bluuebunny/crossref_metadata_2025 huggingface dataset:
Threshold effect of technological innovation on carbon emission intensity based on multi-source heterogeneous data
Authors: Zhao Xiaochun , Xu Huixin , Yin Shi , Zhou Ying
Published: November 2023

It is of much importance to clarify the impact of technological innovation on carbon emission intensity for the low-carbon transformation of China's economy. This study, based on the panel data of 30 Chinese provinces and municipalities from 2010 to 2020, measures and analyzes the carbon emission intensity and the level of technological innovation, establishing a spatial econometric model to study the spatial spillover effect and a panel threshold model to analyze the nonlinear influence of technological innovation level on carbon emission intensity. The findings are as follows: First, the overall carbon emission intensity in China shows a decreasing trend from 2010 to 2020, with the average dropping from 3.09 in 2010 to 1.98 in 2020; Second, the spatial autocorrelation results reveal that the level of technological innovation and carbon emission intensity in China are obviously aggregated in the global spatial distribution pattern. Third, the regression results of the spatial econometric model show that the direct effect of technological innovation on carbon emission intensity is significantly negative at the level of 1%, that is, the improvement of the technological innovation in a certain area has a significant inhibitory effect on carbon emission intensity. Fourth, based on the level of economic development, there is a significant three-threshold effect of the level of technological innovation on carbon emission intensity in China, and the influence of the level of technological innovation on carbon emission intensity varies in the direction of existence and coefficient values within different threshold intervals. As economic development reaches the third interval, the technological innovation level has the most significant inhibition on carbon emission intensity. These findings enriches the research of the nonlinear relationship between technological innovation and carbon emission intensity, clarifies the spatial spillover effect and threshold effect between among them, and provides inspiration for better promote the low-carbon transformation of economy.
Effect of sodium fluorescein strip application on cornea parameters commonly used in laser-assisted in-situ keratomileusis
Authors: Han Dongmei , Xie Wenjuan , Yuan Muqu , Cui Jing , Wang Qifeng , Zhang Qingsong
Published: November 2023

To assess the effect of sodium fluorescein (NaF) strip on corneal parameters commonly used in Laser-assisted in-situ keratomileusis (LASIK). Eighty-six subjects (172 eyes) scheduled for LASIK were recruited between January and March 2022. The study and statistical analysis test were conducted in April 2022. Topographic measurements of corneal parameters, including central corneal thickness (CCT), anterior keratometric (K) readings (K1, flat keratometry; K2, steep keratometry), horizontal corneal diameter (white to white, WTW), and corneal asphericity (Q value), were obtained using a Scheimpflug device (Pentacam) before and 10 min after NaF strip treatmentThe Pentacam recorded a small significant increase in CCT (mean 538.88 ± 28.78 μm to 547.90 ± 29.94 μm; p < .001), with no differences in K1 and K2 (mean 42.24 ± 1.35D to 42.24 ± 1.35D, and mean 43.34 ± 1.50D to 43.32 ± 1.51D; P > .05, for all) as well as WTW(mean 11.58 ± 0.32 mm to 11.58 ± 0.32 mm, P > .05) before and after NaF strip intervention. Furthermore, there was no significant difference was observed in Q value (mean − 0.30 ± 0.13 to − 0.30 ± 0.14, P > .05). These results indicate that clinicians should avoid NaF strip application before obtaining precise topographic measurements of cornea parameters using the Pentacam.
A rare case of a sporadic retroperitoneal hemangioblastoma
Authors: Malagic Polutak Maida , Hartel Mark
Published: November 2023

Hemangioblastoma is a rare, benign, and morphologically distinctive tumor. In most cases, the tumor involves the central nervous system. Extraneural occurrences are rare, with just a few reports of hemangioblastoma situated outside of neural tissue, such as the retroperitoneum. We report a case of sporadic retroperitoneal hemangioblastoma in an 87-year-old male patient, diagnosed as an incidental finding in a CT scan performed because of kidney stone disease. The CT scan showed a mass in the retroperitoneum posterior to the inferior vena cava. The patient reported no remarkable symptoms. We describe our path to diagnosis, the possible differential diagnosis for retroperitoneal masses, and the histopathologic features of the tumor. There are <250 reported extra neuraxial hemangioblastomas and just 14 reported cases situated outside of the neural tissue. Our case is the eighth case report of a hemangioblastoma arising from the soft tissue of the retroperitoneum.
Approaching Children’s Literature
Authors: Hunt Peter
Published: November 2023

Children’s literature is a remarkable area of writing: it is one of the roots of western culture, it is enjoyed passionately by adults as well as by children, and it has exercised huge talents over hundreds of years. It involves and integrates words and pictures, it overlaps into other modes—video, oral storytelling—and other art forms. For both adults and children it serves the purpose that ‘literature’ is frequently claimed to serve: it absorbs, it possesses, and is possessed; its demands are very immediate, involving, and powerful.
Percentage of population who smoke
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

Information on the percentages of men and women in the population who smoke is available from 1948 onwards, when the TRC/TAC surveys started. From 1972 data are also available from the GHS. According to TAC data, the percentage of men who smoke manufactured cigarettes fell from 65 per cent in 1948 to 34 per cent in 1987. The percentage of men who smoke hand¬ rolled cigarettes fell slightly from 13 per cent in 1961 to 10 per cent in 1987. (Men who smoke both manufactured and hand-rolled cigarettes are included in both figures.) GHS data indicate a decline in the percentage of men who smoke cigarettes (manufactured and hand¬ rolled) from 52 per cent in 1972 to 33 per cent in 1988.
Smoking habits: by age
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

Information on smoking habits at different ages is available from the TAC from 1948, and from the GHS from 1972. The age groups used by the 1)C changed in 1976. Before 1976 the TAC used the age groups 16-19, 20-24, 25-34, 35-59,.and 60+ years, oraltematively, 16- 19, 20-24, 25-34, 35-49, 50-59, 60+ years; from 1976 onwards the age groups 16-24, 25-34, 35-49, 50-64, and 65+ years have been used. In most tables containing TAC data, those for 1975 are presented according to both old and new groupings; the discontinuities caused by these changes are indicated on the relevant graphs by a vertical line.
Ex-smokers and persons who have never smoked
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

The TAC provides data on ex-smokers of any form of tobacco and on persons who have never smoked any form of tobacco, classified according to age from 1956-1987, and according to social class from 1975-1987. From 1969 onwards these data have been sales¬ adjusted to correspond with the sales-adjustment that was applied to the percentage of smokers.
The consumption of cigarettes by cigarette type (plain/filter/hand-rolled) and by tar yield
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

TAC data show that, in 1961, 83 per cent of men and 64 per cent of women smokers of manufactured cigarettes usually smoked plain cigarettes. The switch to filter cigarettes began in the 1950s, quickened in the 1960s, and by 1971 plain cigarettes were smoked by only 23 per cent of men and 10 per cent of women who smoked manufactured cigarettes. This change to filters took place most quickly among young adults; by 1987 most plain cigarette smokers were aged 50 and over. Plain cigarettes are more popular with men than with women and more popular with social classes IV, V and VI than with other classes.
Smoking habits: by region
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

In this section, TAC data on the consumption of all tobacco products per person and per smoker in England and Wales and in Scotland between 1956 and 1981 are presented. Also included is the prevalence of cigarette smoking by region between 1974 and 1988 from the GHS.
Children and smoking
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

Data on the smoking habits of children are available from different surveys from 1966 to 1988 and the results are summarized in this section. As one would expect, the adoption of smoking increases steadily as children progress through secondary school. In the 1960s and 1970s, the prevalence of regular smoking (defined as smoking one cigarette or more a week in most surveys) was higher among boys than girls. In the late 1980s the proportion of children smoking was lower than in the early 1980s. Smoking declined more markedly among boys and by 1988 smoking was more prevalent among girls than boys.
Cigarette smoking and age at natural menopause
Authors: Baron John A
Published: November 2023

Women who smoke cigarettes have consistently been found to have a natural menopause at an earlier age than women who do not smoke. Expressed asa difference of median menopausal ages, currently smoking women have a menopause one to two years earlier than never smokers. Expressed as prevalence odds ratios, currently smoking women have a relative risk of 1.6 to 2.0 of being menopausal. Ex-smokers appear to have only a small excess risk of menopause, suggesting that the effect of smoking is reversible. Possible mechanisms for these associations include direct toxic effects on the ovaries, interference in gonadotropin release, and alteration in metabolism of sex steroids.
Hyperemesis gravidarum, uterine fibroids, and endometriosis: effects of cigarette smoking on risk
Authors: Ross Ronald K , Bernstein Leslie , Vessey Martin P , Henderson Brian E
Published: November 2023

There is substantial evidence that smoking produces an ‘anti-oestrogen’ effect (Baron 1984). This important consequence of smoking appears to be the end result of a number of metabolic pathways: altered hepatic metabolism of endogenously-derived oestrogens (Michnovicz et al. 1986), early ovarian failure (Willett et al. 1983), reduced circulating levels of orally ingested exogenous oestrogens (Jensen et al. 1985), and, possibly, reduced ovarian oestrogen production (MacMahon et al. 1982).
Cigarette smoking and benign breast disease
Authors: Rohan Thomas E , Baron John A
Published: November 2023

The rubric ‘benign breast disease’ (BBD) encompasses a wide range of histological conditions, many of which may not actually be diseases (Love et al. 1982). The histological heterogeneity of the process, together with the lack of a universally accepted classification scheme for it, complicate study of its aetiology. Commonly, however, these conditions are either examined collectively as BBD, or the major subcomponents of BBD (fibrocystic disease, itself a collective term, and fibroadenoma) are identified for separate study.
Smoking and gallstones
Authors: Baron John A , Logan Richard F A
Published: November 2023

The formation of gallstones is an oestrogen-related process. Exogenous oestrogen increases biliary cholesterol saturation and epidemiological studies have shown that the formation of gallstones is associated with endogenous oestrogen excretion and with the therapeutic administration of oestrogen. Any anti-oestrogenic effect of smoking might therefore be expected to reduce the frequency of gallstones and clinical gall-bladder disease (GED). Few studies have examined the relationship between smoking and gallstones. Until recently these studies were only concerned with clinical disease and found no reduction in the frequency of clinical GED in smokers. In fact three of these studies found an approximately twofold increase in clinical GED in smokers. Recently, two large ultrasound surveys have reported that smoking was associated with all GED (clinical and asymptomatic combined) in men and to a lesser extent in women.
Cigarette smoking and skin atrophy 1n women. A possible connection?
Authors: Brincat Mark
Published: November 2023

Smokers as a group have a lower serum oestradiol and an earlier menopause. Both these factors have been shown to lead to thinner skin and a lower skin collagen content. Although direct work on smokers has not yet been carried out, the hypothesis that cigarette smoking could affect the skin, especially in women, through a hormonal mechanism is discussed.
Cigarette smoking and cancer of the large bowel
Authors: Baron John A , Sandler Robert S
Published: November 2023

Several aspects of the epidemiology of large bowel cancer suggest that the risks of this malignancy may be affected by oestrogenic stimuli and may therefore also be modified by cigarette smoking. Available data regarding this relationship, however, are contradictory: while several studies suggest a lowered risk of cancer of the colon among smokers, most do not. Further clarification may require consideration of cancer risks at various subsites in the colon.
Oestrogens and smoking-related disease: theoretical considerations
Authors: Canick Jacob A
Published: November 2023

1. In cycling and pregnant women, the primary site of oestrogen production is glandular and circulating oestrogen levels are high, whereas after the menopause, oestrogen production takes place in peripheral tissues, circulating oestrogen levels are low, and locally produced oestrogen probably functions at its site of synthesis. 2. The availability of androgen substrates, especially in post-menopausal women, is critical to the amount of oestrogen that is produced.
Hormonal factors and cancers of the endometrium and breast
Authors: Pike Malcolm C
Published: November 2023

Ovarian hormones play a key role, probably the key role, in the aetiology of endometrial cancer and of breast cancer. A key epidemiological observation leading to this conclusion is the marked protective effect of early menopause (natural or artificial, i.e. bilateral ovariectomy) on both these cancers.
Smoking and hormone related disorders: a summary of the evidence with implications for public health policy and future research
Authors: Wald Nicholas , Baron John , Doll Sir Richard
Published: November 2023

The findings presented during the Symposium confirmed that smoking had an effect on the incidence of certain hormone related disorders leading to an increase or a decrease in risk. Table 24.1 lists the various conditions examined (all medical disorders apart from age at menopause) and gives for each a judgement on whether the conditions have a real association with smoking and, if so, whether the association is positive or negative. If a real association was judged to be present, an estimate is given of the relative risk in smokers compared with that of lifelong non-smokers. The nature of each of the associations is also specified (i.e. whether it was thought to be causal) and, if causal, whether there was at least one known plausible mechanism that could account for it.
Prevention and the economy
Authors: Cohen David R , Henderson John B
Published: November 2023

Economic theory is conventionally divided into two parts; macro-economics, which is concerned with the economy as a whole, and micro-economics, which is concerned with specific decision-making units in the economy, such as the firm or the household. In the same way that macro-economics is about aggregates, the focus of macro-prevention is on reductions in morbidity and mortality generally, rather than on individual preventable outcomes or specific preventive measures. This chapter examines the relationship between macro-economics and macro-prevention.
Economic appraisal in prevention
Authors: Cohen David R , Henderson John B
Published: November 2023

The emphasis of Chapter 1 was on the notion that since resources will never be sufficient to satisfy all human wants and desires, choices have to be made. There are many ways to choose how to allocate resources, and everything from historical precedent to a system of allocating resources to those with the most political power has at least some advocates. Economics does not claim to offer the only criteria for choice. Rather, economic appraisal is advocated as an aid to decision making and never as a substitute for it.
Case studies in primary prevention
Authors: Cohen David R , Henderson John B
Published: November 2023

It is easy to agree with the principles of economic appraisal while at the same time doubting its practicality. The idea of weighing gains against sacrifices is pleasing in theory, but is it really possible to put a money value on reduced pain and suffering? Is there any point in applying the principles of economic appraisal when the aetiology of a disease is largely unknown or subject to controversy?
Prevention: the contribution of health economics
Authors: Cohen David R , Henderson John B
Published: November 2023

This book has attempted to show that there is much that economics can offer to the analysis of prevention. The contribution of economics can be grouped under seven broad headings: (1) the effect of prevention on the economy; (2) the role of economic policy as part of prevention policy; (3) the role of government in the pursuit of prevention; (4) the appraisal of prevention; (5) the provision of information to assist policy making; (6) an understanding of preventive behaviour; (7) a framework for the setting and implementation of prevention policy.
Spain
Authors: Rodriguez Marisol , Calonge, Samuel , Renѐ Joana
Published: November 2023

Other than the manifest interest of the COMAC-HSR project in itself, and its use as a comparative instrument, we must stress that, in Spain, this type of study is unusual. Equity aspects of the Spanish health care system have received little research and, only from the point of view of geographical inequity in the distribution of resources (expenditures, doctors, hospitals, etc.), and not from the aspect of equity associated with income.
Switzerland
Authors: Leu Robert E , Gerfin Michael
Published: November 2023

Equity and solidarity are key issues in the current political debate concerning the Swiss health care system and possible reforms to it. Equal access to medical care has always been a basic principle which has been strongly supported by all political parties and is reflected in the legal framework. Because the health care system is highly decentralized, assigning most of the responsibilities to the 26 cantons, these legal statements exist predominantly on the cantonal level. For example, the communities are compelled by cantonal law to guarantee access to those who need it but cannot afford it (Undritz 1987, p. 21). However, no such consensus exists with respect to health care financing. The conservative parties favour financing schemes which promote efficiency but are regressive (such as a high share of private financing, high co-insurance rates, and deductibles). By contrast, the parties with a strong social committment support financing schemes which are progressive (high share of tax-financing, low co-insurance rates, and deductibles, free care). In the 1980s, the actual development was characterized by a decreasing share of tax-financing and increased co-insurance rates, thus increasing the regressiveness of the financing system. However, this development is likely to be reversed in the near future. A referendum is pending, proposing a massive increase in the share of tax-financed health care, and seems to have a good chance of winning the vote. These developments should be kept in mind when interpreting our empirical findings which related to the situation in 1982.
Wounds: the extent of the burden
Authors: Harding K G , Boyce D E
Published: November 2023

The epidemiology of wounds is too vast a topic to be considered in one chapter when looking at the great variation in wound aetiology. Wound types can vary from burns, chronic, and non-surgical wounds through to surgical, incisional, or excisional wounds. Surgical wound types vary from area to area, even within one hospital, depending on the practice of individual surgeons. Take, for example, the pilonidal sinus - many surgeons within the United Kingdom treat this condi tion by excision with open treatment and formation of granulation tissue (secondary intention), whereas in the United States, more patients are treated by primary suture.
Infection
Authors: Williams N A , Leaper D J
Published: November 2023

multiply in vivo, (iii) interfere with host defencemechanisms, and (iv) cause damage to the host. Possession of strat egies for all of these steps are found in those organisms which are associated with human infectious disease (termed ‘primary pathogens’). However, such organisms are rare in the microbial world. The vast majority of microorganisms lack a means of overcoming one or more of these hurdles to infection of the normal human body. The major barrier to infection is provided by the physical and chemical environment at the body surfaces. In the case of the skin, the tough layer of dead cells and keratin, together with the secretions of the sweat and sebaceous glands, create a formidable barrier. The mucosal surfaces of the respiratory, gastrointestinal, and urogenital tracts as well as the eye have specialized physiological functions which rely on them being more permeable, and thus other mechanisms have evolved to protect these sites.
Management of traumatic wounds
Authors: Whiteside M C R , Moorehead R J
Published: November 2023

A traumatic wound occurs when the body is subjected to a force which exceeds the strength of the skin or the underlying supporting tissues (1).These wounds range from minor cuts or abrasions to extensive tissue injuries which can be life threatening. It is the extent and character of the force which deter mines the nature of the injury and in practical terms wounds can be classified as tidy or untidy (2). In general terms a tidy wound may present a clean incision or laceration, is uncontaminated, less than 6h old, and is caused by low-energy trauma. Conversely an untidy wound has an irregular ragged edge, is contaminated, more than 12h old, and is usually caused by high-energy trauma. These include wounds with crushed tissue or bums.
Clinical aspects of healing by secondary intention
Authors: Mulder G D , Brazinsky B A , Faria D , Harding K G , Rodriguez J L , Baragwanath P , Salaman R , Salaman J
Published: November 2023

Despite their prevalence, venous ulcers remain a multidisciplinary problem and a clinical challenge. For exam ple in the United States alone, between 500000 and 1000000 people are afflicted with venous ulcers. As the elderly popula tion increases, a rise in this number can be expected. This section addresses the pathogenesis, clinical features, and non surgical options for venous ulcerations.
It happens all the time
Authors: Furedi Ann
Published: November 2023

It is a striking fact that in an age when we can send space shuttles to Mars, build computers smaller than postage stamps’ and carry out complex organ transplants, we still can’t control our own fertility. Despite modern methods of family planning, and widespread information about how to use it, unplanned pregnancy is one of the most common medical problems faced by sexually active women under 45.
Enteric infections and arthritis: clinical aspects
Authors: Leirisalo-Repo Marjatta
Published: November 2023

Enteric infections associated with sterile joint inflammation include infections with Gramnegative bacteria such as yersinia (especially Y. enterocolitica, less frequently Y. pseudotuberculosis), salmonella, shigella, and campylobacter (Aho et al. 1985). There are also sporadic reports on the association of joint symptoms with Clostridium difficile (Putterman and Rubinow 1993). On the other hand, bacteria belonging to the normal gut flora (such as Escherichia coli or Klebsiella spp.) are not associated with reactive arthritis.
HLA-B27 subtypes, disease susceptibility, and peptide binding specificity
Authors: Taurog Joel D
Published: November 2023

As documented in Chapters 2 and 12, a great deal of effort has been expended in the investigation of the subtypes of B27. Although the demonstration of disease association with multiple B27 subtypes supported the concept that the B27 molecule itself is a susceptibility factor, until recently it could accurately be stated that B27 subtyping was unhelpful in favoring any particular disease mechanism (MacLean 1992). However, recent application of powerful methodologies, including PCR-based DNA typing of large populations, X-ray crystallography, and sequence analysis of peptides eluted from HLA molecules, has generated epidemiologic and biochemical data regarding the HLA-B27 subtypes that should prove valuable in guiding further research. These recent data are reviewed in this chapter.
Background and overview
Authors: Hope R A , Fulford, K W M , Yates Anne
Published: November 2023

This Manual outlines a course in professional practice skills, The Oxford Practice Skills Course, developed in the University of Oxford Medical School for clinical medical students. The course is described in detail, including tutor’s instructions, student handouts and background materials and methods. Additional notes on practical aspects of developing a course in this area, such as designing a new seminar, introducing a course into the curriculum, and teaching methods and resources, are given in the appendices. The Oxford Practice Skills Course is only one among many possible approaches to this aspect of clinical training. We hope however that our experience, methods and materials as outlined in this manual will be helpful to other medical schools. The Manual is designed to be used on its own, but we welcome enquiries and visits from anyone concerned with teaching in this area.
Syllabus
Authors: Hope R A , Fulford, K W M , Yates Anne
Published: November 2023

Introduction In this chapter we describe the syllabus for the Practice Skills Course by way of: An overview of the course as a whole. An overview of the tutorials in General Communication Skills. Topic lists for ethics, law and communication skills (from which the course is built up). A ‘topic grid’ showing how the main syllabus areas in ethics, law and communication skills are integrated into the Practice Skills Course . There is no overall consensus on the subjects which should be covered in courses of this kind. A core syllabus is beginning to emerge but the details will vary with the needs and resources of different medical schools.
Neuropathological Consequences of Schizophrenia Treatments
Authors: Harrison Paul J
Published: November 2023

The confounding effects of antipsychotic medication on neurochemical studies of schizo phrenia are well known (Harrison, 1999a). Their influence on brain structure, though less well documented, has become apparent from imaging studies indicating that antipsychotics produce striatal enlargement in patients (Chakos et al., 1994; Keshavan et al., 1994; Doraiswamy et al., 1995; see Chapter 1) and in rats (Chakos et al., 1998). Of partic ular relevance here, the drugs also produce neuronal morphometric and synaptic changes which may overlap with and hence confound the cytoarchitectural alterations reported in schizophrenia. This chapter reviews the histological effects of antipsychotics. Brief mention is also made of neuropathological implications of other schizophrenia treatments, and of substances which are commonly abused by people with (or without) schizophrenia.
Wound infection
Authors: Wardrope Jim , Edhouse June A
Published: November 2023

Almost all wounds presenting to A&E departments occur in non-sterile conditions. The risk of wound infection is always present. Routine attention to the details of proper wound care minimizes the risk of wound infection.
Facial wounds
Authors: Wardrope Jim , Edhouse June A
Published: November 2023

Secure the airway early in severe facial wounds. Exclude damage to deep structures: Full neurological examination. Skull and facial bone X-ray where appropriate. Examine neck and X-ray where clinical signs indicate.
Psychoimmunology today: mechanisms mediating the effects of psychological status on the immune system
Authors: Bellinger D L , Thyagarajan S , Lorton D , Madden K S , Tran L , Felten D L
Published: November 2023

Psychosocial factors and stressors can influence the health and well-being of an individual. These environmental stimuli are transduced by the brain into chemical signals that can affect the immune system. Behavioural conditioning studies reveal that the CNS also can detect alterations in immune responses and, subsequent to detection, is able to initiate a change in immune response upon re-exposure to the conditioned stimulus. The specific neural circuits in the brain that mediate these changes in immune function have been the focus of much research over the past ten years. However, these neural circuits are still not well defined, and the functional significance of brain-immune inter actions under a variety of conditions is not fully understood.
Anti-cancer mechanisms involving the immune system
Authors: Szlosarek P W , Dalgleish A G
Published: November 2023

The past five years have witnessed a sustained period of growth in our under standing of the immune system and its interaction with solid tumours. The continuing molecular revolution has undoubtedly been the single most import ant factor in these developments, enabling a redefinition of both the immune mechanisms involved and the pathobiology of the disease at a structural and functional molecular level. New methodologies, including cloning techniques for tumour antigens and hence their characterization (the so-called human cancer ‘immunome’ project), and new quantitative and functional assays detailing the immune response such as ELISPOT and tetrameter analysis have been particularly important. This detailed knowledge has subsequently generated exciting new ideas and treatment strategies, which are based on a rational, scientific approach to the problem of cancer (1–3).
Psychospiritual healing and the immune system in cancer
Authors: Booth R J
Published: November 2023

‘Psychospiritual healing’ combines three terms often nebulously understood or at least interpreted in a variety of ways by different people. What is clear, how ever, is that when people use the terms ‘psychological’, ‘spiritual’, or ‘healing’, they are referring to aspects of human experience that are beyond purely physical dimensions. In order to discuss psychospiritual aspects of healing and the immune system in relation to cancer, we therefore need to address human experience. We will begin by considering something of the nature of human biological existence and then explore how a concept of ‘self’ emerges from the ways in which we interact in the world and make distinctions. This will lead us to a concept of body and mind as mutually influential domains of self-expression which are shaped by spiritual factors. Finally, we will discuss psychospiritual healing and its possible impact on cancer and cancer therapy and treatment.
Can psychosocial interventions extend survival? A critical evaluation of clinical trials of group and individual therapies
Authors: Calde K , Classen C , Spiegel D
Published: November 2023

Does living better mean living longer? A small number of studies published over the last two decades have examined the provocative question of whether or not providing psychotherapeutic support can increase survival time for cancer patients. While initially such an effect would seem implausible, it must be borne in mind that there are two components to the equation that can account for variance in cancer progression: (a) the tumour’s characteristics; and (b) host resistance. The former is largely determined by genetic damage—the tumour’s anaplasty, loss of contact inhibition, ability to induce a vascular supply, and tendency to metastasize. The latter involves the host’s ability to respond to tumour invasion, including physiological systems subject to neural control. These include behaviour, adherence to medical treatment, and the endocrine, immune, and autonomic nervous systems. It is thus not entirely mysterious (if also not well understood) how participation in various psycho therapeutic programmes could affect survival time with cancer.
Psychological factors and cancer progression: involvement of behavioural pathways
Authors: Anderson J , Walker L G
Published: November 2023

Psychological reactions to stressful life events, mood disturbance, personality, coping styles, and compliance with medical treatment have all been implicated in altering the prognosis of individuals with cancer. Research to date has inherent methodological limitations and the evidence that psychological factors independently predict survival is inconsistent. The most compelling evidence for a causal relationship comes from prospective, randomized, controlled trials in which psychological and/or behavioural factors have been manipulated and the effects on survival evaluated. A systematic review of the literature revealed ten randomized trials comparing one or more psychological interventions with a control condition that excluded a formal intervention. Four of these studies indicated that participating in a psychological intervention resulted in a significant survival benefit. Behavioural as well as biological pathways may be involved.
Historical Introduction
Authors: Cameron J Stewart
Published: November 2023

Some years have passed since the first edition of this book, but this brief extension in time has not blunted the truth of this statement by one of the great clinical nephrologists of the last century. Doctors have been looking at the urine for diagnostic information for at least one and a half millennia [2, 3], and the examination of the urine was already part of the Hippocratic system 500 years before the beginning of the past millennium. However, for the first thousand years or more, this enquiry was pursued by eye, unaided by either microscopy or chemistry (Figure 1).
The Formed Elements Of The Urinary Sediment Cells
Authors: Fogazzi Giovanni B , Ponticelli Claudio , Ritz Eberhard
Published: November 2023

The urine can contain different types of cells, some of which derive from the circulation, while others derive from the epithelia of the urinary system (Table 2.1). The majority of these cells include several subtypes, some of which can be identified only by using general or specific stains. Other cells, such as glomerular cells [I], basophilic leukocytes [2], platelets [3] or monocytes [4] have also been described in urine. However, they were identified by special techniques, and their meaning was not always clear. New approaches for studying urine sediments such as those described in Chapter 7 might in the future better clarify the meaning of these cells or might even reveal the presence of other elements unsuspected today. For the time being, however, we base our classification and discussion on the cells which can be identified by conventional techniques.
Head injuries in children
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

The epidemiology of head injury in children differs from that in adults, and the head injury in the child poses special problems of diagnosis, management, and rehabilitation.
Operative surgery
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

In Britain, it is usually possible and desirable for head-injured patients requiring operative intervention to be transferred to a specialist unit. There are occasions when circumstances make this impossible, and the general surgeon or orthopaedic surgeon may be required to operate in the district general hospital. Indeed, in many parts of the world the surgical management of head injuries is, of necessity, the responsibility of the general surgeon.
Delayed complications
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

Epilepsy may complicate both the relatively minor and the severe head injury. In the United States, approximately 500 000 patients are admitted to hospital with head injuries each year, and 30 000 (16%) have posttraumatic epileptic fits. An incidence of 5-7% has been reported in European studies. This development should not be taken to indicate that some new and sinister intracranial event has occurred. It does not, for instance, herald an intracranial haematoma, and does not alone, therefore, indicate urgent admission to a neurosurgical unit.
Transporting the head-injured patient
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

Secondary referral is indicated either when the patient requires specialist neurosurgical attention or when the head-injured patient has other injuries requiring specialist attention not available in the base hospital.
Alcohol, other drugs, and violence
Authors: Raistrick Duncan
Published: November 2023

Drinking and taking other drugs are not only activities that most people in the UK engage in but they are also activities that, for many people, are interwoven with their leisure-time pursuits. The General Household Survey (Office for National Statistics 1998) reports on trends in alcohol consumption: in 1996, 15% of men and 33% of women were categorized as non-drinkers or very light drinkers; 27% of men and 14% of women were categorized as drinking over the recommended safe limits of 21 units and 14 units per week, respectively. Over the last 10 years the proportion of men drink ing over safe limits has remained more or less constant, while the number of women has slowly increased. Information on illicit drug use is much more difficult to collect and there have been no regular population surveys of the kind undertaken for alcohol. Social Trends 29 (Office for National Statistics 1999) collated data from a number of surveys: in 1996, 57% of men and 43% of women aged 20–24 years said that they had not used drugs ‘ever’, while 24% and 12% had used drugs in the ‘last month’. Aside from people seeking help specifically for their substance-use, a significant number of these drinkers and drug-users come into contact with social and health care services for all manner of reasons, which may or may not have roots in substance use.
Compensation for personal injuries caused by crime in Great Britain
Authors: Miers David
Published: November 2023

This chapter is concerned with the possibility of a health-care worker who becomes the victim of an act of violence at work obtaining compensation for any injuries thereby sustained. The definition of violence at work used by the British Crime Survey (BCS) in a recent survey (Budd 1999, p. 2), is: ‘All assaults or threats which occurred while the victim was working and were perpetrated by members of the public’. This therefore excludes assaults and threats committed by co-workers, but clearly includes patients, the patient’s friends or relatives, or persons who are visiting the place of work (which could include a patient’s private home or a nursing home and the like).
The future: the contribution of Accident and Emergency departments to community violence prevention
Authors: Shepherd Jonathan
Published: November 2023

Accident and Emergency departments (AEDs) interface not only with medical services but also with local communities. They have extensive opportunities to work with local public services, of which police services are most important in maintain ing law and order and preventing violence. In the context of violence as an impor tant health issue, this chapter summarizes work that demonstrates the substantial extent to which violence, including violence that results in AED treatment, is not reported to the police; states why reporting is important; lists the obstacles to reporting; and identifies strategies and practical ideas about how these might be overcome to the benefit both of communities and of victims. It is concerned prima rily with violence in which adults are injured. In setting out directions for future research, it identifies the need for evaluations of interventions that focus on both injury outcomes and process outcomes so that the benefits of AED-police collabora tion can be maximized.
Kidney and Lower Urinary Tract Malformations
Authors: Woolf Adrian S
Published: November 2023

Congenital malformations of the kidney and lower urinary tract are common causes of chronic renal failure in infants and young children. In animal experiments, the main causes of such malformations are mutations, chemical and pharmaceutical teratogens, physical obstruction of fetal urinary flow and alterations of maternal nutrition.
Autosomal Recessive Polycystic Kidney Disease
Authors: Guay-Woodford Lisa M
Published: November 2023

Autosomal recessive polycystic kidney disease (ARPKD) is an often devastating form of polycystic kidney disease. The typical onset occurs in neonates and infants and is characterized by cystic dilatation of the renal collecting ducts and dysgenesis of the biliary ductal plate.
Transferability of economic evaluation results
Authors: Drummond Michael , Pang Francis
Published: November 2023

With the growing international literature on economic evaluation, there is a need to undertake, or at least interpret, economic evaluations on an international level. For example, health care decision-makers, especially in those jurisdictions having limited resources for health services research, may wish to reinterpret in their own setting the results of an economic evaluation done elsewhere.
Macrophages and Alzheimer’s disease
Authors: Carlson* K A , Cotter* R L , Williams C E , Branecki C E , Zheng J , Gendelman H E
Published: November 2023

Alzheimer’s disease (AD) is a progressive, age-related, neurological disorder characterized by impairments in memory, learning and behavior. As the most common cause of mental decline and loss of intellectual functioning (dementia) in elderly adults, AD affects over 4 million people in the USA (Martin, 1999) and nearly 14 million people world-wide. The onset of AD occurs often within the seventh to ninth decades of life and eventually leads to dementia. AD-associated complications usually result in death within 10 years of onset (Das and Lal, 1997), leading to approximately 100, 000 deaths per year (Martin, 1999). Although aging is the most significant risk factor for AD, genetic, immune, neurochemical, environmental and other as yet unidentified factors may also play a role in disease onset and progression.
Macrophages in autoimmunity and primary immunodeficiency
Authors: Yoon J -W , Jun H -S
Published: November 2023

Macrophages are a heterogeneous group of cells with common blood-borne precursors, monocytes, originating from stem cells in the bone marrow (van Furth, 1982). The monocytes migrate into various tissues where they mature and become resident macrophages. There are various subsets of macrophages, such as Kupffer cells in the liver, alveolar macrophages in the lung, microglia in the central nervous system (CNS) and synovial macrophages in the joints, with differing expressions of surface molecules and differing morphology depending upon their localization and function (Radzun et al., 1988).
Macrophages in wound healing
Authors: DiPietro L A , Strieter R M
Published: November 2023

Normal wound repair requires the coordinated response of numerous cell types, including fibroblasts, keratinocytes, leukocytes and endothelial cells. These cells participate in an interwoven process, which includes chemotaxis, phagocytosis, mitogenesis, neovascularization and extracellular matrix (ECM) synthesis. The repair response can be viewed as four overlapping phases of hemostasis, inflammation, proliferation and resolution (Figure 10.1). Hemostasis, beginning immediately after injury, involves vasoconstriction and the formation of the fibrin clot. The inflammatory phase, marked by the influx of leukocytes, begins within hours after injury and continues for several days. The proliferative phase is paramount to the healing process, as it includes the period of active protein synthesis, cell replication and differentiation. During resolution, dynamic remodeling of the new connective tissue occurs, in tandem with a physical regression of many of the recently formed capillaries. The four phases are interdependent, and alterations within one can dramatically affect the progression of repair.
Macrophages in cardiovascular disease
Authors: Jessup W , Baoutina A , Kritharides L
Published: November 2023

Cardiovascular disease is the term that describes diseases of the heart and blood vessels, and includes coronary heart disease (leading to heart attack and angina), cerebrovascular disease (stroke) and peripheral vascular disease (intermittent claudication and gangrene). The underlying process in all of these diseases is atherosclerosis. Atherosclerosis is a condition of major arteries, in which progressive occlusion of the vessel occurs, often starting in early adulthood and developing over many years. The occlusion results from an eccentric thickening of the internal layer (intima) of the artery wall (Figure 12.1). In advanced atherosclerotic arteries, the occlusion can be sufficiently extensive to limit blood supply to local tissues. In addition, disruption to the surface of the lesion may precipitate thrombus formation, further restricting blood supply (see Figure 12.1). In general, it is the restriction to blood supply that causes the clinical symptoms associated with atherosclerosis, such as those listed above. Atherosclerosis is a major cause of mortality and morbidity in Western societies.
Structural and operational diversity of serotonin receptors: potential relevance to migraine pathophysiology and treatment
Authors: Martin Graeme R
Published: November 2023

In evolutionary terms, serotonin (5-hydroxytryptamine; 5-HT) is among the earliest of the neurotransmitters. It is therefore not surprising that in mammals this monoamine has been found to play a fundamental role in the regulation of physiological and pathophysiological processes. Dysregulation of serotonergic systems has long been implicated in the aetiology of migraine and numerous other disorders. Indeed, many of the current therapeutics for these disorders interact with one or more serotonin receptors, either directly as 5-HT mimetics or blockers, or indirectly by modulating the active re-uptake of neuronally released 5-HT.
Upregulation of 5-HT1B/1D receptors during organ culture of cerebral arteries
Authors: Hoel Natalie L , Hansen-Schwartz Jacob , Edvinsson Lars
Published: November 2023

5-HT is thought to be involved in migraine headache and acts as a powerful vasomotor agent of the intracranial vasculature in man. The recently developed antimigraine drugs (triptans) are agonists at the 5-HT1B/1D receptors. These drugs cause vasoconstriction in human cerebral blood vessels both in vitro and in vivo, and haemodynamic studies have shown a selective action in causing vasoconstriction in the cranial vascular bed compared to peripheral arteries. Predominance of 5-HT2 receptors in rat cerebral arteries has been demonstrated by Chang and Owman. Therefore, rat cerebral arteries are considered unsuitable as specific test animals for antimigraine drugs..
Role of 5-HT1B and 5-HT1D receptors in sumatriptan-mediated vasocontractile response in rabbit common carotid artery
Authors: Akin Demet , Gürdal Hakan
Published: November 2023

Among the 5-HT1 receptors, 5-HT1B/D subtypes have been attributed to the vasocontractile response to serotonergic agonists. Some studies have shown that mainly 5-HT1B receptors mediate the vasocontractile response to 5-HT1B/D receptor agonists. In this study we examined the presence and involvement of 5-HT1B and 5-HT1D receptors and the role of the signalling molecules such as G proteins, cAMP, and inositol phosphates in the vasocontractile response induced by the 5-HT1B/D receptor agonist sumatriptan in common carotid artery (CCA).