bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of the New York Nurse Practitioner Modernization Act on the Supply of Primary Care Nurse Practitioners: a Difference in Differences Design
Authors: Martsolf Grant , Kandrack Ryan , Poghosyan Lusine , Ferrera Stephen 
Published: June 2022

Abstract
Background: Expanding scope of practice (SOP) for nurse practitioners (NPs) may increase NP supply which can help meet the growing demand in primary care. We examined the impact of enacting less restrictive NP practice restrictions—NP Modernization Act—in New York State (NYS) on the overall supply of primary care NPs and supply in underserved areas. Methods: We used longitudinal data from the SK&A outpatient database (2012-2018) to identify primary care practices in NYS and in the comparison states (Pennsylvania [PA] and New Jersey [NJ]). Using a difference-in-differences design, we compared changes in 1) the presence and 2) total counts of NPs in primary care practice in NYS and neighboring comparison states (i.e., PA and NJ) before and after the policy change.Results: The NP Modernization Act was associated with a 1.3 percentage point lower probability of a practice employing at least one NP on average across each of the 3 post-periods (95% CI: -0.024, -0.002). NP Modernization Act was associated with 0.065 fewer NPs on average across the post-period (95% CI: -0.119, -0.011). Results were similar in underserved areas.Conclusions: The NP supply in NYS was lower after the NP Modernization Act than would have been expected based on the experience of comparison states. The negative relationship may be explained by gains in provider efficiency which leads to reduced NP hiring. More research is needed to understand the relationship between SOP regulations, NP supply, and access to care.
Detecting COVID-19 from Exhaled Breath – Clinical Studies
Authors: Kwiatkowski Andrzej , Borys Sebastian , Sikorska Katarzyna , Drozdowska Katarzyna , Smulko Janusz M. 
Published: June 2022

Abstract
The COVID-19 pandemic has attracted numerous research studies because of its impact on society and the economy. The pandemic has led to progress in the development of diagnostic methods, utilizing the polymerase chain reaction (PCR) as the gold standard for coronavirus SARS-CoV-2 detection. Numerous tests can be used at home within 15 minutes or so but of with lower accuracy than PCR. There is still a need for point-of-care tests available for mass daily screening of large crowds in airports, schools, and stadiums. The same problem exists with fast and continuous monitoring of patients during their medical treatment. The rapid methods can use exhaled breath analysis which is non-invasive and delivers the result quite fast. Electronic nose can detect a cocktail of volatile organic com-pounds (VOCs) induced by virus infection and disturbed metabolism in the human body. In our exploratory studies, we present the results of COVID-19 detection in a local hospital by applying the developed electronic setup utilising commercial VOC gas sensors. We consider the technical problems noticed during the reported studies and affecting the detection results. We believe that our studies help to advance the proposed technique to limit the spread of COVID-19 and similar viral infections.
Balancing closure and discovery: Adaptive expertise in the workplace
Authors: Gamborg Maria Louise , Jensen Rune Dall , Musaeus Peter , Mylopoulos Maria 
Published: June 2022

Abstract
BackgroundResidents must develop the knowledge and skills to handle an everchanging and demanding clinical workplace which requires a high degree of adaptability. To address this need, adaptive expertise has been suggested as an important framework for health professions education. However, research on the development of adaptive expertise has yet to explore how workplace supervision impacts residents’development. This study sought to investigate how clinical supervision might support the development of adaptive expertise.MethodsThe present study used a focused ethnography in two emergency departments. We observed 75 supervising situations with the 27 residents resulting in 116 pages of field notes. The majority of supervision was provided by senior physicians, but also included other healthcare professionals.ResultsWe found that supervision could serve two purposes: closure or discovery. Supervision aimed at discovery included practices that reflected instructional approaches said to promote adaptive expertise, such as productive struggle. Supervison aimed at closure included practices which reflected instructional approaches said to be important for efficient and safe patient care, such as verifying information. Our results suggest that supervision is a shared practice and responsibility.ConclusionWe argue that setting and aligning expectations before engaging in supervision is important. Furthermore, results demonstrated that supervision aimed towards discovery was not significantly more time consuming, and a feasible mode of supervision in appropriate situations.
Expanding our understanding of the Toarcian Oceanic Anoxic Event in the Tethys Ocean: New insights from the Arabian Plate
Authors: Alnazghah Mahmoud , Koeshidayatullah Ardiansyah , Alhussaini Abdulkarin , Amao Abduljamiu , Song Haijun , Al-Ramadan Khalid 
Published: June 2022

Abstract
The Toarcian Oceanic Anoxic Event (T-OAE) has been reported widely across the Tethyan region and globally. In Arabia, and based on ammonite dating, the T-OAE coincided with the deposition of the reddish siliciclastic unit of the Marrat Formation. However, no evidence of the T-OAE was ever reported from Arabia because these red beds were previously interpreted as continental deposits. Recently, these red beds have been recognized as shallow marine deposits which open an opportunity to assess the occurrence of T-OAE in Arabia. In this study, a multiproxy geochemical characterization was performed on the Toarcian Marrat Formation to infer the chemistry of the paleowater column and identify intervals of possible T-OAE in Arabia. The coupled negative excursion of δ13Corg and enrichment of redox-sensitive elements (Mo, U, V, Cr) indicate a period of marine anoxia during the deposition of Marrat red beds, suggesting that they were deposited in shallow marine settings and under anoxic, potentially ferruginous ocean conditions. The reddening is interpreted to have occurred later due to the stabilization of unstable hydrous iron oxides to hematite under oxic marine conditions. This study records the first documentation of the T-OAE in the Arabian Plate. This will have significant implications for the overall understanding of the T-OAE globally and for exploration of hydrocarbon through realizations of potential new source rocks associated with the OAEs in the Toarcian and other time intervals.
Bifurcation phenomena in Taylor-Couette flow in a very short annulus with radial through-flow
Authors: Altmeyer Sebastian , Sankar M. , Do Younghae 
Published: June 2022

Abstract
In this study, the non-linear dynamics of Taylor-Couette flow in a very small-aspect-ratio wide-gap annulus in a counter-rotating regime under the influence of radial through-flow are investigated by solving its full three-dimensional Navier-Stokes equations. Depending on the intensity of the radial flow, either an axisymmetric (pure m = 0 mode) pulsating flow structure or an axisymmetric axially propagating vortex will appear below the centrifugal instability threshold of the circular Couette flow. In contrast to earlier detected propagating vortices, these break Z2 symmetry and exist as a pair of degenerated solutions. Either pulsating or propagating solutions originate owing to the here considered small aspect ratio of the system, resulting in a constant competition between two-and one-cell states. With the variation of radial flow, a pulsating flow appears as a supercritical Hopf bifurcation from a stationary twin-pair state, persisting as the main feature. Thereafter, it undergoes period-doubling bifurcation and another Hopf bifurcation, leading to a quasi-periodic solution on a 2-torus. The propagating vortices are found to exist stably in two separate parameter regions, which feature different underlying dynamics. Although in one regime, the flow appears only as a limit cycle solution upon which saddle-node-invariant-circle bifurcation occurs, the other regime features more complex dynamics with richer Hopf bifurcation bifurcation sequences. The periods double to eventually introduce second and third incommensurate frequencies that change the flow to appear as 1-, 2-and 3-torus solutions.
Retrospective Study of hypofractionated stereotactic radiotherapy Combined with whole brain radiotherapy for Patients with Brain Metastases
Authors: Xie Xie , Peng Hong-Hua , Zhang Xi , Pan Yu-Liang , Zhang Zhen , Cao Pei-guo 
Published: June 2022

Abstract
Background and purpose
To evaluate the clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) combined with whole brain radiotherapy (WBRT) in patients with brain metastases (BMs).
Materials and methods
From May 2018 to July 2020, 50 patients (111 lesions) received HFSRT (18Gy/3F) + WBRT (40Gy/20F). The RECIST 1.1 and RANO-BM criteria were used to evaluate treatment efficacy. Five prognostic indexes (RPA, GPA, SIR, BS-BM, and GGS) were applied. The primary endpoint was intracranial local control (iLC). Secondary endpoints were overall survival (OS) and the safety of treatment.
Results
Intracranial objective response rates (iORR) using the RECIST 1.1 and RANO-BM criteria were 62.1% and 58.6%, respectively. The iLC rate was 93.1%, the 6- and 12-month iLC rates were 90.8% and 57.4%, respectively. The median intracranial progression-free survival (iPFS) was not reached (range 0 − 23 months). The 6-, 12-, and 24-month OS rates were 74.2%, 58.2%, and 22.9%, respectively. The KPS score showed statistical significance in univariate analysis of survival. The 6, 12, and 24 month OS rates for patients with KPS ≥ 70 were 83.8%, 70.5%, and 29.7%, respectively. The median survival time (MST) for all patients and for patients with KPS ≥ 70 were 13.6 and 16.5 months, respectively. Sex, KPS score, and gross tumor volume were significant factors in the multivariate analysis of survival. OS was significantly associated with RPA, SIR, BS-BM, and GGS classes. No acute toxicities of grade 3 or higher were noted.
Conclusion
HFSRT combined with WBRT is a safe and effective local treatment modality for BM patients.
Alterations in the LRRK2-Rab pathway in urinary extracellular vesicles as Parkinson’s disease and pharmacodynamic biomarkers
Authors: Taymans Jean-Marc , Mutez Eugenie , Sibran William , Vandewynckel Laurine , Deldycke Claire , Bleuse Séverine , Marchand Antoine , Sarchione Alessia , Kreisler Alexandre , Simonin Clémence , Koprich James , Baille Guillaume , Defebvre Luc , Dujardin Kathy , Destée Alain , Chartier-Harlin Marie-Christine 
Published: June 2022

Abstract
Levels of expression or of phosphorylation of leucine-rich repeat kinase 2 (LRRK2) and its Rab substrates have the potential for use as disease or pharmacodynamic biomarkers. LRRK2 phosphorylation levels at the S910-S935-S955-S973 phosphosites are reduced for most disease mutant forms of LRRK2, while for phospho-S1292, phospho-T72-Rab8 and phospho-T73-Rab10 levels are increased for most mutants. In addition, all of these 5 phosphosites on LRRK2 are rapidly dephosphorylated upon LRRK2 inhibitor treatment, considered potential therapeutics. The main objective of this study is therefore to characterize leucine-rich repeat kinase 2 (LRRK2) and Rab8/10 in human, non-human primate and rat urine for use as potential disease or pharmacodynamic biomarkers. With urine collected from human subjects as well as animals, we have applied an ultracentrifugation based fractionation protocol to isolate small extracellular vesicles (EVs). We used western blot with antibodies directed against LRRK2, LRRK2 phosphorylation sites as well as Rab8 and Rab10 total and phosphorylated proteins in order to measure these LRRK2 and Rab epitopes in urinary EVs (uEVs). We confirm the presence of LRRK2 and Rab8/10 in human and non-human primate (NHP) uEVs, including total LRRK2 as well phosphorylated forms of LRRK2 pS910, pS935, pS955, pS973, pS1292 and phosphorylated Rab8 and Rab10. We also confirm LRRK2 and Rab expression in rodent uEVs. We quantified LRRK2 and Rab epitopes in human cohorts and found in a first cohort that pS1292-LRRK2 levels were elevated in individuals carrying the LRRK2 G2019S mutation, but did not differ significantly between healthy and PD groups, whether for LRRK2 G2019S carriers or not. In a second cohort, we found that PD was associated to an increase in Rab8 levels and a decrease in S910-LRRK2 and S935-LRRK2 phosphorylation rates. In animals, we found that acute treatment with LRRK2 kinase inhibitor led to decreases in Rab10 phosphorylation rates and to a decrease in pS935-LRRK2 rates in uEVs from NHPs. The identification of changes in LRRK2 phosphorylation at heterologous phosphorylation sites in uEVs of PD patients further reinforces the potential of the LRRK2-Rab pathway as a source of PD biomarkers in uEVs.
A suitable therapeutic approach against LA7 breast cancer stem cells-induced rat mammary gland tumor by starved fibroblasts supernatant with bone marrow mesenchymal stem cells
Authors: Saeedi Fatemeh , Ghorbani Hossein , Karimian Mohammad , Akhavan-Niaki Haleh , Fattahi Sadegh , Gooran Sahar , Pourbagher Roghayeh , Kalali Behnam , Moudi Emaddodin , Mostafazadeh Amrolah 
Published: June 2022

Abstract
This study aimed to investigate the protective effects of 16h-serum starved-fibroblasts culture supernatant (16h-SFS) with and without bone marrow-derived mesenchymal stem/stromal cells (BMSCs) on the pathological and immunomolecular features of LA7 cancer stem cells-induced mammary tumor in rats. In an interventional study, 30 female rats were selected and the breast tumors were induced in all rats by LA7 cell and then were divided into six groups. The rats receiving the DMEM or PBS were considered as control groups. Three other groups received 16h-SFS solution, BMSCs, and 16h-SFS + BMSCs, respectively. After the treatment procedure, the tumor size were measured. Then the tumor tissues were evaluated in 10 high-power fields regarding the angiogenesis rate, mitotic cells, and type of immune cells infiltrated into the tumor microenvironment. Also, the expression of Cxcl9, Cxcl10, and Cxcl12 chemokines in tumors was examined by the Real-Time PCR method. Tumor size in 16h-SFS, BMSCs, and 16h-SFS + BMSCs groups were significantly reduced. Also, the tumor angiogenesis was significantly decreased in 16h-SFS + BMSCs vs. DMEM group. Also, the highest presence of mononuclear immune cells was observed in tumor tissues of the 16h-SFS + BMSCs group. A significant increase in Cxcl9 gene expression was observed in 16h-SFS + BMSCs vs. PBS and DMEM groups. Also, the Cxcl10 gene expression 16h-SFS + BMSCs group significantly increased vs. 16h-SFS, BMSCs, PBS, and DMEM groups. Our findings suggest that simultaneous administration of 16h-SFS and BMSC has an anti-tumor effect against LA7-induced tumors by modulating pathological and immeunological features. Therefore, these compounds could be considered as a promising cancer therapeutic approach.
Comparative petrophysical characterization, BIB-SEM imaging and permeability models of tight carbonates: Case study Upper Jurassic (Malm ß), N Bavaria
Authors: Freitag Simon , Klaver Jop , Malai Iulian S. , Klitzsch Norbert , Urai Janos L. , Stollhofen Harald , Bauer Wolfgang , Schmatz Joyce 
Published: June 2022

Abstract
Tight carbonate rocks are important potential although unconventional geothermal and hydrocarbon underground storage reservoirs and prospective CO 2 -EGS sites. We study these rocks by using the Upper Jurassic “Malm ß” in Southern Germany as an outcrop analog example to understand bulk properties in relation to microstructure and to test a variety of models for permeability prediction. Bulk petrophysical methods (Archimedes isopropanol immersion method, Helium pycnometry, mercury injection capillary pressure, gamma density core logging, gas permeability measurements) combined with microstructural investigations (BIB-SEM) are applied. Samples are macroscopically undeformed limestones collected from a tectonically overprinted quarry wall near the town of Simmelsdorf (38 km NE of Nürnberg city). Bulk porosities are below 5% and argon permeabilities are on average 1.4E-17m 2 . The presence of stylolites in some of the samples has neither a significant effect on porosity nor permeability. Pore sizes are in the submicron range and the diagenetically lithified stiff limestones are characterized by a relatively high Young’s Modulus averaging 73±5 MPa. Moreover, no trends in properties were observable towards the faults, indicating that faulting was post-diagenetic and that the matrix permeabilities were too low for intensive post-diagenetic fluid-rock interaction. Petrophysical properties are very close to those measured in stratigraphic equivalent rocks of the South German Molasse Basin, illustrating the widespread homogeneity of these rocks and justifying the quarry scale (500 x 580 m) as a reasonable reservoir analog for these rocks in the subsurface. The application of various permeability prediction models showed that the Capillary Tube model and the Saki Model are very well suited for predicting permeabilities from BIB-SEM and mercury injection capillary pressure results, respectively. We thereby found that the matrix permeability is primarily controlled by the pore throat diameters rather than the effective porosity.
Decision-To-Delivery Interval in Obese Patients Undergoing Emergent Cesarean Birth
Authors: Futterman Itamar , Navi Liel , Kim Hae-Young , Mendonca Roni , Girshin Michael , Shilkrut Alexander 
Published: June 2022

Abstract
Objective
To examine how increased body mass index (BMI) class impacts time to delivery interval in the setting of emergent cesarean birth.
Study Design
A cohort study of all emergent cesarean births at our institution from 2012–2018. Three comparison groups were divided by BMI category: 1. Non obese; </=30 kg/cm2 (n = 55), 2. Class I obesity; 31–34 kg/cm2 (n = 75), 3. Class II and III Obesity; >/=35 kg/cm2 (n = 51). Primary outcomes were time interval from decision-to-delivery interval and from skin-incision-to-delivery interval.
Results
The mean time interval (minutes +/- standard deviation (SD)) from arrival at the OR to delivery was 25.1 ± 9.7, 26.1 ± 10.6 and 30.2 ± 12.2, highlighting that as patient BMI class increased, the interval time to arrival to the OR and to delivery increased (beta coefficient 95% CI 5.15 (1.01,9,30) p = 0.037). The mean time interval (minutes +/- SD) from skin incision to delivery was 8.7 ± 5.6, 9.0 ± 6.4 and 11.7 ± 7.0, again showing a positive correlation between time interval and increasing BMI class (beta coefficient 95% CI 3.02 (0.65,5.40) p = 0.025).
Conclusion
This study describes the challenge of urgent cesarean births in obese patients, manifested in longer decision-to-delivery and skin-to-delivery intervals as BMI class increases. These findings support prior literature that describe a longer transport and surgical times in obese patients undergoing cesarean birth.
Prognostic Factors Associated with 18 FDG-PET/CT in Esophageal Squamous Cell Carcinoma After Trimodality Treatment
Authors: Feng Wei-Hsiang , Chen Ying-Yi , Kuo Yen‐Shou , Lin Kuan-Hsun , Tsai Yuan-Ming , Wu Ti-Hui , Huang Hsu-Kai , Huang Tsai-Wang 
Published: June 2022

Abstract
Purpose
This study aimed to determine the pathological complete response (pCR), overall survival (OS), and progression-free survival (PFS) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) using post-neoadjuvant chemoradiotherapy (nCRT) F-18-fluorodeoxyglucose (18FDG).
Methods
This is a retrospective study of patients with locally advanced ESCC receiving nCRT and then esophagectomy between January 2011 and December 2018 in the Tri-Service General Hospital, Taipei, Taiwan. A total of 50 patients were enrolled in the study. Survival analysis was performed using the Kaplan–Meier method and Cox proportional hazards model. Univariate and multivariate analysis were used to determine the independent prognostic factors.
Results
Fifty patients were enrolled in the study, and 18 had pathological complete response. Post-nCRT SUVmax ≥ 3 is a poor prognostic factor associated with overall survival (HR: 3.665, P = 0.013) and progression-free survival (HR: 3.417, P = 0.011). Poor prognosis was found in the pCR plus post-nCRT SUVmax ≥ 3 patients compared with non-pCR plus post-nCRT SUVmax < 3 group.
Conclusions
SUVmax ≥ 3 is a poor prognostic factor in esophageal squamous cell carcinoma after trimodality treatment, even in patients having pathological complete response.
Efficient therapeutic combinations of a naturally occurring trans-ferulic acid with different chemotherapies on in vitro hepatocellular carcinoma
Authors: Abdel-Hamid Nabil , ElNakeeb Nadia , El-Senduny Fardous 
Published: June 2022

Abstract
Trans- ferulic acid (TFA) is a polyphenolic compound present in many dietary supplements. To get better chemotherapeutic outcomes through treatment protocols for human hepatocellular carcinoma (HCC). This study focused on the exploration of the in vitro influence of a combination of TFA with 5-fluorouracil (5-FU), doxorubicin (DOXO), and cisplatin (CIS) on HepG2 cell line. Treatment with 5-FU, DOXO, and CIS alone down-regulated oxidative stress, alfa-fetoprotein (AFP), and decreased cell migration through the depression of metalloproteinases (MMP-3, MMP-9, and MMP-12) expression. Co-treatment with TFA synergized the effects of these chemotherapies by decreased MMP-3, MMP-9, and MMP-12 expression, and gelatinolytic activity of both MMP-9 and MMP-2 in cancer cells. TFA significantly reduced the elevated levels of AFP and NO, and depressed cell migration ability (metastasis) in HepG2 groups. Co-treatment with TFA elevated the chemotherapeutic potency of 5-FU, DOXO, and CIS in managing HCC.
Adenosine Reaction of Myosin
Authors: Ubani Solomon 
Published: June 2022

Abstract
Research was to study the adenosine triphosphate in living cells for synthesis. The research question was does process consumed and converts it to adenosine diphosphate or to adenosine monophosphate. The method involves studies of the structural constituents' in combination to adenosine and two phosphate sets. The bisphosphate was studied for the merge with 5’ of the compound. The results showed Atlases were a kind of enzyme for catalysis of decomposition of adenosine triphosphate into bisphosphate and a free phosphate or inverse reaction. The dephosphorylation released the resources, and the enzymes produced reactions. The study showed the usefulness of binding of adenosine triphosphate by myosin Atheist during the cycle. A number of these were synthesized and their reaction with myosin. It concluded in the presence of 0.6 M of potassium chloride, there was an increased myosin Atheist in the solution