bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Bayesian Regression Analysis of the Effects of Alert Presence and Scenario Criticality on Automated Vehicle Takeover Performance
Authors: Alambeigi Hananeh , McDonald Anthony D. 
Published: April 2021

Objective This study investigates the impact of silent and alerted failures on driver performance across two levels of scenario criticality during automated vehicle transitions of control. Background Recent analyses of automated vehicle crashes show that many crashes occur after a transition of control or a silent automation failure. A substantial amount of research has been dedicated to investigating the impact of various factors on drivers’ responses, but silent failures and their interactions with scenario criticality are understudied. Method A driving simulator study was conducted comparing scenario criticality, alert presence, and two driving scenarios. Bayesian regression models and Fisher’s exact tests were used to investigate the impact of alert and scenario criticality on takeover performance. Results The results show that silent failures increase takeover times and the intensity of posttakeover maximum accelerations and decrease the posttakeover minimum time-to-collision. While the predicted average impact of silent failures on takeover time was practically low, the effects on minimum time-to-collision and maximum accelerations were safety-significant. The analysis of posttakeover control interaction effects shows that the effect of alert presence differs by the scenario criticality Conclusion Although the impact of the absence of an alert on takeover performance was less than that of scenario criticality, silent failures seem to play a substantial role—by leading to an unsafe maneuver—in critical automated vehicle takeovers. Application Understanding the implications of silent failure on driver’s takeover performance can benefit the assessment of automated vehicles’ safety and provide guidance for fail-safe system designs.
Understanding the evolution of open government data research: towards open data sustainability and smartness
Authors: Gao Yingying , Janssen Marijn , Zhang Congcong 
Published: April 2021

The past decade has witnessed a rapid development of open government data practices and academic research. However, there is no systematic survey of existing research to understand the evolution of open government data. Such research can facilitate knowledge transfer within and across domains, and foster learning for countries in the early stages of open government data development. This study quantitively extracted the evolution trajectory of open government data based on the main path analysis method and then analysed the underlying motivations. The results show that open government data research went through four main phases and that the open government data movement has spread towards developing countries and smart cities. Different challenges and issues faced by the researchers in each phase drove the evolution of open government data research. Finally, we discuss future directions of open government data research based on our findings and recent development. There is a tendency to create sustainable open government data and smartness by employing artificial intelligence and creating data marketplaces. Points for practitioners Open government data efforts have evolved over the years into a global phenomenon. Countries have learned from each other and more and more efforts are focused on innovating with open government data by stimulating co-creation and using other incentives. The way that data are opened should focus on achieving goals like innovation, participation, transparency and accountability. There is a tendency to create sustainable open government data and smartness by employing artificial intelligence and creating data marketplaces.
Discontinuation and relapse with paliperidone palmitate three-monthly for maintenance of schizophrenia: Two year follow-up of use in clinical practice
Authors: Wallman Phoebe , Clark Ivana , Taylor David 
Published: April 2021

Background: The use of antipsychotic long-acting injections (LAI) aims to reduce risk of relapse and hospitalisation in patients with schizophrenia compared with oral medication. Paliperidone palmitate is currently the only LAI that can be administered at three-monthly intervals for maintenance treatment of schizophrenia. Aim: This prospective study aimed to evaluate relapse and continuation in licensed use of paliperidone palmitate three-monthly (PP3M) over a 2-year follow-up in clinical practice. Method: Non-interventional, observational study of patients treated in the South London and The Maudsley NHS Foundation Trust. Results: A total of 166 patients initiated on PP3M, 55 were excluded from the study (non-F20 diagnosis ( n = 43); F20 >65 years old ( n = 12)). Of the 111 patients included, 67 (60%) continued PP3M for 2 years. Overall 102 patients received more than one dose of PP3M and 92 (90%) remained on the same dose of PP3M for the whole of their treatment duration. Relapse (defined as a step-up in clinical care) occurred in eight patients (7%) while on PP3M. The most common reason for discontinuation was patient refusal and the most frequent medication prescribed after discontinuation was paliperidone palmitate one-monthly (PP1M). Post hoc, we analysed outcome in those continuing any form of PPLAI (those continuing with PP3M and those switching back to PP1M). Continuation over 2 years with any PPLAI formulation was 73% (81/111) and relapse was recorded in 9% (10/111). Conclusion: Overall, PP3M was an effective maintenance treatment for schizophrenia after stabilisation on PP1M in a clinical setting.
Sevoflurane represses the migration and invasion of gastric cancer cells by regulating forkhead box protein 3
Authors: Yong Fangfang , Wang Hemei , Li Chao , Jia Huiqun 
Published: April 2021

Objective Previous studies suggested that sevoflurane exerts anti-proliferative, anti-migratory, and anti-invasive effects on cancer cells. To determine the role of sevoflurane on gastric cancer (GC) progression, we evaluated its effects on the proliferation, migration, and invasion of SGC7901, AGS, and MGC803 GC cells. Methods GC cells were exposed to different concentrations of sevoflurane (1.7, 3.4, or 5.1% v/v). Cell viability, migration, and invasion were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and Transwell assays. Immunohistochemical staining and immunoblotting were performed to analyze forkhead box protein 3 (FOXP3) protein expression in tissue specimens and cell lines, respectively. Results FOXP3 was downregulated in human GC specimens and cell lines. Functionally, FOXP3 overexpression significantly inhibited the proliferation, migration, and invasion of GC cells and accelerated their apoptosis. Moreover, sevoflurane significantly blocked GC cell migration and invasion compared with the findings in the control group. However, FOXP3 silencing neutralized sevoflurane-induced apoptosis and the inhibition of GC cell migration and invasion. Sevoflurane-induced apoptosis and the suppression of migration and invasion might be associated with FOXP3 overactivation in GC cells. Conclusions Sevoflurane activated FOXP3 and prevented GC progression via inhibiting cell migration and invasion in vitro.
Clinical presentation of Rett syndrome in relation to quality of life and family functioning
Authors: Rozensztrauch Anna , Sebzda Agnieszka , Śmigiel Robert 
Published: April 2021

Objective Rett syndrome (RTT) is a chronic condition that manifest in young children, with concomitant comorbidities such as respiratory problems, scoliosis, epilepsy, and malnutrition, which may affect children’s quality of life (QoL) and family functioning. The objective of this cross-sectional descriptive correlation study was to understand the clinical presentation of RTT in relation to QoL and family functioning. Methods We included 23 parents of children with RTT. In this study, we used the PedsQL™ Family Impact Module, the Pediatric Quality of Life Inventory 4.0 generic core scales (PedsQL™ 4.0), and an author-designed questionnaire to assess QoL and family functioning. Results A significant relationship was observed between PedsQL™ 4.0 score and child’s age in the physical functioning dimension. Children aged 8 to 12 years demonstrated significantly higher scores than those in the other age groups. Malnutrition in the child significantly affected functioning of the family in the family relationships dimension. Children receiving 5 hours of rehabilitation treatment a week had significantly higher QoL in the school functioning dimension. Conclusions QOL in children with RTT, as perceived by their parents, is reduced. RTT has a significant negative correlation with family functioning.
Sema3C promotes hepatic metastasis and predicts poor prognosis in gastric adenocarcinoma
Authors: Li Maoran , Xu Danhua , Xia Xiang , Ni Bo , Zhu Chunchao , Zhao Gang , Cao Hui 
Published: April 2021

Objective Semaphorin 3C (Sema3C) may regulate tumor metastasis and prognosis. We determined the biological roles of Sema3C in the hepatic metastasis of gastric adenocarcinoma and evaluated its clinical significance as a potential biomarker. Methods Sema3C expression in gastric cancer (GC) cell lines and tissues was measured using RT-qPCR and western blotting. Moreover, Sema3C functions were analyzed using Transwell assays and in vitro metastasis assays in gain- and loss-of-function experiments. Furthermore, the impact of Sema3C on the prognosis of 80 randomly selected patients with GC was investigated by immunohistochemistry. Additionally, the expression of epithelial-mesenchymal transition (EMT) indicators was verified by immunohistochemistry in GC tissues. Results Sema3C expression was significantly upregulated in highly metastatic GC cell lines and tissues. Additionally, Sema3C promoted invasion, migration and hepatic metastasis in GC cells. Moreover, Sema3C expression was positively correlated with clinicopathological features in GC and paired hepatic metastatic tissues, and Sema3C expression was an independent prognostic factor. Finally, Sema3C expression was associated with node metastasis, hepatic metastasis and EMT marker expression. Conclusions Sema3C may play roles in regulating the EMT and metastasis of gastric adenocarcinoma, highlighting its potential use as a prognostic factor for hepatic metastasis and poor prognosis in gastric adenocarcinoma.
rs1840680 single nucleotide polymorphism in Pentraxin 3: a potential protective biomarker of severe community-acquired pneumonia
Authors: Zeng Qiaojun , Tang Tiantian , Huang Biru , Bu Shiyi , Xiao Yingqi , Dai Yumeng , Wei Zixin , Huang Linjie , Jiang Shanping 
Published: April 2021

Objective Single nucleotide polymorphisms (SNPs) of pentraxin 3 ( PTX3) are associated with various outcomes of lung infections. This study aimed to analyze the relationship between PTX3 polymorphisms and the severity of community-acquired pneumonia (CAP). Methods This is a retrospective case-control study comprising 43 patients with severe CAP (SCAP) and 97 patients with non-severe CAP. Three SNPs in the PTX3 gene (rs2305619, rs3816527, and rs1840680) from peripheral blood samples were genotyped by real-time polymerase chain reaction. The association between each SNP and the CAP severity was analyzed by logistic regression analysis. Results We found that the rs1840680 polymorphism was significantly associated with CAP clinical severity. However, no such association was observed for the genotypes and allele frequencies of rs2305619 or rs3816527. The PTX3 rs1840680 AG genotype was an independent factor for a lower risk of SCAP after multivariate logistic regression analysis. Male sex and coronary heart disease were associated with an increased risk of SCAP. Conclusions The PTX3 rs1840680 AG genotype was found to be associated with a lower risk of SCAP, and may serve as a potential protective biomarker to help clinical judgment and management.
Clinical application of a multi-groove silicone drain combined with unidirectional negative-pressure drainage system in single-operating-port video-assisted thoracoscopic lung cancer surgery: a comparison study
Authors: Wang Ze , Lv Jian , Zhang Si’ang , Chen Wenjie , Wu Bin , Xue Lei 
Published: April 2021

Objective To evaluate the effect of a new negative-pressure drainage system in thoracoscopic lung cancer surgery; thereby, providing a new option for postoperative drainage. Methods We retrospectively analyzed data for 200 patients who underwent thoracoscopic surgery between May 2018 and October 2019. According to the thoracic drainage method, the patients were divided into the thoracic tube group and the new system group. The epidemiological and clinicopathological data were compared before operation, and the clinical effect of thoracic drainage was compared after operation. Results There was no significant difference in epidemiological and clinicopathological data between the two groups. There was also no significant difference in drain removal time, hospital stay, and complication rates between the two groups. However, the incidences of pleural effusion and poor incision healing in the new system group were lower than in the thoracic tube group. Visual analog scale (VAS) scores in the new system group were lower than those in the thoracic tube group at each postoperative interval; therefore, the new system group required less analgesia. Conclusion The new system was not inferior to thoracic tubes regarding the drainage effect after thoracoscopic lung cancer surgery. Hence, the system is an alternative to traditional thoracic tubes.
Exploring the Perth Hamstring Assessment Tool and Lower Extremity Functional Scale in a Proximal Hamstring Avulsion Cohort: A Cross-sectional Study
Authors: Pihl Elsa , Jonsson Kenneth B. , Berglöf Mida , Brodin Nina , Sköldenberg Olof , Hedbeck Carl Johan 
Published: April 2021

Background: The goal of treatment for a proximal hamstring avulsion (PHA) is an objectively restored muscle and a subjectively satisfied, pain-free patient at follow-up. Different self-reported and performance-based outcome measures have been used to evaluate recovery, but their validity is poorly investigated. Purpose: To investigate (1) the correlation between the commonly used self-reported outcome measurements, the Perth Hamstring Assessment Tool (PHAT) and the Lower Extremity Functional Scale (LEFS); (2) to what extent these scores can be explained by physical dysfunction as measured by performance-based tests; (3) whether performance-based tests can discriminate between the injured and uninjured extremity; and (4) which activity limitations are perceived by patients several years after the injury. Study design: Cohort study (Diagnosis); Level of evidence, 3. Methods: We included a consecutive series of patients treated for or diagnosed with PHA in our department between 2007 and 2016 having at least 2 tendons avulsed from the ischial tuberosity. Participants attended 2 study visits, answered questionnaires (PHAT, LEFS, and Patient-Specific Functional Scale [PSFS]), and performed physical performance–based tests (single-leg hop tests, single–step down test, and isometric and isokinetic strength tests). Results: A total of 50 patients were included (26 men [52%], 24 women [48%]; mean age, 50.9 years [SD, 9.8 years]). The mean follow-up time was 5.5 years (SD, 2.7 years), and 74% had been surgically treated. The correlation between PHAT and LEFS was strong ( r = 0.832) and statistically significant ( P < .001). Seven of the performance-based tests exhibited a statistically significant but weak correlation with LEFS (0.340-0.488) and 3 of the tests to PHAT (–0.304 to 0.406). However, only peak torque could significantly discriminate between the extremities. The activity limitation most commonly mentioned in PSFS was running (16 patients [32%]). Conclusion: Although PHAT and LEFS correlated strongly, the correlations between functional tests and the patient-reported outcome scores were weak, and most functional tests failed to discriminate between the injured and uninjured lower extremity in patients with PHA 5 years after injury. In general, patients alleged few activity limitations, but running difficulty was a common sequela after PHA.
Which Aspects of the CanMEDS Competencies are Most Valued in Radiologists? Perspectives of Trainees From Other Specialties
Authors: Lee Stefanie Y. , Sharma Namita , Kagoma Yoan K. , Lum P. Andrea 
Published: April 2021

Purpose: Radiologists work primarily in collaboration with other healthcare professionals. As such, these stakeholder perspectives are of value to the development and assessment of educational outcomes during the transition to competency-based medical education. Our aim in this study was to determine which aspects of the Royal College CanMEDS competencies for diagnostic radiology are considered most important by future referring physicians. Methods: Institutional ethics approval was obtained. After pilot testing, an anonymous online survey was sent to all residents and clinical fellows at our university. Open-ended questions asked respondents to describe the aspects of radiologist service they felt were most important. Thematic analysis of the free-text responses was performed using a grounded theory approach. The resulting themes were mapped to the 2015 CanMEDS Key Competencies. Results: 115 completed surveys were received from residents and fellows from essentially all specialties and years of training (out of 928 invited). Major themes were 1) timeliness and accessibility of service, 2) quality of reporting, and 3) acting as a valued team member. The competencies identified as important by resident physicians were largely consistent with the CanMEDS framework, although not all key competencies were covered in the responses. Conclusions: This study illustrates how CanMEDS roles and competencies may be exemplified in a concrete and specialty-specific manner from the perspective of key stakeholders. Our survey results provide further insight into specific objectives for teaching and assessing these competencies in radiology residency training, with the ultimate goal of improving patient care through strengthened communication and working relationships.
A Novel IRF6 Frameshift Mutation in a Large Chinese Pedigree With Van der Woude syndrome
Authors: Peng Qi , Qin Wenyan , Li Siping , Huang Meihua , Rao Chunbao , Lu Xiaomei 
Published: April 2021

Aims: Van der Woude syndrome (VWS) is one of the most common craniofacial anomalies, causing significant functional and psychological burden to the patients. This study aimed to identify the genetic cause of VWS in a Chinese family. Methods: Whole genome sequencing (WGS) was performed to screen for pathogenic mutations. Various Bioinformatics tools were used to assess the pathogenicity of the variants. Cosegregation analysis of the candidate variant was carried out. Interpretation of variants was performed according to the American College of Medical Genetics and Genomics guidelines. Results: A novel frameshift duplication c.373_374dupAA (p.Asn125Lys fs*43) was identified in exon 4 of the interferon regulatory factor 6 (IRF6) gene in all 3 affected members, which were not found in unaffected family members. The novel mutation leads to a frameshift and a premature stop codon which caused putative truncated protein. Protein alignment indicated high evolutionary conservation of the p.N125 residue, and this mutation was predicted by online tools to be damaging and deleterious. Conclusions: This study demonstrates that the novel mutation c.373_374dupAA (p.Asn125Lysfs*43) in the IRF6 gene corresponds to the VWS in this family. The discovery of this pathogenic variant enriches the genotypic spectrum of IRF6 gene and contributes to genetic diagnosis and counseling of families with VWS.
Surgical outcomes of Ahmed glaucoma valve implantation with plate fixation using vicryl sutures or no plate fixation
Authors: Singer Reut , Kapelushnik Noa , Rotenstreich Ygal , Leshno Ari , Barkana Yaniv , Skaat Alon 
Published: April 2021

Purpose: To summarize the surgical outcomes of Ahmed glaucoma valve (AGV) implantation with plate fixation with vicryl absorbable sutures or no plate suturing. Methods: This study was a retrospective case series that included all glaucoma patients who underwent AGV implantation surgery with vicryl absorbable sutures for plate fixation or without plate fixation by a single surgeon between 2014 and 2019. We reviewed their medical records and retrieved clinical data on intra- and postoperative complications, best-corrected visual acuity, intraocular pressure (IOP), and number of IOP-lowering medications. Results: Twenty out of 29 eyes (29 patients, mean age 61.04 ± 27.1 years, 17 men) underwent AGV implantation without plate fixation and nine had AGV implantation with fixation with vicryl sutures. Complications were observed in 15 cases (51.7%). Nine of these were defined as failure due to the need for removal or repositioning of the AGV or for further surgery for uncontrolled IOP, of which five were no-fixation cases (5/20, 25%) and four were vicryl-fixation cases (4/9, 44.4%). Six of all surgical failures were related to AGV migration (6/9, 66.6%). There were three cases of extrusion and one case of plate migration in the no-fixation group, and two cases of plate migration and one case of extrusion in the vicryl-fixation group. Conclusion: AGV implantation without suture plate fixation or with vicryl suture fixation had a high complication and failure rate, often necessitating reoperation and AGV removal. The high rate of tube-related complications observed after both techniques does not favor either of them. The use of non-absorbable sutures for suturing of the AGV plate is recommended.
Distal superficial femoral vein versus axillary vein central catheter placement under ultrasound guidance for neonates with difficult access: A randomized clinical trial
Authors: Tan Yanzhe , Liu Lifei , Tu Zhenzhen , Xu Ying , Xie Jia , Ye Ping 
Published: April 2021

Background: Epicutaneo-caval catheters (ECCs) are extensively used in premature and ill neonates. This prospective, randomized, observational study aimed to compare the outcomes of ECC placement in the distal superficial femoral and axillary veins in neonates with difficult ECC access. Methods: In a neonatal intensive care unit at a tertiary referral center, 60 neonates with difficult ECC access were randomized into two groups with catheters placed using the ultrasound-guided modified dynamic needle tip positioning (MDNTP) technique: distal superficial femoral vein (DSFV) and axillary vein (AV) groups. Results: The first attempt success rate was significantly higher in the DSFV group than in the AV group [23/30 (76.7%) vs 11/30 (36.7%), p = 0.001; odds ratio (OR), 0.176; 95% confidence interval (CI) 0.057–0.543]. The mean procedural duration was significantly shorter in the DSFV group than in the AV group [mean: 308.5 (standard deviation: 81.1) s vs 522.74 (134.8) s, t = −7.17, p < 0.001]. The incidence of complications was significantly lower in the DSFV group than in the AV group [4/30 (13.3%) vs 12/30 (40.0%), p = 0.019; OR, 4.333; 95% CI 1.203–15.604]. The number of attempts was significantly fewer in the DSFV group than in the AV group ( p = 0.012). Conclusions: The distal superficial femoral and axillary veins are two alternative and safe access points for ECC placement in premature neonates (weight < 2.5 kg) with difficult access. However, access through the distal superficial femoral vein was quicker, easier, and had fewer complications than through the axillary vein.