bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver Injury by the Traditional Chinese Medicine Hanshirento, Zenshikunshito, and Ninjin’yoeito in a Patient with Lung Cancer: Probable Causality Assessed by the Updated Roussel Uclaf Causality Assessment Method
Authors: Funakoshi Haruki , Momo Kenji , Kashima Ayaka , Ida Hitomi , Miyata Yoshito , Sagara Hironori , Sasaki Tadanori 
Published: March 2021

Introduction: Traditional Chinese medicine (TCM) is a traditional treatment based on herbal medicines and holistic healing. It has resulted in both favorable and unfavorable patient outcomes when used to treat cancer. Cancer patients frequently depend on second opinions and folk remedies. In this case, we report the case of TCM inducing repeated moderate liver injury and delay for chemotherapy. Case presentation: A 59-year-old woman was diagnosed with lung cancer and conducted surgery a month ago. She went to a TCM specialty clinic expecting a complete cure for the lung cancer, to improve her physical condition, and to enhance her immunity. She received the TCM formulas hanshirento, zenshikunshito, and ninjin’yoeito. After starting these medicines, she felt severe fatigue but continued them for approximately 2 weeks, After discontinuing the medicine, her fatigue was improved. She was admitted to our hospital for adjuvant chemotherapy. On admission, laboratory tests revealed moderate liver injury (AST: 705 U/L, ALT: 1091 U/L). In view of her medication history, the laboratory tests, and her lifestyle history, we thought that moderate liver injury was caused by TCM, employing the Roussel Uclaf Causality Assessment Method (RUCAM). Discussion: TCM are known to be metabolized by the resident bacteria in the small intestine, but the specific metabolic processes are not well understood. Cancer patients sometimes try TCM from their own research to stay healthy. However, as with our case, TCM rarely induces liver injury, which is not well known to TCM users. Medical staffs need to be vigilant with their drug histories, including TCM, if patients have liver injuries.
Hand function 5 years after treatment with collagenase Clostridium histolyticum injection for Dupuytren’s disease
Authors: Göransson Ingrid , Brudin Lars , Irbe Andra , Turesson Christina 
Published: March 2021

The aim of this study was to report hand function, disability and satisfaction and patients’ perception of functionally troublesome contractures 5 years after injection with collagenase Clostridium histolyticum and hand therapy for Dupuytren's disease. Data from 79 patients were collected before and at 3, 12 and 60 months after treatment. Hand function was significantly improved, and 70% achieved a functional range of motion in the treated hand. QuickDASH scores and range of motion were best at 3 months follow-up. At 60 months, mean total extension deficit was 48°, which was 57% of the deficit before treatment. Thirty-seven patients (47%) had developed recurrent contractures in treated finger(s) meeting the criteria for new treatment. The threshold for functionally troublesome contractures was found to be 30°–60° in the finger joints. Treatment was experienced as painful, but few hand function problems occurred. Most patients would choose this treatment method again. Level of evidence: IV
Comparative assessment of fingertip replantation in paediatric and adult patients within a single institution
Authors: Özdemir Fethiye Damla Menkü , Uzun Hakan , Özdemir Erdi , Aksu Ali Emre 
Published: March 2021

The purpose of this retrospective study was to compare the outcomes of paediatric and adult fingertip replantation within a single institution. Our retrospective study found no significant difference in the survival rate between the paediatric (10/12) and adult (22/26) groups. At 6 months follow-up, there was no significant difference in sensory recovery between both groups, as measured with Semmes–Weinstein testing, but a significant difference in mean static two-point discrimination testing values between the paediatric (4.0 mm) and adult (6.2 mm) groups. Moreover, the mean time for regaining sensation was faster in paediatric patients (1.3 months) as compared with adult patients (4.1 months). Five children and four adults received erythrocyte transfusion. Paediatric fingertip replantation has similar survival rates, faster and better sensory nerve recovery as compared with adults despite a higher erythrocyte transfusion rate. Although technically demanding, paediatric fingertip replantation is recommended, whenever possible, because of the good outcomes achievable. Level of evidence: IV
Influence of colchicine prescription in COVID-19-related hospital admissions: a survival analysis
Authors: Madrid-García Alfredo , Pérez Inés , Colomer José Ignacio , León-Mateos Leticia , Jover Juan A , Fernández-Gutiérrez Benjamín , Abásolo-Alcazar Lydia , Rodríguez-Rodríguez Luis 
Published: March 2021

Aims: To analyze the association between colchicine prescription and COVID-19-related hospital admissions in patients with rheumatic and musculoskeletal diseases (RMDs). Methods: Patients attending a rheumatology outpatient clinic from a tertiary care center in Madrid, Spain, from 1 September 2019 to 29 February 2020 were included. Patients were assigned as exposed or unexposed based on whether they were prescribed with colchicine in their last visit to the clinic during the 6 months before the start of the observation period. Treatment changes during the observation period were also considered. The primary outcome was COVID-19-related hospital admissions between 1 March and 20 May 2020. Secondary outcome included COVID-19-related mortality. Several weighting techniques for data balancing, based and non-based on the propensity score, followed by Cox regressions were performed to estimate the association of colchicine prescription on both outcomes. Discussion: The number of patients entered in the study was 9379, with 406 and 9002 exposed and unexposed follow-up periods, respectively. Generalized Boosted Models (GBMs) and Empirical Balancing Calibration Weighting (EBCW) methods showed the best balance for COVID-19-related hospital admissions. Colchicine prescription did not show a statistically significant association after covariable balancing ( p-value = 0.195 and 0.059 for GBM and EBCW, respectively). Regarding mortality, the low number of events prevented a success variable balancing and analysis. Conclusion: Colchicine prescription does not play a significant protective or risk role in RMD patients regarding COVID-19-related hospital admissions. Our observations could support the maintenance of colchicine prescription in those patients already being treated, as it is not associated with a worse prognosis. Plain language title: Colchicine influence in COVID-19-related hospital admissions
Entitlement problems in digital markets and how antitrust shapes the appropriation of network externalities
Authors: Hoffmann Linus J. 
Published: March 2021

The engine of value creation in the digital economy is network externalities, i.e. the phenomenon by which the value to a new user from adopting a good or service increases in the number of users who already adopted it. But network externalities are not manna from heaven. They are ‘sponsored’ by firms who make demand expanding investments. In areas with imperfect property institutions like the digital economy, a key business decision for profit maximizing firms consists in devising value capture strategies to appropriate their investments. This paper identifies three recurrent types of appropriation disputes in digital markets: Access to software platforms, limitations to the exploitation of raw data and claims over digital content. At the heart of each dispute lies the controversial exercise of an entitlement over a digital asset that is embedded in a context of or exhibits itself network externalities. The appropriation of this asset and its integration into the firm’s ecosystem could make the firm benefit from network efficiencies. Controlling the digital asset in question becomes a proxy. Appropriation strategies by proxy can have pro- and anti-competitive effects. This is why each dispute can not only be understood as a problem of appropriability, but also as a problem of potential harm to competition. And indeed, competition enforcers have brought forward various cases with underlying appropriation disputes. This paper tracks the influence of three of them on the appropriability of assets in the digital economy, and on digital firms’ strategies to capture the value of network externalities.
Evolution of randomized, controlled studies of medical therapy in chronic thromboembolic pulmonary hypertension
Authors: Kim Nick H. , Papamatheakis Demosthenes G. , Fernandes Timothy M. 
Published: March 2021

Although pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), many patients have inoperable disease, and some have persistent or recurrent pulmonary hypertension (PH) after surgery. Alternative options (balloon pulmonary angioplasty (BPA) and PH‐targeted medical therapy) are, therefore, required. Studies of medical therapies for CTEPH have evolved since Aerosolized Iloprost Randomized (AIR), the first randomized, controlled study of a PH‐targeted therapy (inhaled iloprost) to include patients with CTEPH. Key learnings from these studies include the need to evaluate CTEPH separately from other types of PH, the importance of prospective operability adjudication as part of the protocol, and the need for sufficient duration to allow treatment benefits to become apparent. The 16‐week Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase‐Stimulator Study 1 (CHEST‐1) study was the first to operationalize these learnings, demonstrating a significant mean improvement in 6‐minute walk distance (+46 m) and improvements in hemodynamic endpoints with riociguat versus placebo. Findings from previous studies will inform the design of future studies to address key issues related to combination medical therapy. Data on combinations of macitentan with phosphodiesterase type 5 inhibitors or oral prostanoids are available from MERIT, the first study to allow such regimens. No data on combinations including riociguat, the only licensed medical therapy for CTEPH, are available. Studies are also needed for multimodality treatment, including medical therapy plus BPA, and medical therapy as a bridge to PEA in selected operable patients. To address these issues and improve patient outcomes, it is vital that we learn from current studies to improve future trial design.
Short Term Outcomes Following Open Reduction Internal Fixation Surgery for a Distal Radius Fracture: 2 Week Versus 4 Week Immobilization. A Retrospective Analysis
Authors: Toemen Angela , Collocott Shirley , Heiss-Dunlop Wolfgang 
Published: March 2021

Study design: The study was a retrospective cohort analysis for a 41 month period; from January 2013 to May 2016. Introduction: It is suggested that patients following a distal radius fracture (DRF) achieve a comparable outcome at 3 and 6 months post surgery regardless of the time they begin mobilization. In previous studies there has been limited analysis of outcomes within the initial 3 months: functional return, time taken from work and use of therapy resources are key outcomes which have not formally been investigated in previous studies. Purpose of the study: To analyze short term outcomes of patients following open reduction internal fixation (ORIF) for a DRF. Methods: A retrospective cohort analysis was conducted to determine primarily if there is a difference in time from work, number of therapy appointments, cost of therapy materials, time to discharge from therapy and secondarily range of motion (ROM) and grip strength (GS); when measured in patients who begin mobilization prior to 2 weeks compared to those who begin mobilization at 4 or greater weeks post surgery. Results: Patients mobilized early were discharged from hand therapy significantly quicker (p = 0.033) and returned to work significantly faster (p = 0.019) than those mobilized later. Patients who began mobilization at 2 weeks or earlier post surgery had significantly greater wrist extension/flexion arc at 4 weeks (p < 0.001) and 6 weeks (p < 0.001) and rotation at 4 weeks (p < 0.001). Conclusions: Patients who begin mobilization at 2 weeks or earlier following ORIF for a DRF will lose less time from work and will be discharged sooner from hand therapy. They will additionally have increased ROM in the early post surgery phase.
Surgical Repair of Distal Biceps Femoris Avulsion Injuries in Professional Athletes
Authors: Thompson Joshua W. , Plastow Ricci , Kayani Babar , Moriarty Peter , Asokan Ajay , Haddad Fares S. 
Published: March 2021

Background: Understanding the optimal management of distal biceps femoris avulsion injuries is critical for restoring preinjury function, restoring hamstring muscle strength, increasing range of motion, and minimizing risk of complications and recurrence. Due to the rarity of these injuries, prognosis and outcomes within the literature are limited to case reports and small case series. Purpose: To assess the effect of surgical repair for acute distal avulsion injuries of the biceps femoris tendon on (1) return to preinjury level of sporting function and (2) time to return to preinjury level of sporting function, patient satisfaction, and complications. Study Design: Case series; Level of evidence, 4. Methods: This prospective single-surgeon study included 22 elite athletes (18 men [82%], 4 women [18%]; mean age, 26 years; age range, 17-35 years; mean body mass index, 25.3 ± 4.1 kg/m2) undergoing primary suture anchor repair of avulsion injuries of the distal biceps femoris confirmed on preoperative magnetic resonance imaging. Predefined outcomes relating to time for return to sporting activity, patient satisfaction, complications, and injury recurrence were recorded at regular intervals after surgery. Minimum follow-up time was 12 months (range, 12.0-26.0 months) from the date of surgery. Results: The mean time from injury to surgical intervention was 12 days (range, 2-28 days). All study patients returned to their preinjury level of sporting activity, predominately professional soccer or rugby. Mean time from surgical intervention to return to full sporting activity was 16.7 ± 8.7 weeks. At 1- and 2-year follow-up, all study patients were still participating at their preinjury level of sporting activity. There was no incidence of primary injury recurrence, and no patients required further operation to the biceps origin. Conclusion: Surgical repair of acute avulsion injuries of the distal biceps femoris facilitated early return to preinjury level of function with low risk of recurrence, low complication rate, and high patient satisfaction in elite athletes. Suture anchor repair of these injuries should be considered a reliable treatment option in athletes with high functional demands to permit an early return to sport with restoration of hamstring strength.
Essential properties and pitfalls of colorimetric Reverse Transcription Loop-mediated Isothermal Amplification as a point-of-care test for SARS-CoV-2 diagnosis
Authors: de Oliveira Coelho Bruna , Sanchuki Heloisa Bruna Soligo , Zanette Dalila Luciola , Nardin Jeanine Marie , Morales Hugo Manuel Paz , Fornazari Bruna , Aoki Mateus Nóbrega , Blanes Lucas 
Published: March 2021

Abstract
Background
SARS-CoV-2 Reverse Transcription Loop-mediated Isothermal Amplification (RT-LAMP) colorimetric detection is a sensitive and specific point-of-care molecular biology technique used to detect the virus in only 30 min. In this manuscript we have described a few nuances of the technique still not properly described in the literature: the presence of three colors clusters; the correlation of the viral load with the color change; and the importance of using an internal control to avoid false-negative results.

Methods
To achieve these findings, we performed colorimetric RT-LAMP assays of 466 SARS-CoV-2 RT-qPCR validated clinical samples, with color quantification measured at 434 nm and 560 nm.

Results
First we determinate a sensitivity of 93.8% and specificity of 90.4%. In addition to the pink (negative) and yellow (positive) produced colors, we report for the first time the presence of an orange color cluster that may lead to wrong diagnosis. We also demonstrated using RT-qPCR and RT-LAMP that low viral loads are related to Ct values > 30, resulting in orange colors. We also demonstrated that the diagnosis of COVID-19 by colorimetric RT-LAMP is efficient until the fifth symptoms day when the viral load is still relatively high.

Conclusion
This study reports properties and indications for colorimetric RT-LAMP as point-of-care for SARS-CoV-2 diagnostic, reducing false results, interpretations and optimizing molecular diagnostics tests application.
A source-sink model explains the difference in the metabolic mechanism of mechanical damage to young and senescing leaves in Catharanthus roseus
Authors: Chen Qi , Lu Xueyan , Guo Xiaorui , Xu Mingyuan , Tang Zhonghua 
Published: March 2021

Abstract
Background
Mechanical damage is an unavoidable threat to the growth and survival of plants. Although a wound to senescing (lower) leaves improves plant vitality, a wound to younger (upper) leaves often causes damage to or death of the whole plant. Source-sink models are often used to explain how plants respond to biotic or abiotic stresses. In this study, a source-sink model was used to explain the difference in the metabolic mechanism of mechanical damage to young and senescing leaves of Catharanthus roseus.

Results
In our study, GC-MS and LC-QTOF-MS metabolomics techniques were used to explore the differences in source-sink allocation and metabolic regulation in different organs of Catharanthus roseus after mechanical damage to the upper/lower leaves (WUL/WLL). Compared with that of the control group, the energy supplies of the WUL and WLL groups were increased and delivered to the secondary metabolic pathway through the TCA cycle. The two treatment groups adopted different secondary metabolic response strategies. The WLL group increased the input to the defense response after damage by increasing the accumulation of phenolics. A source-sink model was applied to the defensive responses to local (damaged leaves) and systemic (whole plant) damage. In the WUL group, the number of sinks increased due to damage to young leaves, and the tolerance response was emphasized.

Conclusion
The accumulation of primary and secondary metabolites was significantly different between the two mechanical damage treatments. Catharanthus roseus uses different trade-offs between tolerance (repair) and defense to respond to mechanical damage. Repairing damage and chemical defenses are thought to be more energetically expensive than growth development, confirming the trade-offs and allocation of resources seen in this source-sink model.
Appropriate utilization of cardiac computed tomography for the assessment of stable coronary artery disease
Authors: Hammer Michael , Mian Muhtashim , Elhadad Levi , Li Mary , Roifman Idan 
Published: March 2021

Abstract
Background
Appropriate use criteria (AUC) have been developed in response to growth in cardiac imaging utilization and concern regarding associated costs. Cardiac computed tomography angiography (CCTA) has emerged as an important modality in the evaluation of coronary artery disease, however its appropriate utilization in actual practice is uncertain. Our objective was to determine the appropriate utilization of CCTA in a large quaternary care institution and to compare appropriate utilization pre and post publication of the 2013 AUC guidelines. We hypothesized that the proportion of appropriate CCTA utilization will be similar to those of other comparable cardiac imaging modalities and that there would be a significant increase in appropriate use post AUC publication.

Methods
We employed a retrospective cohort study design of 2577 consecutive patients undergoing CCTA between January 1, 2012 and December 30, 2016. An appropriateness category was assigned for each CCTA. Appropriateness classifications were compared pre- and post- AUC publication via the chi-square test.

Results
Overall, 83.5% of CCTAs were deemed to be appropriate based on the AUC. Before the AUC publication, 75.0% of CCTAs were classified as appropriate whereas after the AUC publication, 88.0% were classified as appropriate (p < 0.001). The increase in appropriate utilization, when extrapolated to the Medicare population of the United States, was associated with potential cost savings of approximately $57 million per year.

Conclusions
We report a high rate of appropriate use of CCTA and a significant increase in the proportion of CCTAs classified as appropriate after the AUC publication.
The incidence and prevalence of inflammatory bowel disease in UK primary care: a retrospective cohort study of the IQVIA Medical Research Database
Authors: Freeman Karoline , Ryan Ronan , Parsons Nicholas , Taylor-Phillips Sian , Willis Brian H. , Clarke Aileen 
Published: March 2021

Abstract
Background
Our knowledge of the incidence and prevalence of inflammatory bowel disease (IBD) is uncertain. Recent studies reported an increase in prevalence. However, they excluded a high proportion of ambiguous cases from general practice. Estimates are needed to inform health care providers who plan the provision of services for IBD patients. We aimed to estimate the IBD incidence and prevalence in UK general practice.

Methods
We undertook a retrospective cohort study of routine electronic health records from the IQVIA Medical Research Database covering 14 million patients. Adult patients from 2006 to 2016 were included. IBD was defined as an IBD related Read code or record of IBD specific medication. Annual incidence and 12-month period prevalence were calculated.

Results
The prevalence of IBD increased between 2006 and 2016 from 106.2 (95% CI 105.2–107.3) to 142.1 (95% CI 140.7–143.5) IBD cases per 10,000 patients which is a 33.8% increase. Incidence varied across the years. The incidence across the full study period was 69.5 (95% CI 68.6–70.4) per 100,000 person years.

Conclusions
In this large study we found higher estimates of IBD incidence and prevalence than previously reported. Estimates are highly dependent on definitions of disease and previously may have been underestimated.