bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circadian rhythms in sports performance
Authors: Reilly T , Atkinson G , Waterhouse J 
Published: October 2023

Abstract
The majority of the resting physiological variables mentioned in Chapter 2 are thought to influence human performance. For example, when body temperature, circulating levels of hormones and metabolic functions are manipulated artificially prior to exercise (e.g. by prewarming subjects or by pharmacological agents), performance is affected. Endogenous circadian changes in these resting parameters might mediate parallel changes in both performance and physiological responses to exercise over a 24-hour period. In this chapter, the evidence for such rhythmicity in human physical performance is analysed.
The different types of epileptic seizure and of epilepsy syndromes
Authors: Hopkins Anthony , Appleton Richard 
Published: October 2023

Abstract
Figure 2.1 illustrates the two main classes of origin of seizure. In the top third of the figure, the hatched area indicates a number of nerve cells in the cortex (the name given to the layers of nerve cells on the surface of the brain) which are in some way abnormal, tending to discharge paroxysmally. They may drive other nerve cells to follow their abnormal patterns of discharge. The paths of influence of the discharging nerve cells are indicated by the arrows. As long as the discharge remains in one part of the brain, the seizure is said to be a partial seizure and its cause location-related. What happens during a partial seizure depends upon the exact site and pattern of discharge of abnormal nerve cells. Temporal lobe seizures as described on p. 16 are of this type. The features of these are described in more detail on pp. 14-17, along with those of other types of partial seizures.
The first seizure and the diagnosis of epilepsy
Authors: Hopkins Anthony , Appleton Richard 
Published: October 2023

Abstract
Anyone reading this book who has been present at the first grand mal seizure of a child or other relative will remember the sense of shock and feeling of incompetence at coping with a totally unforeseen situation. A common story is for parents to be woken by the stertorous breathing or grunting of a child in the next bedroom. They go to him, thinking usually that he is having a bad dream, and find him staring, unresponsive, convulsing, and perhaps blue. Few if any parents can cope calmly with such a scene. It is usual for the family doctor to be telephoned at once, and, if there is any delay in his arrival, for an ambulance to be summoned as well. Many parents subsequently confess that they thought their child was dying, so they are acting in an entirely rational way. Almost invariably, however, by the time the family doctor or ambulance has arrived, the seizure is over, the child is sleeping peacefully, and the adults are making tea. But they will not sleep again that night. Many-though not all-are immediately aware of the nature of what they have just seen, and all the worries which this book is attempting to put into perspective crowd their minds.
The long-term outlook
Authors: Hopkins Anthony , Appleton Richard 
Published: October 2023

Abstract
Many patients, family doctors, and even paediatricians and neurologists, are remarkably pessimistic about the likelihood of seizures stopping—a pessimism which is unjustified by the facts. Pessimism stems from hospital experience. In the past, when neurologists were fewer on the ground, they tended to see only those with the worst epilepsy with the worst prognosis. As they taught the future family doctors, these too were infected with the same pessimism.
The promise of the future
Authors: Hopkins Anthony , Appleton Richard 
Published: October 2023

Abstract
The understanding and treatment of epilepsy has improved considerably over the past fifty years. Most of this improvement has resulted from basic scientific research into how and why epileptic seizures start, and from the development of safer and more effective anti-epileptic drugs by the pharmaceutical industry. However, there is still much work which needs to be carried out, not just to improve our understanding and knowledge, but to improve the quality of life of a child or man or woman with epilepsy.
Resuscitation in hospital
Authors: Skinner David V , Vincent Richard 
Published: October 2023

Abstract
In addition to medical skills, efficient resuscitation in hospital requires careful organization. This chapter addresses some of the practicalities of running a hospital resuscitation service, beginning with the general requirements for organization, training, and equipment. In several areas of the hospital (e.g. A&E, the CCU, and the ICU) the availability of equipment and staff will be different from that regularly provided by the hospital crash team; these areas need to develop specific plans for the best management of their patients.
Management of myocardial infarction
Authors: Skinner David V , Vincent Richard 
Published: October 2023

Abstract
Unstable coronary syndromes, particularly acute myocardial infarction, so often cause cardiac arrest that to consider their management is essential. A substantial reduction in mortality from heart attack can now be achieved not only from successful resuscitation, but on a wider scale by appropriate treatment with iv opioids, aspirin, nitrates, beta blockers, thrombolytic agents, ACE inhibitors, and anticoagulants. How these agents exert their beneficial effect is becoming clearer as we understand more of the pathological mechanisms of acute coronary occlusion and its resulting effect on the myocardium.
Who to resuscitate and post-resuscitation care
Authors: Skinner David V , Vincent Richard 
Published: October 2023

Abstract
The decision to resuscitate or not can be difficult. To avoid confusion, if a cardiac arrest should occur in an in-patient, a decision as to whether resuscitation is appropriate should have been made in advance. A variety of factors will influence this decision, but it should be reached by consensus with the medical team involved, together with their nursing colleagues, the patient‘s relatives, and, if appropriate, the patient himself or herself. The patient‘s illness, age, and general quality of life will influence the decision, and various guidelines have been suggested, namely: resuscitation may be withheld for a patient whose general health has been declining progressively over many years, or, for instance, when even if the patient were resuscitated, the quality of life would be so poor as to be regarded by most as unacceptable.
Cancer
Authors: Greaves Mel 
Published: October 2023

Abstract
Every day, 1500 Americans die of cancer, and yet for most of us this deadly disease remains mysterious. Why is it so common? Why are there so many different causes? Why does treatment so often fail? What, ultimately, is cancer? In this fascinating new book, a leading cancer researcher offers general readers clear and convincing answers to these and many other questions. Mel Greaves places cancer in its evolutionary context, arguing that we can best answer the big questions about cancer by looking through a Darwinian lens. Drawing on both ancient and more modern evolutionary legacies, he shows how human development has changed the rules of evolutionary games, trapping us in a nature-nurture mismatch. Compelling examples, from the King of Naples intestinal tumor in the 15th century, through the epidemic of scrotal skin cancer in 18th-century chimney sweeps, to the current surge of cases of prostate cancer illustrate his thesis. He also shows why the old paradigms of infectious diseases or genetic disorders have proved fruitless when trying to explain this complex and elusive disease. And finally, he looks at the implications for research, prevention, and treatment of cancer that an evolutionary perspective provides. Drawing on the most recent research, this is the first book to put cancer in its evolutionary framework. At a time when Darwinian perspectives on everything from language acquisition to economics are providing new breakthroughs in understanding, medicine seems to have much to gain from the insights provided by evolutionary biology. Written in an exceptionally lucid and entertaining style, this book will be of broad interest to all those who wish to know more about this dread disease.
St Peregrine’s Progress
Authors: Greaves Mel 
Published: October 2023

Abstract
Cancer biologists often pictorialize cancer development as a simple linear sequence of mutational steps coupled with progressive selection of increasingly dominant subclones. This provides a time-ordered parallel with the progression of disease that the pathologist can recognize and grade in a biopsy section as disruption of tissue architecture and spread of disease. It also fits with an astute prediction by mathematically minded epidemiologists, Armitage and Doll, in the 1950s, that the exponential increase with age in most incidence of common forms of cancer was most probably a function of the time needed to accumulate a set of mutations in the subclone that eventually dominates at diagnosis.
Off to a Shaky Start
Authors: Greaves Mel 
Published: October 2023

Abstract
A though the majority of mutant genes in cancer arise in single cells in pecialized tissues, some cancers involve transmission and inheritance of mutant gene from parent to offspring. For this to occur requires that at some time in the history of the patient’s family one individual predecessor acquired a new mutation in one of his or her germ cells (sperm precursors or ova). Dad’s germ cells are more at risk than Mum’s because of the greater number of cell divisions that will have occurred prior to conception. We cannot prove how any one such mutation has arisen but most are likely to be accidental consequences of DNA replication, mismanagement, and error-prone repair in germ cells. This seems a thoroughly undesirable and unnatural thing to happen, an appalling lapse of genetic vigilance. But in fact it’s part of nature.
Blind chance - and ultimate extinction?
Authors: Greaves Mel 
Published: October 2023

Abstract
Like all evolutionary changes with the appearance of prudent planning or a smart, selfish manoeuvre, cancer cells and their mutations are not strategic by design or intent. They operate by a throwing of the geneticdice at random or by blind chance, coupled with selection for what might be relatively short-term advantage. The process may have all the attributes of a covert collaboration of mutant genes, but in reality it’s cock-up and chaos that apply, not conspiracy.
Anatomy of the heart relevant to cardiac surgery and anaesthesia
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
The anatomy of the normal heart is described in this chapter. Congenital abnormalities of the heart and the great arteries are described in Chapter 17. The heart is an irregular conical structure located in the middle mediastinum. It can be surface marked on the anterior chest wall by an irregular quadrangle bounded by the following points listed in an anticlockwise direction (Fig. 1.1): third right costal cartilage 1.25 cm from the sternal edge; sixth right costal cartilage 1.25 cm from the sternal edge; fifth left intercostal space 9 cm from the midline; second left costal cartilage 1.25 cm from the sternal edge.
Physiology of the heart relevant to cardiac surgery and anaesthesia
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
Owing to the presence of a specialized conduction system, the heart normally beats in a regular manner. Depolarization spreads rapidly from the sinoatrial node, the normal pacemaker of the heart, through the internodal atrial pathways to the atrioventricular node (P wave). Following a physiological conduction delay at the atrioventricular node, depolarization spreads to the branches of bundle of His and, via the Purkinje fibres, to the ventricular muscle. The normal duration of atrial depolarization and conduction through the atrioventricular node, the PR interval on the electrocardiograph, is 0.12-0.20 s. Normal ventricular depolarization, the QRS duration, takes 0.08-0.1 s.
Guidelines for thoracic aortic surgery
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
Ascending aortic aneurysms are proximal to the origin of the brachiocephalic artery, aortic arch aneurysms are located between the origin of the brachiocephalic artery and the left subclavian artery, and descending aortic aneurysms are located between the origin of the left subclavian artery and the diaphragm. The majority of aneurysms are atherosclerotic in origin. Aortic dissection is one of the most common aortic problems. Patients with aortic dissection can be divided into two main groups: those with hypertension, and those with syndromea involving hereditary defects of the aortic wall. The common finding in both Marfan’s syndrome and hypertension is dilatation of the aorta. Aortic dissections can be classified either into types I, II, and III, based on the site of the intimal tear and the extent of the dissection (DeBakey and colleagues), or into type A, which involves the ascending aorta, or type B, which does not involve the ascending aorta (Daily and colleagues). Both type A and type B aortic dissection are associated with the hypertensive male, and aortic regurgitation can be a concomitant finding.
Preoperative investigations
Authors: Hwang Dr Nian Chih , Sinclair Dr Michael 
Published: October 2023

Abstract
The assessment of congenital heart disease should include ECG, chest radiography, echocardiography, Doppler flow study, and cardiac catheterization. The heart rate, heart rhythm, and any evidence of ventricular strain pattern, characteristic of volume overloading of the ventricles, can be seen on the ECG. Chest radiography will reveal any cardiomegaly, pulmonary vascular congestion, airway compression, and areas of lung collapse consolidation. Intercurrent pulmonary infection is a common finding in children whose lungs have been subjected to chronic excessive pulmonary blood flow.
Endocrinology Key questions answered
Authors: Laycock John , Wise Peter 
Published: October 2023

Abstract
Providing both MCQs and longer questions to test and challenge essential knowledge in endocrinology, this book has been written with the medical student in mind. The innovative questions integrate both the many recent advances and the new concepts in the physiological and clinical aspects of endocrinology. This approach encourages continuity between the physiology and pathophysiology of endocrine disorders, which is vital in clinical practice. Questions and answers are a vitally important for revision and for exam practice. In this book, full answers are given to aid self-directed learning which is increasingly important in the changing medical curricula, and there are key references for further reading at the end of each chapter. Invaluable to medical students in their undergraduate years and through to fellowship exams, this book has been designed to be used on its own or as a complementary volume to the third edition of Essential Endocrinology also by Drs Laycock and Wise. John Laycock is Senior Lecturer in the Department of Physiology, Charing Cross and Westminster Medical school and Peter Wise is Consultant Endocrinologist in the Department of Endocrinology, also at Charing Cross Hospital, London.
Ethics and patient access to information
Authors: Maslin Anna M 
Published: October 2023

Abstract
It may seem dry and uninspiring to look at the impact ethics has on a patient’s ability to access information but the ethical position adopted by society and health care professionals can have a profound effect on a woman’s ability to participate in treatment decision-making. Today in the West it would appear patients automatically have the right to health care information, but this may be a false premise. The premise that underpins the right of a patient, in this case a woman with breast cancer, to access information (or be protected from it if she wishes) is based on a number of ethical principles, e.g. beneficence (a duty to do her good), non-maleficence (a duty not to do harm), and respect for autonomy, to accord to the individual the full rights of selfdetermination (Glover 1990; Waldron 1990; Gillon 1992). There are two of the main moral theories: deontology and utilitarianism (Ross 1930; Kant 1964, 1973; Mill 1962a,b, 1974).
Approaches to shared decision-making
Authors: Maslin A M 
Published: October 2023

Abstract
The evidence appears to support the case for a sentient adult women with breast cancer having a right to express her autonomy, if she so wishes, by accessing accurate evidence-based information relating to her disease and treatment options, and that this information should be communicated effectively to her. But how can a woman with breast cancer access the information and participate, again if she so wishes, in the shared decision-making process? This chapter reviews the common, and a selection of the less common, methods available for the sharing information with patients.
Breast cancer prevention using tamoxifen
Authors: Assersohn L , Powles T J 
Published: October 2023

Abstract
Breast cancer is the most common cancer in women in UK, with one in 12 women developing the disease at some point in their lives. Epidemiological evidence suggests that oestrogen acts as a promoter in the pathogenesis of breast cancer with factors such as early menarche, late menopause, nulliparity, and delayed first pregnancy conferring an increased risk. In addition, it is known that there is a familial tendency to develop the disease with a woman’s risk especially increased if her mother or sister develop breast cancer before the age of 50. Some women have a significantly increased risk of developing breast cancer by inheriting mutations of either the BRCA1 or BRCA2 gene. These, and other highly penetrant genes, account for 10-12% of the breast cancers which occur.
Unstable ischaemia
Authors: Jennings Kevin 
Published: October 2023

Abstract
Angina is held to be unstable when there is recurrent cardiac pain at rest that is more frequent, more prolonged, and more intense than usual. It is usually accompanied by ECG changes, but without cardiac enzyme release. Others will define unstable angina as the recent onset of cardiac pain which was previously stable, and which is now pre cipitated by minimal activity. Unstable cardiac pain is relatively common, and many centres report that unstable angina is a more common presenting diagnosis than evolving myocardial infarction.
Pre-hospital management
Authors: Jennings Kevin 
Published: October 2023

Abstract
Patients begin to die early and unpredictably after myocardial infarction; about two-thirds of the deaths associated with myocardial infarction take place out of hospital, and 50 per cent of the patients who will die do so within two hours of the onset of symptoms, mostly as a result of ventricular fibrillation. All patients with chest pain suggestive of a cardiac origin of 20 minutes’ or more duration, unrelieved by rest or nitrates, should at least be considered for prompt admission. Those patients who present later than 12 hours after infarction have less to gain from CCU admission, although admission to a medical ward will often be required.
Recovery
Authors: Jennings Kevin 
Published: October 2023

Abstract
It is recommended that patients should remain in bed for about the first 48 hours. Thereafter uncomplicated infarct patients are allowed to mobilize in a supervised and graded manner: on days 3–4 patients are allowed to sit out of bed and to walk a few steps around their beds. On days 5–6 slow walking around the ward can be allowed; and discharge can be from day 7.
Surgical Anatomy Of The Bladder
Authors: Karayiannakis Anastasios J , Zbar Andrew P , Karatzas Gabriel 
Published: October 2023

Abstract
Surgery as the primary therapeutic modality for bladder cancer is considered in cases such as primary adenocarcinoma or squamous carcinoma, cancer consequent upon vesical schistosomiasis and bladder sarcoma, all of which have an inherent resistance to radiotherapy or chemotherapy. In transitional cell carcinoma, advanced stages (T3 and T4), as well as extensive superficial carcinoma in situ or multifocal recurrence following intravesical therapy are indications for surgery (1,2). The lack of durable response when radiotherapy alone is used and the failure to demonstrate improved results with preoperative radiotherapy have redefined the role of surgery as a first alternative in bladder cancer treatment (3).
Screening Of Bladder Cancer
Authors: Goldstein Martin M , Messing Edward M 
Published: October 2023

Abstract
Bladder cancer is the fourth most common malignancy in males and eighth most common in females in the United States (1). Nearly 95% of these are transitional cell carcinomas (TCCs). Prognosis is dependent on the grade and stage at the time of presentation. Superficial tumours are relatively easily treated with local therapies and have an excellent prognosis. However, once the tumour becomes muscle invasive the prognosis is quite poor despite aggressive treatment.
Surgical Treatment Of Muscle-Invasive Bladder Cancer
Authors: Olumi Aria F , Richie Jerome P 
Published: October 2023

Abstract
Mortality related to bladder cancer is usually due to the invasive and/or metastatic disease. The greatest improvement in death rates from bladder cancer can be made from appropriate management of the invasive bladder cancer, or those superficial bladder cancers with greatest risk of progression. This chapter will focus on the surgical treatment of invasive bladder cancer. In particular, surgical technique of radical cystectomy, various options of urinary diversion and some recent molecular biology findings with clinical applications will be discussed.
Intravesical Chemotherapy Of Bladder Cancer
Authors: Ziada Ali M , Crawford E David 
Published: October 2023

Abstract
The American Cancer Society estimates that in 1998 there will be 54 500 new cases and 11 700 bladder cancer deaths in the United States (1,2). Although we have not yet succeeded to lower the incidence of bladder cancer, we have managed to improve our approach to treatment. The survival of bladder cancer in the past decade has increased by 8% despite a rise in incidence of 36% (3,4). This suggests both stage migration towards more localized disease as well as improved treatment strategies.
Aggression
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
Aggression is common amongst people with dementia. Aggressive behavioural problems are the single most common cause of referral into psychiatric services in old people’s homes (Margo et al. 1980, Clarke et al. 1981) and it is the commonest cause for institutionalization (Reisberg et al. 1986). Up to 20% of the families of people with dementia report physical violence as a ‘serious’ care problems (Rabins et al. 1982, Argyle et al.