bluuebunny/crossref_metadata_2025 huggingface dataset:
The Value of Laparoscopic Staging in Upper Gastrointestinal Malignancy
Authors: Conlon Kevin C. P. , Minnard Emery A.
Published: February 2020

The goal of the clinical staging of malignant disease is to accurately define the extent of disease, direct appropriate therapy and avoid unnecessary intervention. Recent reports have suggested that laparoscopy can play a useful and complementary role in the staging of abdominal malignancy. This paper reviews the recent experience with laparoscopy in the staging of patients with upper gastrointestinal malignancy.
Tolerability of Nonsteroidal Antiandrogens in the Treatment of Advanced Prostate Cancer
Authors: McLeod David G.
Published: February 2020

This review compares the tolerability profiles of the three currently available nonsteroidal antiandrogens, flutamide, bicalutamide and nilutamide. Pharmacological effects associated with blockade of the androgen receptor are frequent with all three drugs. Gynecomastia and breast pain are seen more frequently during antiandrogen monotherapy than during combination with medical or surgical castration or castration alone, and the reverse is true for hot flashes, which are a side effect of castration. Gastrointestinal symptoms are also common to all three drugs, but diarrhea occurs more frequently in flutamide studies than in bicalutamide or nilutamide studies. Hepatotoxicity has been seen with all three antiandrogens, but acute, reversible hepatitis and fatal fulminant hepatitis have also been reported with both nilutamide and flutamide. All three drugs have been associated with asymptomatic elevations in aminotransferases and may reduce hemoglobin levels. Adverse events that have been reported with nilutamide include interstitial pneumonitis, delayed adaptation to darkness after exposure to bright light and alcohol intolerance. To date, bicalutamide appears to have some advantage over flutamide and nilutamide in terms of tolerability.
Adjuvant Chemotherapy in Advanced Head and Neck Cancer
Authors: Amrein Philip C. , Colecchi Christopher H. , Finkelstein Dianne M. , Fabian Richard L.
Published: February 2020

Purpose. Chemotherapy has been tested extensively in conjunction with standard therapy in the treatment of head and neck cancer, primarily in the form of neoadjuvant chemotherapy, but few trials have shown a survival benefit. Although a few studies have suggested that adjuvant chemotherapy given after standard treatment may improve survival, to date these trials have been troubled by various problems in design and dosing. The purpose of our trial was to determine the feasibility of giving moderately intensive chemotherapy exclusively after standard therapy, and to determine whether survival appeared to be improved as measured against historical data.

Methods. We used adjuvant chemotherapy in two groups of patients with squamous cell carcinoma of the head and neck: group A consisted of 46 patients with newly diagnosed stage III and IV disease, and group B consisted of 46 patients with relapsed disease having been treated with salvage surgery. In all patients, the intended adjuvant chemotherapy consisted of two cycles of combination cisplatin, bleomycin, and infusional 5-fluorouracil (5-FU) given three weeks apart, followed by four cycles of bolus methotrexate, 5-FU, and bleomycin given every two weeks.

Results. In group A, the two-year survival was 72%. In group B, the two-year survival was 58%.

Conclusion. Compared to the vast majority of similarly staged patients with head and neck cancer reported in the literature, the survival of our group seemed considerably better, suggesting that a definitive randomized study testing this schedule of adjuvant chemotherapy is warranted.
Moving Forward with Capecitabine: a Glimpse of the Future
Authors: Biganzoli Laura , Martin Miguel , Twelves Chris
Published: February 2020

Learning Objectives

After completing this course, the reader will be able to:

Appreciate the emerging role of capecitabine monotherapy in the treatment of advanced breast cancer. Explain the current status of capecitabine monotherapy as first or second line therapy in patients with advanced breast cancer. Describe the rationale and current status of capecitabine combination treatment of breast cancer. Balance the safety profile of capecitabine with available alternative treatment options for the treatment of advanced breast cancer.

Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com

Oral capecitabine is a useful chemotherapy for metastatic breast cancer, both as monotherapy and in combination with other cytotoxic drugs. The proven activity of capecitabine has provided the rationale to explore its use earlier in the course of the disease and in combination with other agents, particularly those known to further upregulate thymidine phosphorylase (TP) concentrations in tumor tissue.

The efficacy and safety of capecitabine monotherapy compares favorably with cyclophosphamide/methotrexate/5-fluorouracil in chemotherapy-naïve patients and with paclitaxel in anthracycline-pretreated patients. Therefore, for patients whose disease has progressed during or following anthracycline treatment, but for whom capecitabine/docetaxel combination therapy or taxane monotherapy is not appropriate, capecitabine monotherapy is an attractive alternative to established i.v. treatments.

In combination, capecitabine plus paclitaxel, which further upregulates TP in tumor tissue, has demonstrated high activity in two phase II studies in advanced/metastatic breast cancer. Similarly, combination with vinorelbine showed promising activity in pretreated metastatic breast cancer patients, and triple combinations with an anthracycline and a taxane or cyclophosphamide have proven to be highly active. In the future, capecitabine may be combined with novel biologic agents, such as trastuzumab and bevacizumab; the former combination has already shown encouraging results in a pilot trial. Confirmatory studies for many of these combinations and phase III trials versus standard therapy are now warranted.
Understanding the Financial Needs Following Diagnosis of Breast Cancer in a Setting with Universal Health Coverage
Authors: Kong Yek-Ching , Wong Li-Ping , Ng Chiu-Wan , Taib Nur Aishah , Bhoo-Pathy Nanthini Thevi , Yusof Mastura Mohd , Aziz Azlina Firzah , Yehgambaram Prathepamalar , Ishak Wan Zamaniah Wan , Yip Cheng-Har , Bhoo-Pathy Nirmala
Published: February 2020

Background

A diagnosis of cancer negatively impacts the financial wellbeing of affected individuals as well as their households. We aimed to gain an in-depth understanding of the financial needs following diagnosis of breast cancer in a middle-income setting with universal health coverage.

Materials and Methods

Twelve focus group discussions (n = 64) were conducted with women with breast cancer from two public and three private hospitals. This study specifically focused on (a) health costs, (b) nonhealth costs, (c) employment and earnings, and (d) financial assistance. Thematic analysis was used.

Results

Financial needs related to cancer treatment and health care varied according to the participant's socioeconomic background and type of medical insurance. Although having medical insurance alleviated cancer treatment-related financial difficulties, limited policy coverage for cancer care and suboptimal reimbursement policies were common complaints. Nonhealth expenditures were also cited as an important source of financial distress; patients from low-income households reported transport and parking costs as troublesome, with some struggling to afford basic necessities, whereas participants from higher-income households mentioned hired help, special food and/or supplements and appliances as expensive needs following cancer. Needy patients had a hard time navigating through the complex system to obtain financial support. Irrespective of socioeconomic status, reductions in household income due to loss of employment and/or earnings were a major source of economic hardship.

Conclusion

There are many unmet financial needs following a diagnosis of (breast) cancer even in settings with universal health coverage. Health care professionals may only be able to fulfill these unmet needs through multisectoral collaborations, catalyzed by strong political will.

Implications for Practice

As unmet financial needs exist among patients with cancer across all socioeconomic groups, including for patients with medical insurance, financial navigation should be prioritized as an important component of cancer survivorship services, including in the low- and middle-income settings. Apart from assisting survivors to understand the costs of cancer care, navigate the complex system to obtain financial assistance, or file health insurance claims, any planned patient navigation program should also provide support to deal with employment-related challenges and navigate return to work. It is also echoed that costs for essential personal items (e.g., breast prostheses) should be covered by health insurance or subsidized by the government.
Real-World Evidence in Oncology: Opportunities and Limitations
Authors: Di Maio Massimo , Perrone Francesco , Conte Pierfranco
Published: February 2020

The analysis of real-world evidence to answer clinical and policy-relevant questions in the field of oncology has gained increased interest in recent years. This article highlights the strengths and weaknesses of the use of real-world evidence in cancer care.
Treatment Patterns and Health Resource Use Among Patients with Metastatic Gastroenteropancreatic Neuroendocrine Tumors Treated at a Tertiary Referral Center
Authors: Jalbert Jessica J. , Casciano Roman , Meng Jie , Brais Lauren K. , Pulgar Sonia J. , Berthon Anthony , Dinet Jerome , Kulke Matthew H.
Published: February 2020

Background

Although an increasing number of treatments have become available for patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs), there remains little consensus on treatment sequence and its impact on health care resource use (HRU). We sought to describe treatment patterns and HRU, in a cohort of patients with metastatic GEP-NETs treated at a tertiary referral center in the U.S.

Materials and Methods

We identified patients with a well-differentiated, metastatic GEP-NET evaluated at Dana-Farber Cancer Institute between July 2003 and May 2015. For these patients, we describe the sequence of treatment regimens received for their disease, together with associated HRU.

Results

We identified 682 patients with advanced GEP-NETs. Of these patients, 597 (87.0%) initiated ≥1 treatment over the follow-up period. The mean age at diagnosis was 58.5 years, 50.2% were men, and 94.0% were white. A total of 83.1% initiated a somatostatin analog (SSA) as their first-line treatment, with 55% and 31% of patients continuing with second- and third-line therapies. A total of 31.2% of patients with SSAs underwent dose escalation to above standard dose. In this setting, patients with pancreatic neuroendocrine tumors were more commonly treated with cytotoxic regimens than other NET tumor types and also had higher HRU.

Conclusion

Our study suggests that, at a tertiary referral center, patients with advanced NETs commonly received multiple courses of treatments. Our data suggest a clear preference for use of SSAs as a first-line treatment for patients with advanced NETs, with SSAs commonly escalated and continued throughout the course of treatment in combination with other regimens.
Leveraging the Potential Synergy Between Patient-Reported Outcomes and Body Composition Analysis in Patients with Cancer
Authors: van Seventer Emily E. , Fintelmann Florian J. , Roeland Eric J. , Nipp Ryan D.
Published: February 2020

In the oncology setting, data on the relationship between body composition, patient-reported outcomes, and patient outcomes are limited. This editorial outlines the available data and discusses the potential for using such information as a strategy to predict and enhance patient outcomes.
In Reply
Authors: Flynn Kathryn E. , Vanness David J. , Myers Judith M. , D'Souza Anita , Schiffer Charles A. , Thompson James E. , Atallah Ehab
Published: February 2020

This letter to the editor responds to recent comments by Strohbehn and Daugherty in Mistaking the Trees for the Forest.
Phase I Trial of a Modified Vaccinia Ankara Priming Vaccine Followed by a Fowlpox Virus Boosting Vaccine Modified to Express Brachyury and Costimulatory Molecules in Advanced Solid Tumors
Authors: Collins Julie M. , Donahue Renee N. , Tsai Yo-Ting , Manu Michell , Palena Claudia , Gatti-Mays Margaret E. , Marté Jennifer L. , Madan Ravi A. , Karzai Fatima , Heery Christopher R. , Strauss Julius , Abdul-Sater Houssein , Cordes Lisa , Schlom Jeffrey , Gulley James L. , Bilusic Marijo
Published: February 2020

Lessons Learned

Modified vaccinia Ankara-Bavarian Nordic (MVA-BN)-Brachyury followed by fowlpox virus-BN-Brachyury was well tolerated upon administration to patients with advanced cancer. Sixty-three percent of patients developed CD4+ and/or CD8+ T-cell responses to brachyury after vaccination. BN-Brachyury vaccine also induced T-cell responses against CEA and MUC1, which are cascade antigens, that is, antigens not encoded in the vaccines.

Background

Brachyury, a transcription factor, plays an integral role in the epithelial–mesenchymal transition, metastasis, and tumor resistance to chemotherapy. It is expressed in many tumor types, and rarely in normal tissues, making it an ideal immunologic target. Bavarian Nordic (BN)-Brachyury consists of vaccination with modified vaccinia Ankara (MVA) priming followed by fowlpox virus (FPV) boosting, each encoding transgenes for brachyury and costimulatory molecules.

Methods

Patients with metastatic solid tumors were treated with two monthly doses of MVA-brachyury s.c., 8 × 108 infectious units (IU), followed by FPV-brachyury s.c., 1 × 109 IU, for six monthly doses and then every 3 months for up to 2 years. The primary objective was to determine safety and tolerability.

Results

Eleven patients were enrolled from March 2018 to July 2018 (one patient was nonevaluable). No dose-limiting toxicities were observed. The most common treatment-related adverse event was grade 1/2 injection-site reaction observed in all patients. Best overall response was stable disease in six patients, and the 6-month progression-free survival rate was 50%. T cells against brachyury and cascade antigens CEA and MUC1 were detected in the majority of patients.

Conclusion

BN-Brachyury vaccine is well tolerated and induces immune responses to brachyury and cascade antigens and demonstrates some evidence of clinical benefit.
Cancer-Related Fatigue: Guidelines for Evaluation and Management
Authors: Portenoy Russell K. , Itri Loretta M.
Published: February 2020

Fatigue is a highly prevalent condition among cancer patients. Although most cancer patients report that fatigue is a major obstacle to maintaining normal daily activities and quality of life, it is seldom assessed and treated in clinical practice. Few studies have explored its epidemiology, possible etiologies, or management. Cancer-related fatigue, which recently was accepted as a diagnosis in the International Classification of Diseases 10th Revision-Clinical Modification, reduces physical, psychological, and social functioning and results in significant distress for patients and caregivers. Adequate evaluation of fatigue must do more than simply assess severity. The assessment should clarify other characteristics, determine the degree to which fatigue interferes with the activities of daily living, and identify potential causes, including the underlying disease, disease treatments, intercurrent systemic disorders, psychological disorders, and other conditions. Possible primary therapies include modification of the patient's drug regimen, correction of metabolic abnormalities, and pharmacologic treatments for anemia (e.g., epoetin alfa), depression, or insomnia. Other symptomatic interventions include specific drug treatments, exercise, modification of activity and rest patterns, cognitive therapies, sleep hygiene approaches, and nutritional support. Pharmacologic approaches, which are supported by limited studies and growing clinical experience, include psychostimulant drugs, corticosteroids, and possibly other therapies. Although additional research is needed to further identify the causes and corresponding treatment of fatigue, practitioners should routinely assess and treat patients who may benefit from currently identified interventions, because fatigue can profoundly undermine the quality of life of patients with cancer.
Long-Term Survivors of Childhood Cancer: The Late Effects of Therapy
Authors: Schwartz Cindy L.
Published: February 2020

The successful treatment of pediatric malignancy by multimodality therapy has improved the outcome for children with cancer. It has been estimated that 0.1% of individuals 20 years of age are survivors of childhood cancer. This represents a large cohort nationally who, with maturation, may be increasingly beset by the medical and social consequences of treatment.

The study of long-term effects of cancer chemotherapy has grown enormously in the past decade. Any side effect that does not resolve after the completion of therapy is a long-term effect of therapy. Side effects recognized during the therapeutic period are usually addressed by the treating physicians. More problematic are those effects of therapy that are subclinical at completion of therapy but manifest years later. These are the true late effects of therapy and are the focus of this review.

The cytotoxic effects on maturing tissues become apparent only with development. Thus physical, intellectual and pubertal development as well as reproductive potential may be impossible to assess for a decade or more, depending upon the age at the time of treatment. Nonetheless, the ability to predict the likelihood of a given adverse outcome is enormously helpful to the survivor and may allow for the mitigation of severe effects.

Organ injury may also be subclinical initially. With aging and additional stress, compensatory mechanisms may fail. The development of effective screening methodologies may be essential for early interventions. Lifestyle changes may reduce exposure to further toxins and mutagenic agents such as alcohol and cigarette smoke that may lead to secondary malignancy, particularly if compounded in some instances by genetic predisposition.

Programs for survivors of childhood cancer were developed within pediatric oncology. As the children become adults, the likelihood of continued care at the initial treating institution decreases. Oncologists and other health care professionals who become responsible for the health care of this maturing cohort will need to understand the risks engendered by childhood cancer therapy.
A Staff Dialogue on Do Not Resuscitate Orders: Psychosocial Issues Faced by Patients, Their Families, and Caregivers
Authors: O'Shea Elizabeth M. , Penson Richard T. , Stern Theodore A. , Younger Jerry , Chabner Bruce A. , Lynch Thomas J.
Published: February 2020

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.

The following case of a woman who developed lymphoma was discussed at the July and August, 1997 Schwartz Center Rounds. There were considerable delays and uncertainties in the diagnosis, which was followed by an unpredictably chaotic clinical course. Although she had made it clear to her doctor that she did not want “heroic measures,” she had unexpectedly rallied so many times that her son and her husband wanted her doctors to do everything possible to keep her alive, including the performance of cardiopulmonary resuscitation (CPR). The clinical benefit of CPR in the event of cardiac arrest in those with cancer is discussed, as are do not resuscitate (DNR) orders, living wills, and healthcare proxies. In addition, the issues that surround DNR status, including who should discuss DNR status with a patient, and how and when it should be discussed, are reviewed. Staff raised concerns about the effect of discussing DNR status on the doctor-patient relationship, and wondered whether writing DNR orders adversely affect the care of patients.
The Diagnosis and Treatment of Metastatic Spinal Tumor
Authors: Bilsky Mark H. , Lis Eric , Raizer Jeffrey , Lee Henry , Boland Patrick
Published: February 2020

Metastases to the spine represent a challenging problem in an oncology practice. Treatment decisions require multidisciplinary review. Radiation therapy remains the primary treatment for metastatic spinal tumor, but advances in radiation therapy, chemotherapy, and surgery have changed the roles of each and lead to improved patient outcomes. Regardless of the treatment, diagnosis and treatment before the development of significant neurologic and functional deficits improve outcomes. Physician awareness and appropriate imaging greatly assist in the early detection of tumor.
Acetic Acid Fermentation of Soybean Molasses and Characterisation of the Produced Vinegar
Authors: Miranda Lucas Caldeirão Rodrigues , Gomes Rodrigo José , Mandarino José Marcos Gontijo , Ida Elza Iouko , Spinosa Wilma Aparecida
Published: February 2020

Soybean molasses is a by-product from the production of protein concentrate from soybean meal that predominantly contains sugars, with sucrose as the major component. In Brazil, soybean molasses is used for animal feed or it is discarded, although some industries use it to produce ethanol. This study aims to evaluate the parameters required for the acetic acid fermentation of soybean molasses, and characterise the resultant vinegar. To study the most suitable parameters for the acetic acid fermentation, vinegar was produced from the alcoholic fermentation of soybean molasses through eight fermentation cycles: five for adaptation and three for production. The average acidity of the acetic acid fermentation product was 50.60 g/L, with an acetic acid fermentation yield, total yield of acetic acid in broth and productivity 65.01 %, 92.76 % and 0.033 g/(L·h), respectively. The vinegar produced from soybean molasses had an acidity of 5.07 % (m/V), residual ethanol content 0.17 % (m/V), sugars 7.86 % (m/V), dry extract 14.67 % (m/V), ash 2.27 % (m/V) and a density of 1.023 g/cm3. The contents of total phenolics and isoflavone decreased after the alcohol and acetic acid fermentations. Moreover, the isoflavone profile of the fermented product comprised only three forms: daidzein, glycitin and genistin. According to our results, 3460 L of vinegar can be produced for every tonne of soy molasses, with an acetic acid concentration of 40 g/L, the minimum required by the legislation on vinegar production. Thus, these findings demonstrate that soy molasses represents a useful raw material for the production of vinegar.
Project YES! Youth Engaging for Success: Arthur Davison Children's Hospital Pathology Laboratory's Standard Operating Procedures for HIV viral load and resistance testing v1
Authors: Denison Julie , Mwansa Jonathan , Miti Sam
Published: February 2020

Arthur Davison Children's Hospital Pathology Laboratory’s Standard Operating Procedures used to test Project YES! (Youth Engaging for Success) HIV viral load and resistance testing.
Köyceğiz-Dalyan Özel Çevre Koruma Bölgesi’ndeki Anadolu sığla ormanlarında yarasa (Chiroptera) aktivitesinin belirlenmesi
Authors: URKER Okan , YORULMAZ Tarkan
Published: February 2020

Türkiye
yarasalarının ormanlarımızdaki varlığı, aktivitesi ve orman için ne ifade
ettiğine dair çalışmalar yok denecek kadar azdır. Pek çok canlı için barınma,
korunma, beslenme ve üreme ortamı olan orman ekosistemi, yarasalar için de kimi
zaman tüneme ve barınma yeri iken kimi zamanda beslenme alanlarıdır. Bu çalışma
ile yarasaların orman ekosistemlerindeki varlığı ve çeşitliliği ele alınmıştır.
Bu kapsamda Muğla ilinde
Köyceğiz-Dalyan Özel Çevre Koruma Bölgesi sınırlarında yer alan Anadolu sığla
ormanları içerisindeki yarasa tür çeşitliliği, tür zenginliği ve aktivite
yoğunluğu analiz edilmiştir. Temmuz 2017-Temmuz 2019 dönemleri arasını kapsayan
bu çalışma süresince 30 hektar ile 250 hektar genişlikleri arasında değişen 10
farklı Anadolu sığla ormanı parçasında ampirik gözlemlerin yanı sıra ağ kurulumu,
atrap kullanımı, 18 adet yarasa kutusu yerleştirimi, 1 adet manuel
ve 2 adet full-spektrum yarasa dedektörü (toplamda 67gün-1978 adet ses kaydı) kullanımı metot olarak
tercih edilmiştir. Tüm bu çalışmaların sonucunda toplamda 11 yarasa türünün
varlığı Anadolu sığla ormanlarında ve yakın çevresindeki bağlantılı
habitatlarda kaydedilmiş olup bu türlerden Myotis daubentonii, Myotis
emarginatus, Pipistrellus nathusii, Pipistrellus pygmaeus, Plecotus
macrobullaris bölge için ilk kez kaydedilmiştir.
Synthesis of Robust PID Controllers by Double Optimization Method
Authors: Zhmud V. A. , Vostrikov A. S. , Ivoilov A. Yu. , Sablina G. V.
Published: February 2020

The design of adaptive controllers allows to solve the problem of control of the object with non-stationary parameters. However, if the parameters of the object do not change too much or if only a certain interval of their change is known, it may turn out that an adaptive controller is not required, since the problem can be solved with the help of a robust controller. The robust controller allows to provide an acceptable quality of control even if the parameters of the mathematical model of the object change in some predetermined interval. A method of designing such controllers is known as the method of numerical optimization of the controllers used in the ensemble of systems in which the models of objects are different and the models of controllers are identical. The ensemble uses object models with extreme parameter values. The disadvantages of this method are too many systems that need to be modeled and optimized at the same time if there are several parameters to be changed. In addition, the worst combination of model parameters may not be boundary, but middle, in this case this method is not applicable. This article offers and analyzes an alternative method of designing a robust controller on a numerical example. The essence of this method is the numerical optimization of the regulator for the model with the worst combination of the values of all modifiable parameters. The search for the worst combination of parameters is also carried out using the method of numerical optimization. In this case, a combination of model parameters is found in which the best relation of regulator coefficients gives the worst result of the system. The problem is solved in several optimization cycles with alternating cost functions. The utility of the method is illustrated numerically by an example of a third order dynamic object with a series linked delay element.
Artificial Intelligence in Mechatronic Systems: Problems of Embodiment
Authors: Sergeev S. F.
Published: February 2020

The article deals with the issues related to the possibility and limitations of technological creation of artificial systems endowed with consciousness and acting subject existing in the world of artificial subjective reality. The problems of creating an artificial personality in the given parameters are shown. The main obstacle to the creation of intelligent systems is the lack of progress in our understanding of the nature and mechanisms of the brain in the process of generating mental image and organization of purposeful activities. The transfer of psychology data to the engineering sphere is ineffective due to the difference in conceptual and instrumental areas of these disciplines. The approaches of synthetic psychology and pedagogy designed to provide a solution to the problem of creating an artificial subjective reality and techno-genic modification of man are presented.
Legal Problems of Strategizing in Environmental Law
Authors: Zhavoronkova N. G. , Vypkhanova G. V.
Published: February 2020

Quite a large number of papers in contemporary legal literature are devoted to documents of strategic planning. The recent adoption of numerous concepts, strategies, programmes, and plans, including those in the environmental field, requires not only scientifically sound development, harmonization and approval of planned indicators and benchmarks envisaged in those documents but also their accomplishment. In this regard, the paper highlights the necessity of research and improvement of strategizing as a management function that not only fixes final goals in strategic documents but also provides for the mechanism for their achievement, including monitoring of the planned indicators. Strategising acquires particular importance in the ecological area characterized by instability, deterioration of the quality of the environment under the influence of economic and other activities, its negative impact on the health of the population.

The paper considers the issues of strategizing as an independent process of an organizing ecologic and legal activity and the mechanism of ensuring environmental rights of citizens enshrined in the Constitution. The author has shown the influence of strategizing on efficiency of the state and municipal regulation in the area of environmental protection, sustainable use of natural resources and environmental safety.

The paper justifies the necessity of separating ecological strategizing as an independent type of strategizing and institutionalizing of such relations in environmental law. The paper identifies the problems of strategizing in the field of environmental development, including the procedure of preparation, coordination and adoption of documents of strategic planning, development of criteria and planning indicators, monitoring of their achievement, the activities of relevant authorities and their interaction. The paper has determined the problems and mandatory conditions for the creation of an effective mechanism of ecological strategizing including its information support.

As the result of the study, the author suggests new approaches to the strategizing in the field of environmental development and its improvement.
Main Reasons for the Crisis in the United States Civil Litigation in the Second Half of the Twentieth — Early Twenty-First Century
Authors: Knyazev D. V.
Published: February 2020

In the 1970s and 1980s, a crisis of the judicial system (litigation explosion) broke out in the United States. It manifested itself in a multiple increase in the number of appeals to the courts, the duration of cases, and the legal expenses of the parties. Under the pressure of the idea of reducing the burden on the judicial system, the US civil procedure undergone changes. This paper is a part of a larger study of the nature of these transformations. Thus, the author analyzes the causes and factors that contributed to the development of this crisis. It is established that they are largely related to the sphere of civil procedure. In particular, these are features of the distribution of legal costs between the parties to the dispute — the so-called American rule, which does not impose the legal costs of the opponent on the losing party and therefore does not prevent the presentation of obviously unfounded claims (as in the case of the "loser pays" rule). The possibility of a contingency fee contract between the lawyer and the plaintiff, combined with other factors, led to the emergence of a huge industry based on damages, including class actions. The 1938 Federal Rules of Civil Procedure significantly simplified the requirements for a claim, which also contributed to an increase in the number of appeals. Abuse by the parties during the evidence disclosure procedure became a significant problem, since it is during this procedure that the parties incur the maximum costs. Identifying the factors that contributed to the development of the crisis will allow us to better understand the essence of the changes that the US civil procedure has undergone in recent decades.
Improving the Legal Framework for Social Partnership in the Eurasian Economic Union States under International Labor Standards
Authors: Khasenov M. Kh.
Published: February 2020

In the paper, the author examines the legal mechanism of social partnership in the States of the Eurasian Economic Union for compliance with international labor standards. The status of ratification of the ILO conventions in the field of social partnership in the EAEU Member States is defined, and a brief description of international standards in the exercise of the right to freedom of association, the institution of employee representation, and the implementation of forms of social partnership is given. The author concludes that some approaches to the legislative regulation of collective labor relations differ from international standards, and in some cases contradict them. Based on the analysis of labor legislation, gaps and conflicts in the regulation of collective bargaining procedures, mutual consultations and exchange of information, as well as ensuring the right to freedom of association and representation of employees in social partnership are identified. There is no uniformity in the definition and regulation of forms of social partnership in the EAEU States. The legislation of the EAEU States is characterized by heterogeneous conditions for conducting consultations: in some countries, this form of social partnership is implemented through the mechanism of coordination of important decisions and acts of the employer (Belarus, Kyrgyzstan) with employees’ representatives, in others through the mechanism of taking into account the opinion of the representative body of employees (Kazakhstan, Russia). In Armenia, the labor legislation does not provide for a counselling mechanism. The national legislation of a number of States contains rules that violate the right to freedom of association. The Committee of experts on the application of ILO conventions and recommendations has repeatedly noted this in its reports and recommendations. The author formulates recommendations for improving the legal framework of social partnership in the EAEU States in order to implement international obligations. In particular, it is recommended that the legislation of the EAEU States provide for a more systematic and clear mechanism for regular exchange of information between employees and the employer and their representatives as an independent form of social partnership.
Pendampingan Penulisan Artikel Ilmiah Layak Jurnal Nasional Ber-ISBN Berbasis Sitasi Online Bagi Tenaga Pendidik Se-Kabupaten Bondowoso
Authors: Arifin Imron , Juharyanto Juharyanto , Sultoni Sultoni , Saputra Bagus Rachmad , Adha Maulana Amirul , Bhayangkara Athalla Nauval , Rizkita Karine , Wulandari Putri
Published: February 2020

Tujuan pengabdian masyarakat melalui program pendampingan sitasi berbasis mendeley dalam penulisan artikel layak jurnal bereputasi bagi tenaga pendidik se Kabupaten Bondowoso ini adalah membekali pengetahuan dan keterampilan menyusun artikel kepada para tenaga pendidik se Kabupaten Bondowoso. Luaran dari kegiatan pendampingan tersebut antara lain: artikel layak jurnal berbasis sitasi otomatis dengan plug in mendeley dan artikel pengabdian.Strategi pelaksanaan kegiatan ini antara lain workshop, penugasan, pendampingan individual, fasilitasi pencarian jurnal untuk penerbitan artikel. Strategi pelaksanaan dilaksanakan secara terintegrasi dengan metode: ceramah, tanya jawab, diskusi, modelling, discovery, problem based learning, dan penugasan, serta advokasi.Hasil yang diperoleh adalah peserta memiliki kemampuan dan keterampilan dalam penyusunan artikel berbasis sitasi otomatis dengan plug in mendeley. Hal tersebut diketahui dari luaran berupa draf artikel berbasis sitasi otomatis dengan plug in mendeley yang disusun para guru yang dihasilkan dalam dua hari workshop. Kata kunci— pendampingan, penulisan, karya tulis ilmiah, artikel berbasis sitasi otomatis. Abstract The aim of community service through Mendeley-based citation assistance programs in writing articles worthy of reputable journals for educators in Bondowoso Regency is to equip knowledge and skills in preparing articles for educators in Bondowoso Regency. The outputs of the mentoring activities include: proper articles based on automatic citation-based journals with plug-in delays and service articles. The strategy for carrying out these activities includes workshops, assignments, individual assistance, facilitation of journal search for article publishing. The implementation strategy is implemented in an integrated manner with methods: lecture, question and answer, discussion, modeling, discovery, problem based learning, and assignment, as well as advocacy. The results obtained are participants have the ability and skills in preparing automatic citation-based articles with plug-in mendeley. This is known from the output in the form of an automatic citation-based article with a plug-in mendey prepared by the teachers produced in two days of the workshop.Keywords— assistance, writing, scientific papers, automatic citation-based articles
Gaziantep İli Nizip İlçesi Antepfıstığı Ağaçlarının Yaprak ve Toprak Örnekleri ile Beslenme Durumunun Belirlenmesi
Authors: BOZGEYİK Tuğba , ÇİMRİN Kerim Mesut
Published: February 2020

Çalışma, Gaziantep ili Nizip ilçesini
temsilen seçilen antepfıstığı
bahçelerinin beslenme durumlarını
belirlemek amacıyla yürütülmüştür.
Bu amaçla, 0-30 ve 30-60 olmak üzere iki farklı derinlikten 30 adet toprak
örneğinde bünye, CaCO3,
pH, EC, organik madde, KDK, bazı makro-mikro besin elementleri ile bir kısım ağır
metal analizleri ve aynı bahçelerden alınan 15 adet yaprak örneğinde kimi besin
elementi analizleri yapılmıştır.  Elde edilen
bulgulara göre, araştırma alanı
topraklarının %
63.34’ü kil, % 26.66’sı killi tın, % 6.66’sı kumlu killi tın ve % 3.34’ü ise
siltli kil bünyeye sahip olduğu, toprakların tamamının hafif alkalin
reaksiyonlu ve tuzsuz sınıfında yer aldığı, organik madde içeriklerinin tümünde yetersiz olduğu belirlenmiştir. Toprakların % 26.66’sının fosfor, %10’unun magnezyum,
% 46.66’sının demir, % 46.66’sının çinko, % 93.33’ünün bor içeriği yönünden yetersiz
olduğu belirlenmiştir. Topraklarda ağır metal açısından  kirliliğe rastlanmazken, yaprak örneklerinin % 40’ının azot, tamamının fosfor, % 93.3’ünün potasyum, % 26.6’sının demir, % 40’ının bakır, % 13.33’ünün mangan, % 26.66’sının bor içeriği yönünden noksan olduğu belirlenmiştir. Sonuç olarak elde
edilen bulgular, Gaziantep ili Nizip ilçesi antepfıstığı bahçelerinde beslenme
sorunları olduğunu göstermektedir. Bölgede çalışmalarının artırılarak uygun doz
ve formda gübreleme yanında özellikle, organik gübre kullanımının teşvik
edilmesi ve yağışın düşmediği dönemlerde mutlaka sulanma yapılması
gerekmektedir.
Acil servise başvuran migren hastalarının özürlülük, anksiyete ve depresyon oranlarının belirlenmesi
Authors: ARSLAN Şenol , DELİCE Orhan
Published: February 2020

Amaç:
Çalışmamızın amacını acil servise başvuran migren hastaları ile sağlıklı
kontrol grubu arasındaki anksiyete, depresyon ve özürlülük oranlarının belirti
düzeylerinin karşılaştırılması ve bu düzeylerin hastalık süresi ve atak sıklığı
ile ilişkisinin incelenmesi olarak belirledik.

Gereç ve Yöntemler:
Migren tipi baş ağrısı olan hastalara Hastane anksiyete ve depresyon ölçeği
(HAD) ve Migren Özürlülük Değerlendirme Ölçeği (MIDAS) kullanılarak hazırlanmış
olan form dolduruldu. Kontrol grubuna ise Hastane anksiyete ve depresyon ölçeği
dolduruldu. Daha sonrasında bu hastaların ve kontrol grubunun anksiyete,
depresyon ve özürlülük oranları tespit edilip demografik verilerle beraber karşılaştırmalar
yapıldı.

Bulgular: Çalışmamızda
cinsiyet ve atak sıklığı ile midas skorları arasında anlamlı pozitif bir ilişki
bulunmuştur. Deney ve kontrol grubunda, anksiyete ile depresyon açısından
anlamlı bir farklılık olup olmadığına bakılmış olup, analiz sonucunda, 0.00
anlamlılık seviyesinde, bağımsız değişkenin hem anksiyetehem de depresyon için
etkisi istatistiksel olarak anlamlı bulunmuştur. Deney grubunda anksiyete,
depresyon ve Midas skorları kendi aralarında değerlendirildi.  Analiz sonucunda, Midas ile anksiyete ve
depresyon arasında pozitif bir ilişki bulunmuştur. Deney ve kontrol grubunda
depresyon ve anksiyete arasındaki ilişkiye bakıldı. Analiz sonucunda; Her iki
grupta da depresyon ve anksiyete arasında 0.00 düzeyinde pozitifi anlamlı bir
ilişki bulunmuştur.

Sonuç: Migreni
olan hastaların depresyon ve anksiyetelerini kontrol edersek, bu hastaların hayat
standartlarını artırıp migrenden kaynaklanan özürlülük oranlarını
azaltacağımızı düşünüyoruz. Bu nedenle migren tanısı olan hastaların
psikiyatrik komorbiditeler açısından mutlaka sorgulanması ve bu hastalar için
multidisipliner bir yaklaşım modeli sergilenmesi gerektiğini düşünmekteyiz.
Serum levels of Pentraxin-3, Vaspin, Apelin and troponin in decompensated heart failure patients
Authors: KAYA Bedri Caner , DEMİRBAĞ Recep
Published: February 2020

Aim:
The aim of the present study is to evaluate the levels of these biomarkers in
decompensated heart failure (HF) patients.Material and Methods:
44
decompensated HF patients and 32 healthy individuals were enrolled in the study
as patient and control groups. Transthoracic echocardiography and serum
troponin I, vaspin, apelin, and PTX-3 levels besides routine laboratory
analysis were performed for both groups.Results: Troponin
I and vaspin were higher, apelin was lower in patient group (for all,
p<0.05).PTX-3 levels were higher in patient group, but it was not
statistically significant (p=0.133). Troponin I and PTX-3 levels were
significantly decreased (for both, p<0.05) with in-hospital-HF treatment. Vaspinand
apelin levels did not show any significant change (p=0.938, p=0.121,
respectively). Vaspin had an independent relationship with troponin, apelin had an independent relationship with PTX-3,
troponin and apelin had independent relationship with vaspin, and finally
troponin,PTX-3, and vaspin had independent relationship with apelin in
decompensated HF patients.

Conclusion: Troponin I and vaspin levels were elevated,and serum apelin
levels were reduced in decompensated HF patients. PTX-3 levels were higher in
HF patients, but it was not statistically significant. Vaspin and apelin levels
did not change with HF stabilization in HF patients, but troponin I and PTX-3
levels were significantly decreased.t
Uso de redes neurais artificiais e modelos de regressão para estimar volume de espécies nativas em Portel, Pará - Brasil
Authors: Cardoso Silva Marcos Vinicius , De Andrade Ramos Yasmim , Coimbra Limeira Mathaus Messias , Bueno Coelho Maria Cristina , Ferreira dos Santos André , Giongo Marcos , Luiz Erpen Mauro
Published: February 2020

O objetivo do presente estudo foi comparar as estimativas do volume obtidas por equações de regressão com redes neurais artificiais (RNA) para áreas nativas sob plano de manejo na região de Portel, estado do Pará, a partir dos dados de cubagem rigorosa de 864 árvores com DAP ≥ 45 cm de Unidades de Produção Anual (UPA) manejada em 2015 em área de floresta ombrófila densa de terra firme. O processamento dos dados visou selecionar o melhor modelo de regressão considerando a UPA 1. A equação com melhor desempenho foi escolhida de acordo com a raiz do erro quadrado médio em porcentagem (RQME%), correlação de Pearson e gráfico de resíduos percentuais. Para a seleção da melhor rede e a sua respectiva comparação com a melhor equação de regressão ajustada, as estatísticas utilizadas foram: RQME%, correlação de Pearson entre o volume observado e estimado e bias. O modelo com melhor desempenho foi o Spurr ( sendo posteriormente comparada com a melhor RNA obtida a partir do treinamento dos dados. Verificou-se que ambos os métodos apresentaram estatísticas de ajuste e precisão aceitáveis, com potencial utilização para estimar o volume da espécie. No entanto, a RNA mostrou-se superior evidenciando maior precisão em relação à regressão na estimativa de volume.

 

Palavras chave: Inteligência artificial, cubagem rigorosa, árvores individuais, manejo florestal.
Árboles del Valle Central de Costa Rica: reproducción de gravilia (Grevillea robusta A. Cunn.)
Authors: Rojas-Rodríguez Freddy , Torres-Córdoba Gustavo
Published: February 2020

Se presenta una breve descripción del árbol “Gravilia” (Grevillea robusta A. Cunn.), información sobre fenología como base para la recolección de frutos, el manejo de las semillas, la viverización y el proceso de germinación.

Palabras clave: Grevillea robusta, fenología, manejo de semillas, viverización, germinación, árboles.
Voice from Within: Student Teachers’ Perception on Factor Influencing Willingness to Speak English in Language Classroom at English Education Study Program of UIN Raden Fatah Palembang
Authors: KURNIA ZAKIAH
Published: February 2020

The need for good communication skill in English has become a demand that continues to increase. One frustration is that they have spent years studying English, but they still cannot speak it. Therefore in this case, it is necessary to know what are the things that influence willingness of the students to speak English in the language class. This study investigated the student teachers’ perception on factor influencing willingness to speak English in language classroom at English Education Study Program of UIN Raden Fatah Palembang. I used qualitative study with case study design. The participants of this study were nine students of English Education Study Program of UIN Raden Fatah Palembang in the academic year of 2016/2017. The participants were chosen by using purposeful sampling technique. I employed interview technique to collect the data. The result showed that a number of factors contributed to student teachers’ willingness to speak. These factors included motivation, selfbeliefs’, collocutor, and object discussion.
Las doce teorías que fundamentan la combinación y la unificación de la Psicoterapia
Authors: López Salinas José Félix Cosme
Published: February 2020

Se construye el fundamento teórico necesario para la unificación de la psicoterapia a través de la conjunción de doce teorías pertenecientes a las Ciencias de la Complejidad. Específicamente se expone la manera en cómo se entretejen las teorías cognitiva, de la red epistemológica, de las nuevas lógicas, de la singularidad, de la bifurcación, de los atractores, de las catástrofes, de la fractalidad, del caos, del eclecticismo, de la transdisciplinaridad, de la diversidad, de la organización y de la complejidad. Al final se discute cómo todas ellas se expresan en el acto de la psicoterapia.The necessary theorical basement to unify the Psychotherapy is built though the joint of twelve theories which belong to the Complexity Sciences. It is shown the specific way of how are woven the following theories: cognitive, epistemological, the new logics, the singularity, bifurcation, atractors, catastrophes, chaos, eclecticism, transdisciplinarity, diversity, organization and complexity. How all of them are expressed in the act of psychotherapy is discussed.