How to identify optimal phase II trial designs Providing a practical guide containing the information needed to make crucial decisions regarding phase II trial designs, A Practical Guide to Designing Phase II Trials in Oncology sets forth specific points for consideration between the statistician and clinician when designing a phase II trial, including issues such as how the treatment works, choice of outcome measure and randomization, and considering both academic and industry perspectives. A comprehensive and systematic library of available phase II trial designs is included, saving time otherwise spent considering multiple manuscripts, and real-life practical examples of using this approach to design phase II trials in cancer are given. A Practical Guide to Designing Phase II Trials in Oncology: Offers a structured and practical approach to phase II trial design Considers trial design from both an academic and industry perspective Includes a structured library of available phase II trial designs Is relevant to both clinical and statistical researchers at all levels Includes real life examples of applying this approach For those new to trial design, A Practical Guide to Designing Phase II Trials in Oncology will be a unique and practical learning tool, providing an introduction to the concepts behind informed decision making in phase II trials. For more experienced practitioners, the book will offer an overview of new, less familiar approaches to phase II trial design, providing alternative options to those which they may have previously used.
Peripheral arterial disease (PAD) is a cardiovascular disorder of the peripheral vasculature due to progressive atherosclerotic stenosis of conduit arteries restricting blood flow to tissues. PAD is typically a disease of older individuals, and the incidence of PAD continues to rise due to an increase in cardiometabolic disease and an aging population. Importantly, “all cause” and cardiovascular morbidity and mortality are significantly increased in PAD patients. PAD diagnosis remains a significant challenge, as a large number of patients are asymptomatic. Moreover, PAD results in a significant financial and societal burden with underutilized diagnostics and limited effective therapies. Here we discuss PAD signs and symptoms, pathophysiological mechanisms, current management, and future disease targets and possible therapeutic treatments for PAD.
How our growing knowledge of the evolution of complex ecosystems, using the latest genetic tools, can help us heal them - and survive This is not another Chicken Little book about the environment. Every reader already knows how overpopulation, ignorance and tribalism are contributing to environmental destruction and breakdowns in public health. We are all aware of the grim possibility that during our lifetimes the Earth might "flip" to a new ecological equilibrium, threatening our very survival. Why Ecosystems Matter explores an exciting new way to avoid such threats, by using our exponentially-growing knowledge of how evolution has shaped and is continuing to shape the complex communities of living ecosystems on which we all depend. Throughout this book we will visit ecosystems where the author has worked or has had direct experience, beginning with a tour of the amazing series of ecosystems that span the entire eastern slope of the Peruvian Andes. This journey provides a vivid glimpse of ecosystems' diversity and capacity for rapid change. Next, we trace how Darwin gained a fundamental insight about the origins of such ecosystem complexity. He realized that, when subgroups of the same species inhabit even slightly different ecosystems, these subgroups will evolve in diverging directions. This divergent evolution is primarily driven by interactions with the many other species in each ecosystem, which are themselves evolving in different directions in the different ecosystems. We explore how this subtle and fascinating concept lies at the heart of the evolutionary ferment that powers ecosystem diversity and resilience - the bubbling evolutionary cauldrons of the book's title. This ferment pervades ecosystems, but it is especially active in their microorganism communities. We then examine the evolutionary forces that power these cauldrons, starting with between-species interactions and tunnelling down to their causes. Using real-world examples, we explore how the technologies available for measuring these changes are increasing exponentially in precision and scope. We show how this deluge of new genetic and environmental information can be used to protect and restore a wide variety of damaged ecosystems. Ecosystems have survived dramatic changes in the past, often becoming even more wondrous and diverse than before. We are now learning how this happens, and how we can preserve this astounding ability.
With increasing demands for high precision autonomous control over wide operating envelopes, conventional control engineering approaches are unable to adequately deal with system complexity, nonlinearities, spatial and temporal parameter variations, and with uncertainty. Intelligent Control or self-organising/learning control is a new emerging discipline that is designed to deal with problems. Rather than being model based, it is experiential based. Intelligent Control is the amalgam of the disciplines of Artificial Intelligence, Systems Theory and Operations Research. It uses most recent experiences or evidence to improve its performance through a variety of learning schemas, that for practical implementation must demonstrate rapid learning convergence, be temporally stable, be robust to parameter changes and internal and external disturbances. It is shown in this book that a wide class of fuzzy logic and neural net based learning algorithms satisfy these conditions. It is demonstrated that this class of intelligent controllers is based upon a fixed nonlinear mapping of the input (sensor) vector, followed by an output layer linear mapping with coefficients that are updated by various first order learning laws. Under these conditions self-organising fuzzy logic controllers and neural net controllers have common learning attributes.A theme example of the navigation and control of an autonomous guided vehicle is included throughout, together with a series of bench examples to demonstrate this new theory and its applicability.
The fossil history of animal life in India is central to our understanding of the tectonic evolution of Gondwana, dispersal of India, its northward journey, and its collision with Asia. This book provides the only detailed overview of the paleobiogeographic, tectonic, and paleoclimatic evolution of the Indian plate from Gondwana to Asia. This thorough, up-to-date volume is a must-have reference for researchers and students in Indian geology, paleontology, plate tectonics, and collision of continents.
Robert Burns was by far and away the most iconic figure in nineteenth-century Scotland. Multiple editions of his works poured incessantly from the presses. Unprecedentedly large crowds gathered to commemorate him at huge festivals and at the unveiling of memorials. His work was at the heart of the palpable rise of Scottish-ness that swept Scotland from the 1840s through to the First World War, including demands for Home Rule. If Walter Scott imagined Scotland, Burns shaped it. He gave ordinary Scots in what had been one of the most socially uneven societies in Europe a sense of self-worth and dignity, and underpinned demands for political and social justice. In this major new book, Christopher Whatley describes the several contests there were to 'own' - and mould - Burns, from Tories through Radicals to middle-class urban improvers. But the Kirk condemned Burns as the Antichrist, deplored the Burns cult ('Burnomania') - a slur on a nation that prided itself on its strict Presbyterian inheritance. The result is a fascinating picture of the role Burns played after his death in shaping multiple facets of Scottish society.
Privatising Criminal Justice explores the social, cultural and political context of privatisation in the criminal justice sector. In recent years, the criminal justice sector has made various strategic partnerships with the private sector, exemplified by initiatives within the police, the prison system and offender services. This has seen unprecedented growth in the past 30 years and a veritable explosion under the tenure of the coalition government in the UK. This book highlights key areas of domestic and global concern and illustrates, with detailed case studies of important developments. It connects the study of criminology and criminal justice to the wider study of public policy, government institutions and political decision making. In doing so, Privatising Criminal Justice provides a theoretical and practical framework for evaluating collaborative public and private-sector response to social problems at the beginning of the twenty-first century. An accessible and compelling read, this book will appeal to students and scholars of criminology, criminal justice, sociology and politics and all those interested in how privatisation has shaped the contemporary criminal justice system.
This book traces the background to the Treaty of Union of 1707, explains why it happened and assesses its impact on Scottish society, including the bitter struggle with the Jacobites for acceptance of the union in the two decades that followed its inaugur
Explores the ethical issues faced by GPs in their everyday practice, addressing two central themes; the uncertainty of outcomes and effectiveness in general practice and the changing pattern of general practitioners' responsibilities.
Covering the full spectrum of clinical issues and options in anesthesiology, Barash, Cullen, and Stoelting’s Clinical Anesthesia, Ninth Edition, edited by Drs. Bruce F. Cullen, M. Christine Stock, Rafael Ortega, Sam R. Sharar, Natalie F. Holt, Christopher W. Connor, and Naveen Nathan, provides insightful coverage of pharmacology, physiology, co-existing diseases, and surgical procedures. This award-winning text delivers state-of-the-art content unparalleled in clarity and depth of coverage that equip you to effectively apply today’s standards of care and make optimal clinical decisions on behalf of your patients.
The book, illustrated with case examples, identifies and makes explicit the often diverse values of those involved in healthcare commissioning, whether as commissioners, providers or users of services. It provides a skills base and other support processes for working with differences in values held by those engaged in making decisions.
This book reviews existing sensor technologies that are now being coupled with computational intelligence for the remote monitoring of physical activity and ex vivo biosignatures. In today’s frenetic world, consumers are becoming ever more demanding: they want to control every aspect of their lives and look for options specifically tailored to their individual needs. In many cases, suppliers are catering to these new demands; as a result, clothing, food, social media, fitness and banking services are all being democratised to the individual. Healthcare provision has finally caught up to this trend and is currently being rebooted to offer personalised solutions, while simultaneously creating a more effective, scalable and cost-effective system for all. The desire for personalisation, home monitoring and treatment, and provision of care in remote locations or in emerging and impoverished nations that lack a fixed infrastructure, is leading to the realisation that mobile technology might be the best candidate for achieving these goals. A combination of several technological, healthcare and financial factors are driving this trend to create a new healthcare model that stresses preventative ‘health-care’ rather than ‘sick-care’, and a shift from volume to value. Mobile healthcare (mhealth), which could also be termed the “internet of people”, refers to the integration of sensors and smartphones to gather and interpret clinical data from patients in real-time. Most importantly, with an ageing population suffering multiple morbidities, mhealth could provide healthcare solutions to enhance chronically ill patients’ quality of life.
This book addresses the breakdown of failed democratic systems in Latin America and the Caribbean. The scope of this investigation is a study of political systems of Venezuela, Colombia, and Nicaragua. The implications of the present research on democratic purgatory have real-world applications not only for the above countries but also for those political systems that are currently transitioning and/or consolidating their democracies as well.
WETLANDS The definitive guide to wetlands for students and professionals alike Wetlands rank among the most productive but also the most vulnerable ecosystems. They break down toxins and help maintain aquatic ecosystems, provide both permanent and temporary homes for key species, and contribute enormously to biodiversity and global ecological health. In recent years the importance of wetlands has been increasingly well understood, and their management and restoration has become a particular focus of environmental research. Wetlands provides a thorough and comprehensive overview of wetlands, updated to reflect the latest research findings and methodological approaches, as it has done for more than a generation. The new edition has been optimized for classroom use, breaking down the topic into four parts: introduction to wetlands, the wetland environment, wetland ecosystems, and wetland management. Readers of the sixth edition of Wetlands will also find: A detailed discussion of the role of wetlands in improving water quality, protection from storm damage, and other ecosystem services The latest approaches and examples of wetland creation and restoration A thorough discussion of the impacts of climate change on wetlands, and how to mitigate them Wetlands is essential reading for students and professionals in ecology, environmental engineering, and water resource management.
During the past thirty years, international trade agreements have focused increasingly on areas of provincial jurisdiction. In The Provinces and Canadian Foreign Trade Policy, Kukucha argues that Canadian provinces have maintained a level of autonomy in response to these developments, sometimes even influencing Canada's global trade relations and the evolution of international norms and standards. The first comprehensive review of provincial foreign trade policy in Canada, the book highlights the convergence of debates related to federalism, Canadian foreign policy, and the global political economy as they are played out in the negotiation and implementation of international trade agreements. It will be of interest to students and practitioners of political science, public policy, and economics.
Eternal Life and Human Happiness in Heaven treats four apparent problems concerning eternal life in order to clarify our thinking about perfect human happiness in heaven. The teachings of St. Thomas Aquinas provide the basis for solutions to these four problems about eternal life insofar as his teachings call into question common contemporary theological or philosophical presuppositions about God, human persons, and the nature of heaven itself. Indeed, these Thomistic solutions often require us to think very differently from our contemporaries. But thinking differently with St. Thomas is worth it: for the Thomistic solutions to these apparent problems are more satisfying, on both theological and philosophical grounds, than a number of contemporary theological and philosophical approaches. Christopher Brown deploys his argument in four sections. The first section lays out, in three chapters, four apparent problems concerning eternal life—Is heaven a mystical or social reality? Is heaven other-worldly or this-worldly? Is heaven static or dynamic? Won’t human persons eventually get bored in heaven? Brown then explains how and why some important contemporary Christian theologians and philosophers resolve these problems, and notes serious problems with each of these contemporary solutions. The second section explains, in five chapters, St. Thomas’ significant distinction between the essential reward of the saints in heaven and the accidental reward, and treats in detail his account of that in which the essential reward consists, namely, the beatific vision and the proper accidents of the vision (delight, joy, and charity). The third section treats, in five chapters, St. Thomas’ views on the multifaceted accidental reward in heaven, where the accidental reward includes, among other things, glorified human embodiment, participation in the communion of the saints, and the joy experienced by the saints in sensing God’s “new heavens and new earth.” Finally, section four argues, in four chapters, that St. Thomas’ views allow for powerful solutions to the four apparent problems about eternal life examined in the first section. These solutions are powerful because, not only are they consistent with authoritative, Catholic Christian Tradition, but they do not raise any of the significant theological or philosophical problems that attend the contemporary theological and philosophical solutions examined in the first section.
In coastal seas, from the tropics to the poles, seaweeds supply the energy required to support diverse coastal marine life and provide habitat for invertebrates and fish. Retaining the highly successful approach and structure of the first edition, this is a synthesis of the role of seaweeds in underpinning the functioning of coastal ecosystems worldwide. It has been fully updated to cover the major developments of the past twenty years, including current research on the endosymbiotic origin of algae, molecular biology including 'omics', chemical ecology, invasive seaweeds, photobiology and stress physiology. In addition to exploring the processes by which seaweeds, as individuals and communities, interact with their biotic and abiotic environment, the book presents exciting new research on how seaweeds respond to local and global environmental change. It remains an invaluable resource for students and provides an entry into the scientific literature of a wide range of topics.
The increase in suicides among military personnel has raised concern. This book reviews suicide epidemiology in the military, catalogs military suicide-prevention activities, and recommends relevant best practices.
A chemocentric view of the molecular structures of antibiotics, their origins, actions, and major categories of resistance Antibiotics: Challenges, Mechanisms, Opportunities focuses on antibiotics as small organic molecules, from both natural and synthetic sources. Understanding the chemical scaffold and functional group structures of the major classes of clinically useful antibiotics is critical to understanding how antibiotics interact selectively with bacterial targets. This textbook details how classes of antibiotics interact with five known robust bacterial targets: cell wall assembly and maintenance, membrane integrity, protein synthesis, DNA and RNA information transfer, and the folate pathway to deoxythymidylate. It also addresses the universe of bacterial resistance, from the concept of the resistome to the three major mechanisms of resistance: antibiotic destruction, antibiotic active efflux, and alteration of antibiotic targets. Antibiotics also covers the biosynthetic machinery for the major classes of natural product antibiotics. Authors Christopher Walsh and Timothy Wencewicz provide compelling answers to these questions: What are antibiotics? Where do antibiotics come from? How do antibiotics work? Why do antibiotics stop working? How should our limited inventory of effective antibiotics be addressed? Antibiotics is a textbook for graduate courses in chemical biology, pharmacology, medicinal chemistry, and microbiology and biochemistry courses. It is also a valuable reference for microbiologists, biological and natural product chemists, pharmacologists, and research and development scientists.
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