bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring Adherence Rate to Growth Hormone Therapy and Growth Outcomes in Taiwanese Children Using Easypod Connect: Observational Study
Authors: Su Pen-Hua , Yang Chen , Chao Mei-Chyn , Chiang Chung-Lin
Published: January 2021

Background

Adherence to growth hormone therapy is difficult to detect reliably. Devices such as easypod have been developed for electronic recording of injections. The easypod connect observational study (ECOS) was an open-label, observational, multinational, phase IV study conducted in 24 countries around the world. The final results from ECOS in the Taiwanese cohort are reported in this paper.

Objective

This study aimed to evaluate the adherence and long-term outcomes of growth hormone therapy in pediatric subjects using the easypod electromechanical device.

Methods

Subjects (aged 2-18 years or >18 years without fusion of growth plates) who received Saizen (recombinant human growth hormone, somatropin) via the easypod device were enrolled in this study. The primary objective was to assess the level of adherence in subjects receiving Saizen via easypod.

Results

In Taiwan, a total of 35 and 13 children fulfilled the criteria of full analysis set and complete analysis set, respectively. The mean (SD) age of the complete analysis set was 12.08 (2.72) years. All subjects were growth hormone–naïve, with 38% (5/13) females. The mean adherence rates of 13 subjects were 87.6% at 3 months and 84.3% at 6 months, that of 8 subjects was 81.0% at 9 months, and that of 4 subjects was 91.6% at 1 year. After 1 year of treatment, subjects had a median (Q1:Q3) change in height SD score of 0.30 (0.06:0.48), median height velocity of 6.50 (4.33:8.24) cm/year, and median change in height velocity SD score of 1.81 (–0.04:3.52).

Conclusions

With the easypod device, patients with inadequate adherence and poor response to treatment can be identified. Adherence to growth hormone therapy administered via easypod was generally high in the first year of treatment but the adherence gradually decreased over time. Overall, growth outcomes after 1 year indicated a positive growth response to growth hormone treatment. Future efforts should be focused on personalized management of adherence by using the easypod system.
Spatio-temporal analysis of land use/land cover dynamics in Sokoto Metropolis using multi-temporal satellite data and Land Change Modeller
Authors: Dangulla Murtala , Manaf Latifah Abd , Mohammad Firuz Ramli
Published: January 2021

Urbanization is currently one of the most pressing environmental issues which cuts across all countries at unprecedented rates and intensities, with far reaching consequences on ecosystems, biodiversity and human wellbeing. This paper assessed urban expansion and land use/land cover changes in Sokoto metropolis, North-western Nigeria using Remote Sensing and GIS. Landsat images of 1990, 1999 and 2015 were processed for LULC classification and change detection using the Maximum Likelihood Classification, Post Classification Comparison techniques and the Land Change Modeler. The classification revealed five broad land cover classes which include Built-up Area, Farmland, Green Area, Open Space and Wetland/Water. The Built-up and Green areas continuously increased while Farmland and Open space decreased throughout the study period. The metropolis expanded radially at a faster rate between 1999 and 2015 with the highest rate of increase (1890.5ha per annum) recorded in the Built-up Area. This implies a doubling time of approximately 30 years at the expense of Farmland and Open space which may be completely exhausted in 40 and 29 years respectively. Infrastructural provision should thus align with the rate and direction of growth and where the Green Area is converted, replacement should be made to ensure continued supply and stability of the numerous ecosystem services green areas provide.
Testing a detailed classification scheme for land-cover/ land-use mapping of typical Indonesian landscapes: case study of Sarolangun, Jambi and Salatiga, Central Java
Authors: Danoedoro Projo , Ananda Irvan Nurrahman , Kartika Candra Sari Djati , Umela Assyria F , Indayani Alvidita Beatrix
Published: January 2021

Land-cover/land-use (LCLU) mapping is an important activity to produce very useful information to support  various sectors, such as land supply, spatial planning, disaster mitigation, and agricultural development.  In Indonesia, a LCLU classification scheme has been developed at a scale of 1: 50,000, but it still requires an evaluation due to its advantages and limitations. This study tried to apply a classification scheme for LCLU-based on SNI 7645-1 2014 for two regions in Indonesia with different landscape characteristics, i.e.  Sarolangun in Jambi and Salatiga and surroundings in Central Java.. The trial was conducted by developing methods of Landsat-8 satellite image analysis and interpretation combining digital processing and manual delineation. Based on this research, a number of 52 LCLU classes were identified  in Sarolanguni and 32 classes were found in Salatiga and surrounding areas. The validation showed that the LCLU map of Jambi region reached 80.75.% of total accuracy, while that of Salatiga and surroundings reached 88.7%.  Different accuracies found related to the number of classes produced, the pattern of relationship between LCLU with the existing landform characteristics, and the quality of images due to cloud cover.
Woody debris production and deposition during floods at extreme rainfall period 2012-2013 in Yabe and Tsuwano River Basin, Japan
Authors: Rusyda Muhammad Islamy , Ikematsu Sinya , Hashimoto Haruyuki
Published: January 2021

The behavior of woody debris has become a critical issue in river dynamics. It is still not widely understood, particularly during a flood event. Field investigations were performed to investigate the characteristics of woody debris production and deposition during the 2012 and 2013 floods in Yabe and Tsuwano River Basin, Japan. Ground-level photos, aerial photos, and direct measurements were used to measure the length and diameter of woody debris,   characteristics of obstacles (length. width, diameter, and shape). These investigations revealed that woody debris deposition was divided into two types: the rest of individual woody debris pieces on the riverside slope or floodplain and the formation of a woody debris jam at obstacles such as bridges, riparian trees, houses, and irregular topographic relief. Individual woody debris pieces at the production sites are around two times longer than those at the deposition sites. However, the variation coefficient of piece length at the production sites is smaller than that at the deposition site. Our results also show that the most extended piece in the jam and horizontal scale of the obstacle are two essential factors in jam formation. An empirical equation for predicting the apparent volume of jam at an obstacle is also proposed.
Spatial and Temporal Analysis of Seasonal Rainfall on the East Coast of North Sumatra, Indonesia
Authors: Darlan Nuzul Hijri , Arif Sigit Supadmo , Sudira Putu , Nugroho Bayu Dwi Apri
Published: January 2021

The east coast of North Sumatra has lower rainfall than the central (Bukit Barisan) and the west coast. Meanwhile, the literature on the influence of climate phenomena, such as El Nino, La Nina, and positive/negative IOD, on the rainfall distribution in North Sumatra remains quite limited. This paper aims to describe the spatial distribution of seasonal rainfall on the east coast of North Sumatra and its correlation with ENSO and the IOD. Hopefully, the spatial analysis of seasonal rainfall and its correlation to ENSO and IOD can improve the understanding on rainfall distribution and the influenced factors in the study area. For 16 years (1999–2014), the monthly rainfall data at 52 rain gauge stations that passed the homogeneity test were divided into the seasonal 6-month and 4-month. Hereafter, the seasonal rainfall was spatially analyzed with the Inverse Distance Weighting (IDW) method using ArcMap software. The spatial analysis results can clearly describe the rainfall dynamics and its anomalies, therefore, can be more easily understood. The repetition of rainfall anomaly patterns can be seen in January to June (JFMAMJ), January to April (JFMA), and May to August (MJJA), which occurs in 3–4 years. Furthermore, the Pearson-correlation analysis shows that SOI has a strong positive correlation on JFMAMJ (0.529), JFMA (0.485), and MJJA (0.366), while IOD has a strong positive correlation on MJJA (0.512) and negative on September to December - SOND (-0.341).
Approach coping dan belanja kompulsif pakaian dengan program studi sebagai variabel moderator
Authors: Djudiyah Djudiyah
Published: January 2021

Objektif:Pandemi Covid 19 yang mewabah di seluruh dunia saat ini berdampak pada cara individu dalam melakukan berbagai macam aktivitas, salah satunya dalam melakukan pembelanjaan. Banyaknya aktivitas individu yang dilakukan di rumah dan penggunaan IT dengan intensitas tinggi mendorong pesatnya perkembangan e-marketing dan maraknya pembelanjaan online. Pesatnya perkembangan fashion di Indonesia membuat mahasiswi mudah terpengaruh iklan atau teman, sehingga mendorong mereka melakukan pembelanjaan pakaian secara kompulsif. Mahasiswi dengan approach coping tinggi cenderung rasional dalam berbelanja sehingga mereka memiliki kecenderungan rendah untuk melakukan belanja kompulsif pakaian. Apalagi bila mereka sedang menempuh studi pada fakultas eksakta, yang cenderung banyak menggunakan analisa sintesa dalam proses pembelajaran. Penelitian ini bertujuan untuk mengetahui hubungan approach coping dengan belanja kompulsif pakaian pada mahasiswa dengan fakultas eksakta dan non eksakta sebagai variabel moderator.Metode: Penelitian ini menggunakan pendekatan kuantitatif korelasional. Subjek penelitian ini berjumlah 264 mahasiswi aktif Universitas Muhammadiyah Malang. Metode pengumpul data yang digunakan adalah skala Coping Respon Inventoty (CRI) dan skala belanja kompulsif pakaian.  Analisis data dilakukan dengan metode analisis moderasi (Moderation Analysis) dari Hyes dengan bantuan program SPSS versi 21. Temuan: Hasil analisis menunjukkan ada hubungan negatif antara approach coping dengan belanja kompulsif pakaian pada mahasiswi. Program studi mampu memoderasi hubungan antara approach coping dengan belanja kompulsif pakaian pada mahasiswi.Kesimpulan:Hipotesis penelitian diterima
NICHOLS, Tom. The death of expertise: the campaign against established knowledge and why it matters. New York: Oxford University Press, 2017. 252 p.
Authors: Rufino Luiz Gustavo Bonatto
Published: January 2021

A desvalorização dos conhecimentos e do alcance de parte da produção científica são evidências de que vivemos em uma realidade de culto a ignorância? Qual a importância da formação desenvolvida nas universidades? Qual o papel do jornalismo, da internet e das redes sociais nesse cenário? Em suma: vivemos a morte da expertise e do conhecimento profissional? Essas indagações permitem problematizar parte da conjuntura atual. Um desses aspectos se refere a relação entre profissionais e cidadãos nas sociedades democráticas. De um lado, os especialistas podem assumir posturas arrogantes e autoritárias, centradas no elitismo e no enclausuramento do campo acadêmico. De outro, cidadãos, usualmente considerados ‘leigos’, têm assumido posturas e opiniões baseadas em crenças pouco articuladas com evidências científicas, propagando preconceitos, incompreensões, erros e até mesmo a própria negação do conhecimento.
Apresentação: Religiões afro-brasileiras e a expansão das fronteiras: desafios interpretativos sobre a produção do sagrado e das identidades religiosas na contemporaneidade
Authors: Miranda Ana Paula Mendes de , Bahia Joana , Corrêa Roberta de Mello
Published: January 2021

A organização deste dossiê foi motivada pelo interesse em analisar as especificidades que envolvem a expansão das religiões afro brasileiras em contextos sociopolíticos distintos, bem como os desafios teórico-metodológicos que surgem dessas pesquisas. Interessava-nos debater, a partir de pesquisas  empíricas, como as formas de expressão afro-brasileiras são criativamente produzidas e transformadas e compreender suas consequências político-religiosas. Tal perspectiva é fundamental para uma controvérsia acerca de sua permanência e reprodução no cenário contemporâneo brasileiro de ataques e perseguições a essas tradições, bem como problematizar o debate sobre o que seriam essas novas misturas de religiões, com destaque para o papel dos atores religiosos e como suas crenças e comportamentos afetam os contextos sociais estudados.
Câmera na Mão, Antropologia na Cabeça: Narrativa, Ética e Alteridade na produção de Filme do Autor
Authors: Saretta Mário Eugênio
Published: January 2021

RESUMO: O acesso facilitado a materiais de produção audiovisual tem oportunizado que antropólogos não especializados em antropologia visual sejam também realizadores de produções fílmicas, ocasionando uma crescente diversificação nos seus modos de fazer e nas obras resultantes. Considerando-se a fronteira por vezes tênue entre documentários cinematográficos e filmes que reivindicam caráter etnográfico, torna-se de grande relevância que esses realizadores compartilhem suas reflexões sobre estratégias narrativas, interações propiciadas pelo uso da câmera, dilemas éticos e estéticos envolvendo a produção e a circulação dos seus filmes. Neste artigo, abordarei tais aspectos centrado na elaboração de Epidemia de Cores, documentário realizado por mim em um hospital psiquiátrico no qual desenvolvi pesquisa etnográfica por longo período, que teve exibições em festivais etnográficos e no circuito cinematográfico. Ao longo do artigo, destacarei o protagonismo das materialidades, a prática de realização de fotografias e como influências teóricas parecem ter se expressado na tentativa de produzir afetos por meio da linguagem audiovisual.
Potiguara e Xukuru: Processos de Territorialização e Regressões Estatais
Authors: Palitot Estêvão Martins , De Oliveira Kelly Emanuelly
Published: January 2021

O processo de redemocratização no Brasil propiciou a emergência de novos movimentos sociais que articulam dimensões identitárias, territoriais e ambientais, demandando do estado o reconhecimento de sujeitos políticos de direitos coletivos. O movimento indígena é paradigmático dessas transformações que conseguiram inscrever na Constituição Federal de 1988 as bases para os processos de demarcações das terras indígenas que se efetivaram nos últimos trinta anos. A despeito das garantias constitucionais, a maioria das terras indígenas enfrenta o que denominamos de regressões estatais: ideologias, aparatos e processos internos ao aparelho do estado que atuam de forma a limitar, impedir ou paralisar a efetivação das demarcações, mostrando-se suscetíveis aos interesses de grupos sociais opostos aos marcos constitucionais vigentes. Neste artigo, tomaremos como objeto de estudo os processos demarcatórios das terras dos povos Potiguara (PB) e Xukuru (PE) analisando como as regressões estatais aplicadas aos processos de territorialização desses povos tem representado entraves à efetivação dos direitos indígenas às terras e aos seus modos de vida tradicionais.
Para cima, Antropólogos: perspectivas ganhas em estudar os de cima
Authors: Nader Laura
Published: January 2021

Neste ensaio, descreverei algumas das oportunidades que os antropólogos têm de “estudar os de cima” (studying up) em sua própria sociedade, na expectativa de fomentar mais discussões sobre o porquê estudamos o que estudamos (NADER, 1964). Os antropólogos têm uma grande contribuição para a nossa compreensão dos processos pelos quais o poder e a responsabilidade são exercidos nos Estados Unidos. Além disso, há uma certa urgência para esse tipo de antropologia preocupada com o poder (Cf. WOLF, 1969), pois a qualidade de vida e as nossas próprias vidas em si mesmas dependem do modo como os cidadãos compreendem aqueles que moldam e realmente controlam as estruturas institucionais. O estudo do homem é confrontado com uma situação sem precedentes: nunca antes tão poucos, por suas ações e inações, tiveram o poder de vida e morte sobre tantos membros da espécie humana. Apresento três razões para “estudar os de cima”: seu efeito estimulante e articulador para muitos estudantes, adequação científica e relevância democrática do trabalho científico. Finalmente, considerarei alguns obstáculos e objeções frequentes e tentarei respondê-los.
“Agora quer ser rica?”: negociações cotidianas sobre classe e mobilidade social entre estudantes universitárias
Authors: Macedo Renata Mourão
Published: January 2021

O objetivo do artigo é refletir sobre narrativas cotidianas de classe e mobilidade social a partir da experiência universitária de estudantes mulheres em duas faculdades privadas na cidade de São Paulo (SP). Em comum, todas as estudantes são a primeira geração de suas famílias a cursar essa etapa de ensino. A partir de pesquisa etnográfica realizada com 21 estudantes entre 2015 e 2018, selecionei narrativas presenciais (por meio de entrevistas e conversas) e narrativas online (por meio de debates escritos e imagéticos em redes sociais) a fim de refletir sobre as negociações em relação aos marcadores de classe social e às perspectivas de mobilidade. O artigo destaca, em primeiro lugar, como as percepções de classe são negociadas no cotidiano, ora aparecendo por meio de um sistema binário de classificação – “pobres” versus “ricos” -, ora aparecendo por meio de categorias mais nuançadas, com ênfase nas frações médias. Em segundo lugar, analisa as expectativas cotidianas sobre mobilidade social, tendo em vista que, mais do que o desejo de ascender socialmente, as estudantes tinham como meta conseguir “trabalhar na área”, revelando a polissemia da busca do diploma, mesmo em um contexto marcado por expansão e subsequente crise do ensino superior no Brasil.
O Feminejo e o empoderamento narcísico feminino
Authors: Seixas Leonardo Machado de Aguiar
Published: January 2021

Este artigo tem como objetivo uma análise dialógica da narrativa do feminejo, vertente contemporânea da música sertaneja brasileira feita por mulheres. Para tal, esse estudo busca estabelecer uma relação entre os enunciados narrativos nas canções feminejas e a realidade concreta, identificada nas figuras das intérpretes desse gênero musical e do seu público. O artigo tem como base teórica estudos de Mikhail Bakhtin como sustentação para a ideia depolifonia existente na narrativa femineja; Homi Bhabha, a fim de revelar a tática do  hibridismo narrativo realizado pelo feminejo; e Gayatri Spivak como suporte à compreensão da subalternidade da origem e formação do feminejo com relação à música sertaneja.Ainda, esse artigo se vale dos estudos sobre o narcisismo de Christopher Lasch como esteio à descrição e entendimento das subjetividades identificadas na narrativa do feminejo.
Ciências Sociais, Música e Territorialidades: entrevista com Marina Bay Frydberg
Authors: Portella Machado Gustavo , Espindola dos Santos Mariana
Published: January 2021

Partindo da trajetória da professora Marina Bay Frydberg e de suas análises sobre a Antropologia da Música em diferentes regiões do Brasil, especialmente no Rio Grande do Sul e no Rio de Janeiro, dialogamos sobre as questões territoriais e como elas modificam as perspectivas dentro de um mesmo campo de estudo. Através dessas pesquisas, refletimos sobre novos e necessários olhares para as construções de identidades, tradições e mercados de trabalho.
Os objetivos dos partidos no Brasil (1982-2018): construindo o IOP
Authors: Michel Rebello Maurício , Giora Gustavo , Gomes Pereira Matheus Henrique
Published: January 2021

Há várias interpretações teóricas sobre os objetivos dos partidos políticos ao longo dos dois últimos séculos, as quais culminam com denominações de tipos partidários, como partido de massas, partido catch-all e partido cartel, por exemplo. Neste artigo, adotamos a perspectiva de Wolinetz, para a qual os principais objetivos de partidos políticos seriam: vote-seeking, policy-seeking e office-seeking. A partir de um modelo de escolha racional, propomos a criação do Índice de Objetivos Partidários (IOP). Para a utilização do índice, coletamos dados do Tribunal Superior Eleitoral (TSE) para as eleições de governos estaduais de 1982 a 2018. Os resultados indicam um bom aproveitamento do índice, podendo-se situar os objetivos dos principais partidos políticos brasileiros em um continnum.
A defesa do Estado social no Brasil e nos Estados Unidos da América
Authors: Ferreira Gilberto Soares , Da Luz Cícero Krupp
Published: January 2021

Este artigo analisa a relação entre o aumento da desigualdade no Brasil e nos Estados Unidos da América e a necessidade de um Estado social para o século XXI. Na primeira parte, estabelece-se uma relação entre a consolidação do neoliberalismo e a concentração da riqueza global. Na segunda parte, é feita a descrição da crise do Estado social nos dois países e são apresentadas as propostas de um Estado social para o século XXI. A definição da posição jurídica dos direitos sociais é analisada em conjunto com suas disputas políticas e econômicas, de forma interdisciplinar. Assim, a pesquisa guarda uma referência metodológica exploratória, ainda que se utilize de técnicas históricas e de uma perspectiva teórica marcadamente crítica. Os resultados apontam para uma diminuição da mediação do Estado social entre capital e trabalho. No entanto, estudos científicos e organizações internacionais ainda sustentam que os direitos sociais são centrais para a redução da desigualdade neste século.
Mulheres nos partidos políticos brasileiros: uma análise de estatutos partidários e sítios eletrônicos
Authors: Rezende Daniela , Sarmento Rayza , Tavares Louise
Published: January 2021

Este artigo apresenta uma análise sobre os órgãos de mulheres dos partidos políticos brasileiros, considerando os estatutos e os sítios eletrônicos dos partidos políticos com representação na Câmara dos Deputados brasileira na 54a legislatura (2011-2015), a fim de entender as formas como os órgãos de mulheres aparecem em duas arenas importantes na construção dos partidos: suas diretrizes estatutárias e sua apresentação pública oficial na internet. O conjunto das análises realizadas indica que os órgãos de mulheres têm atuação limitada, o que aponta para seu caráter predominantemente retórico. Ainda que voltada à análise específica de órgãos partidários, a pesquisa realizada pode contribuir para elucidar questões mais amplas, relacionadas a atividades partidárias fundamentais, como o recrutamento de militantes e lideranças e a mobilização política.
Surgical repair of a giant congenital left atrial aneurysm presenting with respiratory distress in a neonate
Authors: Al-Dairy Alwaleed , aljasem hazem , Srour Samir
Published: January 2021

Congenital left atrial aneurysm is a very rare congenital cardiac
anomaly, and very few cases have been reported with neonatal
presentation. Despite the congenital origin of this condition, it may
remain asymptomatic and patients may not present until their third
decade of life. Even in asymptomatic cases, prompt surgical intervention
is indicated for the prevention of fatal thromboembolic events such as
stroke. In neonates and infants presenting early in life, surgical
intervention is urgent to relieve respiratory distress symptoms. Herein,
we introduce the case of a 3-week-old neonate who presented with severe
respiratory distress symptoms requiring prompt intubation and mechanical
ventilation. Diagnosis of congenital left atrial aneurysm was
established and confirmed by transthoracic echocardiography and computed
tomography angiography. The patient underwent surgical resection of the
aneurysm using cardiopulmonary bypass and cardiac arrest. The patient
was discharged from the hospital after three weeks with normal
echocardiography.
Diagnostic Breast Imaging and Breast Cancer Staging
Authors: Sharma Nidhi
Published: January 2021

This review is geared to provide surgeons practical insight on breast imaging, intended to improve breast cancer detection and staging. Breast cancer is a leading cause of death in women in the United States. The American Joint Committee on Cancer staging system provides a tumor-node-metastasis classification that helps in determining prognosis and patient treatment. There is an increasing role of radiologists in ascertaining the correct cancer stage. Screening mammography is the basic tool and most widely used modality to detect breast cancer. The diagnostic work-up of a patient recalled from screening is the next step in assessing the artifacts and benign findings from more suspicious lesions. Additional mammographic views, tomosynthesis, and ultrasonography play an important role in determining if the finding represents a true lesion and if so, to localize and determine its level of suspicion to be cancer. Breast MRI is used both as a screening tool and a diagnostic modality to help in cancer detection and treatment planning. Recognizing patterns of benign masses, malignant calcifications, architectural distortion, and masses via a multimodality approach is the essential first step in further diagnosis. A quick overview of common interventional breast procedures may serve as a practical reference for the readers.
This review contains 10 figures, 8 tables, and 39 references.
Key Words: breast cancer, breast MRI, breast ultrasonography, fibroadenoma, invasive ductal staging, male breast, mammograms, postoperative breast, screening
Anal Cancer
Authors: Tsao Miriam , Shibata David
Published: January 2021

This chapter focuses on anal squamous cell carcinoma and its precursor lesions and summarizes the relevant epidemiology, evaluation, and management. Risk factors including human immunodeficiency virus status and sexual practices as well as the role of human papilloma virus in anal cancer pathogenesis are reviewed. Further understanding of the molecular biology of anal cancer will inform future strategies for targeted therapy, and biomarkers such as p16 and p53 may emerge as important prognostic indicators. Anal low-grade or high-grade squamous intraepithelial lesion histologies are particularly prevalent in at-risk populations, and surgical oncologists should understand the principles that underlie surveillance and management strategies. Finally, the role of chemoradiation and salvage abdominoperineal resection and the options for systemic therapy in the setting of metastatic disease are outlined. 

This review contains 10 figures, 5 tables, and 77 references.
Key Words: Anal cancer, Anal HSIL, Anal LSIL, Anal margin cancer, Anal squamous cell, carcinoma, HPV, p16, Perianal cancer
Neuroendocrine Liver Metastasis
Authors: Rahnemai-Azar Amir A , Dillhoff Mary , Schmidt Carl , Weber Sharon M. , Ronnekleiv-Kelly Sean M , Pawlik Timothy M.
Published: January 2021

Liver is the most common site of distant metastasis in patients with advanced gastroenteropancreatic neuroendocrine tumors. Presence of liver disease and grade and location of primary tumor are major determinants of prognosis. The clinical presentation of patients with neuroendocrine liver metastasis (NELM) depends on functional status of the primary tumor as well as severity of the liver disease. Various treatment modalities are available for management of patients with NELM, depending on pattern of metastasis and anatomical origin. Complete surgical resection remains the mainstay of treatment and only hope for cure. Tumor-debulking surgery might be considered in patients with extreme hormonal symptoms refractory to other treatments, with some survival benefits. Orthotopic liver transplantation also has been shown to be an accepted alternative in highly selected patients. Liver-directed treatment strategies such as radiofrequency ablation and hepatic artery-based therapies can be offered to patients who are ineligible for surgical resection. Somatostatin analogs, peptide receptor radiotherapy, cytotoxic chemotherapeutics, and novel molecular-targeted drugs embrace the mainstay of systemic therapy in NELM. In this chapter, we review the clinical presentation, diagnosis, and recent developments in management of patients with NELM.

This review contains 9 figures, 5 tables, and 50 references.
Key Words: ablation, chemotherapy, hepatic artery-based therapy, liver metastasis, liver transplantation, molecular-targeted therapy, neuroendocrine tumor, surgical resection
Management of Neuroendocrine Tumors of the Pancreas
Authors: Martin II Robert CG
Published: January 2021

Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies, with differences in prognosis and effective therapies. Traditionally, NETs have been characterized by tumor grade, site of primary tumor, functional status, and presence of underlying familial syndrome. However, increased feasibility and use of next-generation sequencing and other methodologies have revealed new genomic and epigenetic aberrations. In the past decade, treatment options available for metastatic well-differentiated gastroenteropancreatic NETs have expanded, with the approval of antiangiogenic and mTOR-directed targeted therapies, and our armamentarium of active therapies is likely to further increase. Optimal surgical therapy both for nonfunctional and functional PNETs has become more personalized and strategic to optimize long-term quality of life time. Management of localized metastatic PNET has become a true multidisciplinary management opportunity that all treating physicians should use. Peptide receptor radioligand therapy is an emerging treatment that uses functional imaging to personalize dosimetry to the tumor and avoid nephrotoxicity. Nevertheless, there is a critical need for further biomarkers, particularly multianalyte biomarkers, to aid in prognostication and predict efficacy of therapies.

This review contains 1 figure, 1 table, and 72 references.
Key Words: carcinoid tumor, islet cell carcinoma, neuroendocrine tumors, pancreatic, surgical management, medical management, metastatic, localized.
Management of Cystic Neoplasms of the Pancreas
Authors: Rendell Victoria R , Julliard Walker A , Awe Adam M , Abbott Daniel E , Winslow Emily R , Ronnekleiv-Kelly Sean M , Weber Sharon M
Published: January 2021

The diagnosis of pancreatic cystic lesions is increasingly common. The majority of pancreatic cysts are now diagnosed incidentally on cross-sectional imaging. Lack of clear evidence-based guidelines and overall poor understanding of the natural history of pancreatic cysts contribute to complexity of managing patients with pancreatic cysts. Pancreatic cystic neoplasm types differ in their presentation, histologic features, imaging characteristics, and predisposition to develop invasive malignancy. The diagnostic strategies to determine cyst type and presence of malignancy—cross-sectional imaging, endoscopic ultrasonography, and analyses of pancreatic cyst fluid aspirates—have improved over time. However, accurate characterization of cysts remains challenging. Several large groups, including the American College of Radiology, the American Gastroenterological Association, the European Study Group on Cystic Tumours of the Pancreas, and the International Association of Pancreatology, have released cyst management guidelines or recommendations that have important differences. In this review, we provide an overview of the most common pancreatic cystic neoplasm, evaluate recent advancements in diagnostic techniques, and compare current management guidelines.

This review contains 7 figures, 5 tables, and 77 references.
Key Words: intraductal papillary mucinous neoplasm, management guidelines, multidisciplinary teams, mucinous cystic neoplasm, pancreatic cyst, pancreatic cystic neoplasm, serous cystadenoma, solid pseudopapillary neoplasm, surgical oncology
Diseases of the Adrenal Gland and Adrenalectomy
Authors: Duh Quan-Yang , Thurston Drake Frederick
Published: January 2021

Evaluation and treatment of adrenal disease encompasses a broad range of disorders, including pheochromocytoma, primary hypercortisolism, primary aldosteronism, and malignancies such as adrenocortical carcinoma and metastases from other primary cancers. This pathophysiologic diversity and the technical challenges of operating on these bilateral organs with the attendant differences in left and right anatomy make adrenal surgery a complex but rewarding endeavor. Adrenal surgeons must be engaged in the physiologic aspects of the disease being treated, the anatomic details of lesion and laterality, and the technical considerations in selecting an operative approach and carrying it out successfully. Guidelines for the management of pheochromocytoma, primary hypercortisolism, and primary aldosteronism are reviewed in this chapter. Consensus is emerging that resection of adrenal metastases from other primary cancers can prolong survival in well-selected patients and that most are suitable for a laparoscopic approach. Most adrenal surgeons agree that large or locally aggressive adrenocortical carcinomas must be resected in an open fashion, though there is some controversy surrounding the operative approach in the setting of small or indeterminate lesions. Minimally invasive techniques have revolutionized adrenal surgery, and surgeons who wish to incorporate adrenal surgery into their practice must master either the laparoscopic or the retroperitoneoscopic approach.
This review contains 8 figures, 2 tables, and 28 references.
Key Words: adrenal cortex, adrenalectomy, adrenal incidentaloma, adrenal medulla, adrenocortical cancer, Cushing syndrome, laparoscopic adrenalectomy, pheochromocytoma, primary aldosteronism, retroperitoneoscopic adrenalectomy
Inflammatory Breast Cancer
Authors: Simons Janine M , Teshome Mediget , Hunt Kelly K
Published: January 2021

Inflammatory breast cancer is a rare but highly aggressive form of breast cancer. It is considered a distinct entity with unique clinicopathologic features. Symptoms of erythema and increase in breast size usually develop over the course of a few weeks. The clinical symptoms result from lymphovascular tumor emboli, which are pathognomonic for inflammatory breast cancer. Timely diagnosis may be challenging, as inflammatory breast cancer can mimic infectious disease such as mastitis or breast abscess. However, timely diagnosis and treatment are very important to provide trimodality management as early as possible. Patients should be imaged for distant metastasis at diagnosis. A combination of neoadjuvant systemic therapy, modified radical mastectomy, and adjuvant radiotherapy is standard of care for inflammatory breast cancer and improves local-regional and systemic control.
This review contains 7 figures, 3 tables, and 59 references.
Key Words: clinical presentation, diagnosis, imaging, inflammatory breast cancer, modified radical mastectomy, multimodality treatment, neoadjuvant systemic therapy, radiation therapy, staging
Management of Locoregional Recurrence of Breast Cancer
Authors: Livingston-Rosanoff Devon , Tevis Sarah E. , Wilke Lee G.
Published: January 2021

Following treatment for breast cancer, disease can recur locally, regionally, or at distant sites. Locoregional recurrence is defined as recurrence in the ipsilateral breast, skin, chest wall, or regional lymph nodes. Concurrent metastatic disease is common in patients with locoregional recurrence; therefore, patients with recurrence should undergo a complete metastatic work-up. Isolated locoregional recurrence should be approached with curative intent, and patients should undergo resection and adjuvant therapy, as indicated, based on previous treatment and location of recurrence. Following treatment for locoregional recurrence, close monitoring should be performed, as patients are at an increased risk for developing metastatic disease.

This review contains 5 figures, 1 table, and 50 references
Key Words: breast cancer, CALOR clinical trial, locoregional recurrence, repeat radiation therapy, repeat sentinel lymph node mapping, adjuvant chemotherapy, repeat breast conserving therapy, mastectomy
Radiographic Staging of Colorectal Cancer
Authors: Engbersen Maurits P. , Lahaye Max J. , Beets-Tan Regina G.H.
Published: January 2021

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging.
This review contains 4 figures and 50 references.
Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification
Cardiac Arrest And Resuscitation
Authors: Hughes Patrick , Mechanic Oren , Grossman Shamai A.
Published: January 2021

The ultimate goal of cardiac resuscitation is full neurologic recovery; however, the probability of achieving this goal deteriorates rapidly with each minute of cardiac arrest. The most essential steps are rapid recognition of cardiac arrest, early high-quality chest compressions with minimal interruptions, and early defibrillation. Additional key components include effective leadership and followership, appropriate airway management, and effectual investigation for possible reversible causes of the arrest. This review discusses the role of and evidence for using pharmacologic agents. Additional discussion evaluates the use of ultrasonography and end-tidal CO2 in cardiac arrest resuscitation. Lastly, this review discusses cardiac arrest in special circumstances, such as patients who are pregnant, have left ventricular assist devices, or are subjects of trauma.
This review contains 6 figures, 4 tables and 102 references.
Key words: advanced cardiovascular life support, antidysrhythmics, asystole, cardiac arrest, basic life support, cardiopulmonary resuscitation, extracorporeal membrane oxygenation, pulseless electrical activity, resuscitation, ventricular fibrillation, ventricular tachycardia
Allograft Liver Biopsy
Authors: Coelho Little Ester , Berenguer Marina
Published: January 2021

Although not ideal, liver biopsy is the best available method for evaluation of the liver and is considered the gold standard. The most common use of liver biopsies in the posttransplantation setting is for diagnosis of allograft dysfunction presenting with abnormal liver chemistry tests. The causes of allograft dysfunction differ according to time. Early on, preservation and reperfusion injury, infection, donor-related disease, and acute rejection are more common. Later, disease recurrence, de novo disease, and chronic rejection are seen more frequently. A complete history and physical examination are followed by ultrasonography with Doppler. If biliary or vascular causes are suspected, further imaging is performed and stents or surgery planned. If these tests are not diagnostic, a liver biopsy is performed. In addition to diagnosis of allograft dysfunction, protocol liver biopsy can be helpful particularly to diagnose disease recurrence, particularly the immune-mediated diseases, as well as to evaluate the patient for eligibility for immunosuppression minimization and possible withdrawal. Given the risks and cost associated with liver biopsy, several methods are used for evaluation of fibrosis and rejection in the liver allograft. Although very promising, these methods have not been widely validated and are not ready for clinical use.
 This review contains 9 figures, 2 tables, and 54 references. 
Key Words: biopsy to diagnose allograft liver dysfunction, disease recurrence after liver transplant, immunosuppression withdrawal after liver transplant, liver biopsy to guide immunosuppression minimization, noninvasive methods to evaluate liver allograft, posttransplant diagnostic liver biopsy, preservation and reperfusion injury, protocol liver biopsy after transplant
Hypothyroidism and Thyrotoxicosis
Authors: Ladenson Paul W.
Published: January 2021

Thyroid disorders are the most common endocrine conditions encountered in clinical practice and can range from clinically obvious to clinically silent. This review provides the definition and epidemiology of the conditions of hypothyroidism and hyperthyroidism. Hypothyroidism can be congenital or acquired, and its pathogenesis, diagnosis, and management are presented. The three most common disorders of thyrotoxicosis (diffuse toxic goiter [Graves disease], toxic nodular goiter, and iatrogenic thyrotoxicosis in thyroid hormone–treated patients are addressed, as well as the many diseases in each of these categories. This review also discusses thyroiditis, goiter, thyroid nodules, and thyroid cancer. Tables list the causes of elevated serum thyroid-stimulating hormone (TSH) levels, the etiologic classification of thyrotoxicosis, characteristic features of thyroiditis, and causes of elevated serum total thyroxine levels. Figures show the prevalence of abnormalities in thyroid function tests in different populations, certain forms of hyperthyroidism that result from pathophysiologic activation of the TSH receptor, and inflammation of thyroid tissue in acute thyroiditis.
 
This review contains 3 figures, 12 tables, and 61 references.
Key Words: Hypothyroidism, Thyrotoxicosis, Thyrotropin, celiac disease, vitiligo, pernicious anemia, Sjögren syndrome, Graves disease, Munchausen syndrome
Bipolar Disorders and Their Clinical Management, Part II: Diagnosis, Differential Diagnosis, and Treatment
Authors: DeMuri-Maletic Bernadette , Maletic Vladimir
Published: January 2021

Bipolar disorder is a biologically and phenotypically diverse disorder and its diagnosis and treatment provides a significant challenge to even the most seasoned clinician. We provide an update on the diagnosis and differential diagnosis of bipolar disorder, reflecting recent changes in DSM-5. Our review provides a succinct summary of the treatment literature, encompassing pharmacologic and psychosocial interventions for bipolar depression, mania/hypomania, mixed states, and prevention of disease recurrence. We provide a brief critical review of emerging treatment modalities, including those used in treatment resistance. Challenges involved in maintaining adherence are further discussed. Additionally, we review common treatment adverse effects and provide recommendations for proper side effect monitoring. There is evidence of significant functional impairment in patients with bipolar disorder and we conclude with a discussion of the impact of impairment on prognosis and quality of life.
This review contains 4 figures, 8 tables, and 45 references.
Key Words: bipolar disorders, differential diagnosis, maintenance pharmacotherapy, prognosis, psychosocial interventions, treatment, quality of life
Obstructive Sleep Apnea: Epidemiology, Causes, and Consequences
Authors: Lim Diane C , Schwab Richard J
Published: January 2021

As part one of the three chapters on sleep-disordered breathing, this chapter reviews obstructive sleep apnea (OSA) epidemiology, causes, and consequences. When comparing OSA prevalence between 1988 to 1994 and 2007 to 2010, we observe that OSA is rapidly on the rise, paralleling increasing rates in obesity. Global epidemiologic studies indicate that there are differences specific to ethnicity with Asians presenting with OSA at a lower body mass index than Caucasians. We have learned that structural and physiologic factors increase the risk of OSA and both can be influenced by genetics. Structural risk factors include craniofacial bony restriction, changes in fat distribution, and the size of the upper airway muscles. Physiologic risk factors include airway collapsibility, loop gain, pharyngeal muscle responsiveness, and arousal threshold. The consequences of OSA include daytime sleepiness and exacerbation of many underlying diseases. OSA has been associated with cardiovascular diseases including hypertension, coronary heart disease, stroke, atrial fibrillation, and other cardiac arrhythmias; pulmonary hypertension; metabolic disorders such as type 2 diabetes, hypothyroidism, acromegaly, Cushing syndrome, and polycystic ovarian syndrome; mild cognitive impairment or dementia; and cancer.
This review contains 4 figures, 1 table and 48 references.
Key Words: cardiac consequences, craniofacial bony restriction, epidemiology, fat distribution, metabolic disease, neurodegeneration, obesity, obstructive sleep apnea
Posttransplant Complications: Biliary and Vascular
Authors: Coelho Little Ester , Berenguer Marina
Published: January 2021

Since it was first described, the overall patient and graft survival after liver transplant have improved with advances in immunosuppression and surgical and anesthetic techniques. Despite this improvement, there continues to be both biliary and vascular complications associated with this life-saving operation, which can lead to further procedures, reoperation, and retransplant. Advances in endoscopic and percutaneous techniques have had a significant impact on the perioperative management of posttransplant complications, resulting in a reduction in reoperations and retransplants. Changes in intraoperative management with the use of thrombolytic therapy have allowed for the expansion of the donor pool, allowing the use of donation after cardiac death with increased safety and decreased risk of ischemic biliary tract injury. This article serves to highlight the vascular and biliary complications following transplant, their etiology, diagnosis, and management.
This review contains 9 figures, 1 table, and 33 references. 
Key Words: bile leak, biliary stricture, deceased donor liver transplant, donation after brain death (DBD), donation after cardiac death, hepatic artery thrombosis, ischemic cholangiopathy, living donor liver transplant, portal vein thrombosis, thrombolytic therapy, venous outflow obstruction.
Adherence to Posttransplantation Medical Regimen
Authors: Jones Lauren S , Serper Marina
Published: January 2021

In this review, we provide an overview of the most current evidence on the prevalence, risk factors, and consequences of medication non-adherence (NA) in liver transplant recipients. Despite the improvement in long-term liver transplantation outcomes, medication NA is the leading cause of graft failure, graft rejection, and poor clinical outcomes. We examine methods of measuring NA as well as interventions that have been carried out to improve medication adherence and posttransplantation outcomes. Common risk factors for NA include low social support, medication-related factors (eg. side effects), regimen complexity, younger age, financial barriers, and low literacy. Additionally, we discuss special at-risk populations with pretransplantation substance abuse or psychiatric comorbidities as well as adolescents making a transition into adulthood and independent self-care. Multifaceted interventions that are personalized and specific to identified adherence barriers for high-risk groups seem to be the most promising approach to improve medication NA and posttransplantation outcomes.

This review contains 4 figures, 5 tables, and 53 references

Key Words: electronic monitoring, immunosuppression, liver transplantation, medication, nonadherence, noncompliance, tacrolimus standard deviation, transplantation outcomes
Evaluation and Treatment of Pediatric Obesity
Authors: Desai Nirav K , Softic Samir
Published: January 2021

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues. 

This review contains 3 figures, 4 tables and 63 references.
Key Words bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery