bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of soluble β‐nucleator's content on crystalline structure and performance of polypropylene pipe
Authors: Guo Jiajun , Zhang Chun , Nie Min , Wang Qi
Published: July 2020

Strength‐toughness clash of polypropylene (PP) pipe is an insurmountable bottleneck for the potential application. Here, we successfully prepared PP pipe with simultaneously enhanced toughness and hoop strength via addition of soluble β‐nucleators (β‐NAs) and application of helical flow in the extrusion. The outstanding combination of strength and toughness in the PP pipe depended on the loading content of β‐NAs and the helical pattern, which determined the morphology and alignment of β‐crystals. At the low content, β‐NAs dissolved completely into the PP melts and distributed homogeneously to promote the formation of β‐spherulites in the PP pipe. When the loading content exceeded the solubility limit, the β‐NAs partially dissolved and upon cooling, the dissolved β‐NAs grew preferentially on the undissolved ones along one direction, assembling into the fibrous aggregates. With the guidance of helical flow, the fibrous β‐NAs aligned off the axis and functioned as an oriented template to trigger the PP crystallization on the surface into hybrid β‐shish‐kebab with fibrous β‐NAs as shish. Increasing rotation speed of mandrel and die elevated hoop contribution to obtain the β‐shish‐kebab with a deviated angle of 55°, endowing the prepared pipe with high hoop strength and toughness.
Estimating coefficient of linear extensibility using Vis–NIR reflectance spectral data: Comparison of model validation approaches
Authors: Rehman Hafeez Ur , Arthur Emmanuel , Tall Andrej , Knadel Maria
Published: July 2020

The coefficient of linear extensibility (COLE) is used to classify soils according to their swell–shrink potential, and its estimation is crucial for engineering and agronomic applications. The aims of the study were (a) to develop a visible–near‐infrared spectroscopy (Vis–NIRS, 400–2,500 nm) calibration model to estimate COLE, (b) to compare two model validation approaches (mixed data and country‐wise), and (c) to test if a variable selection method improves the estimation accuracy of the calibration models. For this purpose, partial least square regression (PLSR) was used on the spectra of 53 soil samples from Slovakia and 24 samples from the United States. First, a calibration model based on 70% of the entire dataset (including samples from both locations) was developed and validated with the remaining 30% (mixed data approach). Second, a calibration model based on the Slovakian samples was validated with the U.S. samples (country‐wise approach). Higher predictability for COLE with standardized root mean square error (SMRSE) of 0.099 was obtained for the mixed data approach than for the country‐wise validation with SRMSE of 0.279. Furthermore, using interval PLSR (iPLSR) as a variable selection method did not improve the estimation accuracy of the mixed data approach (SRMSE of 0.099), and rather resulted in a twofold increase in SRMSE (0.560) for the country‐wise validation approach. Overall, the good estimation of COLE from Vis–NIRS was attributed to the high correlation of COLE with clay content and spectrally active clay minerals.
Research on the enhanced biological nitrogen removal of wastewater by the ultrasound‐hydrolysis acidification of excess sludge
Authors: Wang Yonglei , Liu Yulei , Tian Liping , Xu Xuexin , Liu Yongjian , Qin Yao
Published: July 2020

To simultaneously improve the removal of nitrogen and phosphorus from wastewater with a low C/N ratio and reduce excess sludge production, in this paper, excess sludge ultrasound‐hydrolysis acidification (UHA) pretreatment was coupled with the anaerobic–anoxic–oxic (AAO) process to provide carbon source and enhance biological nitrogen removal performance, and the experimental results can be summarized as follows. First, the total nitrogen (TN) concentrations in the effluent of the system decreased from 16.94 mg/L to 5.74 mg/L, and the removal rate of TN increased by 25.5%. In addition, the concentrations for ammonia nitrogen (NH3‐N) in the system decreased 12.59 mg/L, and the removal rate of this index increased by 29.0%. Furthermore, the specific oxygen uptake rate (SOUR) in the anoxic zone increased significantly because the application of UHA products enhanced the microbial activity, and the addition of UHA products had an effect on the microbial community structure in the system. The amounts of denitrifying bacteria such as Betaproteobacteria and Alphaproteobacteria also increased, which enhanced the nitrogen removal efficiency of wastewater biological treatment.

Practitioner points

Treatment of excess sludge in UHA device as an additional carbon source.

Nitrogen removal efficiency was greatly improved after adding UHA products.

Input of UHA products enhanced microbial activity in AAO system.

Denitrifying bacteria increased with the addition of UHA products.
A review study of functional autoregressive models with application to energy forecasting
Authors: Chen Ying , Koch Thorsten , Lim Kian Guan , Xu Xiaofei , Zakiyeva Nazgul
Published: July 2020

In this data‐rich era, it is essential to develop advanced techniques to analyze and understand large amounts of data and extract the underlying information in a flexible way. We provide a review study on the state‐of‐the‐art statistical time series models for univariate and multivariate functional data with serial dependence. In particular, we review functional autoregressive (FAR) models and their variations under different scenarios. The models include the classic FAR model under stationarity; the FARX and pFAR model dealing with multiple exogenous functional variables and large‐scale mixed‐type exogenous variables; the vector FAR model and common functional principal component technique to handle multiple dimensional functional time series; and the warping FAR, varying coefficient‐FAR and adaptive FAR models to handle seasonal variations, slow varying effects and the more challenging cases of structural changes or breaks respectively. We present the models’ setup and detail the estimation procedure. We discuss the models’ applicability and illustrate the numerical performance using real‐world data of high‐resolution natural gas flows in the high‐pressure gas pipeline network of Germany. We conduct 1‐day and 14‐days‐ahead out‐of‐sample forecasts of the daily gas flow curves. We observe that the functional time series models generally produce stable out‐of‐sample forecast accuracy.

This article is categorized under:

Statistical Models > Semiparametric Models

Data: Types and Structure > Time Series, Stochastic Processes, and Functional Data
Liver fibrosis: Pathophysiology and clinical implications
Authors: Berumen Jennifer , Baglieri Jacopo , Kisseleva Tatiana , Mekeel Kristin
Published: July 2020

Liver fibrosis is a clinically significant finding that has major impacts on patient morbidity and mortality. The mechanism of fibrosis involves many different cellular pathways, but the major cell type involved appears to be hepatic stellate cells. Many liver diseases, including Hepatitis B, C, and fatty liver disease cause ongoing hepatocellular damage leading to liver fibrosis. No matter the cause of liver disease, liver‐related mortality increases exponentially with increasing fibrosis. The progression to cirrhosis brings more dramatic mortality and higher incidence of hepatocellular carcinoma. Fibrosis can also affect outcomes following liver transplantation in adult and pediatric patients and require retransplantation. Drugs exist to treat Hepatitis B and C that reverse fibrosis in patients with those viral diseases, but there are currently no therapies to directly treat liver fibrosis. Several mouse models of chronic liver diseases have been successfully reversed using novel drug targets with current therapies focusing mostly on prevention of myofibroblast activation. Further research in these areas could lead to development of drugs to treat fibrosis, which will have invaluable impact on patient survival.

This article is categorized under:

Metabolic Diseases > Molecular and Cellular Physiology
Virtual monochromatic dual-energy CT reconstructions improve detection of cerebral infarct in patients with suspicion of stroke
Authors: van Ommen Fasco , Dankbaar Jan Willem , Zhu Guangming , Wolman Dylan N. , Heit Jeremy J. , Kauw Frans , Bennink Edwin , de Jong Hugo W. A. M. , Wintermark Max
Published: July 2020

Purpose

Early infarcts are hard to diagnose on non-contrast head CT. Dual-energy CT (DECT) may potentially increase infarct differentiation. The optimal DECT settings for differentiation were identified and evaluated.

Methods

One hundred and twenty-five consecutive patients who presented with suspected acute ischemic stroke (AIS) and underwent non-contrast DECT and subsequent DWI were retrospectively identified. The DWI was used as reference standard. First, virtual monochromatic images (VMI) of 25 patients were reconstructed from 40 to 140 keV and scored by two readers for acute infarct. Sensitivity, specificity, positive, and negative predictive values for infarct detection were compared and a subset of VMI energies were selected. Next, for a separate larger cohort of 100 suspected AIS patients, conventional non-contrast CT (NCT) and selected VMI were scored by two readers for the presence and location of infarct. The same statistics for infarct detection were calculated. Infarct location match was compared per vascular territory. Subgroup analyses were dichotomized by time from last-seen-well to CT imaging.

Results

A total of 80–90 keV VMI were marginally more sensitive (36.3–37.3%) than NCT (32.4%; p > 0.680), with marginally higher specificity (92.2–94.4 vs 91.1%; p > 0.509) for infarct detection. Location match was superior for VMI compared with NCT (28.7–27.4 vs 19.5%; p < 0.010). Within 4.5 h from last-seen-well, 80 keV VMI more accurately detected infarct (58.0 vs 54.0%) and localized infarcts (27.1 vs 11.9%; p = 0.004) than NCT, whereas after 4.5 h, 90 keV VMI was more accurate (69.3 vs 66.3%).

Conclusion

Non-contrast 80–90 keV VMI best differentiates normal from infarcted brain parenchyma.
The physiological roles of tau and Aβ: implications for Alzheimer’s disease pathology and therapeutics
Authors: Kent Sarah A. , Spires-Jones Tara L. , Durrant Claire S.
Published: July 2020

Tau and amyloid beta (Aβ) are the prime suspects for driving pathology in Alzheimer’s disease (AD) and, as such, have become the focus of therapeutic development. Recent research, however, shows that these proteins have been highly conserved throughout evolution and may have crucial, physiological roles. Such functions may be lost during AD progression or be unintentionally disrupted by tau- or Aβ-targeting therapies. Tau has been revealed to be more than a simple stabiliser of microtubules, reported to play a role in a range of biological processes including myelination, glucose metabolism, axonal transport, microtubule dynamics, iron homeostasis, neurogenesis, motor function, learning and memory, neuronal excitability, and DNA protection. Aβ is similarly multifunctional, and is proposed to regulate learning and memory, angiogenesis, neurogenesis, repair leaks in the blood–brain barrier, promote recovery from injury, and act as an antimicrobial peptide and tumour suppressor. This review will discuss potential physiological roles of tau and Aβ, highlighting how changes to these functions may contribute to pathology, as well as the implications for therapeutic development. We propose that a balanced consideration of both the physiological and pathological roles of tau and Aβ will be essential for the design of safe and effective therapeutics.
Single stage reconstruction of a neglected open book pelvic injury with bladder herniation into the upper thigh: a case-report
Authors: Herteleer Michiel , Thüroff Joachim , Rommens Pol Maria
Published: July 2020

When open-book injuries are neglected and result into a pelvic malunion or nonunion, long-term problems, such as chronic pain, gait abnormalities, sitting discomfort, neurological symptoms and urogenital symptoms can occur. In this case report, we describe the repair of a neglected pelvic disruption with the dislocation of the urinary bladder in a one-stage procedure. The clinical image with which the patient presented could be split into unique sub-problems, for which separate solutions needed to be chosen: large symphysis diastasis, instability and pain in both SI joints, malunion of the superior and inferior pubic rami fractures; and urinary bladder herniation into the upper thigh. In a single-stage procedure, the pelvic ring was reconstructed and the bladder reduced. The patient was thereafter continent for urine and could walk independently. A complex clinical problem was divided into its sub-problems, for which specific solutions were found.
An atlas on risk factors for multiple sclerosis: a Mendelian randomization study
Authors: Yuan Shuai , Xiong Ying , Larsson Susanna C.
Published: July 2020

Objectives

We conducted a systematic review and wide-angled Mendelian randomization (MR) study to examine the association between possible risk factors and multiple sclerosis (MS).

Methods

We used MR analysis to assess the associations between 65 possible risk factors and MS using data from a genome-wide association study including 14 498 cases and 24 091 controls of European ancestry. For 18 exposures not suitable for MR analysis, we conducted a systematic review to obtain the latest meta-analyses evidence on their associations with MS.

Results

Childhood and adulthood body mass index were positively associated with MS, whereas physical activity and serum 25-hydroxyvitamin D were inversely associated with MS. There was evidence of possible associations of type 2 diabetes, waist circumference, body fat percentage, age of puberty and high-density lipoprotein cholesterol. Data of systematic review showed that exposure to organic solvents, Epstein Barr virus and cytomegalovirus virus infection, and diphtheria and tetanus vaccination were associated with MS risk.

Conclusions

This study identified several modifiable risk factors for primary prevention of MS that should inform public health policy.
Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section
Authors: Starnoni Daniele , Giammattei Lorenzo , Cossu Giulia , Link Michael J. , Roche Pierre-Hugues , Chacko Ari G. , Ohata Kenji , Samii Majid , Suri Ashish , Bruneau Michael , Cornelius Jan F. , Cavallo Luigi , Meling Torstein R. , Froelich Sebastien , Tatagiba Marcos , Sufianov Albert , Paraskevopoulos Dimitrios , Zazpe Idoya , Berhouma Moncef , Jouanneau Emmanuel , Verheul Jeroen B. , Tuleasca Constantin , George Mercy , Levivier Marc , Messerer Mahmoud , Daniel Roy Thomas
Published: July 2020

Background and objective

The optimal management of large vestibular schwannomas continues to be debated. We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of this problem from a European perspective.

Material and methods

A systematic review of MEDLINE database, in compliance with the PRISMA guidelines, was performed. A subgroup analysis screening all surgical series published within the last 20 years (January 2000 to March 2020) was performed. Weighted summary rates for tumor resection, oncological control, and facial nerve preservation were determined using meta-analysis models. This data along with contemporary practice patterns were discussed within the task force to generate consensual recommendations regarding preoperative evaluations, optimal surgical strategy, and follow-up management.

Results

Tumor classification grades should be systematically used in the perioperative management of patients, with large vestibular schwannomas (VS) defined as > 30 mm in the largest extrameatal diameter. Grading scales for pre- and postoperative hearing (AAO-HNS or GR) and facial nerve function (HB) are to be used for reporting functional outcome. There is a lack of consensus to support the superiority of any surgical strategy with respect to extent of resection and use of adjuvant radiosurgery. Intraoperative neuromonitoring needs to be routinely used to preserve neural function. Recommendations for postoperative clinico-radiological evaluations have been elucidated based on the surgical strategy employed.

Conclusion

The main goal of management of large vestibular schwannomas should focus on maintaining/improving quality of life (QoL), making every attempt at facial/cochlear nerve functional preservation while ensuring optimal oncological control, thereby allowing to meet patient expectations. Despite the fact that this analysis yielded only a few Class B evidences and mostly expert opinions, it will guide practitioners to manage these patients and form the basis for future clinical trials.
Hyperkähler cones and instantons on quaternionic Kähler manifolds
Authors: Devchand Chandrashekar , Pontecorvo Massimiliano , Spiro Andrea
Published: July 2020

We present a novel approach to the study of Yang–Mills instantons on quaternionic Kähler manifolds, based on an extension of the harmonic space method of constructing instantons on hyperkähler manifolds. Our results establish a bijection between local equivalence classes of instantons on quaternionic Kähler manifolds M and equivalence classes of certain holomorphic maps on an appropriate $${\mathrm {SL}}_2({\mathbb {C}})$$

SL
2

(
C
)

-bundle over the Swann bundle of M.
Learn or react? An experimental study of preventive health decision making
Authors: Fink Günther , McConnell Margaret , Nguyen Bich Diep
Published: July 2020

Despite public health efforts, uptake of preventive health technologies remains low in many settings. In this paper, we develop a formal model of prevention and test it through a laboratory experiment. In the model, rational agents decide whether to take up health technologies that reduce, but do not eliminate the risk of adverse health events. As long as agents are sufficiently risk averse and priors are diffuse, we show that initial uptake of effective technologies will be limited. Over time, the model predicts that take-up will decline as users with negative experiences revise their effectiveness priors towards zero. In our laboratory experiments, we find initial uptake rates between 65 and 80% for effective technologies with substantial declines over time, consistent with the model’s predictions. We also find evidence of decision-making not consistent with our model: subjects respond most strongly to the most recent health outcomes, and react to negative health outcomes by increasing their willingness to invest in prevention, even when health risks without prevention are known by all subjects. Our findings suggest that high uptake of preventive technologies should only be expected if the risk of adverse health outcomes without prevention is high, or if preventive technologies are so effective that the risk of adverse outcomes is negligible with prevention.
Energy Efficient Low Latency Multi-issue Cores for Intelligent Always-On IoT Applications
Authors: Multanen Joonas , Kultala Heikki , Tervo Kati , Jääskeläinen Pekka
Published: July 2020

Advanced Internet-of-Things applications require control-oriented codes to be executed with low latency for fast responsivity while their advanced signal processing and decision making tasks require computational capabilities. For this context, we propose three multi-issue core designs featuring an exposed datapath architecture with high performance, while retaining energy-efficiency. These features are achieved with exploitation of instruction-level parallelism, fast branching and the use of an instruction register file. With benchmarks in control-flow and signal processing application domains we measured in the best case 64% reduced energy consumption compared to a state-of-the-art RISC core, while consuming less silicon area. A high-performance design point reaches nearly 2.6 GHz operating frequency in the best case, over 2× improvement, while simultaneously achieving a 14% improvement in system energy-delay product.
Evolution of Human Brain Atlases in Terms of Content, Applications, Functionality, and Availability
Authors: Nowinski Wieslaw L.
Published: July 2020

Human brain atlases have been evolving tremendously, propelled recently by brain big projects, and driven by sophisticated imaging techniques, advanced brain mapping methods, vast data, analytical strategies, and powerful computing. We overview here this evolution in four categories: content, applications, functionality, and availability, in contrast to other works limited mostly to content. Four atlas generations are distinguished: early cortical maps, print stereotactic atlases, early digital atlases, and advanced brain atlas platforms, and 5 avenues in electronic atlases spanning the last two generations. Content-wise, new electronic atlases are categorized into eight groups considering their scope, parcellation, modality, plurality, scale, ethnicity, abnormality, and a mixture of them. Atlas content developments in these groups are heading in 23 various directions. Application-wise, we overview atlases in neuroeducation, research, and clinics, including stereotactic and functional neurosurgery, neuroradiology, neurology, and stroke. Functionality-wise, tools and functionalities are addressed for atlas creation, navigation, individualization, enabling operations, and application-specific. Availability is discussed in media and platforms, ranging from mobile solutions to leading-edge supercomputers, with three accessibility levels. The major application-wise shift has been from research to clinical practice, particularly in stereotactic and functional neurosurgery, although clinical applications are still lagging behind the atlas content progress. Atlas functionality also has been relatively neglected until recently, as the management of brain data explosion requires powerful tools. We suggest that the future human brain atlas-related research and development activities shall be founded on and benefit from a standard framework containing the core virtual brain model cum the brain atlas platform general architecture.
Ein wattierter Hobbes. Zum Menschen- und Geschichtsbild von John J. Mearsheimer
Authors: Zimmer Matthias
Published: July 2020

John J. Mearsheimers neues Buch The Great Delusion. Liberal Dreams and International Realities unterzieht die US-amerikanische Außenpolitik seit dem Ende des Kalten Krieges einer gründlichen Kritik aus der Perspektive des Realismus. Dazu erläutert Mearsheimer die anthropologische Fundierung dieses Zugangs zur internationalen Politik. Diese Analyse zeigt jedoch, dass seine anthropologischen Grundlagen und die Thesen des Realismus nicht zusammenpassen. Hinzu kommt, dass der Wille zum Überleben als unausgesprochene Grundlage der Theorie Mearsheimers heute kooperative Lösungen verlangt.
Analysis of differentially expressed genes in soybean leaf tissue of tolerant and susceptible cultivars under flooding stress revealed by RNA sequencing
Authors: Dhungana Sanjeev K. , Kim Hong-Sik , Kang Beom-Kyu , Seo Jeong-Hyun , Kim Hyun-Tae , Oh Jae-Hyeon , Shin Sang-Ouk , Baek In-Yeol
Published: July 2020

Flooding stress causes severe yield reduction in soybean worldwide. The development of stress-tolerant cultivars could be an effective measure to reduce the negative effects of flooding stress. Molecular information on the gene expression pattern of tolerant and susceptible genotypes under flooding stress could be valuable to improve the flooding tolerance in soybean. The objective of this study was to analyze the differentially expressed genes (DEGs) revealed by RNA sequencing in the soybean leaf tissues of tolerant (‘Paldalkong’ and ‘Danbaekkong’) and susceptible (‘NTS1116’) cultivars under flooding stress. Seedlings were grown in a well-watered condition up to the V1–V2 stage and flood-stressed by inundating ~ 10-cm water for 14 days. A total of 22,468 genes were differentially expressed in flood-stressed condition compared to the well-watered control condition, out of which 13,729, 13,405, and 13,160 were differentially expressed in ‘Paldalkong’, ‘Danbaekkong’, and ‘NTS1116’, respectively. A higher number of some of the flooding tolerance-related genes such as lipoxygenase, expansin, glutathione S-transferase, and sugar efflux transporter were up-regulated in the tolerant cultivars than in the susceptible cultivar. The number of some abscisic acid-related transcription factors of basic leucine zipper domain and myeloblastosis families was also higher in the tolerant cultivars than in the susceptible cultivar. The molecular information about the DEGs of tolerant and susceptible cultivars obtained in the present study could be valuable to improve the flooding tolerance in soybeans.
Traffic Regulator Detection Using GPS Trajectories
Authors: Golze Jens , Zourlidou Stefania , Sester Monika
Published: July 2020

This paper explores the idea of enriching maps with features predicted from GPS trajectories. More specifically, it proposes a method of classifying street intersections according to traffic regulators (traffic light, yield/priority-sign and right-of-way rule). Intersections are regulated locations and the observable movement of vehicles is affected by the underlying traffic rules. Movement patterns such as stop events or start-and-stop sequences are commonly observed at those locations due to traffic regulations. In this work, we test the idea of detecting traffic regulators by learning them in a supervised way from features derived from GPS trajectories. We explore and assess different settings of the feature vector being used to train a classifier that categorizes the intersections based on traffic regulators; also, we test several experimental setups. The results show that a Random Forest classifier with oversampling and Bagging booster enabled can predict the intersection regulators with 90.4% accuracy. We discuss future research directions and recommend next steps for improving the results of this research.
Corporate Governance and Leadership
Authors: Cikaliuk Monique , Eraković Ljiljana , Jackson Brad , Noonan Chris , Watson Susan
Published: July 2020

This Element deals with leadership and governance of corporations from the point of view of the board. We expand our understanding of board leadership by focusing on the modern company as a legal person comprised of a capital fund and the relationships among directors, shareholders, management and stakeholders. We propose a model which integrates insights from the fields of leadership and corporate governance and establishes a theoretical link illustrated by empirical findings in three intersections: team leadership on the board, the chair's leadership of the board, and strategic leadership by the board. We maintain this integrative model provides a powerful means to further an understanding of the board as the nexus of leadership and governance. We close this Element by identifying the new research directions that our integrative model opens up. We also identify the implications for practice for those who either serve on boards or provide support to them.
4109 Acceptability of a Tenofovir Disoproxil Fumarate Intravaginal Ring for Human Immunodeficiency Virus Pre-Exposure Prophylaxis Among Sexually Active Women
Authors: Dobkin April , Barnett Rebecca , McWalters Jessica , Ray Laurie L. , Espinoza Lilia , McGinn Aileen P. , Atrio Jessica M. , Keller Marla J.
Published: July 2020

OBJECTIVES/GOALS: Vaginal ring delivery of antiretroviral drugs may provide protection against acquisition of HIV-1 when used as pre-exposure prophylaxis. As part of a randomized placebo-controlled safety trial of a tenofovir disoproxil fumarate (TDF) intravaginal ring (IVR), we assessed product acceptability through surveys of 17 women after continuous ring use. METHODS/STUDY POPULATION: Sexually active, HIV negative women between the ages of 18 and 45 were enrolled to investigate the safety and pharmacokinetics of three months of continuous TDF IVR use. The study was designed to include 40 US participants randomly assigned (3:1) to a TDF or placebo IVR. Twelve were randomized to TDF and five were assigned to the placebo group before the study was electively discontinued due to development of vaginal ulcerations in eight women in the TDF group. Acceptability data regarding TDF and placebo ring use was gathered via self-administered, computer-based questionnaires at the one- and three-month study visits. Participants were asked about overall attitudes and feelings regarding the TDF and placebo IVR, vaginal changes associated with ring use, and their experiences with ring use during menses and with sex. RESULTS/ANTICIPATED RESULTS: The mean age of participants was 30 years (range 18 - 42). Sixteen of 17 (94%) participants completed all study questions at both visits. When asked about ring likeability at one-month, 12 of 16 (75%) women reported overall liking the ring, including 5 of 8 (63%) who developed ulcerations. Vaginal changes described during ring use included 8 participants who indicated that the “vagina was wetter” and 2 who reported that the “vagina was drier.” Additionally, 10 of 12 (83%) who had their period during the first month of the study were not bothered by ring use during menses, and 11 of 16 (69%) stated that the ring was not bothersome with use during sex. When asked at the three-month visit, most reported that they would prefer to wear the ring rather than use a condom during sex, however, condom use was low at baseline in this population. DISCUSSION/SIGNIFICANCE OF IMPACT: Despite unanticipated ulcers, the IVRs were acceptable, especially when used with menses and during sex. Regardless of the group assigned or vaginal changes experienced, and even amongst those who developed ulcerations, the women had positive attitudes towards the ring, which is promising for future use of vaginal rings as a method for HIV prevention.
4476 Association between socioeconomic status and comorbid conditions in a population of diabetes patients
Authors: Li Riza , Ndura Kevin , Jurkovitz Claudine
Published: July 2020

OBJECTIVES/GOALS: To reduce hospitalizations, health care systems are studying ways of improving social determinants of health (SDoH) in patients with chronic disease such as diabetes (DM). Our goal was to better characterize the SDoH of a cohort of DM patients by using socio-economic information from census data. METHODS/STUDY POPULATION: Our study population included DM patients seen in primary care practices of a large health care system in 2013-2017. We integrated socio-economic status (SES) information from the American Factfinder to data extracted from the electronic health record (EHR). Addresses for the cohort were geocoded using ArcMap to obtain the census tract information for median income, poverty status, educational level, and supplemental food benefits using American Community Survey 5-Year estimates. We used multivariable logistic regression to calculate odds ratio (OR) and 95% confidence intervals [], with 3+ comorbidities as the dependent variable and demographic and SES variables as independent variables. RESULTS/ANTICIPATED RESULTS: Our study population included 13,782 patients: 53% were female, 65% white, 28% Black, 27% were on Medicare, 3% on Medicaid, median age was 60, 53% had 3+ comorbidities. Median income was $66,243, poverty level 6%, receiving food benefits 8%, no high school degree 8%, and bachelor’s degree or higher 30%. After evaluating collinearity, our multivariable analysis showed that patients with 3+ comorbidities were more likely to have income < $52,000 (lower quartile) versus $84,001 (upper quartile), OR = 1.2 [1.0-1.4]; be female, OR = 1.6 [1.4-1.7]; divorced or widowed versus married, OR = 1.5 [1.3-1.7], 1.4 [1.3-1.6]; and be on Medicare, Medicaid or both, OR = 2.4 [2.2-2.6], 2.2 [1.8-2.6], 6.0 [4.5-8.3]. DISCUSSION/SIGNIFICANCE OF IMPACT: Census tract-based SES could provide invaluable information to health care providers when associated to the EHR. We found that median income, which is not collected in the EHR, was significantly associated with a higher burden of disease. Census tract SES could serve as a proxy for evaluating SDoH.
4446 Association between treatment of asymptomatic Trichomonas vaginalis infection and preterm delivery
Authors: Young Anna Marie Pacheco , Yenokyan Gayane , Coleman Jenell
Published: July 2020

OBJECTIVES/GOALS: Trichomonas vaginalis (TV) has a prevalence of 26% in Baltimore and is associated with preterm delivery (PTD). Yet screening and treatment of TV is not advised due to conflicting data on harms. Our goal is to investigate the association between asymptomatic TV treatment and PTD. METHODS/STUDY POPULATION: This is a retrospective cohort study of women who delivered a child at The Johns Hopkins Hospital between 7/1/16 – 11/19/19. Exclusion criteria included multiple gestation, stillborn, miscarriage, diabetes, hypertension/ preeclampsia, HIV, and history of PTD. Chart review and ICD-10 diagnosis codes were used to collect data on demographics, STI test results, lab encounter diagnoses, STI treatment during pregnancy, and labor encounter diagnoses. Preliminary analysis for crude incidence of PTD in asymptomatic and symptomatic women treated for TV was performed using TriNetx, a global research network compiling all de-identified data within the Hopkins system. RESULTS/ANTICIPATED RESULTS: Three hundred and eighty women were tested for TV, 240 (63%) were asymptomatic and 140 (37%) women were symptomatic. Mean ages were 26 (SD:5) and 26 (SD:5) years, respectively. Black women comprised 87% of the asymptomatic cohort and 93% of the symptomatic cohort. Women of Hispanic ethnicity were represented by 4% of the asymptomatic cohort and 7% of the symptomatic cohort. Crude incidence of PTD was 4.1% among asymptomatic women and 7.1% among symptomatic women. Incidence ratio comparing asymptomatic PTD incidence to symptomatic PTD incidence was 0.58 with 95% CI (0.22, 1.56). DISCUSSION/SIGNIFICANCE OF IMPACT: Preliminary data from our study suggests there is no difference in PTD between asymptomatic and symptomatic women treated for TV. Future steps include multiple linear regression using a larger dataset. These preliminary data suggest TV should be considered for screening during pregnancy.
4580 Development of a play-based coaching intervention to improve quality of life and wellbeing for mothers with cancer and their young children
Authors: Roman-Oyola Rosa , Bundy Anita , Castro Eida , Castrillo Osiris
Published: July 2020

OBJECTIVES/GOALS: Mothers with cancer who have young children experience life disruptions when treatment procedures limit mother-child interactions. This study proposes the development of an intervention combining the Coaching approach with the Model of Playfulness to improve Quality of Life (QoL) and wellbeing of these patients and their young children. METHODS/STUDY POPULATION: This embedded mixed method study will be guided by the two initial phases of the ORBIT Model for the development of behavioral interventions for patients with chronic diseases. Participants will be mothers in the post-acute treatment stage of cancer (n = 6) and their children who are between 2 years and a half and 6 years, 11 months. Phase 1A, Definition, builds on qualitative data from a concurrent study exploring the experiences of mothers with cancer playing with their young children. As part of this phase, we will develop a play-based coaching intervention. In Phase 1B, Refinement, we will employ in-depth semi-structured interviews and standardized tools to evaluate acceptability of the intervention and preliminary outcomes. This will serve to further refine the intervention. RESULTS/ANTICIPATED RESULTS: Phase 1A will yield a plan for the intervention and data to enhance its initial implementation. Phase 1B will yield data, from the perspective of the mothers, about acceptability of the intervention procedures (e.g., delivery strategy, place for the intervention, time devoted, and outcome measures). This will enable modifications to the intervention. Additionally, Phase IB will yield preliminary data from specific QoL and wellbeing measures. For the mother, data about anxiety and depression symptoms, stress levels, and parental self-efficacy; for the child, emotional and behavioral indicators; for both: playfulness. DISCUSSION/SIGNIFICANCE OF IMPACT: This study entails the development of an intervention to enhance QoL and wellbeing of mothers with cancer and their children. Play moments as the centerpiece of the intervention, represent an innovative approach. Findings will guide the design of future feasibility studies to advance the development of this outcome driven intervention.
4065 Preferences, Expectancies, and Stigma among Treatment Seeking Combat PTSD Patients
Authors: Moring John , Peterson Alan , Straud Casey , Mintz Jim , Nabity Paul , Bira Lindsay , Young-McCaughan Stacey , Hale Willie , McGeary Donald , Resick Patricia
Published: July 2020

OBJECTIVES/GOALS: Cognitive Processing Therapy (CPT) is a cognitive behavioral treatment for posttraumatic stress disorder (PTSD). CPT is effective in treating combat-related PTSD among Veterans and active duty service members. It is unknown whether improvement in PTSD is related to accommodation of patient preference of the modality of therapy, such as in-office, telehealth, and in-home settings. An equipoise-stratified randomization design allows for complete randomization of participants who are interested and eligible for all three treatment arms. It also allows participants to reject one treatment arm if they are not interested or eligible. Participants who elect to opt out of one arm are randomized to one of the two remaining treatment arms. The primary aim of this study was to evaluate differences in patient satisfaction, treatment stigma beliefs, and credibility beliefs based on patient treatment modality preference. The second aim of this study was to examine if baseline satisfaction, stigma beliefs, and credibility beliefs predicted PTSD treatment outcomes. METHODS/STUDY POPULATION: Active duty service members and veterans with PTSD (N = 123) were randomized to one of three arms using an equipoise stratified randomization. Participants underwent diagnostic interviews for PTSD at baseline and post-treatment and completed self-report measures of satisfaction, stigma, credibility and expectancies of therapy. RESULTS/ANTICIPATED RESULTS: A series of ANOVAs indicated that there were group differences on patient stigma beliefs regarding mental health, F = 5.61, p = .001, and therapist credibility, F = 5.11, p = .002. Post hoc analyses revealed that participants who did not opt of any treatment arm demonstrated lower levels of stigma beliefs compared to participants who opted-out of in-office, p = .001. Participants who opted out of in-home viewed the therapist as less credible compared to participants who did not opt of any arm, p = .004. Multiple regression analysis found that baseline patient satisfaction, stigma beliefs, and credibility beliefs were not predictive of PTSD treatment outcomes, p > .05. DISCUSSION/SIGNIFICANCE OF IMPACT: Combat PTSD patients may opt out of in-office therapy due to mental health stigma beliefs, and visibility in mental health clinics may be a concern. For patients who opted out of in-home therapy, lack of credibility may have decreased participants’ desire for therapists to enter their home. Despite concerns of mental health stigma and the credibility of the therapy in certain treatment arms, patients in each treatment arm significantly improved in PTSD symptomotology. Moreover, patient characteristics, including satisfaction, stigma, and credibility of the therapy, did not significantly predict treatment outcomes, which demonstrates the robustness of Cognitive Processing Therapy.
4022 Recruiting hidden and sensitive populations: methods for recruitment of pregnant women who regularly use cannabinoids
Authors: Kennon-McGill Stefanie , Sward Lindsey , Nesmith Clare , James Laura P
Published: July 2020

OBJECTIVES/GOALS: Prenatal cannabinoid use is increasing and more studies are needed to describe the neurodevelopmental impact on the fetus. However, pregnant cannabinoid users are a “hidden population,” which makes identification of these individuals for research difficult. Our study will employ three methods of recruitment and evaluate the success of each method. METHODS/STUDY POPULATION: We will recruit a total of 40 women in the third trimester of pregnancy who regularly use cannabinoid products thought to contain tetrahydrocannabinol (THC) and/or cannabidiol (CBD) throughout their pregnancies, and 20 control pregnant women who do not use those products. The purpose of this study is to evaluate the effects of prenatal cannabinoid use on the neurodevelopment of their offspring over the first year of life. We will employ three recruitment methods. First, targeted recruitment will occur in two university-based obstetrical clinics, where the obstetrician will present the study material and contact information. Second, we will utilize social media advertisements targeted to a specific demographic of Facebook users. Finally, we will employ the traditional method of distributing flyers in a non-targeted manner. We will track methods of recruitment success and gather information from the mothers on their preferences for recruitment approaches. RESULTS/ANTICIPATED RESULTS: Recruitment will start in January 2020 and continue for several months. We anticipate that the targeted method will yield the highest number of participants, and participants with the best fit for the inclusion criteria. However, it is possible that those women will be deterred by fear of having their drug use status revealed to their care providers, even though all research activity will occur independently from clinic visits and will not be transmitted to the electronic health record. The inclusion of a control group will also help foster “anonymity” for participants. The social media method has the potential for the greatest reach, but we expect many of these potential participants will fail to meet inclusion/exclusion criteria, as this is not as targeted as the first method. We anticipate a similar issue with the flyer-based approach. DISCUSSION/SIGNIFICANCE OF IMPACT: Optimizing recruitment of hidden and sensitive populations is crucial for clinical and translational research. Our goal is to identify strategies that can lead to best practices for engagement of those populations. Our conclusions could be applied in recruitment of sensitive populations for other clinical and translational research projects.
4327 Structural Neural Correlates of Social Functioning in First Episode Psychosis and Malleability in Response to Targeted Cognitive Training
Authors: Miley Kathleen , Yu Fang , Ramsay Ian , Vinogradov Sophia
Published: July 2020

OBJECTIVES/GOALS: Development of interventions that improve social functioning (SF) in first episode psychosis (FEP) is hindered by a poor understanding of the neural mechanisms underlying SF deficits. This research aims to identify neural correlates of social functioning in FEP, and to evaluate whether this substrate is malleable in response to cognitive training. METHODS/STUDY POPULATION: This is a secondary data-analysis of participants in an ongoing randomized clinical trial investigating whether 12 weeks of targeted cognitive training is neuroprotective in FEP, versus treatment as usual. Baseline and post-training assessments include a brain MRI, three measures of SF, and a neurocognitive battery. Healthy controls complete MRI only. Differences in cortical thickness (CTh) and gray matter volume (GMV) in regions of interest between FEP and controls will be determined with ANCOVA. Multiple linear regression will be used to determine the relationship between neural substrate and SF in FEP. Linear mixed models will be used to examine the relationship between change in CTh and GMV and change in SF. Data collection is ongoing for this study. RESULTS/ANTICIPATED RESULTS: In preliminary data including 12 FEP and 9 healthy controls, FEP demonstrated cortical loss in the right superior frontal cortex and the right isthmus-posterior cingulate. Greater cortical thickness in the posterior cingulate cortex was associated with better social functioning across multiple measures when controlling for global cognition. Gray matter volume in the parahippocampal gyrus was also associated with better social functioning. Preliminary results evaluating whether targeted cognitive training is neuroprotective in these regions of interest in a manner that is associated with improved social functioning will also be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: Preliminary results link the posterior cingulate and parahippocampal gyrus to SF in FEP. Further research will investigate the contribution of changes in these brain regions to improved SF. The identification of biological treatment targets for SF may lead to development and optimization of novel interventions to alleviate SF deficits in FEP.
4074 The Role of Immortal Time Bias When Linking Treatment to Outcomes among Older Patients with Incident Hodgkin Lymphoma (HL) using Surveillance, Epidemiology and End Results (SEER)-Medicare Data
Authors: Rodday Angie Mae , Hahn Theresa , Lindenauer Peter K , Parsons Susan K
Published: July 2020

OBJECTIVES/GOALS: Older patients with HL have worse outcomes than younger patients, which may reflect treatment selection, including fewer chemotherapy cycles. Immortal time bias exists when patients must survival to initiation, and even completion, of treatment. We described treatment length and death to evaluate the extent of immortal time bias. METHODS/STUDY POPULATION: This retrospective cohort study utilized SEER-Medicare data from 1999-2014. Patients diagnosed with incident advanced stage HL at age ≥65 years and enrolled in Medicare Part A and B fee for service were included. Chemotherapy or radiotherapy treatment initiated within 4 months of diagnosis was determined from inpatient, outpatient, and physician/supplier claims. No treatment was defined by lack of treatment claims. Dates from claims were used to define length of treatment; ≥4 months of treatment indicated complete chemotherapy cycles. Date of death was obtained from Medicare data. Analyses were limited to 1 year post-diagnosis. Summary statistics were used to describe treatment length and subsequent death. RESULTS/ANTICIPATED RESULTS: We included 1492 advanced stage HL patients with a mean age of 76 years (SD = 7). 428 (29%) patients had no documented treatment; 397 (27%) were treated <4 months indicating fewer chemotherapy cycles; and 667 (45%) were treated for ≥4 months indicating complete chemotherapy cycles. Among those with no documented treatment, 15% died within 1 month of diagnosis with 78% dying by 1 year post-diagnosis. Among those treated <4 months, 36% died within 1 month of their last treatment claim with 64% dying by 1 year post-diagnosis. Among those treated ≥4 months, 7% died within 1 month of their last treatment claim with 14% dying by 1 year post-diagnosis. DISCUSSION/SIGNIFICANCE OF IMPACT: Few untreated patients died within 1 month of diagnosis. One-third of patients treated <4 months died soon after completion of treatment, while patients treated longer survived longer, suggesting some patients did not survive to complete treatment. To account for this immortal time bias, landmark analysis will be used to assess the relationship between treatment and survival.