Early Entry Research Articles

Community Health Center Residency Training: Improving Staffing, Service, and Quality.

Community-based residency programs are an important strategy to address rural and underserved primary care shortages, however, health centers report both benefits and challenges to training. This study aims to understand the impact of new Teaching Health Center (THC) residency programs on health center staffing, patient service, quality of care, and provider productivity. Using the Uniform Data System, we used inverse propensity score weighting to create a balanced sample of new THC and non-THC health centers in 2010. Using 2018 data, we applied propensity score weighted regressions to examine changes in staffing, service, quality of care, and productivity in THC versus non-THC health centers. In 2018, health centers with new THC programs were associated with increased physician (16.40, P<.01) staffing, yet decreased physician visits per full-time equivalent (-425.3, P<.01) relative to non-THC centers. New THC centers had increased delivery visits (231.0, P<.05), and had a greater rate of early entry into prenatal care (4.90%, P<.01). New residency programs are associated with increased provider recruitment, expanded patient service, and some improved health outcomes, but also with potential decreased provider productivity in health centers.

SPEED OF DIFFUSION, RETHINKING TIME AND FIRMS’ STRATEGY: ANALYSIS OF THE INTERACTIONS TO LEAP ACROSS THE CHASM

Although the literature has recognised short time to market and early entry as relevant factors, they are not enough alone to ensure success. In fact, an early entrant may successfully serve early adopters, but then fail in developing products suitable for those who adopt later (i.e., the early majority), dissipating the first-mover advantages previously gained. This paper argues that the likelihood of being successful in the early majority segment depends also on the rethinking time, defined as the time available to firms serving early adopters for planning and developing products that will be offered to the upcoming early majority segment. The rethinking time is here analytically defined through the Bass model and its relationship with product success is investigated. The paper shows that the market leader in the early majority segment is expected to be the incumbent when rapid diffusion occurs and, conversely, new entrants when rethinking time is longer.

Substance use and HIV stage at entry into care among people with HIV

BackgroundInformation regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage.MethodsWe examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site.ResultsWe found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances.ConclusionEarly entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.

Evaluation of the source material for the creation of new apple cultivars

The article presents the results of the study of the gene pool collection of the Crimean Experimental Horticulture Station - branch of the FSFIS “NBG-NSC”. Genotypes with economically valuable and breeding traits in the conditions of the foothill Crimea were identified. New sources of valuable qualities are proposed for inclusion in the breeding process for the given traits: low growth and compactness of the crown - 7 cultivars and 2 breeding forms; late flowering - 5 cultivars and 1 breeding form; long flowering period - 6 cultivars, 1 breeding form; early summer and late winter maturation periods - 8 cultivars; high and stable pollen viability - 6 cultivars and forms; self-fertility - 6 cultivars, including 3 breeding forms; frost resistance of generative buds - 8 samples; complex resistance to scab and powdery mildew - 10 cultivars and 2 breeding forms; drought resistance and heat resistance - 5 cultivars and 5 breeding forms. 12 cultivars and 5 breeding forms were identified with a trait of early entry into fruiting, 11 cultivars of various geographical origin and 5 breeding forms were distinguished by high and stable yield; 17 cultivars and 7 forms have high commercial and consumer qualities; 15 cultivars, including 5 breeding forms, were identified with a valuable chemical composition of fruits. As a result of the study of the storage life of the fruits, 7 cultivars and 7 breeding forms with a long storage period in a conventional gas environment were identified. For the food industry, 3 cultivars and 3 breeding forms are recommended as a source of valuable raw materials in the production of dried fruit products and natural apple puree without preservatives. On the basis of the work done, 3 breeding forms of apple trees with a complex of economic and consumer qualities are identified, recommended for establishment perennial plantings of an intensive type and passing the State variety testing - 1-8-ю, 2-1-18-79, 3-5-с.

Age at First and Current Marriage and Women’s Entrepreneurship in Nigeria

This paper relies on the 2008 and 2013 Nigeria Demographic and Health Surveys and an instrumental variable estimation strategy to estimate the relationship between a Nigerian woman’s age at entry into her first and current marriage and entrepreneurship. The result suggests a 5-percentage point higher likelihood of engaging in entrepreneurship for women with an additional year of at marriage entry. Further, there is about a 12-percentage point increase in the likelihood of continuous engagement in self-employed work over the prior year with an additional year of age at marriage entry. This result is consistent for women who reside in rural and urban locations. Premarital investments in education, lower fertility, and better intramarriage bargaining power are the likely operative channels that explain the estimated relationship. HIGHLIGHTS Early marriage entry has economic costs and hurts women’s overall empowerment. Early marriage in Nigeria is mainly influenced by religious and cultural factors. Women who marry early are less likely to engage in entrepreneurship and to do so continuously. There are no geographic differences in the effects of early marriage entry on entrepreneurship. Later marriage is associated with better education, declining fertility, and improved bargaining power of women.

Inhibition of WEE1 Potentiates Sensitivity to PARP Inhibitor in Biliary Tract Cancer.

PurposeUp to 20% of patients with biliary tract cancer (BTC) have alterations in DNA damage response (DDR) genes, including homologous recombination (HR) genes. Therefore, the DDR pathway could be a promising target for new drug development in BTC. We aim to investigate the anti-tumor effects using poly(ADP-ribose) polymerase (PARP) and WEE1 inhibitors in BTC.Materials and MethodsWe used 10 BTC cell lines to evaluate an anti-tumor effect of olaparib (a PARP inhibitor) and AZD1775 (a WEE1 inhibitor) in in vitro. Additionally, we established SNU869 xenograft model for in vivo experiments.ResultsIn this study, we observed a modest anti-proliferative effect of olaparib. DNA double-strand break (DSB) and apoptosis were increased by olaparib in BTC cells. However, olaparib-induced DNA DSB was repaired through the HR pathway, and G2 arrest was induced to secure the time for repair. As AZD1775 typically regulates the G2/M checkpoint, we combined olaparib with AZD1775 to abrogate G2 arrest. We observed that AZD1775 downregulated p-CDK1, a G2/M cell cycle checkpoint protein, and induced early mitotic entry. AZD1775 also decreased CtIP and RAD51 expression and disrupted HR repair. In xenograft model, olaparib plus AZD1775 treatment reduced tumor growth more potently than did monotherapy with either drug.ConclusionThis is the first study to suggest that olaparib combined with AZD1775 can induce synergistic anti-tumor effects against BTC. Combination therapy that blocks dual PARP and WEE1 has the potential to be further clinically developed for BTC patients.

Exploring the association of social determinants of health and clinical quality measures and performance in HRSA-funded health centres

ObjectiveThis paper explores the impact of service area-level social deprivation on health centre clinical quality measures.DesignCross-sectional data analysis of Health Resources and Services Administration (HRSA)-funded health centres. We created a...

Does Parents' Age at First Birth Moderate Intergenerational Continuity in Early-Onset Cannabis Use?

The aims of this brief report were to examine the extent to which early onset of cannabis use by parents and their children, and intergenerational continuity in early-onset cannabis use by parents and children, differ as a function of parent age at birth of first child. A total of 795 parent-child dyads (57% male parents and 49% male children) were compiled from three intergenerational studies: Oregon Youth Study-Three Generational Study (OYS-3GS), Rochester Youth Development Study and Rochester Intergenerational Study (RYDS-RIGS), and Seattle Social Development Project-The Intergenerational Project (SSDP-TIP). Parents and children identified as non-Hispanic White (29% and 22%, respectively), Black (55% and 47%), and Hispanic (8% and 11%). Early-onset cannabis use was defined as initiation at or before age 15. Time-varying effect models were fit to examine the research questions. Among parents, earlier initiation of cannabis use was associated with an earlier entry into parenthood. Moreover, parents' later age at first birth was predictive of a lower prevalence of early-onset cannabis use among their children. Last, regarding intergenerational continuity, parental early onset of cannabis use increased the likelihood of child early-onset use, but only among older parents (i.e., later age at first birth). We provide a nuanced examination of the associations between parental and child early-onset cannabis use as a function of parents' age at first birth and describe a novel approach to incorporating parent's age at first birth into models of intergenerational continuity.

「소년법」에서의 우범소년 규정에 관한 비판적 고찰

Unlike other subjects of 「Juvenile Act」, the status offender under 4 (1) 3 of 「Juvenile Act」 can only be disposed the possibility of committing a crime. The regulations on status offenses are designed for the purpose of welfare intervention to emphasize the responsibility of the state and society for delinquency and to block delinquency early. However, due to the increase in violent juvenile crime, the notification system is being actively used and cases of abuse are being found. Contrary to the purpose of Juvenile Protection Ideology, regulations on the status offender are becoming an early entry into the juvenile justice system and adds to the social stigma associated with that system. Judgment regulations on the propensity and the reasons for fear of committing a crime are also unclear, so there is room for interpretation depending on the subjectivity of the judge. 「The Riyadh Guidelines」 and 「General Comments by the United Nations Commission on the Rights of the Child」 have expressed concerns about status delinquency. As a result of the National Report on the implementation of the UN Convention on the Rights of the Child, the Republic of Korea was also advised to “Repeal article 4 (1) 3 of Juvenile Act on ‘crime-prone juveniles’.” The rules of the status offender can be used as a means of dissolving the protection of their guardians in combination with the notification system. Because status offenders and general juvenile offenders are treated in the same procedures, the status offenders will be subject to the stigma experienced by general juvenile offenders. Therefore, regulations on status offenders in the 「Juvenile Act」 should be improved. Some argue that the government should change its notification system to one of voluntary regulation or make the requirements clearer. But, the status offenders are runaway or crisis youths and so their welfare must be addressed. This should be improved by resolving the gap caused by repealing the regulations on status offenders, preparing an implementation plan for the provisions of ‘out-of-school juveniles’ and ‘crisis juveniles’ under 「the Act on Support for Out-of-School Juveniles」 and “protective children” under 「the Child Welfare Act」.

Geochemistry and petrographic analysis of Los Cuervos and Molino formations, Cesar Sub-Basin (Colombia): Implications in the petroleum system evolution

A geochemical characterization of Los Cuervos and Molino formations in the Cesar Sub-Basin was carried out using core samples obtained from the ANH-La Loma-1 Well. A total of 113 Rock-Eval pyrolysis analysis, total organic carbon (TOC), total sulphur content (TS) analysis, 13 vitrinite reflectance analysis (%Ro) and 30 thin-section petrographic analysis were performed. Based on these new data, it was possible to classify the quality of organic matter and the current thermal maturation of Los Cuervos and Molino formations. Additionally, a petrographic characterization of 30 samples allowed the correlation of the lithology with the geochemical results. Also, one-dimensional geochemical modelling was implemented in order to contribute to the knowledge of the evolution of the oil system in the Cesar Sub-Basin. The spatial distribution of the formations used in the modelling was obtained from 2 seismic lines two-way time. The results obtained indicate that Los Cuervos Formation presents TOC values from 0.29 to 66.55%, TS values from 0.02 to 11.29%, their organic matter consisted of type III kerogen which is consistent with an immature thermal maturation stage. In contrast, the Molino Formation presents TOC values from 0.23 to 2.28%, TS values from 0.001 to 1.39%, their organic matter consisted of type II/III kerogen this suggests an early entry to the oil window with a maximum pyrolysis temperature (Tmax) value of 442°C. The geochemical modelling tunes better with measured data from palaeo-geothermometers (%Ro and Tmax). The geochemical modelling shows that, between 60 - 40 million years ago (mya), the Cretaceous formations entered in the oil generation window and it is expected that, between 40 - 30 mya, the Lagunitas, Aguas Blancas, and La Luna formations will be at their peak of hydrocarbon generation.

Creative imitation in late industrializing countries: the case of biopharmaceutics in South Korea and India

ABSTRACT Given that the patents of the first high cost and complex biopharmaceuticals have started to expire, biotechnology offers opportunities for developing countries to pursue an upgrading process by entering the sector as early imitators. In the case of biotechnology applied to the health sector, the characteristics of the innovation process and the specificity of the regulatory process for biopharmaceuticals raises new questions as to the learning path open to the developing countries that intend to build an industrial promotion strategy on the basis of early entry as imitators. Given those specific characteristics, it is worth asking how far creative imitation strategies could constitute an opportunity for late late industrializing countries to undertake rapid industrial upgrading processes.

Uncertain Learning Curves: Implications for First-Mover Advantage and Knowledge Spillovers

The existence of a learning curve in which a firm’s costs decline with cumulative experience suggests that early entry provides learning opportunities that create advantage by reducing future costs...

Single-Cell Characterization of Calcium Influx and HIV-1 Infection using a Multiparameter Optofluidic Platform.

HIV-1 causes a chronic infection that affects more than 37 million people worldwide. People living with human immunodeficiency virus (HIV) experience comorbidity related to chronic inflammation despite antiretroviral therapy. However, these inflammatory signaling has not been fully characterized. The role of early entry events on the activation of cellular signaling events and downstream gene expression has not been captured at the single-cell level. Here the authors describe a method that applies principles of live-cell fluorescence microscopy to an automated single-cell platform that cultures and images cells over user-customized time courses, allowing for high-throughput analysis of dynamic cellular processes. This assay can track single-cell live fluorescence microscopy of early events that immediately follow HIV-1 infection, notably the influx of calcium that accompanies exposure to the virus and the development of productive infection using a fluorescent reporter virus. MT-4 cells are loaded with a calcium-sensitive dye and cultured in isolated pens on a nanofluidic device. The cultured cells are infected with an HIV-1 reporter virus (HIV-1 NLCI). A fluorescence microscope positioned above the nanofluidic device measures calcium influx over an 8-min time course following acute HIV-1 exposure. HIV-1 productive infection is measured in those same cells over a 4-day interval. Imaging data from these time courses are analyzed to define virus-host receptor interactions and signaling pathway dynamics. The authors present an integrated, scalable alternative to traditional imaging methods using a novel optofluidic platform capable of single-cell sorting, culturing, imaging, and software automation. This assay can measure the kinetics of events under various conditions, including cell type, agonist, or antagonist effect, while measuring an array of parameters. This is the first established method for nanofluidic high-throughput longitudinal single-cell culture and imaging: This technique can be broadly adapted to study cellular signaling kinetics and dynamic molecular interactions.

Could routine pregnancy self-testing facilitate earlier recognition of unintended pregnancy? A feasibility study among South African women

IntroductionWe explored whether routine pregnancy self-testing is feasible and acceptable to women at risk of late recognition of pregnancy as a strategy to facilitate early entry into either antenatal or...

Targeting the intestinal TMPRSS2 protease to prevent SARS-CoV-2 entry into enterocytes-prospects and challenges.

The transmembrane protease serine 2 (TMPRSS2) is a membrane anchored protease that primarily expressed by epithelial cells of respiratory and gastrointestinal systems and has been linked to multiple pathological processes in humans including tumor growth, metastasis and viral infections. Recent studies have shown that TMPRSS2 expressed on cell surface of host cells could play a crucial role in activation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein which facilitates the rapid early entry of the virus into host cells. In addition, direct suppression of TMPRSS2 using small drug inhibitors has been demonstrated to be effective in decreasing SARS-CoV-2 infection in vitro, which presents TMPRSS2 protease as a potential therapeutic strategy for SARS-CoV-2 infection. Recently, SARS-CoV-2 has been shown to be capable of infecting gastrointestinal enterocytes and to provoke gastrointestinal disorders in patients with COVID-19 disease, which is considered as a new transmission route and target organ of SARS-CoV-2. In this review, we highlight the biochemical properties of TMPRSS2 protease and discuss the potential targeting of TMPRSS2 by inhibitors to prevent the SARS-CoV-2 spreading through gastro-intestinal tract system as well as the hurdles that need to be overcome.

The existence of diversity in Sumbergondo village communities, Glenmore district, Banyuwangi regency, 1949-2012

There was expansion of Sumbergondo Village in 1949 due to a large population growth and a fairly large area covering the villages of Sumbergondo, Bumiharjo, Kaligondo, Tulungrejo now. With the expansion of the Village, Sumbergondo Village formed a unique cultural pattern and was harmoniously related between communities who had different beliefs, although separated in terms of territory and different in terms of belief, the people of Sumbergondo Village still uphold their ancestral beliefs from generation to generation to respect differences. and side by side are the characteristics of the Javanese tribe in general. Until now, the community still maintains the values and norms contained therein, there are three religions whose people maintain each other and have high tolerance, namely Islam, Christianity, and Hinduism. The results of the study show the formation of diversity in Sumbergondo Village. can not be separated from the early entry of existing religions, among others, Hinduism, Islam and Christianity. interaction and mutual need for one another does not differentiate between one adherent and another. The suggestions in this research are expected to provide additional knowledge about the history of religious diversity and tolerance in Indonesia.

Enhancing Pinus pinea cone production by grafting in a non-native habitat

Pinus pinea is an interesting species for its valued pine nuts. Despite the high demand for this nut, the species is mostly harvested from natural forests, because the time elapsed until the trees come into production hinders advances toward a more intensive cultivation. The grafting technique has been used to favor an earlier production in native Mediterranean habitats. In Chile, stone pine has been recently included in orchards. The objective of this study was to assess the initial performance in terms of growth, entry into production and cone yield of three grafting trials of the species established in Chile; two of the trials included nursery-grafted plants and the other, in situ grafting of P. pinea on a 3-year-old P. radiata plantation. An earlier entry into production and a higher number of female strobili and 1-year-old conelets (up to 2.9 times) were found in nursery-grafted plants compared with control seedlings. Growth was higher in trees in situ grafted onto radiata pine than in seedlings; eight years after grafting, the trees had achieved reproductive maturity, 67% had on average three cones per tree, and the presence of female strobili and 1-year-old conelets was 6.6 and 15.6 times higher than in seedlings, respectively. Radiata pine could be a feasible rootstock for either in-nursery or in situ stone pine grafting. Grafting accelerated stone pine entry into production, showing to be an effective tool for stone pine propagation and cropping.

Fejerlectin, a Lectin-like Peptide from the Skin of Fejervarya limnocharis, Inhibits HIV-1 Entry by Targeting Gp41.

Human immunodeficiency virus type 1 (HIV-1) is mainly transmitted by sexual intercourse, and effective microbicides preventing HIV-1 transmission are still required. Amphibian skin is a rich source of defense peptides with antiviral activity. Here, we characterized a lectin-like peptide, fejerlectin (RLCYMVLPCP), isolated from the skin of the frog Fejervarya limnocharis. Fejerlectin showed significant hemagglutination and d-(+)-galacturonic acid-binding activities. Furthermore, fejerlectin suppressed the early entry of HIV-1 into target cells by binding to the N-terminal heptad repeat of HIV-1 gp41 and preventing 6-HB formation and Env-mediated membrane fusion. Fejerlectin is the smallest lectin-like peptide identified to date and represents a new and promising platform for anti-HIV-1 drug development.

Preparing ABSN students for early entry and success in the clinical setting: flipping both class and skills lab with the Socratic Method.

Accelerated Second Degree BSN (ABSN) students have limited time to gain expertise. Reaching competency in skills takes weeks, delaying the application and mastery of skills in clinical practice. Our objective is to describe how our ABSN program fundamentals of nursing course enhances learning effectiveness and prepares students for successful entry into nursing. Using the Socratic Method and flipping the classroom and skills lab, with deliberate practice techniques, ABSN students quickly gain competence in core aspects of nursing. Rapid acquisition of competence early in the program allows for a meaningful clinical experience. NCLEX pass rates for our ABSN graduates averaged 93.84% over the past 4years, and students report high levels of satisfaction with the program. Using the Socratic Method in a flipped classroom and skills lab provides an environment that engages students, fosters NCLEX success, and supports development of clinical judgment critical for positive patient outcomes.

Proteolytic Activation of SARS-CoV-2 Spike at the S1/S2 Boundary: Potential Role of Proteases beyond Furin.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses its spike (S) protein to mediate viral entry into host cells. Cleavage of the S protein at the S1/S2 and/or S2′ site(s) is associated with viral entry, which can occur at either the cell plasma membrane (early pathway) or the endosomal membrane (late pathway), depending on the cell type. Previous studies show that SARS-CoV-2 has a unique insert at the S1/S2 site that can be cleaved by furin, which appears to expand viral tropism to cells with suitable protease and receptor expression. Here, we utilize viral pseudoparticles and protease inhibitors to study the impact of the S1/S2 cleavage on infectivity. Our results demonstrate that S1/S2 cleavage is essential for early pathway entry into Calu-3 cells, a model lung epithelial cell line, but not for late pathway entry into Vero E6 cells, a model cell line. The S1/S2 cleavage was found to be processed by other proteases beyond furin. Using bioinformatic tools, we also analyze the presence of a furin S1/S2 site in related CoVs and offer thoughts on the origin of the insertion of the furin-like cleavage site in SARS-CoV-2.