bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nociceptive afferent phenotyping reveals that transient receptor potential ankyrin 1 promotes cold pain through neurogenic inflammation upstream of the neurotrophic factor receptor GFRα3 and the menthol receptor transient receptor potential melastatin 8
Authors: Yamaki Shanni , Chau Amanda , Gonzales Luigi , McKemy David D. 
Published: August 2020

Abstract
The proper detection and behavioral response to painfully cold temperatures is critical for avoiding potentially harmful tissue damage. Cold allodynia and hyperalgesia, pain associated with innocuous cooling and exaggerated pain with noxious cold, respectively, are common in patients with chronic pain. In peripheral somatosensory afferents, the ion channels transient receptor potential melastatin 8 (TRPM8) and transient receptor potential ankyrin 1 (TRPA1) are candidate receptors for innocuous and noxious cold temperatures, respectively. However, the role of TRPA1 as a cold sensor has remained controversial, and recent evidence suggests that TRPM8 channels and afferents mediate the detection of both pleasant and painful cold. To determine the role of TRPA1 afferents in cold-induced mouse behaviors in vivo, we used functional phenotyping by targeted nerve conduction block with the cell-impermeant lidocaine derivative QX-314. Surprisingly, we find that injection of QX-314 with TRPA1 agonists reduces cold-induced behaviors in mice, but does so in a TRPM8-dependent manner. Moreover, this effect is sexually dimorphic and requires the glial cell line–derived neurotrophic factor receptor GFRα3, as does cold hypersensitivity produced by the activation of TRPA1 channels. Taken together, these results suggest that under conditions of neurogenic inflammation, TRPA1 works upstream of GFRα3 and TRPM8 to produce cold hypersensitivity, providing novel insights into the role of TRPA1 channels in cold pain.
Caring for the Workforce of a Health System During the COVID-19 Epidemic in Brazil
Authors: Duim Etienne , Guimarães Mariana Tavares , Ornelas Rafael Herrera , Brito Natalia Tatiani Gonçalves , Daher Gustavo , Seko Cristiane Yahara , Borges-Junior Flavio Araujo , Szlejf Claudia 
Published: August 2020

Objectives:
To describe the strategies to monitor and expand access to care for a health system workers in the first 2 months of the COVID-19 epidemic in Brazil.

Methods:
Description of the implemented strategy based on the guidelines developed to address the surveillance and care of a large health system's workforce in the COVID-19 epidemic.

Results:
During phase 1, the surveillance strategy focused on monitoring suspected cases among employees. In phase 2, surveillance was restricted to employees with confirmed COVID-19, aiming at monitoring of symptoms and following hospitalizations. Access to care was expanded. A total of 1089 employees were diagnosed with COVID-19, 89 required hospitalizations and none had died.

Conclusion:
The strategies adopted were promptly implemented and could be adapted to the changing epidemic dynamics, allowing low rates of adverse outcomes in this high-risk population.
Asymmetric sensorineural hearing loss and vestibular schwannoma: when to image?
Authors: Conley Morgan , Diaz Rodney C. 
Published: August 2020

Purpose of review
We review the literature on the use of audiometric protocols in the guidance of when to obtain MRI for detection of vestibular schwannoma. This discussion will focus on the sensitivity, specificity, and cost-effective analysis of audiometric criteria of asymmetric sensorineural hearing loss (ASNHL) when used to decide when MRI scans should be performed.

Recent findings
The sensitivity for detecting vestibular schwannomas when invoking published audiometric protocols for triggering MRI acquisition in ASNHL ranged from 50 to 100%. Specificity of these protocols ranged from 23 to 83%. Such audiometric protocols are efficient, achieving sensitivity and specificity at these rates while reducing the screening rate to 18 to 35%. The reduced procurement of MRI while using such audiometric protocols is associated with annual cost savings of between 23 and 82%. While no definitive recommendations can be made from this review, some audiometric protocols offer a better balance of sensitivity and specificity than others.

Summary
Audiometric protocols for triggering MRI acquisition in ASNHL for evaluation of vestibular schwannoma can be both sensitive and specific. These are competitive measures, and so no protocol is both 100% sensitive and specific. Such protocols become less effective in populations with increased incidence of noise-induced hearing loss. Invocation of such audiometric protocols can considerably reduce the annual cost of MRI evaluation for vestibular schwannomas.
Reconstructive options following orbital exenteration
Authors: Yesensky Jessica , Lebo Nicole 
Published: August 2020

Purpose of review
The purpose of this review is to examine current trends in reconstruction following orbital exenteration. Defects ranging from isolated exenteration to more complex midface resections are explored.

Recent findings
Goals of reconstruction include separating the sino-orbital cavities and creating a safe, stable wound that can withstand adjuvant radiation. When planning for orbital rehabilitation, it is important to create a concave cavity that can accommodate a prosthesis. This is primarily achieved through secondary granulation or split-thickness skin grafts. Recently, the use of dermal allografts has been investigated and shown good success with epithelization of the orbital cavity. For complex orbitomaxillectomy defects, musculocutaneous free tissue flaps remain the mainstay for reconstruction.

Summary
Reconstructive options following orbital exenteration are based on extent of the defect, need for postoperative radiation, and plans for orbital rehabilitation with prosthesis.
A Higher Incidence of Isolated Biliary Atresia in Rural Areas
Authors: Nomden Mark , van Wessel Daan B.E. , Ioannou Solomon , Verkade Henkjan J. , de Kleine Ruben H. , Alizadeh Behrooz Z. , Bruggink Janneke L.M. , Hulscher Jan B.F. 
Published: August 2020

ABSTRACTObjectives:Environmental factors may be involved in the pathogenesis of biliary atresia (BA). This epidemiological study aimed to analyze the relationships between the incidence of BA, the incidence of confirmed viral or bacterial infections and population density, and geographical and temporal clustering of BA in the Netherlands.Study Design:Correlations between the monthly incidence of BA and the number of confirmed infections were assessed. BA incidence per province was calculated and compared to the province with highest population density. Birthplaces were classified as rural or urban. Temporal clustering of month of birth and month of conception were analyzed. We performed analyses for isolated BA (IBA) and syndromic BA (SBA) separately. Chi2, logistic regression, and Walter and Elwood test were used.Results:A total of 262 IBA and 49 SBA patients, born between 1987 and 2018, were included. IBA incidence correlated to the number of confirmed infections of, for example, Chlamydia trachomatis (R = 0.14; P = 0.02) and adenovirus (R = 0.22; P = 0.005). We observed a higher incidence of IBA (0.75/10,000; odds ratio [OR] = 1.86; P = 0.04) and SBA (0.27/10,000; OR = 6.91; P = 0.001) in Groningen and a higher incidence of SBA in Gelderland (0.13/10,000; OR = 3.35; P = 0.03). IBA incidence was 68% higher in rural (0.67/10,000) versus urban areas (0.40/10,000) (P = 0.02). The estimated month of conception of patients with SBA clustered in November (85% increase compared to average SBA incidence [0.09/10,000; P = 0.04]).Conclusions:IBA incidence correlated weakly with national confirmed infections. IBA and SBA incidence varied geographically in the Netherlands. IBA incidence was higher in rural than in urban areas, which may be explained decreased exposure to pathogens. Our results provide support for a role of environmental factors in the pathogenesis of IBA.
Gastric Bezoar
Authors: Shah Monisha , Wan David Q. , Liu Yuying , Rhoads Jon Marc 
Published: August 2020

ABSTRACTObjectives:To determine the demographics, potential risk factors, endoscopic interventions and outcomes relating to gastric bezoars in pediatric patients; and comparing results with previously published literature.Methods:Retrospective series by chart review of patients identified by International Classification of Diseases‐9 codes 938 and 935, using the following Medical Subject Headings: 1, term bezoar; 2, Keywords gastric bezoar* or gastric foreign body*.Results:Thirty pediatric patients between ages of 2 to 18 years were found with gastric bezoars, with a female predominance. Majority had a phytobezoar. Six patients were diagnosed with dysautonomia, implying possible role of autonomic dysfunction contributing to abnormal gastric retention. Frequent symptoms included abdominal pain, nausea and vomiting, a decrease in appetite, and unintentional weight loss. A higher prevalence of underlying gastrointestinal disorders was found in those with bezoars. Nuclear medicine gastric emptying scan performed in 13 children was significantly abnormal in only 4 of these children. Most patients were treated with endoscopic removal of the bezoar. Endoscopic removal was accomplished by Roth net, generally requiring multiple passes. At follow‐up, most of the children had improvement of symptoms, with bezoar recurrence in 1 patient.Conclusions:This is to our knowledge the largest series of gastric bezoars in pediatrics. On the basis of our review, phytobezoars may be under‐reported in pediatrics. Bezoars should be considered in children presenting with chronic abdominal pain, nausea, and vomiting; even in developmentally normal children and those with normal gastric emptying. We suggest that dysautonomia and underlying gastrointestinal disorders may be potential risk factors.
The Impact of Age Beyond Ploidy: Outcome Data From 8175 Euploid Single Embryo Transfers
Authors: Reig Andres , Franasiak Jason , Scott Richard T. , Seli Emre 
Published: August 2020

(Abstracted from J Assist Reprod Genet 2020;37:595–602)
Despite advances in the efficacy of assisted-reproductive technology (ART), age-related decline in female fertility remains robust with an approximate 4% live birth rate (LBR) in women older than 42. Although a clear correlation between advancing maternal age and increased rate of aneuploidy has been established, whether or not selection of euploid embryos in these women would mitigate the decline in age-related fertility remain unclear.
Performance of First-Trimester Fetal Echocardiography in Diagnosing Fetal Heart Defects: Meta-analysis and Systematic Review
Authors: Yu Dongmei , Sui Lun , Zhang Nan 
Published: August 2020

(Abstracted from J Ultrasound Med 2020;39:471–480)
Improvements in ultrasound technology, with better resolution and color mapping, have made it possible to assess the fetal heart both transvaginally and transabdominally as early as the first trimester. There is a growing interest in using this technology for the early detection of congenital heart defects (CHDs), which occurs in 5 to 9 per 1000 live births.
Aortic Calcification in Takayasu Arteritis
Authors: Meléndez-Ramírez Gabriela , Soto Maria Elena , Meave Aloha , Ruiz-Elizondo Luis Alberto , Kimura Eric , Alexanderson Erick 
Published: August 2020

Introduction
Aortic calcification is a frequent finding in Takayasu arteritis (TA). The aim of this study was to evaluate the risk factors for aortic calcification in TA and its relationship with disease activity and the presence and type of vascular lesion.

Methods
Nineteen patients with TA underwent nonenhanced computed tomography to measure the calcium score of the aorta and its main branches, which were divided into 13 segments. In each segment, the type of vascular lesion was evaluated by noninvasive angiography. Clinical risk factors and disease activity scores were recorded.

Results
Eighteen of 19 patients (95%) were women, with a median age of 25 years. Median of calcium score was 69 AU (0–12,465 AU). Eleven of 19 patients (57.9%) had calcium score greater than 0. Age, evolution time, and dyslipidemia were higher in patients with calcium, whereas the National Institutes Health and Dabague disease activity scores were lower. There was no association between the presence of calcium and vascular lesion: 60 of 160 segments (37.5%) without calcium had some lesion, compared with 24 of 68 (35.3%) with calcium score greater than 0, p = 0.75. However, occlusion was more frequent in patients with calcium, whereas wall thickening was in those without calcium.

Conclusions
Aortic calcification in TA is related to age, evolution time, and abnormalities in lipid profile and occlusion and, inversely with some activity scores. Identification of calcification could be useful in identifying patients that even without significant lesions might have accelerated atherosclerosis, and who might be benefited with specific treatment.
Upper Extremity Volume/Total Body Volume Ratio for Evaluation of Upper Extremity Lymphedema
Authors: Hattori Yasunori , Hayashi Kota , Sakamoto Sotetsu , Doi Kazuteru 
Published: August 2020

Background
Measurement of extremity volume is the most commonly used method for evaluation of lymphedema. However, volumetry would be inappropriate for comparing patients with different physiques, because body-type significantly affects extremity volume. Thus, we cannot evaluate using absolute values. To overcome this problem, we developed a simple index of proportion of the upper-extremity volume to total body volume (upper-extremity volume/total body volume ratio [UVR]) for body type–corrected volume evaluation of upper-extremity lymphedema. The purpose of this study was to compare upper-extremity volume and UVR in nonedematous upper extremities and to establish normative values of UVR in adult women.

Methods
Eighty-five normal female subjects were included in this study. The average age was 38 ± 12 years, and the average body mass index (BMI) was 21.4 ± 2.9. Volumetry of both upper extremities using water displacement method was tested in all subjects. Upper-extremity volume/total body volume ratio was calculated by dividing upper-extremity volume by total body volume. Total body volume was calculated by dividing body weight (g) by body density (g/mL). We used linear regression equation (body density = 1.0560 − 0.0005 × age) to calculate body density.

Results
UVR of 170 upper extremities averaged 2.580 ± 0.202%. Although there was significant relationship between upper-extremity volume and BMI, there was no relationship between UVR and BMI.

Conclusions
Although further studies are necessary to establish usefulness of UVR, UVR has a potential to allow better body type–corrected volume evaluation for upper-extremity lymphedema.
Long-term Oncologic Results After Stenting as a Bridge to Surgery Versus Emergency Surgery for Malignant Left-sided Colonic Obstruction
Authors: Arezzo Alberto , Forcignanò Edoardo , Bonino Marco Augusto , Balagué Carmen , Targarona Eduardo , Borghi Felice , Giraudo Giorgio , Ghezzo Luigi , Passera Roberto , Morino Mario 
Published: August 2020

Objective:
To assess overall (OS), time to progression (TTP), and disease-free survival (DFS) at 3 years after treatment, comparing stenting as bridge-to-surgery (SBTS) versus emergency surgery (ES) in neoplastic left colon obstruction, secondary endpoints of the previously published randomized controlled trial.

Background:
While SBTS in neoplastic colon obstruction may reduce morbidity and need for a stoma compared with ES, concern has been raised, about long-term survival.

Methods:
Individuals affected by left-sided malignant large-bowel obstruction were enrolled from 5 European hospitals and randomly assigned (1:1 ratio) to receive SBTS or ES. The computer-generated randomization sequence was stratified by center on cT and concealed by the use of a web-based application. Investigators and participants were unmasked to treatment assignment. The secondary outcomes analyzed here were OS, TTP, and DFS. Analysis was by intention to treat. This study is registered, ID-code NCT00591695.

Results:
Between March 2008 and November 2015, 144 patients were randomly assigned to undergo either SBTS or ES; 115 (SBTS n = 56, ES n = 59) were eligible for analysis, while 20 participants were excluded for a benign disease, 1 for unavailability of the endoscopist while 8 withdrew from the trial. With a median follow-up of 37 months (range 1–62), no difference was observed in the SBTS group compared with ES in terms of OS (HR 0.93 (95% CI 0.49–1.76), P = 0.822), TTP (HR 0.81 (95% CI 0.42–1.54), P = 0.512), and DFS (HR 1.01 (95% CI 0.56–1.81), P = 0.972). Planned subgroup analysis showed no difference in respect to age, sex, American Society for Anesthesiology score, body mass index, and pT between SBTS and ES groups. Those participants randomized for the SBTS group whose obstruction was located in the descending colon had a better TTP compared with ES group (HR 0.44 (95% CI 0.20–0.97), P = 0.042), but no difference was observed in terms of OS (HR 0.73 (95% CI 0.33–1.63), P = 0.442) and DFS (HR 0.68 (95% CI 0.34–1.34), P = 0.261) in the same individuals.

Conclusions:
This randomized controlled trial shows that, although not powered for these seconday outcomes, OS, TTP, and DFS did not differ between groups at a minimum follow-up of 36 months.
Referring Patients to Expert Centers After Pancreatectomy Is Too Late to Improve Outcome. Inter-hospital Transfer Analysis in Nationwide Study of 19,938 Patients
Authors: El Amrani Mehdi , Lenne Xavier , Clément Guillaume , Turrini Olivier , Theis Didier , Pruvot François-René , Bruandet Amelie , Truant Stéphanie 
Published: August 2020

Objectives:
We aimed to analyze the outcomes of interhospital transfer (IHT) patients after pancreatectomy, describe the characteristics of transferring hospitals, and determine the risk factors of transfer and mortality in IHT patients.

Background:
Implementation of the centralization process is complex and currently unrealized in France. Alternatively, centralization of patients with postoperative complications to high volume centers could reduce postoperative mortality (POM) and failure to rescue (FTR).

Methods:
All patients undergoing pancreatectomy for cancer between 2012 and 2018 were included. Hospitals’ and patients’ characteristics were analyzed to determine predictive factors for transfer and FTR. POM was defined as death occurring during the hospital stay and FTR as POM rate among patients with major complications.

Results:
Overall, 19,938 patients who underwent pancreatectomy were included, 1164 (5.8%) of whom were transferred. IHT patients were mostly originated from low volume hospitals (60.3% vs 39.7%), from facilities without intensive care unit (46.9% vs 22.4%) or interventional radiology (22.8% vs 12.8%). Among IHT patients, 51% underwent reoperation before transfer and 34.9% experienced hemorrhage complications. The POM was 5.2% and varied significantly between transfer and nontransfer patients (13.3% vs 4.7%, P < 0.001). Patients who experienced major complications after pancreatectomy in low volume hospitals had greater odds of being transferred (Odds Ratio (OR) = 2.46, confidence intervals (CI)95%[1.734; 3.516], P < 0.001). Also, transfer (OR = 2.17, CI95%[1.814; 2.709], P < 0.001) and especially transfer after pancreatectomy in low volume centers (OR = 3.76, CI95%[2.83; 5.01], P < 0.001) were associated with increased FTR rates.

Conclusions:
Transfers after pancreatectomy were associated with high rates of FTR, especially for patients undergoing surgery in low volume hospitals. Local expertise, resources, and volume of hospitals are mandatory to provide appropriate care after pancreatectomy.
Diagnostic Error of Neuro-ophthalmologic Conditions: State of the Science
Authors: Stunkel Leanne , Newman-Toker David E. , Newman Nancy J. , Biousse Valérie 
Published: August 2020

Background:
Diagnostic error is prevalent and costly, occurring in up to 15% of US medical encounters and affecting up to 5% of the US population. One-third of malpractice payments are related to diagnostic error. A complex and specialized diagnostic process makes neuro-ophthalmologic conditions particularly vulnerable to diagnostic error.

Evidence Acquisition:
English-language literature on diagnostic errors in neuro-ophthalmology and neurology was identified through electronic search of PubMed and Google Scholar and hand search.

Results:
Studies investigating diagnostic error of neuro-ophthalmologic conditions have revealed misdiagnosis rates as high as 60%–70% before evaluation by a neuro-ophthalmology specialist, resulting in unnecessary tests and treatments. Correct performance and interpretation of the physical examination, appropriate ordering and interpretation of neuroimaging tests, and generation of a differential diagnosis were identified as pitfalls in the diagnostic process. Most studies did not directly assess patient harms or financial costs of diagnostic error.

Conclusions:
As an emerging field, diagnostic error in neuro-ophthalmology offers rich opportunities for further research and improvement of quality of care.
Oculomotor Nerve Palsy Due to Unusual Causes
Authors: Tian Guohong , Kardon Randy , Feng Chaoyi , Hong Rujian , Sha Yan , Sun Xinghuai , Wang Min 
Published: August 2020

Background:
An isolated oculomotor nerve (CN III) palsy is a diagnostic concern because of the potential for serious morbidity or life-threatening causes. We present 5 unusual causes of oculomotor nerve palsy that escaped initial diagnosis in order to raise awareness of their associated features that will facilitate correct diagnosis.

Methods:
This study consisted of a retrospective analysis of clinical features and imaging of 5 patients who were referred for neuro-ophthalmologic evaluation with presumed diagnosis of oculomotor nerve palsy of unknown reasons.

Results:
A complete CN III palsy and an inferior division CN III palsy were diagnosed with a schwannoma in the cavernous sinus and orbital apex portion, respectively; a middle-aged woman with aberrant regeneration was found to have a small meningioma; an adult man with ptosis was diagnosed with cyclic oculomotor paresis with spasms; and a patient after radiation was diagnosed with neuromyotonia.

Conclusions:
Localizing the lesion of oculomotor nerve palsy and careful examination of the imaging is crucial. Aberrant regeneration, cyclic pupil changes, and past medical history of amblyopia, strabismus, or radiation are also very helpful for diagnosis.
Going with the flow: insights fromCaenorhabditis eleganszygote polarization
Authors: Gubieda Alicia G. , Packer John R. , Squires Iolo , Martin Jack , Rodriguez Josana 
Published: August 2020

Cell polarity is the asymmetric distribution of cellular components along a defined axis. Polarity relies on complex signalling networks between conserved patterning proteins, including the PAR (partitioning defective) proteins, which become segregated in response to upstream symmetry breaking cues. Although the mechanisms that drive the asymmetric localization of these proteins are dependent upon cell type and context, in many cases the regulation of actomyosin cytoskeleton dynamics is central to the transport, recruitment and/or stabilization of these polarity effectors into defined subcellular domains. The transport or advection of PAR proteins by an actomyosin flow was first observed in theCaenorhabditis elegans zygote more than a decade ago. Since then a multifaceted approach, using molecular methods, high-throughput screens, and biophysical and computational models, has revealed further aspects of this flow and how polarity regulators respond to and modulate it. Here, we review recent findings on the interplay between actomyosin flow and the PAR patterning networks in the polarization of theC. eleganszygote. We also discuss how these discoveries and developed methods are shaping our understanding of other flow-dependent polarizing systems.This article is part of a discussion meeting issue ‘Contemporary morphogenesis’.