bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of WALANT technique for repairing finger skin defect with a random skin flap
Authors: Xu Jianhua , Yin Lu , Cao Shuming , Zhan Haihua , Zhang Jianbing , Zhou Qiang , Gong Ketong 
Published: March 2021

Abstract
Background
Wide-awake local anesthesia no tourniquet (WALANT) technique has emerged among hand surgeons with other indications. Surgeries involving pedicled flap and revascularization are no longer used as contraindications. The present study aimed to evaluate the feasibility and merits of the WALANT technique in random skin flap surgery.

Methods
From May 2018 to March 2019, 12 patients with finger skin defects repaired with random skin flaps were reviewed. Abdominal skin flaps or thoracic skin flaps were used to cover the wound. Both the fingers and the donor sites were anesthetized by the WALANT technique. A 40-mL conventional volume consisted of a mixture of epinephrine and lidocaine. A volume of 5 mL was injected at the distal palmar for nerve block, the other 5 mL was injected around the wound for hemostasis, and the remaining was injected at the donor site of flaps for both analgesia and hemostasis. Baseline data with respect to sex, age, side, type of finger, donor sites, flap size, dosage of anesthetics, usage of finger tourniquet, intraoperative and postoperative pain, hemostasis effect, operation time, Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) score, and hospitalization expense, were collected.

Results
All patients tolerated the procedure, and none of them needed sedation. Single finger skin defect in 8 patients and double finger skin defect occurred in 4 patients; 5 patients were repaired by abdominal skin flaps, and 7 patients were repaired by thoracic skin flaps. The good surgical field visibility was 91.7%. All flaps survived adequately, without necrosis, pulling fingers out, and other complications. The average visual analog scale (VAS) score of the maximal pain was 1.1 in fingers vs. 2.1 in donor sites during the operation. On postoperative day one, the average VAS score of the maximal pain in fingers and donor sites was 1.3 and 1.1, respectively. The average hospitalization expense before reimbursement of the whole treatment was 11% less expensive compared to the traditional method. The average QuickDASH score was 9.1.

Conclusions
Under wide-awake anesthesia, patients have the ability to control their injured upper extremities consciously, avoiding the complications due to pulling flap pedicles. With the merits of safety, painlessness, less bleeding, and effectivity, the WALANT technique in random skin flaps is feasible and a reliable alternative to deal with finger skin defect.
Global mental health should engage with the ethics of involuntary admission
Authors: Wickremsinhe Marisha N. 
Published: March 2021

AbstractGlobal mental health, as a field, has focused on both increasing access to mental health services and promoting human rights. Amidst many successes in engaging with and addressing various human rights violations affecting individuals living with psychosocial disabilities, one human rights challenge remains under-discussed: involuntary inpatient admission for psychiatric care. Global mental health ought to engage proactively with the debate on the ethics of involuntary admission and work to develop a clear position, for three reasons. Firstly, the field promotes models of mental healthcare that are likely to include involuntary admission. Secondly, the field aligns much of its human rights framework with the UN Convention on the Rights of Persons with Disabilities, which opposes the discriminatory use of involuntary admission on the basis of psychosocial disability or impairment. Finally, global mental health, as a field, is uniquely positioned to offer novel contributions to this long-standing debate in clinical ethics by collecting data and conducting analyses across settings. Global mental health should take up involuntary admission as a priority area of engagement, applying its own orientation toward research and advocacy in order to explore the dimensions of when, if ever, involuntary admission may be permissible. Such work stands to offer meaningful contributions to the challenge of involuntary admission.
AMPAkines potentiate the corticostriatal pathway to reduce acute and chronic pain
Authors: Zeng Fei , Zhang Qiaosheng , Liu Yaling , Sun Guanghao , Li Anna , Talay Robert S. , Wang Jing 
Published: March 2021

AbstractThe corticostriatal circuit plays an important role in the regulation of reward- and aversion-types of behaviors. Specifically, the projection from the prelimbic cortex (PL) to the nucleus accumbens (NAc) has been shown to regulate sensory and affective aspects of pain in a number of rodent models. Previous studies have shown that enhancement of glutamate signaling through the NAc by AMPAkines, a class of agents that specifically potentiate the function of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, reduces acute and persistent pain. However, it is not known whether postsynaptic potentiation of the NAc with these agents can achieve the full anti-nociceptive effects of PL activation. Here we compared the impact of AMPAkine treatment in the NAc with optogenetic activation of the PL on pain behaviors in rats. We found that not only does AMPAkine treatment partially reconstitute the PL inhibition of sensory withdrawals, it fully occludes the effect of the PL on reducing the aversive component of pain. These results indicate that the NAc is likely one of the key targets for the PL, especially in the regulation of pain aversion. Furthermore, our results lend support for neuromodulation or pharmacological activation of the corticostriatal circuit as an important analgesic approach.
High oil accumulation in tuber of yellow nutsedge compared to purple nutsedge is associated with more abundant expression of genes involved in fatty acid synthesis and triacylglycerol storage
Authors: Ji Hongying , Liu Dantong , Yang Zhenle 
Published: March 2021

AbstractBackgroundYellow nutsedge is a unique plant species that can accumulate up to 35% oil of tuber dry weight, perhaps the highest level observed in the tuber tissues of plant kingdom. To gain insight into the molecular mechanism that leads to high oil accumulation in yellow nutsedge, gene expression profiles of oil production pathways involved carbon metabolism, fatty acid synthesis, triacylglycerol synthesis, and triacylglycerol storage during tuber development were compared with purple nutsedge, the closest relative of yellow nutsedge that is poor in oil accumulation.ResultsCompared with purple nutsedge, high oil accumulation in yellow nutsedge was associated with significant up-regulation of specific key enzymes of plastidial RubisCO bypass as well as malate and pyruvate metabolism, almost all fatty acid synthesis enzymes, and seed-like oil-body proteins. However, overall transcripts for carbon metabolism toward carbon precursor for fatty acid synthesis were comparable and for triacylglycerol synthesis were similar in both species. Two seed-like master transcription factors ABI3 and WRI1 were found to display similar transcript patterns but were expressed at 6.5- and 14.3-fold higher levels in yellow nutsedge than in purple nutsedge, respectively. A weighted gene co-expression network analysis revealed thatABI3was in strong transcriptional coordination withWRI1and other key oil-related genes.ConclusionsThese results implied that pyruvate availability and fatty acid synthesis in plastid, along with triacylglycerol storage in oil bodies, rather than triacylglycerol synthesis in endoplasmic reticulum, are the major factors responsible for high oil production in tuber of yellow nutsedge, and ABI3 most likely plays a critical role in regulating oil accumulation. This study is of significance with regard to understanding the molecular mechanism controlling carbon partitioning toward oil production in oil-rich tuber and provides a valuable reference for enhancing oil accumulation in non-seed tissues of crops through genetic breeding or metabolic engineering.
Deletion at an 1q24 locus reveals a critical role of long noncoding RNA DNM3OS in skeletal development
Authors: Yu Ting-ting , Xu Qiu-fan , Li Si-Yang , Huang Hui-jie , Dugan Sarah , Shao Lei , Roggenbuck Jennifer A. , Liu Xiao-tong , Liu Huai-ze , Hirsch Betsy A. , Yue Shen , Liu Chen , Cheng Steven Y. 
Published: March 2021

Abstract
Background
Skeletal development and maintenance are complex processes known to be coordinated by multiple genetic and epigenetic signaling pathways. However, the role of long non-coding RNAs (lncRNAs), a class of crucial epigenetic regulatory molecules, has been under explored in skeletal biology.

Results
Here we report a young patient with short stature, hypothalamic dysfunction and mild macrocephaly, who carries a maternally inherited 690 kb deletion at Chr.1q24.2 encompassing a noncoding RNA gene, DNM3OS, embedded on the opposite strand in an intron of the DYNAMIN 3 (DNM3) gene. We show that lncRNA DNM3OS sustains the proliferation of chondrocytes independent of two co-cistronic microRNAs miR-199a and miR-214. We further show that nerve growth factor (NGF), a known factor of chondrocyte growth, is a key target of DNM3OS-mediated control of chondrocyte proliferation.

Conclusions
This work demonstrates that DNM3OS is essential for preventing premature differentiation of chondrocytes required for bone growth through endochondral ossification.
Patient safety and public health concerns: poor dissolution rate of pioglitazone tablets obtained from China, Myanmar and internet sites
Authors: Rahman Mohammad Sofiqur , Yoshida Naoko , Tsuboi Hirohito , Maeda Erina , Ibarra Andrea Vanessa Velasco , Zin Theingi , Akimoto Yoshio , Tanimoto Tsuyoshi , Kimura Kazuko 
Published: March 2021

Abstract
Background
Poor quality medicines have serious implications for public health. The aim of this study was to explore the quality of the antidiabetic pioglitazone, using samples collected in China and Myanmar, and samples purchased online.

Methods
In this cross-sectional study, we examined samples (n = 163) collected from hospitals in Shanghai, China in 2012 (n = 44), products purchased via the internet and imported into Japan in 2013 (n = 59), and samples purchased in shops in Yangon, Myanmar in 2015 (n = 60). Collected samples were subjected to visual inspection, authenticity investigation and quality testing (potency, content uniformity and dissolution test) by high-performance liquid chromatography. Samples were rated as compliant or non-compliant based on the relevant pharmacopoeial acceptance criteria.

Results
Visual inspection of all samples revealed compliant products. However, responses from manufacturers during authenticity investigation were poor. Among the n = 44 samples from China, one was non-compliant in the potency test. Among the n = 59 samples personally imported into Japan, 38% of generic samples were found to be non-compliant. In Myanmar, 13.3% of samples were non-compliant. Non-compliant samples predominantly failed in the dissolution test. All non-compliant samples were generic.

Conclusions
Despite the apparent satisfactory outcome on the samples from China, pioglitazone samples collected in Myanmar and purchased online for personal import into Japan included many substandard products, which failed quality assessment predominantly because of poor dissolution. Internet providers did not comply with Japanese regulations in various respects.
Elevational distribution ranges of vascular plant species in the Baekdudaegan mountain range, South Korea
Authors: Shin Sookyung , Kim Jung-Hyun , Dang Ji-Hee , Seo In-Soon , Lee Byoung Yoon 
Published: March 2021

AbstractThe climate is changing rapidly, and this may pose a major threat to global biodiversity. One of the most distinctive consequences of climate change is the poleward and/or upward shift of species distribution ranges associated with increasing temperatures, resulting in a change of species composition and community structure in the forest ecosystems. The Baekdudaegan mountain range connects most forests from the lowland to the subalpine zone in South Korea and is therefore recognized as one of the most important biodiversity hotspots. This study was conducted to understand the distribution range of vascular plants along elevational gradients through field surveys in the six national parks of the Baekdudaegan mountain range. We identified the upper and lower distribution limits of a total of 873 taxa of vascular plants with 117 families, 418 genera, 793 species, 14 subspecies, 62 varieties, two forms, and two hybrids. A total of 12 conifers were recorded along the elevational gradient. The distribution ranges of Abies koreana, Picea jezoensis, Pinus pumila, and Thuja koraiensis were limited to over 1000 m above sea level. We also identified 21 broad-leaved trees in the subalpine zone. A total of 45 Korean endemic plant species were observed, and of these, 15 taxa (including Aconitum chiisanense and Hanabusaya asiatica) showed a narrow distribution range in the subalpine zone. Our study provides valuable information on the current elevational distribution ranges of vascular plants in the six national parks of South Korea, which could serve as a baseline for vertical shifts under future climate change.
The COVID-19 pandemic should be last orders for poor care of people with neurodevelopmental disorders
Authors: Strydom Andre , Corcoran Elizabeth , Rebillat Anne-Sophie 
Published: March 2021

SummaryWe explore whether the needs of individuals with neurodevelopment disorders have been overlooked during the coronavirus disease 2019 (COVID-19) pandemic and set out the issues that need to be considered in response to future health crises and pandemics.
Preliminary results from a phase II trial of docetaxel before castration with degarelix in men with newly diagnosed metastatic prostate cancer.
Authors: Gourdin Theodore Stewart , Lilly Michael B. , Hussain Arif , Savage Stephen , Clarke Harry S , Sion Amy Marie , Grubb Robert , Sellman David , Dincman Toros , Mikoll Jennifer , Patel Pooja , Marshall David T. , Li Hong , Keane Thomas E. 
Published: March 2021

116 Background: Randomized trials have demonstrated a survival advantage to administering docetaxel (D) shortly after initiation of androgen deprivation therapy (ADT) in men with newly diagnosed hormone sensitive metastatic prostate cancer (hsMPC). Clinical trials in breast cancer, research in prostate cancer cell lines, and pharmacokinetic analyses of D clearance in the castrate state, suggest increased efficacy of chemotherapy administered separately from hormone suppression. We proposed that treatment with D before ADT might improve outcomes in newly diagnosed hsMPC. Methods: In an ongoing phase II study (NCT03069937), men with newly diagnosed hsMPC were treated with 4 cycles of D (75mg/m2) every 21 days without ADT followed by 2 cycles of D concurrent with the LHRH antagonist degarelix (Deg) administered every 4 weeks. The Deg alone was continued for a total of 7 injections. Men were trial eligible with high or low volume disease by CHAARTED criteria. Bicalutamide was allowed for < 30 days before trial entry, but LHRH directed therapy was not permitted. The primary endpoint for this trial is percentage of men obtaining PSA < 0.2 ng/ml. Pre-specified secondary endpoints examined here after 4 cycles of docetaxel alone are safety, and efficacy defined by PSA (decrease by > 50%) and radiographic responses. Results: At time of this abstract, 50 patients have been enrolled to trial. Two patients withdrew after 1 cycle of D, and 4 patients have not yet completed 4 cycles. Of the 50 patients evaluable for safety, 6 (12%) had Grade 3 toxicities related to D. No Grade 4/5 toxicities were reported. Of patients who completed 4 cycles of D, 24/44 (55%) had a PSA response and 34/44 (77%) had PSA decline from baseline. All but two patients with declining PSA had stable or improved radiographic imaging. Six of the 44 patients (14%) had PSA progression (>25% increase) with D therapy, 3 of whom also had radiographic progression. Every patient with PSA response after 4 cycles D had PSA decline after 2 cycles. No patient with PSA decline after 2 cycles had PSA progression after 4 cycles. PSA response rate was stratified by baseline variables in table below. Conclusions: In hsMPC patients, 4 cycles D without ADT appears to be a safe and active therapy. Treatment with bicalutamide prior to the start of D predicts poorer PSA response. This result strengthens our hypothesis that sensitivity of hsMPC to taxane therapy may be enhanced if ADT is postponed. Baseline genomics will be analyzed, and we hope to correlate responses to D alone with later primary efficacy outcomes. Clinical trial information: NCT03069937. [Table: see text]
Randomized phase II trial of radium-223 (RA) plus enzalutamide (EZ) versus EZ alone in metastatic castration-refractory prostate cancer (mCRPC): Final efficacy and safety results.
Authors: Kessel Adam , McFarland Taylor Ryan , Sayegh Nicolas , Morton Kathryn , Sirohi Deepika , Kohli Manish , Swami Umang , Nussenzveig Roberto , Agarwal Neeraj , Maughan Benjamin Louis 
Published: March 2021

135 Background: We previously reported that treatment with EZ+RA was associated with a decline in serum bone metabolism markers (BMM), which correlated with improved outcomes compared to EZ alone (Agarwal N et al, Clinical Cancer Research, 2020, PMID 31937614). Here we report the final efficacy and safety results for this trial. Methods: In this phase 2 trial (NCT02199197), patients (pts) with progressive mCRPC were treated with EZ (160 mg daily) ±RA (standard dose of 55 kBq/kg IV Q4 weeks x 6), until disease progression or unacceptable toxicities. Primary objectives of change in bone markers and safety have been reported previously. Secondary objectives included comparison of PSA progression free survival (PFS), overall survival (OS), and long term safety in all pts receiving RA+EZ vs EZ alone. Post hoc analysis included comparison of PSA-PFS2 (defined as time from start of protocol therapy to PSA progression on subsequent therapy or death whichever occurred earlier), time to subsequent/next therapy (TTNT), and long term safety. Survival analysis and log-rank tests was performed using the R statistical package v.4.0.2 ( https://www.r-project.org ). Statistical significance was defined as P<0.05. Results: Between 08/2014 and 11/2017, 47 pts were eligible and enrolled. Median follow up was 22 months (range 3.2-71.5). Thirty-five pts received RA+EZ and 12 pts received EZ alone. Receipt of prior abiraterone was allowed and was balanced between two groups: 60% in RA+EZ vs. 64% in EZ pts. Final efficacy results: TTNT, PSA-PFS2 were significantly improved in the RA+EZ pts over EZ alone pts, and all other efficacy parameters were numerically improved in RA+EZ pts (Table). Final safety results: none of the 12 EZ alone pts had any fracture; two of 35 RA+EZ pts were found to have incidental grade 1 asymptomatic fracture at the site of bone metastasis on routine imaging, at 15 and 31 months respectively after the last dose of RA, and did not require any intervention. No patients developed bone marrow disorders during the follow-up period. Efficacy and safety data will be elaborated during the meeting. Conclusions: In our study, EZ+RA resulted in significant long-term clinical benefit over EZ alone in pts with mCRPC without compromising safety. * NA&BLM; equal contribution. Clinical trial information: NCT02199197. [Table: see text]
Associations of circulating cell-free DNA (cfDNA) and clinical outcomes in metastatic castrate-resistant prostate cancer (mCRPC).
Authors: Shevrin Daniel H. , Yang Mathew , Imas Polina , Gulukota Kamalakar ,   Northshore University Healthsystem
Published: March 2021

137 Background: Genomic profiling of patients (pts) with mCRPC is becoming more widely utilized to assist in prognosis and treatment. Liquid biopsies offer a non-invasive method of assessing gene alterations but questions remain regarding their validity, as well as the association of these alterations with relevant clinical outcomes. Methods: We present a retrospective analysis of 82 pts who underwent genomic profiling at the onset of mCRPC using the Guardant360 cfDNA assay. Clinical outcomes data was recorded in a structured note in the electronic medical record that allowed discrete data elements to be stored and analyzed. Patients received standard treatment with Abiraterone (Abi) and Enzalutamide (Enza) as well as chemotherapy. Relevant clinical outcome endpoints included overall survival (OS) and time on treatment with Abi and Enza (TT). These endpoints were compared between patients grouped by their gene alterations and treatment. Univariate and multivariate association analyses were performed. Results: The structured note was found to be valuable in capturing relevant discrete clinical outcomes data for detailed analysis. Median OS for the 82 pts was 58 months. 15 pts had insufficient cfDNA to perform the assay and these pts had a significantly longer OS than the 67 pts with sufficient cfDNA (median not reached vs 36 months, p = 0.004). The most commonly altered genes were AR and TP53 with 45% pts having alterations in both genes. Our analysis showed significantly shorter OS with BRAF (24 months, p = 0.008) and NF1 (20 months, p = 0.036) alterations. However, the significance was lost after multiple hypothesis correction. We observed that pts with co-occurrence of AR and BRAF had a significantly shorter OS (18.7 months, p = 0.031). BRCA2 mutations were observed in 9 pts and were associated with a significantly shorter TT (23 vs 38 months, p = 0.022) but lost significance after multiple hypothesis correction. Patients who received Abi followed by Enza had a significantly longer TT compared to pts who received the reverse sequence (38 months vs 23 months, p = 0.02). Conclusions: In this retrospective analysis, we did not identify any significant associations between specific gene alterations and relevant clinical outcomes. We observed a trend of shorter OS with BRAF and NF1 alterations and a shortened OS with co-occurrence of AR and BRAF alterations. These associations will require validation in a larger study. The presence of sufficient DNA to perform the assay was associated with shorter OS. The treatment sequence of Abi followed by Enza showed longer TT than the reverse sequence. The structured note allowed capture of relevant clinical outcomes data and is currently being utilized in a larger prospective genomic study of mCRPC.