bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early literacy training among medical students
Authors: Dunlap Marny , Walker Brooks , Nguyen Christine , Gerth Katelyn , Garbe M. Connor , Caldwell Alexandria 
Published: July 2021

AbstractBackgroundThe American Academy of Pediatrics regards literacy promotion as essential. Medical professionals are in a key position to promote children's early literacy, however this requires knowledge of existing literacy programmes. This study describes medical student training, awareness, experiences, and attitudes towards early literacy and the ‘Reach Out and Read’ (ROR) initiative.MethodsAn anonymous online survey was sent to all medical students at a medical school in the Midwest with two campuses. Data were analysed using descriptive statistics.ResultsWe received data from 275 medical students. Almost half (46.5%) had completed their paediatric clerkship, 22.9% had observed ROR, and only 2.9% had received any training. Most (67%), wanted to learn more about early literacy, and 59% expressed a desire for more ROR training. Most respondents expressed preference for learning from residents and faculty in clinic followed by online training. 47% agreed that it was a role of medical students to assess and encourage reading.DiscussionMedical students understand the importance of early literacy in primary care and emphasising this during clinical encounters. Most are eager to learn more about early literacy promotion and ROR. This interest decreases during third and fourth year so targeting the first 2 years of medical school is an important strategy. Providing formal literacy promotion training and education for medical students should be considered during this critical time in their education.
Overexpression of a small GTP‐binding protein Ran1 in Arabidopsis leads to promoted elongation growth and enhanced disease resistance against P. syringae DC3000
Authors: Xu Peipei , Ma Wei , Liu Jing , Hu Jinbo , Cai Weiming 
Published: July 2021

SUMMARYPlants resist infection through an innate immune response, which is usually associated with slowing of growth. The molecular mechanisms underlying the trade‐off between plant growth and defense remain unclear. The present study reveals that growth/defense trade‐offs mediated by gibberellin (GA) and salicylic acid (SA) signaling pathways are uncoupled during constitutive overexpression of transgenic AtRAN1 and AtRAN1Q72L (active, GTP‐locked form) Arabidopsis plants. It is well known that the small GTP‐binding protein Ran (a Ras‐related nuclear protein) functions in the nucleus–cytoplasmic transport of proteins. Although there is considerable evidence indicating that nuclear–cytoplasmic partitioning of specific proteins can participate in hormone signaling, the role of Ran‐dependent nuclear transport in hormone signaling is not yet fully understood. In this report, we used a combination of genetic and molecular methods to reveal whether AtRAN1 is involved in both GA and SA signaling pathways. Constitutively overexpressed AtRAN1 promoted both elongation growth and the disease resistance response, whereas overexpression of AtRAN1Q72L in the atran2atran3 double mutant background clearly inhibited elongation growth and the defense response. Furthermore, we found that AtRAN1 coordinated plant growth and defense by promoting the stability of the DELLA protein RGA in the nucleus and by modulating NPR1 nuclear localization. Interestingly, genetically modified rice (Oryza sativa) overexpressing AtRAN1 exhibited increased plant height and yield per plant. Altogether, the ability to achieve growth/defense trade‐offs through AtRAN1 overexpression provides an approach to maximizing crop yield to meet rising global food demands.
A Nonsmooth Quasi-Static Modeling Approach for Hydraulic Actuators
Authors: Kikuuwe Ryo , Okada Tomofumi , Yoshihara Hideo , Doi Takayuki , Nanjo Takao , Yamashita Koji 
Published: July 2021

Abstract
This paper presents an analytical approach for modeling the quasi-static characteristics of hydraulic actuators driven by four-valve independent metering circuits. The presented model is described as a nonsmooth, set-valued function from the velocity to the set of forces with which the equilibrium is achieved at the velocity. It is derived from algebraic relations among the velocity of the actuator, the steady-state force generated by the actuator, and the flowrate and the steady-state pressure at all valves in the circuit. This approach is also applied to more involving circuits including a regeneration pipeline and those with multiple actuators. The contribution of the paper can be seen as an example case study of the fact that these complicated circuit structures are analytically tractable through an extension of the conventional hydraulic–electric analogy. The obtained analytical expressions of the steady-state velocity–force relations allow for concise visualization of the actuators' characteristics.
Hemodynamic Study of Blood Flow in the Carotid Artery With a Focus on Carotid Sinus Using Fluid-Structure Interaction
Authors: Bantwal Aditya , Singh Aditya , Menon Abhay Ramachandran , Kumar Nitesh 
Published: July 2021

AbstractThe carotid artery is one of the most favorable locations for atherosclerotic plaque accumulation due to its unique geometry. It predominantly occurs at the outer wall of the internal carotid artery (ICA) near the carotid sinus. Fluid–structure interaction study of hemodynamics in the carotid artery with a focus on carotid sinus plays a prominent role in explaining the development and progression of the atherosclerotic lesion. In this study, hemodynamic parameters affecting the plaque accumulation in the carotid artery were investigated with a focus on the carotid sinus. An idealized carotid artery model was taken and hemodynamic parameters such as deformation, wall shear stress (WSS), oscillatory shear index (OSI), relative residence time (RRT), and Helicity were investigated. The atherosclerosis-prone carotid sinus region had significantly low WSS, and low helicity resulting in higher OSI. In these regions, the flow separation had decreased the velocity significantly with a high-velocity angle. The flow divider had significantly elevated WSS due to a higher pressure gradient. Stenosis is predicted to occur at the downstream area of the carotid sinus and develop downstream due to flow separation leading to endothelial dysfunction. Decreased vascular WSS, helicity, and higher OSI are key to the development of endothelial dysfunction leading to atherosclerotic lesion in the carotid sinus.
Initiation of Clockwise Rotation and Eastward Transport of Southeastern Tibet Inferred from Deflected Fault Traces and GPS Observations
Authors: Gan Weijun , Molnar Peter , Zhang Peizhen , Xiao Genru , Liang Shiming , Zhang Keliang , Li Zhangjun , Xu Keke , Zhang Ling 
Published: July 2021

AbstractEastward transport and clockwise rotation of crust around the southeastern margin of the Tibetan Plateau dominates active deformation east of the Eastern Himalayan Syntaxis. Current crustal movement inferred from GPS measurements indicates ongoing distortion of the traces of the active Red River fault and the Mesozoic Yalong-Yulong-Longmen Shan thrust belt. By extrapolating current rates back in time, we infer that this pattern of deformation developed since 10.1 ± 1.5 Ma. This date of initiation is approximately synchronous with a suite of tectonic phenomena, both near and far, within the wide Eurasia/Indian collision zone, including the initiation of slip on the Ganzi-Yushu-Xianshuihe fault and crustal thinning and E-W extension by normal faulting on N-S–trending rifts in the plateau interior. Accordingly, the eastward movement of eastern Tibet and the clockwise rotation of that material seem to be local manifestations of a larger geodynamic event at ca. 10–15 Ma that changed the kinematic style and reorganized deformation not only on the plateau-wide scale, but across the entire region affected by the India/Eurasia collision. Convective removal of some or all of Tibet's mantle lithosphere seems to offer the simplest mechanism for these approximately simultaneous changes.
Diagnostic accuracy of rapid antigen tests in asymptomatic and presymptomatic close contacts of individuals with confirmed SARS-CoV-2 infection: cross sectional study
Authors: Schuit Ewoud , Veldhuijzen Irene K , Venekamp Roderick P , van den Bijllaardt Wouter , Pas Suzan D , Lodder Esther B , Molenkamp Richard , GeurtsvanKessel Corine H , Velzing Jans , Huisman Robin C , Brouwer Lieke , Boelsums Timo L , Sips Gregorius J , Benschop Kimberly S M , Hooft Lotty , van de Wijgert Janneke H H M , van den Hof Susan , Moons Karel G M 
Published: July 2021

Abstract

Objective
To assess the diagnostic test accuracy of two rapid antigen tests in asymptomatic and presymptomatic close contacts of people with SARS-CoV-2 infection on day 5 after exposure.

Design
Prospective cross sectional study.

Setting
Four public health service covid-19 test sites in the Netherlands.

Participants
4274 consecutively included close contacts (identified through test-and-trace programme or contact tracing app) aged 16 years or older and asymptomatic for covid-19 when requesting a test.

Main outcome measures
Sensitivity, specificity, and positive and negative predictive values of Veritor System (Beckton Dickinson) and Biosensor (Roche Diagnostics) rapid antigen tests, with reverse-transcriptase polymerase chain reaction (RT-PCR) testing as reference standard. The viral load cut-off above which 95% of people with a positive RT-PCR test result were virus culture positive was used as a proxy of infectiousness.

Results
Of 2678 participants tested with Veritor, 233 (8.7%) had a RT-PCR confirmed SARS-CoV-2 infection of whom 149 were also detected by the rapid antigen test (sensitivity 63.9%, 95% confidence interval 57.4% to 70.1%). Of 1596 participants tested with Biosensor, 132 (8.3%) had a RT-PCR confirmed SARS-CoV-2 infection of whom 83 were detected by the rapid antigen test (sensitivity 62.9%, 54.0% to 71.1%). In those who were still asymptomatic at the time of sampling, sensitivity was 58.7% (51.1% to 66.0%) for Veritor (n=2317) and 59.4% (49.2% to 69.1%) for Biosensor (n=1414), and in those who developed symptoms were 84.2% (68.7% to 94.0%; n=219) for Veritor and 73.3% (54.1% to 87.7%; n=158) for Biosensor. When a viral load cut-off was applied for infectiouness (≥5.2 log10 SARS-CoV-2 E gene copies/mL), the overall sensitivity was 90.1% (84.2% to 94.4%) for Veritor and 86.8% (78.1% to 93.0%) for Biosensor, and 88.1% (80.5% to 93.5%) for Veritor and 85.1% (74.3% to 92.6%) for Biosensor, among those who remained asymptomatic throughout. Specificities were >99%, and positive and negative predictive values were >90% and >95%, for both rapid antigen tests in all analyses.

Conclusions
The sensitivities of both rapid antigen tests in asymptomatic and presymptomatic close contacts tested on day 5 onwards after close contact with an index case were more than 60%, increasing to more than 85% after a viral load cut-off was applied as a proxy for infectiousness.
Effect of peer-distributed HIV self-test kits on demand for biomedical HIV prevention in rural KwaZulu-Natal, South Africa: a three-armed cluster-randomised trial comparing social networks versus direct delivery
Authors: Shahmanesh Maryam , Mthiyane T Nondumiso , Herbsst Carina , Neuman Melissa , Adeagbo Oluwafemi , Mee Paul , Chimbindi Natsayi , Smit Theresa , Okesola Nonhlanhla , Harling Guy , McGrath Nuala , Sherr Lorraine , Seeley Janet , Subedar Hasina , Johnson Cheryl , Hatzold Karin , Terris-Prestholt Fern , Cowan Frances M , Corbett Elizabeth Lucy 
Published: July 2021

Study objectiveWe investigated two peer distribution models of HIV self-testing (HIVST) in HIV prevention demand creation compared with trained young community members (peer navigators).MethodsWe used restricted randomisation to allocate 24 peer navigator pairs (clusters) in KwaZulu-Natal 1:1:1: (1) standard of care (SOC):peer navigators distributed clinic referrals, pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) information to 18–30 year olds. (2)peer navigator direct distribution (PND):Peer navigators distributed HIVST packs (SOC plus two OraQuick HIVST kits) (3)incentivised peer networks (IPN):peer navigators recruited young community members (seeds) to distribute up to five HIVST packs to 18–30 year olds within their social networks. Seeds received 20 Rand (US$1.5) for each recipient who distributed further packs. The primary outcome was PrEP/ART linkage, defined as screening for PrEP/ART eligibility within 90 days of pack distribution per peer navigator month (pnm) of outreach, in women aged 18–24 (a priority for HIV prevention). Investigators and statisticians were blinded to allocation. Analysis was intention to treat. Total and unit costs were collected prospectively.ResultsBetween March and December 2019, 4163 packs (1098 SOC, 1480 PND, 1585 IPN) were distributed across 24 clusters. During 144 pnm, 272 18–30 year olds linked to PrEP/ART (1.9/pnm). Linkage rates for 18–24-year-old women were lower for IPN (n=26, 0.54/pnm) than PND (n=45, 0.80/pnm; SOC n=49, 0.85/pnm). Rate ratios were 0.68 (95% CI 0.28 to 1.66) for IPN versus PND, 0.64 (95% CI 0.26 to 1.62) for IPN versus SOC and 0.95 (95% CI 0.38 to 2.36) for PND versus SOC. In 18–30 year olds, PND had significantly more linkages than IPN (2.11 vs 0.88/pnm, RR 0.42, 95% CI 0.18 to 0.98). Cost per pack distributed was cheapest for IPN (US$36) c.f. SOC (US$64). Cost per person linked to PrEP/ART was cheaper in both peer navigator arms compared with IPN.DiscussionHIVST did not increase demand for PrEP/ART. Incentivised social network distribution reached large numbers with HIVST but resulted in fewer linkages compared with PrEP/ART promotion by peer navigators.Trial registration numberNCT03751826.
Impact of the COVID-19 pandemic and response on the utilisation of health services in public facilities during the first wave in Kinshasa, the Democratic Republic of the Congo
Authors: Hategeka Celestin , Carter Simone E , Chenge Faustin Mukalenge , Katanga Eric Nyambu , Lurton Grégoire , Mayaka Serge Ma-Nitu , Mwamba Dieudonné Kazadi , van Kleef Esther , Vanlerberghe Veerle , Grépin Karen Ann 
Published: July 2021

IntroductionHealth service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone.MethodsUsing monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (ie, Gombe vs other health zones).ResultsHealth service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lockdown was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.ConclusionThe COVID-19 pandemic resulted in important reductions in health service utilisation in Kinshasa, particularly Gombe. Lifting of lockdown led to a rebound in the level of health service use but it remained lower than prepandemic levels.
Cross-sectional analysis of educational inequalities in primary prevention statin use in UK Biobank
Authors: Carter Alice Rose , Gill Dipender , Davey Smith George , Taylor Amy E , Davies Neil M , Howe Laura D 
Published: July 2021

ObjectiveIdentify whether participants with lower education are less likely to report taking statins for primary cardiovascular prevention than those with higher education, but an equivalent increase in underlying cardiovascular risk.MethodsUsing data from a large prospective cohort study, UK Biobank, we calculated a QRISK3 cardiovascular risk score for 472 097 eligible participants with complete data on self-reported educational attainment and statin use (55% female participants; mean age 56 years). We used logistic regression to explore the association between (i) QRISK3 score and (ii) educational attainment on self-reported statin use. We then stratified the association between QRISK3 score and statin use, by educational attainment to test for interactions.ResultsThere was evidence of an interaction between QRISK3 score and educational attainment. Per unit increase in QRISK3 score, more educated individuals were more likely to report taking statins. In women with ≤7 years of schooling, a one unit increase in QRISK3 score was associated with a 7% higher odds of statin use (OR 1.07, 95% CI 1.07 to 1.07). In women with ≥20 years of schooling, a one unit increase in QRISK3 score was associated with an 14% higher odds of statin use (OR 1.14, 95% CI 1.14 to 1.15). Comparable ORs in men were 1.04 (95% CI 1.04 to 1.05) for ≤7 years of schooling and 1.08 (95% CI 1.08, 1.08) for ≥20 years of schooling.ConclusionPer unit increase in QRISK3 score, individuals with lower educational attainment were less likely to report using statins, likely contributing to health inequalities.
Potential distribution and habitat suitability of Picea crassifolia with climate change scenarios
Authors: Gao Yuan , He Zhibin , Zhu Xi , Chen Longfei , Du Jun , Lin Pengfei , Tian Quanyan , Kong Junqia 
Published: July 2021

The Qinghai–Tibet Plateau in China is a region strongly impacted by climate change, yet its effects on the keystone endemic forest species Picea crassifolia Kom. are unknown. Understanding the changes in potential distribution and habitat suitability of P. crassifolia forest with climate change will contribute to water conservation, forest management, and ecological protection in the upper reaches of the Yellow River. A total of 129 records of species distribution data and 19 environmental variables were chosen for modeling. The MaxEnt (maximum entropy) model was used to analyze the main environmental factors affecting the potential distribution of P. crassifolia in two periods (2050s and 2070s) and four representative emission pathways (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). The main results are follows: (i) the most important environmental variables affecting distribution of P. crassifolia and percentage variance explained were altitude (41.85%), precipitation of driest month (19.76%), slope (12.35%), annual precipitation (6.56%), precipitation of wettest month (5.73%), and precipitation of warmest quarter (5.12%); (ii) habitat suitability of P. crassifolia shifted to the northwest and into high-altitude areas under climate change scenarios, but its core distribution areas were concentrated in northeastern Qinghai–Tibet Plateau, Qilian Mountains, southern Ningxia, and Helan Mountains; and (iii) the total area of potential suitable habitat of P. crassifolia will change significantly in the future, and change of habitat area of not suitable, low, moderate, and high suitability exceed 60%.
Randomized Phase II Study of Axitinib versus Observation in Patients with Recurred or Metastatic Adenoid Cystic Carcinoma
Authors: Kang Eun Joo , Ahn Myung-Ju , Ock Chan-Young , Lee Keun-Wook , Kwon Jung Hye , Yang Yaewon , Choi Yoon Hee , Kim Min Kyoung , Ji Jun Ho , Yun Tak , Nam Byung-Ho , Kim Sung-Bae , Keam Bhumsuk 
Published: July 2021

AbstractPurpose:The role of chemotherapy in adenoid cystic carcinoma (ACC) is controversial because ACC is usually stable without chemotherapy and the lack of randomized trials. Here, we conducted the first randomized trial to evaluate the efficacy of axitinib as compared with observation in ACC.Patients and Methods:In this multicenter, prospective phase II trial, we enrolled patients with recurrent or metastatic ACC whose cancer had progressed within the past 9 months. Patients were randomly assigned to either axitinib (5 mg twice daily) or observation at a 1:1 ratio. Crossover from observation to axitinib was permitted after progression. The primary endpoint was a 6-month progression-free survival (PFS) rate. The secondary endpoints included objective response rate (ORR), overall survival (OS), PFS, duration of response, and adverse events.Results:Sixty patients were allocated to the axitinib or observation group, with response evaluation conducted in 54 patients. With a median follow-up of 25.4 months, the 6-month PFS rate was 73.0% with axitinib and 23.0% with observation. Median PFS was longer in the axitinib arm (10.8 months vs. 2.8 months, P &lt; 0.001). The ORR of axitinib was 0.0%, but the disease control rate was 100.0% with axitinib and 51.9% with observation. Median OS was not reached with axitinib, but was 27.2 months with observation (P = 0.226). The most frequently reported adverse events for axitinib were oral mucositis and fatigue.Conclusions:In this first randomized trial in patients with ACC, axitinib significantly increased the 6-month PFS rate as compared with observation. (ClinicalTrials.gov number, NCT02859012)
A Biparatopic Antibody–Drug Conjugate to Treat MET-Expressing Cancers, Including Those that Are Unresponsive to MET Pathway Blockade
Authors: DaSilva John O. , Yang Katie , Surriga Oliver , Nittoli Thomas , Kunz Arthur , Franklin Matthew C. , Delfino Frank J. , Mao Shu , Zhao Feng , Giurleo Jason T. , Kelly Marcus P. , Makonnen Sosina , Hickey Carlos , Krueger Pamela , Foster Randi , Chen Zhaoyuan , Retter Marc W. , Slim Rabih , Young Tara M. , Olson William C. , Thurston Gavin , Daly Christopher 
Published: July 2021

Abstract
Lung cancers harboring mesenchymal-to-epithelial transition factor (MET) genetic alterations, such as exon 14 skipping mutations or high-level gene amplification, respond well to MET-selective tyrosine kinase inhibitors (TKI). However, these agents benefit a relatively small group of patients (4%–5% of lung cancers), and acquired resistance limits response durability. An antibody–drug conjugate (ADC) targeting MET might enable effective treatment of MET-overexpressing tumors (approximately 25% of lung cancers) that do not respond to MET targeted therapies. Using a protease-cleavable linker, we conjugated a biparatopic METxMET antibody to a maytansinoid payload to generate a MET ADC (METxMET-M114). METxMET-M114 promotes substantial and durable tumor regression in xenografts with moderate to high MET expression, including models that exhibit innate or acquired resistance to MET blockers. Positron emission tomography (PET) studies show that tumor uptake of radiolabeled METxMET antibody correlates with MET expression levels and METxMET-M114 efficacy. In a cynomolgus monkey toxicology study, METxMET-M114 was well tolerated at a dose that provides circulating drug concentrations that are sufficient for maximal antitumor activity in mouse models. Our findings suggest that METxMET-M114, which takes advantage of the unique trafficking properties of our METxMET antibody, is a promising candidate for the treatment of MET-overexpressing tumors, with the potential to address some of the limitations faced by the MET function blockers currently in clinical use.