bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of intellectual property rights on access to medicines in the WHO African region: 25 years after the TRIPS agreement
Authors: Motari Marion , Nikiema Jean-Baptiste , Kasilo Ossy M. J. , Kniazkov Stanislav , Loua Andre , Sougou Aissatou , Tumusiime Prosper 
Published: March 2021

Abstract
Background
It is now 25 years since the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the same concerns raised during its negotiations such as high prices of medicines, market exclusivity and delayed market entry for generics remain relevant as highlighted recently by the Ebola and COVID-19 pandemics. The World Health Organization’s (WHO) mandate to work on the interface between intellectual property, innovation and access to medicine has been continually reinforced and extended to include providing support to countries on the implementation of TRIPS flexibilities in collaboration with stakeholders. This study analyses the role of intellectual property on access to medicines in the African Region.

Methods
We analyze patent data from the African Regional Intellectual Property Organization (ARIPO) and Organisation Africaine de la Propriété Intellectuelle (OAPI) to provide a situational analysis of patenting activity and trends. We also review legislation to assess how TRIPS flexibilities are implemented in countries.

Results
Patenting was low for African countries. Only South Africa and Cameroon appeared in the list of top ten originator countries for ARIPO and OAPI respectively. Main diseases covered by African patents were HIV/AIDS, cardiovascular diseases, cancers and tumors. Majority countries have legislation allowing for compulsory licensing and parallel importation of medicines, while the least legislated flexibilities were explicit exemption of pharmaceutical products from patentable subject matter, new or second use of patented pharmaceutical products, imposition of limits to patent term extension and test data protection. Thirty-nine countries have applied TRIPS flexibilities, with the most common being compulsory licensing and least developed country transition provisions.

Conclusions
Opportunities exist for WHO to work with ARIPO and OAPI to support countries in reviewing their legislation to be more responsive to public health needs.
Operatively treated ankle fractures in Switzerland, 2002–2012: epidemiology and associations between baseline characteristics and fracture types
Authors: Vieira Cardoso Diogo , Dubois-Ferrière Victor , Gamulin Axel , Baréa Christophe , Rodriguez Pablo , Hannouche Didier , Lübbeke Anne 
Published: March 2021

Abstract
Background
Ankle fractures are common, and their incidence has been increasing. Previous epidemiological studies have been conducted in the US, Scandinavia, and Scotland. Our objectives were to provide a current epidemiological overview of operatively treated ankle fractures and to evaluate the influence of age, sex, lifestyle factors, and comorbidities on fracture types.

Methods
We performed a population-based epidemiological study of all ankle fractures treated operatively in a 10- year period from 2002 to 2012.

Results
Two thousand forty-five ankle fractures were operated upon. Men and women differed significantly in age (median 41 vs. 57 years old), obesity (16% vs. 23%), diabetes (5% vs. 10%), smoking (45% vs. 24%), and accident type (daily activities 48% vs. 79%, transportation 24% vs. 9%, sports 21% vs. 8%) respectively. Overall, there were 2% Weber A, 77% Weber B, and 21% Weber C fractures; 54% were uni-, 25% bi-, and 21% trimalleolar; 7.5% of all fractures were open. Weber C fractures were much more frequent among men and with higher BMI (lowest vs. highest category: 14% vs. 32%), but slightly less frequent with older age and among current smokers. Trimalleolar fractures were twice as frequent in women and increased with age.

Conclusion
Men and women differed substantially in age, lifestyle factors, comorbidities, accident type, and type of ankle fracture. Male sex and higher BMI were more frequently associated with Weber C fractures, whereas female sex and older age were associated with trimalleolar fracture. The risk for severe fracture increased linearly with the degree of obesity.
Identification of a De Novoc.1000delA ANK1 mutation associated to hereditary spherocytosis in a neonate with Coombs-negative hemolytic jaundice-case reports and review of the literature
Authors: Xie Lichun , Xing Zhihao , Li Changgang , Liu Si-xi , Wen Fei-qiu 
Published: March 2021

Abstract
Background
To strengthen the understanding of Hereditary Spherocytosis (HS) and determine the disease-causing mutation present with neonatal jaundice. HS is a hemolytic condition resulting from various erythrocyte membrane defects. Many different mutations result in HS, including mutations in ANK1.

Case presentation
A term neonate presented at ten hours with severe jaundice requiring exchange transfusion. At two months he was hospitalized due to repeated pallor and anemia requiring blood transfusions. Using next-generation sequencing, we discovered the responsible mutation in the proband but not in his parents; a heterozygous nucleotide variation of c.1000delA (p.1334Sfs*6) in ANK1. Thus hereditary spherocytosis was diagnosed.

Conclusions
Genetic detection is an important means of discovering the cause of hemolytic anemia in neonates and infants where routine diagnostic tests are unrevealing. We found a novel de novo mutation, c.1000delA (p.1334Sfs*6) in ANK1 that might account for other cases of HS in the Chinese population.
The clinical significance of preoperative plasma fibrinogen levels and platelet counts in resectable colon cancer
Authors: Papila Kundaktepe Berrin , Papila Cigdem 
Published: March 2021

Abstract
Background and aim
Several aspects of the correlation between colon cancer and hemostatic markers are still unknown to many researchers in the field. In this study, we evaluated the association, if any, of preoperative platelet (PLT) counts and plasma fibrinogen levels with postoperative lymph node involvement and venous invasion in colon cancer patients.

Methods
This study retrospectively included eighty patients with colon cancer (mean age 58.09 years; 37% female 63% male).

Results
Patients with negative lymph nodes and venous invasion showed a significantly lower PLT count and higher fibrinogen level than their counterparts, i.e., patients with positive lymph nodes (p<0.001, all of them) and venous invasion (p<0.001, all of them). The results also showed a positive association of PLT counts and fibrinogen levels with lymphatic invasion (r=0.670, p<0.001 and r=0.639, p<0.001, respectively) and a positive association of PLT counts and fibrinogen levels with venous invasion (r=0.3988, p<0.001 and r=0.5268, p<0.001, respectively). According to the results of the ROC curve analysis, when the PLT count cutoff was 290/mm3, the sensitivity and specificity were 82% and 86.67%, respectively (AUC = 0.8840, p<0.0001, 95% CI 0.8084–0.9596). When the fibrinogen level cutoff was 310.0 mg/dL, the sensitivity and specificity were 72% and 96.67%, respectively (AUC 0.8790, p <0.0001, 95% CI 0.8067–0.9513).

Conclusion
The preoperative PLT count and plasma fibrinogen level may be considered key markers to monitor postoperative lymph node involvement and venous invasion in colon cancer patients.
Diagnosis prediction of tumours of unknown origin using ImmunoGenius, a machine learning-based expert system for immunohistochemistry profile interpretation
Authors: Chong Yosep , Thakur Nishant , Lee Ji Young , Hwang Gyoyeon , Choi Myungjin , Kim Yejin , Yu Hwanjo , Cho Mee Yon 
Published: March 2021

AbstractBackgroundImmunohistochemistry (IHC) remains the gold standard for the diagnosis of pathological diseases. This technique has been supporting pathologists in making precise decisions regarding differential diagnosis and subtyping, and in creating personalized treatment plans. However, the interpretation of IHC results presents challenges in complicated cases. Furthermore, rapidly increasing amounts of IHC data are making it even harder for pathologists to reach to definitive conclusions.MethodsWe developed ImmunoGenius, a machine-learning-based expert system for the pathologist, to support the diagnosis of tumors of unknown origin. Based on Bayesian theorem, the most probable diagnoses can be drawn by calculating the probabilities of the IHC results in each disease. We prepared IHC profile data of 584 antibodies in 2009 neoplasms based on the relevant textbooks. We developed the reactive native mobile application for iOS and Android platform that can provide 10 most possible differential diagnoses based on the IHC input.ResultsWe trained the software using 562 real case data, validated it with 382 case data, tested it with 164 case data and compared the precision hit rate. Precision hit rate was 78.5, 78.0 and 89.0% in training, validation and test dataset respectively. Which showed no significant difference. The main reason for discordant precision was lack of disease-specific IHC markers and overlapping IHC profiles observed in similar diseases.ConclusionThe results of this study showed a potential that the machine-learning algorithm based expert system can support the pathologic diagnosis by providing second opinion on IHC interpretation based on IHC database. Incorporation with contextual data including the clinical and histological findings might be required to elaborate the system in the future.
Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing
Authors: Parsons Thomas , Al-Jabri Talal , Clement Nick D. , Maffulli Nicola , Kader Deiary F. 
Published: March 2021

Abstract
Background
The decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon’s preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported outcomes, and that resurfacing is associated with increased risks such as extensor mechanism injury or malalignment, problems with the design of the patella component and technical issues intraoperatively.

Aims
To critically examine factors that should be considered in addition to patient reported outcomes in the decision process of resurfacing or non-resurfacing of the patella in total knee arthroplasty.

Method
A comprehensive literature search was conducted to identify factors that may influence decision making in addition to knee specific patient reported outcome measures such as surgical risks, patient quality of life, procedure cost, re-operation rate, implant design, surgeons learning curve and the fate of remaining cartilage in native patellae.

Results
Patient-reported outcomes are equivocal for resurfacing and non-resurfacing. Critical analysis of the available literature suggests that the complications of resurfacing the patella are historic, which is now lower with improved implant design and surgical technique. Routine resurfacing was cost-effective in the long term (potential saving £104 per case) and has lower rates of revision (absolute risk reduction 4%). Finally, surgical judgment in selective resurfacing was prone to errors.

Conclusion
Patella resurfacing and non-resurfacing had similar patient-reported outcomes. However, patella resurfacing was cost-effective and was associated with a lower rate of re-operation compared to non-resurfacing.
Differential diagnoses of COVID-19 pneumonia: the current challenge for the radiologist—a pictorial essay
Authors: Guarnera Alessia , Podda Pierfrancesco , Santini Elena , Paolantonio Pasquale , Laghi Andrea 
Published: March 2021

AbstractBackgroundCOVID-19 pneumonia represents the most severe pandemic of the twenty-first century and has crucial clinical, social and economical implications. The scientific community has focused attention and resources on clinical and radiological features of COVID-19 pneumonia. Few papers analysing the vast spectrum of differential diagnoses have been published.Main bodyComplexity of differential diagnosis lays in the evidence of similar radiological findings as ground-glass opacities, crazy paving pattern and consolidations in COVID-19 pneumonia and a multitude of other lung diseases. Differential diagnosis is and will be extremely important during and after the pandemic peak, when there are fewer COVID-19 pneumonia cases. The aim of our pictorial essay is to schematically present COVID-19 pneumonia most frequent differential diagnoses to help the radiologist face the current COVID-19 pneumonia challenge.ConclusionsClinical data, laboratory tests and imaging are pillars of a trident, which allows to reach a correct diagnosis in order to grant an excellent allocation of human and economical resources. The radiologist has a pivotal role in the early diagnosis of COVID-19 pneumonia because he may raise suspicion of the pathology and help to avoid COVID-19 virus spread.
Attitudes and awareness of regional Pacific Island students towards e-learning
Authors: Johnson Joel B. , Reddy Pritika , Chand Ronil , Naiker Mani 
Published: March 2021

AbstractThe rise of online modes of content delivery, termed e-learning, has increased student convenience and provided geographically remote students with more options for tertiary education. However, its efficacy relies upon student access to suitable technology and the internet, and the quality of the online course material. With the COVID-19 outbreak, education providers worldwide were forced to turn to e-learning to retain their student base and allow them to continue learning through the pandemic. However, in geographically remote, developing nations, many students may not have access to suitable technology or internet connections. Hence it is important to understand the potential of e-learning to maintain equitable access to education in such situations. This study found the majority (88%) of commencing students at the University of the South Pacific owned at least one ICT device and had access to the internet. Similarly, most students had adequate to strong ICT skills and a positive attitude toward e-learning. These attitudes among the student cohort, in conjunction with the previous experience of The University of the South Pacific in distance education, are likely to have contributed to its relatively successful transition from face-to-face to online learning as a result of the COVID-19 pandemic.
Artificial intelligence-aided CT segmentation for body composition analysis: a validation study
Authors: Borrelli Pablo , Kaboteh Reza , Enqvist Olof , Ulén Johannes , Trägårdh Elin , Kjölhede Henrik , Edenbrandt Lars 
Published: March 2021

Abstract
Background
Body composition is associated with survival outcome in oncological patients, but it is not routinely calculated. Manual segmentation of subcutaneous adipose tissue (SAT) and muscle is time-consuming and therefore limited to a single CT slice. Our goal was to develop an artificial-intelligence (AI)-based method for automated quantification of three-dimensional SAT and muscle volumes from CT images.

Methods
Ethical approvals from Gothenburg and Lund Universities were obtained. Convolutional neural networks were trained to segment SAT and muscle using manual segmentations on CT images from a training group of 50 patients. The method was applied to a separate test group of 74 cancer patients, who had two CT studies each with a median interval between the studies of 3 days. Manual segmentations in a single CT slice were used for comparison. The accuracy was measured as overlap between the automated and manual segmentations.

Results
The accuracy of the AI method was 0.96 for SAT and 0.94 for muscle. The average differences in volumes were significantly lower than the corresponding differences in areas in a single CT slice: 1.8% versus 5.0% (p < 0.001) for SAT and 1.9% versus 3.9% (p < 0.001) for muscle. The 95% confidence intervals for predicted volumes in an individual subject from the corresponding single CT slice areas were in the order of ± 20%.

Conclusions
The AI-based tool for quantification of SAT and muscle volumes showed high accuracy and reproducibility and provided a body composition analysis that is more relevant than manual analysis of a single CT slice.
Right inferior phrenic artery injury as a complication of needle aspiration: a case report
Authors: El Adel Mohamed , Hassan Sayed , Nady Mohamed A. , Ghoneim Ahmed , Seif Hany 
Published: March 2021

Abstract
Background
To the best of the author’s knowledge, inferior phrenic artery injury was not documented in the literature as a complication of chest tube insertion or needle aspiration, and our case was the first to be mentioned in literature.
Traumatic injury to the inferior phrenic artery is extremely rare. It was reported to be injured by blunt trauma such as motorcar accident and may be associated with another organ injury.

Case presentation
The present case represents an unexpected event of inferior phrenic artery injury due to iatrogenic chest aspiration. Despite the safe maneuver we have approached in our center using a blunt dissection technique rather than the trocar technique, an unexpected complication occurred. The right inferior phrenic artery was injured with subsequent intra-abdominal bleeding and shock. It was treated successfully by endovascular embolization of the bleeding artery.

Conclusions
This complication might add a further morbidity and mortality and raising the responsibility of the surgeon to one of the most common daily surgeon’s practices.
Continuous usage intention to e-transaction cards in wholesale markets of agriproducts: empirical evidence from China
Authors: Sui Xuechao , Geng Xianhui 
Published: March 2021

AbstractGeneralizing the e-transaction services in wholesale markets of agriproducts is seen as a way for the government in China to enhance its information services capabilities. These services could also facilitate the transactions of traders. We find that traders are reluctant to use e-transaction cards although they have physical access. This paper identifies factors influencing traders’ continuous usage intention to e-transaction cards in wholesale markets of agriproducts in China. Data were collected from 204 respondents through a self-administered survey completed by traders and analyzed by structural equation modeling (SEM). The results explore that perceived ease of use (PEOU), perceived usefulness (PU) and perceived privacy security (PPS) directly and positively affect traders’ continuous usage intention. It is also demonstrated that both PEOU and perceived transaction security indirectly and positively affect continuous usage intention through PU. This research provides practical guidelines for decision makers to increase traders’ intention to e-transaction cards.
Phase II Study of the WEE1 Inhibitor Adavosertib in Recurrent Uterine Serous Carcinoma
Authors: Liu Joyce F. , Xiong Niya , Campos Susana M. , Wright Alexi A. , Krasner Carolyn , Schumer Susan , Horowitz Neil , Veneris Jennifer , Tayob Nabihah , Morrissey Stephanie , West Gabriela , Quinn Roxanne , Matulonis Ursula A. , Konstantinopoulos Panagiotis A. 
Published: March 2021

PURPOSEUterine serous carcinoma (USC) is a distinct histologic subtype of endometrial cancer, with molecular characteristics suggesting frequent cell-cycle dysregulation paired with a high level of oncogene-driven replication stress. Adavosertib is a potent and selective oral inhibitor of the WEE1 kinase, a key regulator of the G2/M and S phase cell-cycle checkpoints. Because cells with impaired cell-cycle regulation and high replication stress may be vulnerable to WEE1 inhibition, we conducted this study to assess the activity of adavosertib monotherapy in women with recurrent USC.PATIENTS AND METHODSThis was a single-arm two-stage phase II study with coprimary end points of objective response rate (ORR) and rate of progression-free survival at 6 months (PFS6). Women with recurrent USC were treated with adavosertib monotherapy at a starting dose of 300 mg orally once daily days 1 through 5 and 8 through 12 of a 21-day cycle until disease progression.RESULTSIn 34 evaluable patients, 10 total responses (one confirmed complete response, eight confirmed partial responses, and one unconfirmed partial response) were observed with adavosertib monotherapy, for an ORR of 29.4% (95% CI, 15.1 to 47.5). Sixteen patients were progression-free at 6 months, for a PFS6 rate of 47.1% (95% CI, 29.8 to 64.9). Median PFS was 6.1 months, and median duration of response was 9.0 months. Frequent treatment-related adverse events (AEs) included diarrhea (76.5%), fatigue (64.7%), nausea (61.8%), and hematologic AEs. No clear correlation of clinical activity with specific molecular alterations was observed in an exploratory biomarker analysis.CONCLUSIONAdavosertib monotherapy demonstrated encouraging and durable evidence of activity in women with USC, and further investigation of this agent in this cancer and biomarkers of activity are indicated.
Transient Leukopenia After Radioactive Iodine Treatment in Patients With Graves’ Disease: A Retrospective Cohort Study
Authors: Yamashita Kaoru , Morimoto Satoshi , Kimura Shihori , Seki Yasufumi , Bokuda Kanako , Watanabe Daisuke , Yazaki Tomoyo , Abe Koichiro , Ichihara Atsuhiro 
Published: March 2021

Abstract

Context
Radioactive 131I (RAI) for the treatment of differentiated thyroid cancer is known to induce bone marrow suppression, which occurs approximately 1 month after treatment. However, it is unknown whether RAI therapy for Graves’ disease causes bone marrow suppression.

Objective
This study aimed to evaluate the short- and long-term effects of RAI therapy on bone marrow function in patients with Graves’ disease.

Methods
In this retrospective cohort study, we included patients with Graves’ disease who received RAI therapy only once between 2003 and 2019 at Tokyo Women’s Medical University. Blood cell counts at baseline were compared with counts at 1, 2, 4, 12, 24, 48, 144, and 240 weeks after RAI therapy. Moreover, changes in white blood cell (WBC) count and leukopenia at 1 week after RAI treatment were compared by baseline patient characteristics.

Results
We enrolled 48 patients. Leukopenia was observed in 6 patients at 1 week after RAI treatment, and the overall WBC count significantly decreased (P &lt; 0.001) 1 week after the therapy; however, the values were not significantly lower after 2 weeks. Neither red blood cell nor platelet count were significantly altered. Moreover, independent of other factors, the neutrophil count at the baseline was significantly negatively associated with changes in WBC count or the occurrence of leukopenia 1 week after the RAI treatment.

Conclusion
These data showed that RAI treatment induced transient reduction in the WBC count 1 week after treatment, although WBC levels were subsequently restored.