bluuebunny/crossref_metadata_2025_split huggingface dataset:
Framework for the Design Engineering and Clinical Implementation and Evaluation of mHealth Apps for Sleep Disturbance: Systematic Review
Authors: Aji Melissa , Gordon Christopher , Stratton Elizabeth , Calvo Rafael A , Bartlett Delwyn , Grunstein Ronald , Glozier Nick 
Published: January 2021

Background
Mobile health (mHealth) apps offer a scalable option for treating sleep disturbances at a population level. However, there is a lack of clarity about the development and evaluation of evidence-based mHealth apps.

Objective
The aim of this systematic review was to provide evidence for the design engineering and clinical implementation and evaluation of mHealth apps for sleep disturbance.

Methods
A systematic search of studies published from the inception of databases through February 2020 was conducted using 5 databases (MEDLINE, Embase, Cochrane Library, PsycINFO, and CINAHL).

Results
A total of 6015 papers were identified using the search strategy. After screening, 15 papers were identified that examined the design engineering and clinical implementation and evaluation of 8 different mHealth apps for sleep disturbance. Most of these apps delivered cognitive behavioral therapy for insomnia (CBT-I, n=4) or modified CBT-I (n=2). Half of the apps (n=4) identified adopting user-centered design or multidisciplinary teams in their design approach. Only 3 papers described user and data privacy. End-user acceptability and engagement were the most frequently assessed implementation metrics. Only 1 app had available evidence assessing all 4 implementation metrics (ie, acceptability, engagement, usability, and adherence). Most apps were prototype versions (n=5), with few matured apps. A total of 6 apps had supporting papers that provided a quantitative evaluation of clinical outcomes, but only 1 app had a supporting, adequately powered randomized controlled trial.

Conclusions
This is the first systematic review to synthesize and examine evidence for the design engineering and clinical implementation and evaluation of mHealth apps for sleep disturbance. The minimal number of apps with published evidence for design engineering and clinical implementation and evaluation contrasts starkly with the number of commercial sleep apps available. Moreover, there appears to be no standardization and consistency in the use of best practice design approaches and implementation assessments, along with very few rigorous efficacy evaluations. To facilitate the development of successful and evidence-based apps for sleep disturbance, we developed a high-level framework to guide researchers and app developers in the end-to-end process of app development and evaluation.
Comparative efficacy of dabrafenib + trametinib versus treatment options for metastatic melanoma in first-line settings
Authors: Wu Jing , Das Jaydeep , Kalra Manik , Ratto Barbara 
Published: January 2021

Aim:
The objective was to systematically review the literature and assess the relative efficacy of agents approved in first-line settings via network meta-analysis.
Materials & methods:
A literature review was conducted via searching different medical databases. The eligibility criteria included Phase II or III randomized controlled trials that had enrolled treatment-naive adult patients with advanced/metastatic melanoma.
Results:
The network meta-analysis results suggested that dabrafenib + trametinib significantly prolongs the survival outcomes compared with the monotherapies and had comparable efficacy profile compared with encorafenib + binimetinib and cobimetinib + vemurafenib. In comparison with immunotherapies, the results varied for progression-free survival and overall survival.
Conclusion:
Long-term survival data of dabrafenib + trametinib establishes the combination as one of the preferred treatment options for previously untreated melanoma patients.
DIGITAL TOOLS AND PAPER-AND-PENCIL IN SOLVING-AND-EXPRESSING: HOW TECHNOLOGY EXPANDS A STUDENT’S CONCEPTUAL MODEL OF A COVARIATION PROBLEM
Authors: Jacinto Hélia , Carreira Susana 
Published: January 2021

This study aims at understanding the role of the tools chosen throughout the processes of solving a non-routine mathematical problem and communicating its solution. In assuming that problem-solving is a synchronous activity of mathematization and expression of mathematical thinking we take our proposed Mathematical Problem Solving with Technology (MPST) model to analyze the processes of solving-and-expressing-problems. Resorting to qualitative methods for data collection and analysis, we report on the case of an 8th grader working on a covariation problem to examine the role that paper-and-pencil and digital tools play in the development of a conceptual model of the situation. We found that the resources used throughout the solving-and-expressing activity influenced the depth of the conceptual model developed, within a process of progressive mathematization. Whereas paper-and-pencil led to the emergence of a conceptual model based on exploring particular cases, the digital transformation of the solution was triggered by the process of communicating its mathematical justification and expanded the previous model. Moreover, the complexity of this activity is evidenced by its multiple sequences of processes. Finally, the integration process seems crucial as the concomitant use of technological and mathematical resources precedes major advancements in the expansion of the conceptual model.
Ação entre amigos: relações entre banqueiros do bicho e milícias nas disputas político-econômicas da contravenção
Authors: Labronici Rômulo Bulgarelli 
Published: January 2021

O mercado de jogos de apostas ilegais no Rio de Janeiro possui diversas formas de ser abordado. Neste trabalho, busca-se compreender e analisar a relação entre dois grupos distintos, porém complementares, denominados de banqueiros do jogo do bicho e milicianos que administram com mãos de ferro o monopólio desse mercado. Disputas por esse controle envolve a produção de alianças voláteis que se consolidam e se desfazem à medida que os interesses político-econômicos se voltam para a dominação territorial de partes da cidade. Respeitando estruturas hierárquicas e disciplinares, o mercado adquiriu formas empresariais de manter-se lucrativo a partir de valores comuns entre tais os grupos. Além disso, as relações de parentesco e afinidade explicitam o modo com o qual os controles do jogo encontram-se circunscritos entre pequenos grupos inserindo a prática do apadrinhamento como peça inerente a estrutura macropolítica desse mercado.
Delirium In The Emergency Department: Diagnosis, Evaluation, And Management
Authors: Kennedy Maura 
Published: January 2021

Delirium, an acute confusional state characterized by disturbances in attention, cognition, and arousal, is present in 7 to 10% of older emergency department (ED) patients, underdiagnosed in the ED setting, and associated with increased short-term mortality. Delirium is typically precipitated by a physiologic stressor, such as an acute medical illness, a new medication, or a change in environment. The keys to the care and management of delirious patients are timely diagnosis of delirium and identification and treatment of the precipitating cause. The medical evaluation should include a formal delirium assessment that includes tests of attention and targeted diagnostic tests to identify the underlying etiology, such as infection, metabolic derangement, neurologic emergencies, new medications, and/or toxidromes. Pharmacologic treatment of delirium should be limited to patients who are severely agitated and at risk for substantial harm to self and/or others and patients with delirium secondary to alcohol withdrawal. Typical and atypical psychotics at low doses are first line for use in severely agitated patients. Benzodiazepines may worsen delirium and should be reserved for treatment of patients with delirium secondary to alcohol withdrawal or if sedation is required for critical imaging and/or procedures. ED physicians should also be conscious of and strive to minimize iatrogenic precipitants of delirium.

This review contains 2 figures, 10 tables and 53 references
Key words: aged, agitation, arousal attention, confusion, delirium, delirium/diagnosis, delirium/etiology, delirium/therapy, dementia complications, geriatrics, risk factors
Colon Cancer
Authors: Hoehn Richard S , Quezada-Diaz Felipe , Smith Jesse J 
Published: January 2021

Colon cancer is a leading cause of cancer-related death in the United States and worldwide. Routine screening has led to early diagnosis and improved survival for many patients but is still greatly underused. Complete surgical resection provides the best opportunity for cure of localized disease and requires removal of a defined segment of colon along with its lymphovascular pedicle, including a minimum of 12 lymph nodes. Minimally invasive approaches have been shown to provide better perioperative outcomes and patient recovery, with oncologic outcomes equivalent to those of traditional open surgery. Patients with lymph node metastases are at an increased risk of distant metastases and disease recurrence. Survival for these patients has improved in the recent years with the advent of oxaliplatin-based adjuvant chemotherapy. In addition, surgical resection is increasingly being used to control and sometimes cure distant metastases. In this chapter, we review the current strategies for diagnosing and managing colon cancer.

This review contains 1 video, 5 figures, 4 tables and 48 references
Key Words: adjuvant chemotherapy, anastomosis, colectomy, colon cancer, neoadjuvant chemotherapy, surgery, survival, laparoscopic, robotic
Synovial Sarcoma
Authors: Tan Marcus 
Published: January 2021

Synovial sarcomas are a common extremity soft tissue sarcoma, typically arising in the para-articular regions of young adults. All synovial sarcomas are considered high grade. Distinctive clinical features are the two common histologic variants (monophasic and biphasic) and more frequent incidence of nodal metastasis. In addition to the sheets of spindle cells seen in monophasic tumors, biphasic tumors have interspersed areas of glandular differentiation. Synovial sarcomas are characterized by the SS18-SSX translocation. Most biphasic tumors contain the SS18-SSX1 translocation, whereas almost all SS18-SSX2 tumors are monophasic. Radical resection is the mainstay of therapy. Synovial sarcomas are chemosensitive, and ifosfamide-doxorubicin is often used neoadjuvantly. Adjuvant radiation should be considered for tumors greater than 5 cm.
This review contains 7 figures, 2 tables, and 35 references.
Key Words: E-cadherin, extremity sarcoma, ifosfamide, neoadjuvant chemotherapy, nomogram, SS18-SSX fusion, synovial sarcoma, translocation-associated sarcoma
Desmoplastic Small Round Cell Tumor
Authors: Saltsman III James A , Heaton Todd E 
Published: January 2021

Desmoplastic small round cell tumor (DSRCT) is a relatively recently identified, rare, aggressive cancer that arises from the peritoneal lining of the abdominal cavity and predominantly affects male adolescents and young adults. DSRCT is included in the Ewing family of tumors and harbors a unique translocation between EWSR and WT1 genes. Patients characteristically present with advanced disease, including widespread involvement of the abdominal cavity and pelvis, with frequent extraperitoneal metastases involving liver, spleen, and thoracic lymph nodes. Five-year overall survival remains approximately 15 to 20% in recent series despite aggressive multimodal therapy. Neoadjuvant chemotherapy, complete resection, defined as less than 1 cm3 of residual tumor, and consolidative whole abdominopelvic radiotherapy (WAP-RT) appear to play important role in curative treatment. The rarity of DSRCT makes large randomized trials difficult and consensus statements about clinical approach impossible. However, this chapter summarizes the best available data on the pathogenesis, diagnosis, and treatment of DSRCT; highlights the major advances made in these areas; and discusses the addition of local therapy to the treatment paradigm.
This review contains 3 figures, 1 table, and 51 references.
Key Words: DSRCT, peritoneal malignancy, desmoplastic round cell tumor, surface malignancies of the peritoneum, desmoplastic small round cell tumor of the abdomen, surgical oncology, rare malignancies, surgical therapy of abdominal malignancies
Unhealthy Alcohol Use
Authors: Holt Stephen R , Donroe Joseph H. 
Published: January 2021

Unhealthy alcohol use refers to a spectrum of alcohol consumption ranging from at-risk drinking to alcohol use disorder. It is associated with both a high cost to society and to individuals. Globally, alcohol is a leading cause of death and disability, and despite the high prevalence of unhealthy alcohol use, diagnosis, and treatment of alcohol use disorder remains disproportionately low. Risk for unhealthy alcohol use and alcohol related harms is multifactorial and includes genetic factors, gender, age, socioeconomic status, cultural and societal norms, and policies regulating alcohol consumption among others. Excessive alcohol use is associated with a myriad of poor physical and mental health outcomes, and screening for unhealthy alcohol use is universally recommended and effective.
This review contains 1 figures, 2 tables, and 76 references.
Key Words: addiction, alcohol, cancer, diagnosis, drinking, liver disease, screening, stigma, use disorderImportant Advances
Achondroplasia and Hypochondroplasia
Authors: Gooch Catherine , Subramaniam Akila , Robin Nathaniel 
Published: January 2021

Many women with skeletal dysplasias, such as achondroplasia and hypochondroplasia, choose to become pregnant. These women and their partners should receive pre-conception genetic counseling. Once the woman becomes pregnant, a multidisciplinary team at a tertiary care hospital should mange her antepartum care and birth process. An anesthesia plan should be in place that addressed kyphosis, weight based medications and the possibility of a Cesarean Section. Patients should be monitored for respiratory compromise from the gravid uterus on a smaller body frame. Neonatology must be available to help care for the infant. With a supportive antepartum and postpartum care plan, most women with skeletal dysplasia do well and resume routine OBGYN care after birth.
This review contains 5 figures, and 21 references.
Keywords: Maternal Achondroplasia, Maternal Hypochondroplasia, Inheritance patterns, short limb dwarfism, high risk pregnancy, autosomal dominant inheritance
Fiber and Nutritional Health
Authors: Slavin Joanne L 
Published: January 2021

Populations that consume more dietary fiber have less chronic disease. According to the 2002 Dietary Reference Intakes (DRIs), dietary fiber includes carbohydrates and lignin that are intrinsic and intact in plants that are not digested and absorbed in the small intestine. Functional fiber consists of isolated or purified carbohydrates that are not digested and absorbed in the small intestine that confer beneficial physiologic effects in humans. Total fiber is the sum of dietary fiber and functional fiber. Fibers alter laxation, attenuate the rise in blood glucose, and normalize blood cholesterol. The solubility of fibers was originally thought to determine physiologic properties, with soluble fiber linked to cholesterol-lowering properties and insoluble fiber linked to laxation effects. The DRI Committee recommended that other descriptors for fiber be developed, suggesting viscosity and fermentability. Manufacturers are allowed to list total dietary fiber, soluble fiber, and insoluble fiber on the Nutrition Facts panel. DRIs recommend consumption of 14 g of dietary fiber per 1,000 kcal based on epidemiologic studies showing protection against cardiovascular disease. Usual intake of dietary fiber is only 15 g/day. Even with a fiber-rich diet, a supplement may be needed to bring fiber intakes into the recommended range. Dietary messages to increase consumption of high-fiber foods such as whole grains, pulses, fruits, and vegetables should be broadly supported by the medical profession.

This review contains 3 Tables and 38 references

Key words: constipation, diarrhea, dietary fiber, health claims, laxatives, plant foods, stool weight, transit time
Determining Protein Requirements In The Acutely Ill Patient
Authors: Hoffer L John 
Published: January 2021

This review discusses protein requirements in disease. It begins by explaining how protein requirements are determined in normal health and the process of nutritional adaptation. It points out the salient features of diseases that increase a patient’s protein requirement, with detailed attention to the effect of systemic inflammation both to increase protein requirements and prevent normal adaptation to starvation. The review also explains and reconciles problems of uncertainty about how much protein to provide to acutely ill patients. Finally, it provides the clinical information and physiologic reasoning necessary to choose appropriate amounts of protein to provide to individual acutely ill patients.

This review contains 1 figure and 59 references
Key words: adaptation, cachexia, frailty, hypoalbuminemia, inflammation, malnutrition, muscle atrophy, nutritional requirements, protein-energy malnutrition, protein requirements, systemic inflammation
Indications for Dialysis in Acute Kidney Injury
Authors: Patel Ankit , Christopher Kenneth B 
Published: January 2021

Renal replacement therapy (RRT) can be used to support patient’s kidney function in cases of acute kidney injury (AKI). However, timing, modality, and dosing of RRT continue to remain in question. Recent studies have begun to provide data to help guide clinicians on when to initiate RRT, what form of RRT to use ranging from continuous venovenous hemofiltration (VVH) to intermittent hemodialysis, and the impact of high versus low-intensity dosing. Additionally, the risks associated with temporary vascular access with regard to thrombosis and infection, the impact of high efficiency and flux versus low efficiency and flux membranes, and options for anticoagulation in RRT for AKI are also discussed.
This review contains 75 references.
Key words: acute kidney injury, chronic kidney disease, continuous venovenous hemofiltration, continuous venovenous hemodialysis, renal replacement therapy, venovenous hemofiltration,
Peritoneal Dialysis
Authors: François Karlien , Bargman Joanne M. 
Published: January 2021

In peritoneal dialysis (PD), the peritoneum serves as a biological dialyzing membrane. The endothelium of the vast capillary network perfusing the peritoneum functions as a semipermeable membrane and allows bidirectional solute and water transfer between the intravascular space and dialysate fluid dwelling in the peritoneal cavity. PD is a renal replacement strategy for patients presenting with end-stage renal disease. It can also be offered for ultrafiltration in patients with diuretic-resistant fluid overload even in those without advanced renal failure. PD can also be used for patients with acute kidney injury, although in the developed world this occurs rarely compared to the use of extracorporeal therapies.
This review contains 9 videos, 8 figures, 4 tables, and 73 references.
Keywords: peritoneal dialysis, peritoneal cavity, catheter, dialysis fluid, ultrafiltration, tunnel infection, osmotic pressure, renal failure
Medical Management of Transplant Patients
Authors: Vadivel Nidyanandh , Goes Nelson B 
Published: January 2021

Kidney transplant is the best form of renal replacement therapy for most end-stage kidney disease patients due to improved quality of life and superior patient survival compared to chronic maintenance dialysis. Long-term outcome of kidney allograft recipients depends on the longevity of the allograft and optimal management of their comorbidities such as cardiovascular disease risk factors. According to organ procurement and transplant data in the United States, 14.5% of the deceased donor kidney wait list comprised patients who failed their first allograft and were awaiting second kidney transplant. Optimal immunosuppression management is key to both short- and long-term outcomes of allograft transplant by preventing rejection while avoiding or minimizing risk of over immunosuppression such as with infections and neoplasia. Cardiovascular disease is the leading cause of mortality after kidney transplant. It accounts for approximately 50% of deaths in the post transplant period and 30% of deaths among patients with preserved renal allograft function. Hence, it is crucial to optimally manage cardiovascular risk factors such as hypertension and diabetes post transplant. In this chapter, we review medical management of kidney transplant recipients, including commonly used induction therapies, maintenance immunosuppressive agents, and posttransplant medical complications such as posttransplant diabetes mellitus, hypertension, cardiovascular disease, bone disease, and BK viral infection.
This review contains 1 table and 47 references
Key Words: kidney transplantation, immunosuppression, rejection, post transplant diabetes mellitus (PTDM), BK viral infection, calcineurin inhibitors,
Vaginal Birth After Cesarean: Contemporary Update and Ongoing Controversies for the Clinician in the Trenches
Authors: Rosner Mara , Zelop Carolyn M 
Published: January 2021

Mounting evidence underscoring serious maternal complications such as hemorrhage, emergent hysterectomy, thromboembolic disease and even death from multiple cesarean deliveries has refocused attention upon trial of labor after cesarean birth. Research over the last thirty years has provided insight into some of the clinical and demographic factors associated with uterine rupture and successful trial of labor after cesarean delivery. Clinical application of these strategies has the potential to mitigate the dilemma for physicians in the trenches caused by fear of uterine rupture during a trial of labor after cesarean. Individual risk stratification of candidates that optimizes success and minimizes uterine rupture during a trial of labor after cesarean shows promise for implementation of best practices leading to favorable maternal and neonatal outcomes.
This review contains 4 figures, 6 tables, and 97 references.
Key Words: Vaginal birth after cesarean (VBAC), Trial of labor after cesarean (TOLAC), uterine rupture, uterine scar, lower uterine segment, repeat cesarean, placenta accreta, uterine dehiscence
Adjuvant Radiation for Gynecologic Cancers
Authors: Jang Joanne 
Published: January 2021

Radiation therapy plays a significant role in the treatment of nearly all gynecologic cancers, including endometrial cancer, cervical cancer, vaginal cancer, and vulvar cancer. Radiotherapy can be given as the primary modality for curative treatment of gynecologic cancers, most often for cervical, vaginal, and vulvar cancers, but can also be used adjuvantly in the postoperative setting. Radiation can be delivered in the form of external beam radiation therapy or as gynecologic implants for brachytherapy, which is radiation that is delivered internally. This review highlights the data supporting radiation therapy for gynecologic cancers and explains the different methods of radiation delivery.
This review contains 5 figures, and 4 tables, and 40 references.
Key Words: adjuvant treatment, brachytherapy, cervical cancer, endometrial cancer, IMRT, ovarian cancer, radiation therapy, vaginal cancer, vulvar cancer