bluuebunny/crossref_metadata_2025 huggingface dataset:
Vector model
Authors: Freeman Ray
Published: November 2023

NMR phenomena can be described by several different theoretical models, some of them quite sophisticated in their mathematical formalism. However, for a chemist who wishes to use NMR spectroscopy as a tool to solve structural problems, simplicity is probably the most attractive feature of any proposed model, provided that the treatment is valid for the most common experiments. Density operator theory is elegant and comprehensive, but the resulting algebra becomes unwieldy for systems of three or more coupled spins, and it is then difficult to retain a clear picture of the physical processes involved. Physical pictures are important to chemists. Much of their work involves the visualization of the complex three-dimensional relation¬ ships characteristic of molecular interactions, and hence geometry is probably preferable to algebra. The chemist is, above all, a pragmatist, and does not normally seek more complicated solutions than are absolutely necessary for the task in hand. This is why the vector model is so important for the understanding of modern pulsed Fourier transform NMR and the myriad variations on this theme.
Collagen VI: A beaded filament-forming collagen
Authors: Ricard-Blum Sylvie , Dublet * Bernard , der Rest Michel van
Published: November 2023

First called intimal collagen [199] or short-chain collagen due to the small size of its triple helical domain, collagen VI was first isolated from pepsin digests of the intima of human aorta [918] and from bovine placenta [923, 929]. It was designated as collagen VI in 1983 [683, see 11, 46, 47 for reviews] and forms beaded filaments with a periodicity of 100 to 110 nm. Table 2 gives the Swiss Prot database entries for collagen VI.
Paraneoplastic manifestations of renal cell carcinoma
Authors: Masood Nehal , Gold, Philip J , A.Thompson John
Published: November 2023

The triad of hematuria, pain, and a palpable mass is the classic initial presentation for renal cell carcinoma (RCC), but is present in only 10 per cent of patients (de Kernion et al. 1995). More often, nonspecific signs and symptoms, such as fever, malaise, anorexia, and weight loss, may precede other evidence of RCC by weeks to years, or may be found incidentally during routine evaluation (Table 5.1). Many symptoms of RCC are caused by the elaboration by the tumor of specific polypeptide hormones. These substances are responsible for the ‘ paraneoplastic’ effects of the cancer, rather than the direct invasion of vital structures by the tumor or its metastases. Other etiologies for paraneoplasia include peptide production by normal cells in response to tumor, anti- body made in response to tumor, and other mechanisms.
Basic biology and clinical behavior of renal cell carcinoma
Authors: Pantuck Allan J , Zisman, Amnon , Belldegrun Arie
Published: November 2023

The clinical behavior of a tumor reflects its underlying genetic abnormalities, which lead to molecular changes that ultimately result in microscopic and macroscopic pathology. A comprehensive understanding and appreciation for the factors that impact upon the biologic behavior of renal cell carcinoma (RCC) is essential for understanding the natural history of the disease in patients. This is important not only for planning therapy, but also for prediction of disease outcome. Useful prognostic factors should be clinically relevant, should correlate with outcome, and should provide independent significance that is not available from other factors already in use. For RCC, tumor grade and stage remain the most useful, available predictors of clinical outcome.
Radiologic imaging: computerized tomography and magnetic resonance imaging
Authors: Barbaric Zoran L
Published: November 2023

Before attempting to describe how computerized tomography (CT) and magnetic resonance imaging (MRI) contribute to diagnosis, staging, and follow- up of renal and adrenal carcinoma, a few words about the terminology a radiologist uses will hopefully make this chapter more understandable to the practising clinician. Both CT and MRI studies can be obtained with or without contrast material. Sometimes both studies are required. CT contrast is iodine-based and injected intravenously with a power injector at a rate of 1–5 cm3/s for a total of 100–150 cm3. Intravenous (IV) CT contrast is contraindicated in patients with impaired renal function (creatinine < 1.5 mg/dl) and a history of prior severe allergic reaction.
PET imaging in renal cancer
Authors: Seltzer Marc , Filmont Jean Emmanuel
Published: November 2023

Positron emission tomography (PET) is a biological whole-body imaging modality that allows clinicians and research scientists to non-invasively image biochemical processes such as the glucose utilization of tumors. Over the past several years, PET has emerged as an important clinical tool for diagnosing, staging, and monitoring therapy in patients with cancer. Unlike computed tomography (CT) or magnetic resonance imaging (MRI), which primarily examine anatomy, PET provides a functional assessment of tumor biology.
The use of systemic chemotherapy in the treatment of metastatic renal cell carcinoma
Authors: Godley Lucy A , Vogelzang Nicholas J
Published: November 2023

The treatment of metastatic renal cell cancer has remained a challenge for clinicians despite the many chemotherapy agents that are now available. Renal cell cancer is highly resistant to traditional cytotoxic chemotherapeutic drugs, and few are useful in the management of metastatic disease. An approach utilizing immunological agents, especially interleukin-2 and interferon alpha, along with selected chemotherapeutic agents has proven to be the most effective, with response rates averaging about 20 per cent. This chapter will review the use of chemotherapy, hormonal agents, and combination regimens that include immunotherapy to treat advanced renal cell cancer.

merely long- term stabilization of disease (Stadler et al. 1999).
Immunotherapy for metastatic disease— the French experience
Authors: Ngérier Sylvie
Published: November 2023

By the end of the 1980s, Dr Steve Rosenberg (Surgical Branch, National Cancer Institute, Bethesda, Maryland, USA) had opened up the field of immunotherapy in oncology by reporting the first results of trials of interleukin-2 (IL-2) in the treatment of advanced cancers (Rosenberg et al. 1985, 1987). Melanoma and renal cell carcinoma (RCC) had already been identified as the tumors most sensitive to this newly available agent. The enthusiastic clinical development of this cytokine, despite its severe side- effects, was explained by the repeated failures observed with conventional cytotoxic drugs in metastatic renal cancer (Yagoda et al. 1995).
Gene therapy for metastatic kidney cancer
Authors: Alsikafi Nejd F , Sokoloff Mitchell H
Published: November 2023

In the year 2000, kidney tumors (of which renal cell carcinoma (RCC) predominates) were diagnosed in more than 31 200 people and resulted in nearly 12 000 deaths (Greenlee et al. 2000). While localized lesions are amenable to cure with surgery, metastatic disease continues to be a major source of morbidity and mortality. Approximately one-third of patients with RCC present with evidence of disseminated disease. Moreover metastasis will subsequently develop in an additional 30 to 40 per cent of patients with localized or locally advanced disease (Figlin 1999; Vogelzang and Stadler 1998). While the 5-year survival of patients with localized disease treated surgically is greater than 90 per cent, 5-year survival of patients with metastatic RCC remains less than 30 per cent despite recent advances in systemic therapies (Figlin 1999; Vogelzang and Stadler 1998).
Brain metastase
Authors: Rubino Gregory J
Published: November 2023

For patients with renal cell carcinoma (RCC), one of their most frightening moments occurs when they learn that their disease has spread to the central nervous system (CNS). Most physicians hold the perception that patients with RCC metastatic to the brain have a poor prognosis (Halperin and Harisiadis 1983; Decker et al. 1984). While brain metastases generally occur during the later stages of cancer, many modern treatment options are highly effect- ive in controlling intracranial disease. This chapter reviews the incidence of CNS metastasis, the symptoms, patient prognostic factors, and historical and current treatment options.
Adrenocortical carcinoma
Authors: Schulick Richard D , Brennan Murray F
Published: November 2023

Adrenocortical carcinoma is a rare tumor with an annual incidence of between 0.5 and 2 cases per million (Brennan 1987; National Cancer Institute 1975). This is in contrast to the incidence of adenomas of the adrenal gland yielding a relatively frequent finding of an ‘ incidentaloma’ in patients having cross- sectional imaging of their abdominal cavities. As many as 2 per cent of all autopsies show adenomatous changes in the adrenal gland (Brennan 1987).
Open adrenalectomy: indications and surgical options
Authors: Jr E Darracott Vaughan
Published: November 2023

We are fortunate to be operating in an era where we have precise biochemical tests that, coupled with radiographic localization techniques, allow us to identify accurately patients who warrant adrenalectomy (Vaughan and Blumenfeld 1998).
Historical background: social psychiatry and crisis theory
Authors: Gersons Berthold P R
Published: November 2023

Tracing back the steps our predecessors went through in order to develop improved perspectives on mental health for mankind helps us better appreciate how we have arrived at our present lev els of understanding. Sometimes such an historical perspective is used to serve the notion of how wrong our predecessors were and how right we seem to be now. A book that exemplifies this lat ter approach is ‘A history of Psychiatry’ by Edward Shorter (1997). No mention of crisis theory or its pioneers can be found in this publication. The main message is that psychoanalytic theory has been a source of delay for the corning into existence of the jewels of biological psychiatry. Such historians of psychiatry are inclined to forget about the oscillating pictures one gets from looking into the history of science.
A systematic review of single psychological interventions (‘debriefing’) following trauma. Updating the Cochrane review and implications for good practice
Authors: Rose Suzanna , Bisson, Jonathan , Wessely Simon
Published: November 2023

We live in an age of accountability and clinicians are increasingly being asked (particularly in public-funded services) to justify the interventions they use. In many countries, there is a move towards evidence-based practice (EBP) and systematic reviews form an important element of such an approach. In a nutshell, ‘The underpinning of evidence based practice is that when we intervene in the lives of others we should do so on the basis of the best evidence available regarding the likely consequences of that intervention’ (Macdonald, 1998). This chapter highlights the increasing importance of using an evidence based approach when considering early interven tion after trauma and highlights findings of an updated Cochrane Collaboration Review of ‘debriefing’ (Rose et al. 2001).
Early reactions to traumatic events. The diversity of diagnostic formulations
Authors: McFarlane Alexander C
Published: November 2023

Historically, the traditions of medical nosology have, in many regards, had little to offer to the typology of acute reactions to traumatic stressors. Very few psychiatrists or psychologists would, in the course of normal practice, see patients in the immediate aftermath of such events. The theoretical frameworks that have underpinned psychiatric diagnosis are derived largely from sub classifications of psychosis, and the various typologies used to separate pathological anxiety and depression into specific disorders. In most clinical settings the few cases that have provided opportunities for observation of the acute reactions to life events have generally been patients presenting with severe reactions such as psychotic episodes or suicide attempts. The lens for clin ical observation and diagnosis has therefore been highly blinkered by the orthodox concepts applied to help categorizing and understanding patients’ reactions in the face of adversity.
Biomineral types and functions
Authors: Mann Stephen
Published: November 2023

Of the 20 to 25 essential elements required by living organisms, H, C, 0, Mg, Si, P, S, Ca, Mn and Fe are common constituents of over 60 different biological minerals. Among these, calcium has a special place since it is not only exceedingly widespread but also the common constituent of familiar skeletal structures such as bones and shells. It is interesting to note at the outset that whereas bones are composed of calcium phosphate, shells are built from calcium carbonate. The reasons for this significant difference are not known. In both cases, however, the inorganic mineral is intimately associated with a complex assemblage of organic macromolecules—the organic matrix—that is of fundamental importance.
Introduction: the need for a new approach
Authors: Elder Andrew , Holmes Jeremy
Published: November 2023

It is paradoxical that family doctors—who conduct more psychiatric consultations than any other group of professionals in the Health Service—are often not considered ‘mental health ‘ practitioners. In our view a new approach is needed to mental health thinking, which places primary care—with its accompanying differences in emphasis and philosophy—as the base from which to build a fully integrated Mental Health Service. At least 30 per cent of consultations with general practitioners have a direct psychological component and the figure far higher if indirect psychological aspects are included. The vast majority of this distress is contained within the general practitioner ‘s setting: no more than 10 per cent of such patients are ever referred on to specialist services. Despite this—recent shift in Government policy notwithstanding—there is a continuing tendency among policy makers, researchers, and writers to adopt the paradigms, perspectives, and classificatory systems of the secondary services when considering primary care.
Body and mind
Authors: Westcott Richard
Published: November 2023

This chapter looks at the interaction of body and mind, mind and body as experienced in primary care. I start with a particular patient, who appears with what might be called a classic psychosomatic disorder. I show her presentation and the GP ‘s reaction: the diagnostic process and approach to management. Recourse to an authoritative resource reveals illuminating differences between the worlds of secondary and primary care. I consider the nature of paradigms, their role in science generally, and how these (too often) implicit structures can be both helpful, yet obstructive in a consideration of the interaction between body and mind. It becomes clear that primary care discarded the biomedical model some time ago and has subsequently (albeit perhaps unwittingly) moved on from positivism, through social construction into a quasi post-modern world. Secondary care, however, has progressed less evenly, with some specialties in the teaching hospital apparently still firmly rooted in the earlier paradigm.
Systemic family practice in primary care
Authors: Graham Hilary , Mayer Robert
Published: November 2023

We start by quoting from one of our co-authors who has inspired us to introduce family approaches to our general practice work (see Chapter 5):I have always envied GPs for being—at least in theory—in a position of picking up problems early. . . you have to work pretty hard as a teenager to get a referral to a child psychiatrist: attempted hanging or killing the cat, but the rest stays in general practice. I found I could help GPs get at families with teenagers earlier in the story, and encourage parents to take control again. Pathologizing the individual teenager didn’t ‘t seem to help much and GPs can become good at seeing more than one person at a time. It proved to me how useful the family systems approach can be when it comes to prevention or early intervention—and general practice seems the ideal site for this.
Substance misuse
Authors: Crome Ilana , Day Ed
Published: November 2023

General practitioners and their teams are in an excellent position to intervene in drug and alcohol problems. Treatment in the primary care setting can avoid the stigma that many people feel about attending a specialist addiction service and the teams may have the advantage of a long-term perspective on the patient ‘s problems, as well as contacts with potential co-therapists such as family and friends. Furthermore, some of the developing evidence for the effectiveness of both pharmacological and psychological interventions in addictive behaviour has been derived from work in primary care settings.
Who Gets multiple sclerosis?
Authors: Matthews Bryan , Rice-Oxley Margaret
Published: November 2023

There are many unusual facts concerning the distribution of MS in the world population which must be taken into account in any comprehensive theory of cause of the disease. Before describing these I must emphasize that all figures relating to the prevalence of MS are approximate. Early cases are often not diagnosed because the symptoms have been slight or fleeting. The figures are also influenced in the opposite direction because, no matter how careful the exam, in action, there are always some patients thought to have MS who are subsequently found to have some quite different disease. Investigators are forced to classify their patients in separate categories of diagnostic certainty or doubt, the most usual being: possible, probable, or definite, as defined by clinical features, now assisted by results of laboratory and imaging tests. The difficulties in diagnosis must be remembered when discussing the pattern of who gets MS and who does not.
Using the Internet for clinical care
Authors: McKenzie Bruce C
Published: November 2023

Evidence-based practice (EBP) involves the integration of high-quality research evidence with individual clinical expertise and the explicit, conscientious, and judicious consideration of the best available evidence in making healthcare decisions.

EBP resources on the Web include articles underpinning the development of the EBP paradigm; information and products from EBP organizations and networks; critical appraisal guides/checklists; clinical calculators; and materials to answer your clinical questions—databases, structured abstracts, systematic reviews, critically appraised articles and topics, and health technology assessment reports.
Using the Internet for medical education
Authors: McKenzie Bruce C
Published: November 2023

The exponential growth in medical information demands changes in the way medical students are taught and core competencies required.

Educational goals rather than the technology itself must drive the use of technology in medical education.

The Internet promotes the development of self-directed learning strategies essential for effective medical practice and provides greater flexibility than traditional methods, allowing students to learn where and when they choose.

The Internet is used by patients who will increasingly turn to their medical practitioners for guidance about how and where to seek quality information sites. Practitioners require the skills to allow them to respond to such requests.
Using the Internet for patient education
Authors: McKenzie Bruce C
Published: November 2023

More consumers are going online and numbers are rising all the time; health information is commonly sought.

Consumer health information comes from a wide variety of sources including government-sponsored institutions and healthcare providers; information from authoritative organizations and societies; universities, academics, and medical group Web sites; information from commercial concerns; and patient self-support and mutual support groups.

Strategies to cope with Internet printouts brought to the consultation include drawing up ground rules for what can be brought to the consultation; discussing quality issues with the patient; requesting an advance preview of what the patient is going to bring; using the Internet yourself to dovetail with what the patient has found; and letting the patient do your research.
Preparing for teaching
Authors: Hartley Sarah , Gill Deborah , Carter Frances , Walters Kate , Bryant Pauline
Published: November 2023

To be a good teacher you need to be organized, have the skills to get your message across, and want to teach. Good planning underpins all good teaching sessions, and no matter how skilled, charismatic, or humorous a teacher, if they are repeatedly late, disorganized, or teach postgraduates about the basics of diabetes, students will not turn up and make pointed comments on course evaluation forms.
Poisson Approximation
Authors: Barbour A D , Holst Lars , Janson Svante
Published: November 2023

The Poisson `law of small numbers' is a central principle in modern theories of reliability, insurance, and the statistics of extremes. It also has ramifications in apparently unrelated areas, such as the description of algebraic and combinatorial structures, and the distribution of prime numbers. The law of small numbers is only an approximation. In 1975, a new technique was introduced, the Stein-Chen method, which makes it possible to estimate the accuracy of the approximation in a wide range of situations. This book provides an introduction to the method, and a varied selection of examples of its application, emphasizing the flexibility of the technique when combined with a judicious choice of coupling. It also contains more advanced material, in particular on compound Poisson and Poisson process approximation, where the reader is brought to the boundaries of current knowledge.
Introduction
Authors: Longford Nicholas T
Published: November 2023

Clustering is an omnipresent feature in our everyday lives. We associate people with their families, neighbourhoods, companies, or classrooms; responses to the items of a questionnaire or test with the respondents; manufactured products with their batches, dates of manufacture, workshops, or factories, and so on.
Ethnicity and human biology
Authors: Macbeth Helen
Published: November 2023

This chapter has a very broad mandate in its consideration of ethnicity and human biology. Ethnicity as a term has already been discussed in the first chapter. I wish to draw attention to two essential aspects: firstly, it is found in the processes and transmission of ideas of belonging to a group by those in that group, and secondly it is the way people outside the group classify people into that group. Furthermore, it is all the factors, especially those visible and audible, which confirm, and which are recognized as confirming, the classification both to those within and to those without.
The pregnant and post-partum patient
Authors: Mynors-Wallis Dr Laurence , Moore Dr Michael , Maguire Mr Jon , Hollingbery Mr Timothy
Published: November 2023

Mood and anxiety disorders are common during childbearing years. In this chapter the pregnant and the post-partum patient will be considered separately. It has been suggested that pregnancy is protective against psychiatric disorders; however, there is a clear risk of relapse in women who discontinue prophylactic psychotropic medication. There is an increased risk of psychiatric disorder in the first 3 months post-partum, although no increased incidence in the full year post-partum.
Functional neuroanatomy of the human motor cortex*
Authors: Geyer Stefan , Zilles Karl
Published: November 2023

Until the second half of the twentieth century, it was widely believed that the cortical motor system of humans could be subdivided into three regions: the primary motor cortex (area 4) in the caudal wall and on the vertex of the precentral gyrus, the supplementary motor area further rostral on the mesial aspect of the frontal lobe (mesial part of area 6), and the premotor cortex on the lateral aspect of the frontal lobe (lateral part of area 6).
Multicellular organisms—origins as cell colonies
Authors: Fenchel Tom
Published: November 2023

The multicellular organisms represent the next major transition in the evolution of life (after the origin of the first prokaryotic cells and the origin of the eukaryotes). Three groups: fungi, plants, and animals have evolved independently, but they remain relatively close to each other on the eukaryote phylogenetic tree (Chapter 12, Figure 12.8). The fungi descend from a group of fungi-like protists (the chytrids), the plants from green algae, and the animals from a group of flagellates (choanoflagellates).
Physical disability in myotonic dystrophy
Authors: Phillips Margaret F , Mathieu Jean
Published: November 2023

The concept of impairment, disability and handicap was originally defined by the World Health Organization (WHO) in 1980 as the International Classification of Impairments, Disabilities and Handicaps (ICIDH) (World Health Organization 1980). In that model, an impairment was defined as ‘any physiological, anatomical or histological anomaly or alteration’ and a disability as ‘any disturbance resulting from an impairment in the capacity to perform a physical or mental activity considered normal for a human being (depending on his/her biological characteristics)’.
Readings in Credit Scoring
Authors: Thomas Lyn C , Edelman David B , Crook Jonathan N
Published: November 2023

Credit scoring is one of the most successful applications of statistical and management science techniques in finance in the last forty years. This unique collection of recent papers, with comments by experts in the field, provides excellent coverage of recent developments, advances and aims in credit scoring. Aimed at statisticians, economists, operational researchers and mathematicians working in both industry and academia, and to all working on credit scoring and data mining, it is an invaluable source of reference.
Measures for comparing scoring systems
Authors: Wilkie A D
Published: November 2023

The purpose of this note is to describe a variety of measures that can be used to compare different scoring systems with one another. A description of these measures may assist practitioners in deciding which they may find useful for their own purposes and also when discussing scoring systems with clients. It may also help clients to understand what practitioners mean when discussing what may be described as the ‘relative power of different scoring systems. when applied to the same data or to different populations. Different individuals may find some measures more intuitively a appealing than others.

In every case it is assumed that each ‘case in a given data set can be classified either as ‘good ‘ or as ‘bad ‘. For each case a number of characteristics are recorded, each of which is usually subdivided into discrete categories.

A scoring system is a set of (usually integer) scores, one score being associated with each possible category within each relevant characteristic. The score for the case is the sum of the appropriate scores for the categories applicable to that case.
Mental health services for older people: a developing countries perspective
Authors: Prince Martin , Trebilco Peter
Published: November 2023

By 1990, a clear majority (58 per cent) of the world ‘s population aged 60 years and over was already to be found living in developing countries. By 2020 this proportion will have risen to 67 per cent. Over this period of 30 years this oldest sector of the population will have increased in number by 200 per cent in developing countries as compared to 68 per cent in the developed world (Murray and Lopez, 1996). This demographic transition will be accompanied by unprecedented economic growth and industrialization, and by profound changes in social organization and in the pattern of family life. For older people, mental health conditions are an important cause of morbidity and premature mortality.
Psychogeriatric services: trends in Canada
Authors: Shulman Kenneth I , Cohen Carole A
Published: November 2023

Canada will see a dramatic increase in its elderly population, rising from 13 per cent of the general population (approximately 30 million total population) in 2001 to 22 per cent in 2031, an increase due primarily to the bulge of baby boomers reaching old age. Compared to the US.
Psychogeriatric services: current trends in Asia
Authors: Chiu Helen
Published: November 2023

In 2000, the world’s population was 6 billion, 58 per cent of which lived in Asia. The population of Asia is ageing and the percentage of people aged 65 and above will be doubled between 1960 and 2020, from 4.2 per cent to 8.8 per cent. Life expectancy will rise from 66 to 77 years between 2000 and 2050.
Integrated service delivery and quality of care
Authors: Melding Pamela
Published: November 2023

The chief difficulty Alice found at first was in managing her flamingo . and when she had got its head down, and was going to begin again, it was very provoking to find that the hedgehog had unrolled itself, and was in the act of crawling away: besides all this, there was generally a ridge or furrow in the way wherever she wanted to send the hedgehog to, and, as the doubled-up soldiers were always getting up and walking off to other parts of the ground, Alice soon came to the conclusion that it was a very difficult game indeed. The Queen ‘s croquet-ground, Chapter 8, Alice in Wonderland. Lewis Carroll, 1866 In thinking about integrating services, we need to begin at the ‘centre ‘ with the patient. Consider the following scenario. Sandy Jones, a former head teacher, is 75 years old and had a stroke yesterday.
Gathering information and becoming an ‘expert patient’
Authors: Campling Frankie , Sharpe Michael
Published: November 2023

‘Expert patients’ are people suffering with a long-term illness who have chosen to become well informed about how to manage both their disease and their illness. They may do this in two ways—firstly by finding out as much as possible about its causes, management, and prognosis, and by experimenting to see what suits them; secondly, they may work towards managing their illness in a partnership with their doctors. Another way of describing ‘expert patients’ is to call them ‘empowered patients’. They have chosen to take as much control over their illness and their lives as is possible and appropriate.
Using Activity and Exercise
Authors: Campling Frankie , Sharpe Michael
Published: November 2023

You may feel that, because of your illness, exercise is just not possible. Well, our message is that the right kind of exercise will help anybody, with what-ever condition! Even if you are completely bedridden, passive exercise with someone else moving your limbs for you would be a help. Appropriate exercise is the key phrase. You may need to get expert advice to discover just what is right for you, but keeping your body in the best condition possible in the circumstances really is a good idea.
Improving Your Personal Relationships
Authors: Campling Frankie , Sharpe Michael
Published: November 2023

Illness often changes relationships. It puts a strain on both sides. You may be grieving for the past, for your lost job perhaps, for the things that you once could do, or for the changed image of yourself. However, your illness may have affected other people too. People close to you may also have a lot to grieve for. Carers may have had to take on the responsibility for house-work or earning the money, and so have had to give up things they valued. They may be missing out on things they enjoyed previously on their own or with you. Their grief needs to be acknowledged too. You may feel that they are not caring enough; they may feel that you are asking too much. There may be a lot of resentment on both sides. All of this adds difficulties.
Carcinogenic mechanisms in mesothelioma: effects of asbestos on cell signalling events, transcription factors, and inflammatory cytokines
Authors: Swain W A , Mossman B T
Published: November 2023

Occupational exposure to asbestos fibres, particularly crocidolite asbestos, is associated causally with the vast majority of malignant mesothelioma (MM) . The mechanisms of asbestosinduced carcinogenesis have been intensively studied in an effort to establish preventive and therapeutic approaches to MM and other asbestos-related diseases. Studies have largely focused on the properties of asbestos fibres that are important in the development of MM and the mechanisms of action of asbestos in the multistage carcinogenic process.
Surgical and multimodality approaches to the management of operable malignant mesothelioma
Authors: Rusch D J Boffa V W
Published: November 2023

Historically, malignant pleural mesothelioma (MPM) was considered to be a rapidly and universally fatal disease. Most patients were thought to die within 2 years of diagnosis, and this nihilism led to insufficient attention being given to the staging and treatment of MPM. However, during the past two decades, a few investigators have carefully defined the natural history and studied the treatment of MPM. These studies established that patients with stage Ia tumours can be expected to live for up to 2 years without treatment, and patients who undergo surgical resection for stage I and II disease usually live more than 3 years. Effective surgical and multimodality treatments are now available. The surgical mortality of 31 per cent reported by Butchart et al.in 1976 for extrapleural pneumonectomy has decreased to 4–5 per cent, becoming similar to the mortality of standard pneumonectomy and making is possible to offer surgery as a routine part of treatment for MPM [2]. Adjuvant radiotherapy after extrapleural pneumonectomy is now an accepted means of controlling locoregional disease (Chapter 15). Newer chemotherapeutic regimens, including gemcitabine–cisplatin and pemetrexed–cisplatin, have shown encouraging response rates [3,4] In this chapter we address the staging of MPM and the surgical and multimodality treatment of this disease.
Systemic chemotherapy for malignant pleural mesothelioma
Authors: Rudd J P C Steele R M
Published: November 2023

Chemotherapy can be an effective treatment for patients with malignant pleural mesothelioma (MPM). It is arguably the most important of current treatment approaches because few patients are suitable for radical surgery. Palliative surgery is of considerable value but it must be performed by specialist surgeons for optimum benefit [1]. Radiotherapy can control symptoms but does not improve survival . For the majority of mesothelioma patients, who generally have International Mesothelioma Interest Group (IMIG) stage III or IV disease, the major treatment decision is whether or not to opt for a course of chemotherapy. In our experience patients often hold strong views for or against chemotherapy. Some patients in the UK will not accept chemotherapy at any stage of their disease. Alternatively, other patients are determined to proceed with chemotherapy or other drug therapy ‘whatever the side effects’.
Intrathoracic photodynamic diagnosis and treatment of malignant mesothelioma with photodynamic therapy or hyperthermia
Authors: Baas P
Published: November 2023

Diagnosis of pleural malignancies such as malignant pleural mesothelioma (MPM) is sometimes difficult. Despite the relatively good diagnostic yield of cytological examination for malignancies, the differentiation between MPM and adenocarcinoma is often a problem. Histological samples are then required for a definitive diagnosis. Reports on the efficacy of thoracoscopies indicate that in 90 per cent of the cases this procedure is conclusive; however, at least 10, and preferably, 20 biopsies have to be taken during this procedure. Furthermore, adhesions and streaks of fibrosis can make it difficult to determine where the actual pathology is located. Therefore the use of a ‘tumour-seeking’ agent could be of value in such cases to guide biopsies and shorten the thora-coscopy procedure.
Supportive and palliative care in mesothelioma
Authors: Clayson S H Ahmedzai H
Published: November 2023

Mesothelioma is an increasingly important malignant disease affecting all developed and developing countries. The vast majority of cases are linked to occupational exposure to asbestos, whether directly in men and women who worked in industrial environments or indirectly in their wives who washed their contaminated clothing [1]. The proportional mortality ratios of those dying from mesothelioma are highest in metal plate workers, vehicle body builders, plumbers, and gas fitters [2]. Mesothelioma was first recognized as a specific malignant tumour in the 1960s, and it is estimated that the incidence of new cases will rise over the next two decades, reaching a peak in Europe around 2020 [3]. It could eventually account for up to 1 per cent of all deaths of men born in the 1940s [1,3].
The treatment of mesothelioma cases in the US and UK legal systems
Authors: Lipsitz A Budgen J N
Published: November 2023

Mesothelioma patients must deal not only with their debilitating and fatal disease, but also, in many cases, with the legal system. This system includes workers’ compensation laws, which provide no-fault benefits for industrial accidents and diseases, as well as the traditional lawsuit, in which the mesothelioma patient sues asbestos manufacturers, and suppliers, and sometimes landowners. While numerous medical doctors frequently testify as experts in asbestos litigation, many more see an occasional mesothelioma patient in the usual course of their medical practice. In this chapter we provide the legal framework of the mesothelioma case from which the asbestos or occupational disease expert, as well as the medical practitioner, may approach the mesothelioma patient.
Brachytherapy For Uterine Tumours: Cervix And Endometrium
Authors: Hoskin Peter
Published: November 2023

A majority of patients with carcinoma of the endometrium present with early stage I disease, for which the appropriate treatment is total abdominal hysterectomy and bilateral salpingo-oophorectomy. There is debate as to whether pelvic lymphadenectomy be considered a standard treatment in this condition, unlike carcinoma of the cervix, where it is a standard component of the radical hysterectomy procedure. In such patients, based on specific prognostic features, post-operative radio- therapy may be indicated, within which brachytherapy has an important role. For some more advanced tumours, that is bulky stage IB, II, III, and IV tumours of the cervix, and stage II, III, and IV tumours of the uterus, primary radical radiotherapy will be the treatment of choice and within this brachytherapy is an important component. In this setting there is evidence from population-based studies that the outcome is worse for patients who do not receive brachytherapy.
Perineal Implants: Anal Canal, Vagina, And Vulva
Authors: Hoskin Peter
Published: November 2023

Perineal tumours are typically squamous cell carcinomas readily accessible to interstitial or intralumenal brachytherapy. Brachytherapy should be considered in the radical radiotherapeutic management of these sites and it may also have an important role for the palliation of locally advanced or recurrent disease.
Quality Assurance
Authors: Bownes Peter
Published: November 2023

The main objective of any brachytherapy treatment is optimization of the dose distribution to the patient, so that the prescribed dose is delivered to the pre- scribed site within acceptable constraints, while limiting the dose to normal tissues outside the target volume. This allows the treatment to be delivered in accordance with the ALARP (As Low As Reasonably Practicable) principle. A quality assurance (QA) programme is required to ensure that these objectives are met with and that the equipment continues to exhibit satisfactory performance, as defined, when the results from the quality assurance procedure fall within an acceptable tolerance. This tolerance should guarantee a high level of safety regarding the patient and staff and an acceptable accuracy of dose delivery, in terms of positional and temporal accuracy.
Opioid receptors and opioid pharmacodynamics
Authors: Davis Mellar P , Pasternak Gavril W
Published: November 2023

Opioids have a long and rich pharmacology. They are widely used throughout medicine and have been invaluable. However, they come with problems, including side effects such as constipation, respiratory depression and sedation, as well as the potential of abuse. Investigators have long believed that more selective drugs lacking these drawbacks could be developed, leading to the synthesis of novel analgesics that have proven to be extraordinary tools for the early pharmacologists in the field (Fig. 2.1). The structure–activity relationships for the vast number of agents led to the conclusion that there must be specific recognition sites or receptors for these drugs, going so far as to suggest specific molecular interactions between the ligand and its binding pocket.
How to evaluate a family history
Authors: Kerr Bronwyn
Published: November 2023

Cancer is common in the general population, with a lifetime risk of developing cancer in Western Europe, the United States and Australasia of one chance in three. For some of the common cancers, environmental factors are clearly the most important trigger, for example the relationships between papilloma virus infection and cervical carcin- oma or cigarette smoking and carcinoma of the lung.
Guidelines for genetic counselling, testing and referral in North America
Authors: Domchek Susan , Weber Barbara L
Published: November 2023

Cancer is the second leading cause of death in the United States and public interest in risk factors, prevention and screening for cancer is high. Genetic counselling pro- grams are available in most major cancer centres in North America and Europe and provide an opportunity for individuals to learn more about their risk of cancer, options available for prevention and screening, and the likelihood that their family history is due to an inherited genetic factor, such as mutations in BRCA1, BRCA2, APC, MSH2 or MLH1.
Risk estimation in colorectal cancer
Authors: Lalloo Fiona
Published: November 2023

Colorectal cancer (CRC) is the second most common cause of death from malignant disease in Western countries. In England and Wales there are approximately 30 000 new cases each year resulting in 17 000 deaths. Colorectal cancers commonly occur in the seventh decade and about 50 per cent are in the sigmoid colon and rectum. The pathology of CRC is usually adenocarcinoma, most of which develop from adenomas. However, only 5 per cent of adenomas will become malignant.
Management of hereditary non-polyposis colorectal cancer
Authors: Vasen H F A , Burn J , Sheridan E , Houlston R S , Douglas F
Published: November 2023

Bowel cancer affects approximately 3 per cent of the population and most occurs by chance or due to environmental risk. Approximately 10 to 15 per cent of patients with colorectal cancer (CRC) have a family history of CRC, and 5 per cent of patients have early-onset (<45 years) CRC. A combination of genetic and environmental factors is likely to play a role in the aetiology of CRC in these cases.
Gorlin syndrome
Authors: Evans D Gareth R
Published: November 2023

Gorlin syndrome, which is also widely known as basal cell naevus syndrome (BCNS) or nevoid basal cell carcinoma syndrome (NBCCS), was first fully delineated in 1960 (1). It is an autosomal dominant condition with high penetrance, although occasional patients may not have clear features on clinical assessment, even in adult life (2).
Li–Fraumeni syndrome
Authors: Birch J M
Published: November 2023

In 1969, Li and Fraumeni identified four families in which siblings or cousins were affected with soft tissue sarcoma during early childhood. There was a high incidence of cancers diagnosed at unusually early ages in the families of these children, including breast cancer, sarcomas and acute leukaemia. Li and Fraumeni concluded that these familial clusters of cancers were due to inherited predisposition (1, 2).
Relative Category Theory and Geometric Morphisms
Authors: Chapman Jonathan , Rowbottom Frederick
Published: November 2023

Topos theory provides an important setting and language for much of mathematical logic and set theory. It is well known that a typed language can be given for a topos which allows a topos to be regarded as a category of sets. This enables a fruitful interplay between category theory and set theory. However, one stumbling block to a logical approach to topos theory has been the treatment of geometric morphisms. This book presents a convenient and natural solution to this problem by developing the notion of a frame relative to an elementary topos. The authors show how this technique enables a logical approach to be taken to topics such as category theory relative to a topos and the relative Giraud theorem. The work is essentially self-contained except that the authors presuppose a familiarity with basic category theory and topos theory.
Early Scientific Computing in Britain
Authors: Croarken Mary
Published: November 2023

This book is a study of how scientific computation developed in British universities, the scientific civil service, and the armed services during the period 1900-1950. It describes the emergence of computing laboratories in Britain, along with the machines and personalities involved. British computational work is examined from an organizational perspective and the concept of centralized computing power is discussed. Computing methods used up to the 1950s ranged from the use of mathematical tables, via slide rules and other mathematical instruments, to desk calculating machines, accounting machines, differential analysers, and early computers.
Building Symbolic Representations of Intuitive Real-time Skills from Performance Data
Authors: Michie D , Camacho R
Published: November 2023

Real-time control skills are ordinarily tacit—their possessors cannot explicitly communicate them. But given sufficient sampling of a trained expert’s input—output behaviour, machine learning programs have been found capable of constructing rules which, when run as programs, deliver behaviours similar to those of the original exemplars. These ‘clones’ are in effect symbolic representations of subcognitive behaviours. After validation on simple pole-balancing tasks, the principles have been successfully generalized in flight-simulator experiments, both by Sammut and others at UNSW, and by Camacho at the Turing Institute and Oxford. A flight plan switches control through a sequence of logically concurrent sets of reactive behaviours. Each set can be thought of as a committee of subpilots who are respectively specialized for rudder, elevators, rollers, thrust, etc. The chairman (the flight plan) knows only the mission sequence, and how to recognize the onset of each stage. This treatment is essentially that of the ‘blackboard model’, augmented by machine learning to extract subpilot behaviours (seventy-two behaviours in Camacho’s auto-pilot for a simulated F–16 combat plane). A ‘clean-up’ effect, first noted in the polebalancing phase of this enquiry, results in auto-pilots which fly the F–16 under tighter control than the human from whom the behavioural records were sampled.
Managing Computer Viruses
Authors: Louw Eric , Duffy Neil
Published: November 2023

The emergence of a new type of threat to computer security - the computer virus - has attracted much attention from the media, researchers, and entrepreneurs. It is clear that computer viruses and other software menaces, like their biological counterparts, are here to stay. This poses a particular problem for organizations which use computers - how to minimize the threat to their information systems without unduly disrupting their functioning. This book presents a concise overview of the problem and a detailed framework for dealing with computer viruses in organizations. Managers are the target audience, and will find that it offers more than the usual technical information. There is a wealth of advice, much of which applies to the problem of computer security in general. There are also a number of useful technical appendices and an in-depth insight into the biological analogy.