was 90%, which indicates a superior product. Using this participatory and iterative process, we found that structuring the development and revision of the brochure through the SAM+CAM categories provided a useful process to balance the presentation of evidence-based data for CRC screening with community preferences and norms.

Citation Format: Andrew L. Sussman, Kevin English, Matthew Frank, Dolores Guest, Deborah Helitzer, Shiraz Mishra. Development of a culturally grounded brochure to enhance colorectal cancer screening in Southwestern American Indian communities [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A014.
Abstract A020: Utilizing a community navigator's approach to improve breast and cervical cancer screening in the Deep South
Authors: Hardy Clauda M. , Seetela Kumari , Bowman Tara , Norris Katherine , Wright Nancy
Published: August 2020

This presentation illustrates a community-based intervention utilizing community navigators to identify, recruit. and work to eliminate barriers to improve breast and cervical cancer screening in underserved communities in the Deep South.

Background: The UAB Comprehensive Cancer Center built an academic-community infrastructure called the Deep South Network for Cancer Control via funding from the National Cancer Institute Center to Reduce Cancer Health disparities from 2000-2016. The Deep South Network (DSN) utilized a Community Health Advisors (CHA) model combined with community engagement and coalition building to conduct community outreach and community-based cancer disparity research in medically underserved communities in Alabama and Mississippi. Through the utilization of the CHA model, cancer mammography screening rates among the Medicare population saw a 17% difference between AA women and Caucasian from 1999 to 2014.

Purpose: To utilize the DSN model to train community navigators to identify and recruit rarely or never screened women for breast and cervical cancer screening. Community Navigators with support of the CHAs work to address client barriers to improve screening. Through a collaboration with the Alabama Breast and Cervical Cancer Early Detection Program (ABCCEDP), UAB Community Navigators delivered a community intervention to address barriers to breast and cervical cancer screening.

Methodology: The intervention was delivered in eight Alabama counties: seven rural and 1 urban over a 12-month period. Each county had a paid, community-based navigator who received 8-hour training on navigating clients for clinical services. Community Navigators delivered community-based education and identified and addressed barriers to increase cancer screening.

Conclusion: At the end of the 12-month intervention, the community navigators held 212 events such as health fairs and community presentations in public housing and faith-based groups that yielded a reach of 16,038 individuals. Of these events, 273 women indicated an interest in or need for these screenings with 83 % of them between ages 40-54. Navigators worked through client barriers to see an overall significant increase of 5% in women enrolled in the ABBCECP compared to previous years in the nine counties

Citation Format: Clauda M. Hardy, Kumari Seetela, Tara Bowman, Katherine Norris, Nancy Wright. Utilizing a community navigator's approach to improve breast and cervical cancer screening in the Deep South [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A020.
Abstract A055: Pearls and pitfalls of implementing a patient navigation training workshop for Appalachia
Authors: Dignan Mark , Dwyer Sharon , Rohan Elizabeth , White Dana , Castro Georgina , Wilson Reda , Stockton Eric
Published: August 2020

The Appalachian region includes 13 states, ranging from southern New York to Mississippi. The region encompasses large areas experiencing high unemployment rates, poverty, and high rates of chronic disease, including cancer. Patient navigation (PN) is a patient-centered intervention designed to address barriers to timely cancer screening and treatment. Results of a prior project in the region indicated that existing PN training programs did not adequately address issues specific to working in Appalachia. To address this gap, we developed a culturally relevant PN training program to be delivered across the Appalachian region. We supported and delivered 20 trainings to over 300 participants from 2015 through the present, averaging 15 attendees per session. Participants included nurses, social workers, patient navigators, community health workers, and administrators living and working in Appalachia. The training's focus on integrating the unique aspects of Appalachian culture into patient navigation for cancer screening and care was rated high by participants. Additionally, participants appreciated the opportunity to network, since many participants work in isolation. Despite our model of providing multiple trainings in various locations throughout Appalachia, we noted there were still barriers to attendance. We conducted a formative evaluation to understand the challenges and identify solutions. We spent considerable time focusing on curricula development, but more attention was needed for detailed logistical considerations such as 1) earlier engagement of local community resources, including potential barriers to attending workshops and 2) local assistance in selecting training sites that would attract maximum attendance. Application of the guiding concepts in planning and data describing the workshop locations, participants, and evaluation results will be presented.

Citation Format: Mark Dignan, Sharon Dwyer, Elizabeth Rohan, Dana White, Georgina Castro, Reda Wilson, Eric Stockton. Pearls and pitfalls of implementing a patient navigation training workshop for Appalachia [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A055.
Abstract A056: Supporting the next generation of researchers: The effects of a U54 Partnership
Authors: Drennan Marilyn , Loest Helena , Thompson Beti , Unguez Graciela
Published: August 2020

Background: The REACH Education Core of the U54 Partnership between New Mexico State University (NMSU) and Fred Hutch is reaching under-represented (UR) students through summer internships in the laboratories of U54-funded investigators on both campuses.

Objective: The objective of this study is to provide information on successful educational outcomes of under-represented students.

Methods: The Partnership generated an extensive participate tracking database. Outcomes included undergraduate graduation, entry into advanced degree programs, awards, and publications. Using the tracking database, we identified the number of students who achieved these outcomes. In addition, we evaluated student attitudes, efficacy, and participation in collaborative research activities.

Results: We facilitated research internships for 83 undergraduates (83% UR) and 23 graduate students (74% UR). Of the undergraduates, 96% completed their BS degree and 86% are on track to complete a graduate degree. Of the graduates, 96% have completed their graduate degree. Since the inception of the partnership in 2002, 72 (56%) of the total Partnership publications have students as coauthors. A total of 133 student participants are now employed in cancer-related research. A total of 697 students have been exposed to the Partnership's cancer and health objectives.

Conclusions: The Partnership has had a high impact in preparing future scientists who will contribute to the diversification of the biomedical research workforce. The educational components of this Partnership have had exceptional successes.

Implications: This study demonstrates that institutions of higher learning can implement research experiences to maintain, strengthen, and evaluate effective programs for current and future under-represented scientists.

Citation Format: Marilyn Drennan, Helena Loest, Beti Thompson, Graciela Unguez. Supporting the next generation of researchers: The effects of a U54 Partnership [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A056.
Abstract A075: Gender diversity in academic oncology programs
Authors: Seldon Crystal S. , Ahmed Awad A. , Llorente Ricardo , Yoo Stella K. , Holliday Emma B. , Thomas Charles R. , Jagsi Reshma , Deville Curtiland
Published: August 2020

Purpose: This study sought to examine gender diversity among academic faculty of medical oncology, hematology/oncology, and radiation oncology residency programs in the United States (U.S.), Canada, and Spain.

Methods: Data from the Association of American Medical College (AAMC) were used to examine faculty composition of medical oncology, hematology/oncology, and radiation oncology departments in U.S. institutions for the years 1977 and 2017. For international data, public webpages listing post-graduate training programs in medical oncology and radiation oncology were examined and the genders of department heads were recorded.

Results: In the U.S., in 1977, women made up 8%, 9%, and 7% of the total workforce among hematology/oncology, medical oncology, and radiation oncology faculty positions, respectively, compared to 44%, 40%, and 27%, respectively, in 2017. Regarding departmental leadership, in the U.S., 9% (8/89) of radiation oncology department chairs were women. In Canada, for radiation oncology, 11 department heads were men, 1 was a woman, and 1 department could not be determined (8-15% women). For medical oncology, 10 department heads were men, 3 women, and 2 were unknown (20-33% women). In Spain, 12 radiation oncology heads were women, 28 men, and 8 were unknown (25-42% women); for medical oncology, 14 department heads were women, 52 were men, and 11 were unknown (25-42% women).

Conclusions: Women have historically increased in representation in the U.S. oncology workforce; however, they remain under-represented relative to the overall U.S. population. Women were also under-represented at the level of chair in the U.S., Canada, and Spain. Further research and efforts are needed to enlist and advance women in oncologic fields both nationally and internationally and understand barriers to training, practice, and advancement.

Citation Format: Crystal S. Seldon, Awad A. Ahmed, Ricardo Llorente, Stella K. Yoo, Emma B. Holliday, Charles R. Thomas, Reshma Jagsi, Curtiland Deville Jr. Gender diversity in academic oncology programs [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A075.
Abstract A092: Cancer caregiver burden and mental health outcomes: Differences by race/ethnicity
Authors: Thomson Maria D. , Cadua Abigail , Matsuyama Robin , Siminoff Laura A.
Published: August 2020

Background: Informal caregivers (CGs) play a critical role in caring for cancer patients at end of life, often to the detriment of their own health outcomes. However, much of the literature focuses on white CGs, with little specifically addressing the experiences and health outcomes of African American cancer CGs.

Purpose: To compare the outcomes of perceived burden, depression, and distress between white and African American cancer CGs with a focus on the role of social support and CG preparedness to provide care.

Methods: Informal caregivers providing end-of-life care to cancer patients were recruited from an academic cancer center. CGs were administered the following scales: CES-D, Zarit Burden, Distress Thermometer, Preparedness for Caregiving, and demographics. One item each assessed health status and social support from church/religious groups.

Results: Caregivers (n=90) were mostly female (77%), married/partnered (61%), and reported a median annual household income of $45,500. African American CGs (n=44; 49%) reported significantly lower distress [2(88); p=0.04], depression [2(86); p=0.04], caregiver burden [3.8(76); p=0003], and greater social support [2(88); p=0.02] from church/religious groups compared to white CGs. No univariate differences in perceived preparedness to provide care, health status, or spirituality were found. Multiple regression models for depression [R2=0.4, F(8,77)=6.8; p<.0001], distress [R2=0.17, F(8, 78)=3.2; p=.003], and CG burden [R2=.50, F(8, 78)=11.3; p<.0001], were significant. CGs who were African American reported greater preparation and better health and had lower depression and distress. Lower CG burden was associated with CGs who were African American, older age, and reported greater CG preparation.

Conclusions: African American CGs reported lower CG burden and better mental health outcomes compared to white CGs. Some key intervention targets such as perceived CG preparation to provide care have important associations with health outcomes for all CGs. However, there are likely other components such as social support from church/religious groups that vary in level of importance depending on the unique sociocultural perspectives of racial/ethnicity groups. Interventions are needed that support cancer caregivers and protect their own health outcomes. Developers should consider the diversity of experiences and meanings attributed to cancer caregiving when choosing intervention targets.

Citation Format: Maria D. Thomson, Abigail Cadua, Robin Matsuyama, Laura A. Siminoff. Cancer caregiver burden and mental health outcomes: Differences by race/ethnicity [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A092.
Abstract A112: Integrative epigenomic and transcriptomic analyses of kidney cancers from African Americans and European Americans
Authors: Williams Heinric , Mitchell Khadijah A.
Published: August 2020

Background: Kidney cancer ranks as a top ten leading site of new cancer cases (~64,000) in the United States each year. Renal cell carcinoma (RCC) is the most common type of kidney cancer (90% cases), with clear cell RCC (ccRCC) being the most prevalent histology (70% RCC cases). RCC risk factors include nonmodifiable, modifiable, environmental, and occupational causes. RCC subtypes each have a different histology, clinical course, and response to therapy, in addition to distinctive genetic and molecular alterations. African Americans (AA) have higher incidence rates of ccRCC than European Americans (EA) for reasons that are unclear. Biologic determinants of this cancer health disparity have been largely understudied. Recent work has identified population-specific genomic drivers in ccRCC tumors from AA compared with EA. To date, no study has explored epigenomic or transcriptomic determinants of kidney cancer health disparities in AA.

Hypothesis: We hypothesized population-specific changes in DNA methylation, between AA and EA, drive differences in ccRCC biology through regulation of the transcriptome.

Methods: Comparative integrative genomic and transcriptomic analyses were performed using clinical demographic and ccRCC data (Illumina 450K methylation array and mRNA-seq) from TCGA (n=50 AA, 266 EA) and Partek Genomics Suite.

Results: Differential methylation analysis discovered 2,048 genes varied significantly by race (P value + FDR = ≤0.01). Gene Ontology Enrichment Score (ES) analysis revealed these genes were involved with various molecular functions (nucleic acid binding ES 38.52, protein binding ES 38.03), biologic processes (cellular metabolic process ES 78.60), and cellular component localization (intracellular organelles ES 87.24). Differential gene expression analysis revealed 3,296 genes were altered in AA compared with EA race (P value + FDR = ≤0.01). GSEA analysis revealed distinct biologic pathways were enriched.

Conclusion and Future Directions: Collectively, our data suggest that DNA methylation and mRNA expression drive differences in tumor biology amongst AA and EA kidney cancer patients. Future studies include integrating miRNA expression data, validating these findings in a separate cohort, profiling other RCC histologies for population-specific signatures, and using kidney cancer cell lines from AA and EA to explore novel biologic mechanisms for therapeutic purposes.

Citation Format: Heinric Williams, Khadijah A. Mitchell. Integrative epigenomic and transcriptomic analyses of kidney cancers from African Americans and European Americans [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A112.
Abstract B019: Using Big Data to investigate disparities in cervix cancer survival: Racial and ethnic minorities and those with income and insurance disparities have worse overall survival from cervix cancer
Authors: Fisher Christine M. , Robin Tyler
Published: August 2020

Background: The burden of cervix cancer diagnosis is most profound on the medically underserved, who do not have access to prevention and early detection methods for cervical cancer. Using Big Data, the impact of race, ethnicity, insurance status, and socioeconomic status is investigated in those diagnosed with this disease. Our hypothesis is that the burden in diagnosed cancer continues this pattern of afflicting those without ready or optimal access to care.

Methods: Using data from the National Cancer Database (NCDB), which captures about 75% of all cancer care across the United States, patterns of care in cervix cancer patients were investigated. Multivariate Cox regression analysis and Kaplan Meier survival analysis were employed to assess the association between patient characteristics and disease outcomes.

Results: Cervical cancer patients from 2004-2012 were identified, and 15,194 were identified for analysis. The standard of care was used in less than half of the patients (44.3%) and those patients treated per standard of care had improved overall survival of 93 versus 33 months (p<0.001). Patients with lower median household incomes (p<0.001), uninsured patients (p<0.001), Black patients (p=0.026), and Hispanic patients (p<0.001) all had poorer overall survival.

Conclusions: The disparities in those diagnosed with cervical cancer extend to survival from this disease, with the underinsured, Black and Hispanic patients, and those with lower income households all having poorer survival from this disease. Improved access to care will both lower the diagnosis through vaccination and early detection, as well as improve outcomes in those who carry the diagnosis.

Note: This abstract was not presented at the conference.

Citation Format: Christine M. Fisher, Tyler Robin. Using Big Data to investigate disparities in cervix cancer survival: Racial and ethnic minorities and those with income and insurance disparities have worse overall survival from cervix cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B019.
Abstract B021: Canine CAR T-cells therapy for mammary carcinoma in dogs
Authors: Ramos-Cardona Xavier E. , Mohammed Sulma I. , Lee Yong Gu , Low Phillip
Published: August 2020

In women, ductal carcinoma in situ (DCIS) is an often-diagnosed breast disease that is widely considered to be a nonobligate precursor of invasive carcinoma. TNBC is the most aggressive and lethal form of breast cancer and predominantly occurs in women at high genetic risk including those with mutated BRCA1 genes. We provide for the first time an immunocompetent animal model for triple-negative DCIS (TN-DCIS) that will facilitate molecular analysis of preinvasive TNBC and will provide an invaluable resource for identifying and selecting targets for TNBC vaccine immunoprevention or immunotherapeutic intervention. Unlike most studied rodent models, dogs develop TN-DCIS spontaneously without genetic or chemical manipulation. We have shown that canine DCIS resembles human DCIS with shared histopathologic and molecular features and with similar imaging and behavioral characteristics. Dogs are much more outbred than laboratory rodents, yet certain breeds are at increased risk for developing mammary tumors. Indeed, we have found that 50% of randomly screened asymptomatic hound dogs have premalignant mammary lesions and that mammary TN-DCIS often progresses to invasive carcinoma within one year. Given the many common features of canine breast cancer and the high homology between the canine and human genome, the dog model offers an outstanding opportunity for exploiting TNBC immunoprevention and immunotherapeutic strategies. Moreover, the prevalence and rapid progression of canine TN-DCIS provides a much more rapid and cost-effective alternative to human trials for evaluation of the clinical effectiveness of cancer vaccine strategies. One immunotherapeutic strategy we are testing using our canine TN-DCIS model is chimeric antigen receptor (CAR) T-cells. CAR T-cells have shown promise in treating many malignancies, but in solid tumors have been hindered by many limitations. To overcome these limitations, we designed genetically engineered universal canine CAR T-cells that must be activated and targeted by a small-molecule adaptor before it can kill cancer cells. Our results showed that universal CAR T cells are functional and killed canine mammary tumor cell lines in vitro.

Citation Format: Xavier E. Ramos-Cardona, Sulma I. Mohammed, Yong Gu Lee, Phillip Low. Canine CAR T-cells therapy for mammary carcinoma in dogs [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B021.