cssi/SciSciGPT-SciSciNet huggingface dataset:
Congress and Reagan's New Federalism

This article analyzes the congressional response to the Reagan administration's New Federalism proposals in terms of party, region, and constituency during Reagan's first term. While the Congress approved various spending cuts in grants to local and state governments and in means-tested benefit programs to the poor, even in 1981 when New Federalism initiatives enjoyed the most success, Congress terminated only one program, CETA public servicejobs. A stalemate developed in 1982. The Reagan administration and the congressional Republicans could not impose further major spending cuts or program terminations, and the congressional Democrats could not restore the 1981 cuts or add new aid programs. Although the stalemate continued on New Federalism's dismantling of aid programs as a grand scheme even into 1985, after President Reagan's reelection, Congress continued to approve incremental cuts in overall spending, and the $200 billion budget deficit remained as a lever to force even greater cuts and program terminations in the years ahead.
Cardiovascular impact of drugs used in the treatment of diabetes

The International Diabetes Federation predicts that by 2035 10% of the population of the world will have been diagnosed with diabetes, raising serious concerns over the resulting elevated morbidity and mortality as well as the impact on health care budgets. It is also well recognized that cardiovascular disease is the primary cause of the high morbidity and mortality associated with diabetes, raising the concern that appropriate drug therapy should not only correct metabolic dysfunction, but also protect the cardiovascular system from the effects of, in particular, the epigenetic changes that result from hyperglycaemia. A number of new classes of drugs for the treatment of diabetes have been introduced in the past decade, providing the opportunity to optimize treatment; however, comparative information of the cardiovascular benefits, or risks, of the newer drugs versus older therapies such as metformin is variable. This review, in addition to summarizing the cellular basis for the therapeutic action of these drugs, addresses the evidence for their cardiovascular benefits and risks. A particular focus is provided on metformin as it is the first choice drug for most patients with type 2 diabetes.
Detection on HIV in Sichuan Province,2008-2011

Objective To understand the current situation of AIDS detection in Sichuan and provide evidence for the evaluation of AIDS detection strategies.Methods Data of AIDS were collected from Information system of AIDS comprehensive prevention and control of National Disease Reporting Information system and were conducted χ2 test on multi-sample rates.Results During 2008-2011,the positive cases increased successively with rates of 47.86% and 11.67%.The χ2 test on multi-sample rates indicated that the differences on the positive detection rate during this period were statistically significant.The positive detection rate declined from 0.41% to 0.17%.The change on blood sample sources was obvious.The detections in women care centers and general hospitals increased,while the detections in VCT clinics,blood stations and correctional facilities decreased yearly.Comparatively less detection was conducted in high risk population.Conclusion From 2008 to 2011,the detection rate and the amount of positive cases increased,yet the positive detection rate declined.It is urgent to strengthen the HIV detection in people with high risk sex behaviors,such as homosexual and heterosexual activities.
Acoustic method for evaluation of eigen-ray emergent angle in temperature field measurement

On the basis of acoustic rays tracing in temperature gradient field with triangular forward development,a new method-interpolation method was trially employed to evaluate the emergent angle of eigen acoustic rays.Simulative computation was conducted for a typical model of temperature field with the methods of interpolation and shooting,respectively.The result showed that the both of computation accuracy and speed of the former were superior to the latter.
Lifelong Cardiovascular Adverse Effects of Childhood Tobacco Smoke Exposure

Environmental tobacco smoke (ETS) exposure has a significant role in cardiovascular health outcomes, even among children. Approximately 40 % of all Americans exposed to ETS are children; those with poor socioeconomic status, black race, and younger age being disproportionately affected. Parental smoking is the strongest predictor of childhood ETS exposure. The adverse cardiovascular consequences of ETS exposure include its association with congenital heart disease, obesity, and other atherosclerosis promoting risk factors. The effects of childhood ETS exposure last long into adulthood as well. ETS can damage cell composition, is linked to increased inflammation and oxidative stress, triggers endothelial dysfunction, alters arterial distensibility and structure, and changes autonomic function. The prevailing evidence of ETS exposure and its cardiovascular consequences beginning as early as in utero and lasting into adulthood highlight the importance of eliminating ETS exposure. The purpose of this report is to illustrate the epidemiological trends and discuss the mechanisms linking childhood ETS exposure to adverse, lifelong, cardiovascular outcomes.
Embedding Intelligent Tutoring Systems in MOOCs and e-Learning Platforms

Intelligent tutoring systems ITS and MOOCs tend to have complementary pedagogical approaches, but their combination is rarely if ever seen. A key obstacle may be technical integration. We present a generalizable case study of extending ITS authoring technology to make tutors easily embeddable into a variety of MOOC/e-learning platforms and run on a range of web-enabled devices. We enhanced the domain-independent Cognitive Tutor Authoring Tools CTAT to enable integration of CTAT tutors into multiple environments. A salient lesson learned is that use of widely-used web-based technologies HTML and JavaScript may be a major factor in ITS uptake. Also, we found that embedding tutors into existing LMS is challenging, but environment-specific changes can be isolated in a generalizable manner.
The development of teachers’ visions from preservice into their first years teaching: A longitudinal study

Abstract Contemplating and articulating one's vision is a reflective process that guides teachers' instruction and professional development. However, little research has explored how teachers develop their visions from preservice preparation to their first years teaching. The current study describes the visions of nine teachers over the course of seven years. The researchers describe teachers' visions, how the teachers enacted their visions, affordances to enacting their visions, obstacles teachers faced to enacting their visions, and how teachers' negotiated obstacles to enact their visions. Findings demonstrate the stability and influence of teachers' visions and the multitude of factors that impact teachers' daily decisions.
Adhesion and Invasion Assay Procedure Using Caco-2 Cells for Listeria monocytogenes

Listeria monocytogenes is an important Gram-positive foodborne pathogen that is a particular problem in ready-to-eat food. It has an ability to survive in harsh conditions like refrigeration temperatures and high salt concentrations and is known to cross intestinal, placental and blood-brain barriers. Several cancerous cell lines like cervical, liver, dendritic, intestinal and macrophages have been used to study in vitro propagation and survival of listeria in human cells. Human intestinal epithelial cells have been used to study how listeria crosses the intestinal barrier and cause infection. The protocol in this articles describes the procedures to grow Caco-2 cells, maintain cells and use them for adhesion and invasion assays. During adhesion assay the cells are incubated with listeria for 30 min but in invasion assay the cell growth is arrested at several time points after infection to monitor the growth and survival rate of listeria in cells.
DC bus voltage regulation using photovoltaic module: A non-iterative method

Uncertainties in load power demand and unpredictabilities associated with renewable energy sources pose challenges to current microgrids. The situation worsens when the maximum power generated by a Photovoltaic (PV) module exceeds the power demanded by the load. The excess power increases the voltage at the point of common coupling (PCC). This paper addresses the issue of DC-link voltage regulation using a standalone PV module for the scenario when PV output at maximum power point (MPP) exceeds load demands. In particular, the time-scale separation between the fast PV dynamics and the slow variations in weather (temperature and irradiance) conditions is exploited to devise a novel non-iterative control strategy with fast closed-loop dynamics. A disturbance-rejection based robust control framework is employed and the closed-loop voltage regulation and load disturbance rejection performances are compared for the constant current and the constant voltage modes of operation of a PV module. Simulation case studies are presented which examine effectiveness and robustness of controllers for voltage regulation at the PCC.
Statin use and the risk of cardiovascular implantable electronic device infection: A cohort study in a veteran population

BACKGROUND The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of perioperative antibiotics at the time of device placement or revision. This is due, in part, to the presence of multiple comorbid conditions in an elderly population, in general, who require CIED. Statins may have an antibacterial effect, although there is currently no evidence that the likelihood of CIEDI has been impacted by statin use. METHODS A retrospective cohort study was performed to assess whether statins are associated with a reduced risk of CIEDI. The VA Informatics and Computing Infrastructure (VINCI) database, which includes all veterans who underwent CIED placement between 2008 and 2015, was used. A logistic regression model was constructed to estimate the adjusted risk of CIEDI among patients who were receiving statins after adjusting for confounding factors. RESULTS Overall, 18,970 CIED procedures were included, and 98% of them were performed in men with a mean age of 71 ± 11 years. The rate of diabetes mellitus, heart failure, advanced chronic kidney diseases, CIEDI, positive methicillin-resistant Staphylococcus aureus nasal colonization, and statin use were 23%, 15.7%, 3.3%, 1.14%, 12.6%, and 56%, respectively. The logistic regression analysis showed that statins were significantly associated with a reduced risk of CIEDI; after controlling for other effects, the reduction was 66% (odds ratio 0.34 [0.2-0.59], P-value < 0.001). The effect of statins was confirmed by propensity score analysis. CONCLUSIONS Our study showed that among patients receiving statins who had undergone CIED placement, there was a 66% reduction in subsequent CIEDI.
Immunotherapy and survival in stage IV melanoma: A National Cancer Database (NCDB) analysis.

160Background: Interleukin-2 (IL-2) has been the predominant immunotherapy used for stage IV melanoma for the past decades, with newer immunotherapy drugs approved within the past five years. By us...
A Real Time Power Update Scheme for the Smart Grid Using TVWS

The U.S. electrical power grid is going through a major transformation from the traditional centralized, failure prone system to an intelligent, resilient, and less-centralized grid that facilitates two-way flow of energy and information. The smart grid is conceived to have the ability to adopt technologies covering the areas of sensing, wireless connectivity, pervasive computing and adaptive control to significantly improve the efficiency. Tremendous amount of data is being used by different utilities today in the U.S. This led us to explore new spectrum bands and better spectrum management beyond what is available today. In this paper, we analyze various schemes that use the IEEE 802.11af TV white space (TVWS) spectrum to employ power saving channel access mechanism. We also propose a smart real-time power update algorithm with minimal power overhead using the TVWS. Next, we implement a MAC layer scheduling algorithm for wireless Community Area Network (CAN) system to reduce collision rate and transmission delay of smart meters to a utility base station in a neighborhood. Through detailed simulations, we show that the proposed scheme offers intelligent real-time power updates to power facilities with minimal power overhead.
A Phase 3 Comparison of a Novel Liquid Glucagon Autoinjector to Glucagon Emergency Kit for the Symptomatic Relief of Severe Hypoglycemia

Objective: A novel ready-to-use stable liquid glucagon autoinjector (GAI; Xeris Pharmaceuticals), was evaluated for relief of symptoms during rescue treatment of severe hypoglycemia. Research Design and Methods: A randomized, controlled, double-blind, crossover clinical trial was conducted in 80 adults with T1D (mean age 43.6 years) to compare subcutaneous 1 mg doses of GAI vs. Glucagon Emergency Kit (GEK; Eli Lilly) for the treatment of insulin-induced severe hypoglycemia. Serial assessments of 4 autonomic and 4 neuroglycopenic symptoms and sensation of hypoglycemia were performed at each treatment visit. Results: The mean time to symptom relief was comparable between GAI and GEK for both autonomic symptoms (15.4±12.1 min and 14.2±9.7 min, p=NS), and neuroglycopenic symptoms (16.3±10.9 min and 13.9±9.4 min, p=NS). Mean time to resolution of the global feeling of hypoglycemia was also similar between groups. The incidence of all AEs was low in both groups; the most commonly reported AE was nausea (GAI 20.5%, GEK 12.7%, p=NS). Conclusions: The prompt relief of neurologic symptoms is critical in the rescue of severe hypoglycemic emergencies. GAI achieved both autonomic and neuroglycopenic symptom relief during induced severe hypoglycemia, and was safe and well tolerated. These results demonstrate that ready-to-use GAI is a viable alternative to GEK. Disclosure M.P. Christiansen: Research Support; Self; Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Abbott, Novo Nordisk Inc., Senseonics, REMD Biotherapeutics, Xeris Pharmaceuticals, Inc. M.J. Cummins: Employee; Self; Xeris Pharmaceuticals, Inc. S.J. Prestrelski: Employee; Self; Xeris Pharmaceuticals, Inc. P. Strange: Other Relationship; Self; AstraZeneca. Consultant; Self; Valeritas, Inc.. Stock/Shareholder; Self; Valeritas, Inc..
Other Techniques: Perturbation Theory and Direct Products

The matrices used to describe various physical phenomena in previous chapters had eigenvalues and eigenvectors which could be determined exactly. In general, matrix descriptions of physical systems will not be so tractable. However, the complicated matrices can often be analyzed when their elements differ slightly from those of a second matrix whose eigenvalues and eigenvectors are known. This is the purpose of perturbation theory.
The Role of Obesity in Insulin Resistance

Obesity is a rapidly growing health problem in the United States. In 2000, about 20% of U.S. adults self-reported a body mass index (BMI) exceeding 30 kg/m2, a 61% increase in obesity since 1991 (1). This underestimates the real prevalence when body mass index is determined from direct measurements rather than self-report. More than half (56%) reported being at least overweight (BMI ≥25 kg/m2), up from 45% in 1991. Lifetime risk for overweight during the 1990s was approximately 50% for overweight and 25% for obesity in a representative U.S. sample (2). Obesity confers substantial excess risk for morbidity and mortality from a variety of associated conditions, especially type 2 diabetes and atherosclerotic cardiovascular disease (CVD) (3, 4, 5). Although overall body fatness, as measured by BMI, is clearly associated with mortality and complications of obesity (6), fat distribution, especially central fatness as measured by a large waist circumference, may be a more powerful correlate of risk associated with obesity, especially for type 2 diabetes and CVD (7, 8, 9).
Clinical significance of TdT, cell surface markers and CFU-C in 297 patients with hematopoietic neoplasias.

Considerable progress has been achieved in recent years in the therapy of human leukemias and lymphomas. However, the less than 100 percent complete remission rates and the comparatively small number of long-term remissions in hematopoietic neoplasias of adults have stimulated efforts to detect additional clinical and cellular prognostic factors. Characterization of the cell phenotype in these disorders has proved to be a most promising approach in this context, based on the hypothesis that the neoplastic cell type is the most important determinant of clinical behavior [1–3,5,10,11,13,14,24]. Furthermore, cell marker analysis might contribute to our understanding of normal cellular differentiation assuming that most neoplastic cell types represent malignant proliferations “frozen” at distinct stages of the normal developmental sequence of the different cell lineages. Colony formation of myeloid committed stem cells in agar (CFU-c, 19), terminal deoxynucleotidyl transferase activity (TdT[4,6,7,12,15–18,22]) and cell surface marker analysis [1–3,5,8–11,13,14,24] have previously been shown to be of diagnostic and prognostic significance in human hematopoietic neoplasias. The study leading to the results described here, has been designed to evaluate a possibly increased discriminatory potential of multiple cell marker analysis in the diagnostic and prognostic evaluation of patients with hematopoietic neoplasias.
ON THE INCREASE OF TECHNOLOGY

This chapter explores three processes of technologic improvement in which new technical knowledge is some function of the number of researchers employed in that endeavor. It presents an assumption that T(t ) denotes the index of technology at time t , and R( t ) the amount of research done at t . Then, the simplest hypothesis may be the following: T(t ) = ∫ t 0 Φ(R( v )) d v , where Φ(R) is a continuous, increasing, and concave function. This hypothesis implies that T can grow without limit even if R does not. However, this formulation fails to make the productivity of researchers, Φ ( R )/ R , a function of the technology already in existence.
Oxidative Rearrangement Reactions

Oxidative rearrangements comprise a highly diverse group of reactions, some of which enjoy broad usage in synthesis, while others remain curiosities. This chapter necessarily reflects this heterogeneity. The designation ‘oxidative rearrangement’ is not used uniformly in the literature; the discussion in this chapter is limited to reactions which alter the connectivity in one or more carbon-carbon π- or σ-bonds in the substrate, and in which the molecule undergoes a net oxidation. Most often these changes will occur simultaneously, forming part of a single transformation, and the rearrangement is frequently driven by the oxidation. For the sake of brevity, the scope is further narrowed by excluding oxidative rearrangements of heterocyclic rings such as furans, pyrans, pyrroles and indoles; these reactions in themselves are numerous enough to fill a chapter. The overall emphasis is on selectivity and synthetic utility.
GaCl3-Catalyzed Ring-Opening Carbonyl–Olefin Metathesis

The development of a Lewis acid-catalyzed ring-opening cross-metathesis reaction which enables selective access to acyclic, unsaturated ketones as the carbonyl–olefin metathesis products is described. While catalytic amounts of FeCl3 were previously identified as optimal to catalyze ring-closing metathesis reactions, the complementary ring-opening metathesis between cyclic alkenes and carbonyl functionalities relies on GaCl3 as the superior Lewis acid catalyst.
Abstract 2262: Inference of kinase activity for cancer phosphoproteomics using substrate prediction scores

Background: Quantification of global protein phosphorylation abundance levels with residue-level resolution is feasible with mass spectrometry and phosphopeptide enrichment methods. Researchers have inferred kinase activity from phosphoproteomics data using a variety of methods to extract interpretable and biologically relevant information, but analysis of phosphoproteomics data is limited by the fact that detected phosphorylation sites often have unknown function and relevance. Methods: We developed a novel method for aggregating and interpreting phosphoproteomics data that combines kinase prediction scores from NetworKIN with experimental summary statistics to estimate abundance changes in predicted kinase substrates. By weighting student t-statistic scores by kinase prediction scores and summing cumulative scores across all phosphopeptides detected in a given screen, we generated kinase activity scores that reflect the overall direction, magnitude and significance of observed changes in predicted kinase substrates. These kinase scores were assessed using permutation testing to determine their significance versus changes that would be expected from random chance. To evaluate our method, we applied it to a shotgun phosphoproteomic dataset generated to study phosphorylation responses to rapamycin, dasatinib and combination treatment in MDA-MB-231 breast cancer cells. Results: We were able to confirm phosphoproteomic perturbations in expected “hallmark” kinase activities using prediction-based kinase activity inference scores, including decreased phosphorylation of Src and Abl substrates in response to dasatinib treatment, as well as decreases in p70S6K substrate phosphorylation in response to rapamycin. Compared to KSEA, we identified changes in substrate abundance for a variety of potential downstream kinases including DNAPK, PAK2, CDK3, and multiple members of the MAPK family that were observed to be downregulated in single-agent and in combination treatment. Conclusions: Our novel method provides a representation of phosphoproteomic changes based on abundance of predicted kinase substrates. Using predicted substrates allows for a global view of phosphoproteomic changes that extends beyond the relatively small number of known kinase-substrate relationships. Using a drug combination with potential application in breast cancer as an example, we demonstrate that this method can be used to identify phosphoproteomic changes and can potentially be used to rationally design and investigate novel drug combinations. Citation Format: Peter Liao, Jennifer Yori, Ruth Keri, Mehmet Koyuturk, Jill Barnholtz-Sloan. Inference of kinase activity for cancer phosphoproteomics using substrate prediction scores [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2262.
Evaluation of Nursing Facility Resident Safety During Implementation of the INTERACT Quality Improvement Program.

Abstract Background Medicare incentivizes the reduction of hospitalizations of nursing facility (NF) residents. The effects of these incentives on resident safety have not been examined. Objective Examine safety indicators in NFs participating in a randomized, controlled trial of the INTERACT Quality Improvement Program. Design Secondary analysis of a randomized trial in which intervention NFs exhibited a statistically nonsignificant reduction in hospitalizations. Setting NFs with adequate on-site medical, radiography, laboratory, and pharmacy services, and capability for online training and data input were eligible. Participants 264 NFs randomized into intervention and comparison groups stratified by previous INTERACT use and self-reported hospital readmission rates. Intervention NFs randomized to the intervention group received INTERACT materials, access to online training and a series of training webinars, feedback on hospitalization rates and root-cause analysis data, and monthly telephonic support. Measures Minimum data set (MDS) data for unintentional weight loss, malnutrition, hip fracture, pneumonia, wound infection, septicemia, urinary tract infection, and falls with injury for the intervention year and the year prior; unintentional weight loss, dehydration, changes in rates of falls, pressure ulcers, severe pain, and unexpected deaths obtained from the NFs participating in the intervention through monthly telephone calls. Results No adverse effects on resident safety, and no significant differences in safety indicators between intervention and comparison group NFs were identified, with 1 exception. Intervention NFs with high levels of INTERACT tool use reported significantly lower rates of severe pain. Conclusions/Implications Resident safety was not compromised during implementation of a quality improvement program designed to reduce unnecessary hospitalization of NF residents.
Healthcare and Rehabilitation Needs of Individuals with Multiple Sclerosis

There is little research delineating the healthcare and rehabilitation needs of individuals with multiple sclerosis (MS) that is based on the perspectives of those individuals themselves. The medical community is largely well-informed about disease progression, symptoms, and treatment of MS, but little is known regarding the barriers and unmet needs that individuals with MS experience in their interaction with healthcare and rehabilitation systems and providers, and in their efforts to maintain healthy, productive, and participatory lives. In this article, we provide a comprehensive summary of the most frequently identified healthcare and rehabilitation needs of individuals with MS based on a review of over 500 articles, from which 29 articles were selected for inclusion as they specifically addressed the needs or unmet healthcare and rehabilitation needs of people with MS. Based on our review, we identified 11 categories of needs, which we discuss in the context of three broad categories, including (a) emotional and psychological support, (b) healthcare and rehabilitation, and (c) transportation, home care, and financial needs.
Cognitive and Initial Psychometric Testing of the Errors of Care Omission Survey: A New Patient Safety Tool for Primary Care.

Background and purpose Most patient safety studies focus on errors of commission rather than on errors of omission. No tools measure errors of omission in primary care. We developed the Errors of Care Omission Survey (ECOS) and present its cognitive and psychometric testing. Methods Twenty-six primary care providers (PCPs) participated in cognitive interviews, which were audiotaped, transcribed, and analyzed. ECOS was also pilot tested with 37 PCPs. Item analysis and reliability testing w conducted. Results Interviewees agreed that ECOS measures errors of omission and items were clear. The response categories were revised. All items were correlated and subscales had high internal consistency reliability. Conclusions ECOS can measure errors of omission in primary care.
Detachment of Human Endothelial Cells from Fibrinogen Induced by Cleaved High Molecular Weight Kininogen (HKa) Is Mediated by c-Jun Amino-Terminal Kinase (JNK) Signaling Pathway.

We have shown that HKa inhibits angiogenesis by inducing detachment and apoptosis of human umbilical vein endothelial cells (HUVECs) from specific extracellular matrix proteins, such as vitronectin and fibrinogen, but not collagen. To investigate which intracellular signaling pathway led to cell detachment, several specific inhibitors were selected and utilized. SP600125, a JNK inhibitor, and PP2, a Src kinase inhibitor, both produced HUVECs detachment from surfaces coated with fibrinogen while MG-132, a NF-κB inhibitor, induced apoptosis. Neither U0126, an ERK inhibitor, nor SB202190, a p38 inhibitor, detached HUVECs from fibrinogen surfaces. By Western blot analysis, we found that HKa inhibited JNK, but not Src kinase activity. Previous investigators have demonstrated Rho-associated protein kinase (ROCK) regulates the JNK pathway. We demonstrated that Y27632, a ROCK inhibitor, not only inhibited JNK activity, but also caused detachment of HUVECs. Using phospho-antibodies, we found that HKa decreased the phosphorylation of paxillin at Ser178 site, but not Tyr 118 site indicating a serine kinase. Paxillin is a multi-domain adaptor found at the interface between the plasma membrane and the actin cytoskeleton. Paxillin phosphorylation is known to be associated with the coordinate formation of focal adhesions and stress fibres. Since the Ser178 of paxillin is a substrate for JNK, while Tyr 118 is a substrate for FAK and Src, it appears that JNK is responsible. Our studies have uncovered the novel finding that HKa detached HUVECs from fibrinogen through the ROCK-JNK-paxillin (Ser178) pathway, but not Src-paxillin (Tyr118) signaling.
Role of Classical Time Domain CEM Methods for Quantum Electromagnetics

As quantum theory matures, quantum applications that significantly depend on electromagnetic effects are becoming increasingly of interest to engineers. We discuss a number of diverse computations that are needed in the engineering design of various devices leveraging these quantum effects. In each case, the broadband knowledge of the classical dyadic Green’s function of the problem being analyzed plays an important role. As a result, many of these applications require the extremely broadband solution of classical electromagnetic scattering problems in complex geometries to evaluate components of the dyadic Green’s functions. This suggests that classical time domain computational electromagnetics methods will play an important role in the future of quantum applications.
Extramammary Paget disease of the vulva: Management and prognosis

Abstract Objective To evaluate the clinicopathological characteristics, management and prognosis of patients with vulvar extramammary Paget disease of the vulva (EMPD). Materials and methods The U.S National Cancer Database was accessed and patients diagnosed between 2004 and 2015 with microscopically confirmed vulvar EMPD were selected. Overall survival (OS) was calculated for patients diagnosed between 2004 and 2014, who had at least one month of follow-up. Five year OS rates were calculated following generation of Kaplan-Meier curves while comparisons were made with the log-rank test. Results A total of 2602 patients were identified. Median age at diagnosis was 72 years (range 31–90 years) and the majority were of White race (92%), without any co-morbidities (80.9%). Personal history of another tumor was present in 36.9% of patients. In situ EMPD was diagnosed in 994 cases (38.2%) and the majority (95.1%) were managed with local excision or vulvectomy. Five-year OS was 85.8%, while presence of positive margins was not associated with worse OS (p = 0.38). Invasive EMPD was diagnosed in 1608 (61.8%) patients. Staging information was available for 1172 patients, 75.3% had early stage disease. Most patients underwent surgical treatment (91.6%); 53.6% had positive margins. Performance of lymphadenectomy was infrequent (6.8%). Moreover, immunotherapy (4.5%), chemotherapy (1.5%) and radiation therapy (2.2%) were rarely employed in the management of invasive EMPD. Patients with early stage disease (n = 766) had better OS compared to those with advanced stage (n = 278) (5-yr OS rates were 84.3% and 73.6% respectively, p = 0.015) while presence of positive margins was not associated with worse OS (p = 0.35). Conclusions Extramammary Paget disease is a rare vulvar tumor. Surgical excision is the main treatment option while other modalities are rarely employed. Overall survival rates are encouraging.
The Effects of Increasing Training Load on Affect and Perceived Exertion.

Cavarretta, DJ, Hall, EE, and Bixby, WR. The effects of increasing training load on affect and perceived exertion. J Strength Cond Res XX(X): 000-000, 2019-This study was designed to investigate how affect and ratings of perceived exertion based on repetitions in reserve (RPE/RIR) change as a function of increasing load during a 10 repetition maximum (RM) test. Twenty-nine novice lifters completed a 10RM test for 2 different conditions presented in a randomized, counterbalanced fashion. RPE/RIR and affect were assessed immediately after each successful 10RM attempt. RPE/RIR was significantly different at all loads from 50 to 100% 10RM (p 0.344). Affect became less positive only at 100% 10RM compared with all other loads (p < 0.05). Finally, affect was more positive for upper-body exercises compared to lower-body exercises (p = 0.025) and more positive for machines compared to free-weights (p = 0.015). The results of this study suggest that among novice lifters, RPE/RIR increases as load increases during a 10RM and affective valence remains relatively constant but becomes less positive when exercising at maximal intensities (100% 10RM). Further research is needed to replicate these findings and elucidate the effects of different muscles used (e.g., upper vs. lower body) and modality of exercise (e.g., machine vs. free-weight) on RPE/RIR and affect among both novice and experienced lifters.
“Cheers to Babies!”: A Duoethnography Approach to Women and Consumption in a Yummy Mummies

Reality television embodies trendy, yet conventional entertainment facets as jaunt depictions of real-world events uncover varied views of motherhood and gender roles in society (Murray & Ouellette, 2004). The recurrent consumption of such fetishized motherhood imagery impacts consumers’ outlook on life experiences and expectations (Richins, 1995).This abstract explores the consumption of new motherhood on reality television through the researchers vastly different lived experience on the subject. Therefore duoethnography is utilized as a way to examine third-wave feminism and the rejection of the ideal of a shared, collective, experience of women. We dive into the glamorous and uncomfortable world of reality television by choosing to utilize duoethnography and ask, “can a methodology shift the way we, as researchers, see ourselves?” (Schultz & Paisley, 2016, p.142). This methodology will assist us in exploring Yummy Mummies, the Australian reality TV show about wealth, fashion, and motherhood, and how it influences two feminists. Through duoethnography, a few bottles of champagne, along with video and audio recordings, we encounter luxurious motherhood from a safe distance and aim to reflect on layered meanings within our life journey (Shelton & McDermott, 2012).
Resilient Networked AC Microgrids Under Unbounded Cyber Attacks

This paper considers a cooperative and adversarial AC microgrid system consisting of cooperative leaders and inverters, as well as adversarial attackers. The attackers aim to destabilize the synchronization dynamics of the AC microgrid by first intercepting the communication channels, penetrating the local state feedback, and pretending to be a cooperative neighbor, and then initiating malicious attacks by launching unbounded injections. A fully distributed resilient control framework is offered for the secondary frequency regulation and voltage containment to ensure system stability and preserve bounded synchronization. In particular, a virtual resilient layer with hidden networks is developed to integrate with the original cyber-physical layer. The proposed resilient control framework is fully distributed without requiring any global information. A modified IEEE 34-bus test feeder benchmark system is emulated in a controller/hardware-in-the-loop environment, where the control objectives are met under different attack scenarios.
Investigation of topical intranasal cocaine for sinonasal procedures: a randomized, phase III clinical trial.

Background The objective of this trial was to demonstrate the clinical efficacy and safety of topical cocaine as part of the effort to gain regulatory approval from the United States Food and Drug Administration. Methods This phase III, randomized, prospective, double-blind, multicenter, single-dose, placebo- and dose-controlled, parallel-group study aimed to evaluate the safety and efficacy of topical intranasal cocaine (RX0041-002). A total of 925 subjects were screened and a total of 648 subjects were randomized: 95 to placebo; 275 to 4% RX0041-002; and 278 to 8% RX0041-002. Efficacy was assessed with subjective pain intensity scores using the visual numeric rating scale and objectively using the von Frey filament test. Adverse events (AEs), vital signs, Holter monitoring, nasal irritation on visual examination, and smell assessment were recorded. The placebo and experimental groups were compared using a two-tailed Fisher's exact test. Results Topical 4% and 8% cocaine achieved significant subject analgesia, the primary efficacy endpoint. Both doses were safe and well-tolerated, with a safety profile similar to placebo. In the 4% and 8% groups, headache (1.5% and 2.5%, respectively), epistaxis (0.7% and 1.1%), and anxiety (0.7% and 0%) were the only AEs reported by >1 subject. No cardiovascular AEs, serious AEs, or deaths occurred. A higher percentage of subjects in the 4% and 8% groups compared with the placebo group had a modest increase in either systolic or diastolic blood pressure. Conclusion Topical 4% and 8% cocaine is an effective anesthetic that can be safely administered for nasal procedures.
Application of Response Surface Methodology for Optimization of Phenol Removal from Simulated Wastewater using Rotating Tubular Packed bed Electrochemical Reactor

Phenol removal from simulated wastewater by indirect electrochemical oxidation was investigated using a rotating tubular packed bed electrochemical reactor. Effects of operating parameters like current density (3-15mA/cm2), rotation speed (100–500 rpm), initial phenol concentration (20–100ppm), and pH (3-9) were investigated. Optimization of the process parameters was carried out by adopting response surface methodology (RSM) combined with Box–Behnken Design (BBD) where COD removal efficiency (RE %) was selected as a response function. The results indicated that initial phenol concentration has the main effect on the COD removal efficiency followed by current density then pH and rotation speed. The results of regression analysis revealed that the experimental data could be fitted to a second-order polynomial model with a value of determination coefficient (R2) equal to 98.38% .The optimum conditions of the process parameters based on RSM method were an initial phenol concentration of 41 ppm, current density of (9.3 mA/cm2 ), rotation speed of 367 rpm and pH = 3 where COD removal efficiency of ( 99.83%) was accomplished after 60 min of electrochemical oxidation process in which current efficiency of (9.87%) was observed and energy consumption of (179.86 KWh/Kg COD) was required.
The Synthesis and Future Directions of Empirical Research On International Students In the United States: The Insights From One Decade

The purpose of this systematic review was to identify the trends in empirical research on international students in the United States produced between 2010 and 2019. After reviewing and synthesizing the characteristics of 334 research articles published over the past decade, I identify the areas that have been overly researched and the domains that have not yet been adequately explored. The overall findings of this review indicate that recent scholarly efforts have not always been aligned with the international student representation on U.S. campuses. Consequently, I provide eight critical recommendations for future research in the field in the context of over-and underresearched institutional sites (e.g.,institutional type and control), international student populations (e.g.,academic level, field of study, and country of origin), research methods employed, and research questions examined.
Anorectal abscesses: Discussion and treatment

Abstract Infection gains entrance to the anorectal spaces from the anorectal lining, the skin, the glands of the urogenital tract or an infected coccyx and sacrum. Pus localized in the anorectal spaces to form abscesses, spreads along fascial planes to definite areas, namely, the perinephreum, pelvic cavity, thigh, scrotum or labia, along the spermatic cord and the abdominal wall. Treatment is radical drainage to the outside. Emphasis is placed on the search for an internal opening previous to surgical drainage. As a general rule, the external skin incision is made in the same manner whether an internal opening is present or not. If an internal opening can be demonstrated, external drainage alone will be followed by fistula. To avoid fistula formation, internal openings are included in the surgical correction of the abscess, following the same rules as apply to fistula. Surgical drainage should be so radical that reliance need not be placed on rubber drains or gauze packs.
Abstract PO-031: Innate immune genes distinguish the immune microenvironment of early onset colorectal cancer

Despite a decrease in the incidence of colorectal cancer (CRC) over the last 40 years, the incidence of CRC in people under 50 years old is increasing around the globe. Early onset (≤50 years old) and late onset (≥65 years old) CRC appear to have differences in their clinicopathological and genetic features, but it is unclear if there are differences in the tumor microenvironment. We hypothesized that the immune microenvironment of early onset CRC is distinct from late onset CRC and promotes tumor progression. We used Nanostring immune profiling to analyze mRNA expression of immune genes in FFPE surgical specimens from patients with early (N=40) and late onset (N=39) CRC. We found three genes, SAA1, C7, and CFD, have increased expression in early onset colorectal cancer and distinct immune signatures based on the tumor location. After adjusting for clinicopathological features, increased expression of CFD and SAA1 were associated with worse progression free survival and increased expression of C7 was associated with worse overall survival. Our data demonstrate that the immune microenvironment in early onset CRC is unique, location dependent, and associated with worse outcomes. We propose that age specific immune signatures in the colorectal immune microenvironment can be used as biomarkers for prognosis as well as the development of targeted immune modulatory agents. Citation Format: Ivy H. Gardner, Ragavan Siddarthan, Katherine Watson, Elizabeth Dewey, Rebecca Ruhl, Xiangnan Guan, Zheng Xia, Liana V. Tsikitis, Sudarshan Anand. Innate immune genes distinguish the immune microenvironment of early onset colorectal cancer [abstract]. In: Proceedings of the AACR Virtual Special Conference on Tumor Heterogeneity: From Single Cells to Clinical Impact; 2020 Sep 17-18. Philadelphia (PA): AACR; Cancer Res 2020;80(21 Suppl):Abstract nr PO-031.
Climate change literature and information gaps in mountainous headwaters of the Columbia River Basin

Climate change is altering mountainous headwaters and the biophysical and social systems that depend on them. While scientific knowledge on climate change abounds, literature syntheses are needed to understand the multidisciplinary impacts, identify critical knowledge gaps, and assess potential management and policy responses. In this study, we systematically map and analyze the topical and spatial distribution of climate change research in the mountainous headwaters of a major transboundary watershed, the Columbia River Basin (CRB). We find that climate change research in the CRB focuses on impacts much more frequently than adaptation, while mitigation is rarely a focus. Most studies assess trends at large spatial extents, use secondary data, and make projections of climate change impacts rather than observations. The spatial distribution and thematic content of research vary across an international border, with greater concentrations of research in the USA than Canada. A general scarcity of social science research and limited interaction between social and biophysical content reinforce the need for increased collaboration between disparate disciplines. Future research focus areas should include research related to climate change adaptation and mitigation, increased integration between social and biophysical sciences, and collaborations that bridge the international border for a more unified basin-wide focus. Focusing on these new directions for research will increase the potential for science and management communities to co-produce actionable science and effective responses to climate change.
Them and Me - The Care and Treatment of Black Boys in America.

Them and Me When an adolescent psychiatrist interviews parents of Black boys, he frequently comes away with a similar narrative — a story in which normative behavior is characterized as aberrant or...
Racial Differences in Response to Neoadjuvant Chemotherapy: Impact on Breast and Axillary Surgical Management.

Neoadjuvant chemotherapy (NAC), an increasingly used method for breast cancer patients, has the potential to downstage patient tumors and thereby have an impact on surgical options for treatment of the breast and axilla. Previous studies have identified racial disparities in tumor heterogeneity, nodal recurrence, and NAC completion. This report compares the effects of NAC response among non-Hispanic white women and black women in relation to surgical treatment of the breast and axilla. A retrospective review of 85,303 women with stages 1 to 3 breast cancer in the National Cancer Database who received NAC between 1 January 2010 and 31 December 2016 was conducted. Differences in sociodemographic and clinical variables between black patients and white patients with breast cancer were tested. The study identified 68,880 non-Hispanic white and 16,423 non-Hispanic black women who received NAC. The average age at diagnosis was 54.8 years for the white women versus 52.5 years for the black women. A higher proportion of black women had stage 3 disease, more poorly differentiated tumors, and triple-negative subtype. The black women had lower rates of complete pathologic response, more breast-conservation surgery, and higher rates of axillary lymph node dissection, but fewer sentinel lymph node biopsies. Axillary management for the women who were downstaged showed more use of axillary lymph node dissection for black women compared with sentinel lymph node biopsy. The black patients were younger at diagnosis, had more advanced disease, and were more likely to have breast-conservation surgery. De-escalating axillary surgery is being adopted increasingly but used disproportionately for white women.
Mechanisms of creep in shale from nanoscale to specimen scale

Abstract Summary. Creep in shale is a multiscale deformation process across both space and time. In this paper, we propose a scale-bridging technique linking creep phenomena in shale from nanometer scale to specimen scale, and explore the mechanisms of creep at different scales. To this end, we simulate indentation tests on Woodford shale at the nanometer and micrometer scales using an incremental frictionless multi-body contact algorithm based on the Lagrange multipliers method, along with a recently developed Cam-Clay IX constitutive framework that explicitly recognizes the inherent heterogeneity of the rock material. Simulation results suggest that creep of the sample is mostly attributed to the viscoplastic deformation of the material away from the indenter tip, and that such response is highly dependent on the stress rate during the loading stage. Furthermore, simulations of triaxial creep indicate that creep behavior of the bulk sample is dominated by the presence of organics and clay constituents, and that such behavior follows a widely used logarithmic law. Throughout this work, we address the issues of heterogeneity across scales, anisotropy arising from the presence of bedding planes, and viscoplasticity of the individual constituents as they relate to the time-dependent properties of the bulk shale sample.