bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards a unification of independent particle and collective models
Authors: Anagnostatos G. S.
Published: February 2020

A unification of Independent Particle and Collective Models is proposed via the Isomorphic Shell Model. Through this model, based on fundamental properties of fermions, an average shape for each nucleus is derived which simultaneously reproduces independent particle and collective properties. 20Ne is taken as an example.
ОСОБЕННОСТИ ВИЗУАЛЬНОЙ РЕПРЕЗЕНТАЦИИ БУДУЩЕГО РОССИИ: МЕТОДОЛОГИЧЕСКИЕ АСПЕКТЫ ИССЛЕДОВАНИЯ
Authors: Zheltikova Inga Vladislavovna
Published: February 2020

Цель. Целью статьи является разработка и апробация новой методологии изучения визуальных образов будущего современной России.Материалы. В качестве данных для анализа в статье используются видио-проекты конкурса “ Образы будущего России”, состоявшегося в мае 2019 года в Орловском государственном университете.Методы исследования. Автор демонстрирует функционирование комплексной методологии визуальных исследований, позволяющей проводить анализ видеороликов, клипов, презентаций, слайд-шоу. Ее применение раскрывает смысл визуального текста не только через анализ его содержания, но и форму выражения.Результаты. В результате анализа в визуальных образах будущего было выделено три уровня трансляции смыслов. Первый уровень, непосредственно связанный с сюжетом, демонстрирует ожидание быстрого роста IT технологий, роботизации, социального напряжения, доминирование техносферы и обострение экологических проблем. Второй уровень представлен особенностью построения видеоряда. Он обнаруживает активное использование образов прошлого при изображении будущего, показывает, что визуальный ряд может как усиливать смыслы, транслируемые при помощи диалогов героев или закадрового текста, так и создавать с ними контраст. На третьем уровне исследования сочетание различных средств передачи информации – цвета и света в построении кадров, музыкального сопровождения и характер звукового ряда способствует созданию у зрителя определенного настроения – тревоги, растерянности, опасения, безнадежности, оптимизма или иронии.Область применения результатов. Предложенная методология визуальных исследований может найти применение при изучении кинематографа, рекламы, моды с позиции их функционирования в социуме, способствовать выявлению всего комплекса транслируемых смыслов.
Online learning model development using google classroom on the topic of administration server
Authors: Andini Yunita Dwi , Muchlas Muchlas , Jumintono Jumintono
Published: February 2020

This study aims to: (1) generate e-learning-based practice learning model of Server Administration which is valid, useful, exciting, and can be applied to improve the learning outcomes of students in the subject of Administration Server; (2) determine the effectiveness of the implementation of Google Classroom on practice learning Administration Server; (3) monitor the learners in the learning process Server Administration practices inside and outside learning. This study is a Research and Development (R & D) to the conceptual model and using research procedures Borg and Gall. Results obtained eligibility percentage of media experts of 77.5% and 78.5% matter experts with criteria are eligible. Implementation level learning model captured very well at 91.66%. The level of attractiveness of the learners XII TKJ 1 amounted to 83.9% and XII TKJ 2 of 85.1% with very interesting criteria. The results of the analysis of the primary field trials assessing the effectiveness aspect, the value of the students after using the learning model and the overall increase learners or 100% to reach KKM with a limit value of 75, so it can be said to be a beneficial learning model to increase the number of learners.
Integrated learning based on competence in vocational high school
Authors: Wibowo Pangarso Ari , Kuat Tri , Sayuti Muhammad
Published: February 2020

Education in Vocational High Schools (VHS) aims to equip learners with the attitude, knowledge, and skills to be ready for work, absorbed in the world of work, or entrepreneurship. To fulfill the objective, the competence that must be possessed by the students must be in accordance with the needs in the world of work and in the business world. To fulfill the competence, the learning in VHS must be competency-based. In line with the competency and competency-based learning needs, it also needs an integrated learning between adaptive subjects and productive subjects. Integrated learning is modeled by; (1) conducting curriculum study on basic competence of adaptive subjects, (2) inserting productive basic competency subjects on adaptive subjects. After the integrated learning model is prepared then the learning model applied to the class is a competency-based learning model.
Staff experiences of social climate in a medium secure adolescent unit
Authors: French Joanne , O'Sullivan David V , Diggle Tim , Martin Aisling
Published: February 2020

Background/aims

Medium secure units in the UK for adolescents can be stressful and challenging for the staff who work within them. However, only a limited number of research studies regarding the experience of staff have been conducted within these environments. This study sought to explore how staff working in such settings describe their experiences and the overall ‘social climate’.

Methods

A total of 15 members of staff from one of the six medium secure establishments in the UK were interviewed, using a semi-structured interview guide. This included managers, senior clinicians, nurses and support workers. The interviews were analysed using thematic analysis.

Results

Three main themes and seven sub-themes were identified. The three main themes were: ‘the “feel” of the ward’, ‘aspects of ward functioning’ and ‘staff dynamics’. Staff had differing perceptions regarding the social climate of the unit.

Conclusions

There are multiple factors that contribute to perceptions of social climate. Further research is warranted in order to explore this and to identify those aspects that are linked to negative and positive social climates.
Emerging technologies and enhanced therapeutics: the future is bright, the future is nursing
Authors: Green Barrie
Published: February 2020

This year marks the year of the nurse and midwife. Barrie Green reflects on his career in nursing and what he thinks the profession can offer.
Pulse oximetry screening
Authors: Winter George F
Published: February 2020

George F Winter weighs in on pulse oximetry screening as an effective method of testing for critical congenital heart defects in newborns
Baby loss and infertility in the veterinary profession
Authors: Scroggie Nat
Published: February 2020

Vet MINDS (miscarriage, infertility, neonatal death and stillbirth) was founded in 2019. It is a group developed to support all veterinary professionals affected by baby loss and infertility. Vet MINDS is also working to increase awareness and understanding of these sensitive issues, including producing guidelines for employees and employers in the veterinary workplace.
Long-term follow-up of all-polyethylene tibial components when used for oncological endoprosthetic reconstruction
Authors: Bernthal Nicholas M. , Burke Zachary D. C. , Hegde Vishal , Upfill-Brown Alexander , Chen Clark J. , Hwang Richard , Eckardt Jeffrey J.
Published: February 2020

Aims

We aimed to examine the long-term mechanical survivorship, describe the modes of all-cause failure, and identify risk factors for mechanical failure of all-polyethylene tibial components in endoprosthetic reconstruction.

Methods

This is a retrospective database review of consecutive endoprosthetic reconstructions performed for oncological indications between 1980 and 2019. Patients with all-polyethylene tibial components were isolated and analyzed for revision for mechanical failure. Outcomes included survival of the all-polyethylene tibial component, revision surgery categorized according to the Henderson Failure Mode Classification, and complications and functional outcome, as assessed by the Musculoskeletal Tumor Society (MSTS) score at the final follow-up.

Results

A total of 278 patients were identified with 289 all-polyethylene tibial components. Mechanical survival was 98.4%, 91.1%, and 85.2% at five, ten and 15 years, respectively. A total of 15 mechanical failures were identified at the final follow-up. Of the 13 all-polyethylene tibial components used for revision of a previous tibial component, five (38.5%) failed mechanically. Younger patients (< 18 years vs > 18 years; p = 0.005) and those used as revision components (p < 0.001) had significantly increased rates of failure. Multivariate logistic regression modelling showed revision status to be a positive risk factor for failure (odds ratio (OR) 19.498, 95% confidence interval (CI) 4.598 to 82.676) and increasing age was a negative risk factor for failure (OR 0.927, 95% CI 0.872 to 0.987). Age-stratified risk analysis showed that age > 24 years was no longer a statistically significant risk factor for failure. The final mean MSTS score for all patients was 89% (8.5% to 100.0%).

Conclusion

The long-term mechanical survivorship of all-polyethylene tibial components when used for tumour endoprostheses was excellent. Tumour surgeons should consider using these components for their durability and the secondary benefits of reduced cost and ease of removal and revision. However, caution should be taken when using all-polyethylene tibial components in the revision setting as a significantly higher rate of mechanical failure was seen in this group of patients. Cite this article: Bone Joint J. 2020;102-B(2):170–176
Coned hemipelvis reconstruction for osteoporotic acetabular fractures in frail elderly patients
Authors: McMahon Samuel E. , Diamond Owen J. , Cusick Laurence A.
Published: February 2020

Aims

Complex displaced osteoporotic acetabular fractures in the elderly are associated with high levels of morbidity and mortality. Surgical options include either open reduction and internal fixation alone, or combined with total hip arthroplasty (THA). There remains a cohort of severely comorbid patients who are deemed unfit for extensive surgical reconstruction and are treated conservatively. We describe the results of a coned hemipelvis reconstruction and THA inserted via a posterior approach to the hip as the primary treatment for this severely high-risk cohort.

Methods

We have prospectively monitored a series of 22 cases (21 patients) with a mean follow-up of 32 months (13 to 59).

Results

The mean patient age was 79 years (67 to 87), and the mean ASA score was 3.3 (3 to 5). Three patients had high-energy injuries and 18 had low-energy injuries. All cases were associated fractures (Letournel classification: anterior column posterior hemitransverse, n = 13; associated both column, n = 6; transverse posterior wall, n = 3) with medialization of the femoral head. Mean operative time was 93 minutes (61 to 135). There have been no revisions to date. Of the 21 patients, 20 were full weight-bearing on day 1 postoperatively. Mean length of hospital stay was 12 days (5 to 27). Preoperative mobility status was maintained in 13 patients. At one year, mean Merle d’Aubigné score was 13.1 (10 to 18), mean Oxford Hip Score was 38.5 (24 to 44), mean EuroQol five-dimension five-level (EQ-5D-5L) health score was 68 (30 to 92), and mean EQ-5D-5L index score was 0.68 (0.335 to 0.837); data from 14 patients. Mortality was 9.5% (2/21) at one year. There have been no thromboembolic events, deep infections, or revisions.

Conclusion

The coned hemipelvis reconstruction bypasses the fracture, creating an immediately stable construct that allows immediate full weight-bearing. The posterior approach minimizes the operative time and physiological insult in this vulnerable patient population. Early results suggest this to be a safe addition to current surgical options, targeted at the most medically frail elderly patient with a complex displaced acetabular fracture. Cite this article: Bone Joint J 2020;102-B(2):155–161.
Implications of Some Selected Ethical Theories for Environmental Sustainability and Development in Nigeria
Authors: Ikegbu Ephraim Ahamefula , Enyimba Maduka
Published: February 2020

Human actions and conduct have both positive and negative effects on humankind and its environment. This is why ethicists have propounded different theories that are supposed to guide peoples’ conduct in order to distinguish the right from the wrong. Environmental ethics as an aspect of environmental philosophy attempts a justification of the rightness and wrongness of human activities as they affect other non-human members of the society or environment. Despite the efforts of both ethicists and environmentalist, humans have continued to conduct themselves in a manner, most unhealthy to the environmental resources. This is the problematic that informed this research on “Ethics, Environment and Philosophy:  Towards Sustainable Development in Africa”. The main objective is to apply selected ethical theories to the philosophical study of environment in order to ascertain their implications for sustainable development in Africa. To achieve this goal, philosophical methods of critical analysis, conceptual clarification and deduction were employed in the examination and exposition of the nature and tenets of the following selected ethical theories: Platonism, Hedonism, Subjectivism, Teleologism and Deontologism. It was discovered upon application that, these theories present both positive and negative implication for environment, philosophy and development. Hence, humans must be positively minded whenever they undertake any action be it from the perspective of Platonists, Hedonists, Subjectivists, Teleologists or Deontologists. If there must be development and sustainability in the environment, then the positive aspects of each of these theories must be harnessed to yield what this paper describes as environmental eclecticism.

Keywords: Ethical Theories, Environment, Philosophy, Sustainable Development, Environmental Eclecticism.
One Health Approach in Traditional Milk Production as a Part of Steps towards SDGs
Authors: Jevtic Marija , Belic Branislava , Glavas–Trbic Danica
Published: February 2020

The production of milk and cheese assumes activities in the field of agricultural production, veterinary health, and the use of milk and dairy products has public health significance, and can be viewed through the "one health" concept. The aim of the paper is to underline public health and sustainability significance of interconnection among agriculture, veterinary and technology. Production of hard cheese with added value from milk produced in organic and self-sustaining systems research the risks, advantages and possibilities of traditional cheese production and focused on creating conditions for organic milk and hard cheese with added value production, with precisely defined conditions: isolating land plots, livestock farms and processing facilities from possible sources of pollution, water quality, harmonized development of plant and animal production and the capability of producers for organic agriculture with the obligation to constantly innovate knowledge. The new products ensure the employment and livelihood of people in the countryside, the economic prosperity of small family farms, link the activities in the field of veterinary health and agricultural production, contribute to the development of risk-management technology, healthy chooses and compatible with SDGs.

 Keywords: One Health approach, Traditional Milk Production, sustainability, Healthy Choices, SDGs
Optimality of Tax Policy on the Basis of Comparative Analysis of Income Taxation
Authors: Abuselidze George
Published: February 2020

This paper is to determine the optimality of taxation based on a comparative analysis of income taxation in developed and developing countries. In our opinion, the main idea of income tax should be the optimal distribution of tax literacy on the basis of a direct definition of income of taxpayers or progressive taxation.

The theoretical and methodological basis of the research is the main provisions of the market economy, classical and modern tax theories, legislative and regulatory acts of foreign countries. The main part of the empirical material is from 2002 to 2017. In the process of analysis of the actual material, together with the general scientific method of research, is used: Comparative and systemic analysis, analogy, statistical data monitoring and other methods. The comparative and systemic analysis will give us an opportunity to reveal and evaluate the ways of perfection. Analogy and comparative analysis is based on variables and features, such as the of income taxes structure, withdrawal rules, rates, tax base. Statistic concept tries to explain the named phenomena by the way of fundamental analyzing of the statistic data received resulted multiple statistic observation. Previous analyses of tax rates tend to support the hypothesis that Developed countries emphasize the importance of fairness, while developing countries are mainly focused on mobilizing budget revenues and lesser consideration of fair taxation principles, since the tax system performs a fiscal function more effectively than developing countries.

 Keywords: Tax policy, income tax, tax burden, budget, well-being
Urban Form and Productivity in México 1995-2015
Authors: Montejano Jorge , Caudillo Camilo , Monkkonen Paavo , Guerra Erick , Núñez Juan M. , Garza Blanca E. , Ávila Gerardo , Medina Sandra
Published: February 2020

Worldwide, urban policies are encouraging more compact development in cities arguing environmental sustainability and higher economic productivity. However, there is limited evidence for the relationship between urban form and economic productivity outside high-income countries. While we know that workers in larger cities are more productive, existing empirical evidence on the relationship between compactness and productivity is only from high-income countries, with a productive service sector. Given that the economic base of many cities in Mexico consists of land-intensive manufacturing activities, policies promoting urban compactness have potential negative impacts on economic growth by restraining expansion.

In this paper we explore the relationship in time between urban form/spatial structure and economic productivity in Mexico, by testing the hypothesis that growing in a compact way is positively associated with labor productivity. That hypothesis is not completely rejected because several measures of urban form are positively correlated with higher levels of productivity, and other measures are negatively correlated. As the principal findings are counterintuitive, they raise questions about what is the accepted knowledge of urban growth.

Keywords: Urban Form; urban structure; productivity; manufacturing; México.
The Barriers to High-Growth Enterprises: What Do Businesses in Africa Experience?
Authors: Nwajiuba Chinyere Augusta , Igwe Paul Agu , Binuomote Micheal Olayinka , Nwajiuba Anulika O. , Nwekpa Kenneth Chukwuma
Published: February 2020

This study examines the challenges that micro, small and medium enterprises (MSMEs) face and provide insights on African business environment and entrepreneurial ecosystem. In the context of growth-oriented entrepreneurship, good policies and favourable institutional environments support firms' growth, productivity and development, while adverse formal and informal institutions constrain business development. Secondary data from World Bank Enterprise Survey (WBES) was used to capture barriers to entrepreneurship and high-growth opportunities which include – lack of finance, lack of innovation and technology, low skilled workforce, poor infrastructure, unfavorable regulations and more pervasively corruption. These barriers are evident in the micro, meso and macro environments. These have implications on the unemployment rate, poverty rates and economic growth of the African region.

 Keywords: Micro, Small and Medium Enterprises; Entrepreneurial Ecosystem; African Entrepreneurship; African Business Environments.
Curator Searching for Urban Identity; From ''Yousef Abad'' to ''Vali Asr''
Authors: Nezhad Roudabeh Tankarami Bagheri , Kateb Fatemeh
Published: February 2020

By changing the approach of modern art from the middle of the twentieth century to attention to conceptual art, art exhibitions became a spiritual movement that could provide different ways of shaping society. At the same time, the Curator becomes mediator between art and its audience. Victoria D Alexander considers the quality and impact of art on audiences in today's world dependent on distribution systems by presenting a "Better Culture Diamond" based on Wendy Griswold's Crystal Diamond Design.  In this analytic-descriptive study, its data were collected through library studies, field research and interviews, while highlighting the importance of Curator as an important part in the art distribution system by examining two Curatorial projects names "Vali Asr-First Folder" and "Yousef Abad" have come to the conclusion that contemporary Curator in Iran represent the social role of art and seek to redefine social concepts such as "urban identity" through Curatorial projects.

Keywords: Curator, Contemporary Iranian Art, Cultural Diamond, Urban Identity, Identity Crisis
Greening of Public Spaces in Cherepovets during Urbanization, 1870 - 1930s: Contradictions of Sustainable Development
Authors: Agafonova Anna B.
Published: February 2020

From the second half of the XIX century, public gardens and boulevards have become an integral part of provincial Russian towns. They played an aesthetic and sanitary-hygienic role in urban space, being, in fact, green oases in a dusty and noisy town. However, in the XX century, the functional purpose of town gardens has changed: the recreational component is being replaced by the cultural and entertainment one, which became dominant in the Soviet period. This article considers the process of urban space greening in the provincial town of Cherepovets as an example of this process and transforming the functions of the town garden. It also presents the analysis of everyday practices of using urban flora by the population of Cherepovets. The methodological basis of the work is urban environmental history. The research is based on archival and office materials, official statistics, and periodicals. Soviet power kept the tradition of new blocks greening, that formed in the pre-revolutionary period. At the same time, the entertainment and leisure functions of the recreation park supplanted the recreational function, and everyday practices of the town residents showed a dismissive and utilitarian attitude towards the town green spaces. It was due to the peculiarities of urbanization in the city. In the conditions of the constantly expanding town space and the influx of rural population, green spaces could not prevent the degradation of the natural environment, which led to the destabilization of the ecological situation in Cherepovets and prevented the sustainable development of the city.

 Keywords: urban environmental history, urban greening, a city garden, everyday practice
"Never-the-less, I Was Accepted."
Authors: Hebert Kirsten
Published: February 2020

Featured objects from the Lois Bing papers, including her original license issued by the Ohio State Board of Optometry that refers to her as "him" and "he," and a letter sent to the International Library, Archives & Museum recounting her experience as a woman applicant to The Ohio State University's optometry program.
Marx and the Indigenous
Authors: Foster John Bellamy , Clark Brett , Holleman Hannah
Published: February 2020

The "turn toward the indigenous" in social theory in the last couple of decades, associated with the critique of white settler colonialism, has reintroduced themes long present in Marxian theory, but in ways that are often surprisingly divorced from Karl Marx's critique of capitalism, colonialism, and imperialism.
MOBILE PROCESSING OF ASSEMBLY ELEMENTS OF HIGHWAYS
Authors: Safonov S. V. , Smolentsev V. P. , Smolentseva Ya. S.
Published: February 2020

The issues of preparation of connecting elements of pipelines during repair and restoration of highways in the field with a limited number of technological equipment are considered. It is shown that the replacement of traditional methods of processing on the combined types of preparation of the replaced sections of the highways for welding can improve the accuracy of the mating elements, eliminate the appearance of burrs at the junction of parts. This reduces the need for subsequent technological impacts, improves the quality of repair, provides tightness of highways, reduces the cost of operation and the period of restoration of the highways. Justified the field of rational use of combined processing techniques in the Assembly of parts after repair of main pipelines with account of operations in the field or during pre-flight tests on polygons. Here the greatest advantages are gained by the electrocontact method of separation of materials. Which does not require new power sources electric shock can be applied using as a working medium available technical water. Application of electrocontact processing method of connecting nodes on the proposed schemes ensures safe operation at low voltages the current source gives the possibility, without the complexity of mobile means of providing repairs quickly to restore the product to eliminate the causes of abnormal situations in the construction and operation of highways hydraulic systems of transport vehicles, especially in the case of use in service environments under great pressure.
THE VALUE OF EDUCATIONAL RESEARCH IN THE PROCESS OF PREPARING STUDENTS FOR ENGINEERING
Authors: Avdyukhin V. E. , Avdyukhina T. M.
Published: February 2020

Educational and research work of students is an important part of the educational process of training specialists in engineering specialties, which allows conducting research on actual problems. The article deals with the sequence of development of the topic chosen by the student. There are also examples of students’ works, which reveal not only the title of the work, but also the relevance of the topic, as well as the formulation of the research problem and conclusions. The article shows the importance of research work for the educational process of specialists and the form of presentation like reports at scientific and technical conferences, articles in engineering journals, etc.
THE ALGORITHM FOR JUSTIFYING THE CHOICE OF TECHNOLOGICAL THE MACHINING PROCESS OF A PART BASED ON A COMPLEX CRITERION FOR EVALUATING ITS EFFECTIVENESS
Authors: Bezjazychnyi V. F. , Terekhova A. S.
Published: February 2020

The proposed option justify the selection of a specified set of one technological process, based on complex criterion that takes into account the duration of the production cycle of manufacturing parts based on performance, cost and quality. The algorithm of choice of the technological process of manufacturing integrated optimization criterion is provided for solving the problem in the context of a specific base of existing technological equipment.
THE DIGITAL RADIOGRAPHY APPLICATION EXPERIENCE AT WORLDSKILLS KAZAN 2019 CHAMPIONSHIP
Authors: Bagaev K. A. , Galkin D. I. , Puzanov A. V. , Ustinov A. O.
Published: February 2020

The 45 World championship WORLDSKILLS KAZAN 2019 took place this summer in Kazan. The competition of welders was a part of the championship. The quality of welded joints produced by participants was inspected using digital and computed radiography. These technologies deeply reduced time of radiographic inspection. The quality of radiographs corresponded to improved techniques – class B according to ISO 17636-2 standard. Test arrangements used, resulted images and the role of digital radiography software were described inside the article. Several ways to improve productivity of testing were proposed. It was concluded that digital radiography is applicable for wide range of tasks; the preferred method is dependent on task and testing object.
The Case for Prostate Cancer Risk Reduction by 5-Alpha Reductase Inhibitors
Authors: Tanagho Youssef S. , Andriole Gerald L.
Published: February 2020

Overview:

Prostate cancer remains a significant public health problem. The current approach with prostate-specific antigen (PSA)-based screening has questionable effects on prostate cancer–specific mortality but is clearly associated with overdiagnosis of prostate cancer, especially relatively low-risk and low-volume tumors. Methods to decrease overdiagnosis include alterations in screening practices and, potentially, the use of 5-alpha reductase inhibitors. This article reviews the major trials that have evaluated 5-alpha reductase inhibitors in this setting: the Prostate Cancer Prevention Trial (PCPT) and the Reduction by Dutasteride Prostate Cancer Events Trial (REDUCE). Although these trials enrolled different patient populations, their findings are complementary and suggest a potential role for these agents in prostate cancer risk reduction. Use of 5-alpha reductase inhibitors results in an approximate 25% reduction in the detection of prostate cancer, reduces diagnosis of high-grade prostatic intraepithelial neoplasia (PIN), and improves benign prostatic hyperplasia (BPH)-related outcomes and the performance of PSA as a diagnostic test for aggressive prostate cancer. Side effects occur in a small percentage of men and consist of decreased sexual function and libido as well as gynecomastia. The risk of high-grade tumor development while receiving these agents is uncertain.
The Interventional Radiologist Role in Treating Liver Metastases for Colorectal Cancer
Authors: Solomon Stephen B. , Sofocleous Constantinos T.
Published: February 2020

Overview:

Interventional radiologists (IRs) have an expanding role in the treatment of liver metastases from colorectal cancer. Increasing data on the ability to treat liver metastases with locoregional therapies has solidified this position. Ablative approaches, such as radiofrequency ablation and microwave ablation, have shown durable eradication of tumors. Catheter-directed therapies—such as transarterial chemoembolization (TACE), drug-eluting beads (DEB), Y90 radioembolization, intra-arterial chemotherapy ports, and isolated hepatic perfusion (IHP)—are potential techniques for managing patients with unresectable liver metastases. Understanding the timing and role of these techniques in the multidisciplinary care of the patient is critical. Implementation of the IR clinic for consultation has enabled better integration of these therapies into the patient's overall care and has facilitated improved opportunities for clinical studies.
A Renaissance in Therapeutic Options for Pancreatic Neuroendocrine Tumors
Authors: Kunz Pamela L.
Published: February 2020

Overview:

The field of pancreatic neuroendocrine tumors (NETs) has seen a remarkable renaissance in recent years with exponential increases in published research, clinical trials, and U.S. Food and Drug Administration (FDA)-approved treatments. Surgical resection remains the foundation for management of locoregional disease. However, for patients with advanced disease, novel therapeutic options have emerged. Two separate randomized placebo-controlled studies have shown prolonged progression-free survival (PFS) with everolimus or sunitinib. Future studies are designed to answer questions about the role of somatostatin analogs as antiproliferative agents, combinations of biologic therapies, and new cytotoxic chemotherapy backbones.
Role of Doxorubicin in Rhabdomyosarcoma: Is the Answer Knowable?
Authors: Arndt Carola A. S.
Published: February 2020

Overview:

The role of doxorubicin in treatment of rhabdomyosarcoma (RMS) has been controversial for 30 years. Despite its known activity in RMS, because of its risk of cardiotoxicity, its use is not justified in low-risk patients who have an excellent chance of cure with vincristine, actinomycin with or without cyclophosphamide, and primary tumor treatment. For patients with intermediate and high risks, the risk/benefit ratio must be carefully considered. In addition, the peak incidence of RMS is in toddlers, with whom the risk of cardiotoxicity of anthracyclines is higher. A number of trials both in North America and Europe, which are reviewed in this article, have investigated the role of doxorubicin in RMS, with no conclusive outcomes. In addition, differences in risk-group assignment on two sides of the Atlantic further complicate comparisons and analyses. The current European EpSSG 2005 study for high-risk RMS (by the European definition) may come closest to giving an answer to the role of doxorubicin in RMS.
Will Disease Heterogeneity Help Define Treatment Paradigms for Gastroesophageal Adenocarcinoma? A Global Perspective
Authors: Shah Manish A.
Published: February 2020

Overview:

Cancers of the upper gastrointestinal (GI) tract form a heterogeneous group of diseases for which treatment paradigms for localized disease continue to emerge. Recently, several phase III studies in esophagus and gastric cancer that have attempted to define new standards of care have been reported. However, controversy still persists and treatment algorithms often depend on individual preference, patient referral patterns, and treatment biases. In the current era of improving quality control and standardization of care, such variations in practice present a substantial challenge for both patients and physicians. In this article, I will highlight differences in disease biology for upper GI diseases, and in particular, gastric cancer.
Predicting Clinical Outcome in B-Chronic Lymphocytic Leukemia
Authors: Kay Neil E.
Published: February 2020

Overview:

B-Chronic lymphocytic leukemia (CLL) is a relatively common B-cell malignancy that has a very heterogeneous clinical course, despite carrying the designation of “chronic,” which is a gross oversimplification. Being able to give some estimate of the rates of disease progression and overall survival (OS) at first diagnosis is, therefore, important in CLL. The ability to accurately predict response to therapy, as well as subsequent duration of response to therapy, is required given the variability of current therapies to induce and sustain treatment responses. The holy grail of prognostics would be to state with accuracy which therapy or types of therapy are best for a given patient. Although there is no complete answer to prognostic counseling, there is a continued development of markers specific to the CLL B cell and/or to its environment, as well as of testing of prognostic models. These models use both traditional and novel prognostic markers that can aid in the dissection of outcome for early-stage CLL in terms of progression risk and time to therapy. This has resulted in significant enhancement of our ability to guide and predict outcome for our patients with CLL.
Gene Patents and Personalized Medicine
Authors: Klein Roger D.
Published: February 2020

Overview:

The use of genetic information to design and guide therapies and to develop novel diagnostic procedures creates important patent issues. Patents on human gene sequences have likely helped stimulate the introduction of new biologics; however, their role and that of patents on genotype-phenotype correlations in diagnostic testing is highly controversial. Genotype-phenotype associations are at the heart of personalized medicine. The intellectual property rules by which these biologic relationships are governed have profound implications for the growth of individualized medicine.
Prolonged Febrile Neutropenia in the Pediatric Patient with Cancer
Authors: Koh Andrew Y.
Published: February 2020

Overview:

Infectious diseases continue to be major causes of morbidity and mortality in pediatric patients with cancer. Yet not all pediatric patients with cancer with fever and neutropenia are at equal risk for substantial morbidity or mortality from infection. Patients at highest risk for developing infectious complications are those with severe and prolonged neutropenia, substantial medical comorbidity, and hematologic malignancy, or recipients of stem-cell transplantation. These “high-risk” patients also have concomitant host immune deficits as well: severe mucositis, lymphopenia, hypogammaglobulinemia, and gut microbial dysbiosis. Because bacterial and fungal infections are the most common infectious complications, continuation of empirical antibacterial antibiotics that were initiated at the onset of febrile neutropenia and prompt initiation of empirical antifungal therapy in the setting of prolonged fever and neutropenia continue to be the standard of care. In high-risk patients, antibiotic therapy should be maintained until neutrophil counts have recovered. Adjunctive therapies have been shown to be ineffective (e.g., colony-stimulating factors) or necessitate further study (e.g., granulocyte infusions or keratinocyte growth factor treatment to heal mucositis). Prophylactic use of antibacterial and antifungal antibiotics in high-risk patients has shown promise but the fear of inducing antimicrobial-resistant strains remains a deterrent. Finally, the novel concepts of manipulating the host gut microbiota and/or augmenting GI mucosal immunity to prevent invasive bacterial and fungal infections in pediatric patients with cancer offers great promise, but more definitive studies need to be performed.
Identification of Novel Biologic Targets in the Treatment of Newly Diagnosed Diffuse Intrinsic Pontine Glioma
Authors: Robison Nathan J. , Kieran Mark W.
Published: February 2020

Overview:

Diffuse intrinsic pontine gliomas (DIPGs) carry an extremely poor prognosis. Standard practice has been to base the diagnosis on classic imaging and clinical characteristics and to treat with focal radiation therapy, usually accompanied with experimental therapy. As a result of the desire to avoid upfront biopsy, little has been learned regarding the molecular features of this disease. Findings from several autopsy series have included loss of p53 and PTEN, and amplification of PDGFR. Based on these and other findings, murine models have been generated and provide a new tool for preclinical testing. DIPG biopsy at diagnosis has increasingly become incorporated into national protocols at several centers, bringing the prospect of a better understanding of DIPG biology in the future. Initial analyses of pretreatment tumors cast valuable new light and establish the importance of p53 inactivation and the RTK-PI3K pathway in this disease.
Core Elements of the Patient Protection and Affordable Care Act and Their Relevance to the Delivery of High-Quality Cancer Care
Authors: Moy Beverly , Abernethy Amy P. , Peppercorn Jeffrey M.
Published: February 2020

Overview:

The Affordable Care Act (ACA) contains many provisions that affect cancer care. The provisions of health care reform aim to improve access to quality cancer care, particularly among the most vulnerable Americans. However, health care reform also offers many challenges and opportunities that affect every stakeholder in oncology. This article summarizes the ACA provisions relevant to oncology, discusses the ethical implications for the oncology caregiver, and describes the effects on specific oncology stakeholders.
The European Society of Gynaecological Oncology: Update on Objectives and Educational and Research Activities
Authors: Brantnerova Renata , Manchanda Ranjit , Colombo Nicoletta
Published: February 2020

Overview:

The European Society of Gynaecological Oncology (ESGO) is the principal European society contributing to the study, prevention, and treatment of gynecologic cancers. Founded in 1983, ESGO has more than 1,300 members in more than 40 European countries and worldwide who benefit from ESGO's innovative education and research initiatives and networking opportunities. ESGO objectives have been recently identified through a strategic planning process and include education, care, research, collaboration, awareness, and sustainability. As a leading gynecologic oncology society, ESGO holds biennial meetings where experts meet to discuss latest advances in gynecologic treatment and care. The 17th International Meeting of ESGO (ESGO 17) proved to be a resounding success, with 2,700 delegates and speakers who gathered from around the world in the cultured city of Milan, Italy. The structure of the congress included keynote lectures, debates, state-of-the art sessions, and focused sunrise sessions, together with oral and poster presentations and satellite symposia sponsored by pharmaceutical companies. For the first time, during ESGO 17 the Society organized a seminar for European patient groups with an interest in gynecologic cancers with the aim of facilitating different patientrelated activities across Europe. Moreover, The European Network of Young Gynaecologic Oncologists (ENYGO), the European Network of Gynaecologic Oncology Trial Groups (ENGOT), and the European Network of Translational Research in Gynaecological Oncology (ENTRIGO) had their own section during ESGO 17. ESGO also holds numerous workshops throughout the calendar year and provides clinical and research grants, online educational materials, webcasts, and numerous networking opportunities
Patients with Cancer, Internet Information, and the Clinical Encounter: A Taxonomy of Patient Users
Authors: Helft Paul R.
Published: February 2020

Overview:

The Internet has changed all of our lives forever and has certainly changed the way in which patients acquire information, share their stories, find others in similar circumstances, and analyze their medical situations. It is very clear that patients have widely adopted the use of online resources in the face of illness. Access to unfiltered information online clearly has positive and negative potential effects, and the introduction of Internet information into the physician-patient encounter may be managed in more or less productive ways. The means of managing such introductions of information should vary based on physicians' analyses of patients' information preferences and styles and their apparent reactions to the information. Managed well, knowledgeable patients can offer important opportunities of informed and shared decision making.
Drug Development in the Era of Personalized Oncology: From Population-Based Trials to Enrichment and Prescreening Strategies
Authors: Dienstmann Rodrigo , Rodon Jordi , Tabernero Josep
Published: February 2020

Overview:

Recent advances in tumor biology and human genetics along with the development of drugs for specific targets hold promise for an era of personalized oncology treatment. Routine use of modern technologies, such as large-scale genome sequencing, will help to unravel the specific biology of each tumor. Adding a rigorous genomic view could determine key genetic events, critical dependencies, and stratification of patients in early clinical trials. Integrating biomarker development into the early testing of novel agents might provide clinically relevant therapeutic opportunities for patients with advanced-stage cancer and also accelerate the drug-approval process. After recent success stories of therapies targeting driver molecular aberrations in genetically defined tumor subtypes, innovative clinical trials based on a strong biologic hypothesis are expected to bring further excitement to the field. In this article, we describe a new trend in biomarker-driven early drug development using enrichment and prescreening strategies. Technical and logistical obstacles that may hinder progress of this approach will be discussed, along with ethical and economic concerns.
Controversies in Adjuvant Endocrine Therapy for Breast Cancer
Authors: Johnston Stephen R.
Published: February 2020

Overview:

Adjuvant endocrine therapy for early-stage breast cancer has had the single biggest impact on improving survival from the disease—with tamoxifen alone contributing to saving many thousands of lives. In postmenopausal women, additional progress has been made by the incorporation of aromatase inhibitors into the treatment of early-stage, estrogen receptor (ER)–positive breast cancer, as several large well-conducted trials have established either “up-front” or “switch” strategies that are now widely used. To date, both have been shown to be beneficial when compared with tamoxifen alone, although controversy exists as to which approach is superior. Increasingly, extended adjuvant therapy is being considered, as “longer may be better” for some women who have an ongoing risk of recurrence beyond 5 years. However, controversy remains as to how long adjuvant endocrine therapy should be given for; in clinical practice, clinicians balance the level of risk for individual patients versus any ongoing toxicity concerns. For premenopausal women, with ER-positive breast cancer, tamoxifen remains the gold standard with uncertainty in the added overall benefit of ovarian suppression. Important clinical trials have recently been completed that may help answers this question, including whether complete estrogen deprivation using a luteinizing hormone releasing hormone (LHRH) agonist plus aromatase inhibitors (AIs) is of added benefit. In recent years, molecular profiling of ER-positive breast cancer has started to distinguish those women with a low risk of recurrence on endocrine therapy who may not need chemotherapy. Thus, with more therapy options and greater tumour stratification, modern, adjuvant endocrine therapy is becoming increasingly personalised to suit each individual patient's risk.
PI3 Kinase in Cancer: From Biology to Clinic
Authors: Workman Paul , Clarke Paul
Published: February 2020

Overview:

The discovery and clinical development of small-molecule inhibitors of the phosphatidylinositide 3-kinase (PI3 kinase) family of lipid kinases have marked a remarkable 20-year journey that follows the progressive developments in cancer biology over the last few decades: from hypothesis-driven, basic cancer research that began with viral oncogenesis and developed in the 1960s and 70s, through the discovery of individual mutated oncogenes and tumor suppressor genes in 1970 and 80s and the linkage of these cancer genes to signal transduction pathways in the 1990s, to all large-scale genome-wide sequencing, functional screening, and network biology efforts today. Thus, PI3 kinase research began with the discovery in 1985 of a new type of enzyme activity associated with viral oncogenesis. It benefited greatly from the discovery of wortmannin and LY294002 as PI3 kinase inhibitors and chemical tools in late 1980s to mid-90s. Alongside these tools, genetic validation of PI3 kinase as a target initially involved activation by upstream oncogenic receptor tyrosine kinases and RAS mutation, together with overexpression and amplification of the p110α catalytic isoform of PI3 kinase and frequent loss of the tumor suppressor and negative regulator of PI3 kinase activity, PTEN. As PI3 kinase drug development began, further stimulus came from the discovery through genome sequencing of mutations in PIK3CA, which encodes p110α and is the most frequently mutated kinase in the human genome. From these beginnings, there are now many PI3 kinase inhibitors in clinical trials and more in preclinical development. We review progress, current challenges, and future opportunities in this article.